What can a humanitarian response offer the Central African Republic?

Jan 4th, 2010 2:12 PM UTC
By Alina Potts

Alina Potts writes this piece as part of our ongoing series about the Central African Republic:

In our two months of surveying around CAR, we saw very little traffic. The white vehicles and blue flags of the United Nations provided us with a great deal of safety, security, and speed, but the roads were eerily free of passing trucks or pedestrians, even in the conflict-free areas. Outside our windows we observed tiny villages, really collections of mud houses – maybe 15 or 20 – laid out along the road, often with great swathes of forest stretching between them. The typical sights we associate with travel in Africa, those of overcrowded bush taxis, women carrying large market bundles on their heads, and children leading loaded-down pack animals to a bustling market, were eerily absent in CAR. Beyond the 50 kilometers of paved road outside of the capital, Bangui, the near total lack of gas stations or banks pays testament to the scarcely-felt effects of governance.

One of the few things we did notice, particularly as we drove through the conflict-affected North, were white NGO Land Cruisers parked in small villages. Sometimes it was Triangle seemingly there to check on a water pump; sometimes it was the International Committee of the Red Cross (ICRC) engaged in what looked to be a meeting with the community. In our own vehicles, a UNICEF Child Protection Officer sometimes rode along to check the condition of schools and meet with village leaders. Yet in this context of remote, often isolated villages, linked by poor roads and tormented by bandits … how does one deliver health services? NGOs have built large, well-equipped hospitals in town centers, yet many Central Africans outside of those towns cannot reach them. Community-based health workers, mobile clinics, and free ambulance services are some of the tried-and-true tools in the aid work arsenal for increasing availability and accessibility of health services.

Close to the Chadian border, we stopped in a village in rebel-held territory and met a very sick young woman. One of our interviewers, a trained, female social worker from CAR, spoke with this woman and her mother. She had tuberculosis, and from the sound of her labored breathing, she was not doing well. She had sought treatment in the capital, but decided this was too far from her family. Faced with isolation from everything she knew and loved, and certain death, she had chosen the latter.

Unable to transport her ourselves due to the infectious nature of TB, we drove back to our base of Bocaranga and went immediately to the Médecins Sans Frontières (MSF) feeding clinic. With the sick woman’s permission, we explained to the MSF staff her condition, the remote location of the village, and how to find her. We can only hope that their ambulance service reached her in time.

Having services provided by NGOs is not ideal for many reasons, sustainability being primary among them. Capacity building of government is a slow process, near impossible in areas outside of government control. In the interim, NGOs can provide the bridge from no services to more sustainable ones, saving lives and reducing suffering in the process. For this young woman and many others—the woman willing to walk 30 miles to an MSF feeding center with her infant until we gave her a ride; the child suffering from malaria until we found medicine in the market, because the city’s hospital did not have enough drugs for a full course of treatment—health cannot wait, and it cannot depend on the serendipitous intervention of strangers.

TAGS: Central Africa Republic Series, ONE