Central African Republic: Mortality rate reaches emergency levels
13 December 2011
The Central African Republic (CAR) is in the grips of a chronic medical emergency, according to a report released today by the international medical humanitarian organization Doctors Without Borders (MSF) .
Four mortality studies carried out by MSF over the past 18 months reveal crude mortality rates in some regions of CAR at three times the emergency threshold of one death per 10,000 people per day, which, according to the World Health Organization, is considered a humanitarian crisis. These rates constitute an “out of control” situation, even though the areas with the highest mortality rates are not affected by conflict or a high number of displaced people.
The MSF report, “Central African Republic: State of Silent Crisis,” concludes that existing levels of medical assistance are not enough to meet the scale of CAR's medical needs. The report outlines the need for more actors to conduct larger medical operations that reach more of the population and devise new models of care.
"A health system torn apart by years of political and military instability, major organizational problems, and a lack of security in the northern and eastern regions of the country have had a catastrophic effect on the health of the population and show, to a large extent, how the extremely high mortality rates have come about,” said Olivier Aubry, MSF head of mission in CAR.
At just 48 years, the Central African Republic has the second lowest life expectancy in the world, and it features the fifth highest death rate from infectious and parasitic diseases. In much of CAR, mortality rates are the result of seasonal epidemics, economic downturns, as well as conflict, displacement, and a poor health system.
“In Carnot, the under-five mortality rate last July was three times as high as the under-five mortality rate in Kenya’s Dadaab refugee camp, where people who have fled from Somalia live in dire conditions. In Carnot, the crisis was unknown.”
And yet, the report argues, the commitment by the government and by the international community is going in the wrong direction. The government has been scaling back its investments in health, as have international donors, while humanitarian assistance has failed to reduce the widespread medical crisis.
“If I had not been treated with the help of MSF, I would be dead by now,” said Monkoj Pascal, a patient. “I had diarrhea and a migraine so I went to a doctor in Batangafo and he referred me to the lab for clinical tests. The result confirmed I was HIV-positive. With treatment I am no longer a sick person. I am happy, and I no longer worry about anything.”
Despite the great need, both the government and international donors appear to be disengaging from health provision in the country. And the need for more medical assistance is great.
MSF calls on all actors, including the government and the international community, to expand assistance to healthcare.
MSF’s programs in Central African Republic
Doctors Without Borders (MSF) has been working in the Central African Republic since 1997. At the end of 2010, 1,243 staff members were present in the country. MSF programs support nine hospitals and 36 health centers and health posts. In almost all cases, MSF works in Ministry of Health facilities, seeking as close cooperation as possible. In 2010, 582,253 people were treated as outpatients and 24,185 people as inpatients.