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Central African Republic: The daily reality of violence and displacement in Ippy

25 May 22

Central African Republic: The daily reality of violence and displacement in Ippy

MSF medic Pelé Hubert Kotho-Gawe speaking to a patient at an immunisation event in Ippy Caption
MSF medic Pelé Hubert Kotho-Gawe speaking to a patient at an immunisation event in Ippy

Far from the attention of international media, armed violence continues to rage in many parts of the Central African Republic (CAR), forcing entire communities from their homes and onto a path of death and despair. 

In early 2022, the area of Ippy in the centre of the country experienced renewed clashes between rebel groups and government troops supported by allied forces. 

Fleeing violence, thousands of people from rural villages rushed to Ippy town and the camps for displaced people that popped up there in recent months and years.

“When violence broke out, we fled to the neighbouring village, but it was attacked too, and my three sons were killed,” says Jeremy, who moved with his wife and children to Ippy’s Yetomane camp, some 25 miles from his home. 

“We buried them in a mass grave and set off again. Since then, I have not been able to sleep.”

“[People] are destitute, with no means to pay for healthcare or food. Some are traumatised by the physical and sexual violence suffered during their journeys or by the living conditions in the sites."

René Colgo
|
MSF coordinator for CAR

Olga and Jean-Claude travelled almost 87 miles with their six children to reach the Bogouyo camp.

"We walked for a week, with old people, children and sick people," they explain. 

"Some died along the way, and we were forced to abandon their bodies in the bush without being able to bury them. They were only covered with grass. 

“The children saw it all. How will they forget such images?” 

Emergency response

In February, MSF sent an emergency team to Ippy to provide medical support to vulnerable people like Jeremy, Olga and Jean-Claude. 

"As essential needs were not met in the sites, our first priority was to limit the risk of hygiene and water-related diseases," explains René Colgo, who coordinates MSF’s work in CAR.

"In the emergency phase, we built 269 latrines, installed water points and organised distributions of soap and jerry cans.” 

A resident of Bogouyo displacement camp using a water point set up by MSF Caption
A resident of Bogouyo displacement camp using a water point set up by MSF

The installation of water points increased access to drinking water from just 1.6 litres per person per day to 15 litres. When other organisations arrived and were able to take over the management of these facilities, MSF teams focused their support on two local health facilities.

"Basic healthcare was available for displaced people, but the most complex medical cases needed better care, especially for children and pregnant women, who are particularly at risk," says René.

"We therefore provided staff and equipment to strengthen paediatric and neonatal services, management of pregnancy complications, and refer patients to these care facilities.”

In just two months, 381 children were treated in MSF-supported hospitals. Most of them had severe malaria

Our teams also provided medical care for 31 women with pregnancy complications, performed 20 caesarean-section deliveries and referred a dozen patients to facilities in the town of Bambari for more critical care. 

In early May, MSF also launched a vaccination campaign to provide basic protection for preventable diseases like measles, polio, yellow fever, meningitis and tuberculosis to nearly 20,000 children under the age of 10, as well as to 9,000 pregnant women. 

Launched in Ippy town, the vaccination drive also included immunisation against COVID-19 and will continue until July. 

At MSF's out-patient department in Batil refugee camp Gandhi Pant, a nurse, escorts a patient with a possible appendicitis to a waiting ambulance. 

Batil is one of three camps in South Sudan’s Upper Nile State sheltering at least 113,000 refugees who have crossed the border from Blue Nile state to escape fighting between the Sudanese Armed Forces and the SPLM-North armed group. Refugees arrive at the camp with harrowing stories of being bombed out of their homes, or having their villages burned. The camps into which they have poured are on a vast floodplain, leaving many tents flooded and refugees vulnerable to disease. Mortality rates in Batil camp are at emergency levels, malnutrition rates are more than five times above emergency thresholds, and diarrhea and malarial cases are rising.

Help us prepare for the next emergency

An uncertain future

Today, the situation is slightly calmer in Ippy and residents have started to return to their villages or settle in the town. But, in an area marked by years of chronic insecurity and displacement, the situation for many people remains dire and uncertain. 

“The nearest health centre is more than 15 miles away from the village. My children have never been vaccinated. I don't even know if any of the children in the village have ever been.”

Olga
|
Bogouyo camp resident

“While people are leaving sites, the needs remain massive in the area,” says René. 

“Way before the latest waves of displacement, access to healthcare services and water were already limited in Ippy. The recent events have further exacerbated this situation. 

“Many are destitute, with no means to pay for healthcare or food. Some are traumatised by the physical and sexual violence suffered during their journeys or by the living conditions in the sites. Sustained support is clearly needed.” 

Olga poses with her children in front of her shelter at Bogouyo displacement camp Caption
Olga poses with her children in front of her shelter at Bogouyo displacement camp

"We are herders, but we have lost all our animals when we fled the village,” says André, who lives with his family in the Foulbé camp. 

“And here, we can't farm because wherever we go, someone comes to tell us that we are on their land and chases us away. We can’t even pick up wood or leaves. What will become of us?”

This expression of despair is also shared by Jean-Claude and Olga. 

“The future? How can I talk about the future when I don't even know if we are going to eat today,” says Jean-Claude. 

"Our future is very vague, but we hope to return to our village one day, to start life again.” 

However, Olga is less hopeful about returning. 

“There is nothing left there, and we live in fear of being attacked or getting sick,” she says.

“The nearest health centre is more than 15 miles away from the village. My children have never been vaccinated. I don't even know if any of the children in the village have ever been. I can't see myself going back.”

The situation in Ippy unfortunately mirrors the reality of many other areas in CAR, where decades of intermittent conflict have fueled one of the world’s most critical situations in terms of life expectancy, maternal mortality, malnutrition and lack of access to healthcare. 

According to the latest UN figures, almost 30 percent of the population are now either refugees or internally displaced, and more than 60 percent need humanitarian assistance.

MSF in the Central African Republic

Since gaining independence in 1960, the Central African Republic has been plagued by political instability and violence. It remains one of the poorest countries in the world, despite considerable natural resources.

Médecins Sans Frontières/Doctors Without Borders (MSF) first began work in Central African Republic in 1997. Our teams run projects for local and displaced communities in eight provinces and in the capital, Bangui, providing primary and emergency care, maternal and paediatric services, trauma surgery and treatment for malaria, HIV and tuberculosis.