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As the Central African Republic (CAR) awaits the final round of presidential elections, due to take place in early February, the threat of inter-communal violence keeps the population on edge, with many fearing a flare-up of tension at any moment.
The worsening security situation has also crushed the hopes of the 450,000 internally displaced people - and a similar number of refugees who have fled to neighbouring countries - of returning home anytime soon.
In the capital Bangui, over 30,000 people have taken refuge in overcrowded, unsanitary makeshift camps or in churches and schools across the city.
To enable access to free, quality healthcare for this vulnerable population, Médecins Sans Frontières/Doctors Without Borders (MSF) is providing healthcare and running mobile clinics in five camps around Bangui.
MSF also runs a hospital and a maternity clinic in Mpoko, and provides medical care once a week at the central mosque in the Muslim enclave of PK5.
The displaced persons camp in Benzvi.
Many people in the camps have witnessed shocking scenes of violence and have had their homes pillaged and looted. Lucienne, a woman in her forties, fled her home two years ago when four of her neighbours were killed. Since then, she has been seeking safety in Mpoko together with her family.
“Life is too difficult in the camp. It’s unsafe, dirty and the flies are everywhere,” she says, as she helps her sick daughter make an appointment at the MSF hospital in the camp.
In the Benzvi camp, located in a part of Bangui which has seen relatively less violence, some 2,000 people have sought refuge.
Many have had to flee their homes with little or no belongings, and are sleeping in makeshift tents or out in the open. In order to have something to eat, many rely on small plots of land to grow crops.
MSF comes to Benzvi twice a week to deliver medical care. On an average day, MSF sees around 150 patients, mostly seeking care for diseases such as malaria, respiratory infections and diarrhoea – many of which are a result of the deplorable conditions in the camp.
In order to ensure people in the camp have access to safe drinking water, MSF runs, in collaboration with partner organisations, a water pumping and purifying station which delivers purified water to Benzvi and other camps.
Thirty-year-old Nadège, with her son Prosper and daughter Gabriella, in the Benzvi camp, Bangui.
Ethna and Nadège have been living in Benzvi after their homes in the PK5 district were attacked by armed groups.
They have been friends for years, and are both single mothers with several children to feed. Their children have fallen ill with malaria several times since they moved to Benzvi but have received free treatment from MSF’s mobile clinic.
To survive, they bake cakes and sell them in the street: “We only have enough food for ourselves and our children for one meal a day,” says Ethna.
“During the day, many people return to the neighbourhood where they lived, but they are too afraid to stay there at night so they sleep here in the camps,” says Reims Pali, who works as Assistant Field Coordinator for MSF.
Being from Central African Republic, he has witnessed the situation in the country descend further into lawless chaos over the last two years.
“In comparison to the abuses, killings, robberies and lootings that the people have witnessed in their neighborhoods, they feel relatively safe here.
“But the living conditions in the sites are very difficult. They live in tents built of waste tarpaulins that are full of holes. They sleep on mats on the ground and are exposed to mosquitoes which may carry malaria.
"Unless the security situation gets better, they will have to stay here in these camps,” he adds.
Operating in CAR since 1996, MSF now has over 300 international and more than 2,000 Central African staff deployed in the country.
In addition to Bangui, MSF runs activities in 15 locations across the country, and also provides assistance to Central African refugees in the neighbouring countries of Chad, Cameroon and Democratic Republic of Congo.
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