The Central African Republic is back at war after violence started to drastically increase last September. However, the crisis remains largely out of sight and unfolds with very little attention from the international community. This video shows the consequences of the war in CAR on the civilian population as well as the difficulties MSF faces to provide impartial medical care in this very polarized context.

Bangassou has only been marginally affected by the devastating conflict of 2013-2014 and was praised for the reconciliation work and social cohesion which followed. However, on May 13th the town’s Muslim neighborhood was attacked during a major offensive by so called “auto-defence” groups and the situation drastically changed: Bangassou has become a ghost town controlled by loosely organized armed men. Most of the population has fled to Ndu, on the Congolese side of the river, a trading post which now host over 16.000 people in addition to its 1.000 residents.

About 2.000 Muslim people have sought refuge in the “Petit Séminaire St Louis” of the Catholic Church and have been living there since May with little support from international actors. Indeed, recurrent fighting in town forced most actors to leave Bangassou and today only MSF and the Catholic church are present. MINUSCA has also troops there. The site does not fit the requirements for the protection of IDPs and despite presence of some MINUSCA around, most Muslim people do not feel secure enough to leave the site, nor risk going to town for fear of being killed by “auto-defense” groups.

MSF runs mobile clinics to this area and therefore can provide basic medical care to IDPs. However references to the MSF-run hospital in town are very difficult and some IDP in need of hospitalization flat out refuse to be referred. MSF also runs mobile clinics in Ndu, on the Congolese side of the river, where they encounter the same difficulties if they need to refer Muslim patient to Bangassou hospital.

As a consequence of the violence and the massive displacement of population, the 115 bed hospital in Bangassou is only functioning at 60% of its capacity. In opposition peripheral health center supported by MSF, as well as mobile clinics, provides twice or three times more consultations than before. However, the poor living conditions of IDPs, the lack of medical staff or supply in most health centers in the region, as well as the fear which prevent people to seek help in medical structures in due time means that patients reach the hospital in a much more severe state than before. For example, MSF team in Bangassou have noticed this year an increase of severe malaria in the hospital.