2017 was not a good year for the population in CAR. After the deadly civil war that took place in 2013-2014, the country enjoyed a period of relative calm and the democratic elections in early 2016 brought hope for stabilization in the country. However, tensions between the now more numerous armed groups, often based on religious or ethnic affiliations, exploded again at the end of 2016, throwing the country into a renewed spiral of violence. The conflict has developed in 2017 in the form of volatile and violent attacks in several locations. At the end of the year, CAR, with a total population of 4.5 million, recorded the highest number of internal displaced people since the conflict started in 2013: 688.000 (60% more than the year before). And more than 540,000 have fled the country (UNHCR: January, 2018).

With projects all over the country, MSF is a first-hand witness to the worrying state of CAR, one of the most dangerous countries for aid workers. This year, violence reached several locations where we are working, even on occasion entering inside medical facilities. In 2017, MSF registered almost 40 incidents against its teams, its patients or against medical structures, including the killing of patients in front of our eyes. In some places, the teams were forced to stop activities, withdrawing from the location and leaving the population, most of it displaced, and sometimes without medical care.