MSF is present in Bossangoa, Ouham region, Central African Republic (CAR) since the beginning of the 2013 -2014 political and security crisis, when the town (the second one in terms of population in CAR) has been the theatre of violent attacks the different armed groups against the local population, who was forced to seek refuge in churches and makeshift camps to flee from violence. MSF started then with an emergency medical and humanitarian response to help civilians and later, since 2015, the project turned into a more stable intervention to continue providing healthcare to a population still lacking of basic services.
MSF currently manages the pediatric, nutrition, intensive care unit and emergency departments of Bossangoa Regional Hospital (200 beds), and is in charge of the hospital logistic and of the laboratory. Mental health consultations are also offered to the patients and recently, MSF opened a small unit to provide medical and psychological support to victims of sexual violence (Clinique Tongolo).
From January to September 2019, 4549 people have been hospitalized in MSF managed facilities in Bossangoa hospital, and 1336 have received a mental health consultation. A total of 262 MSF staff, mostly from Central African Republic, work in Bossangoa, in Boguila and along the axes, and 200 staff from the Ministry of Health are supported by the organization to run medical activities.

In addition, MSF supports the health care in the remote areas in the north of Ouham. Access to healthcare remains a huge challenge for rural populations living in the most far-off villages. Over there, people are still suffering the consequences of years of violence, instability and displacements, resulting now in extremely poor infrastructure, and a lack of available medication and medical staff. The lack of roads and transport means patients have to cover large distances on foot to get even the most basic medical care.
Field staff encounters the same obstacles, resulting in the difficulty to reach the patients and bring medical care where it is needed the most. On the top of it, the lack of maps and detailed geographic and demographic data represents an additional challenge for outreach teams. It is extremely difficult to plan activities and to reach the most faraway areas, until 150 km from Bossangoa, close to the northern border with Chad.
MSF outreach teams are currently deployed along the axes at the North of the Bossangoa: on the axe of Nana Bakassa, where MSF supports 3 health posts – Benzambe, Kouki and Bowaye, as well as a health center in Nana Bakassa. In Boguila, MSF works in a health center as well as in two other health posts in the periphery – Sido and Boaya, where the organization provides ambulatory consultations, sexual and reproductive healthcare, handles vaccination and the management of malnutrition cases. In this same region, MSF also supports 12 malaria points (points palu) to improve the detection and the treatment of malaria cases at a local level.
In Ouham region, malaria remains the main killer: 85% of patients treated by MSF staff from the beginning of 2019 have been tested positive with malaria, meaning 155 845 people out of a total of 187 966 people who received a medical consultation from MSF. The rainy season is the moment when the peak of malaria cases is registered.
Patients suffering of malnutrition, pneumonia and TB are the other big majority: 1952 children have been hospitalized in the nutrition department of Bossangoa hospital from January to September 2019.