Médecins Sans Frontières - Does Anybody Care

Unique Identifier Code / URN MSB164739

Date taken / Date Recorded 23/03/2023 12:00 AM

Country Central African Republic

Commissioning section MSF-BELGIUM

Photographer / videographer / producer Julien Dewarichet

Copyright Julien Dewarichet/MSF

Usage Rights (MSF) MSF Publications, Social Media

Formal Consent Copy available yes

Editor's rating ★★★ (F)

Video format h264 (Main) (avc1 / 0x31637661)

Duration 14m25s

Maximum Size 1920px × 1080px 1.65 GB

Additional Information / Shotlist DOES ANYBODY CARE
SCRIPT

Dr Louis-Marie SABIO
Director of Bakouma hospital - Ex MSF

00:00:18:10 - 00:00:20:14
When I was at MSF,

00:00:20:19 - 00:00:21:21
we didn't understand that,

00:00:22:10 - 00:00:24:06
because we had
the needed equipment.

00:00:25:06 - 00:00:26:22
But when you leave the main cities,

00:00:27:01 - 00:00:30:08
you'll understand that
in these villages,

00:00:30:12 - 00:00:32:08
there are people who are suffering enormously,

00:00:32:15 - 00:00:34:11
who don't have access to healthcare.

TITLE ON SCREEN
DOES ANYBODY CARE

TEXTS ON SCREEN
Decades of violence and instability
fueled a critical humanitarian situation
in the Central African Republic.

More than half of the population
needs humanitarian aid.
This largely goes unnoticed by the world.

Overshadowed by headlines on security dynamics in CAR,
another hidden violence rages on.
MAP CAR TO MBOMOU AND BANGASSOU

Pelé KOTHO-GAWE
MSF outreach activities nursing supervisor

00:01:19:18 - 00:01:23:03
Médecins Sans Frontières
has been in Bangassou since 2014.

00:01:23:17 - 00:01:27:04
At the beginning,
we were concentrating on the hospital.

00:01:28:10 - 00:01:31:12
Since 2015
we've added three health centres.

00:01:31:22 - 00:01:34:07
But then we reviewed the strategy

00:01:34:12 - 00:01:37:08
and now we're all over Mbomou.

00:01:41:05 - 00:01:45:07
The aim
is to make a system of referals.

00:01:45:12 - 00:01:49:24
All the complicated cases,
because the health system

00:01:50:03 - 00:01:54:13
is a bit lacking,
we bring it down to hospital level.

00:01:54:20 - 00:01:58:14
Now, in the health posts,
we've also started taking care of

00:01:58:23 - 00:02:02:08
of three priority diseases
which are malaria,

00:02:02:21 - 00:02:06:07
diarrhoea
and respiratory infections.

00:02:09:00 - 00:02:11:08
- Departure time is
at what time?

00:02:12:03 - 00:02:13:13
- Scheduled for 7 a.m.

00:02:15:03 - 00:02:16:21
- 7 o'clock, OK.

MAP OF GANZI

Joseph GONOPA
Nganzi health post director

00:02:52:03 - 00:02:56:18
The old building that housed us
was completely damaged.

00:02:57:03 - 00:03:00:01
The roof was completely damaged,
impossible to work during the rainy season

00:03:00:01 - 00:03:01:22
at the risk of seeing
the equipment damaged.

00:03:02:04 - 00:03:06:12
If a patient is brought to us
to be given a serum,

00:03:06:12 - 00:03:06:16
If a patient is brought to us to be given a serum,

00:03:06:16 - 00:03:11:17
he'll get wet from the rain.

Guy-Emmanuel KEBONGO
MSF logistics supervisor

00:03:18:01 - 00:03:20:03
The Nganzi health post,

00:03:20:03 - 00:03:23:08
I think this is typical of health posts

00:03:23:13 - 00:03:26:09
in other regions.

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If we want to
support the population, anyway,

00:03:33:09 - 00:03:37:02
there weren't the necessary conditions
for good care.

00:03:37:11 - 00:03:39:21
So that's how the teams,

00:03:41:04 - 00:03:42:19
medical and logistics,

00:03:42:24 - 00:03:46:20
agreed to improve
the structure

00:03:47:06 - 00:03:50:02
by building a new building.

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It's a metal bed
being assembled.

00:03:55:07 - 00:03:56:23
And it will stay here,

00:03:57:01 - 00:03:59:13
in the post-partum room.

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Here you go.

00:04:13:24 - 00:04:17:22
This is the well
we use for activities

00:04:18:21 - 00:04:22:01
at the Nganzi health post.

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There is no improvement
for it to be clean.

00:04:26:18 - 00:04:31:10
Even so, this is what
they use for activities.

00:04:33:02 - 00:04:35:02
So, if there are other partners

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who can help the community
with construction, drilling

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or the development of spring water,

00:04:43:14 - 00:04:45:17
it can help the community.

MAP OF LENGO

Brigitte GANDA
Village chief of Lengo

00:04:55:04 - 00:04:57:15
We have a lot of
of problems here.

00:04:57:19 - 00:05:00:16
That's why we built this health post.

00:05:02:02 - 00:05:05:07
Without the help of any authority

00:05:05:17 - 00:05:08:18
from Bakouma or elsewhere.

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This is the community itself,
noting the 10km

00:05:11:20 - 00:05:13:05
separating us from Bakouma.

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If someone gets sick,

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they can't be transported
to Bakouma.

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They die on the way.

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We want to fight the distance.

00:05:27:22 - 00:05:32:14
That's the reason for this health post,
to get closer.

Pelé KOTHO-GAWE
MSF outreach activities nursing supervisor

00:05:33:16 - 00:05:35:03
This is a typical example.

00:05:35:08 - 00:05:39:19
The population, the community
mobilised to get this,

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but there's no one to give
the equipment or the medicines.

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And the house,
let's not even talk about it.

00:05:46:14 - 00:05:52:03
This is a typical example
of the care system in the Mbomou,

00:05:52:18 - 00:05:55:12
where MSF is not.

MAP OF BAKOUMA

Pelé KOTHO-GAWE
MSF outreach activities nursing supervisor
Dr Louis-Marie SABIO
Director of Bakouma hospital - Ex MSF

00:06:12:07 - 00:06:14:09
Oh! Papa!

00:06:16:00 - 00:06:18:05
- How are you?
- I'm fine, Papa.

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- How are you?
- I'm fine.

00:06:20:06 - 00:06:22:24
- How was the road?
- It's ok. The road was...

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- Are you OK here now?
- Yes, we're fine.

00:06:33:01 - 00:06:36:03
- How's the situation in the city?
- Fine, it's calm.

Dr Louis-Marie SABIO
Director of Bakouma hospital - Ex MSF

00:06:37:20 - 00:06:39:22
Why did I apply?

00:06:40:02 - 00:06:43:02
Because I was first
with MSF in Bangassou.

00:06:43:10 - 00:06:44:22
So I know a bit

00:06:46:06 - 00:06:48:09
the suffering of the population,
what's wrong,

00:06:48:14 - 00:06:49:17
referals.

00:06:51:15 - 00:06:54:01
There hadn't been a doctor
for twelve years.

00:06:54:06 - 00:06:56:13
It was a hospital run

00:06:56:17 - 00:06:58:14
by a health assistant.

00:06:59:14 - 00:07:01:22
The first impression, for me,

00:07:02:16 - 00:07:05:04
it was as if I'd fallen
into a void.

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It's empty.

00:07:11:23 - 00:07:12:19
There's no light.

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There's only this
that we use exclusively for the block.

00:07:17:04 - 00:07:19:03
There's no light there.
There's no light there either.

00:07:19:08 - 00:07:20:20
At night, everything is black.

00:07:21:00 - 00:07:23:13
We have to turn off
all these lights to wait...

00:07:24:01 - 00:07:26:06
to deal with emergencies.

00:07:26:11 - 00:07:30:04
The scialytic is non-functional
because it requires

00:07:32:10 - 00:07:33:08
an electrical source.

00:07:33:12 - 00:07:34:06
Since I've been here,

00:07:34:12 - 00:07:36:20
I've never used it
because there's no electricity.

00:07:41:09 - 00:07:43:07
We should have a pharmacy only

00:07:43:12 - 00:07:46:22
for the block, with all the medication,
everything you need,

00:07:47:11 - 00:07:49:03
but it's a shame, we don't have that.

00:07:49:05 - 00:07:52:01
This is just the block,

00:07:52:04 - 00:07:54:09
but the rest of the hospital
is the same.

Thierry WOZZA
Manager of pediatric and general medicine units

00:08:10:03 - 00:08:11:05
As you can see,

00:08:11:10 - 00:08:13:15
beds are currently empty.

00:08:13:18 - 00:08:15:00
There aren't enough mattresses.

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It's because the mattresses
have been looted.

00:08:19:05 - 00:08:21:05
It started in 2017.

00:08:21:20 - 00:08:23:22
And in 2020, when I was there,

00:08:24:02 - 00:08:28:19
the events have started again...

Dr Louis-Marie SABIO
Director of Bakouma hospital - Ex MSF

00:08:40:17 - 00:08:43:08
There are cases of transfers
that we should stabilise first.

00:08:43:21 - 00:08:46:11
Because the role for a hospital

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or for anything that's
hospital centre,

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is to stabilise,

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is to make sure that the patient
will arrive safely, if you like.

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Stabilize, transfer.

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That's the goal.

00:08:58:12 - 00:09:02:05
But given that the technical level
is limited for a hospital,

00:09:02:22 - 00:09:03:22
I transferred this baby.

00:09:04:02 - 00:09:08:02
He died just,
I don't know, a few kilometers from here.

00:09:08:18 - 00:09:10:04
And on a motorbike.

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There is no ambulance.

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We don't have an ambulance.

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This problem with
the technical level

00:09:15:24 - 00:09:17:09
is a real problem.

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Shall we start?

00:09:29:02 - 00:09:30:09
How are you doing?

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Need gloves.

00:09:39:01 - 00:09:41:18
- You're a new mum, aren't you?
- Yes, I am.

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- That's not the right way to breastfeed.

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I have 17 staff

00:09:48:11 - 00:09:51:21
working in this hospital.
Including me, there are 18 in total.

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But unqualified, of course.

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So the only qualified person
is me.

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The rest are either
first aid nurses

00:10:01:19 - 00:10:05:21
or matrons
in the hospital.

00:10:06:12 - 00:10:08:20
- I'll show you how
give her the milk.

00:10:09:08 - 00:10:10:22
You have to draw her to you.

00:10:11:11 - 00:10:13:00
That's the way.

00:10:15:24 - 00:10:18:16
What I have on hand
is to train them.

00:10:19:23 - 00:10:23:09
And then recruit people
at least qualified

00:10:23:14 - 00:10:27:16
for this hospital because "hospital
it's still a "hospital",

00:10:28:12 - 00:10:33:10
so we need qualified staff
for key services.

00:10:35:23 - 00:10:38:10
1, 2, 3...D-4 of life.

00:10:40:00 - 00:10:42:01
OK, keep feeding her the milk.

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The treatment will continue for 7 days.

00:10:43:17 - 00:10:46:10
Then we'll see if you can leave.

00:10:58:00 - 00:11:01:08
We're here
just for the referal system

00:11:01:21 - 00:11:03:08
and also vaccination.

00:11:03:15 - 00:11:07:15
But apart from that,
there's the maternity ward, it's a big place

00:11:08:04 - 00:11:11:08
where all the women should
have prenatal consultation,

00:11:11:10 - 00:11:12:23
clean delivery.

Pelé KOTHO-GAWE
MSF outreach activities nursing supervisor

00:11:14:00 - 00:11:18:08
In terms of support
for this secondary hospital,

00:11:18:10 - 00:11:20:20
for it to be
a secondary hospital,

00:11:21:00 - 00:11:24:00
there are still many,
many, many, many needs

00:11:24:09 - 00:11:28:13
that need to be addressed to bring it
to the level of a secondary hospital.

00:11:28:24 - 00:11:31:16
What MSF is doing here
is just two packages of activities,

00:11:31:23 - 00:11:34:06
but the majority of all the other packages,

00:11:34:16 - 00:11:38:02
is not covered by anyone else.

MAP BANGASSOU

Fanny MOUSSA
Patient

00:12:21:05 - 00:12:24:03
I was hospitalised for a week in Bakouma
before I came here.

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I have a back problem.

00:12:27:01 - 00:12:28:11
A large wound.

00:12:29:23 - 00:12:33:09
Since they couldn't treat me there,
I was sent to Bangassou.

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I thought you'd already left.

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I saw you once in the corridors,

00:12:39:23 - 00:12:42:03
when I was going to wash up.

00:12:43:08 - 00:12:48:02
They'll probably have to do a skin graft.

00:12:48:08 - 00:12:51:05
It's a bit of a big wound.

00:12:51:13 - 00:12:53:18
Have you been told how it goes?

00:12:54:22 - 00:12:59:12
We clean the wound and
place a new skin.

00:12:59:17 - 00:13:02:03
This will help the wound heal.

00:13:02:06 - 00:13:03:19
You'll be able to get out faster.

Dr Louis-Marie SABIO
Director of Bakouma hospital - Ex MSF

00:13:04:14 - 00:13:05:08
There are cases,

00:13:05:10 - 00:13:07:04
quite a few cases referred here

00:13:07:07 - 00:13:09:19
which in fact required
local management.

00:13:10:01 - 00:13:12:13
But we refer to Bangassou
for the care.

00:13:13:10 - 00:13:16:00
Simply because we don't have
an ideal technical platform

00:13:16:08 - 00:13:18:05
to deal with these patients.

Pelé KOTHO-GAWE
MSF outreach activities nursing supervisor

00:13:28:08 - 00:13:30:13
There is armed violence
that caused everything.

00:13:30:22 - 00:13:34:14
It's a region that has seen
a succession

00:13:34:19 - 00:13:39:24
of armed groups, anti-balaka,
Séléka, CPC, everywhere.

00:13:40:09 - 00:13:42:19
So it's a complicated situation.

00:13:43:17 - 00:13:46:12
MSF cannot do everything.

00:13:46:17 - 00:13:48:10
So really, there is a need for

00:13:48:15 - 00:13:53:04
other actors, at all levels,
to try and help

00:13:53:08 - 00:13:55:15
this Mbomou region.

Dr Louis-Marie SABIO
Director of Bakouma hospital - Ex MSF

00:14:02:24 - 00:14:05:16
It never crossed my mind
the idea of giving up.

00:14:05:24 - 00:14:08:06
It's true that I left MSF

00:14:08:12 - 00:14:12:11
where I had everything at hand.

00:14:12:23 - 00:14:16:00
And I arrived,
I didn't have that atmosphere,

00:14:16:03 - 00:14:19:03
that luxury with me, it's true.

00:14:19:11 - 00:14:21:14
But to give up, it's like saying

00:14:21:22 - 00:14:22:23
to the whole population:

00:14:23:00 - 00:14:26:08
"All right, listen,
I don't care about you, I'm leaving".

00:14:26:11 - 00:14:27:24
I can't do this, it's not possible.

00:14:28:06 - 00:14:30:18
That's not human,
that's not humanism.

END

Does Anybody Care | Docu 16/9 EN

Does Anybody Care | Docu 16/9 EN