Since hostilities resumed in the north of the Bangassou prefecture, there has been an increase in inter-community tensions across the region. Since 2017, the insecurity along the main road axis has made the access to the hospital extremely difficult for some communities, which had a direct impact on patient references from Gambo, Pombolo, Bakouma, Rafaï health centres to the hospital in Bangassou. Major communication initiatives were undertaken with all relevant actors in order to resume movements and re-establish the reference system.

Despite these difficulties, MSF has maintained its mobile clinics in the Petit Séminaire of Bangassou where most displaced people live and supported the Ndu health centre in the Democratic Republic of the Congo, where many refugees from Mbomou are still present.

In 2019, a particular focus was given to mortality reduction within the hospital throughout the implementation of a special unit for critical care with a view to improving adequate provision of health services and follow-up of severe cases. The medical personnel of the hospital were trained in the identification of and care for patients whose state of health requires a transfer to the critical care unit. In the sanitary district of Bangassou, MSF conducted 11,539 outpatient consultations, assisted 1,789 births and admitted 2,147 children under five year old to its paediatric service.

As part of a new agreement with the Ministry of Health, MSF has planned to progressively disengage from the surgery, paediatric and maternity services. Capacity building and empowerment initiatives are underway and will be maintained until these services are handed over to the hospital management. MSF continues to provide all inpatient health services in order to maintain free services within the hospital.