Central African Republic

Situation Report

Highlights

  • The Central African Republic faces since mid-March the second COVID-19 wave.
  • Multisectoral emergency response reached 2,000 internally displaced people at the PK3 site in Bria, where a fire destroyed their homes.
  • In Bossangoa, thousands of displaced people return home in uncertainty
  • In January and February, more than 16,000 internally displaced people in Bangassou received multi-sectoral humanitarian assistance.
  • To meet the most urgent needs in 2021, humanitarian partners plan to assist 1.84 million people, for what they will require US$ 444.7 million.
Mwala Georgette, 24, holds her baby boy, Kuri Isai, nine-months old by a church used to shelter families displaced due to the latest wave of unrest on March 17, 2021 in the capital Bangui. ©OCHA/Siegfried Modola, Bangui, CAR, 2021.
Mwala Georgette, 24, holds her baby boy, Kuri Isai, nine-months old by a church used to shelter families displaced due to the latest wave of unrest on March 17, 2021 in the capital Bangui. ©OCHA/Siegfried Modola, Bangui, CAR, 2021.

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Central African Republic

Situation Report

Key Figures

4.9M
Population
2.8M
People in need of humanitarian assistance
1.84M
People targeted for assistance in 2021
1.6M
People assisted in 2020
2.3M
Food-insecure people
738K
Internally displaced people (31 Mar 2021)
650K
Central African refugees
6737
COVID-19 cases
93
COVID-19-related deaths

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Central African Republic

Situation Report

Funding

$444.8M
Required
$124.5M
Received
28%
Progress
FTS

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Contacts

Vedaste KALIMA

Head of Office

Maxime NAMA CIRHIBUKA

Head of Public Information

Anita CADONAU

Reporting Officer

Central African Republic

Situation Report
Feature
An employee measures the temperature of a patient, before she enters the Bimbo Hospital near the capital Bangui. The NGO ALIMA implements a project at the hospital to prevent COVID-19 and treat patients. ©OCHA/Siegfried Modola, Bangui, CAR, 2021.
An employee measures the temperature of a patient, before she enters the Bimbo Hospital near the capital Bangui. The NGO ALIMA implements a project at the hospital to prevent COVID-19 and treat patients. ©OCHA/Siegfried Modola, Bangui, CAR, 2021.

COVID-19: The second wave hits the Central African Republic

A year has passed since the Minister of Health of the Central African Republic announced the first case of COVID-19 on 14 March 2020. Measures to contain the spread and to protect the population were taken immediately, with the support of the humanitarian community. By the end of March 2020, schools were closed countrywide, group gatherings were banned, international flights were halted and movements between Bangui and the regions restricted, with the exception of movements related to humanitarian assistance. Two months after the first positive case was detected, the first death related to COVID-19 was recorded.

One year later, the country faces the second COVID-19 wave, with an upward trend of new cases reported since mid-March 2021. As of 2 May 2021, the Ministry of Health has reported 6,601* confirmed cases and 91 COVID-19-related deaths. The country looks back at a year during which humanitarian needs soared. Never in the past five years have there been so many people in acute need as today. The pandemic hit a country already ravaged by decades of armed conflict and underdevelopment.

Challenges on all fronts

According to the World Health Organization (WHO), the Central African Republic was among the least prepared countries to face the pandemic. A series of aggravating factors render the country both vulnerable and the response to the pandemic difficult.

Fragile health system and poor access to water

First, the health system is barely functioning, due to a chronic shortage of skilled health workers, medical equipment and basic medicines. Seventy per cent of health services are provided by humanitarian organizations and over 2.5 million people, half of the population, need health assistance. One in four Central Africans needs to walk for over an hour to reach the nearest clinic and for many, the bills for consultations and medications are unaffordable.

When it comes to one of the most basic measures to avoid contracting COVID-19 – regular hand-washing with soap and water – the situation does not look brighter. Only one in three Central Africans has access to clean water, a toilet and shower. And for many, soap is a luxury good. Access to water and sanitation is particularly problematic at the many sites where 203,000 internally displaced people (IDPs) live, often in crowded makeshift shelters where physical distancing is not practicable.

Supplies and logistics

The provision of protective equipment and medical devices to diagnose and treat COVID-19 patients posed a serious challenge, particularly at the onset of the pandemic. Six months into the pandemic, the country possessed only two ventilators and 25 in the pipeline, representing three per cent of the identified needs. Poor road infrastructure and the six-month rainy season disrupt supply chains to large parts of the country. Insecurity further hinders access to services and the possibility of humanitarians to reach people in need of assistance. A severe lack in cold chain infrastructure further impedes the safe supply of medicines across the country.

And the human factor

On top of these tangible challenges came widespread disbelief about the existence of the virus and misinformation about contagion and prevention. Verbal aggression, intimidation and stigmatization against foreigners, including humanitarian workers, occurred during the first months of the pandemic, as they were thought to have imported the virus.

Unprecedented humanitarian response

Faced with these challenges on all fronts, humanitarian organizations and development actors scaled up support to the Ministry of Health to provide a comprehensive and decentralized response and to strengthen the public health system and access to water and sanitation. Nearly a third of the US$ 553.6 million budget for humanitarian assistance in 2020 was dedicated to the COVID-19 response.

In January 2021, WHO supplied the Ministry of Health with 100 oxygen concentrators and 21 ventilators, including five for children.

Buckets and soap

Boreholes were drilled and water points set up. Hand washing stations were installed. Buckets, soap, face masks and chlorine were distributed to health centres, schools and IDP sites. Tents and mobile housing units were turned into medical isolation and consultation sites for suspected cases. Humanitarian organizations reorganized IDP sites, creating zones to isolate suspected cases and grouping families with patients into designated zones to provide assistance. The capacity and availability of health personnel was increased. Communication plans were elaborated, community workers trained to sensitize the population on prevention measures and radio messages were aired. Remote learning programmes for children were developed to make up for the school closure.

As a result, in 2020, humanitarian partners improved access to health care for more than 938,000 people and access to water and sanitation for 770,000 people, including many IDPs. Awareness-raising and risk mitigation campaigns reached over two million people.

Airbridges for people and goods

An immediate priority of the response was the procurement and expedition of urgent humanitarian cargo and the prepositioning of stocks. The European Union set up an airbridge in May 2020 and shipped 40 tonnes of personal protective equipment and resuscitation equipment to Bangui. The United Nations Humanitarian Air Service (UNHAS) transported humanitarian personnel and relief items to Bangui when commercial flights were halted from March to July 2020 and continue enabling the medical evacuation of aid workers and the deployment of teams to remote locations.

Investing in communications

Humanitarian partners established a tracking initiative to monitor misinformation and fear associated with COVID-19 among the communities. Over 1,300 community feedbacks were gathered and analysed to adapt the response and communication efforts. Health and protection actors developed and disseminated key messages on stigmatization, misinformation and manipulation related to COVID-19, for example in the Weekly Bulletin on COVID-19 Rumours and Information. Over 10,000 radios were distributed between April and July 2020 alone and 90 per cent of Central Africans were reached with lifesaving information on COVID-19.

Adapting the modality of assistance

Cash-based interventions became a preferred modality of assistance that avoids large crowds and provides a safer space for humanitarian assistance in times of a pandemic. With 48 per cent more beneficiaries reached in 2020 compared to the previous year, cash-based assistance experienced a surge. Over 375,000 people received US$ 11.6 million for COVID-related multisector assistance in cash or vouchers, first and foremost, to improve hygiene standards and access to water.

Everyday implications for everyone

Despite unprecedented efforts on the part of the humanitarian community and the worst-case scenario prevented, the year has not passed without leaving its traces.

Exacerbating the learning and protection crisis

The Central African children paid a particularly heavy price during the pandemic. Most were out of school for half of the year. The Education Cluster estimates that 1,4 million pupils were affected by the school closure. Fear persists that some children will never return to school, adding a further layer to the already poor level of education. Analysis also showed a rise in sexual violence against girls in many areas of the country and in particular in Bangui during the school closure. Some schools closed again during the second wave in April 2021 as a reaction to positive COVID-19 cases among their students and teachers. However, a second countrywide school closure could so far be averted.

Soaring costs of living and food insecurity

The pandemic has also had direct and indirect impacts on food security and nutrition. Disruption of imports due to border closure and increased border controls has affected the supply of and demand for certain products and hence, their prices, in a country that relies heavily on imports. Families lost their income at a time when they faced higher living costs related to the pandemic. Containment measures limited physical access to areas where people normally earn their living and increased transport costs. Today, 2.4 million people – nearly half of the population – do not have enough to eat. This figure has increased by 570,000 people in just three months. To mitigate the effects of the pandemic on food security, humanitarian organizations in 2020 assisted 900,000 vulnerable people with food distributions and agricultural support helped 170,000 farmers to produce their own food and increase their income.

An outlook

In February 2021, the Minister of Health Dr Pierre Somse launched the process of developing a national roll-out plan for the COVID-19 vaccine, which has been submitted to the COVAX Facility and is currently under technical review at the regional level. The country will benefit from the global roll-out of vaccines through COVAX with at least 372,000 doses, according to the distribution forecast of February 2021, in additional to bilateral donations, that have already been announced. The United Nations on 21 April 2021 started a vaccination campaign for its personnel in the Central African Republic and staff from eligible partner INGOs, as part of its duty of care.

Vaccine scepticism

A recent survey conducted by the NGO Ground Truth Solutions indicates that Central Africans are ready to be vaccinated against COVID-19 and believe that the vaccine will help to eradicate the virus. However, the survey also showed some negative opinions and misinformation about the vaccine among some religious and community leaders. As they are perceived as a reliable source of information on COVID-19, religious and community leaders are being integrate into awareness campaigns, currently being developed by the Ministry of Health and supported by humanitarian and development partners, to avoid the spread of false information about the vaccine.

While the pandemic halted life in large parts of the world, at least momentarily, in the Central African Republic, COVID-19 has added just another layer to an already protracted humanitarian crisis that traps large parts of the people.

* Given limited testing capacities, the government’s diagnostic strategy since July 2020 limits tests to suspected cases and people at risk. Thus, the number of confirmed COVID-19 cases should be interpreted with caution. For illustration, 49,191 people have been tested for COVID-19 as of 1 May 2021.

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Central African Republic

Situation Report
Emergency Response
A devastating fire ravaged the PK3 IDP site in Bria, Haute-Kotto prefecture, leaving at least 2,000 previously displaced people homeless. ©OCHA/Ali Dawoud, Bria, Haute-Kotto Prefecture, CAR, 2021.
Young women help each other to carry the relief items they had just received. Most if not all of their belongings have burned in an accidental fire at the IDP site a week earlier. ©OCHA/Anita Cadonau, Bria, Haute-Kotto Prefecture, CAR, 2021.

Devastating fire ravages IDP site in Bria

Some 364 shelters were destroyed and at least 2,000 people left homeless at the PK3 site for internally displaced people (IDPs) in Bria. A fire accidentally broke out in the afternoon of 18 April. Strong winds during the current dry season quickly spread the flames across three blocks of the densely populated site that is home to more than 50,000 people. Some of the victims found refuge with relatives, others slept under the roof of 25 communal shelters that UNHCR and INTERSOS quickly set up with the participation of affected IDPs as an immediate emergency response.

Medical partners IMC and MSF took care of 103 injured people, most of them women, many who suffered from smoke inhalation while trying to save family members and belongings from the flames. Not only physical injuries were taken care of but IMC’s mental health team also treated patients with stress reactions and psychological shock.

As soon as the fire was extinguished with the help of the UN peacekeepers, humanitarian organizations present in Bria, under the leadership of the UN Office for the Coordination of Humanitarian Affairs (OCHA), started assessing the damage and planning the emergency response. Water tanks, toilets, school buildings and health facilities were fortunately not affected by the flames. OXFAM continues supplying water and ensuring the functioning of sanitation facilities. To prevent the spread of Covid-19 and other diseases at the communal shelters, soaps and buckets were distributed. WFP distributed food rations to the 364 affected families for three weeks to make up for the loss of their food stocks. A joint distribution of non-food items by several humanitarian organizations took place on 25 April. Tarps were distributed to protect from the approaching rainy season, hygiene items and clothes for the 2,000 people to make up for what was lost in the flames.

OCHA coordinates with the UN peacekeepers to ensure regular patrols at the IDP site to prevent looting that was observed after the fire and to mitigate protection-related concerns.

While humanitarian partners focus on an emergency response to alleviate the immediate effects of the fire, they have also started improving living conditions at the congested IDP site – the largest in the Central African Republic. ACTED is undertaking a fire hazard assessment to reduce the risk of future fires at the site.  

The PK3 site in Bria has been a refuge for displaced people for several years. Some have fled intercommunal tensions, others violence and clashes. Some IDPs have come from far, others from parts of town just a few kilometres away. As the security situation in Bria is improving and returning from the PK3 site could become a possibility in the near future, ACTED has started a comprehensive survey among IDPs about their intentions to return to where they had fled from. The survey involves in a first round the 335 families affected by the fire. In the coming weeks, it will be extended to a representative sample of the 7,400 families, who live at the site, to inform future humanitarian assistance.

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Central African Republic

Situation Report
Visual

Overview of incidents affecting humanitarian workers in April 2021

Overview of incidents affecting humanitarian workers in April 2021

A decline in security incidents affecting humanitarian organizations was recorded in April (34 incidents against 53 recorded in March). However, the civilian population remains the first victim of the renewed tensions and violence observed in several prefectures since the end of 2020. The prefectures of Nana-Gribizi (7 incidents), Ouham (6 incidents), and Bamingui-Bamoran (5 incidents) were the most affected this month. Theft, robbery, looting, threats, and assaults accounted for half of the incidents (16 out of 34), while the other half were interferences and restrictions. 9 humanitarians were injured in April 2021.

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Central African Republic

Situation Report
Visual

Overview of population movements as of 31 March 2021

Population movement March 2021

As of 31 March, 738,279 people were internally displaced in the Central African Republic, according to the latest figures published by the Population Movement Commission. The trend indicates a slight decrease in March 2021 of 3,600 IDPs (-0.5 per cent) compared to the previous month, after the number of IDPs increased continuously from December 2020 to February 2021 in the context of the electoral crisis. In March, 33,571 new IDPs were registered, mainly in the Nangha Boguila, Bozoum, Paoua, Kouango and Alindao sub-prefectures and in the outskirts of Bouar. Beyond main towns, displacement was also reported in the surrounding bushes and on axes such as Bossangoa – Nana-Bakassa and Paoua – Bozoum. The regaining of control of tows by the armed forces has resulted in return movements. In March, 37,171 people returned, mainly in the Bangassou, Rafai, Bambari, Grimari, Baboua, Bimbo, Birao, Markounda and Bouar sub-prefectures.

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Central African Republic

Situation Report
Analysis
Bossangoa edit 4
Displaced people on the grounds of the Catholic parish in Bossangoa. ©Abbé Hillaire Penendji. Bossangoa, Ouham Prefecture, CAR, 2021.

Bossangoa: Multiple challenges to overcome

More than 14,000 people have been displaced since 21 February in Bossangoa, in the north-west of the country, fearing an offensive by the Central African Armed Forces (FACA) and their allies. Three days later, they took over the city from the armed group Coalition of Patriots for Change (CPC). Most of the displaced people, mainly settled within the grounds of the Catholic parish, started returning home and in the bush last week in a worrying security situation. This explains why the level of returns and the residents’ perspectives vary from one location to another, while more than 350 displaced people still settled within the hospital compound, according to the findings of a multisectoral assessment mission conducted on 10 March in the city by humanitarians. While in some of the return areas people got back to their usual business and spend the night in their homes, others have to spend the night in the bush, fearing for their security. Food prices have also increased from 25 to 50%, for a population barely returning home. Pupils resumed school in the few classes that were occupied by the displaced people in the catholic parish, but other schools in the town still closed. In order to better understand the situation, humanitarian workers are also planning to visit the Bossangoa-Bouca, Bossangoa-Bangui, Bossangoa-Benzembé and Bossangoa-Nana Bakassa axes.

Humanitarian response faced with access constraints

Those affected most by the recent outbreak of violence in the country are civilians. Access constraints make it difficult for humanitarian organizations to respond adequately to people’s needs. In less than two months, nearly a dozen lootings and robberies attributed to armed groups have targeted humanitarian actors in Bossangoa, four of them in a single week at the end of February. As aresult, most humanitarian organizations have relocated their employees or reduced their presence, thus affecting their response capacity significantly. Despite these difficult conditions, the NGO Médecins sans frontières (MSF) built 60 emergency latrines and showers, and set up a water tank that provides the IDPs with 60 m3 per day. Following the returns, the NGO is removing these facilities and desinfecting the area, with the exception of the water tank. The NGO also provides medical care for children and youth at the regional hospital, and has received nutritional supplies from the United Nations Children's Fund (UNICEF) for the care of malnourished children. The CODIS health center, near the Evêché IDP site, received medicines from UNICEF. The NGO CARITAS carries out protection monitoring and referral activities for cases requiring special attention. While mobilizing the necessary resources, the partners involved in food security are identifying the best way to assist the IDPs, considering particularly their protection.

Concerns beyond the city

While there is hope for a lull in Bossangoa town, the situation on the surrounding axes remains worrisome, especially north of Bossembélé. Several abuses of civilians by armed elements have been reported, including houses that were set on fire along the road leading from Bossembelé to Bossangoa. Similarly, forced displacement of villagers living in the surroundings of Bossangoa have been reported; their numbers remain to be assessed when access to the region becomes possible. Due to prevailing insecurity, humanitarian actors have not yet been able to reach this area, evaluate humanitarian needs and provide the necessary response.

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Central African Republic

Situation Report
Background
A grant allowed shopkeeper Blanche to replenish her stocks and offer her customers a more varied selection of goods. ©OCHA/Anita Cadonau, Bangui, CAR, 2020.
A grant allowed shopkeeper Blanche to replenish her stocks and offer her customers a more varied selection of goods. ©OCHA/Anita Cadonau, Bangui, CAR, 2020.

Cash-based assistance: the power of choice

Blanche has had her « table », how she calls her shop in all modesty, for the past four years, tucked in a residential neighbourhood of the capital Bangui. Products have become rare in recent months and prices of food and basic commodities have soared across the Central African Republic (CAR) – consequence of the latest crisis that has hit the country since December.

A few clicks with a great result

Single mother of a 11-year old girl, Blanche has received 150,000 FCFA, a generous US$ 280, through a project funded by the CAR Humanitarian Fund and implemented by the NGO Mercy Corps. Blanche received it via electronic transfers – a first-ever for the 37-year old. Thankfully, she already had a cell phone and with the help of the NGO, she quickly understood the few clicks needed to turn a SMS into cash at a nearby vendor of phone credit. “Simply fabulous and so easy,” says the woman and smiles, “and I got to choose what I want to buy.” With the grant, she replenished her stocks and now offers a more varied selection of food at her shop. Groundnuts, pumpkin seeds, cassava, dried fish and caterpillars – a local specialty – neatly piled up in front of her. The availability of the goods is striking. With the revenue, she provides for her family.

Making the case for financial assistance

Globally, such cash-based interventions (CBI) make up only 6 per cent of the US$ 25 billion humanitarian funding, according to the Cash Learning Partnership. CBI include the distribution of money or vouchers – the latter often coupled with a fair with goods to choose from – and the transfer of electronic money, usually done via a mobile network operator. The remaining 94 per cent of today’s humanitarian aid takes the form of in-kind assistance, such as food rations, shelter materials, seeds and tools or household items. But the trend is shifting towards CBI because of the evidence of its advantages.

Cash assistance allows people to choose what they need, when they need it, under the condition that local markets are functioning and products available at a stable price. It puts power in the hands of those who need it most and allows people to spend money on what matters most to them. Apart from the direct advantages of CBI for the beneficiaries, local spending of cash assistance often functions as a multiplier in the community.

A look at the Central African Republic

In CAR, over half of the displaced people living at sites prefer cash-based food assistance over receiving food products. On the other hand, three out of four prefer in-kind health assistance due to the lack of qualified personnel and medications. In view of these and similar findings, humanitarian assistance in CAR has started to shift towards CBI. Of the 1.6 million Central Africans who received humanitarian assistance in 2020, about one in two (47 per cent) received some sort of CBI. Over US$ 29 million were distributed through CBI last year, 80 per cent as emergency response. The food sector was by far the sector with the most beneficiaries: 80 per cent of those who benefited from CBI received cash or vouchers to improve their food security. CBI targeted those in large towns, for example Bangui and Kaga-Bandoro, where nearly 400,000 people were assisted with cash, for reasons of availability of products and financial institutions.

Preferred modality in times of pandemic

With a 48 per cent increase in the number of beneficiaries reached in 2020 compared to the previous year, CBI has experienced a surge; a trend which is certainly not unrelated to the onset of COVID-19. About 40 per cent of CBI in 2020 aimed at containing the pandemic. Small-scale grants allowed families to purchase soap, jerrycans and masks to improve their hygiene and prevent propagation. CBI further strengthened the capacity of health workers and facilities to test and treat patients. Cash transfers became more important than ever during the pandemic as they avoid large crowds. In line with the Humanitarian Response Plan 2021, humanitarian actors are committed to continue scaling up CBI in 2021.

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Central African Republic

Situation Report
Emergency Response
A displaced woman receives a bag of food during a distribution organized by the World Food Programme at the IDP site in Siwa. ©OCHA/Adrienne Surprenant, Bangassou, Mbomou Prefecture, CAR, 2021.
A displaced woman receives a bag of food during a distribution organized by the World Food Programme at the IDP site in Siwa. ©OCHA/Adrienne Surprenant, Bangassou, Mbomou Prefecture, CAR, 2021.

Multisectoral assistance despite multiple challenges

Little Rose was born only half an hour after the new health post in Siwa village opened. In January, her parents fled clashes 30 km from Bangassou in the south-east of the Central African Republic. Like Rose and her parents, more than 44,500 people have fled to the outskirts of Bangassou and the Democratic Republic of Congo in January and February, following the recent outbreak of violence in relation to the elections. Some are living in six sites for internally displaced people (IDP) near the city of Bangassou, while others have found refuge with host families. Despite the insecurity in the region, humanitarian organizations are providing multi-sectoral assistance to the displaced people.

Emergency medical assistance

The Siwa site, located 12 km from Bangassou, hosts 5,676 displaced people. Several childbirths without medical assistance had led to maternal and infant deaths in recent weeks, before the health post opened. At its opening, the World Health Organization (WHO) provided the health post with supplies to assist safe childbirth and essential medicines for a period of one month. Moreover, the NGO Médecins d'Afrique runs a mobile clinic that comes to the Siwa site and other IDP sites once a week for nutritional screenings and to refer survivors of sexual and gender-based violence to the Bangassou Hospital for medical care. The NGO also runs an emergency vaccination campaign at the IDP sites in and near Bangassou.

Insecurity, logistical challenges and the lack of nutritional supplements limit the capacity of humanitarian health organizations to respond to people’s needs. Access to the 147 displaced families on Limbongo Island, for example, is a particular challenge as the dropping water level of the Mbomou River does not allow the use of the only boat available in the region.

Food assistance

« We didn't take anything with us when we fled from our village. We spent three weeks in the bush, eating taros and wild yams. When we arrived in Siwa, the village chief and those who live there helped us, » said Yangbo Rollande, a displaced woman. In the Central African Republic, the vast majority of the displaced are generously taken in by host families who share what little they have. But in Siwa, the number of displaced people was three times higher than the number of inhabitants, putting further pressure on already scarce resources, mainly outputs from small-scale farming. In an emergency response, the World Food Programme distributed in mid-February 12 tonnes of food to 872 families at the Siwa site. The 15-day food ration consisted of high energy biscuits, rice, beans, oil, salt and a fortified blend of corn and soya. Planning for the next food distribution is currently underway.

And the provision of non-food items

In mid-February, the NGO ACTED distributed essential household items to 236 families at the Bangui Ngoro IDP site. Each household received a package consisting of a tarpaulin, a blanket, a mosquito net, a mat, soap and a bag. Access to drinking water remains one of the most pressing needs of the displaced people. To address this issue, ACTED distributed 60 water purification tablets to each household, providing them with safe drinking water for a month. In addition to the people in Bangui Ngoro, IDPs at the Nzakou Mbemba and Siwa sites – more than 2,500 families in total – have also received household items.

"If we were to prioritize, the most important needs would be water, hygiene and sanitation, household items and food security. Even if we have already set up a response to address the most important needs, we don't have enough resources to cover everything", said Margot Charles, ACTED's Deputy Area Coordinator for Basse-Kotto and Mbomou.

Unmet needs remain

In January and February, more than 16,000 IDPs in Bangassou received multi-sectoral humanitarian assistance. Although humanitarian organizations are making great efforts to respond to the emergency, many needs remain unmet. More than 2,500 displaced households living at the Siwa site have no access to safe drinking water. The two sources that serve this locality are not maintained and consuming the water can lead to water-borne diseases. Latrines and showers are also lacking at the Siwa, Limbongo Island and Cesacoba sites. Following a needs assessment on March 4, the NGO Mercy Corps will provide an emergency response by building latrines and setting up two water sources for the benefit of more than 1,000 families at the Siwa site.

Access to people in need of humanitarian assistance remains difficult due to insecurity and the continued presence of armed groups in the region of Bangassou. For weeks, humanitarian actors have only been able to reach those up to 15 km from Bangassou. At the end of February, the villages of Niakari and Loungougba, located about 20 km from the city, became accessible following the withdrawal of armed elements. A health assessment carried out by WHO, Médecins Sans Frontières and the NGO COOPI on 26 and 27 February revealed that access to health care has become very difficult in these villages. All health facilities have been looted and vandalized by armed elements and health staff have fled. The Office for the Coordination of Humanitarian Affairs (OCHA) and its partners are coordinating the emergency response and are continuing to assess humanitarian needs in other locations that are becoming newly accessible around Bangassou.

Logistics are also hampering humanitarian activities. On some routes, for example, bridges have been destroyed by armed groups, preventing access to remote areas. Despite these difficulties, humanitarians continue their efforts to assist the internally displaced. They also pursue negotiations to open up humanitarian corridors in areas under the control of armed groups.

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Central African Republic

Situation Report
Feature
Burned to the ground by recent clashes, Fatima looks into the direction of where her hut used to be. ©OCHA/Anita Cadonau, Bambari, Ouaka Prefecture, CAR, 2021.
Burned to the ground by recent clashes, Fatima looks into the direction of where her hut used to be. ©OCHA/Anita Cadonau, Bambari, Ouaka Prefecture, CAR, 2021.

Starting over, over and over again

Life has resumed in Bambari. This is at least the impression one gets when driving through the dusty streets. The latest delivery of trading goods from Sudan adds colour to the shops along the main street, carpenters saw up what will become furniture and motorcycles whizz past pedestrians.

Nothing as it used to be

But life is not as it used to be for everyone. The town in the heart of the Central African Republic is just emerging from its latest crisis. Two days lasted the combats in mid-February that seem momentarily forgotten in the centre of the city.

Not so for Fatima, sitting on a stool at the Elevage site, her home for the past four years and home for 8,500 other internally displaced persons. The site was the scene of fighting for 48 hours. When Fatima heard the first gunshots, the young woman grabbed her children and ran to a nearby building that used to house the local livestock authority. Made of concrete, it promised better protection than Fatima’s makeshift shelter made entirely of straw. The family stayed there for three full days. Children, the elderly, women and men, all crowded close together. « There were many of us, so many… », Fatima closes her eyes as she tries to recount how many families had gathered in the bare building and eventually becomes silent. The youngest were crying because they were hungry. The mothers were crying because they could not give them anything to eat, as the fighting was felt right up to their doorstep.

What little they had

A rocket-propelled projectile hit the roof of their refuge but fortunately did not explode. But the smell of smoke indicated that not everything was in order. Hours after the last footsteps were heard outside their hideout, Fatima stepped into the sunlight and saw the destruction. Her home was gone, burned to the ground, with only a circle of ashes left. So were her neighbours’ huts. In the middle of the battlefield, they probably caught fire from falling projectiles. Of what little they had, everything was gone – blankets, clothes and food supplies – with only a carbonized pot left behind. Left with no more than their lives, Fatima and her children were taken in by neighbours who now share what little they have.

A heavy price to pay

Clashes in Bambari on 15 and 16 February took the lives of more than 10 people. Another 36, including eight women and nine children, the youngest just over a year old, sustained gunshot wounds. They received surgery and care at the local hospital supported by Médecins Sans Frontières. A health clinic at the entrance of the Elevage site for the displaced that serves about thousand people was severely damaged by the fighting and had to close for days, further compromising the already precarious access to health care. Three other health facilities in Bambari suffered heavily from the recent clashes; one was also damaged, and two others looted.

Fatima’s children are running around her as she sits on her stool. The family has been spared from visible injuries. But the fresh experience weighs heavily, particularly on the children. They have been out of school since last December. Violence related to the general elections has since kept schools closed across the region – even across the country, where one in two children is out of school. In Bambari, four schools were vandalized – furniture used as firewood and doors and windows stolen – two schools were even occupied by armed groups. But there is hope for the young ones in Bambari with the planned reopening of schools in March. UNICEF and other humanitarian partners support the local school board in identifying what is needed ahead of the opening, now that the town is relatively calm and armed groups have vacated the schools. The clashes in Bambari also halted the work of humanitarians. As the situation calms, they are now able to assess people’s needs and assist them accordingly.

When the abnormal becomes normal

Not everyone found refuge from the recent clashes in Bambari in the vicinity of their homes, like Fatima did. Thousands of people are thought to have fled into the surrounding bushes, found protection at the hospital, near the UN peacekeepers or with relatives or strangers in other parts of town. Since the situation has become calmer, most of the displaced have returned.

Already before this latest crisis, Bambari was home to over 15,000 internally displaced persons from the region or other parts of the country. The prefecture, Ouaka, is the fourth most affected by internal displacement with 74,000 displaced women, men and children. Displacement is part of life for so many Central Africans. Preventive, pendular or long-term displacement, each time an interruption of life. One in four Central Africans is currently displaced, either within the country or as a refugee abroad. Since mid-December of last year, the surge in violence related to the elections has newly displaced over 276,000 people within the country and pushed over 45,000 across the borders, according to registrations by the UN Refugee Agency. Over half of the internally displaced have since returned home. A return to a, often, shattered life, to gathering pieces of what remains.

Perpetual new beginning

Starting from scratch after each displacement requires energy. Building a new home, saving to buy household items, replanting gardens and fields. Fatima has done this before. Looking at her children chasing each other around the muddy ground, she knows why she has no other choice. « If it wasn’t for my children, I wouldn’t know where to take the energy from », says the young mother and looks wistfully into the direction of where her home used to be.

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Central African Republic

Situation Report
Background
Ousmane has named his garden "Perseverance". Many of his friends gave up the work because of lack of water or similar challenges, but Ousmane insisted and grew his crops. OCHA/Virginie Bero, Birao, Vakaga Prefecture, CAR, 2021.
Ousmane has named his garden "Perseverance". Many of his friends gave up the work because of lack of water or similar challenges, but Ousmane insisted and grew his crops. OCHA/Virginie Bero, Birao, Vakaga Prefecture, CAR, 2021.

Peaceful periods allow for humanitarian assistance in Birao

Located in the far north of the Central African Republic, on the border with Chad and Sudan, the city of Birao is experiencing relative calm despite the country's instability. This calm has come after an escalation of violence in 2019, which had resulted in dozens of deaths and the displacement of more than 23,000 people. Humanitarian actors, already operational in the city before the 2019 clashes, have further strengthened their presence and stepped up the multisectoral response to urgent needs. Thanks to their mobilization, the level of severity of humanitarian needs has dropped significantly in one year. Thus, the proportion of the population with an acceptable level of food consumption has almost doubled from 39 per cent to 74 per cent, and half of the city’s’ population now has access to drinking water compared to only a quarter in 2019. Today, only 5 per cent of the population is forced to defecate in the open due to a lack of latrines, down from 37 per cent in 2019. Even though emergency assistance has been provided, humanitarian needs remain.

An unwanted dependency

After fleeing her neighborhood in Birao in 2019, Zénaba found herself at an IDP site with her four children. She had no resources to survive, as she was forced to save her life and the lives of her children, leaving behind all her belongings. Being a trader, she found herself at the IDP site without her goods. "If we did not receive aid from humanitarians, my two-year-old son would have died," she said. Being at the site, the population does not have access to the fields due to the presence of armed groups around Birao and they depend, in large part, on humanitarian assistance. The displaced people receive monthly food rations from the World Food Program (WFP), consisting of oil, cornmeal, salt, beans and millet.

A peaceful period in February 2021 enabled WFP to ship 143 tonnes of food from Sudan via Am-Dafock to Birao. A first distribution was carried out from February 11 to 13 to help 2,367 vulnerable families in Am-Dafock (65 km east of Birao), where 28,150 tons of food were distributed in 15-day food rations. From February 16 to 21, internally displaced people from different IDP sites in Birao, such as the Chinese site, the Yata site and the Hospital site, as well as those in host families, estimated at more than 4,000 families, received 66 tonnes of WFP food in 15-day food rations. In order to consolidate its stocks for assistance in the coming months, WFP received 10 trucks from Bangui carrying more than 470 tonnes of food.

Make agriculture a means of resilience

Other NGOs provide other assistance. The NGO Triangle Génération Humanitaire, for example, provides support to 400 people who have formed a group to cultivate vegetable gardens. Support with seeds, tillage tools and technical knowhow from an agronomist enabled them to plant vegetables such as okra, squash, melons, amaranths and onions. These vegetable gardeners have testified that they survive from the sale of the produce they harvest. "I have benefited from the support of the NGO Triangle for more than two years; I can attest to the benefits of the support that this organization has given us. Without this help, I will not know what to do with my family,” said Ousmane, a gardener and father of three children. The NGO Triangle also distributed 12 tons of seeds such as peanuts, sesame, cowpea, sorghum and 15,000 cassava cuttings to 1,000 households on the axes that lead from Birao to Ouada, Djallé, Terfel and Matala. This distribution enabled the revival of agricultural activities, in areas where the security situation allows it. In addition to assistance in agriculture, 10 groups of beekeepers benefited from tools to promote the resumption of their activities, namely beehives and protective equipment, while 30 groups of fishers received canoes, nets and fishhooks. In parallel, Triangle launched a campaign to distribute cattle and donkeys to 45 groups of farmers to enable them to prepare for the next agricultural season. Triangle's intervention also took into account the valorization and processing of local products by providing two peanut oil extraction machines to the village savings and credit association of Birao.

At the end of January 2021, the city of Birao had three sites for displaced people, the largest of which, called the “Chinese site”, is located next to the peacekeepers base, and counts 8,000 people. For these people, even if they benefit from multisectoral assistance, protection remains a major challenge. Free movement and access to the fields is compromised due to the presence of armed elements around the city.

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Central African Republic

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Feature
A family displaced by recent post-election violence has arrived at a new site for internally displaced people in Batangafo and is unpacking the few belongings it was able to take along. ©OCHA/Adrienne Surprenant, Batangafo, Ouham Prefecture, CAR, 2021.
A family displaced by recent post-election violence has arrived at a new site for internally displaced people in Batangafo and is unpacking the few belongings it was able to take along. ©OCHA/Adrienne Surprenant, Batangafo, Ouham Prefecture, CAR, 2021.

Alarming rise in displacement across the Central African Republic

A surge in violence has displaced over 276,000 people within the Central African Republic. More than half of the displaced have returned in recent weeks but 129,000 people remain displaced inside the country. Most live in deplorable conditions in the bushes surrounding their villages in fear of renewed attacks. And new people are forced to flee almost every day with no end in sight to the current crisis. In addition to the internally displaced, the UN Refugee Agency (UNHCR) has registered more than 45,000 newly arrived refugees in the Democratic Republic of Congo, Cameroon, Chad and the Republic of Congo.

This new wave of violence and displacement began in mid-December ahead of the general elections and adds on to decades of armed violence, which was topped last year with the Covid-19 pandemic, increasing humanitarian needs in the Central African Republic to new heights. While this latest armed offensive was launched in the west, attacks and displacement have since spread across the country, affecting also the center and south-east and sparing only few regions.

Deplorable living conditions and urgent humanitarian needs

Most displaced people have found temporary refuge in fields and forests near their towns, which they consider safer. Some return to their homes during the day to fetch household items or personal belongings or in search of food and water, only to return to the fields for the night. Others have found protection at schools, in churches, near the bases of UN peacekeepers or with host families.

In view of ongoing violence, protection is among the displaced people’s most urgent needs. Sexual violence against women and girls and child protection issues such as unaccompanied and separated children and forced recruitment have been reported. Humanitarian assessments further show that food, primary healthcare, water and sanitation, basic household items and shelter are the most pressing humanitarian needs. Even before the most recent displacement crisis, one in four Central Africans, nearly 1.3 million people, were displaced in the country or across its borders.

Saving lives under most difficult conditions

Despite the growing insecurity in many parts of the country, humanitarian partners have been scaling up their efforts to save lives and provide emergency response assistance to the displaced and those most in need. They support hospitals with medical teams and essential medicines, supply people with drinking water, distribute food and build latrines to prevent the spread of diseases. The volatile security context demands highest flexibility and readiness from humanitarians.

In early January, obstructed road access to Dékoa in the central Kémo Prefecture was overcome thanks to a helicopter and 2,000 families displaced by armed groups’ attacks could be provided with water purification tablets, high energy biscuits and medicines. A rapid needs assessment under the lead of the UN Office for the Coordination of Humanitarian Affairs (OCHA) during the same mission provided the basis for other humanitarian partners who scaled up the response in Dékoa in the days after. The UN World Food Programme (WFP) provided food assistance to over 10,000 families, the NGOs Médecins d’Afrique (MDA) resumed its nutritional support and Médecins du Monde (MDM) established a presence in Dékoa to support access to health care and psychosocial services and to support survivors of sexual and gender-based violence, including the most vulnerable displaced outside the city. In addition to Dékoa, humanitarians have reached four other hard-to-access areas by helicopter since mid-December – Bouca and Batangafo (Ouham Prefecture), Dimbi (Basse-Kotto) and Ouango (Mbomou) – to deploy rapid assessments teams and to deliver much needed humanitarian cargo.

In the western town of Bouar in Nana-Mambéré Prefecture, humanitarian organizations assist 12,500 newly displaced people, the majority of whom now live in churches and parishes. Water pumps are being repaired and bladders installed to cater for the increased demand of drinking water at those displacement sites. High energy biscuits, flour, beans, oil and salt are being distributed, health facilities are supplied with essential medicines and nutritional supplements to treat children suffering from malnutrition.

And in Bangassou, in the south-eastern Mbomou Prefecture, humanitarians await with stoical calmness each safety window that allows them to reach displaced people. They have already assisted 15,000 people with food and water, shelters and emergency latrines and nutrition support for malnourished children, including at the Cesacoba sites and other displacement sites in and around Bangassou.

In Batangafo in the north-western Ouham Prefecture, where 30,000 internally displaced people had been living at sites before the current crisis, over 600 people arrived since January 2021, fleeing the upsurge of violence in Bouca, where most of them were already displaced. Thanks to access by helicopter, humanitarian partners ensured that those people have access to water and received essential household items and hygiene products.

Humanitarians face more challenges than ever

Despite major achievements in assisting people in these difficult times, the work of humanitarians is getting more and more challenging. While the population is the main victim of the conflict, humanitarians have been increasingly targeted, including with offices being looted and vehicles stolen. The month of December 2020 has seen 59 incidents against humanitarian personnel and property, including an aid worker killed and five others injured – almost double the monthly average of incidents recorded in 2020. January 2021 has continued in the same precarious way with 66 incidents recorded, the highest ever.

The disruption of the country’s main supply route connecting the capital Bangui with Cameroon prevents the safe and timely delivery of vital aid. Over 500 trucks with critical UN and partners’ supplies, including food and medicines, have been stuck at the Cameroonian border since mid-December, along with over 1,100 trucks transporting commercial goods. These constraints on an already fragile food supply are again driving up the prices of basic food commodities and jeopardize the lives of those 1.9 million Central Africans already food insecure. Furthermore, the state of emergency declared on 21 January 2021 has been extended for six months until early August, in addition to a countrywide curfew (20:00 to 5:00) put in place after an attempted attack on the capital Bangui on 13 January, with restrictive effects on humanitarian access to people in need.

As of 17 March 2021, only 16 per cent of the Humanitarian Response Plan for the Central African Republic were funded, at a time when humanitarian needs are more pressing than ever. Urgent funding is required to sustain principled and effective humanitarian response.

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Central African Republic

Situation Report
Feature
Planted fields now surround the abandoned and tree-lined main avenue that had been a main traffic route between the capitals of Chad and the Central African Republic (N'Djamena and Bangui). IDP can walk on the route but all the buildings are abandoned after being destroyed. ©OCHA/Anne Kennedy, Batangafo, Ouham Prefecture, CAR, 2020.
Planted fields now surround the abandoned and tree-lined main avenue that had been a main traffic route between the capitals of Chad and the Central African Republic (N'Djamena and Bangui). IDPs can walk on the route but all the buildings are abandoned after being destroyed. ©OCHA/Anne Kennedy, Batangafo, Ouham Prefecture, CAR, 2020.

“Here We Do Not Go to the Fields”

A salary that may be stolen from you, a commute with the threat of rape, a workplace in 35-degree heat. Farming in Batangafo, in the north of the Central African Republic, is one of the hardest jobs in the world. If Rosalie Fiobona* [48] and Antoinette Ngaïnam* [25] seem both incredibly tired and incredibly tough, it is clear why.        

They, along with many displaced women in Batangafo, have always been farmers. Both inherited their farms from their fathers, one on land so flat it is near where aeroplanes land and the other in the rich, damp soil near the Ouham River. But today she says:

“I have fear because we go to the fields and on my return the armed men can attack us, rape us … assault us”

Antoinette Ngaïnam, Farmer.

They, and 35,000 other displaced people, have been forced to flee from their homes in Batangafo, a large portion of whom live on just 1km². Within this small space there are MINUSCA peacekeepers and humanitarians distributing food and supplies who try to create a safe area. But there are only three dirt roads surrounding this triangle of land and endless entry points. The violence is not localised nor continuous; its seasons are not predictable. Months of farming work can be lost when armed groups appear on land worked beyond its borders.

“At the start I made an effort to go to plant, but I had no time to harvest…if I went to the fields the armed men chased me and said the displaced had no right to go there”

Rosalie Fiobona, Farmer

Even those attempting to help the displaced people in Batangafo are, themselves, becoming targets. Batangafo is one of the sub-prefectures most affected by incidents against humanitarian workers in a country already listed as one of the most dangerous countries in the world to be a humanitarian. On several occasions emergency aid work had to be suspended as humanitarians were forced to withdraw. Every day an average of at least one act of violence is registered against humanitarian workers in the Central African Republic. Batangafo was the fourth most affected sub-prefecture with 39 incidents against humanitarian personnel or property in 2020. In January 2021, 66 incidents were recorded across CAR – more than double the monthly average in 2020.

Neither Rosalie nor Antoinette have any property within the triangle. And even if they did, every inch has a shelter, a person, a purpose. Both women’s properties are less than 3km away. Most of the displaced people have homes that are heartbreakingly close. An afternoon’s walk, a simple stroll across the road, a short hour away. There, there are houses with burnt roofs and grass where crops were planted before. Most still visit their homes despite the danger. Not just for food but also to be, for an hour or two, in their own homes. The lure of the memory of a time when they had control of their own lives, when they could work to feed themselves, surrounded by their neighbours and families, is so great that even the threat of rape and death cannot always conquer it.

As the evening closes in Rosalie and Antoinette walk back into the centre of the displaced people’s site. When everything they want and have worked so hard for: independence, control and home, lies, impossibly, in the opposite direction.

*names have been changed to protect the interviewees

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Visual

Humanitarian dashboard 2020

Humanitarian dashboard 2020

In 2020, humanitarian actors in the Central African Republic assisted 1.6 million people, 88% of the people targeted for emergency assistance. This included mitigating the immediate effects of food insecurity and malnutrition, providing shelters, water and hygiene services to populations displaced by armed clashes and natural disasters and protecting the most vulnerable. The humanitarian community relied on the air and road cargo services which transported 3,243 MT of goods across the country and nearly 9,000 passengers by humanitarian aircraft to the most remote and hard to reach areas.

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Emergency Response
©OCHA/Anita Cadonau, Bangui, CAR, 2020.
©OCHA/Anita Cadonau, Bangui, CAR, 2020.

The Humanitarian Response Plan 2021 for the Central African Republic

To meet the needs of the Central African population in 2021, humanitarian actors plan to provide an inclusive, protective and humanitarian-based response to 1.84 million extremely vulnerable people. The response, based on a common understanding of humanitarian needs, will primarily target people affected by shocks linked to violence and natural hazards, and those living in areas with the most urgent humanitarian needs, including in hard-to-reach areas. To achieve this, humanitarians will require US$444.7 million. The strategy that will guide their response is detailed in the Humanitarian Response Plan 2021. As of 17 March 2021, only 16 per cent of this plan are funded at a time when humanitarian needs are extremely alarming. Since violence and tensions related to the December 2020 elections erupted, almost 200,000 people have been internally displaced. Half of them have returned, but 100,000 people are still displaced.

The Humanitarian Needs Overview for the Central African Republic, published in October 2020, tells us that more than half of the Central African Republic's population needs humanitarian assistance and protection in 2021. Among them, 1.9 million people have acute needs related to their physical and mental survival.

The Humanitarian Response Plan 2021 is structured around three strategic objectives. Each of them aims to address one of the three most critical humanitarian consequences identified in the Humanitarian Needs Overview. The response will mitigate the impact of the crisis on people's physical and mental well-being, living conditions and protection. Within this framework, 1.4 million people will benefit from timely and integrated multi-sectoral emergency assistance, in cash or in kind, needed to address the most critical issues related to their physical and mental well-being. Some 1.2 million women, men, girls and boys affected by the crisis will improve their living conditions through dignified and tailored assistance provided in a timely and protective environment. And thirdly, the protection and respect of the human rights of 1.3 million crisis-affected people will be ensured.

The humanitarian response in the Central African Republic in 2021 will be developed as close as possible to and with the people affected, listening to their concerns, priorities and grievances. Humanitarians will pay particular attention to the voices of women, people with disabilities and the elderly to ensure that their specific vulnerabilities are considered and interventions are adapted.

To find out more, see the Humanitarian Response Plan 2021 for the Central African Republic.

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Scale-up of cash-based initiatives in 2020

Scale-up of cash-based initiatives in 2020

Humanitarian actors have scaled up cash-based initiatives (CBIs) in 2020, with 48 per cent more people assisted compared to 2019, in line with the Humanitarian Response Plan 2020. Between 1 January and 31 December 2020, some 848,000 people received 29.2 million USD through cash transfers, vouchers or electronic transfers, the vast majority in emergency response. 44 per cent of the people assisted benefitted from COVID-19 related CBIs. The UN Cash Common System (UNCCS) continues to collaborate with the Cash Working Group on further CBI scale-up in 2021, in line with the Humanitarian Response Plan 2021, particularly in urban areas such as Bangui and Kaga-Bandoro. Find out more about the Humanitarian Response Plan 2021: http://bit.ly/3jaKYWq

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Central African Republic

Situation Report
Forecast
The Humanitarian Needs Overview 2021 reveals a further deterioration of the humanitarian situation across all sectors. ©NRC/C. Igara, CAR, 2020.
The Humanitarian Needs Overview 2021 reveals a further deterioration of the humanitarian situation across all sectors. ©NRC/C. Igara, CAR, 2020.

The survival of 1.9 million people in the Central African Republic is at risk

In 2021, 2.8 million Central Africans – 57 per cent of the population estimated at 4.9 million – will need humanitarian assistance and protection. Of those, three-quarters have acute needs. In other words, the survival of 1.9 million people, or 39 per cent of the population, is at risk. The Humanitarian Needs Overview 2021 for the Central African Republic, the result of an unparalleled data collection and extensive analysis, shows a further deterioration of the humanitarian situation across all sectors.

The figures reveal the dramatic consequences of a pandemic in a country already ravaged by decades of armed conflict, underdevelopment and where natural disasters are becoming more frequent and severe. The figures also reveal the grim daily life the majority in the country, who live in such difficult conditions that they are struggling to feed themselves. Even those who have enough food find it difficult to find decent housing or to get their children an education. The data also shows that there is a danger of humanitarian actors disengaging when development actors are slow to take over.

The humanitarian situation continues to worsen

Since last year, the number of people in need has increased from 2.6 million to 2.8 million (+8 per cent). Meanwhile, the number of people with acute needs is 12 per cent higher than in 2020 (with 1.9 million people in 2021 compared to 1.7 million in 2020). In the past five years, there have never been as many people in humanitarian distress in the Central African Republic as today. This increase is a direct consequence of the downward plunge of the economy, the spreading of the violent conflict, rising food insecurity and the COVID-19 pandemic.

The Central African Republic continues to face a serious protection crisis, with a steady increase in violations of human rights and international humanitarian law despite the signing of the Political Agreement for Peace and Reconciliation in 2019. Those who suffer most are not those fighting, but rather the civilians. One in four Central Africans are displaced either within the country or in a neighboring country, and the return of internally displaced people and refugees has slowed down considerably.

Gender-based violence is a plague, with one incident reported every hour by the humanitarian alert system, which covers only 42 per cent of the country – and these figures are only the tip of the iceberg. Humanitarian actors have recorded an almost two-fold increase in the number of cases of violence against girls and women as a result of restrictions related to COVID-19. Across the Central African Republic, children continue to be exposed to risks. One in four families fears for the safety of its children, mainly in relation to sexual violence, forced labor and recruitment by armed groups.

The sector with the most people in need is thus protection, followed by health, water, hygiene and sanitation and food security. 40 per cent of Central African households are in a situation of acute food insecurity. In the capital of Bangui, the number of food insecure people has almost doubled since last year, now affecting 45 per cent of the population. The number of people in need in 2021 has increased in all sectors except nutrition, where there has been a slight decrease.

The Central African Republic is also one of the most dangerous countries for humanitarians in the world. On average, more than one incident per day affecting humanitarian workers was recorded in 2020 (424 in total), with three aid workers killed and 29 injured.

The next steps

To meet the population’s needs in 2021, humanitarian actors in the Central African Republic in collaboration with the government develop a common strategy to guide their interventions, detailed in the Humanitarian Response Plan 2021, published in December 2020.

Despite generous donor contributions, as of October 2020, the current Humanitarian Response Plan is funded at just over half of the US$ 553.6 million required. To enable humanitarians to meet the ever-growing needs of the population in 2021, they are counting on donors’ commitment to stand by those Central Africans who cannot meet their basic needs.

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Feature
The mixed Congolese and Central African surgical team performing its first fistula surgery at the Hôpital de l’Amitié in Bangui. ©Mukwege Foundation, 2020.
The mixed Congolese and Central African surgical team performing its first fistula surgery at the hôpital de l’Amitié in Bangui. ©Mukwege Foundation, 2020.

Holistic care for survivors of sexual violence in the Central African Republic

The inauguration of the project Nengo on the eve of the first day of «16 days of activism to end gender-based violence» in Bangui could not have been timelier. «Nengo» in the local language Sango means dignity. And dignity is what the project aims to restore for thousands of women and girls, but also boys and men who survived violence directed at them based on their gender.

One of the country’s darkest chapters

Every single hour in the Central African Republic, a case of gender-based violence is reported. And the situation is certainly worse, since the respective information management system (GBVIMS) supported by humanitarians covers only 42 per cent of the country. Widespread insecurity in the country maintains a context conducive to gender-based violence, but also deeply rooted gender inequalities, the abuse of power and harmful norms contribute to this crime. The COVID-19 pandemic has further increased existing vulnerabilities, particularly during its first months. As lives retreated inside homes due to lockdown measures introduced by the government, an alarming increase in violence against women and girls was reported in the Central African Republic. Women and girls had to stay at home with their abusers – often spouses, partners or family members – increasing cases of violence by at least by 10 per cent, while limiting survivors’ possibilities to seek protection and assistance.

Project Nengo sets up a centre for the holistic care of victims within a public hospital in Bangui, the Hôpital de l’Amitié, and within the Central African Women Lawyers Association, two recognised referral centres for survivors of sexual and gender-based violence in the country. After months of preparation, teams from the gynaecology-obstetrics and maternity department at the Hhôpital de l’Amitié and the Women Lawyers Association, with the support of international partners, launched the holistic care programme for survivors of sexual violence.

A «one stop centre» to rebuild lives

The newly established centre provides a single point of reference, a «one stop centre» for survivors of sexual and gender-based violence to receive a comprehensive response to their needs. This holistic care model was developed by 2018 Nobel Peace Prize laureate Dr Denis Mukwege and his team at the Panzi hospital in Bukavu in the eastern Democratic Republic of Congo (DRC). It structures around four pillars, which respond to the essential healing needs of victims and their empowerment:

The response includes medical care and the treatment of severe gynaecological injuries, which may include surgery. Survivors often show signs of depression, fear, behavioural disorders and self-shame. They face social exclusion and troubles rebuilding trust and relationships. The second pillar of the response therefore centres on psychosocial care, an integral part of the healing process that both anticipates and complements physical treatment. The survivors also receive legal assistance to demand justice, including judicial counselling and an accompaniment throughout the judicial process. And fourth, survivors are empowered socio-economically, for example, through literacy training, small business management and microcredit programmes and scholarships. Economic reinsertion and rebuilding independent livelihoods are particularly important for those survivors whose subsistence depended on their aggressor.

Having all services united underneath one roof is practical for those seeking assistance and it makes referrals between services easier. But it is also an important component of victim protection. It avoids that the survivor has to tell her or his story over and over again, reliving the atrocities.

Project Nengo will also contribute to the prevention of sexual and gender-based violence in the Central African Republic through advocacy, strengthening of the rule of law and reducing structural causes of these types of violence by promoting gender equality.

South-south skills transfer

Faced with the grave situation in the Central African Republic, a consortium of four international institutions – the Pierre Fabre, Panzi DRC and Dr Denis Mukwege foundations and the Francophone Institute for Justice and Democracy – joined forces and with financial support from the French Agency for Development, replicate Dr Mukwege's holistic care model from the DRC in Bangui.

The «one stop» model for survivors of sexual and gender-based violence is also being replicated in other countries, including Guinea, Colombia and Uganda. The transfer of skills between Congolese and Central African actors will strengthen the capacities of the public hospital and the local lawyers association for the benefit of people in the long run. Improving the quality of care in the gynaecological-obstetrics department of the hospital will moreover benefit the entire population and not only survivors of violence.

Beyond the capital

Over 3,000 survivors will be able to receive treatment and support at the new centre over the course of the next four years. Although located in Bangui, the centre will also be accessible for survivors from outside the capital through a referral system between the Nengo project and NGOs, health care providers and civil society organizations located throughout the country.

On the eve of project Nengo’s inauguration, the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) intervened at the project's Strategic Steering Committee workshop to present mechanisms for the prevention of sexual abuse and exploitation within the humanitarian community, and will continue to bridge the project with humanitarian actors working in the areas of protection, health care and empowerment.

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