Haut-Mbomou on the brink of a devastating humanitarian crisis
Already one of the prefectures most affected by a decade of conflict and structural problems, Haut-Mbomou has seen its security and humanitarian situation progressively deteriorate over the past year. Two armed groups have been clashing against the backdrop of community conflicts and control of resources, with devastating consequences for the population. In 2024, more than 80 per cent of the Prefecture's inhabitants will be in urgent need of humanitarian assistance and protection.
Civilians paying the heaviest price
Since the beginning of the year, following clashes between these armed groups, an unknown number of civilians were killed, houses were burnt and over 4,300 people were displaced from Mboki and are currently taking refuge in the region of Zémio in the neighbouring Mbomou prefecture. Some 1,950 of these people are said to have crossed the border into the Democratic Republic of the Congo. In recent months, several attacks have been reported on the Zemio-Mboki axis, specifically targeting individuals based on their ethnic or religious background. As a result of persistent insecurity, access to markets and basic services such as healthcare is currently very limited for the population, whose humanitarian needs remain among the highest in the country, particularly in terms of food security. Additionally, humanitarian activities have been suspended in the sub-prefecture, and physical access problems to several villages are observed during the rainy season (April to October) due to flooding and associated high risk of population movements associated.
Health particularly affected
In May 2023, armed men looted the base and pharmacy of the NGO providing healthcare in Mboki, resulting in a total shortage of essential medicines. The Kadjemah health post was also looted and destroyed. Following the resulting insecurity, the NGO teams were evacuated from Mboki. Furthermore, armed men issued death threats against healthcare personnel and humanitarian workers. A midwife was killed for allegedly supporting one of the parties to the conflict. In early 2024, health posts in Maboussou and Gpabou were looted by armed men. Rehabilitation work at the Mboki health center was suspended, as were humanitarian activities in the area. As a result of these acts of violence, 80% of the population living along the Zemio-Mboki axis sought refuge in the bush. Currently, there is no physical humanitarian presence in Mboki. This insecurity has also resulted in a decline in the utilization of healthcare services, including in refuge areas, notably in Zemio and Mboki. Reproductive health services and vaccination activities are particularly affected, while risks of a resurgence of measles epidemics and peaks in malaria cases are high. Assisted childbirths have fallen by over 55 per cent, in a country with the fifth-highest maternal mortality rate in the world (829 deaths per 100,000 live births).
An emergency humanitarian response
In May 2023, humanitarian organizations provided healthcare to internally displaced persons in Zemio, particularly in primary and reproductive healthcare. Among other things, they have provided the Zémio Health Center with medical supplies to meet the needs of around 1,400 people, notably for the treatment of sexually transmitted infections and post-rape situations. Since the beginning of this year, humanitarian organizations have undertaken several initiatives to address the needs of vulnerable populations. Each month, around 500 households receive cash distributions, and Cash for Work (CFW) programs are implemented. Additionally, coordination and site management activities have been conducted, including household registration and site layout. The ongoing response also includes the rehabilitation of boreholes and wells to enable displaced persons to access drinking water, the distribution of food seeds to nearly 450 households, and the establishment of a "Child-Friendly Space" in the communities of Banangui and Maboussou. Furthermore, training sessions on child protection have been conducted for over 15 individuals in the communities of Zemio center, Feinzane, Kamanda, and Gouyanga. The objective of these efforts is to assist 3,150 of the most vulnerable individuals. Given the scale of the needs at national level and the context that is undergoing new developments, notably with the impact of the Sudan crisis in the north of the country, as well as the challenges related to the transportation of necessary supplies for project implementation, the capacity to absorb additional needs is becoming increasingly limited.
Fragile protection
Despite ongoing assistance, protection remains the main priority for populations who can no longer access their fields, the main source of their survival. The return of people currently displaced continues to face a number of protection challenges, particularly in terms of freedom of movement, including the risk of being used as human shield by parties to the conflict, and access to means of subsistence. Civilians also continue to suffer reprisals, including killings, for allegedly supporting one or other of the parties to the conflict.