Central African Republic

Situation Report
Emergency Response
Staff at the Ippy Hospital receive medications from humanitarian partners after the massif influx of internally displaced people led to a significant shortage. ©OCHA/A.Cadonau, Ippy, Ouaka Prefecture.
Staff at the Ippy Hospital receive medications from humanitarian partners after the massif influx of internally displaced people led to a significant shortage. ©OCHA/A.Cadonau, Ippy, Ouaka Prefecture, CAR.

People in complete distress after fleeing to Ippy

The situation of the people living in Ippy, a sub-prefecture in the centre of the Central African Republic (CAR) which has long been notorious for its insecurity, has again deteriorated considerably in recent months.

Cyclical armed clashes displaced more than 4,800 people from the surrounding axes to Ippy town since early January, in addition to the 12,000 internally displaced people (IDP) who had arrived previously. And new people are arriving every day, fearful, desperate and with not much more than the clothes they are wearing. An enormous burden for a town with an estimated 50,000 inhabitants and an infrastructure for water, education and health care that cannot provide for a fraction of the population – even before the current crisis.

Straw huts are springing up like mushrooms in Ippy. Simple constructions of branches covered with straw collected in the surroundings protect the newly arrived IDPs from the sun and the cold at night and give them the feeling of having a roof over their heads, a little comfort in a world that is collapsing – for many not for the first time. They know that these huts will not last for long when the rains start in just a few weeks.

The people who fled have witnessed armed clashes, exactions, lootings and reprisals – caught between the conflicting parties. Entire villages have been destroyed, human rights and international humanitarian law gravely violated. Other people have fled preventively in fear for their lives.

Worsening of an already precarious humanitarian situation

The needs of the distressed population are enormous. Both IDPs and host families lack the basic necessities for survival: people no longer have access to the fields where insecurity reigns, the market is empty, diseases are rampant, healthcare and schooling is unaffordable and people are afraid.

The latest cycles of violence come in an already precarious context: 40,000 people need assistance and protection in the sub-prefecture, a number that has sharply increased in recent months. Ippy is one of the 20 sub-prefectures (out of 72) most affected by food insecurity and classified in the emergency phase of food insecurity (IPC phase 4). A recent national food security survey indicates that more than 80 per cent of the population does not have enough to eat. At the same time, the minimum monthly basket of food and non-food items considered necessary to survive is at XAF 87,000 (US$145) nearly 50 per cent more expensive than the national average, while more than 94 per cent of households report earning less than XAF 50,000 (US$86) per month. The calculation for survival simply does not add up.

Fear in their eyes

One can still see the fear in the eyes of those who recently fled to the town of Ippy. At the Ippy Hospital, the fearful memories of what Tatjana and Guillaume experienced mix with the fear for her daughter. The young parents seek treatment for their one-year old who suffers from malaria and an associated anaemia. Since they fled on foot from their village, 30 km away, a fortnight ago, they have been sleeping on the bare floor of a straw hut with their three children and other displaced families. Exposed to mosquitos and the chill of the night, and equipped with only a blanket and mat for the entire family. “It was only a matter of time before the first child would get sick. And that’s the last thing we need now”, says the young father in a voice that suggests how tired he must be. With no money in their pockets, buying simple materials like a blood transfusion bag for their daughter suddenly seems like an insurmountable problem, and fear rises. The hospital staff realise the seriousness of the situation and cover the costs. But how long will they be able to do so when thousands of patients are desperate? Guillaume sets off for the lab to see if he can save his daughter with his blood. Severe anaemia is widespread and emergency kits for blood transfusions are urgently needed, along with equipment for caesareans and incubators for premature babies.

In the adjacent building at the Ippy Hospital, Arsène sits on a bare hospital bed with beads of sweat on his forehead next to the large bandage that covers the spot where he was hit by a machete. “The attack came as a surprise when I was hunting in the forest. I probably wouldn’t be here today if someone hadn’t taken me the 10 km to Ippy by bicycle”, says the young man, looking thoughtfully at the bare concrete wall.

The Ippy Hospital is bustling with activity. A young woman is being transported on a stretcher. The waiting area in front of the paediatric clinic is crowded. Barely born babies are already suffering from diarrhoea, their lives hanging by a thread. The hospital staff is working day and night to cope with the massive rush the main health facility in Ippy has been experiencing for weeks.

In Yetouman, a spontaneous settlement that has sprung up in recent weeks and which shelters 700 families from surrounding villages, Marie Noëlla and her six children rely entirely on the solidarity of others to feed themselves. The few cassava sticks they had been able to take with them were quickly consumed after their arrival in Ippy two weeks earlier. The IDPs share what little food they have with each other. But how long will this be possible, as stocks are slowly but surely being depleted?

Scaling up emergency assistance

The Humanitarian Coordinator in CAR rang the alarm bells after an inter-agency assessment mission to Ippy on 3 February. Immediately, humanitarian organisations activated emergency response. Food supplements arrived on 3 February to cure and prevent malnutrition of the most vulnerable – children and mothers. Some 1.3 tons of medications were flown in by helicopter on 9 February after a major shortage was reported at the hospital. Basic supplies such as antibiotics were no longer available due to the increasing number of patients.

Urgently needed food and other relief items arrived in Ippy by road on 9 February and their distribution started immediately. The World Food Programme (WFP) distributed food to 15,000 people, inducing the newly arrived IDPs. The Refugee Agency (UNHCR) distributed tarps, mats, kitchen utensils, soap, buckets and solar lamps to 400 families and the NGO ACTED will distribute further relief items to the newly arrived, who have not yet received anything, after ACTED already assisted 1,186 families in late January. ACTED rehabilitated two boreholes and built 24 emergency latrines, including at the Yetouman site; the rehabilitation of a spring and the development of a well will follow.

Children are given specific attention by the NGO Esperance and UNICEF. They provide psychosocial support to 508 displaced children to overcome what they experienced; take care of a dozen children separated by their families during the flight and place them in host families; and monitor that children’s rights are respected and act, if they are violated. To keep children in school, UNICEF and partners are setting up emergency classes in tents for nearly 1,000 displaced children, mobilize teachers among the IDPs and provide basic school supplies.

UNICEF and the NGO COHEB support nutritional therapy and medical treatment at the Ippy Hospital. Some 225 severely malnourished children were already taken care of between early January and early February, saving lives. Mobile clinics take care of small children, pregnant women, young mothers and emergencies at the IDP sites and COHEB medical staff work alongside government health personnel at the Ippy Hospital, providing additional expertise and workforce.

The peacekeeping mission MINUSCA reinforces patrols on the main surrounding axes and strengthens capacities of the Armed Forces and Gendarmerie to protect civilians. Moreover, peacekeepers will rehabilitate boreholes outside of town.

Strong and continued commitment

The Humanitarian Response Plan for CAR requires US$461.3 million in 2022 to assist 2 million people whose survival is at risk. Donors in CAR remain committed to the Central African population. “Thanks to the longstanding partnership with the European Union and Switzerland, whose representatives travelled to Ippy with me to see the impact of the recent crisis first-hand, and the flexible funding they provide, OCHA and partners are able to do whatever it takes to help the most vulnerable people”, said the Humanitarian Coordinator Denise Brown. In 2021, thanks to the generosity of donors and the strong mobilisation of humanitarian actors, 1.8 million vulnerable people received life-saving multi-sectoral assistance.