Central African Republic

Situation Report
Emergency Response
Rapid nutritional screening in Ouadda during the interagency mission
Rapid nutritional screening revealed alarming results. @WHO/Arsène Konzelo. Ouadda, Haute-Kotto Prefecture, CAR, 2020.

Delivering life-saving assistance to people in hard-to-reach areas

In the Central African Republic (CAR), recurrent violence, limited and dilapidated road infrastructures have long prevented humanitarian actors from accessing vulnerable people. While the dry season from November to May is an opportunity to access areas that remain off limits during the rainy season, some localities are difficult to reach all year round.

The country has a surface area of 622,984 km2 but only 2.5% of its road network is paved. Insecurity resulting from armed groups activities has displaced one in four Central Africans.  Some 2.6 million people, more than half of the population, are still in need of humanitarian assistance. The COVID-19 pandemic has exacerbated existing vulnerabilities amid dwindling resources. Only 38% of the US$ 553 million requested under the 2020 Humanitarian Response Plan (HRP) have been mobilized to date. 

The locality of Ouadda in the south eastern prefecture of Haute-Kotto faces multiple challenges. Access to basic services is among the lowest in the world and inter-community conflicts take place on a regular basis. Last July, five people were killed and 1,520 others - about 20% of the town´s 7,700 residents - were displaced following inter-community clashes. Despite a mediation mission conducted in early August by local authorities, the displaced have not been able to return home. Several checkpoints set up by armed groups have since restricted the freedom of movement for civilians. There are no armed forces or internal security forces in the area. 

Since the last humanitarian mission to Ouadda in December 2019, Ouadda has remained isolated from the rest of the country, as there are no telephone network covering the area. On 7 August, the humanitarian community chartered a helicopter from the United Nations Humanitarian Air Service (UNHAS) and traveled to the town. With a  US$ 9 million allocation from the CAR Humanitarian Fund,  the deployment of the helicopter to CAR will enable the delivery of life-saving assistance in hard-to-reach areas, and the provision of multisectoral responses to the most urgent needs identified in the 2020 HRP. The helicopter will also carry in-country medical evacuations of humanitarian personnel. 

During the interagency mission to Ouadda, humanitarian actors found that the only government-supported medical facility had stopped functioning and receiving medications three months ago. For fear of abuse at the hand of one of the parties to the conflict, patients are reluctant to go the only private health facility. Five weeks before the mission, four deaths linked to suspected cases of malaria had been recorded among IDPs living in the bush. A rapid nutritional screening of 40 children aged six-59 months revealed a Severe Acute Malnutrition (SAM) rate of 17.5% and a Moderate Acute Malnutrition (MAM) rate of 70%. [Access the Interagency mission report here ] Humanitarian actors provided emergency assistance including tarpaulins, jerricans, water purifiers, personal hygiene kits and high energy biscuits to more than 300 vulnerable families.  On 29 and 31 August, the World Food Program (WFP) and the NGO Plan International conducted three additional rotations by helicopter from Bria to Ouadda to assist 1,500 people with emergency food assistance and 100 malnourished children with food supplements. In total, 15-day food rations composed of 6.6 tons of basic food items, including flour, beans, vegetable oil and salt were distributed. 

In mid-August, the humanitarian community used the same helicopter to fly to Nzacko in the eastern Prefecture of Mbomou where access issues and insecurity had prevented the establishment of a permanent humanitarian presence [Access the Interagency mission report here]. Between March 2017 and February 2020, recurrent clashes between armed groups resulted in serious abuses against civilians, including the killing of 100 people, the burning down of houses and population displacement. The relative calm following the 2019 peace and reconciliation agreement between the government and armed groups has led to the return of 15,000 people. However, 4,000 IDPs fearing for their safety have not yet returned home. 

Access to basic services remains very poor in Nzacko. Tests conducted during the mission revealed that the water of wells frequently used by the population was not drinkable. Of the 334 water points, none qualifies as an improved water source. Between May and July 2020, the morbidity rate for water-borne diseases was 43% out of 1,000 consultations. A single health structure is operational for a population of over 15,000 people, albeit without the required minimum amount of drugs and number of qualified personnel. Children under the age of five have not received routine vaccinations for over a year. A rapid nutritional screening of 82 children revealed a SAM rate of 20%. Humanitarian actors provided life-saving assistance, including medications and food supplements to malnourished children, enough to cover six-month worth of medication and one-month worth of food supplement, as well as hand washing stations, buckets, soap, disinfecting sprays in the event of an outbreak of COVID-19 and awareness raising material.