Central African Republic

Where they haven’t been abandoned because communities and medical staff have fled, healthcare facilities are targets for attacks by different parties to the conflict.

With just 56 % of healthcare facilities in the country still functional, it is impossible to respond to the needs arising from increasing numbers of people being injured, people with mental health problems, survivors of sexual violence, the incidence of communicable diseases and the risk of epidemics. Most outlying health facilities lack trained staff and the supply system for medicines and equipment is failing.

The infant mortality rate is the fifth highest in the world, with 103 deaths per 1,000 children under the age of five. Maternal mortality also ranks fifth globally, with 835 deaths per 100,000 live births. Only 40 % of births are attended by qualified health workers.

2.5 million people, or 41 % of the population of the Central African Republic, are experiencing acute food insecurity, including 492,000 who are classed as being in an emergency situation. Over 50,000 children under the age of five require urgent treatment.

The volatile security context leads to markets being closed and people being unable to go into the fields to work and this is coupled with galloping inflation. These crises have a severe impact on people’s resources and livelihoods, especially in rural areas and in the most affected locations.

The Central African Republic is at the sharp end of climate change and experiences recurrent natural disasters which lead to population displacements. Wildfires, flooding and ever longer droughts are severely disrupting people’s livelihoods and making them vulnerable to the diseases and epidemics that regularly rage across the country. The poor condition of basic services make it impossible to provide a rapid response.

In total, 22,100 cases of gender-based violence were recorded in 2024, against a background of significant reductions in funding for humanitarian programmes. This violence may take the form of sexual violence (38 % of reported incidents), physical assaults (27 %), psychological violence (17 %), denial of resources (16 %) or forced marriage (2 %).

Violence has reached epidemic proportions in the country and affects everyone. Although women and children with disabilities are particularly at risk, sexual violence against boys and men also exists and is a doubly taboo topic.

We are setting up a minimum emergency response package for sexual and reproductive health and rights, comprising pre- and postnatal consultations, family planning, gynaecological consultations and referral of obstetric emergency cases. In 2024, sexual and reproductive health services were provided to 10,000 people and staff attended 1,962 births at health centres, including 37 caesarean sections.

The Médecins du Monde teams establish multidisciplinary services for survivors of gender-based violence. This includes both medical and psychosocial support. We also encourage community engagement around issues of sexual and reproductive health and mental health.

We seek to strengthen synergies between different stakeholders to ensure effective and sustainable interventions. For example, we provide emergency medical assistance and psychological first aid and, for survivors who want it, referral to partner services providing legal and psychosocial support.

Since 2019, Médecins du Monde has been providing emergency mobile responses in the event of incidents such as population displacements and epidemics. The mobile clinics combine support for the local healthcare system with rapid response capabilities.