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Central African Republic

Central African Republic: Bamingui Bangoran and Nana Gribizi Prefectures

» FIELD LOCATIONS
Three bases: Bangi (coordination), Ndele and Mbres (operations)

» TARGET POPULATION
46,620 men, women and children in N’dele;
27, 000 in Mbres.

» A.M.I. TEAM
9 expatriates: 1 head of operation, 2 program coordinators, 2 medical advisers, 1 HIV adviser, 1 administrative and financial coordinator, 1 logistics coordinator, 1 medical coordinator
51 local staff members: administrators, logistics assistants, head nurses, head midwives, community development technicians, etc.

» FUNDING
United Nations Central Emergency Response Fund (CERF), United Nations Population Fund (UNFPA), Emergency Response Fund (ERF) via the United Nations Development Fund (UNDP), World Health Organization (WHO), United Nations Children’s Fund (UNICEF), European Commisson Humanitarian Aid Office (ECHO), French Ministry of Foreign Affairs Crisis Center, UNICEF via Merlin.


For the past twenty years, the Central African Republic has been suffering from a crisis of chronic nature due to socio-economic problems and political instability. Irregularity in payment of government employee salaries has added to social and political unrest in the country. In addition, the north has been experiencing a security crisis since mid-2006, with rebels and the military forces engaging in two different conflicts of separate natures, one in the northeast and one in the northwest. Despite peace agreements within the framework of the All-Inclusive Political Dialogue designed to reconcile the armed forces of the country, the situation is still unstable in many areas. The deterioration of living conditions makes it more and more difficult for the people of CAR to gain access to basic social services. For the past twenty years, life expectancy has been declining, and now stands at 40 years of age for men and 45.7 for women. The rate of infant mortality rose from 97 per 1,000 births in 1995 to 132 per 1,000 in 2003. Maternal mortality increased from 683 to 1,355 per 100,000 live childbirths. Malaria is one of the main causes of mortality in CAR, which is also severely stricken by the HIV/AIDS pandemic. The current health situations in the Bamingi-Bangoran prefecture and in the Mbres subprefecture (Nana Gribizi prefecture) are cause for much concern, due to the fact that the area is isolated as a result of its poor road infrastructure and the tension between armed factions.


Early in 2007, an A.M.I. evaluation in the Bamingi-Bangoran prefecture led to the launch of a program in the city of N’dele and its vicinity, where the hospital had been sacked in late 2006. After the opening of a coordination base in the capital of Bangi in April 2007, an operations base was opened in N’dele in May 2007. In this area where access to primary health care was no longer effective, A.M.I. reinforced the capacity of the hospital in N’Dele with regard to primary, maternal and infant health care.
This enabled workers to provide seven times the previous number of consultations. Support extended to three health care structures in the vicinity and included vaccinations and HIV/AIDS awareness sessions. In November 2007, a second A.M.I. operations base was opened in the Mbres subprefecture, a neglected area in the prefecture of Nana Gribizi.


» Mbres
In the subprefecture of Mbres, the objective is to restore access to health care by supporting the basic health care center and four health care stations, and by establishing a mobile clinic. In cooperation with local health care authorities, three lines of action were defined:
> access to primary health care:
- rehabilitation of health care structures
- reopening of previously closed health care stations
- construction of latrines, incinerators and waste areas for health care centers and stations
- supply of equipment and staples, both medical and logistic
- follow-up of routine vaccination activities and support for mass vaccination campaigns organized by the Ministry of Health
- support for routine prevention activities within health care structures (prenatal and postnatal consultations and preventive care consultations for children under 5)
> support to the basic health care center of Mbres:
- supply of equipment for the operating room
- specific training for surgery
- support and training for laboratory work and emergency blood transfusions
> training of personnel:
- training of nurses, head nurses and pharmacy managers
- bi-monthly supervision and monitoring in health care structures
- management training for health care center heads and for presidents and treasurers of COGES.

» N’dele
A.M.I.’s main objective is to help restore access to health care for all. Accordingly, A.M.I. teams are focusing their efforts on:
> support for the N’dele hospital and for the three peripheral health care stations and centers, providing rehabilitation of the centers, medicines, equipment, training, supervision and monitoring
> the creation of a blood transfusion station for emergencies
> the expansion of maternal and infant care, support for maternity wards, and preventive care in seven peripheral health care stations
> follow-up of routine vaccinations in 11 centers in a widespread vaccination program through training, supervision and maintenance of refrigeration.

In line with A.M.I.’s policy to support its local health care partners, cooperation with the health authorities is the subject of an agreement to provide affordable health care.