South-western Central African Republic (CAR) currently faces a serious nutritional emergency. The crises in the mining industry, on which many of the region inhabitants depend, has been the last straw for an already highly vulnerable population.

Alerted by the local authorities, the Médecins Sans Frontières (MSF) teams have opened four feeding centres in one month in Carnot, Boda, Nola and Gamboula and implemented a number of outpatient treatment programmes in the area. The first assessments have revealed severe malnutrition rates way over the emergency threshold in some areas.

In barely one and a half months over 1,300 children, mostly suffering from severe malnutrition, have been admitted to the MSF programmes. A large number of patients suffered from medical complications and had to be admitted.

"In Boda and Nola, for instance, it is difficult to find patients only suffering from malnutrition, as many of them arrive here suffering from other diseases and their condition is very severe," explained Clara Delacre, MSF coordinator in Nola. "There are many cases of malaria, diarrhoea, tuberculosis or AIDS, which further complicates children's already delicate condition.

"Several elements can explain this situation, one of them is the crisis affecting the diamond and gold sector, the main means of sustenance for most of the people in the area."

The crisis has left many men working in the mines unemployed and without income. In addition, many of the diamond and gold buying and selling businesses have been forced to close down in the past few months. The economic crisis, however, is only a circumstantial factor that now has been added to the chronic difficulties in the region: a very poor cassava-based diet, the lack of access to health for most of the population and the fact that the rainy season is already here increases the risk of contracting malaria and other diseases.

In the region, the staple diet is almost only cassava-based. Other basic food such as meat is now as hard to find as diamonds. According to the area inhabitants, the problem started some years ago when groups of bandits started threatening cattle farmers. As a result, the latter fled to Cameroon and have not returned as of yet. Moreover, another crisis-triggering factor is the lack of access to health. People have to pay to receive medical care and medicines, which they cannot afford. This, to cap it all, has been compounded by the recent loss of income in many families and the closure of many health centres.

"MSF has come here to respond to the emergency treating the most severe cases. Yet there are background problems requiring a broader response," said Delacre.