Violent clashes in the city of Bambari, southern Central African Republic, on 15 and 16 February wounded people and hit a medical centre supported by Médecins Sans Frontières (MSF) with bullets and explosives. The violence further compromises the already very precarious access to healthcare for people in the city.

The MSF surgical team and colleagues in the Ministry of Health treated a total of 36 war-wounded patients at Bambari Regional Hospital. The majority of the wounded arrived on Tuesday, as soon as the fighting subsided, allowing ambulances and patients to access the hospital. Among the injured were eight women and nine children aged between 17 months and 17 years old.

“The current humanitarian crisis in Bambari and across the country is dreadful and violence affecting civilians has to stop,” says Marcella Kraay, MSF Deputy Head of Mission. “The Central African people have already suffered so much, and what we saw last week was yet another example of the toll of violence on people, including women and children with bullet and shrapnel wounds.”

“Constant tensions and fighting deeply impact an already vulnerable and traumatised people, who have been hard-hit by years of civil war and chronic medical crisis, therefore extremely limiting their access to healthcare,” Kraay says.

The Elevage Centre de Santé in Bambari, where MSF supports the Ministry of Health to provide basic healthcare serving a community of about 1,000 people, was found severely damaged by the fighting. The MSF team inspecting the grounds after the violence discovered that an explosion and gunshots had damaged our medical tent, including the patient consultation rooms.

Bullet casings could be seen littered on the floor throughout the medical compound. As the fighting came closer and closer to the clinic, they were told, the medical team present during the fighting fled the scene. A medical centre is a neutral space protected under International Humanitarian Law and must never be targeted or used for fighting or any military purposes.

“In this time of crisis, we are calling on all parties to the conflict to respect medical facilities, ambulances, medical staff, as well as patients and their caretakers at all times,” says Kraay. “Unhindered and sustained access to the people affected by the violence must be ensured in order to allow the delivery of much-needed medical care.”    

In the past two months, fighting has erupted between a coalition of non-state armed groups and government forces supported by international military allies, plunging the country into a new cycle of violence. The city of Bambari, in the Ouaka prefecture, has been the theatre of clashes since mid-December. So far, we have treated 111 war-wounded patients in Bambari since December 2020. The impact of the fighting on the Elevage Centre de Santé further compounds people’s suffering, limiting them from accessing healthcare for a full week, until damage has been repaired and medical activities have resumed again.

Beyond the direct victims of this violence, communities in Central African Republic in general are left with very limited access to essential medical services due to growing violence and insecurity. Over 200,000 people have already been displaced either inside or outside of the country and live in very precarious conditions.

We are working to ensure continuity of care in all our projects and have increased our surgical capacity to respond to the influx of casualties. We are also providing assistance to displaced people in the areas where we are present. MSF teams stand ready to support the Ministry of Health in coping with a potential surge in the number of war-wounded and to assist the displaced across the country.