Central African Republic
In the Central African Republic, Cap Anamur is expanding the Bossembélé hospital into an interdisciplinary clinic. A team of doctors also provides care for the patients and trains local staff.
The Central African Republic is one of the poorest countries in the world. Access to medical care is severely limited, especially in rural areas – a situation that worsens dramatically during the rainy season.
Our project coordinator Ole travelled to the prefectures of Ouaka and Basse-Kotto in August and September to see the situation for himself. Even the journey there shows how difficult it is to reach these remote regions: during the rainy season, it takes around eight hours to cover just under 200 kilometres. Roads turn into muddy gullies, vehicles get stuck repeatedly, tyres spin. Cars have to be pulled out of the mud or detours have to be found time and again. Rivers can often only be crossed with rickety wooden ferries that can only accommodate two vehicles. Sometimes materials have to be transported across rivers in dugout canoes because the land route is impassable.
Ole describes: ‘You drive a few kilometres, get stuck, everyone gets out. Once the car has been pulled out, you continue. Before the next impassable section, the water depth is checked before crossing, everyone gets out, then at some point you continue. That’s what a whole day of travelling looks like.’
This has dramatic consequences for the rural population: even a short journey to the nearest hospital becomes a day-long trip – if a suitable vehicle is available at all. And even if one is found, the cost is prohibitive for many families. A trip by motorbike or car can easily cost several times the average monthly income.
‘I have met families who simply have no choice. They know their child is seriously ill – but they cannot afford the journey.’
These difficult conditions have a direct impact on medical care:
- Supply shortages: Medicines and supplies from the capital Bangui often reach facilities only after long delays, if at all. Stocks of antibiotics, HIV and tuberculosis medicines, and specialised nutrition for malnourished children are depleted in many places.
- Overworked staff: In remote districts such as Kouango, Alindao and Mobaye, there are often only one or two doctors working. They not only treat patients, but also take care of all the logistics – from procuring petrol to transporting urgently needed medicines.
- Births and emergencies: Many women continue to give birth to their children at home. They only seek help at a clinic if complications arise – often too late due to the difficult journey, which is often only possible by motorbike. Fractures cannot be treated, and transfers to the capital Bangui are often impossible due to poor roads or high transport costs.
During the rainy season, all these problems are exacerbated: ambulances are unable to reach their destinations due to flooded roads, medicine deliveries get stuck in the mud, and entire regions are left to fend for themselves for weeks on end. ‘During the rainy season, villages are cut off from the outside world for days on end – no doctors, no medicines, no help. You can only imagine what that means in an emergency,’ says Ole
At the end of his journey, he sums up: ‘Sometimes it takes almost a whole day to travel less than 200 kilometres – and even then, it’s not certain that you’ll get there at all. For the people here, this means that those who are ill often have no chance of getting medical help in time. Seeing this reality makes it clear how urgently our support is needed.’
Cap Anamur supports a local district hospital and is committed to ensuring that medical care is also available in remote regions of the Central African Republic. Despite impassable roads, a lack of infrastructure and adverse conditions, we stand by the local people.