After decades of political violence, displacement and insecurity caused by clashes between rebel groups and government forces, as well as armed bandits, thousands of people in Central African Republic (CAR) are vulnerable to disease and have little access to health services, aid agencies say.
According to the UN Office for the Coordination of Humanitarian Affairs(OCHA), many health centres in the north and southeast of CAR are either looted or not operational because medical workers are often compelled to leave the area. Since 2008, the government has spent only 1.5 percent of GDP on public health, hence its dependency on some 19 medical NGOs to provide drugs and medical equipment and improve the skills of health workers.
Malaria remains the leading cause of morbidity, accounting for 13.8 percent of deaths. There are resurgent meningitis outbreaks as well as other communicable diseases such as wild poliovirus, measles and yellow fever but the principal afflictions are water-borne, skin and respiratory diseases.
The Consolidated Appeal report 2011 states that only 30.5 percent of the population (28 percent in urban and 32 percent in rural areas) have access to safe drinking water , while the Food and Agriculture Organization (FAO) says that with rural agricultural production abandoned in many areas due to insecurity, farmers do not have access to productive capital, having lost seeds, tools and harvests when forced to flee. Sixty-seven percent of the population live on less than US$1 and thousands are food-insecure or living on aids agencies.
According to the UN Children’s Fund, 16 percent of children under-five are acutely malnourished, while 6.6 percent are severely acutely malnourished, but there are only 25 therapeutic feeding centres and 60 outpatient facilities, covering one-third of the cases that would have to be managed.