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CAR: MSF vaccination campaign begins in the country's largest camp
This week sees the start of a mass vaccination by Médecins Sans Frontières / Doctors Without Borders (MSF) for 18,000 children living in the Internally Displaced Persons (IDP) camp in Batangafo, the largest in northern Central African Republic (CAR).
MSF aims to vaccinate at least 18,000 children up to the age of 15 against measles and polio, as well as provide vitamins and treatment against parasites.
Preparations for the vaccination campaign, initially scheduled for next month, have accelerated after suspected cases threatened to unleash an epidemic among children in the camp, where the population has not stopped growing since last August. The vaccination targets more than 16.000 children in the camp and around 2.000 more in the few families still living in their houses in Batangafo. The camp, now with a population of around 35,000 people has become the largest in the country.
Ongoing fighting has forced mass displacements
A series of armed clashes that took place in the summer of 2014 in Batangafo forced hundreds of people to flee their homes, seeking protection in the IDP camp, which is located between the hospital and international peacekeeping headquarters.
Armed militias continue to attack and loot homes in the region, forcing even more residents out of their homes and into make-shift huts in the camp. Today, Batangafo’s neighbourhoods appear deserted.
Numbers in the camp continue to grow as residents from the surrounding areas outside Batangafo move in, seeking refuge not only from militia violence but also from attacks by the nomadic shepherd communities in the north.
While friction between nomadic and static communities over land at the end of the rainy season is common, the current state of war in CAR has exacerbated this fighting. Thousands of residents are being forced to flee armed nomadic groups that are becoming increasingly violent.
Overcrowding in the IDP camp poses a risk of an epidemic
The unstoppable growth of the Batangafo camp, initially prepared for 12,000 people, is pushing the limits of the area of the camp (about two square kilometres), which increases the risk for the displaced people’s health.
"Overcrowding is a major risk factor for the occurrence of diseases in the camp," says Carmen Terradillos, medical coordinator for MSF in Batangafo. "In addition to starting the vaccinations, we are strengthening our hospital resources in case we see an increase of consultations. So far, there has been no large increase, partly because the first priority for many families is to find food for the day, so when someone is sick they don’t bring them to the doctor until their condition is severe."
In order to try and avoid that situation, MSF is enhancing health promotion activities among the displaced, and medical staff will start surveillance visits to the IDP camp.
Lack of security keeps people stranded
Displaced people in Batangafo say the same thing again and again: they will not leave while there is no security for them, even though the rainy season will arrive within a couple of months. The huts are not prepared for the rain and many of them are located in areas where water will stagnate.
Brigitte has been living for months in the Batangafo camp with her husband and five children.
"We will not move until the militias that attack us incessantly are disarmed," says Lea Nukofio. She is 59 years old and cannot remember having seen such a level of violence in the country ever before.
She has spent the last two years fleeing militia attacks with almost one hundred people from her village, Kambakota, located about 50 kilometres west of Batangafo.
"We will not move from here until their weapons have been removed," she adds emphatically.
Challenges to the work of MSF in the IDP camp
The daily arrival of dozens of people from the areas surrounding Batangafo shows that insecurity prevails throughout the area. MSF has five health posts in the periphery of this village, but the lack of security makes it impossible to manage the outposts and prevents thousands of people from receiving basic health assistance in the region.
"These people are in an extremely vulnerable situation, even worse than those in the IDP camp. They have virtually nothing," says Terradillos. "If there is no security on the roads we cannot provide essential medical attention," adds Stella Aprile, deputy head of mission for MSF in the country. She explains that in northern CAR you find "all the typical diseases in the country, such as malaria, respiratory infections and conjunctivitis, and they all remain undiagnosed and without attention if we cannot intervene."
MSF in Central African Republic
MSF has been working in the Central African Republic since 1997 and currently has more than 300 international and 2,000 Central African workers in the country. Since December 2013, MSF has increased its medical projects from 10 to 20 in response to the crisis, and is carrying out six interventions for Central African refugees in neighbouring Chad, Cameroon and the Democratic Republic of Congo.
In Batangafo, MSF manages the general hospital (165 beds) and supports five health centres in the periphery. Between December 2013 and the end of 2014, more than 37,000 people were provided medical assistance in the area and more than 500 surgeries were performed.