Far from international media attention, armed violence continues to rage in many parts of Central African Republic (CAR), forcing entire communities from their homes. 

In early 2022, the region surrounding the town of Ippy was the site of renewed clashes between rebel groups and government troops, causing thousands of people to flee their villages for Ippy town and nearby camps for internally displaced people (IDPs).

“When violence broke out, we fled to the neighboring village, but it was attacked too, and my three sons were killed,” said Jeremy, who moved with his wife and children to Ippy’s Yetomane site, 25 miles from his home. “We buried them in a mass grave and set off again. Since then, I have not been able to sleep.” 

Olga and Jean-Claude traveled more than 80 miles with their six children to reach the Bogouyo IDP camp.  

"We walked for a week, with old people, children and sick people," they explained. "Some died along the way, and we were forced to abandon their bodies in the bush without being able to bury them. They were only covered with grass. The children saw it all. How will they forget such images?”  

MSF’s immediate response 

In February, Doctors Without Borders/ Médecins Sans Frontières (MSF) sent an emergency team to Ippy to provide medical support to vulnerable people like Jeremy, Olga, and Jean-Claude.  

"As essential needs were not met in the sites, our first priority was to limit the risk of hygiene- and water-related diseases," said René Colgo, MSF's head of mission in CAR. "In the emergency phase, we built 269 latrines, installed water points and organized distributions of soap and jerry cans.”  

The installation of water points increased access to drinking water from just 1.6 liters per person per day to 15 liters. When other organizations arrived and took over the management of these facilities, MSF teams focused their support on two local health centers. 

"Basic health care was available for displaced people, but the most complex medical cases needed better care, especially for children and pregnant women, who are particularly at risk," said Colgo. "We therefore provided staff and equipment to strengthen pediatric and neonatal services, management of pregnancy complications, and refer patients to these care facilities.” 

In just two months, 381 children were hospitalized with MSF support, primarily for severe malaria. Our teams also provided medical care for 31 women with pregnancy complications, performed 20 C-sections, and referred a dozen patients to Bambari for more critical care.  

In early May, MSF launched a vaccination campaign to provide basic protection for diseases including measles, polio, yellow fever, meningitis and tuberculosis for nearly 20,000 children under the age of 10, and  9,000 pregnant women. Based in Ippy town, the vaccination drive also included immunization against COVID-19 and will continue until July.  

Needs in Ippy remain massive 

The situation has slightly improved in Ippy and some residents have started to return to their villages or settle in town. But in an area troubled by years of chronic insecurity and displacement, people’s  futures remain uncertain.  

“How can I talk about the future when I don't even know if we are going to eat today,” said Jean-Claude. "Our future is very vague, but we hope to return to our village one day, to start life again.”  

Olga is less hopeful about returning. “There is nothing left there, and we live in fear of being attacked or getting sick. The nearest health center is more than 25 kilometers [15.5 miles] away from the village. My children have never been vaccinated. I don't even know if any of the children in the village have ever been. I can't see myself going back.” 

"We are herders, but we [lost] all our animals when we fled the village,” said André, who lives with his family at the Foulbé site. “And here, we can't farm because wherever we go, someone comes to tell us that we are on their land and chases us away. We can’t even pick up wood or leaves. What will become of us?” 

The medical humanitarian needs in Ippy speak to a wider issue across CAR, where decades of intermittent conflict have fueled one of the world’s most critical situations in terms of maternal mortality, malnutrition, and lack of access to health care. Life expectancy in CAR is the lowest in the world, at just 53 years old, as of 2019. According to the latest UN figures, almost 30 percent of people in CAR are now either refugees or internally displaced, and more than 60 percent need humanitarian assistance.  

“While people are leaving sites, the needs remain massive in the area,” said Colgo. “Way before the latest waves of displacement, access to health care services and water were already limited in Ippy. The recent events have further exacerbated this situation. Many are destitute, with no means to pay for health care or food. Some are traumatized by the physical and sexual violence suffered during their journeys, or by the living conditions in the sites. Sustained support is clearly needed.”