Central African Republic: a State of Silent Crisis

Central African Republic is one of the world's forgotten health crises. In the beginning of 2012 MSF issued the report Central African Republic: a State of Silent Crisis, which indicates the serious medical situation in CAR. The country is in a chronic medical emergency with mortality rates exceeding what is considered to be the “emergency threshold”.

Looking at a country like CAR, where the structural shortcomings of the health system are appalling, makes it necessary to touch upon the ongoing discussion on MSF's operational priorities. These are outlined in the OCB Prospects 2011 – 2013.

Even though OCB has no operations in Central African Republic, this type of context can be identified as an area of sustained attention as depicted in the Prospects. The operational challenges included in the areas of sustained attention are maternal and child health, vaccinations, malaria, HIV/TB and neglected diseases such as Human African Tripanosomiasis (“sleeping sickness”). The section describing the areas of sustained attention, along with the key areas of increased attention, such as surgery interventions and hospitals, outlines the various areas in which OCB plans to operate. This means that on the one hand nobody will ever question the presence of MSF in a country like CAR, where health systems are failing and national and international interest remain low or even decrease. On the other hand, looking at the OCB operational budget for 2012, a third of the money is dedicated to HIV/Aids and another third to hospital projects, which leaves only a third of the budget for all other activities. How does this stem with the unmet needs of CAR? Are we also at risk of forgetting crises like CAR in favor of new and more costly activities?

While this important debate goes on as the movement continues to debate the vision, our members in the field keep on working in and facing the daily realities.

Concluding with the words of Kristina Bolme Kühn (president of the MSF-Sweden Association) "[...} CAR is the perfect first MSF mission; a rural area where the needs are enormous, there’s nobody else out there and wherever you put your finger, you will make a difference. It’s a project at the heart of the organization! ".

By: Association Intern