Medical aid charity says mortality rates in some areas three times the emergency threshold
LONDON (AlertNet) - Neglected Central African Republic is in the grip of a chronic medical emergency with people dying in unacceptable numbers, Medecins Sans Frontieres (MSF) said on Tuesday.
Hemmed in by Democratic Republic of Congo, Republic of Congo, Cameroon, Chad, Sudan and South Sudan, the country has the second-lowest life expectancy in the world, at 48 years, and the fifth-highest death rate from infectious and parasitic diseases.
Four mortality surveys carried out by MSF in the last 18 months showed mortality rates in some regions of the country far exceeded the emergency threshold – measured as one death a day for every 10,000 people, and two deaths a day for every 10,000 under-fives.
For example, it said last July, the mortality rate for children under five in Carnot, in the west of the country, was three times as high as that among under-fives in Kenya's Dadaab refugee camp.
The international medical charity said mortality rates at this level indicated the situation was "out of control" and it called on donor countries, the government of CAR and other aid groups to do more to help the country's 4.4 million people.
"What we found in CAR with these mortality numbers is that normal is unacceptable ... normal itself is pretty damn bad," said Sean Healy, MSF humanitarian affairs officer and the author of Central African Republic: a state of silent crisis.
"While amongst the humanitarian community (CAR) is not as neglected as it might have been 10, 15 years ago – then there was virtually no presence whatsoever – there's still nowhere near the scale that is needed to tackle the needs that we see."
MSF said CAR risked becoming trapped, with the outside world not considering it urgent enough for significant emergency aid or trustworthy enough for meaningful development assistance.
PHANTOM HEALTH SYSTEM
MSF, which has worked in CAR for the last 14 years, said the massive prevalence of preventable diseases such as malaria, which infects every person in CAR at least once a year, contributed to the high mortality rate.
Other major killers included tuberculosis, HIV and the more unusual sleeping sickness, a tropical disease transmitted to humans by the tsetse fly.
MSF also blamed conflict and displacement for the crisis.
CAR has endured years of misrule since independence from France in 1960 and a mix of local rebels, bandits and the spillover of conflicts from its neighbours have thwarted efforts to stabilise the nation.
Seven out of the country's 17 prefectures are plagued by conflict. Besides that, 10 armed groups roam the country, which has also been terrorised since March 2008 by the rebel Lord's Resistance Army (LRA).
Despite the dire level of needs, government spending on health fell between 2001 and 2009. MSF said health spending was only $7 per capita per year, the fifth lowest in the world.
"Many parts of the health system are almost completely non-functional outside of the capital," Healy told AlertNet in a telephone interview.
"At the political level, I do think there could be more done to prioritise the health of the population," he said.
"That is what we're saying with this report, that the government of CAR even at the level of the president himself should be looking more carefully at this situation and planning how to boost investment."
President Francois Bozize, who took power in a 2003 coup, was re-elected in January this year.
(Editing by Rebekah Curtis)
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