Field Notes: The View from Camps in Central African Republic

"After nearly 20 years in humanitarian assistance I thought I was almost unshockable..."
Children in CAR
Conditions in camps for displaced residents in Central African Republic are frightening. Photo: ACF-CAR, S. Dock

Editor's Note: Mike Penrose, Executive Director of Action Against Hunger in France, recently visited a series of camps for displaced persons in and around Bangui, Central African Republic. The following are excerpts from his dispatches from the field.

After nearly 20 years in humanitarian assistance I thought I was almost unshockable, but the living conditions in some of the camps in the Central African Republic are as bad as I have seen or heard about. The sanitation situation is appalling, and there is next to no camp management or organization. These aren’t the refugee camps you see on television, like Zatari in Jordan, or Daadab in Kenya, with orderly lines of tents, medical clinics, latrines and food distribution centers. These are chaotic and ad-hoc settlements, with no refuse collection, little sanitation, and poor medical services. These are rubbish dumps on which people have to live.

While NGOs like Action Against Hunger are doing what they can to provide the basics of hygiene, sanitation and nutritional support to the most vulnerable, there is much, much more that is needed. The latest estimation of Severe Acute Malnutrition or SAM (the kind that kills) is currently around 5%. The overall level of malnutrition is estimated to be much higher. To put this in perspective the global threshold for declaring a malnutrition emergency is 2% SAM.  This means in the camps around Bangui and Bossangoa that one child in 20 of the children surveyed is at imminent risk of death. Many more are malnourished. The security situation is challenging, but NGOs like ours are able to access many of the most vulnerable children. We need the resources to do it. We need money, and we need it quickly. As was rightly publicized by the UN recently, this is a real and present humanitarian crisis…

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Having written about how bad the camps are here in the Central African Republic, it is probably a bit strange to now mention that there is something good about them, but when compared to many others I have seen there is one thing that is really quite positive. Unfortunately this positive aspect is also masking a real health and nutrition time-bomb.

" the camps around Bangui and child in 20 of the children surveyed is at imminent risk of death. Many more are malnourished."

Despite there being limited clean water, food, sanitation (one latrine per 1,000 in many camps, compared to the humanitarian standard we all strive for of one for 50), high levels of rubbish, poor healthcare and no organization, they are at least dry. It is hot here in Bangui, sometimes 86-95 degrees, and this means the sewage stays in the few latrines that have been dug, and children stay dry.

In many refugee and displaced camps around the world the biggest child killers, and the cause of the majority of malnutrition, isn't an absence of food, it is respiratory infections (caused mainly by the damp and cold) and diarrhea (often caused by poor sewage management).  These diseases take already undernourished children with lower than normal immune systems and turn them into severely malnourished clinical patients at risk of death in a matter of days.

The camps I have visited today and over the course of this week don't have high levels of these illnesses, yet. Unfortunately in between six weeks and two months the rains will come. These rains will cause children to get damp, the sewage that will be piled high in the overused latrines will spill out, and children will begin to cough and catch infections...If we are to prevent this we need to start preparing for the worst…

And we need you, our supporters, to help us help the children here. The UN estimates nearly half of the four million residents have been affected by this crisis, and one million are already displaced or are refugees. Together, we can ensure that 'very very hard' doesn't mean fatal for many of the most vulnerable. Especially children.

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About Mike Penrose

Mike Penrose

Mike Penrose is the Executive Director for Action Against Hunger in France.