Tuesday, October 06, 2009

Central African Republic: Highways and healthcare

Women at a site for internally displaced people in Kabo town. Prospects for peace in the area are looking up, the two rebel movements active in the area are nominally at peace with the government

Father Michel Ange Ningando was born and raised in Kabo; he left the town to pursue his studies but returned two years ago to head the local Catholic church.

“I remember this town when it was really something,” Ningando told IRIN. “As a young boy I used to go out dancing in the moonlight. You had everybody working in their fields. It was ‘Kabo the beautiful’ and it really counted for something. Now it’s something else.”

Kabo’s cotton industry has long since disappeared. The market is poorly stocked, although there are products from Cameroon, Chad and even Nigeria. Officials warn of growing tensions between local farmers and visiting pastoralists, arguing that access to land needs to be more tightly regulated.

However, the situation in town has improved. The hundreds of displaced who fled the fighting in 2007 and 2008 have left, their camp long dismantled. Security incidents have become rare. The international medical agency Médecins Sans Frontières provides free healthcare, crucial in an area where malaria is rife, along with intestinal diseases and respiratory infections.

The two rebel movements active in the area, the Democratic Front of the Centrafrican People (FDPC) and the Popular Army for the Restoration of the Republic and Democracy (APRD), are nominally at peace with the government. A major road-building programme is under way, backed by the Agency for Technical Cooperation and Development (ACTED), which Ningando believes will contribute to Kabo’s growth, bringing this part of the north in closer contact with Bangui, the capital. But Ningando warns it is too early to talk of a recovery.

“You have to remember that people have lived with this rebellion for five years,” Ningando emphasises. “Some have spent three years in the bush, coming out when they thought it was safe, returning when it became dangerous again. Nothing can be taken for granted.”

Peace prospects

Jonas Zininga, mayor of the nearby village of Ngoinikira, is more upbeat about prospects for peace. Clashes between the APRD and the army (FACA) in 2007 led to the evacuation of the village. “Everyone has returned now,” says Zininga. “People need help building their houses, replacing what was burned, but things are picking up.”

Zininga warns of serious disruptions to agriculture, arguing that production of crops like maize and millet will be down because of people’s lack of access to land in the recent past. But he talks confidently of reorganizing both farmers and pastoralists and acknowledges that ACTED’s road-building programme, employing hundreds of local labourers, is an important boost to the economy.

The APRD is still active in Ngoinikira. Patrice, 22, wearing a baseball cap, introduces himself as the local “brigade commander”, in control of 150 men, with five years of military experience under his belt. “The war is over now and we are waiting for disarmament,” he says, referring to the UN and government-backed disarmament, demobilization and reintegration (DDR) programme.

While Patrice argues that the APRD’s struggle was motivated in part by anger at the state’s chronic underdevelopment of the north, he talks also of a long battle against the Zaraguinas - bandits. “They were threatening our people and it is we, the APRD, that have brought them under control.”

The Zaraguinas are frequently cited as the main source of instability in the region. There are contradictory accounts of their origins and composition - described by some as “off-duty” soldiers and rebel combatants, by others as highly organized nomadic gangs from outside the region.

For Ningando, the APRD and FACA should now be working on a joint strategy to make the roads safe. “These forces are now at peace and they have young men capable of giving us protection,” says Ningando. “This problem has gone on for far too long and it is crippling our economy.”

Medical help

The road north from Kabo towards Chad is particularly vulnerable. The village of Bokayanga, 15km north of Kabo, witnessed fierce clashes between the FACA and the FDPC in April. Houses were destroyed, as was the local school. The village chief, Alphonse Soguina, deplores the conditions of his community, forced to live in the bush with no access to clean water, schools or healthcare. “We need security. The government has to give us that.”

Security problems on the road to Bokayanga have ruled the area off-limits to MSF’s mobile clinics, so villagers arrive on foot or by bicycle at the MSF-run hospital in Kabo.

Domiuta Kraton brought his two daughters to hospital. “They were tested for malaria and given medication. I was also diagnosed with malaria.” It is not a journey Kraton relishes. “There is always the risk of running into Zaraguinas. They will rob you, or if you have nothing on you they may assault you.”

MSF has been active in the Kabo region since 2006. Dozens of patients come every day to the hospital in Kabo, which includes maternity and paediatric units, while others visit outlying clinics in villages like Ngoinikira and Farasala. MSF is committed to building local capacity and each clinic is run by a local management committee.

Speaking for the health ministry, Gaetan Zabo-Zobel, who heads the health centre in Kabo, concedes that health structures were minimal before MSF’s arrival and that far fewer patients sought hospital treatment. He says information campaigns and training are playing a vital role in strengthening local capacity, preparing the way for MSF’s eventual departure and a guarantee of reliable health services in the future.

Disclaimer:This material comes to you via IRIN, the humanitarian news and analysis service of the UN Office for the Coordination of Humanitarian Affairs. The opinions expressed do not necessarily reflect those of the United Nations or its Member States.
Photo: Copyright IRIN

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