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Humanitarian crisis in central Africa

By Mike Thomson
Today programme

While much of the world's attention has been focused on the plight of the civilians in Sudan and Congo, a humanitarian crisis has been unfolding in a country which borders both those lawless nations.

Two refugees from Darfur
Refugees from Darfur have come to the Central African Republic in search of food and security
The Central African Republic has seen more than 300,000 people forced from their homes over the past three years, due to civil war and attacks by armed bandits.

Many remain in the bush too frightened to return. One in five of the nation's children never reach their fifth birthday and the percentage of women dying in childbirth is amongst the highest in the world.

In many areas of the country, only parts of which the government controls, there is little or no health care and the average life expectancy has fallen to just 42.

Despite the Central African Republic's potential wealth - uranium deposits, diamonds and other mineral resources - donor nations are reluctant to provide the investment it needs. Corruption is rife.

The maternal mortality rate is the second worst in the world, worse than Darfur
Jean-Sebastien Munie
Violence is endemic. Victims tell of bandits carrying out wholesale killings in some of the villages they attack.

One father of four, Zaoro Joseph, told of bandits killing eight people in his village and beating those that remained.

But when the government soldiers came to chase the bandits away, they robbed and burned the village too.

"They even took things the government had recently given us. They left us with nothing," he says.

Rebel leaderAwash with gunsWarlordAbandoned villageWidow villageHumanitarian disaster Read Mike Thomson's reports from Central African Republic

International aid agencies say helping victims of such violence is not easy. Simon Ashmore, country head of the International Committee of the Red Cross, says people in Central African Republic are victims of "successive waves of violence".

Logistical difficulties

There are only 500 miles of paved roads in an often lawless country that is bigger than France.

"Logistics in a country with an infrastructure like we have here is very difficult," he says.

"Coming here today we got over one of the bridges but we're convinced we can't get back over it." Before distributing the aid, he was forced to ask the chief to get young men to remake the bridge.

Hunger and disease contribute to high mortality rates. A fifth of children die before the age of five. In Bossangoa, five hours drive north of the capital, malnutrition is rife. One in 10 of the children who reach the emergency feeding centre run by Unicef die. In remote areas, mortality rates soar.

Child at feeding centre in Bossangoa
Acute malnutrition affects up to a third of all children
Jean-Sebastien Munie, who is head of the country for the UN's Office for the Co-ordination of Humanitarian Affairs, says: "The maternal mortality rate is the second worst in the world, worse than Darfur.

"They are also exposed to recurring meningitis, yellow fever and other infectious diseases which are not seen anywhere else in the world."

In Bossangoa, a clinic attempts to treat those suffering. Around 60 people, mainly women and young children, wait for food or emergency medical help.

But in areas outside government control, medical facilities vanish; while the numbers of men carrying weapons grows.

Deep in rebel territory, a clinic run by the aid agency Merlin, is overseen by Dr Diana Gulu. It is one of the only places offering basic healthcare and was set up after months of negotiation with rebel leaders.

"Some areas don't even have roads. You saw the evidence when you were coming," says Dr Gulu.

"They walk [to get here] - some of them for 72km to get here. Most of them are dying on the road."

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