The Central African Republic (CAR) is one of the poorest countries in the world and among the ten poorest countries in Africa. Years of misrule, violence between rebel groups and government forces and the ongoing activities of bandits have left its population extremely vulnerable.
Acute malnutrition among children is increasing at an alarming rate. Maternal mortality is among the highest in the world and less than a third of under-fives are fully immunised against common childhood diseases.
The health infrastructure is particularly weak, with severe health worker shortages, demotivated staff and dilapidated health facilities. For example in Bouar hospital, just 24 health workers serve a population of 250,000. None of the staff in Bouar have received a salary since 2007, and some have not been paid since 2005.
HOW MERLIN IS HELPING
Merlin has been working in the Central African Republic (CAR) since October 2007 and has significantly improved the quality of health services available in our project catchment areas. We have rehabilitated 15 health facilities, provided drugs and medical equipment and improved the skills of health workers through training and supervision. As a result, the number of people using health facilities has risen considerably over the two year period.
In response to the acute food shortages, we added a nutrition component to our programme in 2008. Over 100 community members have been trained to identify and refer patients who are suffering from acute malnutrition and are supporting local health staff to be able to do this.
Addressing the health worker crisis
Merlin is addressing the health worker crisis in CAR by providing training to staff on safe delivery, rational prescription and accurate disease diagnosis. We are also strengthening Ministry of Health (MoH) capacity, providing technical and managerial support, training local management committees, and helping to put in place a system of incentives for health workers.
As part of our Hands Up for Health Workers campaign, we are highlighting how the severe lack of health workers in CAR is affecting the country’s ability to get back on its feet. Get involved in our campaign for health workers here…
Rehabilitating and supporting health facilities
Merlin is supporting 11 health facilities in Nana Gribizi, providing free primary health care for more than 5,000 people every month. We have also rehabilitated nine health posts and two health centres, repairing damage caused by years of neglect and conflict. In Nana Mambere, Merlin supports three free primary health centres that serve a population of 75,000 people, and is currently rehabilitating these health centres, including the construction of latrines and incinerators, securing a clean water supply, alongside general building work.
Supporting the delivery of primary health services
Merlin supports the delivery of primary health services by increasing the overall capacity of CAR’s Ministry of Health and its staff. Through these activities we can also assist the MoH in identifying the health needs in the areas where Merlin has a presence. We have also taken part in various vaccination campaigns.
Nutrition programme
We are providing free health care, drugs and staff training to reduce the prevalence of deaths caused by malnutrition in children under five and pregnant and nursing women.
Key achievements
- Continuing to support 11 health facilities serving 65,820 people in Nana Gribizi
- Leading the campaign against a meningitis outbreak in Nana Gribizi in January 2008. In collaboration with the World Health Organisation, Merlin staff prepared a plan and vaccinated more than 38,000 people in the project area. Merlin also trained health workers to help respond to this epidemic
- Three training programmes completed for Ministry of Health workers on nutrition, HIV/AIDS and maternal health
- Started a programme in Nana Mambere in July 2008 providing comprehensive primary health care at three health centres to a population of approximately 75,000 people
Donors supporting Merlin's work
UNICEF, CHF, CERF
Read more about CAR
Field diary: Forced to accept the unacceptable in CAR
10 Aug 09: Lydia Cordier is project assistant in Bangui, Central African Republic. Here she describes a recent trip to Dissikou health centre with Merlin medical supervisor Olga.
Malnutrition in CAR: "Now I know that we are all at risk"
12 Mar 09: In Ndomete, a village in northern Central African Republic (CAR), lines of women and babies occupy the benches in front of the health clinic. Patricia Kakuamba, 23, is waiting to see the nurse who will examine the progress of her young children, Martine and Gus. Both suffer from malnutrition.
First MP to ever visit CAR outlines appalling humanitarian situation
18 Dec 08: Brooks Newmark MP recently visited the Central African Republic - the first British MP to do so - to find out the true cost of a neglected health system.
Let's put our hands up for the Central African Republic
8 Sep 08: After a decade of coups, rebellion and conflict, find out how Merlin is helping the Central African Republic, and its health service, recover.
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