Central African Republic:
the lost country

The collapse of the country after more than a year of violence

Médecins Sans Frontières

The free fall continues

Two years after the coup that triggered the spiral of clashes and retaliation between rival militias, the violence continues to claim the lives of many people in the Central African Republic. There are still nearly one million displaced persons and refugees, many of them outside of the areas which humanitarian aid can easily reach. Homelessness and poverty are increasing while agricultural activity cannot be carried out as normal, and the people are more divided and polarised than ever as a result of the violence.

With a scant population of 4.5 million of people it is one of the poorest countries in the world

With a very low life expectancy 50 years for men and 52 for women

With only one doctor for every 55,000 people

Representative graph of number of inhabitants per doctor

and one midwife for every 7,000, an estimated 130 children out of 1,000 will not reach their fifth birthday, due to malaria, measles, meningitis or malnutrition.

Almost a million people from the Central African Republic are still too scared to return home.

454.000 refugiados /  437.000 desplazados internos

Data March 2015 - Source OCHA

Most of the country’s hospitals and health centres have been destroyed or damaged.

454.000 refugiados /  437.000 desplazados internos

Beginnings of the conflict

Seizing power in a March 2013 coup d’état, the Séléka armed coalition violently abused the civilian population. The subsequent creation of community self-defence militias called the Anti-Balaka also led to abuses, especially against Muslim communities they accused of being complicit with the Séléka.

Over one year later, thousands of people are dead and wounded, at least one million people have been displaced, homes, farms and livelihoods have been destroyed, and CAR’s population is now polarised between Muslims and Christians.

1 Conflict evolution

2012 December - 2013 March

Rebellion accomplished

At the end of 2012, the Séléka coalition, comprised of several armed groups including soldiers from the northeast, as well as Sudan and Chad, denounced the neglect of the northern regions by CAR’s President François Bozizé.

In just a few weeks they took over most of northern CAR. The Libreville agreements, which set up a transitional government, were signed in Gabon on January 11, 2013.

The rebels continued to control most of the country, from Kaga-Bandoro, Sibut, Alindao, Ndélé, Bria, Bambari and Soam Ouandja. The national army, few in number, disappeared from the north.

2Conflict evolution

March - September 2013

SÉLÉKA Territory / ANTI-BALAKA Reaction

The Séléka occupied Bangui and deployed across CAR, and Michel Djotodia became the new president. From an initial 5,000 men, the Seleka grew to an estimated 20,000 men, joined by unemployed Christian and Muslim youth as well as newly released prisoners and mercenaries.

As widespread abuse and atrocities by armed men against civilians were reported, Djotodia ordered the dissolution of the Séléka to distance himself from the accusations. However, the violence continued and the Anti-Balaka militias emerged, first attacking Bouca and the outskirts of Bossangoa.

The displaced population increased to the hundreds of thousands. MSF drafted its first report deploring the lack of humanitarian aid.

3Conflict evolution

October - December 2013

Expanding terror

The fighting between the Anti-Balaka and Séléka prompted a massive displacement of CAR’s population into the bush.

The first large IDP camp was set up inside the Catholic mission compound in Bossangoa. Many IDPs stayed just miles from their homes, but could not return for fear of being killed. Villages within one hundred kilometres from Bossangoa were totally abandoned. They would not come back to life until the protection of the communities was guaranteed, and people felt safe to return and resume farming.

Meanwhile, the Anti-Balaka militia started to target the Seleka as well as Muslim civilians.

4Conflict evolution

December 2013

The battle of Bangui

The Anti-Balaka militias attacked Bangui and grew strong on three fronts; in the Boy Rabe, Boeing, and PK12 neighborhoods of Bangui. The Seleka fought back and targeted people they believed to be Anti-Balaka.

Séléka and Anti-Balaka fought from neighbourhood to neighbourhood and in just one month 1,000 people are estimated to have died from the fighting.

Up to 1,400 French reinforcement troops as part of Operation Sangaris arrived while the African Union presence, called MISCA, had 3,600 troops on the ground. The Sangaris and MISCA initially disarmed the Seleka militia, which enabled the Anti-Balaka to gain territory.

5Conflict evolution

January - May 2014

CAR divided

President Michel Djotodia was summoned to N’Djamena. He was forced to resign due to his inability to control his men, now called the ex-Séléka, and his failure to prevent the emergence of Anti-Balaka groups, suspected of being partly supported by the former President François Bozizé.

Anti-Balaka militias now controlled the western part of the country. The Séléka withdrew from Bangui and western CAR.

In the west, Muslim communities were trapped inside about 20 neighbourhoods, threatened by the Anti-Balaka controlling the area and unable to flee to Cameroon or Chad. Many sought shelter in mosques and churches. In Bangui, Muslims were attacked by the Anti-Balaka and the Christian population, with many killed. Protected by international forces, they eventually moved out of Bangui to Chad, Cameroun and to the east.

Between January and May of this year, the Muslim population in Bangui was reduced from 100,000 to 2,000. The ex-Seleka remain in control of eastern CAR, and fears of a possible partition following ethnic and religious lines are rekindled.

6Conflict evolution

June 2014 - May 2015

The never-ending flight

The new transitional government appointed in January 2014 was commissioned with preparing the country for elections in 2015. A massive humanitarian campaign is launched but so far it has not reached all corners of the country and focuses on Bangui.

A ceasefire agreement signed in Brazzaville (Republic of Congo) in July 2014 between representatives of Seleka and Anti-balaka soon came to nought as it was invalidated by dissident factions on both sides.

In late 2014 the UN began to deploy a 12,000-strong peacekeeping force, the largest international contingent in the country's history. However, the Seleka and Anti-balaka militias continue to be armed and active.

Fighting between these groups and the peacekeeping forces has been common in the past year in places like Batangafo, Ndele, Bria and Bambari; and the country's de facto division is maintained. Moreover, abuses by armed groups against civilians have not subsided. Fear is still a part of daily life for Central Africans, and the number of refugees and displaced persons has not fallen. There were 900,000 in April 2014 and this number has not changed one year later despite a decrease in armed clashes. Many thousands of people are in IDP or refugee camps in enclaves within cities such as Bangui, Berberati and Carnot; but many more have fled to the forests and are in an extremely vulnerable situation.

Homelessness and poverty are increasing among many of the inhabitants of the CAR, and the public is more divided and polarized than ever as a result of the violence.

More information

MSF started working in the Central African Republic in 1997 and has been warning about the difficult medical and humanitarian situation endured by the population ever since.

In 2011, MSF published a paper called CAR: The Silent Crisis, reporting the neglect the country was suffering and the reduction by the government and donors of their investment in public health. In this report, MSF included various surveys carried out in different provinces in the country registering mortality rates well above the emergency threshold.

In July 2013, in the midst of the emergency due to the conflict and following the coup by the Séléka, MSF published another report called CAR: A Forsaken Country Left to Fend for Itself. In this report, MSF spoke out for the first time about the lack of humanitarian aid in an already fragile country and at a time when its vulnerability was highly visible. The report was followed by an an open letter to the United Nations criticising their inaction.

In March, MSF published a summary of its experiences in CAR during the year following the coup.

Later that year, the study entitled Suitcase or Coffin Conducted among groups of refugees from the Central African Republic in Chad showed the enormous violence they suffered while fleeing their country. A retrospective analysis showed that around 10% of the population studied died en route to exile during the campaign of persecution against the country’s Muslim minority and almost all of the deaths were caused by the violence.

Click here for more news about CAR.


MSF has been working in the Central African Republic since 1997 and currently has more than 300 international staff and more than 2,000 Central African workers in the country. Since December 2013 and in response to the crisis, MSF has doubled its medical projects and currently runs around 20 projects, including several for Central African refugees in neighbouring countries such as Chad, Cameroon and the Democratic Republic of the Congo.

Despite the difficulties associated with our assignments, in 2014 MSF teams carried out 1.3 million outpatient consultations, the majority related to malaria, and more than 13,000 surgical procedures.

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Texts: Lali Cambra and Pau Miranda
Pictures and videos: Juan Carlos Tomasi, Marta Soszynska, Louise Annaud, Jana Brandt and Pau Miranda

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