Central African Republic: a forgotten country

According to the UNICEF report 'Crisis in the Central African Republic', 43 000 children are severely malnourished. In total, two out of three children in the country are in need of humanitarian aid, that is one and a half million, and that figure continues to rise. The Central African Republic ranks last in the Global Hunger Index, behind Chad and Yemen.

In order to tackle some of these harrowing problems, the Brothers of Charity are active in Bangui, the capital of the Central African Republic (CAR). They provide community based psychosocial care for children with post-traumatic stress disorders (PTSD) and psychosocial care and guidance for prisoners.

Violence and trauma

Decades of political instability, natural disasters and violence in the Central African Republic (CAR) have resulted in the destruction of the national economy, the weakening and almost total implosion of state institutions with disastrous consequences for the impoverished and highly traumatised population.

The precarious situation in CAR took an even more dramatic turn after the coup d'état in March 2013, when the conflict escalated into unprecedented violence between armed groups. Even after a new electoral cycle in 2016 and a new government, the overall security situation remained extremely precarious. In 2018, the violence flared up again in all its intensity.

The weakest - the children - are the first to suffer, as you can see in the pictures below.

Shocking lack of mental health care

The WHO describes the catastrophic state of mental health care in CAR in 2017 as follows: “24 beds, 2 psychologists, 2 nurses, 1 social worker, 1 part-time doctor: all mental health care in Central African Republic” - Dr. Kette, Coordinator of Mental Health Care CAR.

The response of the Brothers of Charity

1. Community-based psychosocial care for children with PTSD in Bangui

In the same region of Bangui, where the lack of mental health care (as in the whole of CAR) is particularly distressing, the Brothers of Charity - with financial support from the King Baudouin Foundation and the Grauls Fund (Belgium) - started in 2015 an outpatient psychiatric clinic with a focus on children and adolescents with post-traumatic stress syndrome (PTSD). This is the first phase in a broader plan for the organisational development and anchoring of professional mental health care in CAR.

In accordance with current scientific insights in terms of humane and expert psychiatric care, maximum use is made of the concept of a rehabilitating and integrated 'community-based approach'. A strongly developed outpatient work, an active involvement of the family context and an outreach approach to the local communities, especially with regard to the general image of the mentally ill, are important pillars in this respect.

There are intensive training courses for both employees and family members and psycho-education via various channels: in schools, in the local communities (photo, January 2019), through radio programmes, etc.

These psycho-educations are strongly based on the 'strength-based' principle, in which a conscious and active appeal is made to the respectful reinforcement of the competencies that are already present, both on an individual level and within groups and communities.

Thus, the positive resilience of the local community and the competencies regarding the constructive approach to psychological problems are reinforced by a clear bottom-up approach and strong local anchoring, in which the child or the young person with psychological problems, within the own family and the community, is central.

2. Psychosocial care and counselling for prisoners

Since the decision to open a local community in Bangui in 2010 and to train local candidate Brothers, the local archbishop's concrete request for the development of social and pastoral care in the central prison for men in Ngaragba (Bimbo) has also been met. Through an agreement on 16 September 2011 between the Congregation Brothers of Charity, the national government of CAR and the archdiocese of Bangui, a provision was built with modest means to offer psychosocial help, encouragement and support to the more than 700 prisoners, who lived in inhumane living conditions.

In the prison of Ngaragba, this daily presence of the Brothers has been extended with a small pharmacy (with periodic delivery of medication) and a small nursing post. Since 2015-2016, a specific form of psychotherapy (individual and in group), literacy and education has been used.

More recently, since 2017, these activities were also extended to the prison for women in Bimbo (Bangui) and the annex of Camp de Roux.

Active cooperation with other organisations

In order to make this local anchoring concrete and sustainable, Fracarita International actively calls on local volunteers, who are trained for this purpose. They act as connecting contacts for our team to the communities and families. As we find respect for the local culture important, there are also volunteers who speak the local language, the Sangho.

In the field of local anchoring, advice is sought, consultations are held and there is cooperation with international organisations such as UNICEF, WHO, MINUSCA, the CAR government, CORDAID and the archdiocese of Bangui.

The future

The initiative has the strong intention to become financially self-sufficient after the start-up phase (2016-2019). Discussions are already ongoing with the CAR government with a clear view to recognition and partial subsidisation of staff costs. In addition, there are own initiatives to develop a number of IGAs (Income Generating Activities).

The road to a bright future in CAR is still very long. However, step by step, the Brothers of Charity and Fracarita International do their utmost to take care of the most vulnerable children, youngsters and adults in CAR by providing necessary (mental) health care.

Your support makes the difference

Your support makes the difference for the vulnerable children, youngsters, men and women in Central African Republic. If you want to support our projects in CAR, you can donate to the accounts below. To do this, please use the following notation: “Bangui CAR”.

CITIZENS OF OTHER COUNTRIES

Fracarita International

Boeveriestraat 14

8000 Bruges

BELGIUM

www.fracarita-international.org

Tel. +32 50 44 06 90

fracarita-international@fracarita.net

DONATIONS:

Fracarita International

IBAN number: BE59 7370 2766 2726

BIC: KREDBEBB