As the plane lands in Bangui, I am plunged into the country's newest displaced persons camp. About 100,000 of the city's inhabitants pack every available space around the runways. The fortunate occupy abandoned hangars.
A squalid shanty town has sprung up, home to scared inhabitants seeking shelter and safety from the violence that has engulfed the capital since December 2013. On an average day, Médecins Sans Frontières/Doctors Without Borders (MSF) teams carry out a thousand consultations, deliver 15 babies and refer 16 patients to hospital. MSF surgical teams have treated hundreds of wounded from both communities.
In addition to Bangui, MSF is working in 10 locations around the country, providing free medical care to about 400,000 people. More than 200 international and 1,800 local staff are working in 12 hospitals, 16 health centres and 40 health posts.
CAR spirals out of control
What is the cause of all this suffering? It's complicated. In March 2013, a mainly Muslim coalition of rebel groups called Seleka swept down from the north and took control of Bangui, the capital of CAR. Once in power however, coup leader Michel Djotodia was unable to control the loose-knit alliance and ex-Seleka elements exacted a heavy toll on the civilian population.
Violence begets violence: after several months, community defense groups sprang up across the country, and violent attacks and counter-attacks ensued between the two groups. Civilians, bent on vengeance, have taken matters into their own hands. The violence between communities has led to massive population displacements and overwhelming humanitarian needs.
The injury profile in our clinics changed from largely mortar and gunfire injuries to knife and machete wounds, as mobs brutalized people of the other religious group.
Much of the world has chosen to look the other way. There is little sign of other aid actors in CAR and the UN is perennially understaffed. At the airport camp there is precious little plastic sheeting, no tents, few latrines, no places for the thousands of children to play.
A million people are displaced country-wide and state services have collapsed -- health posts, schools and police. CAR is on the edge of descending into chaos, but the world has largely responded with indifference.
Here at the airport, the UN and its implementing agencies have only been able to help about one tenth of the camp residents. This despite the fact that the airport is easily accessible and well protected by the French army.
How is it possible for such brutality to spiral out of control as the world looks on? Was there no early warning system? Did these events catch the world unawares?
Early warnings ignored
In fact there were regional peacekeepers on the ground in CAR. The UN conducted monitoring and assessment missions in 2013, and was aware of the slow and steady unraveling of the peace process.
For months the deteriorating situation was all but ignored by the UN and member countries, as CAR became increasingly dysfunctional and the violence increased. The UN should have prepared to deal with the enormous humanitarian consequences of the violence. By the country's own estimates, half the inhabitants of CAR are now dependent on humanitarian assistance.
Meanwhile the French intervention force dithered and African Union (AU) forces failed to materialize in adequate numbers. Those that deployed often did so on a shoestring budget, lacking basic supplies, logistical support and, in some cases, even ammunition.
It is therefore unsurprising that disbanded units of Seleka rebels were able to loot, maraud and rape their way across the country before so-called community defense forces mobilized and took revenge. Inter-communal reprisal killings have pushed CAR to the brink. For there to be any hope of stability, CAR needs to get back on track with the Libreville peace agreements. And to do that, the violence has to be brought under control.
In the past few weeks, it seems that the international alert is starting to be heard. The Economic Community of Central African States has finally intervened, forcing Djotodia to resign as interim president, in hopes of replacing him with someone who can restore law, order and basic services. The AU peacekeeping force has been reinforced, as have the French forces. And yet tragically, for CAR and the hundred thousand civilians living near the Bangui airstrip, they have been unable to restore order and prevent the ongoing escalation of violence.
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