World Health Day

Teaming up to rebuild a health system: the Central African Republic's health workers

Heroes for health in the Central African Republic

Health workers in the Central African Republic also suffered in the recent conflict: many were victims of the violence. The health workers are owed 48 months' back pay, like all other state employees. Yet they carry on working, for it is the work they have chosen.

The overwhelming majority of their patients are not charged for their treatment: few can afford to pay consultation fees, which are used to cover many of the hospital's running costs. The resulting lack of hospital funds has led to deteriorating health care for patients and poor working conditions for the staff. Despite small improvements since 2003, the situation remains very difficult.

Central African Republic health workers have few resources to deal with the psychological damage caused by the violence. Psychological counselling is all but nonexistent; insomnia, depression, dementia and suicide are all on the rise.

Nonetheless, health workers have worked hard to put their country's health system back on its feet. Two years after the latest period of conflict, progress slowly continues. These men and women are the true heroes for health, the silent menders of this silent crisis.

"WHO never left us."

Dr Léodégal Bazira

WHO's offices in Bangui were looted and razed to the ground in the 2001–2003 wars, but it did not withdraw from the Central African Republic. Despite the danger, WHO staff kept working. WHO Central African Republic Representative Dr Léodégal Bazira said that people are really grateful that WHO did not abandon them in the darkest hour.

In September 2005, as a part of ongoing assistance to the Central African Republic, health authorities were presented with 17 motorcycles for the country's vaccination outreach programme, as well as HIV/AIDS testing kits by Regional Director for Africa, Dr Sambo. First-aid medical supplies were also brought to flood victims in the Bangui suburb of Boeing.

L'écrasante majorité des patients ne sont pas appelés à payer leurs soins: bien peu d'entre eux peuvent s'acquitter des honoraires de consultation, lesquels sont la principale source de financement des hôpitaux. Il en résulte que, par manque de fonds, le niveau des soins apportés aux patients se détériore, ainsi que les conditions de travail du personnel. Malgré les quelques progrès réalisés depuis 2003, la situation actuelle reste très préoccupante.

Les personnels de santé centrafricains n'ont que peu de ressources pour faire face aux traumatismes psychologiques causés par les violences. Les psychologues qualifiés manquent à l'appel; insomnies, dépressions, démences et suicides sont en hausse constante.

Néanmoins, les personnels de santé ont travaillé au rétablissement du système de santé. Deux ans après les conflits, une lente amélioration se poursuit. Ces hommes et ces femmes sont les héros méconnus d'un combat perpétuel pour la santé, travaillant sans bruit à résoudre cette crise silencieuse.

Dr L. Gomes Sambo, Regional Director for Africa, WHO

"They cannot provide the necessary care to people who are really suffering with diseases, and dying."