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HEALTH AND NUTRITION IN BOSSEMPTÉLÉ

“Health and Nutrition for the Vulnerable Population of the Sub-Prefecture of Bossemptélé’ has been a project that we have told you about many times, recounting all the milestones that we have gradually achieved. The project, part of the ‘Emergency Initiative to Support the Vulnerable Population in the Central African Republic’, was funded by the Italian Agency for Development Cooperation (AICS) and started in September 2021.

The interventions were concentrated in Bossemptélé, the town where the John Paul II Hospital – the health hub of the entire region – is located, and in the surrounding 75 km. We are in the Central African Republic, an endemically poor country, where many of the basic services are the preserve of a few, while the majority of the population suffers from precarious and insecure conditions, both health and food. For some years now, moreover, rebel groups have been making the country even more unstable, carrying out violent acts and frightening the already hard-pressed population.

Anche noi di Salute e Sviluppo – nel corso di questo progetto – abbiamo dovuto affrontare questa situazione, che ha rallentato i lavori, rendendoli più difficili e pericolosi. Despite this, we were able to achieve most of the goals we had set ourselves, including the construction of an emergency room for the John Paul II Hospital. Before our intervention, the hospital did not have the possibility to accommodate the most serious patients in a suitable room, now the emergency room has been completed, both in terms of structural construction and equipment. During this year in which construction work proceeded, the hospital was nevertheless able to see more than 9,000 patients, of whom about one third were admitted to receive the right treatment.

Another deficiency we had identified at an early stage concerned the hospital’s ability to guarantee the necessary meals for in-patients: most of those arriving at the facility have a severe state of malnutrition and need to re-establish a proper diet. In the course of this project, we built a kitchen adjacent to the hospital premises, which can offer three meals a day to all patients. Despite the fact that the structural work has only just been completed, a temporary kitchen has been set up since the start of the project, which has managed to provide three full meals a day for more than 1600 patients.

In order to increase the capacity of the John Paul II Hospital to adequately meet the local population’s demand for care, we decided to start a training programme for health personnel. Thanks to this initiative, 38 workers specialised in obstetrics, ophthalmology, laboratory techniques and maintenance of medical equipment were trained.

In order to provide widespread access to care also in the rural areas surrounding Bossemptélé, we rehabilitated, and in some cases built from scratch, the postes de santé located in some villages within the sub-prefecture. Before our arrival, these facilities were unsafe, with severe structural problems and without any furniture or machinery useful for first aid. During the year, we renovated, furnished and equipped the poste de santé of Gbawi (40 km from Bossemptélé), Bodangui, (10 km), and Bombalou (45 km) with sanitary materials, and we built a new poste de santé in the village of Yangoro, 15 km from Bossemptélé. In addition, we have trained more than 30 workers who will ensure an efficient health service by manning these postes de santé. In addition to each of these facilities, a well was also rehabilitated or constructed to provide drinking water, not only to the poste de santé, but also to the entire population of the corresponding village. Thanks to some budget balances, we were able to rehabilitate an additional well in the village of Boyaram. In total, more than 21,000 inhabitants have access to drinking water.

In addition to these villages, there are many others that, not having a poste de santé and being far from Bossemptélé, remain uncovered in terms of health. To solve this problem, we activated and strengthened the mobile clinic service, which – during the course of the project – was able to visit more than 27 villages, providing first aid to the local population. The mobile clinic also started awareness-raising meetings focusing on different health topics, and managed to involve more than a thousand people. In recent months, the climate of instability in the country has worsened: armed rebel groups have targeted large areas, including part of the area where the mobile clinic operates, some of which have been forced to flee. Due to this situation, it was not possible to visit many villages and proceed with all the previously planned activities.

Despite these difficulties, which caused several slowdowns, the project recorded positive results: 14% more of the local population had access to health services, 25% more had access to drinking waterwhile malnutrition dropped from 40 to 38 per cent. The facilities we have built and the activities we have initiated will continue to be a valuable aid for the locals, who will finally have access to adequate health services of a higher standard.

This article was produced within the framework of the project Health and Nutrition for the Vulnerable Population of the Subprefecture of Bossemptélé AID 05/RCA/12049/2021 funded by the Italian Development Cooperation Agency. The contents of this publication are the sole responsibility of the author and do not necessarily represent the views of the Italian Development Cooperation Agency. The Italian Development Cooperation Agency is not responsible for information that is considered erroneous, incomplete, inadequate, defamatory or in any way reprehensible.

MANY ACHIEVEMENTS IN BOSSEMPTÉLÉ

Not many months have passed since we told you about our project Health and Nutrition for the Vulnerable Population of the Sub-Prefecture of Bossemptélé, which is part of the ‘Emergency Initiative in Support of the Vulnerable Population in the Central African Republic’ funded by the Italian Agency for Development Cooperation (AICS), and whose aim is to improve the living conditions of the population of the Bossemptélé Sub-Prefecture, which is particularly tried by the instability in the country. Translated with www.DeepL.com/Translator (free version)

The Central African Republic has never enjoyed such tranquillity as to allow it to grow and prosper; on the contrary, it has had to contend with numerous coups d’état and as many dictators who, acting without scruples, have allowed the exploitation of the country’s resources, without a thought for the increasingly sacrificed population. The situation in recent years has been particularly difficult: rebel groups have clashed several times with state forces, causing violence and deaths, especially among the most vulnerable population.

In this complex context, the John Paul II Hospital played a key role, providing a point of reference for the population of the sub-prefecture. Despite the clashes and violence, the hospital has always continued to operate and provide support.

Our project starts with the John Paul II Hospital with the intention of increasing its capacity to respond adequately to the needs and requirements of the population. Before our intervention, the facility did not have a proper emergency room in which to receive urgent patients. Now the renovation and extension work on the premises is almost complete and by the end of the project – December 2022 – it is also planned to provide the emergency department with all the necessary furniture and machinery.

Another deficiency found within the hospital concerned the nutritional aspect: a triple problem considering that most of the patients are in a serious state of malnutrition upon admission, that food is necessary to ensure a proper course of treatment and rehabilitation, and that most of those who come from the neighbouring villages, once they arrive in the city, do not have the possibility of buying anything at the local market due to the excessively high prices.

For these reasons, it was decided to build a canteen to provide three full meals a day – based on cereals, meat or fish – for the in-patients, who can thus follow a correct diet and sufficient caloric intake to aid their recovery. The canteen service is also offered to relatives from afar who care for patients in severe need. Currently, more than 2250 meals per month are provided.

In order to improve the quality of the hospital’s services, it was necessary to train 38 in-service health workers in specialist disciplines such as obstetrics and ophthalmology. The training courses are already leading to a significant improvement in hospital performance.

One of the most ambitious components of our intervention is the strengthening of the medical centres located in the villages surrounding Bossemptélé, where services are almost non-existent. Thanks to the AICS-funded project, we have rehabilitated – or in some cases built from scratch – several postes de santé, each of which has a well with access to drinking water. The work is almost complete and the population of the villages of Gbawi, Bodangui, Bombalou and Yangoro already has access to basic health services, without having to make the journey to the city of Bossemptélé, unless strictly necessary for the treatment of more complex illnesses.

Not only qualitative reinforcement of the hospital and postes de santé, but also a mobile clinic service that, twice a week, visits the most difficult-to-reach villages, providing treatment and health education with awareness-raising meetings on prevention and first aid.

Thanks to the support of AICS, our work in the Central African Republic has reached new heights that we hope will mark the beginning of a better life for many people living in the sub-prefecture of Bossemptélé.

This article was produced within the framework of the project Health and Nutrition for the Vulnerable Population of the Subprefecture of Bossemptélé AID 05/RCA/12049/2021 funded by the Italian Development Cooperation Agency. The contents of this publication are the sole responsibility of the author and do not necessarily represent the views of the Italian Development Cooperation Agency. The Italian Development Cooperation Agency is not responsible for information that is considered erroneous, incomplete, inadequate, defamatory or in any way reprehensible.