Central Africa: internally displaced people struggle to return home

Successive waves of violence in the Central African Republic (CAR) have forced people to flee their homes, leaving everything behind. They continue today to endure the adverse effects of years of armed conflict. In Bria, where the country’s largest internally displaced people’s camp is, many of them struggle to return home and rebuild the lives they left when they fell victim to an outbreak of violence in the town in 2016. 

Over one million Central Africans (almost 20 percent of the population) are either internally displaced or refugees. Insecurity, lack of money, and land disputes are some of the many obstacles they face to a safe and lasting return. While the Central African armed forces, supported by their allied forces, have regained control of the main towns, clashes regularly take place around remote villages. The living conditions of local and displaced people alike are still precarious.   

Even now there are more than 36,000 people in PK3 displaced persons camp situated three kilometres outside Bria. In late 2016, when fierce fighting broke out between rival factions of the former Seleka rebel coalition and anti-Balaka militias, over 80 percent of people from in and around the town took refuge opposite the UN peacekeeping mission base (MINUSCA).  

Six years later, prospects are still limited
Almost everyone in PK3 camp has lost everything. Their houses and fields have been destroyed and their belongings looted. Going back home after so many years is challenging. 

“I fled with my husband and our three children in 2016. The other two were born in the camp. Looking after them is tough because life here is hard and my husband – he’s a motorcycle taxi driver – can’t make enough to make ends meet. We can’t go back to Bria. Our home’s gone and we don’t have the money to start over,” Diane explains.

The vast majority of people in the region work the land or in mines, which is often controlled by armed men and inaccessible. Shattered from years of living a destitute and rootless existence, and with few possibilities for obtaining regular and adequately paid employment, families find it hard to scrape enough money together to re-build a home.

A scarred generation  
“In 2017, my sister and I came to the camp with our husbands because of the community violence. We have 11 children to look after and we can’t prepare a future for them. My husband died recently, so I live with my sister and her husband and kids. Life in the camp is really hard,” says Priscille, accompanied by her sister and two of her children. 

Displaced people still endure extremely harsh living conditions in the camp, which has insufficient access to clean water, sanitation, food, education and medical care. Some also suffer from psychosomatic and post-traumatic stress disorders.

Many of the children were born and have grown up in the camp. All they’ve ever known is an overcrowded and enclosed space where they are exposed to abuse – including sexual. The lucky few attend the camp’s school, but its capacity limited, others have to go three kilometres to Bria. Then there are the kids who, deprived of an education, spend all day in the camp with their families playing.  

MSF’s medical response
“The conflict, which has affected this region particularly badly, has left communities unable to afford even the most basic necessities and health services continue to be inadequate and hard to access,” explains Ange Francelin Ble, MSF’s project coordinator in Bria. 

Deployed in Bria since 2013, in 2017, MSF teams set up a medical clinic to deliver paediatric treatment. The teams also go round the different blocks to ensure people have access to medical care. 

Installed in a tent in 2017, the clinic now has its own permanent building where hundreds of children are treated every day. MSF teams have given over 250,000 paediatric consultations to under 15-year olds – curative, vaccination, but also victims of sexual abuse. The most serious cases are immediately referred to the hospital in Bria where we work with the Ministry of Health. 

We have already given 27,500 consultations in the camp this year. More than 70 percent have been for malaria – a disease the teams are particularly attentive to given that is the principal reason for consulting health services in the country and also the leading cause of death in children under five. 
A timid return.

In spite of everything, small numbers of displaced people have begun returning home. Since May 2022, a few families have been able to go back to their old neighbourhoods through a pilot scheme run up by the UNHCR and its various partners. Chancela’s family is one of them.

“Our lives aren’t that different to what they were in the camp. But, we feel more comfortable and safer in our home. The children have a big space to play in and we can attend to their education. That wasn’t always the case in the camp because there was no privacy,” explains Chancela.

The family, who left at the same time as the head of their camp block, were among the first to return. “We feel so fortunate and happy,” adds Chancela. Sceptical about returning home, many neighbours who visit them look to their own futures.

Chancela’s home is 500 metres from the camp. “Without MSF’s free medical care, we would have lost many of our children during our years in the camp. And we still take them to the MSF clinic when they need medical treatment,” Chancela continues. Her second son, Ezéchiel, has just been discharged from the hospital in Bria. The MSF clinic referred him there after he split open his forehead playing near his house. 

“Some people are starting to leave the camps, but this is an area that has suffered years of chronic insecurity and population displacements. Living conditions in and around Bria are still challenging and unpredictable,” warns Ricardo Fernandez Sanchez, MSF’s head of mission in CAR. 
The situation in Bria is a sad reflection of what is happening throughout the country. Instability, tensions and chronic violence continue to fuel one of the world’s worst crises away from the media spotlight.