Since December 2020, a new wave of violence has swept over the Central African Republic (CAR), exacerbating an already dire humanitarian crisis.

Renewed fighting between armed groups and government forces backed by foreign troops broke out in many parts of the country, often taking a heavy toll on civilians and leaving more than half of the country’s nearly five million people in need of aid.

The country has struggled to find stability since it descended into a full-blown war in 2013 that led to the deaths of thousands and destroyed critical infrastructure and basic services.

Even before the war broke out, CAR’s healthcare system had been weakened by decades of mismanagement and turmoil. Years of fighting since then have ravaged what is left of it, resulting in limited access to many services and facilities – and the latest cycle of violence has made things even worse.

This situation disproportionately affects displaced people and refugees, whose numbers have skyrocketed since December. Currently, 1.3 million Central Africans – more than one in three people – are internally displaced or refugees abroad, often in very precarious living conditions.

On January 3, a coalition of armed groups waging a nationwide offensive captured the city of Bangassou, in the southeast of the country, forcing some 13,000 people to flee. The residents crossed the Mbomou River to find shelter in the small village of Ndu, in the neighbouring Democratic Republic of the Congo.

On the same day, nearly 800 people – most of them women and children – took refuge in the compound of Bangassou University Hospital. The number of people seeking shelter at the hospital kept on growing over the days.

In such circumstances, women’s health is, particularly at risk. Even outside of periods of acute violence, their socioeconomic status in CAR, their exposure to violence and the very poor access to family planning make them particularly vulnerable. As a result, the country has one of the highest maternal mortality rates in the world.