Since gaining independence from France in 1960, the Central African Republic has repeatedly experienced political crises. Following the civil war in 2013, the living conditions of the population deteriorated massively and the healthcare system collapsed. The staff of numerous health centers had to flee. As a result of looting, many health facilities now lack medicines as well as urgently needed medical materials and equipment. As a result, maternal and infant mortality rates are among the highest in the world and neglected tropical diseases (NTDs) such as leprosy, filariasis, Buruli ulcer and worm diseases are finding a fertile breeding ground.

This situation is hitting the indigenous Aka particularly hard. The Aka are an ethnic group who live as semi-nomadic hunter-gatherers in the tropical rainforest in the Congo Basin. Deforestation of the rainforest is massively restricting their habitat and forcing them to change their traditional way of life. They are openly discriminated against and the vast majority have no access to healthcare due to their low purchasing power.

With our project, we enable the neglected people - especially the marginalized Aka - in the Lobaye prefecture to access urgently needed healthcare. To this end, we ensure that the health facilities in the project area are equipped with medicines and medical supplies as required and that the health staff receive needs-based training that is adapted to the context. In addition, we educate people about how they can improve their own health and promote their self-determination - especially that of the Aka and people with disabilities - by enabling them to actively participate in the management of local health facilities, among other things. To this end, FAIRMED works closely with the local health authorities.

The main objective of the project is to improve health care in Lobaye. To achieve this overall goal, the project pursues the following specific objectives, which will be achieved through the activities listed below, among others:

The quality of health care and access to health services for the people of Lobaye (especially the Aka, people with disabilities and women and children) is ensured

• Midwives, medical professionals, volunteer health workers, laboratory managers and health facility management committees are trained and educated according to their needs.

• By means of free vouchers, women can take advantage of prenatal and postnatal examinations and give birth to their children under medical supervision. Newborn Aka babies receive a birth certificate.

• Aka mothers and traditional Aka midwives are trained and sensitized on all topics related to childbirth.

• An emergency transport and treatment system ensures that even people living in remote areas receive life-saving treatment in the event of an emergency. Bicycles are provided to the villages for this purpose. In the event of an emergency, a helper can then use a bicycle to go to the nearest health facility and provide information. The motorcycles provided there can then be used to pick up the patient in the village and transport them to the health center or, if necessary, transfer them to a more qualified health facility.

• The Aka and people with disabilities are supported in learning income-generating activities and having a say in healthcare. They are also informed about the means by which they can take action against discrimination and abuse.

Neglected tropical diseases are detected as early as possible and treated properly

• Health staff and voluntary health workers receive training and further education on the early detection and treatment of neglected tropical diseases.

• Health authorities receive support in the distribution and storage of medicines, in the organization of early detection campaigns and in the management of data related to NTDs.

The health facilities are supported in hiring enough qualified health personnel and paying them appropriately

• Doctors, nurses, midwives and auxiliary nurses are employed with the support of FAIRMED and adequately remunerated in accordance with the guidelines of the United Nations Office for the Coordination of Humanitarian Affairs (UN-OCHA).

Health facilities are equipped with medical supplies, infrastructure and essential medicines

All FAIRMED projects are implemented in cooperation with the local official agencies and with the inclusion of the population on the ground. The regional FAIRMED country offices are staffed exclusively by local employees. With this approach, and aided by consistent monitoring, problems can be identified in a timely manner, causes can be analysed, and methods and objectives can be adapted where necessary. The direct integration of health ministers and partner organisations also ensures that projects can be transferred at a later point and continued without the support of FAIRMED.

The beneficiaries of the project are the 354,140 inhabitants of the health districts of Mbaïki, Bimbo and Boda in the Lobaye prefecture. This includes around 27,000 Aka (last update: 2018, exact figures are not recorded by the government and are difficult to ascertain due to the high mobility of the Aka).