Central African Republic
ten years of violence
1997 — 2007
First humanitarian response by Médecins Sans Frontières in the Central African Republic
MSF teams provide maternity care in Bangui and help displaced people and those fleeing neighbouring countries.
Coup d'état by François Bozizé
On the 15th of March 2003, after months of clashes and violence against the population, François Bozizé, former Chief of Staff of the Armed Forces, and his troops overthrow President Ange-Félix Patassé and take power in Bangui. This is the sixth coup d'état since the country's independence.
2004 - 2007
First Civil War
In 2005, Bozizé wins the presidential election after it is postponed several times. New rebel groups form: the People's Army for the Restoration of the Republic and Democracy (APRD) in the north-west of the country and the Union of Democratic Forces for Unity (UFDR) in the north-east. The army intervenes in 2006 and 2007 to support Bozizé’s regime. Mass violence breaks out, leading to population displacements. MSF teams treat the victims and launch numerous emergency medical operations across the country.
2008 — 2012
Signing of the Libreville Agreement between the government and the APRD and UFDR rebels
However, fighting quickly resumes and new armed groups appear. In September, an amnesty law is passed for all war crimes committed since 1999. Then, in December, an inclusive dialogue brings together, in particular, all armed groups, the opposition parties and former President Patassé.
Re-election of François Bozizé as head of the country
The twice-postponed election sees François Bozizé elected in the first round, ahead of former President Patassé and former Prime Minister Martin Ziguélé, a victory denounced by the opposition who point to fraud and irregularities.
MSF warns of the state of medical emergency in the country. The results of epidemiological surveys conducted in several regions indicate a high excess mortality, above the 'emergency threshold'. In Carnot, the overall mortality rate is estimated at 3.7 deaths per 10,000 people per day and 7 among children under five, meaning that on average 35 children have died every day since the beginning of 2011.
Several rebel groups, mainly from the north of the country, join forces in the Seleka coalition. They launch an offensive and take control of the majority of the country, looting and committing numerous atrocities. Thousands of people flee to the bush or to Bangui. MSF teams launch emergency operations and maintain their hospital activities, particularly in Ndélé, Kabo and Batangafo, three towns affected by the violence.
2013 — 2014
Seleka seizes Bangui and overthrows Bozizé
Michel Djotodia becomes president in April. This marks the end of the second Central African civil war, between 2012 and 2013, followed very quickly by the beginning of the third. Clashes in Bangui leave many dead and wounded, some of whom are treated by MSF teams at the Community Hospital.
Deployment of the African-led International Support Mission to the Central African Republic (MISCA)
The Anti-balaka, made up of village self-defence militias and former members of the army, mostly Christians and animists, form to oppose the Seleka fighters, most of whom are Muslim.
Deployment of Operation Sangaris by France, following the passing of Resolution 2127 by the United Nations Security Council on de-escalation of the conflict and protection of civilians. On the same day, the Anti-balaka launch an attack in Bangui which leads to urban guerrilla warfare and extreme violence. The Friendship Hospital is attacked and looted and patients are killed there.
“Our teams did indeed see around ten corpses lying in front of the [Friendship] hospital (...) About 260 injured were treated between the 5th and 8th of December. Most have gunshot wounds or wounds inflicted by machetes and knives. Just over 100 people are currently hospitalized.”
MSF press release
9 December 2013
Resignation of Michel Djotodia
Catherine Samba-Panza is elected by the Parliament and a transitional government is formed. In the wake of the withdrawal of the ex-Seleka forces, who continue to loot and kill, Anti-balaka militias target Muslim communities and encourage or lead massacres. This marks the beginning of a mass exodus, particularly in the western part of the country. Transit zones are set up where thousands of Muslim civilians, hoping to flee, find themselves trapped and threatened.
Intercommunal violence in Carnot, in the west of the country
Nearly 1,000 people, mostly Muslims, have taken refuge since March 2014 in Carnot’s Catholic Church, surrounded and threatened by Anti-balaka groups. The MSF teams provide on-the-spot medical care and escort people who need to go to hospital.
“On the 7th of February a group occupied a house in which 86 displaced people - men, women and children, all Muslims - were hiding: seven men were executed and three people were injured, including a 12-year-old child wounded with machetes... On several occasions, armed men have entered the city’s hospital where we work, either to murder patients, particularly Peulh people, or to attack the few displaced people living there. The hospital teams had to intervene each time.”
MSF press release
11 February 2014
Between December 2013 and March 2014, MSF teams treat more than 4,000 injured across the country.
16 civilians, including three MSF workers, are killed by armed ex-Seleka members during an armed robbery in Boguila hospital. Between December 2012 and April 2014, MSF staff in the Central African Republic experienced 115 incidents, including 31 armed robberies.
Epicentre, MSF's satellite dedicated to epidemiology and research, publishes a survey conducted among Central African refugees in Sido, in Chad: 8% of the members of the families surveyed, or 2,599 people, died in the Central African Republic or during their exodus. In the course of a few months, the western half of the country has been emptied of the majority of its Muslim inhabitants.
2015 — 2019
Bangui National Forum
This leads to several measures relating to DDR (Disarmament, Demobilization and Reintegration), the postponement of the presidential election and the extension of the transitional government’s mandate until the end of the year. Justice and reconciliation mechanisms pave the way in particular for the creation of the Special Criminal Court for war crimes committed since 2003. Violence continues, at lower intensity, including in Bangui.
Election of Faustin-Archange Touadéra
After the adoption of a new constitution in December 2015, former prime minister Faustin-Archange Touadéra is elected with 62% of the vote after the second round.
End of Operation Sangaris
The security situation deteriorates again in the north and east of the country following clashes between more than a dozen armed groups, including Seleka and Anti-balaka factions, sometimes allied to each other. These groups still control a large part of the country’s territory and its resources, including the exploitation of mineral resources, transhumance corridors and trade routes, from strongholds such as Ndélé, Bambari and Bria. Their acts of violence fuel a cycle of revenge and reprisals.
“Fierce fighting broke out early on Saturday morning in the city of Bangassou (...) In the space of a few hours, MSF received 21 wounded people. Some of the inhabitants have fled the city, but the rest are barricaded in their homes or have found refuge in places they hope will be safe. It is currently impossible to have a precise idea of the number of casualties because the intensity of the fighting prevents any movement in the city centre.”
MSF press release
13 May 2017
Signing of the Sant'Egidio Peace Agreement in Rome between 13 armed groups
The signatories commit to 'the immediate establishment of a ceasefire throughout the country'. The very next day, however, fighting erupts in the town of Bria, where several armed groups coexist - including factions of the FPRC, the UPC and the Anti-balaka militias, each claiming to be defending the interests of a community.
“Intense shooting started at 6 a.m. By 9:30 a.m., we had already received 35 wounded patients at the hospital, mostly with gunshot wounds (...) About 41,000 people, more than 85% of Bria's population, have fled their homes. The majority of these newly displaced people have gone to the PK3 site, where they hope to be safe. The site was equipped for 3,000 people following the fighting in November 2016; it now houses 25,000.”
MSF press release
20 June 2017
April - May2018
Days of violence in Bangui
On Sunday the 8th of April, a joint operation by Central African and international security forces targeting local armed groups in the PK5 district, the economic heart of the city inhabited mainly by Muslims, leads to clashes resulting in dozens of casualties. On the 10th of April, fighting resumes and the injured stream into the city's health facilities. 64 of them, mainly with gunshot wounds, are treated by MSF teams at SICA hospital over these two days. On the 1st of May, a new wave of violence shakes the capital, particularly the Fatima and PK5 districts. About twenty people die in the attack on the Church of Fatima. More than 70 wounded are treated at SICA in the space of a few hours.
May - June2018
Escalation of violence in Bambari
The discovery of two people killed on the roadside sparks renewed violence in Bambari, despite the fact that it was declared 'free of weapons' a year earlier following the MINUSCA operations that drove armed groups out of the city.
“On the morning of the 15th of May, we heard gunshots all over the city and the wounded started arriving at the hospital. Entire families were shot and injured. For a week, Bambari was in a state of war. From mid-May to mid-June, 36 people were injured, but we believe the number of casualties is much higher, as many people were unable to reach the hospital.”
MSF press release
29 June 2018
Peace and Reconciliation Agreement between the government and 14 armed groups
This agreement, facilitated by the African Union, provides among other measures for the creation of special mixed security units, made up of elements from armed groups and regular forces, and the formation of an 'inclusive government'.
2020 — 2023
Creation of the Coalition of Patriots for Change (CPC)
The CPC brings together several armed groups united against the outgoing president, Faustin-Archange Touadéra, while the population is called upon to elect a new president on the 27th of December.
Several front lines open up on the main roads linking Bangui to provincial cities as well as in several localities such as Bambari, Bangassou and Bouar. The fighting pits the CPC against government forces, supported by the United Nations Stabilization Mission in the Central African Republic (MINUSCA) as well as Russian and Rwandan military reinforcements.
CPC forces at the gates of Bangui
On the 13th of January, a CPC attack is repelled by government forces and their allies in the PK12 district, on the outskirts of Bangui, while in the south-east of the capital, particularly the Boy Rab area, rumours spread of infiltration by CPC elements. Faustin-Archange Touadéra is declared re-elected with 53% of the vote following a contested first round. Earlier in the month, the CPC attack and take control of Bangassou, causing more than 10,000 people to flee across the Mbomou River to take refuge in the Democratic Republic of Congo. Intense fighting also takes place in Bouar, located on a strategic road for supplies to Bangui.
“More than 8,000 people have been forced to leave their homes [in Bouar]. Nearly half are currently living in the city's former cathedral. Those who have decided to stay are victims of kidnapping, robbery and extortion by armed men who now control part of the city. This violence has not spared humanitarian workers, who have frequently been victims of looting.”
MSF press release
26 January 2021
The military counter-offensive by the Central African government, supported by Russian allies, has allowed the state to regain control of the country's main cities and roads. Driven out to the periphery and weakened, the armed groups are nevertheless still capable of inflicting harm, and both sides are regularly accused of atrocities.
Destruction of a displaced persons camp in Bambari
The Elevage camp on the outskirts of Bambari, created in 2013, is burned to the ground following clashes between government forces and CPC elements. The site, where an MSF health post was located, housed 8,500 people.
A former Anti-balaka and CPC leader, who was a minister in 2019, is arrested in Chad
He is transferred by Chad to the International Criminal Court in The Hague in the Netherlands to be brought to trial.
The UN condemns atrocities committed both by rebel groups and by government forces, as well as by their foreign supporters, particularly Russia. “The military operations have reportedly led to serious human rights violations (...) Murders, sexual violence and serious abuses against children have been alleged against all parties.”
The Special Criminal Court opens its first trial in Bangui against three members of an armed group accused of war crimes and crimes against humanity. They are sentenced in November 2022 to terms ranging up to life imprisonment.
The Office of the United Nations High Commissioner for Human Rights publishes two reports on events that occurred in the Central African Republic between 2020 and 2022, which could be classified as war crimes and crimes against humanity. The first refers to 'a brutal and organized attack on a village by a pro-government militia', while the second describes how specific armed groups committed 'recurrent acts of sexual violence, in a systematic and widespread way.'
In 2023, the Médecins Sans Frontières teams in the country comprise nearly 3,000 people, the vast majority of them Central African. They provide numerous medical services such as paediatrics, trauma surgery and HIV/AIDS care. Every year, around 900,000 consultations are carried out via these projects, in partnership with the health authorities.