The latest clashes in the Central African Republic began in December 2020. They involve armed groups and government forces and have forced over 180,000 people to flee their homes, seeking a semblance of safety.
Some are living in camps for displaced persons near the town of Kaga-Bandoro.1 But whether they have just arrived or been here for months – or even years – everybody in these camps shares the same painful experiences.
The stories of pillaging, rape and summary execution are endless, and they are all similar. We hear them from men and women, and also from children who, like their parents, are in real need of psychological support.
In addition to losing their familiar surroundings, many of these children have been deeply affected by what they have experienced or witnessed. Many have lost family or friends.
Fabrice (13) had to watch, powerless, as his brother was murdered in 2019. “They shot at my brother. He fell. He lay dying on the ground. It hurts when I think of him. I sleep very badly. I have lots of nightmares.”
In a country where psychiatric services are virtually non-existent (there is only one psychiatrist practising in the whole of the Central African Republic), and the health system suffers from chronic under-funding, traditional healers,2 marabouts and shamans are the usual option when it comes to treating psychological trauma. Parents turn to these practitioners when their child suffers from nightmares or from images they cannot shake off, when deep depression makes them avoid their friends, or when they faint for reasons their families cannot understand.
Romaric Debas, a Central African Red Cross volunteer: “The most common emotions are fear, sadness and anger. Some children are really sad, and some even refuse to speak.”
Since 2014, ICRC mental health specialists in the Kaga-Bandoro region have been in dialogue with traditional healers and parents, to convince them that the traditional approach and “modern” treatment can be complementary. Healers3 are now sending children to the ICRC, either immediately – without taking action themselves – or when a child’s condition fails to improve despite their rituals.
In all cases, the aim is to make the child better, while respecting everyone’s beliefs. When the parents give their consent, the ICRC’s therapists can get to work.
By replying to a questionnaire, parents provide the information needed to assess the psychological state of their child. Psychological support is provided once a week in the camps for displaced persons, with the aid of Central African Red Cross volunteers, either in groups or with individual children.
Therapists use stories, drawing, breathing exercises or simply the spoken word during individual sessions at Kaga-Bandoro Hospital.
Karine (10) has been deeply affected by her family’s forced displacement and the recent death of her mother. She tells us that talking to the therapy team has helped: “I went to see the people from the Red Cross and they comforted me. I don’t have nightmares any more. I can have fun with the other children.”
Parents are always involved in the therapy. The ICRC sets up an oral contract with them, enabling its therapists to monitor the child’s progress. On average, therapy lasts three months. Over 550 children in the three camps for displaced persons at Kaga-Bandoro underwent therapy in 2020.
The needs remain enormous, with the result that none of the children affected by the most recent displacements have been able to receive psychological support so far. But the results are encouraging. Parents living in the town are starting to contact the ICRC, asking the organization to treat their children.
ICRC president Peter Maurer was in Kaga-Bandoro on 11 February to see the results of the mental health programme for himself. “When we started thinking about a more holistic approach to health problems, we began talking about psychological problems, the kinds of mental health problem that people are exposed to during war. I’m very encouraged to see that the first programmes are now under way. Because it’s true that in the past, we perhaps paid too much attention to the physical aspect. We saw the physical wounds and we treated them. But we didn’t see the invisible.”
The ICRC hopes that the Central African government will be able to start providing adequate mental health services in the not too distant future, if stability and development replace violence.3 So that Central African society – children and adults alike – can finally overcome its deep psychological traumas.
1 Kaga-Bandoro (pop. 27,000) is the main town of Nana-Gribizi prefecture. Between 2016 and 2018, it was the scene of major tensions. There is little government presence in the prefecture and essential services are lacking. These factors, together with sporadic fighting and rampant crime, are making the lives of its citizens increasingly difficult. Violence between livestock herders and farmers is also a worrying factor. The most recent attack occurred in Ngouvouta in December 2020, leaving several people dead and dozens of houses pillaged and burned. Over 4,300 people had to flee their homes.
2 In 2020, 90% of children treated by ICRC therapists had previously been to see a traditional healer.
3 The Central African Republic occupies second-to-last place on the UNDP’s Human Development Index at number 188, just ahead of Niger.
For further information, please contact:
Taoffic Mohamed Touré
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ICRC media relations, Dakar
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Location: Kaga-Bandoro, Central African Republic
Date: 8–11 February 2021
Running time: 7’53”
Camera operator: Birom Seck
Video editors: Birom Seck/Tristan Audéoud
Production: Didier Revol
Languages: French, Sango and Fula
Copyright: Copyright-free images
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Kaga-Bandoro. Displaced persons camp run by MINUSCA (United Nations Multidimensional Integrated Stabilization Mission in the Central African Republic). Improvised market (3 shots).
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Fabrice and his father, Christian (46) set up a fence. Fabrice is 13 years old. During an attack in 2019, Fabrice had to watch, powerless, as his elder brother was executed. He still has nightmares, and he still makes drawings of the tragedy and of weapons and blood.
00:00:21,440 --> 00:00:29,719
Interview with Fabrice (Sango, 8 sec.), aged 13, who is receiving therapy at the Red Cross counselling centre in the camp.
“It hurts when I think about my big brother who was killed. I sleep very badly. I have lots of nightmares.”
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Fabrice draws in the counselling centre (3 shots).
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Soundbite: Eudoxie Marida (Sango, 7 sec.), ICRC psychosocial officer, speaking to Fabrice.
“Drawing will help to make you less sad.”
00:00:51,520 --> 00:00:56,000
Soundbite: Fabrice (Sango, 13 sec.), telling Eudoxie what happened.
“They shot at my brother. He fell. He lay dying on the ground.”
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“They accused him of theft and drove off in their car.”
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Soundbite: Eudoxie Marida (French, 13 sec.), ICRC psychosocial officer.
“The children often draw weapons, arms bearers or their vehicles.
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It’s around the half-way stage that they gradually start to feel better.”
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Mbella displaced persons camp, Kaga-Bandoro (3 shots).
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Fatimé stares into space. Fatimé (15) and her family fled the violence in Bangui and came to live in Mbella camp in 2018. Recently, when she had just about recovered from the trauma of losing everything, her father died of illness, and she had to learn to take care of her brother and sisters.
00:01:33,400 --> 00:01:40,760
Interview with Fatimé (Fula, 14 sec.), who is receiving therapy at the Red Cross counselling centre in Mbella camp.
“What makes me sad is the death of my father. There’s no-one left to take care of us.”
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“When I feel bad, I go to the counselling centre. That helps me feel better.”
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Children’s counselling centre, Mbella camp for displaced persons, Kaga-Bandoro.
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Fatimé and her sister Khadidia look into the camera.
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Hégelie (ICRC psychosocial officer) and Daoud (Central African Red Cross volunteer) do breathing exercises with Fatimé (6 shots).
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Fatimé teaches her sister Khadidia to play with a skipping rope (3 shots).
00:02:29,439 --> 00:02:33,840
Interview with Maïmouna Aboubacar (Fula, 16 sec.). She is a widow and the mother of Fatimé and three other children. She has been a displaced person since 2019.
“They’ve just lost their father, and the dark thoughts have returned.”
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“When I notice that my daughters are not doing well, I send them to the counselling centre.”
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“Going to the counselling centre helps them a lot. They listen to the advice they get and they behave differently at home.”
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Lazare displaced persons camp, Kaga-Bandoro (3 shots).
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Interview with Jeannot Laguère (55), former farmer (French, 24 sec.). Jeannot had to flee the violence in 2018, with his two wives, his daughter Karine and his four other children. After hiding out in the bush, they arrived at Lazare camp having lost everything.
“Karine lost her mother when she was seven.”
00:03:05,120 --> 00:03:09,439
“She still sleeps badly and has nightmares.”
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“Since she’s been taking part in the mental health programme, she answers quickly when I speak to her. There has been a change.”
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Soundbite: Jeannot speaking to his daughter Karine (French, 3 sec.). “Recite what you learned at school.”
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Karine (French, 15 sec.).
“Recitation: The idler.
Lazybones! You waste your time doing nothing.
When will you stop sleeping?
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What will happen to you when you’re old?
You should work, because then your life will be better.”
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Soundbite: Karine (French, 19 sec.).
“I feel better now. Before, I was sad and I was frightened after my mummy died.”
00:03:49,080 --> 00:03:53,919
“I went to see the people from the Red Cross and they comforted me. I feel better.”
00:03:53,919 --> 00:04:00,240
“I don’t have nightmares any more. I can have fun with the other children.”
00:04:00,240 --> 00:04:21,879
Karine goes back to her friends and plays with them on a swing (4 shots).
00:04:21,879 --> 00:04:27,319
Soundbite: Romaric Debas (Sango, 13 sec.), Central African Red Cross volunteer, reads a story to Karine, of which the hero is called Riki.
“And sometimes, when he went to sleep, he had nightmares.
Those bad dreams frightened Riki very much.”
00:04:27,319 --> 00:04:29,720
“Riki is feeling better.”
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“Now Riki plays with the others and he takes his dog for walks.”
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Karine goes back to her friends, to take part in a drawing workshop (2 shots).
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Karine with her drawing.
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A child, alone, looking sad, watches the other children drawing.
00:04:50,319 --> 00:04:56,959
Soundbite: Romaric Debas (French, 1 min 8 sec.), Central African Red Cross volunteer.
“The most common emotions are fear, sadness and anger.”
00:04:56,959 --> 00:05:03,240
“Some children are really sad, and some even refuse to speak.”
00:05:03,240 --> 00:05:09,079
“Children can express themselves through drawings. They can say what they’ve experienced.”
00:05:09,079 --> 00:05:15,720
“A child may draw a person with a weapon killing someone.”
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“The process of drawing releases something that’s causing pain.”
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Soundbite: Romaric Debas, Central African Red Cross volunteer.
“It’s essential to involve the parents, so that they understand what their children are going through and so they can tell us what signs of trauma their child has been showing.”
00:05:34,160 --> 00:05:47,920
“Take Elcana, for instance. His father is a traditional healer. But he allows his son to come and see us, so we can help him.”
00:05:47,920 --> 00:06:06,839
Elcana’s father, Arthur Metefara, is a traditional healer and father of 14 children. He has been a displaced person since 2018. Here, he is preparing for a consultation. Elcana helps him set up his equipment (5 shots).
00:06:06,839 --> 00:06:13,319
Soundbite: Arthur Metefara (Sango, 13 sec.). He prescribes a medicine to treat stress.
“When you feel stressed, take this medicine. You boil it up and then you drink it.”
00:06:13,319 --> 00:06:20,240
“You need to free yourself from the anger that’s inside you. Only then will you feel better.”
00:06:20,240 --> 00:06:29,639
Interview with Arthur Metefara (Sango, 26 sec.).
“Elcana has taken part in activities with the other children at the ICRC counselling centre. He’s received advice that has helped him improve his behaviour.”
00:06:29,639 --> 00:06:38,600
Now, if I have an argument with his brothers or his mother, he’s the one who calms us all down. He has brought change to our home.”
00:06:38,600 --> 00:06:47,000
“When someone comes to see me and I can tell they have an illness I can’t treat, I send them to the hospital.”
00:06:47,000 --> 00:06:58,120
Elcana finds it difficult to express himself. Despite the support of his parents, he remains at a distance from the others and draws in silence. (3 shots)
00:06:58,120 --> 00:07:04,720
Soundbite: Peter Maurer, president of the ICRC (French, 18 sec.) 11 February 2021. Conversations with displaced families in Kaga-Bandoro.
“War, violence and exposure to these acts of cruelty change something in your families.”
00:07:04,720 --> 00:07:16,279
“But one also has to to take account of all the internal wounds that cause so many problems in individuals, families and communities.”
00:07:16,279 --> 00:07:35,519
Interview with Peter Maurer, president of the ICRC (French, 37 sec.).
“When we started thinking about a more holistic approach to health problems, we began talking about psychological problems, the kinds of mental health problem that people are exposed to during war.”
00:07:35,519 --> 00:07:41,600
“I’m very encouraged to see that the first programmes are now under way.”
00:07:41,600 --> 00:07:53,920
“Because it’s true that in the past, we perhaps paid too much attention to the physical aspect. We saw the physical wounds and we treated them. But we didn’t see the invisible.”