Despite its wealth of natural resources, the Central African Republic is among the poorest nations on earth, ranking 188th out of 189 countries, according to the Human Development Index. In this land racked by conflict for nearly twenty years, there are tens of thousands of women and girls that have been victims of sexual violence.
In light of these atrocious circumstances, the Fondation Pierre Fabre and its partners have pooled their experience to establish a comprehensive care centre for victims of sexual violence at the Hôpital de l’Amitié in Bangui. The funding agreement for this programme was officially signed on 28 November 2019 by Pierre-Yves Revol, President of the Fondation Pierre Fabre, Béatrice Garrette, the Foundation’s Executive Director, and Rémy Rioux, Chief Executive Officer of the Agence Française de Développement (AFD). The signing ceremony was attended by Dr Denis Mukwege, winner of the 2018 Nobel Peace Prize, and other partners, including Magalie Besse, President of the Francophone Institute for Justice and Democracy, Dr Roch M’Betid for the Hôpital de l’Amitié in Bangui, and Nadia Carine Fornel Poutou, Executive President of the Association of Women Lawyers of Central African Republic (AFJC).
A comprehensive care plan for victims
Since 2017, at the Bulenga Rural Hospital (DRC), the Fondation Pierre Fabre has been supporting the replication of the “one-stop centre” model developed by Dr Denis Mukwege, based on four key treatment areas – medical, psychological, legal and socio-economic – that address victims’ essential healing and empowerment needs. Faced with the situation in the Central African Republic, and with shared experience in the Democratic Republic of Congo, the Fondation Pierre Fabre, the Panzi Foundation DRC, the Dr Denis Mukwege Foundation and the Francophone Institute for Justice and Democracy have decided to again join forces, with financial support from the French Development Agency, to replicate Dr Mukwege’s holistic care model at a public hospital in Bangui (the Hôpital de l’Amitié) and within a Central African association (Association of Women Lawyers of Central African Republic), both already recognised as referral resources for victims of sexual and gender-based violence in the country.
In this programme co-funded by the French Development Agency in the amount of 3 million euros, the Fondation Pierre Fabre, at the helm of this group of partners, will contribute 1.2 million euros. The Foundation will also offer its medical and scientific expertise and will be in charge of the programme’s administrative and financial management.
This programme is slated to run for an initial four-year period and will give survivors of sexual and gender-based violence in Bangui and the provinces access to good-quality, holistic care dispensed in a complete, coordinated, controlled manner by virtue of the “one-stop” approach at the Hôpital de l’Amitié and the Association of Women Lawyers of Central African Republic (AFJC) in Bangui. This programme will also be involved in preventing sexual and gender-based violence in the country. With support from international partners (Fondation Pierre Fabre, Dr Denis Mukwege Foundation, Panzi Foundation DRC, Francophone Institute for Justice and Democracy), this programme relies on South-to-South skills transfer between Congolese and Central African entities. It will also strengthen the capacities of a public hospital and a recognised local association, both of which are already recognised as referral resources for victims of sexual and gender-based violence in the country.
“This programme is an important part of the Fondation Pierre Fabre’s commitment to supporting Dr Mukwege in his work and serving the most vulnerable populations. It is a very challenging context, but the programme will have at its disposal the complementary skills of French, Congolese and Central African partners with the common objective of providing the multidisciplinary care and support that victims of sexual and gender-based violence in the Central African Republic need to recover from their trauma.”
Pierre-Yves REVOL, President of the Fondation Pierre Fabre
A healthcare system shattered by 20 years of conflict
The Central African Republic (CAR) is a landlocked country bordering Cameroon, Chad, Sudan, South Sudan, the Democratic Republic of Congo and the Republic of the Congo (Congo Brazzaville). Central Africans have a life expectancy of 53.5 years . The country has 4.6 million inhabitants , 600,000 of whom live in the capital city of Bangui. The country’s security context is very unstable and humanitarian needs exceed available resources.
The CAR has seen conflicts for almost twenty years. In the early 2000s, tens of thousands of women and girls were victims of sexual violence during the civil war that ended with the peace agreements signed in 2007. Since 2012, the CAR has been experiencing one of the most serious political and security crises in its history. That year, several rebel groups joined forces to form the Séléka (meaning “Coalition” in Sango), with the objective of overthrowing the François Bozizé government (overthrown in March 2013). Civilians quickly became targets and were constantly vulnerable to reprisals. On 17 October 2018, the Office of the United Nations High Commissioner for Refugees (UNHCR) estimated that there were 636,489 internally displaced persons (IDPs) and 574,638 refugees. While the Khartoum peace accords signed on 6 February 2019 should help strengthen peacebuilding in the country, they have not yet fully stabilised the political and security situation, as was the case with the previous democratic transition, and are also likely to generate new concerns to be addressed, particularly with respect to the fight against impunity.
In this context, gender-based violence (GBV) demands special attention. This violence takes different forms, including sexual violence (SV). Acts of sexual violence, already considerable prior to the crisis, are now used in this conflict as an instrument to terrorise and “punish” civilian populations, and rape – whether by gangs or individuals – and sexual slavery are now common practices among armed gangs. Furthermore, as happens in the majority of armed conflicts, gender-based violence, such as domestic violence, sexual exploitation and forced marriage, is on the rise. This means that the number of survivors continues to grow, including men and children. The statistics are all the more alarming because many of the survivors are not taken into account by virtue of their not having sought help due to fear of stigmatisation, lack of information on the initiatives available and insufficient financial means.
 INED (French Institute for Demographic Studies) 2018 estimate
 INED 2018 estimate