AUDIE CORNISH, HOST:
Sectarian violence in the Central African Republic has killed thousands of people since erupting a little over a year ago. The conflict began with the takeover of the majority-Christian nation by Muslim extremists and targeted attacks on Christian communities. This spawned a Christian backlash against Muslim communities. The humanitarian group Doctors Without Borders has been trying to get a sense of the death toll. That's difficult because many victims are never counted. They're buried by family or don't make it to the hospital. But the group's just released a report based on interviews with refugees. It shows more than 2,400 people were killed between December of last year and this April. Sylvain Groulx leads the Doctors Without Borders mission in CAR. I asked him to describe the conditions the refugees are facing.
SYLVAIN GROULX: We were able to go to a camp, where many of the Muslim populations had fled from Bangui, in northern Chad. And we were able to pick up all of this information because they were gathered together in different camps along the Chadian border. And what comes out of it is that 8 percent of the population that fled died because of the violence. That's astonishing. But what's even more astonishing for me is the fact that we have hundreds of thousands of people that are still living out in dire conditions in the bush. They not only are prevented from going back to their homes because of the violence, but they are prevented from having access to basic health care, to their water, to proper food. And unfortunately, what we don't know is how many untold thousands of people are dying out in the bush from easily preventable diseases such as, you know, malaria, diarrheas, etc. And we're really concerned, especially after having seen this - the results of this retrospective mortality survey.
CORNISH: Give us some context about the fatigue you're seeing in the civilian population among the displaced. How is it changed in terms of how - what kind of condition people are coming to you in?
GROULX: The violence has evolved, obviously. Initially, the type of patients that we would see were mostly related to gunshots and explosion wounds. What we saw after the attack in Bangui - a lot of wounds were now coming in that were more people beating up a person on the street, attacking them with machetes and, you know, our teams were faced with seeing children and women coming in completely cut up in numerous pieces. Very, very complicated.
CORNISH: What's involved in the support that you offer and how is that changed over the years?
GROULX: It's, unfortunately, full support more and more. Back in 2011, we had a report that came out that demonstrated that there was significant problems in CAR while the country was at peace. We had mortality rates that were above the emergency threshold. And what we have seen since then is the whole public administration and especially all of the doctors, nurses, midwives that we work with flee. The hospitals essentially don't have the drugs. They don't have the equipment. It has been looted. Medical personnel are, unfortunately, still being harassed or threatened by armed groups. And even our patients - we had an incident just a few days ago where a patient was unfortunately killed as he was taken out of the hospital. It's really, really horrible the violence that is still ongoing on a daily basis. So it makes our medical mission so much more hard.
CORNISH: You're the outgoing head for the mission in CAR for Doctors Without Borders. How does this compare with other areas of violence that you've worked in?
GROULX: Yeah, I have to say I've traveled in, unfortunately, in a lot of violent areas - a lot of war zones. What I've noticed is that - especially when you look at continent such as Africa - things are evolving positively, generally. Unfortunately, this is the only country that I know that has regressed, has completely - I was there back in 2003 during the first coup d'etat by the ex-President Bozize, and I have seen what has happened over the next 10 years and where we stand today. And the country is in a much worse state today, 10 years later, than it was.
CORNISH: Sylvain Groulx. He's head of the Doctors Without Borders mission in the Central African Republic. Thanks so much for speaking with us.
GROULX: Thank you for having me. Transcript provided by NPR, Copyright NPR.
