“To be born or to give birth is to take a risk”

In the Central African Republic (CAR), coming into the world or giving birth is a risk. Decades of instability and armed violence have led to a situation where access to care for pregnant women and newborns is among the most critical in the world. There are only about 15 gynaecologists in the country, for a population of six million. Largely overshadowed by the media because of the situation in the country, maternal and child health is a forgotten emergency in the Central African Republic crisis and remains one of the priorities for action for MSF teams. Discover the story of Archange.

Archange was born at just 28 weeks and weighed 800 grams at birth. The baby was in a critical condition but fought for his life for 45 days in the neonatology intensive care unit supported by MSF in Bangui’s community university hospital, in the Central African Republic (CAR). The medical team were so impressed by his fight to survive that they nicknamed him "Little General”.

Archange won this battle for life and could get out of the intensive care unit.

The MSF team then persuaded his mother Stephanie to try ‘kangaroo care’, a technique where premature babies are held close to their mother’s bodies 24 hours a day. The prolonged skin-to-skin contact keeps them warm, maintains their emotional balance and ultimately improves their chances of survival. “I was stressed and not convinced. But soon I saw that he was getting better, and that his health was improving. Today he weighs 1.5 kg. Soon I'll be able to go home with him.”

Archange is a survivor in a country like CAR, where maternal and child mortality rates are among the highest in the world. Decades of instability and armed violence have contributed to essential medical care being out of reach for many, particularly pregnant women and newborn babies.  Few hospitals can provide the kind of life-saving neonatology services that Archange benefitted from. On average, a baby in CAR is 25 times more likely to die before its first birthday than if it had been born in Europe.

The critical situation in CAR around maternal and child healthcare has prompted MSF to provide free emergency obstetric care for women and newborns in locations across the country. MSF is also training Ministry of Health staff and renovating and equipping medical facilities so they can provide a good standard of care. In 2021, MSF teams helped nearly 19,600 women to give birth, including 1,020 by caesarean, while 1,900 newborn babies were treated in MSF-supported neonatal units across the country.