Unspeakable horrors in a crisis on top of a crisis

Humanitarian and development indicators were not looking good before the coup, but now they look even worse. A A massacre of the innocents is taking place in the heart of Africa as the world looks the other way.

In this country that rarely makes the news, 1.1 million people are estimated to be severely or moderately food-insecure; 400,000 people are estimated to be internally displaced (IDPs), which is double the figure of just a few months ago, and around 65,000 people have been forced to flee the country, most of them to neighbouring Cameroon.

"CAR was a failed state before. Now, it's just worse," Amy Martin, country head of the UN Office of Coordination for Humanitarian Affairs (OCHA) told IRIN News service.

"We're estimating over 1.5 million people who need assistance of various kinds, whether it's health, nutrition, shelter, protection," she said.

Aid agencies, whose vehicles have come under attack, can only guess at what's happening in some areas, and Martin said the actual number of people affected by the crisis could be much higher.

Adequate response is further hampered by a lack of funds: just 44 percent of the $195 million dollars sought to tackle the crisis has been forthcoming.

Never much more than a phantom state, the CAR has sucked in thousands of mercenaries from neighbouring countries and, France warned on Thursday, now stands "on the verge of genocide". Self-defence groups, called "anti-balaka" - armed with machetes, bows and arrows and spears - have sprung up and committed atrocities against both Seleka (a coalition of rebels, mainly Muslim, although called "Muslim-lite", who ousted President Bozizé and are accused of killing, looting and raping) as well as the larger Muslim community. Such inter-faith conflict is a new phenomenon in CAR.

Aside from the terror of the conflict, people are suffering from illnesses as they hide in their fields with no shelter, medicine and food. Only the bravest or sickest take the highway to seek medical help.

Despite the conflict, malaria remains the biggest killer, especially among children.

Instability has pushed 70 percent of the nation's children out of education, and seen 3,500 recruited into the Seleka rebel forces, and an unknown number recruited into the anti-balaka.

The humanitarian emergency in the CAR, a landmass bigger than France where the average male life expectancy is 48, remains a blind spot for most of the international community and has been referred to as "the worst crisis most people have never heard of".

You can download the new report by Doctors Without Borders here.