Most of the 45,000 Central African Republic (CAR) refugees living in eastern Cameroon are diseased, malnourished and generally in bad health, non-governmental organisation (NGO) and UN workers say.

Since 2005 the Mbororo pastoralists of western CAR have been fleeing child kidnappings and violent attacks - including throat-slitting - by masked bandits whose identities remain unknown.

The refugees arrive “very weakened, after long days of walking and a lot of stress and they live in very difficult conditions”, Eric Grimaldi of Médecins Sans Frontières (MSF) told IRIN.

Once settled in some 60 villages in eastern Cameroon, their health does not improve significantly. For every 10,000 people, there are between three and seven deaths per day among the refugees. According to MSF, the situation is particularly bad in the village of Ngaoui in Adamaoua Province, home to 5,000 refugees and receiving 100 new refugees a month.

“[The refugees] suffer from malnutrition, typhoid and amoebic diseases,” said a nurse in a missionary hospital in the small eastern town of Letta. “The health of the refugees is really very bad… And they always arrive in a critical state to begin with.”

Rare paralytic disease

According to the UN Children’s Fund (UNICEF), 17.2 percent of refugee children under five are malnourished.

MSF has registered several cases of tuberculosis and about 50 cases of a rare paralytic disease called `konzo’. Known as “the disease of the poor”, it results from exclusive consumption of the bitter manioc plant, which, though inexpensive, is poor in vitamins and nutrients. Manioc also contains salt cyanide, which can be toxic if improperly cooked. The result can be irreversible paralysis of the lower limbs, as well as hearing and sight problems.

“We have met families where several children are now paralysed,” MSF’s Grimaldi said, adding that the Cameroonian authorities do not have the material or human resources to prevent the disease and very few doctors know how to treat it.

Difficult to access nutritional centres

The nutritional situation was “so alarming” according to MSF, that in July the UN Refugee Agency (UNHCR), the World Food Programme (WFP), MSF and another aid agency, CARE, in collaboration with the Cameroonian Public Health Ministry, began monthly food distributions.

Five nutritional centres have also been created, but refugees have settled over such a wide area that “[they] have trouble getting to the centres,” the head of UNHCR in Cameroon, Jacques Franquin, told IRIN. “Plus, it’s hard for a mother to stay at a nutritional centre for a month with one of her children while leaving the others at home.”

The refugees have limited access to healthcare, largely because of the bad roads and ill-equipped health centres.

Refugees lack water

Many refugees are equally confronted by a lack of water.

“It takes us six or seven hours to find water,” said Aladji Abdoulaye Gidjo Gargain, father of a refugee family in Borongo, about 450km northeast of Yaoundé. “When we were in CAR, we didn’t have this problem.”

“The arrival of the refugees created imbalances,” explained UNHCR’s Franquin. “They don’t always have access to the wells of the Cameroonians.” Either they cannot afford to pay or there is not enough to share, he said.

The UNHCR has built 15 new wells, but 10 times more are needed.

“Many water points in the region have already run dry, and the dry season hasn’t even started yet,” MSF’s Grimaldi said.

Traumatised

He added that many refugees were still affected by the attacks and kidnappings that they experienced. “We realised that many children refused to eat because they were traumatised by what they had seen and lived [through].”

Unfortunately, Grimaldi said, no one has taken the time - or has the time for the moment - to treat these psychological problems.