The killing follows a series of attacks and threats against humanitarian organisations and health workers during the past months. In June, an MSF aid worker, Elsa Serfass, was killed by rebel gunfire in the northwest, leading to a lengthy reduction of MSF operations.

A woman was shot dead in an MSF ambulance when an unidentified gunman fired on the vehicle in Vakaga province in the northeast of the Central African Republic (CAR) on March 10.

As a result, MSF has suspended its mobile clinic activities outside the main towns in the region.

This is the second person to be killed in an attack on MSF in the past nine months in Central African Republic. The ambulance was carrying a mother and her baby who had been discharged from the MSF health centre in Gordil. The 32 year old woman leaves behind six children.

"We are shocked and outraged that our patient's mother was shot," says Nicole Henze, MSF Head of Mission. "This attack is unacceptable. Our ambulance was clearly targeted, making us reconsider our activities in remote areas and our presence in the country. All armed persons are obliged to respect humanitarian aid. This includes medical personnel and, above all, our patients."

The killing follows a series of attacks and threats against humanitarian organisations and health workers during the past months. In June, an MSF aid worker, Elsa Serfass, was killed by rebel gunfire in the northwest, leading to a lengthy reduction of MSF operations.

Until this attack, throughout northern CAR, MSF was providing basic health care to populations in remote areas, as well as referral and access to secondary care in more serious cases. However, MSF considers that the necessary conditions for its medical teams to provide aid to these isolated populations do not currently exist.

Large parts of the civilian population in northern CAR are subject to roadside banditry, abuse by armed actors and repeated displacement. Villages have been attacked, pillaged and burned, forcing people to flee into inhospitable forest and severely restricting their access to health care.

In northeastern Vakaga province, MSF provided assistance to a population of about 35,000 through mobile and fixed clinics in Birao and Gordil. MSF teams work in seven other locations in Ouham-Pendé, Ouham and Nana-Grébizi in the northwest of the country.

From its health structures MSF carries out emergency surgery, provides primary and secondary health care and treats patients for tuberculosis, HIV/AIDS and sleeping sickness. MSF has been working in the country since 1997.