All in one bed: An MSF project in Bossangoa

Sylvia is a German doctor, currently working in the Central African Republic on her first assignment with Médecins Sans Frontières / Doctors Without Borders (MSF). In this blog, she writes about the reality or working in the remote town of Bossangoa.


I've now been in Bossangoa for more than two weeks... time flies by!

There is always a lot to do in the hospital. For our team, that means working at full speed, and for the hospital, that means maximum bed occupancy.

For example, on the therapeutic feeding ward for malnourished children, there are currently more than 90 young patients with their mothers. However, there are only 45 beds.

In most cases, two children share a bed and even the mothers sleep in the beds. So that makes four people per bed!


Facily, Sylvia's MSF supervisor, examining a young patient
Facily, Sylvia's MSF supervisor, examining a young patient

There is a garden, kitchen, and laundry room... not much is comparable to European standards here.

One of the first things that one learns here is that the Western European standards regarding concerns such as privacy, hygiene and care are almost impossible to meet due to lack of resources.

Here, the children's relatives take care of many nursing tasks. So, food is provided by the hospital for both the children and a parent or caregiver.

It is balm for the soul when you see how fast and uncomplicated we can help some people.

At the moment, my supervisor, Facily, accompanies me (luckily) on my rounds. We visit about 50-60 patients daily.

Malaria is by far the most common diagnosis as it is currently rainy season in the Central African Republic… and the rainy season could just as well be called “malaria time”.

Fortunately, malaria is a disease that we can treat quickly and effectively. The seriously ill children who come for treatment are usually significantly better after a day or two.

It is balm for the soul when you see how fast and uncomplicated we can help some people.

However, as far as the difficult cases are concerned, practical medical skills are needed. Because the diagnostic possibilities are – even if great for local standards – very limited compared to what I was used to.

I enjoy working with young patients (which are very different from adult patients I am used to working with at home), and the great team in the hospital are immensely helpful – even if you have to ask (again) for something.

Also, it is not difficult to feel good amongst our wonderful terrain.

In the evening there is always someone with whom one can talk about the events of the day and have a cool after-work drink.

Or, you can add energy with a bit more activity. On the volleyball field, for example, we recently organised a match with an international presence: Congolese staff playing together with international specialists from different countries.

And, in front of my door, I have now planted a few seeds – salads and herbs – in the soil. Let's see how they will grow here.