JAMA LogoThe Central African Republic is said to be a house of violence. Over the past decades, people residing here are engulfed with trauma, and may face severe economic setback. Experiencing traumatic events further elevates vexation, or at least this report claims so. Scientists suggest that more than half of the people belonging to Central African Republic subjected to trauma reveal depression or anxiety.

For ascertaining the levels of violence in the country, a survey was undertaken on 1,879 adults belonging to an average age group of 36.4 years. These investigations were commenced in five administrative units of the Central African Republic from October to December 2009. Amongst the five units, three were in the south that is free from recent violence, and two in the north, in which violence continues.

Experts explain, “For decades, the Central African Republic has experienced violence, economic stagnation and institutional failure. The latest wave of violence erupted in 2001 and continues to this day in some areas. Yet there has been little attention to the conflict and even less research to document and quantify the conflict’s human cost.”

Patrick Vinck, Ph.D., and Phuong N. Pham, M.P.H., Ph.D., of the University of California, Berkeley, and Tulane University, New Orleans questioned the study participants about deaths in their households, exposure to traumatic events, sense of insecurity and physical and mental health status. A very high percentage of the study subjects had either witnessed or personally endured potential traumatic events during the conflicts. The survey was then thoroughly scrutinized by the authors.

Scientists quote, “Mortality rates, lower levels of physical health and access to health services and symptom scores for anxiety were higher among study respondents in the two northern prefectures experiencing ongoing violence compared with those in the south. Mortality rates in all the areas in the study were three to five times higher than that for sub-Saharan Africa and were higher than rates in some comparable conflict and post-conflict areas.”

While 80.8 percent displaced and 76.4 percent had witnessed violence, 67.3 percent had been threatened with death. Around 60.7 percent had property stolen or destroyed, 10.8 percent were abducted and 3.6 percent were victims of sexual abuse. Among the study participants, 29 percent revealed a bad or very bad level of security walking in their village at night. On the other hand, 27.4 percent suggested unpleasing level of meeting strangers and 25.7 percent reported unsatisfactory level of traveling to the nearest town or village.

Investigators share, “The associations of violence with physical and mental health need to be further explored to develop a better framework in which to offer health care services in conflict and post-conflict situations. Unaddressed, these issues could further undermine Central African Republic’s development and slow its progress toward social reconstruction.”

Every month the death rate was five per 1,000 individuals in which 0.8 deaths per 1,000 per month were a result of violence. On questioning about physical health, 35 percent revealed good or very good and 29 percent ascertained their health to be bad or very bad. While 55.3 percent participants were suffering from depression, 52.5 percent displayed anxiety. The experts revealed a probable link of exposure to violence and self-reported physical health status to these mental health conditions. The study probably suggests the introductions of aid program and security sector reforms protecting these civilians.

The study is published in the August 4 issue of JAMA, a theme issue on violence and human rights.