"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."

MSF presence jeopardized by second killing in 9 months

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 MSF was providing basic health care to populations in remote areas throughout northern CAR as well as referrals and access to secondary care in more serious cases. However, MSF considers that the necessary conditions for its medical teams to provide assistance 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 the 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 TB, HIV/AIDS and sleeping sickness. MSF has been working in the country since 1997.