Nothing, absolutely nothing, is easy at Bouar hospital and no-one knows that better than the quietly spoken 33-year-old trainee GP doctor Wilfred Komoyo.

Remember the trainee bit, as you read on.

We met this morning as he was scrubbing up to perform an operation and even that isn’t easy.

A woman bears a pitcher full of water from the outside well on her head. There is no running water in this hospital. Only after the kettle has been boiled on a gas stove can he prepare for the operation.

The sterilizing machine is broken. The electricity generator is broken. The fan is broken.

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And the operating light is broken – even if the electricity worked. So here’s the doctor’s problem, that is the trainee doctor.

The patient has a bullet entry wound in his lower abdomen but no exit. If they don’t get the bullet out, lethal infection is almost certain.

When you don’t have running water or power the idea of an x-ray to locate said bullet is a distant dream.

What you have to do is basically slice open the abdomen from that entry wound, gently expose the intestines and simply feel your way in until – with luck – you feel something hard.

This though is far from the only complication the patient has given his consent to be filmed but I shall not name him because that could put his life in danger. That’s what it’s like around here.

Because there’s no electricity, they cannot monitor the right amount of anaesthetic. So they make a rough and painful guess. Our patient’s legs and arms are strapped firmly down, arms outstretched in a crucifix system with thick leather straps.

Throughout the 90 minute ordeal the man is only just under, grimacing, gritting his teeth, and moaning in great pain all through the procedure.

Eventually the doctor turns to us with a small dark object the size of a large pea, rolling around in the palm of his hand, gloved in white blood stained plastic.

“Voila monsieur – on a trouver la balle,” says the doctor – we’ve got the bullet.

For this trainee GP that will not be the end of the day’s work, for he reckons to be the one doctor for 57,000 people in this area. This country is bigger than France and has fewer than 10 qualified working surgeons.

You may think given that Bouar hospital would be overrun. But it is empty. Thousands remain out in the bush with zero medical care – or any care come to that.

Since gunmen attacked this hospital they won’t come here and the presence of heavily armed African peacekeeping troops in the hospital grounds does not reassure the people.

The good doctor does what he can but all around this place are ghost villages and the growing fear.

Fear of the gunmen of course but fear that the wider world cannot, does not, and will not understand the chaos now descending here in the heart of Africa.

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