DAKAR (AlertNet) - The global financial crisis has led to an alarming rate of urban malnutrition in the south of the Central African Republic, where diamond mines have closed as demand for the gems falls, the medical relief group Medecins Sans Frontieres (MSF) says.

Diamond production fell two thirds over 2008 as mines closed, raising unemployment and cutting incomes, leaving people struggling to feed their families.

"It is a kind of vicious circle now - parents cannot feed their children, we have sick children who cannot get treatment and become malnourished and because they are malnourished they become even sicker," said David Noguera, an emergency response manager for MSF.

MSF has admitted over 1,300 severely malnourished children within a month in its temporary clinics in the towns of Carnot, Boda, Nola and Gamboula.

Although child malnutrition is a seasonal problem in rural areas due to malaria and the lack of protein in the staple food cassava, MSF said the situation in towns was a new challenge.

"This is urban malnutrition and it is weird because some of these urban people do not have the fields or plots and capacity to plant things to feed their families," Noguera said.

"All they know is to work in mines and get paid and eat the next day - it is that kind of economy; and the moment they lose their jobs they do not have any kind of coping mechanism and there is a big sense of uncertainty about the future."

The country has already suffered decades of political instability leaving the health system shattered, weak and neglected.

"The government has not been able to pay health worker salaries for years, so, many doctors and nurses have left the health system for jobs that will feed them and their families," Bruno Fugah, country director of the medical relief organisation Merlin, told AlertNet.

With just 1,800 health workers for a population of 4.4 million, all of the country's health facilities are run by community members, who have received no more than six months on-the-job training before being sent to man a health centre and clinics, serving 5,000 people, Merlin said.

In addition to the absence of health infrastructure and personnel, high poverty levels and insecurity in the north of the country, which is still affected by internal rebellions and incursions by Ugandan rebels, makes it harder to effectively tackle endemic problems like malaria and sleeping sickness.

"People are still living in the bush with poor housing and it is hard to distribute bed nets and have them used because people often sell them, sometimes to buy food," Kai Braker, an MSF medical advisor for the Central African Republic, told AlertNet.

In a country where around two thirds of people live below the U.N. poverty line of $1.25 per day, many cannot afford healthcare.

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