International staff: 10
National staff: 300
Situated in a region shaken by tension and violence, and virtually outcast by the international community, Liberia is limping along in the wake of seven years of civil war and three years of unstable peace. The war left most of the country's infrastructure - including the health system - in ruins. MSF works in Monrovia, Maryland county (in the southeast) and Lofa county (in the northeast).
Security incidents prompt evacuations
The entire region of Lofa, home to many displaced Liberians and refugees from neighboring Sierra Leone, is gripped by chronic instability and insecurity. The kidnapping of two MSF volunteers in August 1999 was a sharp reminder of this. The volunteers (kidnapped with other aid workers near Kolahun) were released unharmed, and MSF evacuated its staff in the area. In January 2000, the organization was able to return.
However, in summer 2000, clashes between factions of the Liberian army and the kidnapping of an MSF driver again forced the evacuation of the Kolahun mission, where MSF gives medical care at a small hospital and three local clinics. There are no Liberian doctors and no other aid agencies in the area.
A shortage of doctors
In the capital, Monrovia, MSF supports four clinics and one hospital, working closely with Liberian staff. The
clinics have about 13,000 consultations per month, reflecting the dire need for medical services in this city of 750,000 people. In the entire country, in fact, there are only 100 Liberian doctors, with over 80 of them concentrated in the capital.
MSF works in the main hospital in Maryland county, in the town of Harper. MSF is renovating the hospital building and looking at improving access to and the quality of care. Key medical problems include advanced respiratory infections, tuberculosis and malaria.
Work at another hospital in the small town of Tubmanburg ceased at the end of May, though MSF will supply drugs through the end of 2000. After determining that the Ministry of Health lacked the resources to manage the hospital, MSF turned over the administration of the facility to the hospital staff. MSF also fulfilled its goals at the health centers in Salala (Bong county) and Kakata (Upper Margibi county), but continues to pay staff salaries.