Ivory Coast: Renewed violence deepens crisis

The eruption of violence in November 2004 posed a challenge to MSF's work in the country. Government and rebel forces clashed, resulting in the intervention of French troops who, together with UN troops, guarded the demilitarized zone in the center of the country.

MSF works on both side of the conflict's frontlines, providing medical personnel for health facilities and urgently needed care. At hospitals in Bouaké, Man and Danané, MSF staff provide essential medical care including pediatric consultations, emergency medicine, obstetric and gynecological care and surgery. Mobile clinics are also used in the west to bring care to those living in more isolated areas.

A team in the town of Guiglo provides more than 2,500 medical consultations each month (many of them for children with malaria), assists malnourished children and gives aid to those displaced by violence.

Because malaria is the largest threat to children's health in Côte d'Ivoire, MSF treated more than 70,000 malaria patients in the last year, using artemisinin-based combination therapy (ACT), the most effective treatment available. MSF also carried out a mass measles-vaccination campaign for almost 10,000 children in the Bangolo area south of Man, in 2004.

More violence rocks the country

The eruption of violence in November 2004 posed a challenge to MSF's work in the country. Government and rebel forces clashed, resulting in the intervention of French troops who, together with UN troops, guarded the demilitarized zone in the center of the country.

The unrest caused such strong anti-French sentiment that more than 8,000 foreigners were evacuated from the country. Despite the tense situation, MSF managed to keep its projects running with skeleton teams of international and national staff.

In the western town of Danané, hospital services continued throughout the crisis, providing up to 70 consultations a day. Airstrikes on a military base in Bouaké injured many civilians, and on 4 November, 39 people were urgently referred to the town's public hospital where an MSF medical and surgical team were prepared to treat them.

MSF also responded to the needs of those who had been displaced by the fighting. In other parts of the country, basic medical assistance was given to wounded civilians caught in the crossfire. Tons of medical and surgical material including medicines, dressings, bandages, compresses and gloves were distributed to several hospitals throughout the country.

At the end of February 2005, an attack on the rebel-controlled village of Logoualé, south of Man, created new tensions in the "demilitarized zone". Since that incident, MSF teams have witnessed a pattern of attacks on villages followed by population movements that raise concerns that a form of ethnic cleansing could be under way.

Prison riot

MSF teams also provided assistance during a week-long riot that began on 2 November in the MACA prison, formally known as the Maison d'Arrêt et de Correction d'Abidjan. MACA prison holds about 5,000 inmates, although it was built to house only 1,500.

The growing political tension in November permeated the prison, and inmates began a mutiny to demand better living conditions. These conditions - overcrowding, poor hygiene and insufficient food - give rise to frequent cholera epidemics, high levels of tuberculosis (TB) and malnutrition.

The riot injured 75 people and resulted in 24 deaths. The MSF team transferred 12 seriously wounded patients to the university hospital in Yopougon.

MSF conducts more than 1,200 medical consultations with prisoners each month. In 2004, the organization extended its activities in the prison's TB ward in collaboration with the country's national TB program and began treating six people who had multidrug-resistant strains of the disease. An estimated 150 detainees benefit from a supplemental nutrition program established by MSF.

Since its teams began working in the prison, MSF has been able to improve health care and increase the number of medical staff on duty. In addition, the prison's budget has been increased. Because of these positive developments, MSF is now decreasing its support in the prison and plans to close most of its projects there, except for the multidrug-resistant TB program, by the end of 2005.

MSF has worked in Côte d'Ivoire since 1990.

INTERNATIONAL STAFF 55 NATIONAL STAFF 1,284