Ivory Coast: A silent crisis

While drastic in its own right, the high level of STIs is also a clear indicator that HIV/AIDS is spreading in the region, making prevention and treatment efforts all the more urgent.

This is one of the worst cases of sexually transmitted infection (STI) that the midwife has seen in her 20 years of experience. Despite immediate treatment by the hospital staff, the patient goes into cardiac arrest and dies of septic shock. She is 13 years old.

A 14-year-old girl comes to a mobile clinic complaining of general pain in her head and stomach. She does not know whether she is pregnant, but the nurse examining her discovers that she is carrying both a baby and an STI. The young girl tells MSF that she is unmarried but often has sex with a boy in the military. She explains that, in exchange for sex, she receives money, clothes and protection for herself, her brothers and sister.

The civil war and subsequent collapse of the country's health care system have provoked a medical crisis in parts of CÃ?´te d'Ivoire. MSF teams in the western part of the country have encountered alarmingly high rates of STIs. These infections can lead to horrible complications in reproductive health.

While drastic in its own right, the high level of STIs is also a clear indicator that HIV/AIDS is spreading in the region, making prevention and treatment efforts all the more urgent. Family separations and the influx of soldiers have left many women and young girls vulnerable to sexual violence, prostitution, unwanted pregnancy and STIs.

MSF teams diagnose STIs in about 20 percent of the adults visiting their clinics in some towns. The teams are convinced that the actual prevalence is higher, and that many STIs, including HIV/AIDS, often go undiagnosed and untreated.

The teams are frustrated by these alarmingly high numbers of STIs and the lack of effort to prevent the spread of these diseases, including HIV/AIDS. Despite an estimated 10 percent prevalence rate for HIV in CÃ?´te d'Ivoire, little is being done to combat it outside of the major city centers.

In addition to boosting education, prevention and treatment of STIs, MSF is advocating for increased prevention of mother-to-child transmission of HIV, treatment of opportunistic infections and treatment of AIDS with effective medication.