ABIDJAN
Travel across several areas of the city once became possible last week. Yet serious tension remains in a number of neighbourhoods. As a result it remains difficult to assess needs in several areas of the city in order to have a greater understanding of the extent of the medical needs. What is clear is that it is still a humanitarian emergency.
However; as the health system in Abidjan was totally paralysed for 10 days, hospitals continue to struggle as a result of shortages of drugs and food. MSF teams continue to organise rapid donations and provide medical care where the needs are most acute. However, people are still reluctant to seek healthcare as a result of continuing fear or the financial burden of treatment in many health centres.
Abobo Sud
For now, our operations continue in the hospital in Abobo Sud (north of Abidjan) where we receive between 15 and 20 casualties per day (mainly gunshot and sporadic violence), except from the night before and during the day of capture of Laurent Gbagbo, when the team received more than 60 wounded by gunfire and 20 others wounded related events.
MSF Donation have been made to an Ivorian NGO in another site (PK18).
We visited the Embassy of Mali where 2000 Malian people are gathered. We have already made a donation of drugs and we start to work there in order to improve hygiene and sanitation.
Treichville
On April 3rd through the Ivorian Red Cross, MSF was able to provide enough medical supplies to treat 50 wounded people in the general hospital in Treichville, in the southern part of Abidjan. Three days later, MSF again donated further supplies to the hospital. The intense days of violence up until April 11th meant several hospitals in the area were unable to receive essential supplies. As soon as security allowed, MSF immediately organised further rapid donations to help provide medical care where needs were most acute. On April 11th and 12th MSF donated further supplies to Treichville hospital, including high energy food for patients and staff. MSF also donated essential drugs and medical supplies to Attecoube maternity hospital, Yamoussoukro hospital and again to the Ivorian Red Cross. Next week, to deal with the significant numbers of people who need trauma surgery for wounds, MSF will open a trauma centre in Nanan Yamousso clinic, in the Treichville area of the city.
Anyama (northern suburbs of Abidjan):
We just start to work this Thursday in a part of the hospital of 156 beds in Anyama. We should have 50 beds (emergency room, surgery, hospitalization for pediatric cases, maternity)
We start support for 4 health structures based in Abobo and Anyama districts (donations of drugs and referral in Abobo Sud or Anyama hospital for severe cases)
Treichville
MSF continues to donate essential medical supplies to the Treichville central hospital, in the southern part of Abidjan, in addition to supplies of food for staff and patients. In the coming week, MSF plans to open a trauma centre in the Nanan Yamousso clinic, also in the Treichville area of the city, to provide surgical care for violent trauma and injuries.
Koumassi general hospital
The hospital was not functioning since the start of the fighting in Abidjan early april, as most of the medical staff could not come to work. We restored the free access to primary and general care and the maternity; the medical teams are seeing an average of 130 patients per day in outpatient and are performing around 10 deliveries per day. Complicated cases are referred to the CHU of Treshville for the moment.
Some logistic and watsan work will be needed in the hospital to insure basic hygiene condition (no running water at the moment).
Yopougon
Team made a donation of medical and surgical material to the CHU and visited an IDP site where we set up a dispensary.
IN THE WEST:
MSF teams continue to provide primary and secondary healthcare in many locations in the western region of Ivory Coast, which remains one of the most tense areas in the country and where people have been greatly affected. The main morbidities are malaria, respiratory tract infections and diarrhoeal diseases, while continuing wounds from violence as a result of intercommunal tension remain a serious concern. Many villages were razed to the ground during the violence, and still lie abandoned, while thousands of people are displace. Many of these remain hiding in fear in the bush without access to proper food, sanitation or healthcare, while others continue to flee to Liberia. It cannot be stressed enough that violence must not be targeted at civilians, and that they must not be prevented from seeking the essential medical and humanitarian assistance they require.
Duekoue: working in two health centers, one in the camp (Catholic Mission : 30000 IDPs) and one in a site called Cocoma for primary health care. We manage an emergency room in Duekoue hospital (for wounded stabilization) and we plan to send a surgical team of 3 people asap. For the moment, we refer the surgical cases to Bangolo.
We started again our mobile clinic (interrupted on March 3) on the north east on Duekoue
In Guiglo: in Nicla (health center with 10 inpatient beds for pediatric cases in a hospital unit) + 1 IDP site (church of the city: 2000 people) + water distribution
We’ll start soon to work with home visitor for an estimated 15,000 people who live in private homes : distrib + water + reference cases (pregnant women, sick or malnourish people) at the health center.
Blolequin: concerns in this town located 60 km from Guiglo (base MSF). Ghost town (40 to 50,000 inhabitants usually). People fled into the bush for fear of reprisals. They’re waiting for the return of ONUCI (Present in Guiglo) before moving. A First explo before yesterday, a second explo back on yesterday in order to assess the needs of population : only few people seen. We start mobile clinics.
Danane / Man / Bangolo : MSF continues to support hospitals in Danané and Man with medical supplies, while the MSF surgical team continues its important work in Bangolo hospital.carrying out 566 surgical consultations between March 28 and April 10. While the number of people seeking care for violent wounds decreased this week, this does not necessarily mean that violence against civilians has ceased and the situation remains tense in the west.
MSF continues to run mobile clinics twice a week in Bangolo, and also in several locations near the Liberian border, including Bin Houyé, Zouan Hounien, Danané and Glépleu, where between 70 and 100 patients receive primary healthcare with each mobile clinic visit. With people still hiding in the bush in fear, MSF teams are currently assessing a number of new areas to establish additional mobile clinics to assist those without access to medical care. Next week MSF plans to establish new mobile clinics in Toulepleu, Péhé and Sahibli.
LIBERIA
On the Liberian side of the border, tens of thousands of Ivorians have sought refuge in Nimba county. The majority of these people are scattered in villages throughout the county, staying with host families. This massive influx of people continues to put pressure on local communities and on their ability to cope with their already fragile access to basic services such as water or food.
The UN has set up a refugee camp in Nimba county for 15,000 people. So far, about 2,000 people have been staying in the camp. Some refugees have started to go back to their home village in recent weeks, yet signs of the continuing insecurity in Ivory Coast remain with people with fresh wounds fleeing across the border in recent days.
In addition a new wave of refugees has arrived in Grand Gedeh County, just south of Nimba. MSF team are organizing mobile clinics for local communities and refuges in many locations in both counties, with an average of 80 patients per day and per location. Malaria, diarrhea, respiratory or skin infections are the main health issues being treated.
Currently, MSF has 50 international staff working together with 150 Ivorian staff in Ivory Coast. In Liberia, there are 10 international staff working with 30 Liberian staff. MSF, an impartial medical humanitarian organization, which observes strict neutrality in its operations. Its activities in Ivory Coast are funded exclusively by private donors, ensuring the organization’s complete independence.
