MSF faces challenges in Ivory Coast

2011-03-25 08:31

Ivory Coast has been stuck in an escalating political crisis since the November 28 presidential elections which saw Laurent Gbagbo refusing to step down as president and hand over power to Alassane Outtara, who is internationally recognised as the country's new leader.

Increased armed conflicts have led to the displacement of thousands of people. The violence has also resulted in many being killed and wounded. This has, as a result, put a lot of pressure on Médecins Sans Frontières (MSF) also known as Doctors without Borders, a humanitarian organisation which is providing emergency medical care to the wounded in that country.

News24 interviewed MSF’s Renzo Fricke who is the Emergency Co-ordinator.

News24: In a nutshell, what is your comment on the political situation in Ivory Coast and how has it impacted on MSF’s attempt to deliver medical services to the wounded?

Fricke: As a neutral organisation, MSF does not comment on the political situation. But what we can say is that the deterioration and the spreading of fighting have had serious consequences on the population. People are trapped in the conflict, which means they are wounded and have to flee the violence – as we witness in Abidjan as well as in the western part of Ivory Coast and in Liberia, on the other side of the border which has to provide refuge to those fleeing.

This very volatile and tense situation makes it hard for the patients to access health care and we are concerned about this, notably in Abidjan. It also makes it difficult for our teams on the ground to effectively render their services especially nearby the frontline. It is crucial that patients have access to health care and MSF is trying to put in place mobile clinics to enhance accessibility.

News24: How long has the MSF team been in that country and what are some of the challenges?

Fricke: MSF went there after the elections and when tensions started to flare. Our team assessed the needs, organised donations of medical kits to several hospitals in the western part (in Danané, Man, Bangolo hospitals) of the country and in Abidjan. The team stayed on the ground and treated wounded people early in February in Duékoué, as the medical staff of the hospital had left.

However, the medical staff are now back in Duékoué and the MSF team continues to provide primary health care consultations in this structure. It’s also providing medical services in a camp where 12 000 displaced people are staying. The team is also organising mobile clinics in different places.

News24: What could be interesting is to know just how you have managed to work in a country where there are battles going on almost on a daily basis. How do you prepare yourselves to work under such conditions?

Fricke: MSF is used to working in conflict zones. What has always been important for us is to be a neutral organisation and to be recognised as such by all parties involved in the conflict. This is our best guarantee to work in these settings. MSF has worked for many years in Ivory Coast, and is well known throughout the country.

Our principles of impartiality and neutrality remain crucial for us where the need arises. In Ivory Coast, we work with both “sides” involved in the conflict. But I must say that even with such an arrangement in place, due to security reasons, sometimes it is still difficult to access the patients. It is also a challenge for the team to be as mobile as it wants in its endeavour to reach places where most accurate needs are.

We also prepare ourselves by being quickly reactive, and able to adapt to an evolving situation. We can quickly mobilise human resources to be in the field and we can mobilise our logistical teams to make available on short notice, the material we need to work with. The fact that we are financially independent is also a crucial asset that enables us to work in these conflict environments.

News24: How many of your staff are in Ivory Coast right now?

Fricke: We have about 35 international staff in Ivory Coast. These are working along with 130 national staff. We also have five international staff working together with 25 national staff at the border between Ivory Coast and Liberia. 

News24: And just how difficult is it for the people to access your assistance?

Fricke: In Liberia and in the western part of Ivory Coast, as explained above, it is crucial that MSF is mobile in order to reach the patients. In Ivory Coast, roads are uneasy and not safe for the people. People are scared to move around, so we have to adapt ourselves and be mobile to reach them. In Liberia, as tens of thousands of refugees are mostly scattered in more than 70 villages in the bordering district of Nimba, there are pockets of refugees in many places. This is why we provide mobile clinics in several locations which number up to 10 at the moment.

Nevertheless, we remain concerned about the access of the patients in different zones in Ivory Coast. Being displaced, people are hiding in the bush and most of the residents in Abidjan are too scared to come out of their homes and go to the clinic.

News24: What comments do you have about some of the wounds that you treat – how severe are they?

Fricke: Over the past three weeks in Abidjan, we treated about 200 people in the only functional hospital of Abobo neighbourhood. Last Thursday, we received 66 wounded, including men, women and children - with wounds from gunshots and shell explosions. Eight people died shortly after their arrival at the hospital, and nine other dead people were brought to the hospital.

News24: How many wounded people would you say you attend to on a daily basis?

Fricke: We can’t say the total. What we can only say is that MSF team treated about 200 wounded people during fighting in Abidjan over the past 3 weeks.

News24: There is mention in an MSF statement in our possession that the fighting in Ivory Coast has had serious consequences on the country’s population. Could you please elucidate on this.

Fricke: The consequences on the Ivorian population are diverse and serious. We see people trapped in the fighting and being wounded - notably over the last three weeks in Abidjan. People are fleeing the violence. Some tell us they have hidden in the bush alone or with their family, some are displaced inside Ivory Coast.

News24: There were reports recently that the Gbagbo-led forces shot at a group of women protesting the battles in the country and this resulted in the death of seven of them. What can you say about the security of women and children in Ivory Coast?

Fricke: In our mobile clinics, we see women and children, and as always women and children, notably children under five, are amongst the most vulnerable. In Liberia, we see and treat lots of women who have fled with their children, while the men are trying to stay in the home village to look after the house. In general, we see the population suffering from the consequences of the current violence in Ivory Coast. Women and children, men as well as older people have fled the country.

News24: How long does the MSF intend to stay in Ivory Coast?

Fricke: This will depend of the evolution of the situation. Right now, we are ready to reinforce our team and our medical assistance in Ivory Coast as well as in Liberia.

News24: Anything else that you might want to share with us?

Fricke: Commercial and financial sanctions imposed by the international community, together with transportation problems, have led to shortages of medicines and medical supplies. Health facilities in many regions lack basic medicines for treating chronic and acute illnesses.  MSF's donations of medicines and medical supplies to health facilities are thus critical, but they cannot meet all the needs in a country caught in a worsening crisis.

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