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Picking Up The Pieces
August 15, 2003
After nearly three weeks of limited activity because of fighting in the Liberian capital of Monrovia, Doctors Without Borders/Médecins Sans Frontières (MSF) teams are now actively traveling to other areas of the city and beyond to assess health needs and reopen clinics and cholera treatment units that had been forced to close.
With no functioning health care system and more than 75% of the country cut off from humanitarian aid, MSF anticipates the country's medical needs to be considerable. In the coming days, MSF plans to undertake rapid assessments of health needs and provide medical care in as many areas of the country as possible.
"Now that the fighting in Monrovia has largely subsided and we are able to travel to more of the city and to rebel-held areas in the north, our work is just beginning," said Christopher Stokes, an MSF Director of Operations for Liberia. "With most of the country's population unaccounted for and cut off from medical care and adequate food or water, MSF is extremely concerned that the health needs in the country could be enormous in the coming weeks and months."
Assessments show needs
Recently, MSF teams completed three assessment trips to rebel-held areas of Monvoria city and Montserrado, Grand Cape Mount, and Bomi counties where there is virtually no access to health care for residents and displaced persons. On Friday and Saturday, August 8/9, MSF and the International Committee of the Red Cross (ICRC) carried out two assessment trips to rebel-held Bushrod Island in northern Monrovia.
The assessment team visited Redemption Hospital, a clinic operating in the Club Beer Brewery, the Clara Town clinic, and two additional small clinics. Two of the clinics had managed to provide basic triage, dressings, and amputations for war wounded during the last round of fighting, as well as treatment for diarrhea and suspected cholera cases. MSF and ICRC donated basic medical kits, dressings, supplies for oral and intravenous rehydration, and water to the clinics visited.
First contact in over eight months
On Wednesday, August 14, two MSF teams traveled north of Monrovia to rebel-held camps for displaced in Montserrado County, and on to Bo Waterside on the Sierra Leone border in Grand Cape Mount County, and to Tubmanburg in Bomi County. This was the first time in more than eight months that humanitarian organizations had reached Grand Cape Mount and Tubmanburg.
At Bo Waterside, one MSF assessment team joined another MSF team from Sierra Leone that was carrying out a rapid nutritional survey to assess the health needs in villages in the area.
In Tubmanburg, the second MSF assessment team found the city hospital - where MSF has previously worked - empty and non-functioning. MSF donated medical supplies and medicines to a small clinic in Tubmanburg where several local health care workers have been doing their best to provide the only medical care available in a city reported to have over 14,000 residents.
The MSF assessment team also visited the camps for displaced persons in Montserrado County where MSF had been running three clinics. The populations of the camps have been dramatically reduced as people fled the fighting or were pressured to move northward.
During the past two and a half weeks, the two MSF Mamba Point Hospitals functioned primarily in emergency mode to treat war wounded and emergency cases. In the past week, the two hospitals have resumed seeing regular patients in their out patient clinics. On Monday, August 11, the second Mamba Point Hospital out patient clinic saw over 200 patients on its first day.
The most common ailments being treated are malaria, respiratory tract infections, diarrhea, malnutrition, and cholera. The out patient department (OPD) facility has added a new building for its pharmacy and for mother-child healthcare.
Cholera unit reopens
On Tuesday, MSF reopened the UN Drive Cholera Treatment Unit (CTU). Although patient numbers are not as high as the 350 cholera cases per week being treated in June before the last round of fighting, MSF's three CTUs are beginning to admit new cases.
In addition, MSF is reactivating eight rehydration points established in heavily populated areas of the city before the last round of fighting to provide oral-rehydration salts and water for people suffering from diarrhea and refer suspected cholera cases. To alleviate a serious lack of clean water for drinking and washing in the city, particularly in the centers of displaced persons in the city, MSF is currently trucking over 100,000 liters per day, seven days a week, to selected places in Mamba Point and the Monrovia city center.
Last week, MSF opened additional out patient clinics in a convent school in Mamba Point and one in Paynesville in Monrovia, and reopened Soniwein, New Georgia, and Garnersville clinics, and began supporting the Star of the Seas clinic in the West Point area of the city. Duport Road clinic continued to offer medical care throughout the fighting, providing over 4,600 consultations in July alone.
Redemption Hospital and the clinics in Clara Town and Logan Town remain closed, but MSF hopes to reopen these and other clinics in Monrovia and the camps in Montserrado County in the coming days.
Measles vaccination campaign
In response to ten cases of measles in MSF's two Mamba Point Hospitals, an MSF team has launched a vaccination campaign in the buildings, churches, and schools in Monrovia where tens of thousands of displaced persons are living in cramped, unhygienic conditions with little access to food or clean drinking water. MSF has already vaccinated over 3,000 children under five.
At the Samuel K. Doe Stadium where an estimated 40,000 displaced persons have taken shelter, MSF continues to offer out-patient and short-term in-patient medical care, as well as run a cholera treatment unit.
In Bong County, east of Monrovia, MSF teams in three camps for 60,000 displaced persons continue to provide medical care and water and sanitation support. In response to finding over 100 children severely malnourished in the Salala camp in Bong last week, MSF launched a supplementary feeding program for over 4,000 children under five.