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MSF in Ivory Coast, 2006
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Sporadic violence and instability continue in the Ivory Coast, despite a peace agreement signed between the government and rebel forces in 2003.
The country has effectively been cut in two and the healthcare system was decimated through the conflict that began in 2002. Ministry of Health (MOH) staff are slowly returning and medical services are resuming, but there remains little or no healthcare for most of the population.
As well as providing basic healthcare in both the north and south, MSF is pioneering new ways of delivering HIV care in the west of the country, proving that this is possible in a place where fighting can break out at any time.
HIV prevalence is estimated up to 15 per cent in some areas. Previously, HIV/AIDS care was administered by doctors in hospitals, but for many people with HIV this is not viable for a host of reasons, including distance and the difficulty in accessing hospital care because of conflict. As an alternative, MSF is training nurses and clinical officers to provide care in health clinics. Education and communications activities encourage people to come forward for voluntary counselling and testing, with free antiretroviral therapy (ART) and treatment of opportunistic infections provided for those in need.
In Danané, MSF in 2005 built a new hospital unit for pregnant women with HIV, dedicated to providing treatment that will prevent these women from passing the virus on to their babies. In its first four months, five per cent of the 922 women tested were found to be HIV positive. In Bin Houye, MSF is supporting Ministry of Health HIV/AIDS treatment programs in three health centers and has started voluntary counselling and testing services. MSF also supports the government's HIV/AIDS program in Man.
Providing essential healthcare
At hospitals in Danané, Bouaké and Man, MSF continues to provide essential medical care, including paediatric consultations, emergency medicine, obstetric and gynaecological care and surgery. In 2005, MSF teams in Bouaké provided approximately 4500 consultations monthly and in Man more than 8000. Mobile clinics are used to provide basic healthcare in more isolated areas and in the "zone of confidence", the buffer area between the north and south, where MSF runs a hospital in Bangolo and a health center in Kouibly.
In January 2006, whilst many organizations were forced to evacuate amidst riots and demonstrations against international organizations — labelled occupying forces by certain groups — MSF teams in Guiglo were able to continue their work, providing primary healthcare for up to 6000 displaced persons and the local population (3200 consultations per month) and treating severely malnourished children in a therapeutic feeding center.
Handover of prison project
After eight years working in MACA prison, formally the Maison d'Arrêt et de Correction d'Abidjan, MSF successfully handed this project to the MOH at the end of 2005.
MSF has worked in the Ivory Coast since 1990.