Monrovia, Liberia, June 27, 2003 - The few health facilities still functioning in Monrovia are stretched to their limits. The international medical humanitarian organization Doctors Without Borders/Medecins Sans Frontieres (MSF) has transformed two of its compounds in the Mamba Point area of the Liberian capital into emergency hospitals with outpatient and inpatient facilities. The vast majority of people they receive are civilians who arrive with wounds from stray bullets and mortars.
"Our compound is overcrowded. It was never meant to be a hospital, so we are improvising as we go," says Nathalie Civet, MD, from one of the MSF bases. "We manage, but only just. One of the saddest things is that we have to turn away people who show up with signs of cholera, as we cannot build an isolation ward in our compound." For the moment, the team is not able to reach its cholera treatment unit on the other side of the city, which on Tuesday alone received 111 new patients.
Since war returned to the streets of Monrovia early this week, a steady stream of wounded has come to seek medical care from the remaining MSF teams. In the compound where Dr Civet is based, 150 wounded arrived on Wednesday and another 50 yesterday. As fighting was again fierce last night, more admissions are expected today.
Earlier in the week, the team converted the living quarters of the compound into a clinic. There is now an inpatient department on the ground floor. On the first floor the team improvised a pediatric ward and a surgical theater.
Dr. Civet says that the team is running low on some materials needed for basic surgery. In addition, the 4,000 liters of water consumption per day in the makeshift hospital is well beyond the capacity of the well that is located in the compound, the only water source available for the moment.
"About 80 percent of the work we do is surgical," says Dr Civet. "We stabilize the wounded and perform minor surgery. For more complicated treatment we refer people to the JFK surgical ward, which is run by the ICRC. But here, we have also had to amputate an arm of a one-and-a-half year old baby. On Wednesday three people died and we had to bury them on the beach. Yesterday again, three people died. We do what we can under these conditions, but compared to the huge needs of the population it is absolutely insufficient."
MSF reiterates the responsibility of the warring parties to protect the civilian population, allow them access to health care, and make sure health facilities can continue or resume functioning.
Yesterday, four babies were born - including twins - by Caesarian sections. The deliveries provided the team, patients, and relatives gathered in the compound with short moments of joy in what is otherwise a grim situation.