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Nurses run checkpoint gauntlet to get medicines for north
Thursday 21 October 2004
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COTE D IVOIRE: Nurses run checkpoint gauntlet to get medicines for north

[This report does not necessarily reflect the views of the United Nations]

©  IRIN/Karene Bassompierre

Many health workers left Odienne and other northern towns after the crisis erupted

ODIENNE, 30 August (PLUSNEWS) - Battling your way past rebel and government soldiers to buy medical supplies does not fall under a nurse's usual job description. But for Sister Rosalia, trying to treat the sick in the northern half of Cote d'Ivoire, it is an unavoidable chore.

The world's top cocoa producer has been split in two since an uprising in September 2002 and aid workers and residents say the humanitarian situation is deteriorating in the rebel-held north of the country.

Sister Rosalia works in the town of Odiennem which has more than 20,000 inhabitants, and can remember the four months of civil war until January 2003 when her health centre took in the war-wounded round the clock.

"During the crisis we were the only place that was open," the Italian nun, who is in her 50s, recalled. "People injured in fighting all over the region came to us and we worked day and night."

Now some of those same soldiers man the checkpoints along the 600 km road from Odienne to Abidjan, demanding bribes or unofficial taxes from nurses making the journey to get medicines for the already cash-strapped clinic.

"Today we have problems getting medicine. We go to Abidjan but at the checkpoints we always have to pay. Even though we were there for those people and have stayed," she said, the anger rising in her voice.

Sister Rosalia has been in Cote d'Ivoire for eight years and runs the clinic with another Italian nun. Their former colleagues - a doctor and a midwife - fled to the southern half of Cote d'Ivoire last October, fearing for their safety.

The United Nations Children's Fund (UNICEF) estimates that 80 percent of the doctors, nurses and midwifes in the north have fled since the outbreak of war.

Sister Rosalia went south to recruit new staff and was taken for a spy by soldiers as she made the journey. A new doctor has now arrived from Abidjan but the clinic is still waiting for a midwife and has had to abandon its monthly visits to small villages in the neighbourhood.

Other obstacles have been thrown in the nun's path.

"For days, we have not have a drop of water or a spark of electricity," she explained.

Not an isolated case

The health centre's hand-to-mouth existence is not a rarity in northern Cote d'Ivoire.

A mid-August visit by a United Nations humanitarian team found that most inhabitants in the rebel-controlled parts of the country lacked basic health, sanitation, water and education services and recommended that government workers and civil servants return to the northern and western reaches of the country more quickly.

UNICEF says drugs and equipment have been looted from hospitals and health centres and the system for monitoring the outbreak of epidemics has been paralysed.

Public hospitals in the north can only guarantee a minimal service and while humanitarian organisations like the International Committee of the Red Cross and Medecins Sans Frontieres are trying to plug the gaps, it is not enough.

The main hospital in Bouake, the largest city in the rebel-held sector, can only deal with the most urgent, life-threatening cases. No x-rays can be done in Odienne so patients have to travel more than 200 km to Korhogo, the second biggest town in the north. And in rural villages, many health centres have had to shut their doors.

In June, the European Union stumped up 3.5 million euros (US$ 4.2 million) to re-equip health centres in 25 districts affected by war, which were mainly in the north of the country.

But one northern district health director told PlusNews at the time that because the government was no longer paying for the upkeep of health services in areas outside its control, he would have to sell some of the drugs being provided through the grant in order to cover basic operating costs.

The UN mission has called for more funds.

"Investment in the health sector is very important," Abdoulaye Mar Dieye, the mission leader and UN Humanitarian Coordinator for Côte d’Ivoire, told reporters in Bouake.

"People are being urged to do what they can to solve the problem of war but if we don't sort out the problem of HIV/AIDS or the problems with drugs then it will all be for nothing," Mar Dieye added.

Cote d'Ivoire has the highest rate of HIV in West Africa, with the health ministry estimating that 10 percent of the country's 16 million population is HIV positive. But in some northern areas, the UN mission said, the percentage of people living with HIV/AIDS was double the national average.

Bad sanitation breeding disease

Water-borne diseases like typhoid are also a problem in a region where the UN says many people do not have access to clean drinking water because village pumps are badly maintained. Blocked drains and rubbish dumped with abandon are aggravating the water problem, residents say.

"About 80 percent of our patients since April are believed to have typhoid but we don't have the means to test them," Sister Rosalia said.

And malaria rates are running high, with the rainy season creating a breeding heaven for mosquitoes. Medecins Sans Frontieres estimates about 50 percent of sick children are suffering from the life-threatening disease.

The New Forces (FN) rebel group says the government in the south cannot afford to ignore the north's problems.

"Health and sanitation issues need to be taken seriously. The risks are not limited to our region," the FN's human rights officer Mamadou Coulibaly told reporters

"We're seeing a resurgence of diseases we'd managed to conquer and some of them could reach the south," he added, without giving details. "We want an appeal to be launched for all doctors to come back. The very fabric of the health system is deteriorating."

But some residents say the rebels themselves are to blame for the miserable conditions in which people in the north are forced to live, whether it be avoiding malnutrition or dodging stray bullets.

With many of their husbands unemployed after businesses were crippled by the rebellion, the main struggle facing the region's women is how to feed the family.

The World Food Programme hands out food rations and is also providing seeds to enable a degree of self-sufficiency in the future. But times are still tough, say some residents.

"It's been so hard since the crisis, there's not enough food," 21-year-old Tene Coulibaly, who lives in Korhogo, told PlusNews.

And then there is the sporadic violence, like the fierce clashes between rival rebel factions in Korhogo in June, which makes life dangerous for ordinary citizens trying to eke out an existence.

"There are often stray bullets," said Fatoumata Coulibaly, a 30-year-old mother of five who lives in a village outside Korhogo. "Some even make it into the house and could end up on your bed. But the FN are not bothered about the population."


Recent COTE D IVOIRE Reports
AIDS prevention measures collapse in rebel-held city,  5/Oct/04
Civil war hinders planned expansion of AIDS treatment,  27/Sep/04
Private AIDS clinic brings hope to Abidjan slum,  23/Sep/04
Nationwide HIV/AIDS prevalence survey to be launched in November,  15/Sep/04
Government slashes price of ARV treatment for AIDS,  3/Jun/04
VIH Internet
Sida Info Services
Le Fonds mondial de lutte contre le SIDA, la tuberculose et le paludisme
Le Réseau Afrique 2000

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