With the attempt of a crime against the state in 2002, the Côte d’Ivoire has been divided in two: the North was inhabited by the rebels and the government was in the South. The border was a safe area and taken in charge by the United Nations. This is where Doctors without borders (MSF) installed its offices in order to set up the Danane hospital, which was unoperational since the staff ran away. The work done by the non governmental organization was possible because of the donations of people like you and the Canadian International Development Agency (CIDA). Let’s now take a look at the MSF’s emergency plan in Côte d’Ivoire.

A team of Doctor without borders making an intervention in Côte d’Ivoire

MSF is a non governmental organization which is very different from the others. It does not work in development, but in humanitarian help. “We intervene in emergency situations such as armed conflicts, natural disasters, outbreaks, etc. We never stay in a country for long. We arrive during the crisis and we leave once the situation has improved”, explains Frederic Sanchez, MSF operations counsellor in Côte d’Ivoire

In Côte d’Ivoire, the attempt of a crime against the state in September 2002 conducted to a civil war. Of course, the health infrastructures fell down. Doctors were not getting any money and had no more medical tools at their disposal, so they left for refugee camps, as well as most of the population. For its part, MSF arrived in the country in 2003.

Free quality health cares
“We sent a small group of expatriates to take the health infrastructures in charge. In the city of Danane, we put back the hospital on its feet and we have ordered medical tools from Europe. Moreover, we have hired a team of local interveners, working in health and management fields, in order to take the operations in charge with us”, mentions Mr Sanchez.

MSF has for policy to provide everyone, without discrimination, quality health cares. “The hospital cures many persons in an area, but we also travel to help people in farther villages. Malaria is probably the disease that we encounter the most in Côte d’Ivoire, since it is the major disease of the country. We also give tritherapy to the ones who have HIV”, adds Mr Sanchez.

Thanks to the non governmental organization, some nutrition clinics have been created in the country. In 2006, almost 600 kids suffering from malnutrition have been cured. Even with an unstable country, MSF succeeded in building an hospital room in Dadane for HIV positive pregnant women. “When a pregnant woman is tested HIV positive, we give her tritherapy in order to reduce the risks of transmission to the baby”, explains Mr Sanchez.

A dream come true
MSF, which is a neutral organization, intervenes in crisis situations, when health cares are not provided anymore and this, without asking any money to sick persons. The population reacts positively to the arrival of the organization in their country. “It is obvious that when parents do not have access to health cares for a sick kid, they welcome the organization happily. Moreover, we talk a lot with them and we always do everything with their approval”, explains the operations counsellor.

The presence of the non governmental organization is a real opportunity for the Ivorians, which mostly are unable to pay for health cares with the costs recovery system of the Health Act that was implemented before the conflict. Moreover, MSF has conducted a survey on the city of Bin Houye, where 50% of the population has malaria. This means that if the government reimplements its costs recovery system when MSF will leave the country, only a couple of persons will be able to pay for health cares.

“It has been four years now that the population receives free health cares. This is one of the reasons why they would like MSF to stay in their country”, confirms Mr Sanchez.

Getting ready for a transition
Unfortunately, this is not MSF’s mission. “We only intervene in emergency situations. We do not have to be in charge, at long term, of the health cares provided to the population. It is the responsibility of the government”, explains Mr Sanchez.

MSF works with several lenders and various United Nations agencies so the population will have access to health cares once the non governmental organization leaves the country, which will happen soon. In fact, the rebels have signed a peace agreement last March. The situation in this country is now more stable.

“The first reaction of the Ivorian government is to put back in place the former cost recovery system once we leave the country. On the other hand, we are actually discussing with the Ministry of Health and we are doing some pressure so the Ivorians would have free health cares. We are also having discussions with the World Bank, which is financing many free health projects of the African governments and seems ready to invest money in Côte d’Ivoire”, explains the operations counsellor.

So, even if the mission of MSF is principally to provide health care in crisis situations, the members of the non governmental organization are also worried about what will happen after they leave the country. “We can leave the country rapidly if it is impossible to discuss with the authorities. On the other hand, if communication is easy, such as in Côte d’Ivoire, we try to make a real difference for the population”, explains Mr Sanchez.