Ivory Coast: Abobo Sud hospital operating at a high level today

May 14, 2011

Ivory Coast: Abobo Sud hospital operating at a high level today

The Abobo Sud hospital in Abidjan has been transformed. This facility, which resembled a 20-bed clinic before Abidjan was overwhelmed by violence in recent months, is now crowded with patients. The MSF team has used every last bit of space for hospital beds. Entryways have been turned into hospital rooms, and two tents have been set up in the middle of the courtyard. Capacity now totals 130 beds.

The hospital director relies on humor to describe the hyperactivity that characterizes the hospital. "It's like an epidemic of work!" he says. Indeed, the staff is working non-stop since February 28, when an international MSF team and eight Ivoirian volunteers reopened the hospital. Now that fighting is over in this northern metropolitan neighborhood, the number of Ivoirian volunteers has grown to 250.

The obstetrics department is never empty. Sophie, a French midwife supervising the unit, says it's like being on another planet. She is accustomed to five deliveries per day, but more than 40 women give birth daily here. "Oh, yes, they make lots of babies here!" a hospital midwife says, laughing. The young mothers leave within three hours of giving birth, turning their spot over to other women who will deliver in their turn.

The operating room is also humming at full speed. The Gbagbo regime fell on April 11. Until then, at the height of the fighting, the hospital treated more than 100 patients with bullet wounds every day. While calm has returned to almost all of Abidjan's neighborhoods, wounded patients continue to arrive at a rate of approximately 10 per day. Large numbers of armed men circulating throughout the city cause accidents. One morning, a little girl, barely two years old, was playing in front of her house and was struck in the thorax by a bullet. Another grazed her head. There are many more typical surgical emergencies, too, such as caesarians and peritonitis.

Medicine and medical supplies are no longer in short supply. MSF can now arrange for all necessary items to be delivered to Abidjan. Transporting supplies was very difficult in late March and early April. The hospital was on the front line. Employees could not leave and supplies were blocked. Inventories fell to dangerous levels. Instead of throwing away gloves after each procedure, the staff washed them with soap and chlorine so that they could be reused. But health care workers didn't give up. They slept in the hospital and ate there, too—thanks to a young woman named Patricia who arrived on February 28 to help out, risking her safety by going to the market and preparing meals for everyone.

"The team was very motivated," explains Dr. Chibu Okanta, MSF medical coordinator. "Doctors were cleaning the beds. Nurses were carrying stretchers." The stress never let up. Bullets whistled nearby, and tanks rolled back and forth on the other side of the hospital walls. Hospital workers had to instruct fighters to leave their weapons at the door when they delivered wounded patients. The MSF team did manage to laugh a little in the evening over dinner. While the pressure has eased, the team still doesn't have much time to breathe. Daily life has resumed and patients fill the hospital. After remaining hidden at home for days and, even, weeks, people are coming for treatment.

The waiting line outside the hospital begins forming at 5AM. The door opens for medical visits at 7:30. The MSF doctors see between 350 and 400 patients every day. Patients include pregnant women and mothers with children suffering from severe malaria, sometimes complicated by anemia. Some reach the hospital too late and die when they arrive.

To help ease the flow, MSF has reopened hospitals in the Anyama and Abobo Nord neighborhoods and is providing support to a health center in the district. The situation is no different there. The population lacked access to medical care and medicine throughout the crisis that paralyzed the country.

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