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The dispute over Ivory Coast’s presidential election in November 2010 provoked violence that had escalated to full-scale war by February 2011.

According to the UN, more than 1,000 people were killed. Hundreds of thousands of people fled their homes, as villages were burned. While some gathered in camps or crossed the border into Liberia, others hid in the bush, afraid to seek assistance.

Many of the country’s health facilities closed due to the conflict. Médecins Sans Frontières (MSF) set up mobile clinics and supported hospitals and health centres in Abidjan and western Ivory Coast, where the heaviest fighting took place.

Western regions

In the western regions of Moyen-Cavally and Dix-huit Montagnes, medical facilities that had not been destroyed were short of supplies and staff. Many people who had been displaced by violence had no access to medical services. MSF began to offer emergency medical assistance in the town of Duékoué in early January. Staff provided emergency treatment for some 4,600 patients and assisted more than 1,480 births. Close to 100,000 consultations were held at mobile clinics and a health centre in the area.

From March, teams began to support the hospital and operate mobile clinics in the department of Guiglo, carrying out more than 77,000 consultations. New programs were opened in Bloléquin, to the west, and Taï, further south, in September and December, respectively. In total, almost 1,000 patients were admitted to hospital.

MSF also set up mobile clinics and carried out more than 33,000 consultations in and around the towns of Man, Zouan-Hounien and Toulépleu. Over 300 malnourished children were admitted to a nutrition program in Man between July and September. The 15-bed health centre in Bin Houye, just north of Toulépleu, was reopened, and staff provided emergency care for 175 patients.

In March alone, a surgical team in Bangolo performed 147 operations, more than 70 per cent of which were for gunshot wounds. Some 470 patients received psychological support. Staff also ran mobile clinics in the surrounding area, seeing over 5,000 patients.

In May, medical programs were opened further east, in the towns of Tabou and Daloa, and staff carried out more than 80,000 consultations in total.

Abidjan

On 28 February, MSF opened Abobo Sud hospital, on the front line of the conflict in Abidjan. Surgical teams worked around the clock. Between mid-April and the end of August, they performed more than 2,200 operations. Some 3,890 patients were admitted to the emergency department, and in other departments, MSF staff assisted over 4,100 births and conducted around 20,250 consultations. As the violence calmed, more people came to the hospital, and queues started to form from 4am. To reduce the pressure on Abobo Sud, MSF began working in eight health centres and in two other hospitals in the north of the city – Anyama and Houphouët-Boigny.

In the south, Koumassi hospital was the first health facility to resume activities and offer free healthcare to a population of 600,000. MSF health workers provided support to hospital staff, holding more than 19,800 consultations between April and May. In June, MSF set up a cholera treatment unit in the hospital to respond to an increase in the number of people with the disease. The team also set up a unit in the camp where the majority of cholera patients came from, and organised the decontamination of areas where cholera was found.

In Treichville, MSF donated essential drugs and medical supplies to the hospital and opened a trauma centre in Nanan Yamousso clinic. Gynecological and obstetric services started shortly afterwards, and staff treated more than 750 emergency patients, performing over 470 operations. In June, as the number of patients grew, the teams transferred activities to the larger Port-Bouët general hospital, just east of Treichville.

At Port-Bouët, MSF renovated two operating theatres and the inpatient department, increasing the number of beds to 120. Staff carried out more than 4,000 emergency consultations and 1,300 surgical procedures, and assisted 1,250 births. Handicap International worked with MSF, rehabilitating patients after surgery. In addition, MSF supported six health centres located around the hospital between May and July, carrying out over 17,700 consultations. The team set up a cholera treatment unit and treated 84 patients.

In the west of the city, in Yopougan, MSF began handling emergency admissions at Attié general hospital in April, when fighting in the immediate surroundings had severely restricted access to the hospital. Some 22,270 consultations were held in just over a month. Close to 950 patients were admitted for surgery, including 169 who had been wounded by bullets or shrapnel. A team also set up a mobile clinic at a nearby church, where more than 1,000 people had taken refuge.

As the violence subsided and people returned to their homes, access to healthcare slowly improved across Ivory Coast, and MSF began handing activities back to the Ministry of Health and non-governmental organizations.

At the end of 2011, MSF had 646 staff in Ivory Coast. MSF first worked in the country in 1990.