The Abobo Sud hospital in Abidjan, Ivory Coast 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 Médecins Sans Frontières (MSF) team working here 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.

Ivory Coast © Thierry Huaume/MSF
A young patient in the hospital in Abobo Sud.

The hospital director relies on humour to describe the hyperactivity that characterizes the hospital. "It's like an epidemic of work!" he says. Indeed, the staff has been working non-stop since Feb. 28, when an international MSF team and eight Ivoirian volunteers reopened the hospital. Now that fighting is over in this northern metropolitan neighbourhood, 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. Former president Laurent Gbagbo's 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 most of Abidjan's neighbourhoods, 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.

Ivory Coast © Brigitte Breuillac/MSF
People seeking medical help line up outside the Abobo Sud hospital. The queue begins forming at 5 a.m., and the first patient is seen at 7:30 a.m.

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 in Abobo Sud 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 healthcare workers didn't give up. They slept in the hospital and ate there, too – thanks to a young woman named Patricia who arrived on Feb. 28 to help out, risking her safety by going to the market and preparing meals for everyone.

Ivory Coast © Benoit Finck/MSF
A mother and child in the emergency room of the hospital in Abobo Sud.

"The team was very motivated," says Chibu Okanta, a doctor and 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 5 a.m. The door opens for medical visits at 7:30 a.m. 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 neighbourhoods and staff are providing support to a health centre in the district. The situation there is no different: people lacked access to medical care and medicine throughout the crisis that paralyzed the country.