Africa, Development & Aid, Headlines, Health, Poverty & SDGs

COTE D’IVOIRE: Protecting Public Health Despite Political Impasse

ABIDJAN, Jan 24 2011 (IPS) - The political stand-off between Alassane Ouattara, certified by the United Nations as winner of Nov. 28 elections, and the incumbent president, Laurent Gbagbo, who has refused to step down, is stretching into its eighth week.

U.N. peacekeepers outside the Golf Hotel. Credit:  Monica Mark/IRIN

U.N. peacekeepers outside the Golf Hotel. Credit: Monica Mark/IRIN

Civil disobedience in support of Ouattara in the north of the country means up to 800,000 children did not resume school as scheduled two weeks ago. In the south, uncertainty prevails over the safety of children or teachers as gunfire is heard around the Golf Hotel where Ouattara is protected by United Nations troops.

The 9,000-strong U.N. Operation in Côte d’Ivoire (UNOCI) was reinforced with 2,000 additional peacekeepers last week, as armed forces loyal to Gbagbo said they would stop and search U.N. vehicles.

U.N. officials have been prevented from visiting the sites of alleged human rights violations; UNOCI puts the death toll from political violence at 260. Fifty thousand people have been displaced, as many as 30,000 of these across the border into neighbouring Liberia.

Health workers fearful

Maintaining public health

A polio vaccination campaign aimed at the 6.8 million children under five years old was strongly disrupted by the campaigning ahead of the first round of voting on Oct. 31 last year.

"We are not sure that this last campaign (against polio from 26-29 october) reached 90 percent of the country," said nurse Aurélien Kouamé. "The doses of the vaccine were available, but we couldn't reach people because of the political situation. So we'll have to consider a resumption of the campaign."

The December 2010 meningitis campaign by the World Health Organization, deploying a new vaccine across the 25 countries that make up the "meningitis belt" never got off the ground at all as the crisis exploded on Dec. 3.

Dr Kadi Kamara, a general practitioner in Abidjan, says the health situation is worrying.

"There is a situation of duality at the apex of the state. In this context, it's not prudent, for international humanitarian organisations, to take upon themselves the decision to carry out a (vaccination) campaign in the country, above all if it will involve a new treatment," said Kamara.

Health services have also been disrupted. Aurélien Kouamé, a nurse at a dispensary in Borotou, in the northwest of the country, returned to the capital with three of his colleagues immediately after the elections. He is waiting for a peaceful resolution before returning to his station.

“We were afraid for our safety (as government workers),” he told IPS. “And as you’ve seen in many other sectors of government, many people have fled areas under control of the former rebels out of fear. Health services have been abandoned.”

Speaking to IPS by phone from the northern town of Odienné, health worker Daouda Soro said, “Essential drugs are beginning to run out in hospitals. Before the crisis, it was the Public Health Pharmacy that supplied us. For the past two months, there has been nothing. Sick people have turned to self-medicating with medicine bought on the street.”

One urgent public health exercise is going ahead. A yellow fever vaccination campaign, twice postponed, began on Jan. 22 and will last a week. UNICEF, the United Nations Children’s Fund, is targeting 830,000 adults and children over the age of nine months in four districts. The $100,000 campaign is in response to an epidemic declared three months ago in several areas in the centre and north of the country.

“The campaign has effectively begun in the four health districts of Béoumi, Katiola (centre), Séguéla et Mankono (nord). The population is coming forward without problems,” Louis Vigneault-Dubois, head of communications for UNICEF-Côte d’Ivoire told IPS over the phone.

“For the moment, we are working exclusively with NGOs and we will do the same to administer the vaccines to everyone.”

Containing an epidemic

Yellow fever, a viral disease transmitted by mosquitoes, which each year infects 200,000 people around the world – killing 30,000. It is regarded so seriously, that even a single confirmed case in a country is considered an epidemic.

UNICEF says the two central districts involved in the campaign have registered 66 cases of yellow fever since November 2010, with 25 fatalities. There is no cure for yellow fever, but a safe and readily-available vaccine confers immunity for ten years.

“These are rural areas where the overall rate of vaccination is low, and that is unacceptable,” said Dr Eli Ramamonjisoa, head of the Child Survival Unit for UNICEF in Côte d’Ivoire.

“We are also working with our partners to rebuild stocks of vaccines and antiretroviral treatments throughout the country, in particular in hard-to-reach places.”

The interim head of UNICEF in Côte d’Ivoire, Sylvie Dossou, said, “This campaign shows that despite the political impasse the country is going through, humanitarian work continues and is saving lives in Côte d’Ivoire.”

Dr Kadi Kamara, a general practitioner in Abidjan, says the health situation could become a concern if the political situation is not normalised quickly. She vividly recalls a serious meningitis outbreak that hit Côte d’Ivoire in January and February 2008, killing 29 people in the the centre and north of the country.

“We are in practically the same time period. If that explodes again – added to the yellow fever epidemic – it will be a catastrophe for the population in this part of the country,” she said.

AU envoy fails in Ivorian mission

Kenyan Prime Minister Raila Odinga has said that force was a “last resort” to solve Cote d’Ivoire’s crisis, but warned that time was running out for a peaceful settlement.

“The window for a peaceful negotiation is closing very fast,” Raila Odinga told reporters on returning to Kenya on Friday after leading a failed African Union mediation bid.

“We will continue to walk the extra mile to find a peaceful resolution… The use of legitimate force is there and we will say that it is the ultimate resort, the very last resort if everything else has failed,” he added.

Ivorian incumbent Laurent Gbagbo has defied calls to quit after U.N.-certified results showed him to be the loser of a Nov. 28 election, prolonging a stand-off with rival Alassane Ouattara.

But there is little appetite among African nations for armed intervention that could cause more bloodshed in a country where 260 have already died in violence linked to the deadlock. Nations such as Ghana say they will not offer troops.

Leaders of the 53-state African Union will discuss next steps at a summit at the end of the month, and signs are emerging of cracks in an official AU line insisting that Gbagbo immediately make way for Ouattara to take power.

* with additional reporting from Al Jazeera

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