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Côte d'Ivoire

UNICEF and European Union rehabilitate medical infrastructure in rural Côte d'Ivoire

By Eva Gilliam

YAPLEU, Côte d’Ivoire, 6 October 2010 – It’s Tuesday morning at the Yapleu health centre in the Central Northwest region of Côte d’Ivoire. This means it’s check-up time – and Yapleu’s team of midwives and nurses are eagerly examining the local children.

VIDEO: 14 September 2010 - UNICEF's Eva Gilliam reports on a joint UNICEF-European Union programme that is helping families by supporting health clinics in rural Côte d'Ivoire.  Watch in RealPlayer


They have been advocating a breastmilk-only diet for children under six months of age, and today they are seeing positive results. Chubby, healthy babies sit patiently on the laps of their mothers waiting for their turn to be weighed and measured.

“Truly, well done Emily,” says one of the Yapleu clinic’s midwives, speaking to a mother of four. “You followed our instructions, and we see that Dorade is doing very well! Congratulations.”

Emily smiles proudly as she takes her baby from the midwife. Dorade is her youngest child, and she remembers this clinic from before the civil conflict here, when it had a good reputation – but also from the war years, when nothing was happening.

“There weren’t enough midwives. During the war, the doctor wasn’t even here,” she explains. “But after the war, they came – the European Union and UNICEF – and now it’s good.”

Effects of conflict

The Central Northwest region of Côte d’Ivoire straddles what was the front line of the country’s civil war, which began in 2002 and wiped out much of the region’s health infrastructure.

© UNICEF Côte d’Ivoire/2010/Ayé-Aké
Emilie Goh and her daughter Dorade at a health centre in Yapleu, Côte d'Ivoire, where workers ensure that the baby is healthy and has received her vaccines.

Many clinics lost their medical staff, and buildings were looted and destroyed. Medical equipment became scarce, and doctors and nurses were left without tools to do their work.

“Morale was horrible,” says Regional Health Director Dr. Kouadio N’zué. “Doctors would show up for a couple of weeks, then get frustrated because they couldn’t do anything, and leave.”

The impact on the population was devastating. Vaccination campaigns lapsed, child mortality increased and basic illnesses were left untreated, killing helpless Ivoirians.

Rebuilding and training

In response, the European Union (EU) and UNICEF forged a partnership to rehabilitate medical facilities and train personnel. In recent years, the project has gone full steam, rehabilitating clinics and hospitals, and providing them with basic equipment, medication and training for medical staff.

© UNICEF Côte d’Ivoire/2010/Ayé-Aké
Community health workers Côte d’Ivoire liaise between health centres and villagers to ensure that families know that health care is available.

Bernard Gossan Anoman is a senior nurse at the Yapleu clinic, where he has worked for 12 years. He was one of the 28 staff to participate in the EU- and UNICEF-supported medical training programme.

“Of course, I do have university medical training, but this additional training from the EU and UNICEF, it helps so much,” he says. “It stimulated my mind and updated me on new ways of doing things. Here we’ve seen the rate of child mortality decrease significantly. I myself am very impressed.”

Point A to point B

Transportation remains one of the greatest challenges in much of the region. To address this problem, the EU and UNICEF have provided trucks, motorcycles and thousands of bicycles for use by medical staff and volunteer community health workers bringing their services into rural areas and responding to emergencies.

© UNICEF Côte d’Ivoire/2010/Ayé-Aké
A community health worker in Angouayaokro, Côte d’Ivoire, talks to mothers about the importance of adopting good health practices and encourages them to go to the nearest health centre to seek professional care.

“With these trucks and motos, we are able to bring the medication to the centres,” says Dr Lucien Lehié Bi, Director of the Dedievi Health District. “But also, it allows us to attract the nurses and qualified personnel we need. They see that now we have the tools for the job, and they are returning to work.”

Koffi Nguessan was chosen by his community to be their liaison with the local clinic. With his bicycle, he comes to the clinic and returns with information twice a week. He also checks in on individuals, teaches basic health practices and helps out with referrals for emergencies. In short, he is the key to an integrated health care system.

Care in the community

“The community health workers know each mother in their community, each child,” explains Etienne Kapia, a nurse at the Mononouble health clinic, 42 km outside of Bouake. “They follow the progress of individuals, and that is invaluable.”

With a network like this, the new EU and UNICEF project aims to dramatically improve the quality of local health care and increase access to medical personnel and facilities for millions of Ivoirians.



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