Natural bounty and manmade poverty: that sums up my experiences in Ivory Coast. This was my second mission with MSF, working as a Medical Doctor. Postconflict Abidjan, where my plane landed, was a wasteland of deserted streets and shut-down shops, as if it was in mourning for the loss of lives and the struggles that had taken place there. This was in contrast to my return journey, when Abidjan was alive and humming with nightlife, like any other metropolis in the world.

I travelled by car to Daloa, which was to be my home for the next six weeks. Within a couple of days I was caught up in activity, setting up mobile clinics in places where health centres had either been looted or were non-existent. Every Ministry of Health clinic and hospital was running short of essential medicines.

Unlike many other African countries, Ivory Coast is unique in that it has a well established health system in place with adequate trained manpower, but with a serious crunch in resources. Political instability has deterred the country – with its rich natural resources and well educated society – from the path to progress. With my ever ambitious project coordinator and my technical logistician, within a week the three of us had started running mobile clinics, exploring possible new sites, liaising with Ministry of Health authorities and slowly expanding our team of national staff. Soon we were joined by our expat nurse colleague, and it was wonderful to have a team who –irrespective of job titles – were pitching in to do whatever was necessary. In fact Ivory Coast gave me an opportunity to see the varied presentations of malaria – so that by the end my project coordinator would teasingly refer to me as the “walking paracheck”.

For people who were traumatised and victimised by ethnic tensions, who were gambling their lives with malaria in the bush, who were in desperate search of food and security, our presence did make a difference. Our mobile clinics focused on malaria, malnutrition, antenatal care, respiratory infections and diarrhoea, and it was always difficult to turn away the chronically ill patients who had no access to free medications as well.

Even though everything seemed calm on the surface, we did witness militias guarding the entry points to Ministry of Health clinics so as to collect dues from the poor patients accessing healthcare; we also saw innumerable barricades on all the important highways, and at virtually all entry and exit points to each and every village, making life extremely difficult for the common man.

I was also fortunate enough to work in a second project site in the latter half of my mission, called Tabou. Tabou is a beautiful place on the shores of the Atlantic ocean, and just five minutes from the MSF house one could step onto the wild beach. Alas, there was never a moment to relax and enjoy the serenity of the surroundings, as there were too many things for my team to do. We were running mobile clinics, establishing an inpatient therapeutic feeding centre, in cooperation with Tabou general hospital, and raising awareness about our project for treating the survivors of sexual and gender based violence. Having only 24 hours in a day seemed like God’s cruel joke when we so urgently needed more hours in which to work! All these toils would melt away when the malnourished children welcomed you with a shy smile as you entered the ward of the inpatient feeding centre. This rewarding experience would soothe away the anguish of treating and providing support to a young female child who survived a horrible experience which had happened to her just because she was a girl and she was born in an unfortunate place.

My experience of working for MSF was even richer this time around, because I could really see what a difference we were able to make to so many people’s lives, even in small measures – just by a smile, a handshake, a listening ear, by simple treatment measures – and just by being there.

-Kalyansundari -MD