EU re-equips 25 health centres, mainly in the north

The European Union has provided a grant of 3.5 million euros ($4.2 million) to re-equip health centres in 25 war-affected districts of Cote d'Ivoire, mainly in the rebel-held north of the country. The vehicles, computers, mosquito nets and medical kits were handed over to the United Nations Children's Fund (UNICEF) at a ceremony in Cote d'Ivoire's official capital Yamoussoukro on Thursday. However, one district health director in the rebel-held north told IRIN on the sidelines of the ceremony that he would have to sell some of the drugs being provided in order to cover basic operating expenses since the government was no longer paying for the upkeep of hospitals and health centres in areas outside its control. According to UNICEF, 80 percent of the doctors, nurses and midwives in northern Cote d'Ivoire have fled since the country plunged into civil war in September 2002. Drugs and equipment have been looted from hospitals and health centres and the system for monitoring the outbreak of epidemics has been paralysed, it said in a statement. Jacques Adande, the head of UNICEF in Cote d'Ivoire, said the EU-financed project to re-equip hospitals and health centres serving five million people in war-affected parts of the country would be carried out over a period of 15 months. UNICEF said the EU money would provide each health district with a four-wheel drive vehicle, a computer, refrigerators and several mopeds for outreach workers. Each health district would also receive basic kits of medical equipment and essential drugs, such as antibiotics and painkillers and specialist treatments for malaria and de-worming, along with several thousand mosquito nets impregnated with insecticide for malaria prevention. Anatole Ganhi, the director of health of Sakassou district, just across the front-line to the north of Yamoussoukro, pointed out that only 12 of the 17 health centres in his zone were functioning at present. These were operating with a skeleton staff of one doctor, seven nurses and two mid-wives, one third of the staff normally required, he added. Ganhi said the health service in Sakassou district needed three doctors, 17 nurses and 12 midwives to function properly. In order to cope, it had been forced to give greater responsibility to its handful of nurses and train up auxilliary workers, he added. "We have redefined the tasks that can be carried out by the nurses and we have trained dispensers to look after the health centres," Ghani said. The government is still paying salaries to health service employees, but it is difficult for those working in rebel territory to receive their wages since all banks there have been closed for the past two years. Health service administrators said an even bigger problem was a lack of funds to pay for the operating expenses of hospitals and health centres in the north. Amani Konan, the director of Katiola health district, just to the north of the rebel capital Bouake, told IRIN that even where the government was sending doctors and nurses back to their posts, they were hamstrung by a lack of funds to enable them to carry out medical work. "The most important problem is that no (financial) measures are being implemented to accompany the redeployment of personnel," he said. "So long as we have no budget, we will continue to sell drugs in order to pay our local non-medical staff. We have no choice and we will be obliged to do the same with the drugs that UNICEF has just given us." Doctor Abel Guede, the director of health in the northern city of Korhogo, near the border with Burkina Faso, said the Ministry of Health had stopped the budget for his district and he relied on the International Committee of the Red Cross (ICRC) for a supply of drugs.