The 'confidence zone' in Ivory Coast does not live up to its name. Created as a buffer between warring parties, it has turned into one of the most unsafe parts of the country. On June 28, the Médecins Sans Frontières (MSF) team in the zone saw this illustrated once again, when they received 12 wounded people in Bangolo hospital.

Eleven had sustained serious injuries requiring referral to the better-equipped hospital in Man, outside the contested area. Only two months before, five people had been killed and ten injured in a similar bout of fighting.

The violence started with an early-morning attack on a small village near Diéouzon, during which nine people were killed.

Seeing the wounded arrive at the hospital gate, hundreds of people, who were there for treatment or visits, started running for safety, fearful that the violence might come their way. This population has experienced ongoing physical violence and short-term displacement. Repeated assaults have left them vulnerable to illness at the same time as they fear insecurity when travelling to health structures.

A young woman described what happened this time: "My family was inside the house. It was 4am when we heard shooting. Armed men broke open our door. We all escaped through the window and tried to hide in the forest. Then my baby started to cry and the armed men began shooting in our direction. My baby was hit by a bullet and killed. I was wounded in my face and chest. We stayed in the bushes until the armed men had fled."

The 'zone of confidence" is a strip of land 1,200 kilometers long and 15 kilometers wide, a buffer zone established by the UN to avoid fighting between rebel groups to the north and pro-governmental military to the south. The area effectively divides the country in two and is patrolled by a peacekeeping force of around 7,000 UN soldiers who work alongside 4,000 French military.

But together with the larger conflict, ethnic issues and land disputes continue to create an atmosphere of constant tension and unpredictable violence. The area is a key region for the growth of cocoa. Many farm workers have come from other parts of Ivory Coast or from abroad.

Nobody is spared the effects of the violence. An elderly woman recalls what she lived through on Wednesday, June 28: "I was at home. It was dark, it must have been around 4pm. I heard gunshots and decided to hide under the bed. The door was forced open and 13 armed men burst into the house. They found me hiding under the bed and started shooting. I was injured. After the men left and the shooting had stopped, I decided to come out from under the bed. When I walked out of the house, I saw three dead people and many injured."

MSF started working at Bangolo in the 'zone of confidence' in January, 2004, because the people living in this no-man's-land had no access to health facilities and medical care. In the first three months of 2006, MSF treated over 310 patients for violent trauma. Of these, 14 were children under five years of age. Since the war in Ivory Coast ended in 2003, hospitals had been abandoned by their staff and looted by armed groups.

"Cynically, the zone of confidence is the part of Ivory Coast where we see the highest level of insecurity for the population," says Stephan Goetghebuer, MSF Operational Coordinator for West Africa, based in Brussels. "Since the war ended, there have been virtually no civilian authorities in this area. In this vacuum, violence may not be huge on a daily basis, but the villages are not secure and the numerous attacks go without response."

In addition to running the hospital in Bangolo, which sees 400 consultations daily, MSF provides health services to outlying villages in the zone of confidence with mobile medical teams.