Abidjan - The international organisation Médecins sans Frontières (MSF) is extremely concerned about the humanitarian situation in western Côte d'Ivoire that has been provoked by war and widespread violence.

At a time when the civilian population is becoming more vulnerable, food is scarce and there is no functioning healthcare system in what has been called "the Wild West" of the country. Actions undertaken by national and international actors fall far short of the needs. MSF fears a rise in malnutrition, disastrous morbidity and mortality rates and urges those responsible to quickly address the food and health needs of the civilian population.

MSF is today bearing witness to an unfolding health crisis in western Côte d'Ivoire. Qualified health staff has fled the violence en masse and a significant amount of the healthcare system's physical infrastructure has been looted and vandalized. The partitioning of the country between fighting forces has cut supply lines for drugs and medical materials. A few humanitarian organisations currently attempt to fill the vacuum. Yet, important health programs such as vaccinations, tuberculosis and HIV/AIDS are no longer being implemented.

The collapse of the healthcare system comes at a terrible time, as the vulnerability of the civilian population has increased due to violence and displacement.

"People who come to our mobile clinics describe how their villages were suddenly attacked by armed groups who burned their houses and food stocks. Deliberately targeted, people fled into the bush - often more than once - and many families were separated. Both young and old, female-headed households and even unaccompanied children are now slowly emerging from the bush in dire need of medical care," says the MSF Head of Mission in Ivory Coast. "Outdoor exposure, lack of clean water and limited access to food leaves them very vulnerable to malaria, skin diseases and malnutrition."

Today MSF takes care of more than 500 severely malnourished children in its Therapeutic Feeding Centres (TFC) in the West. Although no general nutritional survey has been conducted, MSF fears that these numbers are indicative of a nutritional crisis.

Persistent insecurity in the region has prevented cultivation and there are fears that the population has now missed an entire growing season. Food distributions undertaken by the authorities and responsible international organisations have thus far been limited.

Infants under 5 are the first to be affected, but MSF is worried that, if the food situation is not addressed immediately, malnutrition will increase even further and will also be seen in older children.

MSF started mobile clinics in April 2003 in the Man and Danané Districts to address the overwhelming health needs, especially along the border with Liberia. MSF supports Man hospital to provide emergency healthcare services and in which they operate a TFC to address the high numbers of severely malnourished. MSF also runs a TFC in Guiglo and supports a health centre in Toulepleu.