Monrovia, Liberia - For the second time in two weeks, staff and patients have had to leave Redemption Hospital in the Liberian capital, Monrovia. Besides the JFK surgical ward, run by the International Committee of the Red Cross (ICRC), Redemption was the only public hospital providing medical care to civilians.

A team of Médecins Sans Frontières (MSF) has evacuated all patients as fighting between rebel groups and governmental forces approached the northern area of the city. The battle between LURD fighters and the Liberian army for the streets of Monrovia started on the June 5. Large numbers of people who had been on the run for years moved into the city, only to find that shelter, food, water and medical care were unavailable there.

Their numbers grew as residents of northern Monrovia also started to flee for safety. The signing of a ceasefire and withdrawal of rebel troops from the city made it possible to provide minimal assistance to the displaced population. Many returned to the camps outside the city.

Now again, since yesterday, they are running for their lives, and once more lifesaving assistance threatens to be cut off as the city plunges into more violent fighting. "These people have gone through hell and back already; now they face hell again," says MSF's operational director, Christopher Stokes.

"We have heard many stories of how people lost relatives during earlier attempts to find safety. People got stuck in the swamps or drowned while trying to cross rivers. The Liberians in the camps and in the streets have reached the absolute limit of what you could ask anyone to cope with." Redemption Hospital was re-opened four days ago.

MSF installed a second cholera treatment unit, isolated from the other wards to fence off a further spread of the disease. At the time of evacuation yesterday, the team were treating 35 people in the cholera units. MSF had also initiated a therapeutic feeding centre (TFC) to take care of the most severely malnourished children. Yesterday, MSF evacuated all patients from Redemption Hospital.

Some are now receiving continued treatment in two MSF compounds in the Mamba Point area of Monrovia, which already functioned as hospitals with outpatient and inpatient emergency facilities. "Today, we have to decide again whether to reduce our teams," concludes Christopher Stokes.

"We are committed to stay with the Liberian population, but have to concede that at a time when their needs are even greater than they were, our capacity to bring lifesaving assistance is again reduced as a result of the violence and insecurity." MSF demands that the warring parties respect the rights of the civilian population, allow them unhindered access to health structures, and safeguard that humanitarian organisations can bring them the assistance they need.