Introduction

The civil war and subsequent collapse of the healthcare system have provoked a medical crisis in parts of Côte d'Ivoire. Responding over the past two years to high levels of malaria, malnutrition and other diseases, Medecins Sans Frontieres ("MSF") teams in the West of the country have encountered an alarmingly high number of sexually transmitted infections ("STIs"). These STIs lead to horrific complications in reproductive health and carry disease to younger and younger segments of the population. While drastic in its own right, the high level of STIs is also a clear indicator that HIV is spreading, making prevention and treatment efforts all the more urgent.

The STI crisis is not a side effect of personal behaviour, but rather a symptom of conditions fuelled by war, displacement and economic desperation. Since the outbreak of conflict in Côte d'Ivoire, MSF has reported on the devastating effects that the conflict has had on the country's health structures. At the time of the 2003 ceasefire, MSF reported: "The civil war has caused the total collapse of the healthcare system in the West." In 2005, the Ministry of Health ("MOH") and other actors struggle to work in this divided and volatile country.

MSF has been working in western Côte d'Ivoire since 2003. Given acute needs and the unstable security situation, MSF's interventions have particularly focused on western Côte d'Ivoire. Working on both sides of the front lines, MSF runs projects in the West based in Bin Houyé, in Government territory, and Danané in territory controlled by the Forces Nouvelles rebel movement, an area with a total population of about 350,000. In this volatile area, along the border with Liberia and Guinea, MSF bears witness to the crisis in STIs.