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Last Updated: Friday, 20 June, 2003, 12:10 GMT 13:10 UK
Diary of a Liberian aid worker
Medecins Sans Frontieres is one of the few aid agencies still working in Liberia.

Tom Quinn, who works for MSF, is writing a diary for BBC News Online.

Tom Quinn
Tom Quinn who works for MSF in Liberia

Monrovia, 19 June, 1600 Liberia time/GMT

Everywhere we go in the camps people keep rushing up to us, begging for food.

My ears are ringing with cries for help. Our feeding centre is overflowing.

Our camp supervisor Willy and I walked around the camp, talking to the people and these are some of the stories we heard:

Nelly, not her real name, is from Bomi, in the North. Six of her children have died and her husband was killed by the fighting in 1990.

Food ration

Since then she has been struggling to keep her remaining four children alive. She has only received one food ration this year, which ran out long ago.

Now she relies on breaking and selling firewood to feed her family, but no one here has the money to buy it. She is hungry and her children are hungry. Clara, also not her real name, is just 18 years old and also from Bomi.

She left a year ago with her husband, baby, brothers and parents, but was separated from her husband when the fighting reached this camp a few weeks ago, and hasn't been able to find him since.

Armed groups

Every day she walks five hours to cross the river to work as a labourer in the fields, then five hours back again in the evening. She is paid in cassava root, but has to hand some over for the river crossing.

Often, she is forced to give up her food to armed groups. She is hungry and her children are hungry.

Sophie, again I have changed her name, is 32 from Lofa county. She fled the civil war in the region last year along with her four children and family.

But now it has followed her here and one of her brothers is dead caught in the cross-fire of the recent fighting.

She too sells wood to buy food. She too is hungry and her children are starving.

Mobile clinics

It goes on and on.

These people once had homes and full bellies.

Tomorrow morning we will reopen Redemption Hospital and another organisation, ACF, is now also running some feeding centres so we're referring patients to them as well.

We have mobile clinics running in the camps at Bong as well as three camps here and the various clinics around central Monrovia, and we have more medical staff and 15 tonnes of supplies coming in from Sierra Leone tomorrow.

We'll continue to do what we can and it counts. But there is no getting away from these sad stories.

17 June, 1500 Liberia time/GMT

The ceasefire has been signed! This is fantastic news!

We heard the announcement over BBC World Service just a minute ago and now everyone in the street is jumping with joy.

For the first time the people have real hope!

17 June, 1230 Liberia time / GMT

I'd been desperately hoping that there wouldn't be any cholera cases in Claratown before we had the new clinic refurbished and ready to take patients but there was no turning away from the sight that greeted me this morning.

There, on the floor of the waiting room of our make-do clinic, was a frail old man, lying in a pool of vomit and diarrhoea.

He was almost unconscious and so weak he could barely swallow the rehydrating salts we were giving him.

Other patients in the room looked on as the overworked staff attempted to clean up the mess and encourage the poor man to drink.

We immediately drove the old man to the cholera treatment unit.

It broke my heart to see he was completely alone with no family members to care for him.

But at least I knew that once he reached the unit he wouldn't die. As soon as we got back to the clinic we found another case. This is exactly what I didn't want to happen.

This clinic is set up in a community hall in a residential neighbourhood surrounded by houses and markets.


In the neighbouring school 300-400 displaced have set up camp and have been living there for over a week but there is no toilet and in the clinic there is only one.

There are a few pay-for-use loos in the street but at $5 Liberian dollars a go they are out of reach for these people who can't even afford food.

And we can't dig latrines because of the water table.

This is not the place to have a cholera outbreak. To make matters worse, the clinic is completely swamped.

Yesterday they had between 300-400 consultations. More than twice the usual number.

So with all the rooms in this cramped hall already overflowing there is no chance of sectioning off an isolation ward.

So this morning we focused on quickly getting the clinic we were refurbishing in a state to receive patients.

We can have proper latrines there and it also means we can turn the hall into a isolation ward for those suspected of having cholera.

Fingers crossed we can get it all done in time.

There is just so much work to be done and not that many of us to do it.

Along with the ICRC we are the only international aid workers here in Monrovia and we simply can't be everywhere at the same time but we're trying and we're making a difference for those that we can reach.

16 June, 1500 Liberia time/GMT

Busy visiting all the clinics at the moment so not much time to write.

The cargo from Freetown is finally on its way which is a great relief. We're setting up more and more clinics and need supplies.

Latest project has been starting up a feeding centre in the compound to treat severely malnourished children. Already the patients are pouring in.

Malnutrition in the camps also worrying. I visited several camps today and saw many starving children. Wasn't able to figure out exact numbers.

This time of year is the equivalent of the 'hunger gap' - no food until this season's crops have ripened. And there's a fair way to go yet.

Meanwhile, cholera cases on the rise.

Just yesterday we came across 16 cases in the clinic outside Redemption Hospital alone and drove them off immediately to the cholera treatment unit. There have been four reported deaths so far.

Please don't let this become an epidemic.

Must go - another checkpoint coming up. You might think central Monrovia is beginning to stabilise but up here in the northern outskirts it still looks like a war zone.

Kids wandering around with huge guns and high as kites. I just hope this ceasefire holds - there is so much suffering without there being further bloodshed.

Sometimes it's difficult to see an end to it all.

13 June, 2032 Liberia time/GMT

Yesterday the Minister of Health announced that at least 300 people died as a result of the recent fighting.

I don't know how they got that figure. How can they tell? The whole city is still such a mess with people dead in the streets and in the hospitals.

We managed to check on Redemption Hospital today and the entire northern area which has been shot to pieces between the hospital and the river.

I saw dead bodies decomposing in the gutters and in some areas the smell of rotting flesh makes you gag - something I'd rather not dwell on.

Absolutely everything has been looted - shops, schools, offices.

Alain, MSF's head of mission here, even saw some guys carting off a coffin with a dead body in it, stolen from the funeral parlour. Chaos.

We really need to get Redemption Hospital up and running again, but the area is still too unstable and insecure.

In the meantime the ICRC (International Committee of the Red Cross) has a small surgical unit running and we have started hospitalising a few patients in our compound - mostly children suffering from severe malnutrition. But we desperately need a referral hospital.

Cholera is also worrying me. Although we can't return to the hospital we've managed to get the clinic we were running from the back of Redemption Hospital functioning again and we've already had suspected cases come through.

Even more of a concern are the four cholera cases in the high school where we set up a clinic a few days ago.

We immediately referred them to our cholera treatment unit, but there will no doubt be more - when people are living in such cramped, unhygienic conditions, with no clean water and poor nutrition cholera can spread like wildfire.

Despite my fears and the exhaustion I feel there are also moments when this work blows your mind. Today, we managed to return to the camps on Monrovia's northern outskirts and the welcome we got was amazing.

As we drove in people ran out to greet us, singing and dancing. I was overjoyed to meet up with some of our national staff again.

We found two people who had been shot, including a woman who was shot in the face, and drove them off to the surgical unit.

Even with the ceasefire the threat of violence these people live with is staggering. They don't know when bullets will start to fly again, when they will be able to return to their homes.

But at least if we are here they know they can get medical treatment. I hope we can get our clinics working again soon.

But now it's the end of a long day and I'm missing my girlfriend Lucy. Since she was evacuated from here last Thursday I have barely had a chance to speak to her and I know she is worried.

I'm going to go now and see if I can give her a call. Then hopefully get some sleep before it all starts again.

13 June, 1000 Liberia time/GMT

There are 18 people stark naked and tied up before me - two of them women. The young men with guns who are guarding them are also roaming the streets where MSF boxes are strewn everywhere.

Out of the corner of my eye I can see a young kid carting off an MSF kit of food packages and all I can do is laugh. I hope he uses it.

The MSF warehouse of medical supplies was partially looted last night and I'm desperately trying to see if there is anything we can salvage.

It's going to take a lot of careful negotiation. The alleged looters are the poor souls tied up before me by the government forces who have come to restore order. It is a tense situation and I have to be very careful.


The one thing I've learnt through working with MSF is that you can't afford to be scared or think about your own predicament.

You have to focus on the work at hand and remain calm and professional - see what you can do. I've been in these situations before in Sierra Leone and I know you just have to get on with the job. And keep things light. Never lose your temper or your ability to see the lighter side.

So right now I am trying to save some of our medical supplies in the warehouse. It's very difficult to ship some of these items in and we could well need them badly sometime soon. We now have additional clinics in the school, in the stadium and in the compound but they aren't going to be much good if they don't have supplies.

But my heart is with those 18 people tied up. Even if they did do the looting they certainly don't deserve to die for it and that's often what happens to thieves who are caught around here.

There is nothing I can do for them right now. I have to concentrate on what I can actually achieve and to try to step in would be suicide. But it's frustrating and upsetting. I hope to hell they'll be ok.

12 June, 1445 Liberia time/GMT

I am standing inside Gibson high school in central Monrovia.

Between 3,000 and 4,000 displaced people have gathered here.

There are people everywhere.

They have jammed chairs in windows to try to free up more floor space and also to stop the rain from pouring in.

There is dirty clothing draped all over.

Queues have begun to form because they have heard that the government will be here soon to distribute some food.

Let's hope so.

Need to prioritise

We came across this school yesterday.

Each day our team has been visiting various locations around the city.

There are thousands of people gathering in all manner of places and we simply can not address all their needs.

It is so hard sometimes, but we have to prioritise.

Today our head of mission, Alain, has been sorting out the trucking of water to the stadium where between 10,000 and 20,000 people have gathered.

They are installing water tanks to improve hygiene to help prevent epidemics such as cholera, which is endemic in Liberia.

Meanwhile, Willy and I have visited various health clinics and makeshift camps.

Willy is our amazing clinic supervisor - a star of a man who has worked with us for 3 years now.

And now we are here.

Rebel ceasefire

Looking around at the chaos that surrounds me, I decide that this school is going to have to become a priority.

There are no latrines, no plastic sheeting, no clean water.

The only food people have is that which they managed to bring with them when they fled from the camps on the city's northern outskirts.

They need our medical help.

So I will discuss it with the team this afternoon and propose we set up a clinic.

By the way, I heard that Charles Taylor and the rebels agreed to a ceasefire yesterday evening.

It is hard to know how to react.

But of course we are all relieved that the promised bloodbath is not about to happen.

But the people here have been through so much that it is hard for them to trust what they hear.

They will just wait and see.

In the meantime, there are not many smiles to be seen.

11 June, 1415 Liberia time/GMT

I woke up this morning at 0500 to silence.

Sometimes you hear artillery and mortar but it has been quiet these last few days.

I wonder how much longer it will last - the rebels have given Charles Taylor 72 hours to step down and it is difficult to know what he will do.

We have a new plan for today.

Yesterday, staff and patients in Monrovia's last remaining public hospital, Redemption Hospital, were forced out on to the streets and the hospital was looted.

Our team found patients trying to escape in ambulances or being carried by staff or relatives.

There were dead bodies in the main street - the smell was terrible.

The situation is critical.

Although there are a few MSF health clinics around the city which I have made sure are fully supplied with medication and staff, it is not enough.

Team spirit

So over breakfast this morning we decided there was nothing for it but to build our own hospital right here in the compound.

All of our national staff and their families have moved in to the compound with us, including those from Redemption Hospital, and there is a great feeling of team spirit.

Together we cleared out one of the houses and began to build.

Funnily enough, spirits have been high. It is a great relief to be able to do something constructive again, especially for many of the national staff, many of whom have been unable to go to work because of the insecurity in the streets.

These people never cease to amaze me.

They are just unbelievable.

They have walked for miles and miles every day despite the fighting to come to the office and help with work.

Their commitment is simply staggering.

And now it's mid-afternoon and the first patients have just walked in.

Several of our team have spent the morning going through the streets and letting people know that we will soon have this facility set up and that they can come to us for help.

There are 10 people here already, almost all with dysentery and I'm sure there will be hundreds by evening.

Time to run.

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