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Last Updated: Thursday, 28 August 2003, 15:42 GMT 16:42 UK
Diary of a Liberian aid worker VI
Tom Quinn
Tom Quinn who works for MSF in Liberia
Medecins Sans Frontieres has been working in Liberia throughout the conflict.

Tom Quinn, who works for MSF, has kept a diary for BBC News Online.

1600 GMT Tuesday 23 September

Been a while since I picked up my pen but unfortunately can't be long as we're about to leave on another venture into the great unknown. I wonder what we'll find.

On the last trip we came across a ghost town - you could almost picture the people dropping what they were doing and fleeing. It was eerie.

On the whole things are looking up. For the first time in months people will give me a grin and there is no longer that animal smell of fear. But that doesn't mean there is food in their bellies or a roof over their heads. Far from it.

So although there is a great sense of relief, for us, the work is just beginning and to be honest, I'm really enjoying the challenge.

To rise to the occasion MSF are shipping in record number of staff and supplies.

MSF now has a total of 44 international staff and over 900 national staff running hospitals, clinics, feeding centres and cholera treatment centres - a regular army - and together we're pulling out all stops to try to reach the poor sods who are still out there with nothing.

This is no mean feat given the state of the bridges. But that's another story.

Hunger

For now, the biggest problem is hunger: people are starving to death. I don't know what's been happening to all the food supplies I hear are pouring in but it certainly isn't making it to those that need it most.

I haven't been working there myself, but apparently the situation is so bad in Bong County that our feeding centres are overflowing with hundreds of starving children.

It seems the deployment of peacekeeping troops outside of Monrovia is keeping the fighting at bay but it doesn't put food in mouths.

So we've started making food distributions to families with young children in Bong. But we're not a food agency - this isn't our field of expertise.

I just hope some other actors arrive to address this issue soon.

And the rest goes on. We still have cholera and there aren't enough hospitals. But we're getting there bit by bit - opening new hospitals and clinics and bringing in supplies.

And now I've got to run. Try to get to those people that still lie beyond our reach.

0800 GMT Thursday 28 August

Well, that was one hell of a journey. We were trying to drive all the way up north to Lofa County on the border with Guinea but we just couldn't get through.

This area has been inaccessible to us for years now and we're really worried about the state of the civilians.

But the roads were just too bad - or more specifically the bridges.

And after spending an hour-and-a-half stuck in mud trying to find another way of crossing a river we had to admit defeat.

If they get sick they either manage to get through it on their own or they die.
So it seems the two roads to get up north are impassable.

That's a worry.

It would all be a lot easier if the authorities would just let our teams access the area from the other side of the border in Guinea.

Fortunately we still got a fair way.

Many of the villages just outside of Monrovia have been deserted but along the border with Sierra Leone there are more people.

Amazingly the clinics there are completely empty but intact and if we wanted we could walk in there tomorrow and start working.

I'm certainly in favour of it. These people have had no access to health care for years - if they get sick they either manage to get through it on their own or they die. But the problem is security.

Access

These villages are too far away from Monrovia to make daily journeys but to stay there overnight is something we'll have to think hard about.

More news on that one later. It sums up the main problem though: Access. Bad roads, closed borders, ongoing fighting.

It doesn't make it easy. Speaking of which, we are hearing reports of serious fighting to the east in Nimba but it's hard to know for sure who's responsible.

It's a great worry for us though as we work in camps all along the road from Gbatala and Salala and if the fighting heads further in that direction we will see a repeat of what happened before with all the people in the camps fleeing and descending on Monrovia.

I don't want to see that again. I'm off to an area just south of Lofa later today so I'll be out of touch for a couple of days. We're off to Wiesua - a dead end place right out in the sticks.

We have absolutely no idea what we'll find or even if there'll be anybody left there so I'm prepared for anything.

Welcome to Liberia.

0800 GMT Friday 22 August

An early morning entry because today I'm due to be off into the wilds of Lofa County, right up in the North.

Not sure that we'll get there though, as the roads are reported to be beyond shocking and possibly impassable.

I can imagine that, from my experience of neglected, war-worn roads in Sierra Leone. What with the rainy season and the potholes, it's going to be a struggle.

Somehow he had been surviving on "greens", which means any old leaves he could get his hands on, for the last month.
Looking forward to the trip because the scenery should be special.

And it's quite a mission into the unknown because the people up there have had no help from outsiders for up to three years now.

MSF couldn't get to them, even from across the borders in Guinea and Sierra Leone. The governments wouldn't let vehicles across.

And from this side, within Liberia, the security was just too uncertain.

It's only in the last few days with the peace agreement that we've been able to plan for anything outside Monrovia.

Even that peace is rather uncertain. There was still fighting going on to the North East. Not clear who is fighting who but that road would still be too risky. And it's a real worry for the tens of thousands of people who are stuck in camps up there in Bong county.

Camps

Did my rounds of the camps in the city on Thursday with another nurse, Matthias. Lots of fixing up to be done; mainly bullet holes in the roofs.

In Ricks camp the clinic was completely destroyed, so the re-opened one that we're planning for Saturday will have to be in another building. A bit a work needed too on the latrines.

Talking of which, the numbers of cholera cases around the city are really climbing again. We still don't know what happened to them during the fighting.

But now that the clinics are re-opening the numbers are back over 300 for the last week and rising.

Gola

Down in Segbe camp we picked up one of the saddest cases I've seen for a while. Sad because it was an old man, with no family, who had been left by himself in a hut while the fighting swirled past outside and the other people ran.

He couldn't run, partly because he has badly swollen legs. Not sure yet whether the cause is malnutrition or heart problems - possibly a combination of the two.

Anyway, he turns out to be the most charming, lovely old chap by the name of Gola. Not that he speaks any English but you don't need to follow his local language to know that he is a sweetie.

Somehow he had been surviving on "greens", which means any old leaves he could get his hands on, for the last month.

Got him back to the hospital now and I hope by the time I get back, he will be on the mend.

The proper hospital, Redemption, started working again. Lots of bullet holes plugged and new locks where they were smashed off in the recent fighting.

And as we get ourselves sorted out back in the MSF office cum hospital, I've finally got my bed back.

When the compound had hundreds of people sheltering there, some of them took over my space and I was sharing the finance office with a couple of other expats. Really good to get a decent night's sleep again.

1900 GMT Tuesday 19 August

A bit later back than usual today. I've been out on another of those look and see missions, trying to locate where the real problems are now that the fighting has died down.

We know a lot about how bad they are in the city but for the first time in months we can now get outside into some other parts of the country.

Today it was over to the West again, towards the Sierra Leone border along the coast. About half way is this little town called Robertsport. That was the target for the trip.

I didn't know until I got there but it's a magical little place.

The most beautiful natural setting on hills around a bay, with a lagoon and beach.

A great little seaside town - in another time perhaps.

The reality sets in when you get close enough to see the state of the buildings. There's a lot of destruction. Not from this round of fighting, just never repaired from the last bout in 1998.

The hospital was amazingly intact but not providing any services.

Just as with 90% of Liberia, the place has had no proper health services for months and months and often years.

On the way back I came across just one little, sad illustration of what that means for families here.

We drove into a village and stopped off to find the driver's daughter, who lived there. She started telling us about the people who were most sick in her community.

A bit of a list. And the one I really had to take back to Monrovia and the feeding clinic was a four-year-old girl with severe malnutrition.

Just pure luck that we happened to drop by and find her.

Yesterday I was out at the old familiar camps in the outskirts of the city again. Re-opened the clinic at Plumco and made sure the community health workers were out and about in the other two camps that need to feed their cases into that clinic.

Mind you, I expect I'll be opening the one at Ricks pretty soon because the camps are really filling up again.

People are coming back from the bush where they went into hiding from the fighting.

Part of the attraction with these camps as well is that the Ecomil forces are now deployed along the nearby Po River and the effect they have on reducing the number of armed men around is probably comforting.

The general security feeling is improving all the time. And certainly MSF has had no problem at all in travelling around into the Lurd-controlled areas.

They are very happy to welcome us. And that's the next challenge; we want to get right up into Lofa County towards the border with Guinea to see what help is needed there, as soon as we get clearance for the trip.

I'm on the team standing by and looking forward to it.

1800 GMT, 15 August

Lots of movement for me today. A great big sweep through all the camps across the river that we had been helping with medical care until the fighting stopped us.

Now we are back. And that means, for me, a return to worrying how to set up the clinic system again, while in the meantime treating the people who are sick right now.

True, the camps are much less full. It looks like the Lurd fighters pretty much told people it was time for them to "go home".

Five of the eight camps are almost empty. Ricks, Segbe and Plumco have still got a few thousand between them.

Among those who stayed, there are some nasty examples of what this sort of existence does to you.

Twenty or so cases of Kwashiorkor; manifested here in young children presenting with terribly swollen bellies from extremely poor diets.

People are more cheerful. They are becoming more confident the fighting is not about to start again.
I am in the process of getting them out and across this side of town for emergency feeding.

Then I came across three young women with really bad dehydration from diarrhoea. All from one part of a camp and all very probably with cholera.

The priority tomorrow is to get a clinic re-established to deal with the threat. It is clear that the water and sanitation in the camps need urgent work if we are going to stop more of this happening.

A happier story though from a young woman in Ricks, who had been in labour for several days.

It really looked as if the baby was stuck and probably dead. I left her with the clinic supervisor, Magic Willie as I am now calling him, to have a closer examination.

I came back in half an hour and bingo, she had given birth to a perfectly healthy little girl. Just when you think all hope has gone, the human body surprises you again. Now we have a Wilhemena.

'Free' beer

And it looks a bit more likely that Wilhemena may have a slightly brighter future.

People across the city are starting to be more cheerful today. They are becoming more confident that the fighting is not about to start again.

The Nigerian and even American soldiers are much more visible and taking up positions in what was the Lurd area.

The cheerfulness got a bit out of hand this morning when tens of thousands of people were streaming to cross over from Mamba point.

It took me an hour to go across with them and it should have taken a quarter of that. It was like a football crowd or a street carnival.

They were after food of course, which is everywhere on the other side of the river. And not just food. For some reason there is an endless supply of toothpaste that must have been looted from somewhere and is now on every market stall.

There is still free beer as well. The factory is being looted by the gallon as people soak off their sample from a huge vat.

And the most amazing thing is the paint. Another factory that has been looted and its contents now all over the street in lurid stripes.

The Lurd fighters have been collecting up all the cars they can before leaving and are making sure they are brighter, sexier motors with the most outrageous colours.

My prize went to a fluorescent green job with decorative spots all over the windscreen. Very fetching.




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