A battered pick-up truck weighed down by a dozen passengers sitting on sacks of mangoes crawls though a checkpoint and enters Ivory Coast's rebel zone.
ODIENNE, Ivory Coast A battered pick-up truck weighed down by a dozen passengers sitting on sacks of mangoes crawls though a checkpoint and enters Ivory Coast's rebel zone.
Behind the truck is the government-controlled South, where much of the population in the main towns has access to state-run hospitals, medicines, and in many places, running water.
Ahead is the rebel-controlled North, cut off from the southern administration since a civil war split the country two years ago and where disease is staging a revival as health care and clean water become increasingly rare.
"It is much worse than before the war. The progress we had made has stopped, and now we are going backwards," said Sister Rosaria, an Italian nun who has been working as a nurse at a clinic in the northwestern town of Odienne since 1996.
When the rebel New Forces seized the northern half of the world's top cocoa grower in September 2002 after a failed coup, many doctors and nurses fled to the South, where public services have kept going despite the difficulties caused by war.
But like much of the North of the West African country, the northwestern Denguele region around Odienne has seen its infrastructure crumble and its economy brought to its knees.
"There is a lack of medicines and water," said Rosaria, who sees about 60 patients a day at the Pietro Bonilli clinic in Odienne. "People have been bringing me water from the well just so I can do the cleaning. Before the war, I could buy medicines at the chemist, but now it is impossible. Typhoid, malaria, and diarrhea are affecting a lot of children at the moment," she said, adding that even before the war, the public hospital had struggled to meet local needs.
What's more, polio has returned to Ivory Coast this year for the time since July 2000. There have been four confirmed cases in the past four months in the rebel zone, taking the tally in the country since February to 12, the U.N. said this month.
"Ivorian health staff are yet to be redeployed in some cases they have been absent since the crisis began two years ago and the various state structures responsible for provision of medicines and other supplies are not in place," it said.
Poor Turn to Traditional Remedies
United Nations inspectors who visited the region in May found hundreds of water pumps in Denguele's villages were broken. They concluded that restoring the water supply was vital to avoid the spread of diseases such as cholera.
And while economic corridors have been carved through a buffer zone manned by French and U.N. troops separating the North from South, banks have been closed for two years, and the decline in economic activity has increased poverty.
Undeterred by slow trade since the war, Doukoure Lamine, 68, sells pottery made by his two wives in the foyer of an Odienne hotel a symbol of happier times when tourists came to the area bordering Mali and Guinea. He mans his stall to try to repay a loan for drugs used to treat one of his spouses when she fell ill with typhoid fever.
"Hospitals here don't have medicines," he said. "I had to borrow more than 50,000 CFA (US$93) to buy them at the chemist and give them to the doctors. But now my wife is better, thank God."
He says there are others who may not be so lucky if struck by serious illness because they are forced to rely on cheaper, traditional remedies.
"A lot of people are getting by with indigenous medicines made from leaves and roots, but you can't treat typhoid with that," he said.
AIDS on the Rise
Local officials in Odienne say the increase in poverty and unemployment since the 2002 rebellion and a rise in promiscuity that has followed means years of progress in the fight against the spread of HIV/AIDS are also being undone.
Rebel officials in their stronghold of Bouake some 220 miles from Odienne say Ivory Coast's power-sharing government, which was born out of a January 2003 peace deal and includes three rebel ministers, should help more.
Mamadou Togba, a New Forces official in charge of social affairs, says unless the government sends doctors and medicines to the North, there could be a "a humanitarian catastrophe." He warned that diseases in the North could spread quickly to the South as the country's faltering peace process drags on.
"Without an iron curtain, illnesses which had been wiped out could return to the South," he said, addressing a team of diplomats and aid workers touring northern towns last month. "Are we going to let people die while we wait for our civil servants to return?" he asked. "We are sounding the alarm."