Liberia

The Crisis

Malaria in Liberia

Malaria is the primary cause of morbidity and mortality in Liberia, attributing to 38% of outpatient consultations and is the number one cause of inpatient deaths with 42% from malaria. A recent malaria indicator survey (MIS) in 2008-2009 indicated that malaria parasites were found in 32% of blood slides taken from children 6-59 months, and the distribution within the country ranged  from 15% in one region to 42% in the most malaria endemic region.

Ivoirian Refugee Crisis

As a result of growing conflict caused by Laurent Gbagbo's refusal to concede power to Alassane Ouattaram, who was democratically elected president for Ivory Coast in November 2010, almost 100,000 refugees have crossed the border into Liberia. At least another 700,000 people have been internally displaced in Ivory Coast, and hundreds of thousands more may seek refuge in Liberia in the coming weeks in order to escape the armed fighting, killings and other human rights violations which are now daily occurrences.

To date, Liberia has received the largest number of Ivoirian refugees, with 78,280 registered arrivals into its eastern borders axis of Butuo, Gborplay, and Loguatuo, into 25 villages in Nimba County. Also 15,064 refugees have been registered in 45 villages across Gbarzon, Konobo and Tchein Districts of Grand Gedah.

Malaria is the leading cause of morbidity and mortality in this border region, and the refugee crisis puts both the Ivoirian refugees and the host population at much greater risk. Health facilities are already unable to meet the needs of the current case load of patients and with no means of malaria prevention and poor access to health services in many affected areas, malaria will take a severe toll on refugees and their host communities alike.

The Government of Liberia and UNHCR have identified 15 villages within Nimba County (located at 15 km to 30 km away from the border) where refugees are encouraged to relocate for security reasons. One refugee camp (Bahn) with a capacity of 18,000 people has been established and two additional camps with a total capacity of 30,000 refugees are in the process of being constructed. However, as of 21st March (source UNHCR), only a few thousand refugees have been moved into Bahn camp. Therefore the vast majority of refugees are sharing the cramped homes of Liberian villagers or are living rough and still on the move in forest areas. MENTOR has surveyed 1153 occupants from 90 households in Nimba. Of these, 772 were refugees. 60% (150/250) of children aged 5 years and under were infected with malaria parasites, and 15.1% of children above 5 years and adults were sick with malaria.  Currently, none have access to any form of protection from malaria and access to treatment in this border region is poor. Many of the existing health facilities lack basic diagnostic tools and drugs to treat malaria effectively. Nimba and Grand Gedah Counties and neighbouring areas of Ivory Coast have high malaria transmission with significant risk of malaria infection all year round (4-8 infections annually per person, slightly higher during the rainy seasons). The rainy season has now begun.