Ivory Coast - Bright smiles despite it all

Defying poverty, disease, and the terrors of civil war, Ivorians refuse to give up hope.
Ellie Ismailidou, Reporting from Man, Ivory Coast
Photos: Ellie Ismailidou

The sun is just rising above the tropically lush green mountains. The morning humidity evaporates into blazing heat and the bracing scent of smoke laces the air, curling up out of the tiny village huts. The deep ruts in the muddy dirt road make the UNICEF vehicle rock and lurch as it approaches the Yapleu village Health Center. The center lies all but hidden in the jungle between cocoa and coffee plantations in the northern part of Ivory Coast. The hospital is a square cement building with a tin roof and a courtyard shaded by dry palm fronds. Fifteen thousand people in total – half of whom exist on just a dollar a day – are the patient population that relies on the center’s services for day-to-day survival. 

Hundreds of women wait patiently for their turn to be immunized while they watch the original pro-breastfeeding performance
Hundreds of women in colorful scarves wait their turn to be immunized; they have lively conversations as they hold babies with braided hair, and balance trays of smoked herring on their heads. Barefoot children approach the strange fair-skinned people hesitantly, the first people of a different color they’ve ever seen. A bit farther down the road a group of women dance and sing to the rhythm of an innovative song:“Breastfeed your babies, breastfeed your babies,” is the song they have come up with to promote breastfeeding in a country where only 10% of women nurse and as a result thousands of infants die before the age of six months. The impromptu melody mingles with the rhythmic chanting of another woman shouting “the tetanus vaccine does not cause infertility.” We later learn that this misconception alone is responsible for 59.000 infant deaths every year in Africa.

The civil war, which broke out in 2002, transformed Ivory Coast, once one of the most prosperous countries in Africa, into an endless battlefield. The northern regions remain the most ravaged. “Everything collapsed, food and medicine supplies simply disappeared, doctors and educators left and public infrastructure was destroyed. Even the water pumps stopped working because there was no one left to make repairs, resulting in thousands of deaths from dysentery; the tragedy is that the required repairs would have cost less than one hundred euros to be completed,” explains Dr. Cyril Ziao, director of the UNICEF chapter in Man, one of the richest areas in natural resources and home to some of the most impoverished people in the country. 

Weighing the babies is part of the routine that nurses are trying to persuade mothers to follow.
Public infrastructure collapsed due to the civil war. As a result malfunctioning water pumps have caused thousands of deaths from dysentery. While some amenities - such as clean water - are considered luxuries for Ivorians, others - such as mobile phones - are widespread commodities.
UNICEF employees teach Ivorians the correct procedure for hand washing. According to UNICEF most dysentery cases result from inappropriate hand washing, most often due to the reuse of dirty water.
UNICEF hires women to pay regular visits to mothers who have recently given birth, in order to train them in breastfeeding and sanitation. Greek singer and UNICEF ambassador, Ms. Eleutheria Arvanitaki, is observing a training session with a mother who gave birth seven days ago.
“By 2005, in just three years of civil war, the entire supply of vaccinations was depleted. Polio, cholera, yellow fever and tetanus were decimating the population,” explains Frederick Kontio, director of UNICEF’s Ivory Coast vaccination campaign. In 2007 the humanitarian crisis came to a head: four in every five infants were dying of dysentery and other diseases in remote agricultural areas. 
In an effort to gather the necessary resources to fund a vaccination campaign UNICEF has forged strategic contacts with businesses and institutions. At the same time field workers create relationships with tribal leaders and shamans in rural areas of the country, in order to convince the communities of the importance of vaccination. “Tribal leaders fill the role that media personalities have in the western world. The superstitions and rumors that circulate about the dangers of immunization spread fear and compound common misconceptions. Winning over the community leaders is invaluable; if convinced, they become the most important and effective ally of a cause,” points out Louis Vigneault-Dubois, UNICEF’s local communications representative. 

“Purchasing vaccines is just the beginning of the struggle; in order to save lives we need to change the way people think about health. UNICEF’s multidimensional approach aims to target and educate different areas simultaneously, says critically acclaimed Greek singer Eleutheria Arvanitaki, in her conversation with the To Vima. Arvanitaki is visiting Ivory Coast in the role of ambassador to the Greek campaign "1 package=1 vaccine" by Pampers, a P&G brand, and Unicef against infant tetanus. In 2007 the Pampers brand began collaborating with UNICEF on the aforementioned campaign that has already donated 300 million vaccines based on sales across Europe – 11 million of those sales were made in Greece. Largely because of the effectiveness of the campaign, tetanus has been almost completely eliminated in Ivory Coast, which is now awaiting official validation from the World Health Organization in the year 2011.

The vaccination booklet is essential for monitoring a baby's vaccination program and general health record. However, UNICEF officials explain that mothers in secluded rural areas have trouble keeping an organized record, since they cannot read or even speak French, Ivory Coast's 'lingua franca'.
Bright smiles prevail despite the terrors of civil war and the danger of diseases.
Video games are very popular among young Ivorians. 'Playstation centers' like the one shown above are often seen in the slums of Abidjan and other big Ivorian cities.
Football is a sport that Ivorians learn at a very young age. Thousands of children grow up with the dream of becoming the next Didier Drogba, Ivory Coast's most internationally acclaimed football player
Ellie Ismailidou, published October 16th, 2010, ‘To Vima’ print and online edition
Photos: Ellie Ismailidou 
See original publication in Greek here