Ivory Coast has now registered 140 cases of COVID-19 (as of March 29 according to WHO) and recently entered the stage of local transmission. In response, the Ivorian authorities, like those in most neighboring countries, have quickly taken measures to restrict movement, according to the medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF), which has been supporting preparation measures in the country for over two weeks.

For several days, increased surveillance has been implemented in travel points and airports in the country. At a transit center in Abidjan, MSF supported the Ministry of Health by screening and referring people with symptoms compatible with COVID-19 to a care center. Over four days, an MSF doctor and two nurses examined more than 800 passengers from Europe, Asia, and the United States. The team also set up a hygiene system and informed passengers about the need for self-confinement and measures they should adopt at home in order to limit the risk of transmission to others.

MSF teams are also present in Bouaké, the country's second largest city, assessing the local capacity to manage cases of COVID-19. In Ivory Coast, as elsewhere, the limited availability of tests is a major obstacle to rapid response, but some suspected cases have been tested in the area in the past days.

"Bouaké is located on the northern road that connects to the border of Burkina Faso and Mali," said Abdoul-Aziz Mohamed, executive director for West and Central Africa for MSF in Abidjan. "With the current evolution of the situation in Burkina Faso, it is essential to ensure a presence there to be able to react quickly if a case is confirmed and quickly cut the chain of transmission. To do this, it is necessary to prepare for the management of cases, to ensure the protection of health personnel, but also, and above all, to invest in raising awareness among the population."

Training activities for health workers and screening at the different entry points of the city are already ongoing. Water and sanitation activities are also being implemented in Bouaké: Hand-washing points have been set up in six health centers as well as in the university hospital center. In the coming days, a hospitalization capacity of 10 beds will be established for the care of potential patients. An additional series of training sessions for health workers is also planned in Bouaké and Abidjan to train medical staff on preventive measures and case management.

MSF's priority has been to keep its current medical activities running, where possible, and to coordinate with local health authorities to offer support in prevention and case management in countries where it works. In some parts of West Africa, notably in Senegal and Burkina Faso, MSF is in discussion with health authorities and the WHO to support the response.

Mohamed warns that some of the prevention measures being taken in West Africa, such as restrictions on the movement of people and supplies, could have negative consequences on the health and humanitarian situation in areas already shaken by armed conflict and population displacement.

"While we understand that these measures are essential today to help stop the spread of coronavirus, in the long term they are likely to exacerbate the difficulties of access to health services for people who are already in vulnerable conditions," he said. "They will also reduce the capacity of health structures to respond to the already numerous killer diseases in the region, particularly due to the lack of pharmaceutical supplies, since more than half of the continent's supplies are imported."

More information about MSF's activities and the global coronavirus pandemic is available here.