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04 from emergency to recovery Thankfully, after negotiations with British officials, all the aid workers were freed unharmed several days later. The incident and the increasing levels of violence that followed led to the suspension of the Lofa programme. In 2000, Merlin identified significant health needs among refugees fleeing to Liberia from the civil war in neighbouring Sierra Leone. More than 30,000 had arrived since 1991 and were totally dependent on humanitarian aid. Former faction leader Charles Taylor wins presidential elections Fighting resumes; peacekeeping forces leave Merlin focused on improving the knowledge and practice of health care among the refugee population in Montserrado and Grand Cape Mount by training more than 350 Sierra Leonean health professionals and community health workers. Health education was also conducted to raise awareness of malaria, HIV, diarrhoea, breastfeeding, nutrition and family planning among 4,000 refugees. Rebel forces from Guinea launch attacks in Lofa In the thick of battle This photograph was taken just moments after a shell landed in the Greystone compound at Mamba Point, Monrovia, in July 2003. Pictured at the front left is Dr Clement Peter, Merlin’s Medical Co-ordinator at the time. Dr Clement and his team were on the scene attending to the wounded and shuttling them to the trauma unit at JFK Hospital for further treatment. “I remember that last shelling very well. I think 22 people were affected, with six or seven people dying instantly,” Dr Clement recalls. After making an immediate assessment of the survivors, Dr Clement decided that the man on the stretcher should be his first priority. “We thought that he had a good chance of survival, so I was moving him quickly to the ambulance before going back to get another patient,” says Dr Clement. Throughout this final year of the war, Merlin co-ordinated a huge relief effort, which included a city-wide ambulance service, construction of 400 latrines and the provision of 7 million litres of clean water. Magnus Wolfe-Murray, Merlin’s Country Director at the time, explains how they kept going under such difficult circumstances: “We knew for certain that if we were not there to serve these people, there would be nobody else to do the job. We saved so many people every day we had no way of keeping count.” Liberian forces launch offensive against rebels in the north UN Security Council re-imposes arms embargo 1997 1998 1999 2000 2001
05 10 years of health care in Liberia Security deteriorates, but Merlin scales up operations In 2001 Merlin began working in two new counties- Grand Bassa and Rivercess - as part of a push to improve access to and uptake of essential sexual and reproductive health services. At the time, there were only four certified midwives in Grand Bassa and one in Rivercess. Merlin took an integrated approach, by creating and supporting networks of trained traditional midwives. A community education programme to reduce high rates of teenage pregnancy was launched, which included raising awareness of family planning and sexually transmitted infections. As well as constructing four new clinics and renovating 29 existing ones, Merlin installed solar panels at these health facilities to ensure that mothers could deliver in safety at night. By the end of the year, the clinics had recorded 6,400 antenatal care visits and a 20 per cent increase in uptake of family planning methods. Sumo Goyah, now Merlin's Clinical Supervisor for Montserrado, oversaw the immunisation programme in Rivercess. “When we got there, there were only two More than 50,000 people flee renewed fighting Fighting intensifies; rebels battle for control of Monrovia nurses and one physician’s assistant serving 18 health facilities. There were no doctors at all. It was really a great task for Merlin to take on. “We started to educate people about immunisation. We started training the traditional birth attendants to strengthen their midwifery skills, and we supplied clinics with vaccines. I'm proud to say that Merlin was able to help thousands of people.” Despite increasing violence in 2002, Merlin scaled up its operations further in Grand Bassa, Rivercess and Sinoe counties, where it began renovating clinics and providing refresher training for local health staff. As the year progressed, the security situation in the south and east of the country began to deteriorate rapidly. Merlin launched emergency responses for thousands of refugees and returnees in both Grand Gedeh and Nimba, providing medical care and health education, as well as chlorinating water supplies. International donors pledge more than $500 million for reconstruction Presidential elections held A Survivor’s Story Musu Flome was 16 when fighting erupted in her home town of Buchanan in 2003. For weeks, she had been experiencing severe pain in her abdomen. Musu suspects that the poor quality of food she had been eating was responsible for what culminated in emergency surgery at the Merlin-supported hospital in Buchanan. At the height of the fighting, Musu was in so much pain that she knew she had to get urgent medical treatment. She had an infected bowel, and was literally hours away from death. “Outside when there was fighting it was so dangerous - you couldn't go outside. We had to wait until it was quiet for a time and then they carried me to the hospital. “The doctors cut the infected section out. They then sewed me back together again. They saved my life.” Now 20, Musu still lives in Buchanan where she is attending cookery classes. “I'm learning how to bake,” she adds. “Any type of bread you want, I can make it. Perhaps I will open a bakery one day.” Ellen Johnson-Sirleaf inaugurated as President Charles Taylor’s war crimes trial begins in The Hague 2002 2003 2004 2005 2006 2007
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