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Inside Port Harcourt's 'ER' clinic Inside Port Harcourt's 'ER' clinic
(about 3 hours later)
By Andrew Walker BBC News, Port HarcourtBy Andrew Walker BBC News, Port Harcourt
Port Harcourt is oil rich but state hospitals are resource poorPort Harcourt is oil rich but state hospitals are resource poor
Calm has returned to the Teme Hospital in Nigeria's oil capital Port Harcourt after a weekend of violence saw 15 men with gunshot wounds brought to their trauma clinic.Calm has returned to the Teme Hospital in Nigeria's oil capital Port Harcourt after a weekend of violence saw 15 men with gunshot wounds brought to their trauma clinic.
A turf war between gangs, known as "cultists", flared in the city's waterfront slums when armed men zoomed into the docks on boats late on Friday.A turf war between gangs, known as "cultists", flared in the city's waterfront slums when armed men zoomed into the docks on boats late on Friday.
"I'd call it stressful," says Thierry Goffeau, field co-ordinator at the clinic after the weekend's shootings."I'd call it stressful," says Thierry Goffeau, field co-ordinator at the clinic after the weekend's shootings.
Only one man died of his wounds at the hospital, the surgeons there are experienced at dealing with gunshots - they see three or four every day.Only one man died of his wounds at the hospital, the surgeons there are experienced at dealing with gunshots - they see three or four every day.
But in Nigeria's oil capital, the home of the nation's multi-billion dollar oil industry, this accident and emergency ward is run by a charity more known for aiding in war zones and natural disasters.But in Nigeria's oil capital, the home of the nation's multi-billion dollar oil industry, this accident and emergency ward is run by a charity more known for aiding in war zones and natural disasters.
Attention is not given early enough to patients because they have to pay, and you might find that before a patient can get these things together it may be one or two weeks Dr Charles Nwagbara Nigeria is theoretically rich with oil money, and Rivers State has received billions of dollars from the federal government, but when people are injured in Port Harcourt they turn to Medecins Sans Frontieres - Doctors Without Borders - for help.Attention is not given early enough to patients because they have to pay, and you might find that before a patient can get these things together it may be one or two weeks Dr Charles Nwagbara Nigeria is theoretically rich with oil money, and Rivers State has received billions of dollars from the federal government, but when people are injured in Port Harcourt they turn to Medecins Sans Frontieres - Doctors Without Borders - for help.
The French aid agency, founded by Bernard Kouchner - now French foreign minister- after his experiences as a Red Cross doctor during the Nigerian civil war, has been running a clinic here since 2005. The international aid agency, founded by Bernard Kouchner - now French foreign minister- after his experiences as a Red Cross doctor during the Nigerian civil war, has been running a clinic here since 2005.
It provides free healthcare to anyone who comes, and its wards are often occupied by wounded police officers and gang members at the same time.It provides free healthcare to anyone who comes, and its wards are often occupied by wounded police officers and gang members at the same time.
The clinic maintains a strict neutrality, and the respect of both gang members and police, by treating both without asking too many questions.The clinic maintains a strict neutrality, and the respect of both gang members and police, by treating both without asking too many questions.
It receives between 25 and 30 patients a day.It receives between 25 and 30 patients a day.
Most of those are road traffic accidents, but a quarter are victims of violent crime, gunshot wounds, stabbings and beatings, doctors say.Most of those are road traffic accidents, but a quarter are victims of violent crime, gunshot wounds, stabbings and beatings, doctors say.
FeesFees
When the BBC visited in July the clinic was calm.When the BBC visited in July the clinic was calm.
Dr Ike Oruaari is the first person an injured person meets when they arrive at the clinic.Dr Ike Oruaari is the first person an injured person meets when they arrive at the clinic.
Doctors say Port Harcourt feels like a war zone at timesDoctors say Port Harcourt feels like a war zone at times
"Sometimes they're in such a terrible state we have to drop everything or they die.""Sometimes they're in such a terrible state we have to drop everything or they die."
Other hospitals do not work like that, he says.Other hospitals do not work like that, he says.
Doctors in hospitals that are funded directly by the state will not touch a patient until they have paid their fees.Doctors in hospitals that are funded directly by the state will not touch a patient until they have paid their fees.
Dr Oruaari got his medical degree from Port Harcourt University three years ago.Dr Oruaari got his medical degree from Port Harcourt University three years ago.
"I don't think I'll be going back to the state government run hospitals," he says."I don't think I'll be going back to the state government run hospitals," he says.
He is not the only one.He is not the only one.
Orthopaedic Surgeon Dr Charles Nwagbara used to work at Imo State Teaching Hospital.Orthopaedic Surgeon Dr Charles Nwagbara used to work at Imo State Teaching Hospital.
"Attention is not given early enough to patients because they have to pay, and you might find that before a patient can get these things together it may be one or two weeks," he says."Attention is not given early enough to patients because they have to pay, and you might find that before a patient can get these things together it may be one or two weeks," he says.
Bad ones come inside the place and just started shooting Prince Akpelou, gunshot victimBad ones come inside the place and just started shooting Prince Akpelou, gunshot victim
"Port Harcourt is a very violent place, its right that MSF should be here," he adds."Port Harcourt is a very violent place, its right that MSF should be here," he adds.
Rivers State government acknowledges the situation is not good.Rivers State government acknowledges the situation is not good.
"In the past the administration did not have its priorities right," said state spokesman Ogbonna Nwuke."In the past the administration did not have its priorities right," said state spokesman Ogbonna Nwuke.
He says more clinics are being built and improvements made to the state hospital.He says more clinics are being built and improvements made to the state hospital.
This year, government spending on hospitals and clinics has been increased almost sevenfold on paper, to 13bn naira ($110m, £55m).This year, government spending on hospitals and clinics has been increased almost sevenfold on paper, to 13bn naira ($110m, £55m).
But campaigners say they are waiting to see if the government can deliver and if they will pay the salaries necessary to attract medical professionals of the right quality.But campaigners say they are waiting to see if the government can deliver and if they will pay the salaries necessary to attract medical professionals of the right quality.
ViolenceViolence
Prince Akpelou, 20, was in a beer parlour when he was shot in the arm and back.Prince Akpelou, 20, was in a beer parlour when he was shot in the arm and back.
"Bad ones come inside the place and just started shooting. Everyone ran away. I was the first one they shot.""Bad ones come inside the place and just started shooting. Everyone ran away. I was the first one they shot."
The clinic receives three or four gunshot victims every dayHis brother was shot dead. The clinic receives three or four gunshot victims every day His brother was shot dead.
Unemployed, he is from a rough neighbourhood and says the men were not robbers, they were just shooting people at random.Unemployed, he is from a rough neighbourhood and says the men were not robbers, they were just shooting people at random.
In Port Harcourt gang violence is extreme.In Port Harcourt gang violence is extreme.
Jobless youths are armed by gang leaders who sell their services to crude oil stealing cartels.Jobless youths are armed by gang leaders who sell their services to crude oil stealing cartels.
Law and order has almost completely broken down, civil society campaigners say.Law and order has almost completely broken down, civil society campaigners say.
Last year scores were killed and injured in a week of violence that saw a curfew imposed on the city.Last year scores were killed and injured in a week of violence that saw a curfew imposed on the city.
The military tried to regain control with helicopter gunships.The military tried to regain control with helicopter gunships.
'Mass casualty''Mass casualty'
At times, doctors say, it feels like a war zone.At times, doctors say, it feels like a war zone.
The only other clinic MSF operates like this is in Haiti, where poverty, lawlessness, and gang warfare perpetually pitch the country at the brink of chaos.The only other clinic MSF operates like this is in Haiti, where poverty, lawlessness, and gang warfare perpetually pitch the country at the brink of chaos.
French doctor Cecile Barbou, a veteran of MSF missions in southern Sudan and Colombia says that the numbers of people who are victims of violence justify MSF's presence in Port Harcourt.French doctor Cecile Barbou, a veteran of MSF missions in southern Sudan and Colombia says that the numbers of people who are victims of violence justify MSF's presence in Port Harcourt.
They believe it is possible the violence could get worse.They believe it is possible the violence could get worse.
"It's true, it's quite a wealthy country and they have some structures in place to deal with health, but we wanted to be in place in case something very important occurs.""It's true, it's quite a wealthy country and they have some structures in place to deal with health, but we wanted to be in place in case something very important occurs."
"We hope it doesn't occur, but we want to be ready if there is any mass casualty occurring," she says."We hope it doesn't occur, but we want to be ready if there is any mass casualty occurring," she says.