It started as a mere speck, a small blemish on Arelan Yao's skin. Francoise Aou Kirou recalled seeing the nodule on her daughter's ribcage when she was 5 years old, and she remembers shrugging it off as no more than a bug bite, something all too common in the Ivory Coast village of Sokrogbo.

Within weeks, however, it had grown progressively worse, and within months it was an excruciating cyst, known as Buruli ulcer, that covered much of her side.

Meanwhile, further north, in the village of Kodinan, 7-year-old Firmin Kouadio Kouassi was finding it more and more difficult to walk. He began to limp, but soon he could not even do that. A victim of Guinea worm, it would take weeks for the dangling parasite to exit through the skin of his right ankle.

The diseases villagers face in this tropical West African nation are largely unknown in the developed world, and the country's years-old political turmoil has only exacerbated the health crisis.

Since 2002, when a coup failed to oust president Laurent Gbagbo but nevertheless split the country in two, tensions have remained high between the rebel-controlled north and government-controlled south. More than 750,000 Ivorians have fled their homes in northern cities and villages, taxing already strained government-run health facilities in southern towns. Children like Arelan and Firmin, who live in isolated villages dotted with thatched-roof huts, often have little, if any, access to adequate medical care.

Yet the children remain remarkably resilient. Despite oppressive circumstances, they often smile and laugh, and they play. Last week a barefoot Firmin, having shed his parasite long ago, scored a goal with a half-inflated rubber ball during a soccer game on a small, dirt field. His teammates cheered. The children have little. But they remain hopeful. And they are not without assistance.

Medical Assistance Programs International is taking steps to help the people of Ivory Coast alleviate their health and other problems. MAP has reduced water-borne diseases such as typhoid, dysentery and Guinea worm by repairing water purification pumps and providing hundreds of biosand filters to villages throughout the country. MAP has stocked rural health clinics with free medication and has trained health workers in advanced techniques for treating Buruli ulcer and other diseases.

MAP is also establishing a new program - the Total Health Village - in Sokrogbo to help people address not only health problems but educational and economic issues as well. By providing classes on agricultural techniques and other such projects, MAP will help people like Arelan's mother better care for their needs - and the needs of their children.

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