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10133
Torino, ITALY email:=
ccm@
ccm-italia.org =
&n=
bsp;  =
;
http: www.ccm-italia.org Comitato Collaborazione Medica
Corso
Giovanni Lanza, 100
&n=
bsp;
=
Tel:
(+39) 011 660 27 93
&n=
bsp;
Fax: (+39) 011 3839455
CCM ANNUAL REPORT YEAR 2005
Presentation
Comitato
Collaborazione Medica - Medical Cooperation Committee - is a Non Government=
al
Organization founded in Turin in 1968. In 1972 it obtained accreditation fr=
om
the Italian Ministry of Foreign Affairs for the implementation of projects =
of
cooperation in developing countries.
The guiding principles=
of
the CCM are solidarity and fairness, respect for cultural diversity,
improvement in the use of human resources and promotion of self-development,
regardless of religious belief, nationality or social status of the benefic=
iary
people.
Among the operative principles, are the special
attention for the poorest and most deprived communities, the effort to give
dignity and value to local resources, both human (capacity building) and
material (appropriate technologies), and to guarantee the continuity of the
projects in the years.
The main target of CCM is to improve the health st=
atus
of the populations of the developing countries, by ensuring adequate health
assistance, both through emergency interventions and, above all, through the
support of existing local health facilities.
The most important activity of the Association is =
to
offer preventive/curative medical services both of primary nature (Primary
Health Care) and of secondary or hospital nature (Secondary Health Care). As
previously said, it is considered essential to involve the local population=
and
to train local staff.
CCM carries out mainly medical activities, but tak=
es a
holistic approach, as the cooperation with projects in other fields (such as
education, provision of safe water, environment hygiene, animal’s hea=
lth,
and governance) is considered greatly important and essential.
Since the beginning of the activities, 157 volunte=
ers
have worked in various locations, under long-term contracts. Furthermore, o=
ne
needs to take into consideration the dozens of people who have donated
volunteering counselling assistance with short-term missions (there were 38
such missions in 2005, with an average stay of 22 days in DC).
·
Accredited by Italian Ministry of Foreign Affairs =
on
19/6/72 (D.M. 0012), and confirmed on 14/9/88 (D.M. 1988/128/004187/2D)
·
Framework Partnership Contract signed with ECHO: n=
. 94/0084
of 18/4/94; n. 99/0084 of 26/2/99; n. 3-029 on 7/11/03
·
Member of Operation Lifeline Sudan/Unicef since
2/3/1992
·
Member of
Cipsi since 1988
·
Member of Italian NGO Association
·
Member of People in Aid since 2003
·
Member of HIV Observatory since 2003
Accr=
edited
in the following countries
· - Ke=
nya n.
OP.218/051/94103/618 –20/6/96
· - Et=
hiopia
n. 45 – 29/4/97
· - Bu=
rundi
n. 12 – 1/4/97
· - Su=
dan
22/10/95
· - Ug=
anda:
12/7/98
1. AC=
TIVITIES
IN ITALY
The CCM is part of
“Consorzio delle ONG Piemontesi – COP”, (NGOs Consortium =
of
Piedmont), supported by the Piedmont Region, which has provided technical a=
nd
administrative support to all the organisations involved in regional projec=
ts
of food security and struggle against poverty in Sahel and West Africa.
With the COP, CCM play=
ed
an important role in the EAS projects, offered to the schools in Piemonte
focusing on health education. Furthermore, CCM collaborated with the
“Istituto Addestramento Lavoratori – IAL” (Training Worke=
rs Association),
in a course intended to the training of technicians involved in Internation=
al
Cooperation.
CCM has co-operated wi=
th
the Committee “Cittadella delle civiltà” that groups together the different NGOs in Turin, in
organizing, among the different activities, the event called “MONDO IN PIAZZA”, wh=
ose
objective is to sensitize the population to the concept of international
cooperation and to facilitate the collaboration between organisations in Tu=
rin
with foreign ones.
In 2005
the CCM has been involved in the meetings of AIDS/NGO’s Panel (26 NGOs
operating in developing countries), with the objective to sensitize and inf=
orm
the public opinion on this matter.
Concerning
the activities started in 2003, the CCM has continued the campaign to sensi=
tize
the population on the matter of FGM (Female Genital
Mutilations=
), using
a documentary made in the Somali Region in Ethiopia, along with a presentat=
ion
related to health and anthropological aspects of the matter, reaching different social
backgrounds (schools, theatres, associations etc.) =
&nb=
sp; =
1.1. Information and sensitization
Aware of the
importance of continuous and appropriate information and sensitization about
developing countries, especially among young people, CCM has joined with
enthusiasm the project of National Voluntary Civil Service proposed by the =
City
Council. In the second Announcement of 2004, the CCM has involved fo=
ur
voluntary girls in a project called “Awareness to problems of coopera=
tion
North-South and promotion of the CCM activities on the regional
territory”: the four girls started working in February2005.
The overall
evaluation of the first year’s activity is surely positive, regarding
both the personal commitment of the volunteers and the results obtained: ma=
ny
articles have been written, some of which were published on scientific
magazines, whereas some videos produced by CCM in Africa were broadcasted by
national TV networks (RAI 1 and Taxi Channel). The four girls in the Civil
Service updated the CCM website (www.ccm-italia.org) and the on-line newsletter is sent to more
than 500 addresses.
Among many events organ=
ized
by CCM, it is necessary to take into consideration first of all the photogr=
aphic
exhibition entitled “Families=
of
Africa”. The exhibition consists of fifty didactic panels and a
photographic book, from which a calendar was also produced. The exhibition =
has
been presented in many places, such as the Lingotto Bonheffer library in Tu=
rin,
many schools and libraries in different towns and cities.
The new exposition on w=
omen
working life, called “From 4 to 2 - the working hours of women in
African rural areas”, has accompanied in some locations the
exposition “Families of Africa”.
CCM has started
collaborating with the graphic institute of Steiner and with the IED (Europ=
ean
institute of design), to study with some schools the development of possible
campaigns to improve the awareness on “Sanitary situation in South
Sudan” and “Children rights are the face of the peace”
A new calendar 2006 was
created.
Many meetings to improve
the awareness on the sanitary problems in Africa and a round table on the
matter of “Disability in the North and South of the world: experience=
s on
the field” have been organized.
The CCM was present dur=
ing
the “Marcia di Assisi”; in the meeting “One World” =
and
“Young World Happening” organized by the city of Turin during t=
he
Olympic period; in the 3WEEC(Third Environmental Education Congress).
Furthermore, many activ=
ities
(such as ethnic dinners, exhibitions of African crafts...) have been organi=
zed
in order to collect funds for the different activities.
In the 2005 selection f=
or
National Foreign Civil Service, the CCM employed four volunteers for the
Sanitary Service in Africa. Since the beginning of October 2005, four
volunteers have started to attend the CCM location in Turin, in order to be
trained on administrative/organisational and sanitary matters. Later, they =
have
started working in the CCM offices of Nairobi and Addis Ababa for 7 months.=
A course of “Trop=
ical
Surgery” has been offered in collaboration with the University of Tur=
in.
CCM
has continued to collaborate with the Medical Association of Turin and Cuneo
which have shown particular interest in getting involved in health projects=
in
developing countries. They have destined parts of their newsletters to spec=
ific
CCM projects, especially in South Sudan, in which some of their medical doc=
tors
were involved.
CCM has contin=
ued to
co-operate with Solidarietà Internazionale (International Solidarity=
), a
magazine edited by CIPSI (a NGO’s network, of which CCM is part)
1.2. Institutional
activities
The annual CCM
members’ general Assembly was held on June 30th 2005. Afte=
r a
presentation by the anthropologist Alberto Salza on “The rights of no=
mad
shepherds in the Somali region of Ethiopia in the matter of health and water
availability”, an overview on the association’s activities and
works and projects in progress in the developing countries followed.
In order to imp=
rove
the relations with the members and supporters of CCM, a second assembly was
held on November 26th, introduced by a debate on the topic
“From vaccination to the pill. Prevention and cures in the health
projects by the CCM in Africa”. It followed the presentation of the
development in the second semester of 2005.
Executive Council
As usual, CCM Executive Council has gathered during
the past year on a bi-weekly basis.
According to the Statute, the Council is responsib=
le
for the management of all the activities and has to take decision about eve=
ry
issue concerning the Association. CCM’s practice is to allow supporte=
rs,
partners and anyone interested in getting involved in the Association’=
;s
activity, to attend the Council meeting. This is to emphasize the clearness=
and
the willingness to share the managerial responsibility by the members.
Supporting groups and external relations
The supporting groups were very active in dealing =
with
mobilization and fund raising, focusing on specific projects. We would like=
to
remember, among others:
·
Volpiano’s Friends Group: they organized
activities involving teachers and students of local schools; the Volpiano C=
ity
Council funded CCM projects in Burundi and participated in many local events
(Patron’s Saint feast, charity sales) involving local people for CCM
solidarity proposal.
·
Sololo’s hospital supporting groups, divided=
in
two groups: the group from Cuneo Province has been working for many years to
modernize the hospital buildings, by sending volunteer technicians for
maintenance; the second group from Robbiate supports the territorial health
program, sponsored by private donors and by Sacchi Foundation.
·
Sudan’s supporting groups, among which Chieri
and Stupinigi Rotary Clubs, have contributed to the CCM projects for many y=
ears
with mobilization and fund raising campaigns. Also, the “Nanni’s
Friends” group has been particularly active this past year. (It found=
ed
in Cuneo in April 2004 to honour the memory of Doctor Ugliengo, who died du=
ring
a rescue mission on the Alps).
·
The Bergamo Group which, in collaboration with the
local NGO Ji-Duma Eau et Vie, gives a continuous support for the access to
drinkable water in Mali.
·
Mandelli and Seymandi friends, in memory of their
friends killed in an aircraft accident, organized a relevant support group =
for
Rumbek Hospital, mainly focusing in the administration of the hospital and =
the
prevention of malaria.
The distinctive feature of these informal supporting groups is that many
members offer personal contribution travelling on their own expenses to
operation places and using their professional skills to help carry out the
projects.
2. ON GOING PROGRAMS IN DEVELOPING COUNTRIES
2.1.1. Shared Project with CISV/CCM/LVIA n. 7451 “Improvement =
of
the sanitary, alimentary and water supply conditions in the province of
Cibitoke” financed by M.A.E.
The first objective wa=
s to
be able to continue to provide support that would guarantee timeliness in
urgent surgical, gynecological and obstetric problems, in the Cibitoke
hospital, which is the only sanitary facility for roughly 400.000 people. A local gynecologist, already hire=
d and
paid by CCM in past activities, is now part of the staff of this current
project.
He has been
implementing:
a) C=
ontinuous
medical advising assistance;
b) S=
urgical
operations: 25-30 per month (hysterectomies, cesarean deliveries, etc.);
c) T=
raining
of the doctors for gynecological emergencies: as it is now, the hospital
director is able to take the place of the gynecological specialist on Sunda=
ys
and holiday.
The Hospital
provides an indispensable service intended for all the population that would
not be able to go to the main cities hospitals due to distance, transport,
security and cost problems.
An obstetric n=
urse e=
mployed
in the project has been in charge of organizing the hospitalization departm=
ents
and training the nurses.
The transfusion
department in the hospital has been built with MAE financial support in 199=
3.
Its activity was halted for security problems in 1996 and then it has start=
ed
working again in 2000.
In order to
maintain, at least partially, its functioning, four laboratory attendants h=
ave
been sent to the Transfusion department of Bujumbura for specific training.=
Their job is:<= o:p>
-  =
;
To sensitize the local population to volunta=
ry
blood donation;
-  =
;
To collect the blood donations in the villag=
es,
schools and in the transfusion center of Cibitoke. CCM provides the
transportation to the furthest villages and schools;
-  =
;
To carry out the blood examinations of diffe=
rent
groups and evaluate the compatibility for transfusion;
-  =
;
To perform a test for the voluntary depistag=
e of
HIV. The laboratory attendant is also responsible for communicating to the
people the AIDS results of the examinations made in Bujumbura.
The collected =
blood
is sent to the national transfusion center of Bujumbura in order to be test=
ed
for HIV and then redistributed, according to the demand, to the hospital of
Cibitoke. The blood in surplus is used by the National Center for the hospi=
tals
in the capital. The total bags per years are more than one thousand, and the
transfusions are about 50 per month, mainly in the pediatric and maternity
departments.
The laboratory=
with
the spectrophotometer has able to carry out, along with the basic tests for
malaria, tuberculosis, intestinal parassitosi, the tests for glycaemia,
azotemia, transaminase, serology for typhus, syphilis and test for HIV.
Radiology
A radiologist =
has
been trained to use a portable radiological device. This has turned out to =
be
very useful in this region due to the very high incidence of pulmonary
tuberculosis.
Public pharmacies
Since 1993, du=
e to
the civil war, the Burundi government has not been able to supply its
population with free essential drugs, as said by the law. Consequently,
especially in larger urban centers, many private pharmacies have opened sel=
ling
drugs at costs too high for the greatest part of the population.
Through the emergency project of CISV/CCM/LVIA,
financed by MAE, in 2001 five public pharmacies have been opened in the
province of Cibitoke, and more specifically in Rugombo, Mugina, Mabay, Murg=
wi
and Buganda. In 2002 the CCM opened another pharmacy in Bukinanyana, using =
an
old building provided by the City Council. Right now, each of the six
pharmacies is run by a manager employed by the sanitary system of the provi=
nce,
despite receiving an extra financial incentive from the CCM. Each pharmacy =
has
its own management committee, chosen by the local population. The CCM is
responsible to buy the drugs in the Capital, through a qualified nurse empl=
oyed
for this purpose. Each month an NGO’s supervisor inspects the
administrative management of the pharmacies. While the financial resources
needed for the purchase of the drugs are now supported by the income of the
pharmacies, the CCM is still in charge of the organization for the purchase=
of
the drugs in the capital, of the costs of distribution and of the
administrative management. In 2005, under the suggestion of the provincial
doctor, the CCM found two more areas, where two public pharmacies might be
opened.
2.1.2. Technic=
al
Assistance to PATSBU (Transitory Supporting Project to the Burundi Health
System), financed by European Union.
In line with a task star=
ted
during the previous years, with the project VII FED (Fond Européen de
Développement), CCM gave technical assistance in the Cibitoke provin=
ce
in this transition project in preparation for the IX FED.
The staff of technical assistance in 2005 included=
: a
public health doctor, an administrative manager, an accountant, a surgeon, =
an
anesthetist, a pediatrician.
The main objective of th=
is
global project was to improve the health status of the five provinces. The
doctor employed by CCM, has been working in close collaboration with the lo=
cal
Province Doctor in order to improve the financial and administrative
management; to create a sanitary information system able to connect the data
from this province to national data base system and to implement a network
system between the local dispensaries and the central hospital.
Special attention was pa=
id
to the possibility of developing a system that would cut down various expen=
ses
by the active participation of the local communities in the management of t=
he
project.
In the hospital and in t=
he
dispensaries, the doctors improved the quality of the services offered, thr=
ough
the extensive training of nurses, who have attended courses on the most
frequent pathologies and on the new therapeutic protocols.
·  =
;
In order to guarantee a correct fol=
low-up
of the CCM activities in the country, since September 2005, Dr. Louis Marie=
de
Montfort Nshimirimana has been working for CCM as the legal figure of the
organization. The doctor will also be in charge of the promotion of new
initiatives intended to widen the activity of the NGO in the country.
2.2. ETHIOPIA
2.2.1. Support=
to
the regional Health Office in the provision of health services in the regio=
n of
Gode, the Somali region of Ethiopia (October 2002 – September 2005,
extended until May 2006)
The objective =
of
this three-year project, co-financed by the Austrian Cooperation, is to imp=
rove
the health status of the population, by extending the area covered by the
service and by improving the quality of the sanitary service offered by the
government system. This has been accomplished with a close collaboration wi=
th
the Health Ministry of the Somali Region.
The different activities of the mobile clinic are still in progress =
and
new medical ambulatories have opened. In this way, the local villages covered by t=
he
mobile hospital are now 36 in the districts of Kelafo, Mustahil e Gode. The
vaccination activities, maternal and infant health protection programs, and=
the
therapy of the most common pathologies have been running regularly, with the
supervisor visits. In the woredas in which CCM has been working, the
vaccination coverage is 23%, a relatively high percentage if compared to th=
e 5%
coverage present in the whole Somali region. At the same time, training cou=
rses
for traditional birth attendants (TBA), community health workers (CHW) and
nurses have been offered. The material needed for the development of the pr=
oject
has been regularly distributed.
All the Health
Committees of the village are fully operational and have given their full
participation to the activities of the mobile Hospital. It has been found t=
hat
the clinics have adequate availability of the most important primary drugs,
although the population claims of not being able to afford them.
All the tradit=
ional
birth attendants and community health workers, always being trained, are fu=
lly
operational and produce regular monthly reports.
Special confer=
ences have
been organized on the matter of genital mutilation, in which civil and
religious authorities, women associations and circumcisers have actively
participated. The people trained and responsible for this project have been
going to the various villages once every two months in order to engage the
population in the discussion of this matter.
2.2.2. Supporting Project to Health System in Libaan e Afdheer, Soma=
li
Region, Ethiopia (April 2003 - September 2004, extended to March 2005)
The main objec=
tive
of the project, co-financed by the Austrian Cooperation, is to improve the
health status in the area of interest. As a result, particular attention wi=
ll
be paid to the diagnostic and curative aspects of the project, to the exten=
sion
of the area covered by the prevention campaign and to the improvement of the
administrative system managed by the local health authorities.
All the integr=
ated
medical preventive and curative activities (vaccinations, prenatal check-up=
s,
special treatments…) are regularly conducted monthly in twenty-one
different areas with the mobile clinic and in two permanent hospitals.
The population contacted represents about 58% of the residents and t=
he
vaccination coverage is about 30%.
The supervision of the hospital is conducted regularly. The project =
has
supplied basic equipment and material for eleven health structures.
The project supply equipment and basic materials for 11 health
structures. Furthermore, the cold chain is now operative.
Training cours=
es for
traditional birth attendants (TBA) and community health workers (CHW) have =
been
conducted.
The activities of Health Committee in the villages and the activities
for the reduction of female genital mutilation are in good progress, simila=
r to
those in the zone of Gode.
In January 2005, the vaccinations of children in nomad populations h=
ave
continued. The active presence of a veterinary surgeon, along with an
anthropologist and a Somali nurse, has allowed a drastic improvement in the
animal and consequently in the human health status.
2.2.3. Supporting project in the Health System in =
the
zones of Libaan e Dollo, Somali Region, Ethiopia (June 2005 - May 2008)
This project is the continuation of the previous one, always with the
financial support of the Austrian Cooperation.
In the project there i=
s a
sub-project called: “Operative research to find a solution for the
distribution of Western medical principles among the nomad shepherd populat=
ions
in the Somali region of Ethiopia, in the Libaan area.”
This section o=
f the
project is financially supported by the Italian Cooperation.
2.2.4. Supporting the traditional social system of nomad populations=
in
the Somali region of Ethiopia
(December 2004 - December 2005, extended to March 2006)
The project, financed by the European Community, budget line
“Microproject in Ethiopia” has the objective to preserve and
strengthen the lives of the nomad population in the area, paying particular
attention to the environment; indeed, only the transhumant nomadism is
compatible with the semi-desert territory of these areas, where agricultural
activities are impracticable. The nomad sheep farming is the only way to be
able to inhabit this environment, in which these populations have completely
integrated, preserving it and impeding a total desertification.
The proposal has invol=
ved
the nomads of the Kelafo Region, in the Gode zone, trying to create an
association able to cooperate with the Ethiopic government.
The activities have been
monitored by three missions on the field, conducted by experts in anthropol=
ogy
and human rights, in the periods March-April, July-August and in the future=
in
February-March 2006. The members of the families, belonging to the three cl=
ans
present on the territory, have been involved, firstly in order to understand
their conception of human rights and later to inform them about these conce=
pts,
in line with the Ethiopian law. At the same time, the committee was able to
find a possible strategy in order to mediate between two opposing visions. =
In
the first mission, 4000 people were approached and asked to fill in a
questionnaire, which has provided a list of factors that these populations =
find
essential for the improvement of their life quality: health accessibility,
access to clean water and capability of movement were the top ones.
Many training sessions and workshops on human rights have been held,=
in
which both members of the nomad population and local authorities have activ=
ely
participated. A first draft of the Statute of this nomad association has be=
en
produced.
Finally, in order to show the practical results of the implementatio=
n of
these rights, different activities have been carried on: the construction of
new wells to underline the importance of the right of access to clean water;
the rehabilitation of new routes in order to increase the mobility; a campa=
ign
on vaccination against measles for the right of health access.
2.2.5. Implementation of basic obstetric services in the area of Bal=
e,
Oromia Region, Ethiopia (January 2005 - January 2008)
The main objective of the project, financed by the European Communit=
y,
budget line 21.020703 (ex B7-6312), is to reduce the mortality of women and
newborns with well-organized basic obstetric services in the Bale area. The
basic strategy is to give technical, managerial and financial support to the
local authorities in order to extend the area covered by the service and to
improve the quality of obstetric services offered to the population in the
area. The project is integrated with the Health Sector Development Program
(HSDP) in the development of the Region. The project is in close collaborat=
ion
with the Zone Health Department (ZHD). The analysis of the needs, the plann=
ing
and the realization are conducted by the staff of ZHD and CCM, according to=
the
guideline of WHO.
An Italian gynecologist has been working with the local colleagues of
Goba hospital, both in surgical operations and assisting troubled pregnanci=
es.
Furthermore, the doctor has trained and kept updated the local medical staf=
f.
Finally, the project also includes the rehabilitation of some medical
structures and the maintenance of the medical equipment.
An Italian doctor is responsible of coordinating the whole project, =
of
organizing the peripheral hospitals (13/18), of training midwifes and of the
supply of medical tools. Furthermore, an anthropologist is studying the
traditions linked to the child birth in Oromo populations and is trying to =
find
the best way to introduce the western medicine practices to the women (such=
as
regular control visits, spread of sanitary practice information on the
management of the newborn in his/her first months).
Projects waiting to be implemented
Improvement of Programs for Community
Rehabilitation in Addis Abeba, Ethiopia
The aim of the project is the improvement of Rehabilitation Programs
(CBRP) in Addis Ababa, in Ethiopia. The main objective is the improvement of
the life quality of people with handicaps or disabilities, in order to allow
them to take active participation in the social, economic and political liv=
es
of their communities. The specific objective is to extend the area covered =
by
the services provided and to improve their quality. The strategy includes t=
he
improvement of the technical, managerial and organizational abilities of the
different organizations working in the area. The project has been presented=
to
the DGCS of the MAE. It is expected to last for three years
2.3. GUATEMALA
In 2005 CCM has
continued its activities of cooperation in order to develop the rural area =
of
Palajunoi Valley, in Quetzaltenango periphery in Guatemala.
Due to the fac=
t that
CCM does not have other projects in Guatemala, all its activities in this
country have been part of the consortium of 4 NGOs of Turin (CISV; MAIS; RE=
TE;
e CCM), that have been working together in order to originate a cooperative
relationship with a consortium of local NGOs, responsible of an extensive
3-year project, financed by MAE.
From the opera=
tional
point of view, in 2005 the CCM has tried to continue the activities started=
in
the previous years, through the implementation of a six-month project, fina=
nced
by the city of Turin and planned by the local NGOs, later revised by the NGO
consortium in Turin and by the CCM for the medical aspects of the project. =
This
project, in line with the projects financed by City of Turin in the pervious
years, has been focusing on the training and supervision of sanitary activi=
ties
conducted by twenty Community Health Workers (CHW), previously selected and
trained on specific areas, such as: counseling; correct management of the
drugs, in order to increase the quantity and improve the quality of the
pharmaceutical products stored in the community pharmacies; the values and =
the
risks of the traditional medicine, in order to give the population the tools
necessary to evaluate which traditional practice can be useful in the
prevention and treatment of various diseases and which can be dangerous. The
activities have been developed during March and November of 2005.
As in the prev=
ious
years the Piedmont Region has continued in its participation in the coopera=
tion
of Quetzaltenango, by financing a project for the realization of 4 local
missions of 30-40 days each, conducted by representatives from the four NGO=
s in
Turin. The main objective of these missions was to expand and facilitate the
cooperation of the local NGOs in the planning part of the project MAE.
As part of the
activities organized by the City of Turin for the Olympic Games, in Septemb=
er
2005 mayor of Turin organized a meeting with a delegation of the City of
Quetzaltenango, formed by the vice-mayor and three counselors; the CCM, with
the other NGOs of Turin, was present during the welcoming ceremonies and the
discussions with the representative people of Quetzaltenango, Turin’s
twin city.
Last year, Gua=
temala
was hardly hit by Hurricane Stan, which has caused enormous material damage=
and
has caused many deaths. The Department of Quetzaltenango and particularly t=
he
Palajunoj Valley have been less hardly hit than the rest of the country,
although there will certainly be consequences, both in the sanitary and
economic sectors. After a detailed and quick analysis of the situation by a
professor of the University Juan Carlos of Quetzaltenango and his students =
made
a very dept analysis about the consequences for a sanitary and production
situation, and in line with the big necessity of help asked a request of
financial help that has been approved by the Piemonte Region, damages due to
the disaster produced by the STAN Storm.
2.3.1. Consortium Project for rural development in Palajunoj valley = and supporting action for the decentralized cooperation with the city of Quetzaltenango (7692/CISV/GUA) co-financed by MAE-ONG CSV responsible <= o:p>
Since September
2005, the consortium project has started and has been promoted by the Piedm=
ontese
NGOs CISV, CCM, Mais and Rete. In this cooperation project, lasting three
years, CCM is mainly responsible of the health aspects and, through its
activities, it tries to rehabilitate the primary care facilities and to rai=
se
the quality of the services provided. Furthermore, CCM intends restoring and
reactivating second level facilities, in which patients with more complex
pathologies can be treated. Not less important is the implementation of a
protocol for the smooth functioning of the three levels of health care, the=
ir
specific roles and the passage of patients from one level to the other.
In the
triennial MAE project, CCM has selected and trained cooperating personnel, =
for
a mission in loco of six months, from February 2006.
2.4. KENYA
2.4.1. Project CCM/2611/KEN, co-financed by MAE
In this last year,
concluded on the 31st March 2005, the main objective of the proj=
ect
was to provide the poorest people of Nairobi access to health services. This
was accomplished by offering:
1) D=
iagnostic/Therapeutic
services in the peripheral ambulatories;
2) H=
ealth
education and prevention from the HIV/AIDS infection;
3) Handicap prevention, physiotherapy and rehabilitat=
ion
for handicapped people;
4) Support to the hospital for assistance in general
surgery, traumatology, orthopedics, corrective surgery; 5) Training for local people. =
1) =
Basic and specific health services in the
Shantytowns . The peripheral
ambulatories of general surgery, pediatrics, gynecology, surgery and
orthopedics have kept on being the only centers of reference for the poorest
inhabitants of the Shantytowns of Nairobi. Due to the on going
decline of the social system in Nairobi and more specifically in the Shantytowns<=
/span>,
many difficulties concerning the security of both the local and the foreign
staff arose. The various health activities have been conducted in the diffe=
rent
ambulatories, as discussed below. A) KARIOBANGI
DISPENSARY. Each Monday, a
doctor of CCM has been regularly present in the ambulatory of General Medic=
ine.
He is responsible of the dispensary, property of Comboniane Sisters, who ha=
ve
always worked in close collaboration with the CCM and, in this past year, h=
ave
expanded the laboratory in order to guarantee the basic examinations and the
test for HIV. The doctor is =
also
responsible for training the laboratory staff. Furthermore, in the dispensa=
ry,
minor surgical interventions have been conducted. Once a month t=
he
ambulatory has made screening for handicapped children and follow-ups for
hyper-tension cases. <=
o:p> B) ST. THERESA DISP=
ENSARY,
EASTLEIGH – MATHARE VALLEY St. Theresa
dispensary is the main peripheral center for the poorest patients of Eastle=
igh,
with a significant Somali immigration, and for the Shantytowns of Mathare Valley, the =
most
populous (circa 250.000) among those in the north/east part of Nairobi. Each Wednesday, the
ambulatory of General Surgery, Orthopedics and Traumatology has been opened=
by
the CCM Medical Doctor. The medical intern has
provided weekly medical counseling. The patients w=
ith
complex surgical or trauma cases have been sent to the Mbaghati hospital. T=
he
ambulatory has taken care of the follow up sessions. The gynecological and
ecografic services have functioned for the whole year and have been the only
one in the entire region, affordable for the poorest. The diagnostic
activities (including radiological examinations, blood tests for HIV,
hepatitis, hemochrome, thyroidal tests, parasites’ examinations,
etc…) were offered from Monday through Friday. C) KAYOLE DISPENSARY- MED=
ICAL
AMBULATORY The ambulatory=
, in
which the CCM doctor was present every Thursday, is the basic medical cente=
r,
through which the poorest people were able to have access to health facilit=
ies
and, when necessary, to more specialized medical centers. The cases of surg=
ery,
gynecology and traumatology were transferred to the dispensary of St.Theres=
a or
to Mbagathi Hospital. A nurse, offered by the mission, has assisted the doc=
tor
and has helped as “cultural filter” when necessary. The most
frequent pathologies have been HIV/AIDS transmission, respiratory and
gastro-intestinal diseases. D) MEDICAL AMBUL=
ATORY-
KIVULI DISPENSARY The CCM doctor=
has
opened every Saturday the ambulatory for general medicine and pediatry. <=
o:p> Many orphans f=
rom
Dagoretti, Karangware and Riruta, satellite quarters of Nairobi, often come=
to
the ambulatory. The doctor has=
been
assisted by the nurse, hired by the medical center, who is in charge of the
management of the dispensary and of the selection and reference of the most
serious cases. E) PEDIATRIC AMBULATORIES - KARIOBANGI Last year the ambulatory has worked regularly every
week, also due to a large demand from smaller centers, which take their
patients to Kariobangi. The children, recipient of this service, are mainly
AIDS orphans, who have been contacted by the nurses and the social workers
operating on the territory of the Shantytowns=
span> of
Korococho and Huruma. The vaccination campaign has continued regularly, hav=
ing
a fundamental role in prevention of infectious diseases. - KOROCOCHO - =
HURUMA Last year, the
ambulatory for orphans living in the streets have been offered on Tuesday,
Thursday and Friday in the Shantytowns of Korococho, in St. John’s School in Huru=
ma,
in St. Martin’s School in Kariobangi and in the school in Watoto Wetu=
. The
forth social center in Boma Rescue has been used for health education. The nurse hire=
d by
CCM has organized different activities of health education, with classes on
hygiene and prevention. Furthermore, she was responsible for the distributi=
on
of essential drugs to the population. F) OSTETRIC AND GINECOLOGY
AMBULATORY. Every
two weeks the gynecologist of CCM came in the dispensary of St. Teresa to
guarantee a service for the women living in the Shantytowns.
Furthermore, the doctor has organized counseling service for the women that=
get
tested for HIV. Many women have gone to the dispensary for infertility issu=
es. G) =
AIDS
PATIENTS CLINIC CCM has kept on working in close collaboration with the Medical Miss=
ion
Sisters, who are taking care of more than 1000 patients with AIDS. The pati=
ents
receive medical service directly at home. Last year, some antiretroviral dr=
ugs
have been available in a governmental ambulatory in the Mbagathi Hospital, =
to
which the most serious patients have been sent. 2) Progr=
am of
sanitary and prevention education of AIDS in Korococho, Kariobangi, Huruma,
Ngei. This program is
going on “EDUCATION FOR LIFE” in the very poor areas of Karioba=
ngi,
Huruma e Ngei, were has been managed meetings with young people in the scho=
ols with
parents and teachers. Even this year CCM organized a public meeting for the
Aids Day with very big participation of people. <=
o:p> 3) Community Based Rehabilitation Programme
(CBRP) a Korococho e Kariobangi. Many families,=
in
continuous increasing number, have been involved in this program. The
physiotherapy and therapy sessions for occupations are attended by a contin=
uous
number of people; the mothers of handicap children are helped with financial
support to continue small working activities giving the possibility to crea=
te
income. The patients, who must be assisted with surgery, are taken care by =
the
CCM doctor who developed two missions during the month of May and November =
and
December. The most serious cases=
has
been sent to the physiotherapy department of Marathi Hospital, powered by CCM p=
roject
for structures, tools and training. <=
o:p> 4) Clinic- surgery
hospital activity The collaboration with the Hospital of Mbagathi has been reinforced
overcoming the problems linked to the opening of a new surgery department,<=
o:p> The surgery area is fully operational starting from may 2004, covering
the needs of patients of “slums”. The surgeon of CCM and the staff of clinical officer of anesthesia, t=
wo
clinical officers in training were in charge to make the training on the jo=
b.
In the last two months two new expert nurses has been employed for surgery =
room
and anesthesia. The orthopedic missions has been in line with the project forecast, m=
any
boys have been visited coming from the poorest areas. Very important was the
work made by the Hospital off Mbagathi in the new place for internal and
external patients 5) Conti=
nuing
Medical Education Many seminars =
and
training on the job in line with the CCM program have been developed for
sanitary staff of Mbagathi
In particular =
the
nurse Dorotea Mworia, coordin=
ator
of educational and prevention AIDS
group, ended the second year of course of public sanitary and achiev=
ed
the degree.
2.4.2. Service for primary medicine and support to Sololo Hospital
The
North Kenya is the historical
presence of CCM projects since the ’80 years; the operative place has
been the missionary Hospital of Sololo village, Moyale district, with a
population of 60.000 people, Borana =
majority.
During these years the CCM has been engaged in the area with project financ=
ed
by MAE but also with private support. The most important activity has been =
the
support to the Sololo Hospital with doctors, hospital attendants, Italian
technician with two years contract and voluntary presence of fiends. Due to
drought problems the ONG worked in the improving hydric resources with a
particular care of territory medicine. The activities developed in 2005, au=
to
financed and with the contribution of private people is concentrated in two
main tasks in North Kenya.
The
first group of activities concerns:
·
·
·
·
In the
current year have been defined the basis to build same
“family.houses” for the orphans due to the AIDS; a voluntary CCM
mission is in charge to start the works.
In the second group the task=
was the support to the Hospital structure of=
Sololo with maintenance of the electrical syste=
m and
the system for treatment of water drain, opening of a new well and a system=
to
collect raining water, new structure for Out-patients department.
2.4.3. Scholarship in Medicine
The
student of Medicine University is going on in Nairobi financed by CEI.
2.5. MALI
The task of the
project is to contribute to the solution of drinkable water in the villages=
in
the area of Mali, in collaboration with the local ONG Ji-Duma Eau et =
Vie.
During<=
span
lang=3DEN-US style=3D'mso-bidi-font-family:Arial;mso-ansi-language:EN-US'> =
2005, 9
new wells are working; about 5500 people can now have drinkable water near =
home
in the village of NYAMINA.
Other 5 wells =
are in
working process with the financial helps of November.
During<=
span
lang=3DEN-US style=3D'mso-bidi-font-family:Arial;mso-ansi-language:EN-US'> =
January
of the current year will be available the last tranche of financial
contribution that will be used to end the 2004-2006 program for the
construction of other 5 new wells.
For other 6500
people the clean water will not be any more a problem.
In June 2005 started=
=
to work=
a mill in the villa=
ge of
Kolimana in the comun of Nyamina.
The realizatio=
ns
made during 2005 have been visited by a auto financed mission of CCM
voluntaries with some partners. All the wells are well built with a good
availability of water, the mill is in a good state of maintenance and the w=
omen
are very satisfied.
The realizatio=
n in
2005 has been done thank to the private helps because no public support were
available.
The collection =
of
financial resources for the project”19 wills in Nyamina” is now
ended.
Is not still s=
olved
the problem of water availability in the Sahel village not far from Nyamina
were voluntary people of CCM during a visit in the area of Koula and Doumba
defined the necessity of at list 19 wells. We hop realize I the next 3 year=
s.
2.6. MOROCCO
2.6.1.In this Country CCM has been helped with a financial support of
Piemonte Region for the annual project: development of multy function center
for the social and working insertion of young boys coming from the peripher=
al
area of OUJDA
The project ended in April 2005.
He Oujda City is characterizes by an
growing urbanization due to t=
he
illegal economy from the near frontier, and the immigration is concentrated=
in
the poor quarters not legal.
Project objectives:
1.&n=
bsp;
Support the autonomous work with a professio=
nal
qualification to push the young boys to artisan jobs.
2.&n=
bsp;
Help the young people( 14-18 ye=
ars
old) to be integrated in the new social and economical reality
3.&n=
bsp;
Improve the existing service structure and
reinforce the local association.
4. S=
upport
the people witch want emigrate in Italian territory with information desk
organized by “Vedo Giovane” in the provinces of Verbania , Biel=
la,
Novara, Vercelli.
Q=
ualification
courses have been organized involving about 250 people and 80 people have b=
een
trained to write and read..
M=
any
opportunities of meetings have been created between different quarters at t=
he
boundary as Marathon race for primary schools, a show market for typical
products coming from the laboratories
A lawyer lady gave his legal assistance to ma=
ny
families for the emigration procedures in Qujda poor area
2.7. SOMALILAND
2.7.1. Improve=
ment
program for the control of tuberculosis
In the Program=
of
Global Fund against Tuberculosis, AIDS and Malaria, since jaunary2005 the C=
CM
is responsible of monitoring and evaluation of implementation program to TB
control; the team, doctor and laboratory technician, make periodically visi=
ts
the center were the disease are treated.
The task is:
data collectio=
n in
the different centers
quality evalua=
tion
of given services
quality contro=
l of
laboratory data
Staff training=
in
the Tb centers
During the per=
iod of
visits the supervisors stay in each center for 8 days working with the local
people to better evacuate the service level an making if necessary training
directly in the field In a qu=
arter
base the reports prepared by CCM are analyzed by members of Global Fund
Tuberculosis and by the local authorities to define action plans to improve=
the
activities
2.7.2.Implemen=
tation
of a strategic plan to prevent and control the HIV/AIDS and sexual diseases=
in
the population of Somailand
Always in the =
Global
Fund CCM is also responsible =
for
monitoring and evaluate the HIVAIDS implementation program: these control
activities, due to internal war in the country, were near inexistent since =
2005.
CCM selected a team to implement this
program developing tools and strategy to be used by the operative partners:=
the
supervision visits will start in February 2006
2.8 SUDAN
&=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; =
During 2005 CCM kept on with his work in South Sud=
an
among the usual logistic difficulties and the great hopes born after the pe=
ace
agreement signed on January 9th, 2005. The peace process is however threatened by several clouds repre=
sented
by the problems not dealt wit=
h in
the mentioned agreement (laity of the State, interethnic stress, marginalis=
ed
areas). The death in an air crash, still obscure, of John Garang, historical
leader of the nationalist mov=
ement,
has provoked demonstrations and a stressful situation in Khartoum and Juba.
These events have been followed by the prompt assignment of John GarangR=
17;s
inheritance to Salva Kiir May=
ardit,
as Vice President of Sudan and President of Southern Sudan.
The international community has offered an importa=
nt
contribution for the development of the country as acknowledgement of the
brilliant result achieved after one of the bloodiest African conflicts.
The International Agencies are supporting the
reconstruction of the New Sudan through projects aimed to foster the civil
society. The critical situation of Southern Sudan makes however difficult t=
he
equal and incisive distribution of humanitarian help.
=
&nb=
sp; =
&nb=
sp;
The target of the project is the empowerment of
medical services and the fost=
ering
of professional capacities of Sudanese staff
The engagement of the health activities and the
improvement of the hospital infrastructure, supported also by other
Donors, has borne an important amelioration of the
hospital level-
2.8.2 Rehab=
ilitation
activity of Rumbek State Hospital
The
hospital of Rumbek, which is supported by CCM since the disengagemen=
t of
Government Army in 1999, is considered one of the few possible
headquarters for an action of humanitarian help. Many Agencies have contrib=
uted
with different kinds of action to support the hospital medical activities.<=
span
style=3D'mso-tab-count:3'> &=
nbsp; &nbs=
p; =
The action =
UTL NB
Emergency aid n. 7916.01.06 has been funded by the Local Technical Unit=
of
the Italian Embassy in Nairobi (1/1/05-15/11/05). The project concerned the
rehabilitation of the out-pat=
ient
Dept., emergency dept., pharmacy,
mortuary, medicine dept.,
maternity, houses for =
the
hospital staff.
The United Nat=
ions
High Commission for the Refugees promoted the action UNHCR 05/SB/SUD/RP/=
331,
started on February 2005. The aim of the first phase was the rehabilitation=
and
the extension of pediatric dept., for which UNHCR contribution was integrat=
ed
by a supporting group of private donors. The second phase will provide the
electrification of the whole hospital compound, through the purchase of two
generators.
The project, s=
tarted
on June 2005, concerns the rehabilitation of a building, inside the hospital
compound, in order to provide a center for the training of local staff, especially the obstetrical personn=
el.
Establishment of a Midwifery Training Center=
in
Rumbek, South Sudan
The action, st=
arted
on October 2005 and financed by DFID through WHO, aims to implement a Midwi=
fery
Training School.
Once the build=
ing
and the furnishings are over, CCM will care for the selection of trainers a=
nd
tutors and later on of thirty students who will attend the first training
course for midwives.
2.8.3. Project=
2169
“Surgery in Remote Areas of South Sudan”
co-financed by the Italian Ministry of Foreign Affairs
The project ai=
ms to
provide adequate surgical services
to the population of remote areas in South Sudan.
The action is
carried on in five remote locations, two of which, Adior and Billing, are
supported as permanent
facilities where=
as the
other three Gordhim, Pochalla and Turalei, are supported by periodic surgic=
al
missions carried out by a mobile team of Italian volunteer consultants:
surgeons/anesthetists/theatre nurses.
In the permane=
nt
stations two adequately trained
Sudanese M.D. are resident doctors,=
this entailed a better
efficiency of hospital services and of the implementation of the surgical
missions.
As per the past
years, this project provides:
-&nb=
sp;
mobile and permanent services in the selected
areas through the regular presence of a surgical team in order to allow the
population to benefit of essential surgical services
-&nb=
sp;
continuous support to the two locations of Billing and Adior;
-&nb=
sp;
training of=
local staff. One of the main objectives of the action is the
“training on the job” of local staff on “primary
surgery”, carried on during every surgical mission.
2.8.4. Primary
Health Care Program in Tonj County - AG 3912=
Overall goal of the project, cofinanced by DFID, is to improve the health status of=
the
population living in Akop, Ananatak and Luacjang payams of Tonj County thro=
ugh an improvement of the overall quality and accessibili=
ty
of primary health care services. Activities include the delivery of standard
curative services and antenatal care through trained TBAs and the conduction of Guinea Worm
Eradication and IMCI programs as well as vaccine campaigns and health and HIV/AIDS education sessions to sensi=
tize
the general population and high risk groups. The project also maintains an outbreak and
nutritional surveillance system operational and improve the technical capac=
ity
of health care workers through formal and on the job training. The overall
implementation scheme shifts the focus of health care delivery from the rel=
ief
action implemented by MSF CH in the area since 1998 to a development approa=
ch
tailored on the environment expected in South Sudan after the recent peace
settlement signed by the Government of Sudan and the SPLA.
TB control is at its early stage of development in the Southern Sect=
or
of Sudan, covering only 25% of the total population. The full adoption of t=
he
DOTS strategy took place only in early 2002. In light of the extremely seri=
ous
burden of TB, the program needs to scale up DOTS activities as quick as
possible.
The overall goal of the program, financed by Glo=
bal
Fund HIV,TB Malaria programme=
, is to reduce mortality and morbidi=
ty due
to TB and prevent the development of anti-TB drug resistance. The objective=
is
to expand DOTS activities to cover 4 million people (50% of total) and to
detect 4,000 TB cases (33% of the total incidence) annually by 2005, and
maintain the activities. In addition to the 12 present TB units, 12 new TB
units will be established during the first two years of implementation. As =
for
the 4th and 5th years, it is not possible to make a
detailed DOTS expansion plan because of the unpredictability of the situati=
on.
The eventual expansion of the program for these years it will be decided at=
a
later stage. The global target on treatment will be met, while the global
target on case detection will be met only in the areas covered by the progr=
am
Expanding DOTS activities to achieve an overall 33% case detection rate is a
practical and realistic objective considering of the complex emergency
situation existing in t=
he
Southern Sector of Sudan. During the five years of implementation (2003-200=
7),
a total of 16,750 TB cases will be detected and treated.
In order to achieve the above objectives, the partners will be assist=
ed
in expanding DOTS services through: staff recruitment, installation of new
facilities, training, monitoring and supervision, partnership development a=
nd
covering very specific costs for TB control in the Southern Sector of Sudan
such as transport. Strengthening local capacity through recruiting of local
staff, training and supervision is a priority so that the local authorities=
, in
collaboration with the partners, will be able to sustain the activities even
under complex emergency situations. All partners will work closely through =
the
TB Coordinating Team.
The project sta=
rted
on 31 January 2005, CCM locations involved in the programme have been Adior
(Yirol East County), Billing (Rumbek East County), Pochalla (Pochalla Count=
y),
Luanyaker (Gogrial County), Bunagok (Awerial County).
<= o:p>
<= o:p>
The project is
cofunded by Compagnia San Paolo di Torino and is based at Bunagok village
in Awerial County.
Its aim is to
provide with basic services of preventive and curative medicine a vast catchments area, An health =
Centre
has been built and opened. Bunagok is one of the locations of Global Fund TB
programme.
T=
he
project, based in Adior and Bunagok, is funded by WHO. The action is based =
on a
modified package of the Integrated Management of Child Illnesses. Morbidity
pattern from the area shows that malaria is the leading cause of both morbi=
dity
and mortality in the community while respiratory infections and diarrheoal
diseases are the other two major killers in children. The area is also high=
ly
endemic for Guinea Worm . The major outputs expected from the project
implementation were to achieve 80% management of new Guinea Worms cases and to reac=
h an
extension of the modified IMCI programme services to at least 40% of the ta=
rget
group.
2.8.8. Health =
staff
training programme cofunded the Italian Bishop Conference.
Training of lo=
cal
staff is a priority in the strategy of any cooperation programme in Develop=
ing
Countries, particularly in the health interventions. This 3-year programme =
aims
at offering to the Sudanese staff employed in CCM activities the opportunity of =
basic
education and training in Nursing and Medical Schools.
2.9 UGANDA
2.9.1.
Support and expansion of the rehabilitation services in the Northern part of
Uganda
The three
year project is co-financed by MAE and is realized with AVSI (Volunteer
Association for the International Service) and the CUAMM (University College
for prospective medical missionaries).
The part
of the project of which CCM is responsible is the logic continuation of the
previous three year project managed by CCM in the St. Mary’s Lacor
Hospital in Gulu.
The activities accomplished are the follo=
wing:
-&nb= sp; supply of materials and medical equipment for the surgical-orthopedic activities;<= o:p>
-&nb=
sp;
supply
of tricycles, wheelchairs and orthopedics equipments;
-&nb=
sp;
activities
of sensitization in order to promote different activities involving the who=
le
population in order to facilitate the social acceptance of handicapped peop=
le;
-&nb=
sp;
surgical
interventions;
-&nb=
sp;
physiotherapy
Hundreds
of Free Cards have been distributed in order to allow the handicapped people
free treatments and services in the St. Mary’s Lacor Hospital.
Working
with the AVSI, many different courses on the topic of disabilities for Ugan=
dan
medical and paramedical personnel have been organized.
On the
hospital level, around half of the patients in the surgical departments are
orthopedics patients with injuries due to weapons or car accidents.
The
total number of surgical interventions in 2005 has been 242. The minor orth=
opedic
interventions have been conducted by local personnel under the supervision =
of
CCM surgeons.
Finally,
the orthopedic ambulatory is open twice a week.