médecins du monde

Transcription

médecins du monde

05
MÉDECINS DU MONDE
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2 0 0 5
02/03
I do not ask your race or
your religion, I ask you what
your pain is.
”
Louis Pasteur
,,
> Composition of the Board and Executive
Committee of Médecins d u Monde
General Assembly and Board Meeting held on 14 and 15 May 2005
President
Deputy Treasurer
Deputy Board Members
> Dr Françoise JEANSON,
> Dr Pierre MICHELETTI,
> Dr Arnaud BOURDÉ,
General practitioner, Bordeaux
Public health doctor, Grenoble
Anaesthetist-resuscitation specialist,
Saint-Denis de la Réunion
Vice-Presidents
International projects representative
reporting to the President
> Dr Laurence BOURGEOIS-GENET,
> Dr Olivier BERNARD,
Paediatrician, Marseille
> Joseph DATO,
> Dr Régis GARRIGUE,
> Dr Patrick DAVID,
Emergency doctor, Lille
Anaesthetist-resuscitation specialist, Reims
Nurse, associate professor at Grenoble
University
General Secretary
Board Members
> Dr Bernard GRANJON,
> Dr Bernard JUAN,
> Dr Thierry BRIGAUD,
Gastroenterologist, Marseille
Company director, Montpellier
General practitioner, Paris
> Dr Jacky MAMOU,
> Dr Frédérique DROGOUL,
Paediatrician, Paris
Deputy General Secretary
Psychiatrist, Paris
> Dr Claude MONCORGÉ,
> Dr Fabrice Giraux
> Dr Pascale ESTECAHANDY,
Anaesthetist-resuscitation specialist, Paris
General practitioner, Paris
Hospital doctor, Toulouse
Hospital doctor, Château-Thierry
Former Presidents
> Dr Françoise SIVIGNON,
Treasurer
> Pierre KEMPF,
Assistant hospital director, Vichy
Radiologist, Paris, Amsterdam
04/05
> Table of Contents
03
04
06
WELCOME
BOARD MEMBERS
ACKNOWLEDGEMENTS
POLITICAL STANDPOINT
07
OUR AIM
17
2005 IN FIGURES
TESTIMONIES
19
MÉDECINS DU MONDE IN PICTURES
PROJECTS
35
36
38
104
104
105
107
116
ATLAS OF INTERNATIONAL PROJECTS
Map of international projects
Country files
ATLAS OF MISSION FRANCE
Map of French actions
Introduction to Mission France
Action files
Contacts
PROJECT SUPPORT
119
MdM MOBILISATION
129
130
139
THE REPRESENTATION NETWORK
143
144
146
147
148
150
152
REGIONAL OFFICES
INTERNATIONAL OFFICES
OPERATIONS
ORGANISATION
Association Life
Department news
The Médecins du Monde International network
Sister associations and local partners
Médecins du Monde and civil society in France
Médecins du Monde and international institutions
> Acknowledgements:
Our private : A 13, A2P et associés, Adonix application et services, A Novo, Pradines Abbey, ACB Xerox, ADCS, Affival, Aladin, AMCM, Amicale cardiologue de Paris, Amicale des
sapeurs-pompiers de Poitiers, Amitiés loisirs Gouvernes, Antin résidences, Arasim, Arche promotion groupe Arcade, Assurances médicales Ales, Arrfliv, Aubry artist and painter, Axalto
international SAS, Beat SA, Beaulieu sports, Begon Bonneau, Herbert Bouchard SCP, BHV, Bretagne Enchères, Brossard - Saveurs de France, Camif solidarité, Capa télévision,
Carrefour DMG, Carte et Services, CGMI, Champion, Charpentier travaux publics, Chercheminippes, Risle-Gospel choir, Club Méditerranée, Soroptimist Club, CMP, Codara SA,
Cofiroute, Comanaging SAS, Meyzieu Social Work Committee, Comptoir des voyages, Consort Netcom, Construction mécanique de l'Isère, Crédit coopératif, Croissy-sur-Seine tennis
club, Decobat SARL, Desmarez SA, Diager SA, Divers et Imprévus, Eberle SA, Echanges & Solidarités, En apparence, Entraide majolane, Equus SA, Eric Bompard SA, Euro Assurance,
Euro information service, Eurofeu SA, Factum finance, Fermod, Finaler Friedrich, Football breton solidaire, Heilbronn Fiszer FHF, Geste, GFS SA, Go Voyages, Goéland productions,
Grands Moulins de Strasbourg, Hammerson France, Hilti France, Hydrosystem, ING fixations, Ifcic, Impact Immo, Intermed exportation, Iveco France, JP Chaussures, Kahn et associés,
Keyrus, la Baguetterie, la Boutik, la Mimetaine, la Ronde des âges, le Canard enchaîné, Leclerc Siplec, Leo Pharma, l'Esprit de sel, le Coin du feu bookshop, Logicacmg SAS, Lowendal
Group, Marc Orian, Marie Marchand multimédia SARL, MBP France, Mc Racing, Medi-Science, Mohn Media, Mondial Assistance, Mr and Mrs Peters, Munch Sa, Nec, New Deal HBC,
New Deal Sarl, Oddo, Olives Arnaud Sa, Opera Paris, Orange Réunion, Optimege, Ouest Affiche, Peugeot Citroën automobile, Peep Ass school library, Pierson Meunier export SA, Nièvre
département bailiffs office, Polypore Europe SA, Prima Solutions, Production La Prade SARL, Renzo Piano Building Workshop, Readers Digest Selection, Reuters, Rotary Clubs of
Gordes, Toulouse Ouest and Papeete-Tahiti, Rousseau, RS Com SA, SACD, SAFI, SA IFB, Sagone SA, Saulnier Blache SARL, See Velado, Sers, SFR, Sham, Smith And Nephew SAS,
SNPE group, Sodang, Sofisol, Solutys, Sonia Rykiel SA, Sopag Maine Parking, Stade Rennais FC, Stratégie investissement, Suzuki France, TAP Services, Taxi Jocelyne Perree, TBWA,
Techmo Systems SA, Techni Alarme, Tele2 France, Temex, TF1, La Michaudière Theatre, Théatre de la Tête noire, Top Famille, TV5 monde, UFG, ULIF, UNIM, Vialtis Fournisseurs, Vivendi,
Voyageurs du monde, Wargny Katz (SCP), Wegener DM.
Foundations: Annenberg Foundation, Arradon Foundation, Bois Brillou Foundation, Club Méditerranée Foundation, Deniber Foundation, Drosos Foundation, Florindon Stiftung, Fondation
de France, Fondation de Lille, GlaxoSmithKline Foundation, Johaniter Foundation, Mantegna Stiftung Foundation, Niarchos Foundation, Sancta Devota Foundation, Seviajer Foundation,
Sternstunden Foundation, Vinci Foundation, Union des blessés de la face et de la tête.
The works councils and employees of: Agefi, Banque de France, Caisse d'épargne Ile-de-France Paris, CCSO social, Cetim Senlis, Georges Dumas Clinic, CPAM Sélestat, CPR, Crédit
agricole Centre France, Crédit coopératif, Crédit foncier de France, Galeries Lafayette, GlaxoSmithKline, IBM Eurocoordination, Marsh, Natexis Banques populaires, Nestlé Waters, Vosges
Prolabo, PTC Nestlé, Réel, Thalès, UES LCF, UFG, Screg Sud-Ouest, Wyeth Pharmaceuticals.
Public partners:
Of our international projects: Administration des biens et des majeurs protégés, Association des régions de France, Canadian International Development Agency (CIDA),
Centre For Disease Control And Prevention, Chaîne du bonheur (Suisse), Columbia University, communauté d'agglomération du bassin d'Aurillac, Cordaid, Department For
International Development, Dutch ministry for Development Cooperation, ECHO, Embassy of Canada, Europeaid, German, French and Japanese Foreign Affairs ministries,
Global Fund to fight Aids, tuberculosis and malaria, Ile-de-France SAFER Joint United Nations Programme on HIV/Aids, IOM, Lille education authority, PACT, Population services international, PACA region, Radio-protection and Nuclear Safety Institute, Rhône-Alpes region, Rouen chamber of commerce and industry, Swiss Development and
Cooperation Department, United Cities againsy Poverty, UNDP, UNICEF, UNFPA, UNOCHA, United Nations Office on Drugs and Crime, USAID, World Bank.
Town halls: Aigremont, Audincourt, Bassens, Behren-lès-Forbach, Bonnelles, Bourg-lès-Valence, Brioux-sur-Boutonne, Chilly-Mazarin, Drancy, Garlin, Goussainville, LacroixFalgarde, Le Croisty, Le Crouesty, Lormont, Paray-Vieille-Poste, Paris, Paris 17e, Petrosella, Saint-Estève, Saint-Jean-de-Gonville, Saint-Sylvestre-sur-Lot, Sucy-en-Brie,
Toulouse, Tréport, Val-d'Isère.
Of our regional international projects: département councils: Bouches-du-Rhône, Alpes-de-Haute-Provence, Gironde, Charente-Maritime, Vosges, Doubs, La Réunion, MidiPyrénées, PACA ; regional councils: Provence-Alpes-Côte d'Azur and Rhône-Alpes; Presidency of the Regions, prefecture of the Guadeloupe region.
Of our French projects: the Army, CNAM (National Health Insurance Office), CAF (Family Allowance Fund), CMR (Regional health offices), CPAM (health insurance offices),
CRAM (regional health insurance offices), CCAS (Social Action Community Centres), Rouen CHU (University Hospital) CDAG (free anonymous screening centre), Nantes PASS
(access to healthcare service), CDAG, CISIH (HIV treatment and information centre) CHUl and CHRS (Accommodation and Social Rehabilitation Centre), département-level
councils, FNPEIS (regional health education and information councils), DIV (Interdepartmental Delegation to the City), DGS (Directorate General of Health), DGAS (Directorate
General for Social Action), DDTEFP (Département-level labour departments), DRASS and DDASS (regional and département-level branches of Ministry of Health), Fonds national de prévention (National prevention fund), town halls, ministries, MILDT (Interdepartmental Mission for the Fight against Drugs and Drug Addiction), OFDT (French Monitoring
Centre for Drugs and Drug Addiction), prefectures, Rouen reception centre for travellers, Poitier town-hospital network, URCAM (Regional unions of health insurance offices).
Our partner associations: Aides, ALC Nice, Alerte Group, Alsace group of associations working with people involved in prostitution, les Amis du Bus des femmes, Amnesty
International, ANEF, Association of French regions, ATD Fourth World, Avenir et Coopération, Brittany Football League (and the clubs of Brittany), Communication and Action
for Access to Treatment Association, Congregation of the Augustinian Sisters, CSF, DAL, DHL Liens, Drug Users Self-Support and Harm Reduction Association, D'une rive à
l'autre, Emmaüs, Emmaus Committee, Entraide majolane, Federation of associations for housing provision (Fapil), le Foyer association, French Campaign for the Right of Asylum,
French Harm Reduction Association, Friends of Marist Community, Gisti, Health Networks Coordination Initiative (CNR), Health Without Frontiers, Humanitarian Bank,
Humanvillage, IFHR, Inadaptés des Po association, International Harm Reduction Association (IHRA), IOP (International Prison Monitoring Centre), LDH, Max Havelaar,
Mouvement du Nid, National Union of the Associations of Reception and Social Reintegration (Fnars), ODSE (Foreigners' Right to Health Monitoring Centre), Passerelle la santé
sans frontières, Pays de la Loire Planning Centre, Pays de Retz Doctors' Association, Pharmacie humanitaire internationale, Platform against Trafficking in Human Beings, Rasko,
the Red Cross, Rimbaud Mobile Team, Restos du Cœur, St-Benoît hostel, Sanatatea association, Stade Rennais FC, Secours catholique, Sid'espoir, Sonacotra hostel, SOS
Drogue internationale (SOS DI), SOS Femmes, Strasbourg Psychiatrists and General Practitioners' Collective on exclusion from health care, Support for the Victims of Bam
Group, Techno Plus, Travellers' Association, UNIOPSS, Veille sociale, Vialtis.
And all our other partners who have supported our work in France and abroad during 2005, as well as our individual donors.
> Our aim
07/16
> Combating oblivion
After twenty-five years of providing care to the most vulnerable populations, of fighting against the dictatorship of violence, inhumanity and abandonment, 2005 gave us the opportunity to give a dual focus to
Médecins du Monde's anniversary: commitment and forgotten crises. By changing our slogan to highlight
again our objective of bringing the populations we support out of oblivion, we are pointing out our distinctiveness in the confusion lying in wait for international humanitarian action today.
> Consider the context …
UN Reform
We are paying particular
attention to the replacement
of the Commission on
Human Rights, which has
lost all power and
credibility, with a Human
Rights Council which would
sit permanently.
Post-crisis contexts
Amongst these regions,
MdM is working in DRC,
Liberia, Angola,
Afghanistan, Kosovo and
Serbia.
In a context of global struggle against terrorism, the pursuit of murderous conflicts
as in Darfur or Chechnya or enduring political crises as in Haiti, the 60th birthday
of the UN saw the drawing up of a mixed assessment of a vital multilateral policy
whose credibility and real impact require reform which the states were incapable of
adopting in its entirety.
Ten years after the Srebrenica massacre, the slow reconstruction of the Balkans illustrates how fragile the return to peace between its peoples is, although this is a vital
prerequisite to a stable and lasting reconstruction. The same can be said for many
regions in the world where there is a great temptation for the international community to
speed up the reconciliation process. However, no peace is lastingly viable unless it is
shared and anchored in the communities involved.
The cancellation of the multilateral debt of the poorest countries by the G8 states in
July was accompanied by a promise to double aid to Africa between now and 2010.
However, against that good news, we need to set the distressing assessment of the
progress towards the Millennium Development Goals (MDGs) after 5 years. The gap
between rich and poor is increasing everywhere, burdening the future of more than a
billion people in the world, whereas radicalism of all kinds feeds on the sources of
poverty and real or perceived injustice.
08/09
> ... Respond to it with care and
,,
In October, contrary to generally accepted ideas, the Human Security Centre announced a
fall in the number of conflicts in the world since the end of the cold war, although it said
that violence experienced by civilians now came more from internal conflicts, state
repression or poor governance, phenomena which exacerbate poverty, hunger and lack
of access to healthcare. Because of its distinctive medical focus, Médecins du Monde
must respond to violence of this kind.
“It is through, and thanks
to, medical work that we can
denounce and bear witness
to injustice, and we try to
treat its consequences as
well as its causes.”
”
testimony
In disasters
The start of the year was marked by the tsunami which ravaged South East Asia
in December 2004. Right from the start, we were working in Indonesia and Sri Lanka,
caring for victims and survivors, and we then supported the rebuilding of health systems.
In the face of the enormous number of agencies involved and the resulting confusion,
and the ruthless competition of some of those involved who were more interested in
gaining a higher profile than providing rational and quality support for the populations,
we took pains to carry out our work according to our principles, and based on survivors'
needs rather than the money we had available. At Mallavi, as well as dealing with the
consequences of the tsunami, our aim was to ensure we were in place should the
conflict between the rebels and the government army break out again. Our project there
was extended for a minimal period so that we would be on the spot should the situation
deteriorate. These principles were presented clearly to our donors who then authorised
their gifts to be reallocated to other projects, thus enabling us to open programmes in
areas which were just as legitimate, but forgotten by the media, such as the suburbs of
Jakarta or the prisons of Madagascar.
It was because of these principles that we could respond in a major way to the aftermath
of the violent earthquake which devastated Pakistan. Getting aid to those living
in the deep-sided and isolated valleys was particularly complex and to begin with many
victims were unable to get any aid. We were present from the very first
Tsunami
impartiality,
proximity
and partnership
In Indonesia and Sri Lanka,
we chose to intervene in
areas which were in danger of
being overlooked by
international aid, either
because they were hard to
reach (such as Calang in
Aceh) or because they were
subject to political
disturbances (such as Mallavi
in Sri Lanka); our projects
were set up to support local
workers.
Pakistan
At Mansehra, more than
2,000 operations were carried out in precarious
conditions; at Thakot, our
health post received between 50 and 100 patients
each day; at Kaghan, our
mobile clinics saw between
40 and 70 people per day.
,,
In Pakistan, the
teams' living and
working conditions
were particularly
difficult, with
uninterrupted work,
housing in tents and
long walks at
altitude to reach
isolated villages
”
Putin's Law
Openly opposing this antifreedom law, MdM has started a joint mobilisation bringing together the medical
charities working in Russia
together with human rights
charities. In conjunction
with partners from Russian
civil society, this coalition
has lobbied the European
authorities to get President
Putin to withdraw the law.
days, and our surgical and medical teams were able to cope with the influx of injured
whose health was worsened by the previous lack of access to healthcare in these
neglected regions. Once the first emergency phase was over, we followed the victims to
the camps set up on the outskirts of the major cities, then into more distant camps that
had sprung up and which had received no aid at all.
Today, we are being very vigilant about the conditions survivors are returning to, as these
must respect people's rights and choices. We are particularly concerned about
the situation of women, who have been made even more vulnerable in a country where
their rights are flouted on a daily basis and where impunity prevails for those subjecting
these women to violence. In the Dar-ul-Aman (refuges), our care for women who are the
victims of domestic violence is also aimed at fighting for their protection and their rights.
In conflicts
Although 2005 was marked by these disasters, as an NGO we have a legitimate role in
conflicts and this must be strengthened, especially in Darfur, where our programme in
Kalma has been supplemented by mobile clinics in isolated villages inhabited by the
different ethnic groups involved in the conflict. In the face of this human disaster which is
becoming entrenched and to which no one can see an end, we have denounced, alone
and in partnership with others, the crimes committed by the Janjaweeds, the violence
against women, and the pressure put on those involved in humanitarian action, which
endangers our work and the local staff working alongside us. Beyond humanitarian aid,
only the massive political commitment of the international community, going beyond the
interests of individual states, and strong resolutions from the Security Council will be able
to bring an end to this neglected war.
In Chechnya, the normalisation displayed is totally fictitious. So that nobody can dispute
it, President Putin has introduced a law in the name of Russian national security condemning local organisations and expelling international NGOs “guilty” of freedom of speech.
In Iraq, civil war has followed the failure of the American and British intervention. The
human rights in the name of which the armies intervened are flouted by those supposed to
defend and protect them while terrorism kills more people each day and the humanitarian
situation is now disastrous. In this situation, where an expatriate presence is impossible,
Médecins du Monde wants to find a response appropriate to the health needs
10/11
without endangering those involved. Our past involvement in the region means we can
consider action directed from outside the country, relying on a trusted local network. This
is possible operationally and support at a distance must, amongst other
things, allow us to respond to the main request of doctors who have stayed
in Iraq which is to bear witness to the humanitarian disaster which the Iraqi
population is living through today.
Despite the reconstruction process which has begun, the end of the war in DRC is still
accompanied by dozens of deaths each day of victims of the ongoing humanitarian crisis,
the armed bands who continue to hold sway in the east of the country, and of social
breakdown. We have strengthened our presence in the abandoned areas, and have begun
work in Kalemie, where we are treating, amongst others, countless women who are
victims of rape.
Whether it is the death of Arafat or the election of Hamas, the construction of the Wall or
the evacuation of the Gaza settlements, the Palestinian people continually face one
emergency or another. Where we used to support high-tech medicine, we are now caring
for diseases caused by poverty. We are supporting a bloodless health service for a population which is suffering the harsh health consequences of the political situation, despite
amazing resilience. We must bear witness to the health of populations, the lack
of access to healthcare and the shortage of structures and healthcare staff.
In lasting crises
The urgency of intervening in Niger divided the Association, setting those supporting an
economic analysis of the famine against those supporting a structural analysis. Media and
humanitarian frenzy followed the “revelation” of this food crisis which is now being forgotten once again. At the end of 2005, we started paediatric medical work in partnership with
Action Against Hunger, each bringing our skills to give overall, quality care to children. The
principle of repeating this partnership in other programmes has been launched within the
association.
Other areas, less reported in the news, have caught our attention. Liberia, Angola,
Afghanistan and DRC are all countries devastated by long conflicts, states that have
Iraq
As part of its support for the
journalist Florence Aubenas,
kidnapped with her team
member in December 2004,
MdM has become a
spokesperson for
humanitarian workers who,
together with journalists, are
being led to intervene in
contexts which are all the
more dangerous in that their
activities are often confused
with civilian and military
operations.
Palestinian Territories
MdM is involved in primary
health care, preparations for
emergency situations and
mental health work.
Liberia
health care, mental health
care, and the shortage of
healthcare staff.
Colombia
healthcare, maternal and
infant health and amongst
minorities.
The People's
Health Movement
A global network of health
workers and organisations
(mainly from southern
countries) fighting for access
to health care for everyone.
Working closely with
vulnerable populations and
the daily experience of
access to care are at the
basis of this movement,
which aims to make the right
to health recognised as a
priority in health policies at
local, national and
international levels.
Support for
involvement
of the South
It is for this purpose that we
are currently taking part in
the “Health personnel in the
South: a fatal shortage”
campaign to ask the French
state to strengthen its
support for health policies.
completely broken down, with health systems which do not exist for the majority of
the population who cannot pay for private healthcare. NGOs provide the majority of
healthcare due to a lack of staff and health structures.
In Colombia, the last country in conflict in Latin America, the most vulnerable
civilian populations are the hostages of violence but they have also been totally
abandoned by a privatised health system which offers little access to the poorest.
In addition to its medical activities and in order to carry out advocacy
work, Médecins du Monde is studying the actual access to care from
which the most vulnerable populations will benefit in the reconstructions planned by international donors and private companies.
The number of new projects, regional international projects (Guatemala, Burkina
Faso, Algeria and Bulgaria) or wider programmes (Mongolia, Borneo, Peru, etc),
continues to grow. Although each one involves a specific population, the problem of
financial exclusion from healthcare is systematic. In this area, it is vital that we
involve southern healthcare staff in promoting access to healthcare for everyone.
Our presence at the People's Health Assembly, organised by the People's Health
Movement at Cuenca, allowed southern doctors to identify us as a partner committed to the most vulnerable and supporting existing initiatives. The nature of our work
shows clearly that we are committed to medical care for the most vulnerable and
that we support involvement in favour of healthcare workers in the South. These
networks encourage partnerships which will make it easier to get involved in new
regions.
In the fight against infectious diseases, 2005 will have been marked by
the withdrawal of the Global Fund to fight Aids, tuberculosis and malaria
from Burma as a result of the constraints imposed by the ruling military junta on
humanitarian organisations, sadly symbolising the subordination of health to political
issues. A whole vulnerable population, which had benefited from long-term
psychological and therapeutic care, has been abandoned, and local workers, trained
with the prospect of a pull-out, have been forsaken. We condemned this decision
and have asked the Global Fund to reconsider its position or to put alternative
12/13
funding mechanisms in place. We have called on the French Minister for Foreign
Affairs to vehemently make known French protests with respect to the human rights
violations suffered by the Burmese population.
Another disappointment with regard to Aids has been the integration in Indian law of
the WTO-imposed constraint in a law guaranteeing the preservation of patents for
pharmaceutical products. Despite amendments softening the law, the possibility
of supplying southern countries with effective treatments at affordable prices remains
a vital issue.
Pharmaceutical
patents in India
Amendments allow generics
already produced in the
country to be exempt from
this law, in exchange for the
payment of “reasonable
royalties” to licence holders.
New medicines which have
not yet been copied will be
protected but subject to
“compulsory licensing” in the
event of a health crisis.
In Asia, as in Africa, fifteen years of experience amongst peoples affected by
HIV/Aids provide experiences of differences but also of constraints overcome
as regards feasibility, operational methods and social and anthropological approaches.
After fighting for access to medication and setting up clinical and technical reference
programmes, and in the face of the expansion of the epidemic, we must now devise and
apply means for dealing with Aids as part of primary healthcare, and strengthen
the testimony of MdM's international network in this direction.
,,
In access to healthcare for migrants
Although the western media revealed the dramas of Ceuta and Melilla, the
identical conditions experienced by migrants on the Mexican-American border
have passed unreported. We have been working in a reception centre for
expelled migrants in Tijuana for a year and have gathered testimonies which echo
those collected in France and in Europe. Physical or regulatory barriers are being
erected everywhere to protect wealth which has never been so poorly distributed
across the world. This major question should be more of an issue for us
as a northern organisation, and we should be committed to protecting
these people whose only crime is to seek a better life.
Lobbying for an amendment to the European directive “on the return of foreigners
in an irregular situation” that condemns sick foreigners expelled without a
guarantee of healthcare in their country of origin, to a certain death, setting up the
In Morocco, a health
project amongst African
migrants is due to start in
the coming weeks.
”
Averroès Project
The aim is to build a network
of field medical organisations
covering the 25 European
Union states asking, amongst
other things, all the states that
are signatories to the
European convention to
ensure access to healthcare
and preventive medicine to all
foreign residents, regardless
of whether they are in the
country legally or illegally,
under the same conditions and with the same level of
resources - as those offered
to nationals.
Advocacy
Launched this year, the
advocacy service will let us
compile statements and
proposals to strengthen our
capacity to put pressure on
the authorities.
Averroès project, and the progress with the French access to healthcare monitoring
centre, and more recently the European monitoring centre, are all initiatives which
embody the reality of migration, too often reduced to a statistical phenomenon
grossly overused by politicians searching for a scapegoat. In the coming years we
will continue this work in favour of human rights.
Today, access to care, reconstruction, migrants' health, violence against
women; tomorrow, street children, indigenous peoples, health in
prisons. The same themes are emerging from our international activity
as those which we are involved with in France and in Europe.
Understanding them in a cross-disciplinary way helps us to analyse their
many aspects and to develop clear advocacy, which is more convincing,
and therefore more effective in modifying in a lasting way the scandals
to which we bear witness.
> In France too
Health policy for the most vulnerable populations has continued to decline
this year. Although the public health act perpetuates the harm reduction programmes, it
constrains them financially and prohibits testing, the only approach that effectively creates
a link with individuals. Although the health insurance reform encourages access to mutual
insurance for people living just above the CMU (Universal Health Insurance) threshold, we
are now seeing how it complicates access to healthcare for those excluded and increases
the cost of care and hospitalisation for them. Even though the “access to emergency
care” circular slightly lessens the health and human consequences of the decrees limiting
access to AME (state medical aid) for those without residence papers, it is quite useless
when a new law encourages the police to pursue these people even in hospitals and
healthcare and reception centres. Finally, although the Ceseda law (on foreigners entering
and staying in the country and the right of asylum) retains regularisation for healthcare, it
makes access to health for foreigners much more difficult. Whether through the media or
legal proceedings, we will continue to fight against these laws of suspicion and inhumanity
which weigh on the most vulnerable.
14/15
The autonomy of the “methadone buses” and the harm reduction projects under conditions which allow them to continue their work was won
after a major struggle in 2005. A federation bringing together the organisations
born out of these actions allows Médecins du Monde to continue to be active and to
be a forerunner, observing, in particular, the growth in the consumption of products
and fighting for the health of users and for their recognition, in France and abroad.
Life on the streets is torture. Sleep deprivation and lack of food ruin health.
Despite the belated recognition by the law of health-stop beds this summer, and
despite some magnificent community initiatives, all our teams have noticed how the
number of people living on the streets is increasing and how their health is deteriorating. The expulsions without re-housing last summer are just making the situation
worse. It was to oppose a policy which manages misery instead of combating
it that the Paris homelessness project called on public opinion and the
government by making the homeless visible by distributing tents, symbols
of the shortages of which they are the victims.
No health without a roof, no health under an insalubrious roof or within walls
containing lead. This is another motivation for our commitment to the fight for a
binding right to housing. Our presence amongst squatters, who organise a parallel life to society in alternative places, once again marks Médecins du Monde's ability
to adapt and our desire to leave no-one on the margins of society.
,,
Our reception, care and orientation centres (CASOs), like our projects
outside centres, measure the decline in access to healthcare on a daily
basis. With the setting up of the ICPC (International Classification of Primary Care),
we are hoping to bear witness more to the impact of exclusion and poverty on
health. We are careful observers; however, it is by preserving our calling to
disappear that we will be able to avoid the pitfalls of our work being institutionalised.
This policy is
repressive, complex and
incoherent at the same
time and is undoubtedly
made at the expense of
the health of the poorest.
As our country is not
choosing to give care to
everyone, we will
continue to fight against
this injustice, which is
unworthy of the country
of the rights of man.
”
Community
initiatives
For the last three years, the
Night Hostel in Bordeaux, for
example, has welcomed
those who have nowhere
else to stay, without
conditions.
,,
Echoing the twenty-five
years of commitment brought
to light by the Rondeau
exhibition, the theme of
forgotten crises, the slogan of
our new campaign, was
embodied in the
presentations made by local
workers on that occasion.
”
Finally, between here and over there, Médecins du Monde's adoption
service has enabled 315 children this year to find a family. Amongst them,
28 suffer from curable diseases, and only the distinctive medical work of Médecins
du Monde means they can leave the orphanages. It is the stated desire of the
Association to encourage the adoption of these children with specific needs who
were not able to be adopted in their country of origin.
> The organisation
We celebrated our 25th birthday in a very warm atmosphere. The general assembly
was a time of celebration, but the proposal to reform our articles of association
meant that it was also a time of reflection. Although it was not passed, it led to many
discussions focussed on our healthcare work and the importance of volunteers, on
our medical identity and on the perspectives in which we wished to commit a charity
born out of both humanitarian action and political debate.
I would like to thank everyone who, by their work in the field or support, here and
over there, provide care, protect populations and advocate the cause of the victims.
It is the commitment of each one of us which makes Médecins du Monde a credible,
independent and innovative NGO.
Dr Françoise Jeanson
President of Médecins du Monde
21 April 2006
2005 in figures
• MdM's structure
16/17
• MdM's balance:
(at 31/12/2005, in FTE):
415 volunteers went out to the field
150 short-term field staff (full time equivalents)
1,300 volunteers at head office, in the provinces and Mission France
16 regional offices
4 international representation offices
1,556 members
153 paid staff (full time equivalent) at head office and 17 paid field staff
13 paid staff in regional delegations
66 paid staff on Mission France and Harm Reduction projects
i.e. 249
paid staff in total
48.2
million Euros
in 2005
Distribution of expenses by
department (excludes exceptional items):
1.0%
7.1%
18.2%
73.1%
0.2%
0.4%
Communication
and information costs
Administration/head office costs
Fundraising costs
International
and domestic projects
Costs of seeking sponsors
Costs of other forms of appeal
Origin of resources
• The MdM international
network:
12 international offices
Argentina, Belgium, Canada, Cyprus, France, Greece, Italy, Portugal,
Spain, Sweden, Switzerland, United States
73
million Euros budget
in 2004 (budget N-2)
(excludes exceptional items):
62%
35%
2%
1%
Public generosity
Public grants
Private grants
Other
2005 in figures
• France:
• International:
medical consultations in
93
40,039 CASOs for 20,324 patients
international projects
in 51 countries
(excluding new bases and
projects, and excluding adoption)
i.e.
85
38
18
13
12
4
4
More than 70,000 HR contacts
10,000 contacts with people
involved in prostitution, through 6 projects
43
24
12
10
6
5
mobile community projects
in 23 towns, carried out by
761 volunteers
14 Harm Reduction programmes
Geographical distribution of
expenses of international
projects:
Africa
Asia
Latin America
Eastern Europe
Middle East
Central Asia
45,783
consultations in total in 21 Reception,
Care and Orientation Centres (CASOs)
Geographical distribution
of MdM's programmes:
Africa
Latin America
Asia
Eastern Europe
Middle East
Central Asia
5,744
dental consultations carried out in
10 towns for 2,576 patients
Distribution of Mission France
expenses in 2005:
41%
39%
11%
8%
1%
Harm Reduction
CASOs
Outside centres
Mission France co-ordination
Hospital sponsorship
> MdM in pictures
HENK VISSCHER
19/34
South-East Asia
Rebuilding after
the tsunami
Six months after the tidal wave
which affected Indonesia and
Sri Lanka in December 2004,
MdM's teams have gradually
brought their emergency
projects to an end.
“Our desire is not to replace
the health staff in the long term
but, on the contrary, to help
them to get hospitals, health
centres and health posts back
on their feet,” says Frédéric
Penard, the programme coordinator in South-East Asia for
the Emergency desk. The
Indonesian and Sri Lankan
health structures are
recovering.
MdM
“I am a doctor in Tijuana,
where the Association is
carrying out an access to
health programme among the
migrant population,” explains
Jorge Arellano Estrada, a
local doctor. “I do prevention
work amongst migrants. Each
afternoon I go to Casa del
Migrante, the largest
migrants' hostel in the town,
and to Casa Madre Assunta,
for women and their children.
I hold consultations and
answer their questions. As I
am in contact with them on a
daily basis, friendships have
developed. Each week, I also
give a talk on AIDS
awareness and prevention. I
am trying to identify migrants
who are at risk because of
their behaviour and I tell them
about the different ways HIV
can be transmitted. I am also
trying to remove the taboos
and help change attitudes
about this disease.”
MICHEL REDONDO
In transit,
in danger
MdM
Mexico
20/21
Pakistan
Adapting
day by day
Following the earthquake
which struck Pakistan on 8
October 2005, an emergency
project was set up to provide
aid to the victims. “The first
three weeks were devoted to
giving medical care to the
injured, in particularly difficult
conditions,” explains José
Luis, a general practitioner.
The work was then continued
by setting up permanent
consultations in several camps
for displaced persons, in the
outskirts of Islamabad for
displaced people from
Kashmir, and around
Mansehra for displaced
people from the Kaghan valley.
MdM
Women
taken for targets
MdM
HENK VISSCHER
In addition to the postearthquake project, MdM is
running a project to help
women seeking help in
refuges called Dar-ul-Aman.
Each year, in the Punjab
region alone, hundreds of
women are burned by fire or
acid. The programme plans to
provide global care for these
women within three refuges. It
includes medical help,
hygiene awareness sessions,
psychological support and
legal help. Practical training
also helps social and
economic reintegration. For
example, the Association
organises therapeutic theatre
sessions during which the
women act out their own
stories in front of the other
residents and the Pakistani
staff in the refuges.
DAVID DELAPORTE
Long protected by their
isolation, indigenous people
today are the victims of
their confrontation with the
modern world. Their
habitat, environment and
culture are threatened. And
they are now affected by
many infections or diseases
related to ethno-stress
(alcohol or drugs). The
Association's objective is to
support these little-known
people, who are forgotten
by the international
authorities more often than
not. Projects aimed at them
are usually organised in
difficult conditions and
workers have to adapt to
very specific ways of life.
“To carry out a project, we
must first of all know the
social and cultural
environment well. This
approach is specific to
MdM's ethnic minority
group,” explains Franck
Desplanques, the group coordinator. “This leads us to
begin our medical work by
sending an ethnologist or
anthropologist to study the
distinctive features of these
communities,” he adds. In
Indonesia for example,
projects have been built
around two indigenous
peoples: the Dani tribe,
living in West Papua, who
make up 1% of the
population but more than
42% of cases of AIDS
nationally, and the Punan
on the island of Borneo,
who receive no healthcare
in the heart of the forests,
and who are exposed to
many diseases when they
emigrate to the cities.
REINER SPRUIT/MdM
Forgotten faces
22/23
,,
Russia, Nenets people
Before intervening,
we tried to understand
the codes, taboos and marks of respect of this
society, as well as how they view the body and
illness. The Nenets people are just as much at
ease with a lassoo for capturing reindeer as with
a computer keyboard. They know that their
survival involves opening up to modernity. It was
therefore essential to understand the whole of
that culture. A farmer cannot consider leaving his
FRANCK DESPLANQUES
herd for six months to receive hospital treatment.
It would endanger his whole family's survival. We
must keep this in mind when we consider long
treatments such as for tuberculosis. In terms of
training, we have developed a very pragmatic
educational approach. We have trained health
technicians in the remotest corners of the region.
Some have continued to work well, others not. It
depends greatly on the involvement of the
doctors in each district. Without support from the
local authorities, this work would not have been
effective. Now the Russians have taken over the
,,
the programme and we are trying to build on
this experience in other regions of Siberia.
ARMELLE DESPLANQUES-LEPERRE,
FRANCK DESPLANQUES
Project Co-ordinator
Opération Sourire
Each year, some thirty shortterm projects across Africa
and Asia are involved in
putting the smile back on
children's faces. Volunteer
surgeons, nurses and
anaesthetists perform
operations to cure congenital
deformities, harelips, burns
or the after-effects of war
trauma. Opération Sourire
has just celebrated its 15th
birthday. In 2005, teams
worked in 12 countries:
Benin, Cambodia, Chad,
Eritrea, Ethiopia, Laos,
Madagascar, Mali, Niger,
Mongolia, Pakistan and
Rwanda. “In the countries
where we work, surgery is
often only used in
emergencies,” explains Dr.
François Foussadier, the
project co-ordinator.
“Performing operations for
functional and morphological
reasons was sometimes
considered worthless by our
local colleagues. It was only
after they had seen the
results that they understood
how much these operations
transformed patients' lives.”
The Opération Sourire
volunteers also train local
teams. “When the Opération
Sourire surgeons arrived in
Niger in 1996, they made me
aware of reconstructive
surgery as they knew that I
was interested,” says Issa, a
young 29-year old Nigerian
surgeon. “They taught me to
carry out skin grafts, and
today, I am the only one in
Niamey who knows how to
do them.”
CATHERINE HENRIETTE
Reconstructive
surgery
24/25
The Homeless
Re-establishing
access
to healthcare
MdM
CÉDRIC HELSLY
MdM
In 2005, 80% of the work
carried out in France was
through mobile
programmes which allowed
teams to go out and meet
the most deprived people,
and especially the
homeless. “We met
Béatrice at the station
during one of our rounds,”
says Marie-Thérèse
Raymond, a psychologist
and co-ordinator of the
homelessness project in
Poitiers. “She was pregnant
but she did not know
exactly how far on she was
and had never been
monitored. What struck me
was that her arms were all
scratched. Our doctor
thought that it was a mental
illness. As I talked with
Béatrice, I realised that it
was simply her way of
expressing her anguish. She
had just arrived in Poitiers,
not knowing anyone, with
nowhere to live, no income,
no papers, and she was
expecting a baby. Who
wouldn't be distressed in
such a situation? It was
one of the worst situations
of distress that I have ever
come across. I directed
Béatrice to our care centre.
With the project's midwife
and social worker, we got
her back on her feet.
Recently, she came to thank
us. She had somewhere to
live, a job and papers and
she had a wonderful baby in
her arms. It is by people like
her that I measure how
valuable our project to the
homeless is.”
Sudan, Darfur
As the conflict between the
rebel movements and the
governments intensifies, the
health situation in Darfur
continues to worsen.
Refugees, most of them
women and children, are
fleeing the fighting and
heading for the camps where
the living conditions remain
extremely precarious. In the
Kalma camp, MdM''s care
centre includes a
hospitalisation unit, delivery
room, 4 consultation rooms for
curative care, vaccination
services, etc.
“Sudan is set for a lasting
crisis. The south is fading from
our memories, but Darfur in
the west is being violently
shaken while tensions have
grown in the east,” says a
worried Laurent Joseph, the
project co-ordinator. The
Association is also denouncing
the worsening of security
conditions and the obstacles
the population faces to have
access to healthcare.
THIERRY DUDOIT/L’EXPRESS
Forgotten crisis
Afghanistan
JANE BIRMANT
“The role of NGOs is to
encourage sufficient
autonomy amongst the
Afghans so that they don't
need us any more,” explains
Florence Maurin, medical coordinator of the project
supporting mother-and-child
health centres in Kabul and
Herat. “In addition, when I
see the student midwives
being trained in our clinics, I
am very hopeful. I am
convinced that we must build
using these generations. I
believe that it is thanks to
them that we will see a real
reconstruction process in this
country which has become in
some way my own.”
/ mdm
Hope in midwives
26/27
,,
Chechnya
Our country is
devastated and
occupied
by an army that carries out many acts of
repression against civilians. Houses are
looted, people are faced with many acts of
violence, humiliations, arrests or even total
disappearances. Psychological trauma
affects young and old. As a psychologist,
my work involves training doctors at Grozny
SÉBASTIEN GEORGES
hospital so that they can detect its
symptoms in their patients. Then they send
these people to me so that we can start
one-to-one work. This initial contact
sometimes also lets us reach other family
members who would not have come to the
hospital, but who are also suffering serious
problems. Drawing is my main means of
getting children to talk about and express
the trauma they have been through, as they
are often haunted by tragic scenes. These
scenes often re-emerge through their
behaviour, in nightmares, aggressiveness,
withdrawal into themselves, and memory
problems. In this way, we can reconstruct
each child's story.
KHAPTA, Chechen psychologist
DR
for the project at Grozny hospital
,,
AIDS
Prevention,
care and training
BRUNO FERT
MdM
/ VOUS ÊTES ICI
LAHCÈNE ABIB
Every six weeks, AIDS
produces as many victims as
the tsunami did. In 2005, the
Association carried out a
study in 20 countries where
the MdM international
network works. This study
showed that the lack of
availability of medicines is not
the only obstacle to access
to antiretroviral treatments
(ARVs). Some countries are
incapable of coping with the
epidemic even when they
have ARVs. In effect, there
are far too few health
professionals with AIDS
training and the treatments
offered in hospitals are often
a very long way from the
primary health centres.
Prevention, care and training
are therefore the three main
objectives of these projects,
which are being carried out in
about ten countries across
the world.
Setting up programmes to
fight AIDS is not always easy.
For example, Burma devotes
only 2.2% of its health
budget whereas 45% is
destined for the army. How
can this gap be reduced?
“Our aim is to make civil
society more aware of this
epidemic,” explains
Françoise Sivignon, the
project co-ordinator in
Burma. Thirteen years after
the project began, attitudes
have begun to change as the
epidemic is now considered
the 3rd public health priority
nationally.
28/29
Cambodia
LAHCÈNE ABIB
LAHCÈNE ABIB
Treatment
gives hope
More than 400 million
people across the world
suffer from mental,
neurological or psychosocial problems. These
invisible evils have many
causes: armed conflicts,
political violence, forced
displacements, exclusion
from healthcare systems,
etc. These complex
situations do not make
treatment easy, especially
as these problems are often
stigmatised. “Because of
very strong cultural
pressure, people are
ashamed to talk about
psychological illnesses,”
says Emmanuel Dignonnet,
co-ordinator of the mental
health programme in the
Palestinian Territories. In
Nablus, living conditions
have deteriorated strongly.
“The check points, the
repeated incursions, the
occupation and destruction
of houses are all traumatic
events.” In this sensitive
area, teams have set up
information campaigns,
training and theatre projects
in schools with a view to
breaking the isolation. In
Liberia, another country
scarred by fourteen years of
war, it was necessary to
open a mental health
programme. “The body
cannot be well if the mind is
ill, especially when you are
dealing with children
traumatised by war,” says
Akemoh Maroe, a mental
health worker. Boys have
seen scenes where close
relatives were killed; girls
have been used as sex
slaves… Today these young
people are receiving
psychological treatment.
The Roma
There are more than 2 million
Roma throughout the
European Union and they have
a history of great
discrimination against them
since their arrival in the 14th
and 15th centuries. Is this
simple misunderstanding of
this population or is it racism?
In France, their life expectancy
is 15 to 20 times lower than
that of the French population
and their infant mortality rate is
5 times higher. Each year,
many families are expelled
from sites where they have
settled. Their illnesses are
related to poor living
conditions and to their lack of
access to healthcare in
France. The Association is
continuing its community
health work in sites, with a
particular focus on children
and mother-and-child health. It
deals with more than 3,000
people in France.
JULIEN DE WECK
Deep-rooted
discrimination
DRC
BRUNO FERT
War, poverty, malnutrition and
lack of healthcare have
caused the death and
displacement of millions of
people in Democratic
Republic of Congo. Many
initiatives are being carried out
in the country to put the health
system back on its feet,
especially in North Katanga,
with a view to fighting AIDS. In
Goma, specialist
consultations, anonymous
and free screening and ARV
treatments are now available.
In Kinshasa, a programme to
help reintegration has been
set up for street children.
/ VOUS ÊTES ICI
Rebuilding health
30/31
Mental Health
Caring for
invisible evils
VALÉRIE DUPONT
SÉBASTIEN GEORGES
VALÉRIE DUPONT
More than 400 million people
across the world suffer from
mental, neurological or
psycho-social problems.
These invisible evils have
many causes: armed
conflicts, political violence,
forced displacements,
exclusion from healthcare
systems, etc. These complex
situations do not make
treatment easy, especially as
these problems are often
stigmatised. “Because of very
strong cultural pressure,
people are ashamed to talk
about psychological
illnesses,” says Emmanuel
Dignonnet, co-ordinator of the
mental health programme in
the Palestinian Territories. In
Nablus, living conditions have
deteriorated strongly. “The
check points, the repeated
incursions, the occupation
and destruction of houses are
all traumatic events.” In this
sensitive area, teams have set
up information campaigns,
training and theatre projects
in schools with a view to
breaking the isolation. In
Liberia, another country
scarred by fourteen years of
war, it was necessary to open
a mental health programme.
“The body cannot be well if
the mind is ill, especially when
you are dealing with children
traumatised by war,” says
Akemoh Maroe, a mental
health worker. Boys have
seen scenes where close
relatives were killed; girls have
been used as sex slaves…
Today these young people are
receiving psychological
treatment.
Haiti
Escalation
of violence
“Like all human beings, we
are dreamers. He who stops
dreaming can sink into
violence,” says Professor
Toussaint, a Haitian
sociologist. Currently, the
country is seeing an
escalation of violence
politically and socially. That is
why, in Port-au-Prince in
particular, the Association is
treating victims of this
violence by providing them
with medical, psychological
and legal support, but also by
training local staff.
Since the end of the civil war,
MdM has been providing
medical support to the
weakest populations in
Huambo province and in
Lobito. “It was becoming
urgent to open a programme
giving street children access to
hygiene and healthcare,”
explains Luc Jarrige, the
project co-ordinator. “The
beneficiaries, aged between 7
and 15, form a population who
has been totally forgotten by
the health authorities and the
main sponsors.” In Huambo
province, another programme
is aimed at children suffering
from malnutrition.
VÉRONIQUE BURGER
Street children
/ PHANIE
Angola
Népal
MdM
Nearly half the Nepalese
population lives below the
poverty line. This is the first of
a long list of alarming
indicators (life expectancy,
infant mortality, illiteracy). For
the past ten years, MdM has
been running a programme
against STIs and HIV.
STÉPHANE LEHR
Fighting against
HIV
32/33
Child Buddy Scheme
PASCAL DELOCHE
PASCAL DELOCHE
Energy
transfusion
Since 1988, a project has
been aimed at isolated
children in hospitals in Paris
and the surrounding area. It is
run by volunteers who provide
emotional support to these
weakened children, who are
separated from their families
while they are hospitalised.
“One day, a buddy noticed
that a child would not answer
to his first name,” recalls
Catherine Peterman, the
project co-ordinator. “A long
telephone conversation with
the parents made her realise
that the first name on his
passport that the hospital was
using was not his usual name.
The next day, the child's face
finally lit up. This support is all
the more valuable as a nurse is
not always available to do this
job.” More than 1,500 children
from foreign countries, the
provinces or a DDASS (local
health authority) have already
benefited from it.
Lead poisoning
SOPHIE BRANDSTROM
/ L’OEIL PUBLIC
Illness of poverty
Child lead poisoning is a littleknown scourge. Yet, 150,000
to 300,000 children are
potentially exposed to this
risk in France. This lead
poisoning, caused by
absorbing or inhaling paint
dust in dilapidated or
unhealthy housing, leads to
disasters. It stunts a child's
psychomotor development.
Since 1993, there has been a
specific project fighting
against this disease by
finding and protecting these
children.
Colombia
The war here cannot
always be seen.
However, there is definitely a guerrilla war
going on between the FARC and the United
Self-Defence Forces of Colombia (AUC).
These armed groups carry out drugs
trafficking on a large scale. One group claims
to protect small coca producers against large
capital, while others profit from this manna to
build up their presence outside the urban
to choose which side it supports. It just
submits! On top of selective executions there
is repression from one side and assassination
MICHEL REDONDO
areas they control. The population is not free
attempts and attacks on police stations by the
other which leave the civilian population
undefended and victims of this war most of
the time. Security measures for the team are
drastic: boats are clearly identified, flags fly
over accommodation centres, and T-shirts
and jackets with the Médecins du Monde
dove emblem are worn at all times. Travel
outside the villages or at nights is not allowed.
,,
Logistical self-sufficiency is total. The danger is
not seen, but it is felt and it is permanent.
CHRISTIAN RAGGIOLI,
MICHEL REDONDO
Project Co-ordinator
,,
>Atlas of international projects
35/118
Les
missions
Médecins
duinternationales
Monde’s
Cuba
1
Haiti
Mexico
2
1 3
1
Guatemala 1
El Salvador
Dominican Republic
1
1
Colombia
l
2 1
Peru
1
Brazil
Emergency: a situation where people's lives
and livelihoods are in immediate danger
(natural disaster, armed conflict, etc.)
x * Response: involvement through substitution.
Crisis: situation where people's basic needs are
not being met in the long term (civil war, forgotten
conflict, HIV pandemic).
x * Response: technical assistance and mobilisation
of local resources.
Development: support for meeting the needs or
carrying out the policies expressed by local
x * partners, community or administration in a
situation where there are insufficient resources.
Response: partenarship and transfer of skills.
* X: number of projects per country.
Bolivia
Argentina
1
1
1
42/37
36/37
deinternational
Médecins du
Monde
projects
Russia
Belarus
1
1
1
Mongolia
Moldavia
Bulgaria
Serbia
1
Turkey
3
2
Chechnya
1
1
Afghanistan
2
Kosovo 2
China
Egypt
1
Morocco
Algeria
Burkina Faso
Equatorial Guinea
1
1
3
Nepal
Pakistan
Mali
1
Chad
1
2 1
1
Ethiopia
Cambodia
1
1
1
Sri Lanka
1
Uganda
Democratic Republic of Congo
Vietnam
1
Sudan
Ivory Coast
1
1 1
Burma 1
1 1
1
1
1
1
Benin
Liberia
Georgi
orgia
1
Lebanon
1
1
1
4 1
3
Tanzania
Angola
Indonesia
3
3
Zimbabwe 1
Madagascar
4
4
Adoption
Countries of intervention
and associated
countries in 2005
Albania
Brazil
Bulgaria
China
Colombia
Russia
Vietnam
In 2005 adoption work was carried out by 212 staff and volunteers at head office and
14 regional offices. As the leading authorised adoption body (OAA) in France and the
only OAA integrated in a medical NGO, the aims of Médecins du Monde's adoption project are to affirm its humanitarian purpose by defending the most vulnerable people (children, the first victims of economic and environmental crises, insecurity or geopolitical
conflicts), to defend their fundamental rights (the right to a family to grow up in, access
to healthcare and the right to education), to find families for children who have not been
able to be adopted in their country of origin, and to facilitate the adoption of children
with special needs (i.e. 119 children, that is to say 37.7% of the children adopted in
Co-ordinators
> Project: M. Brugière, F. Giraud
> HQ: G. André-Trevennec
Sources of funding
> adopting families, MAI, MdM
Budget
> 2005: 374,000 euros
2005).
Families for children
Activities: 1,634 letters received at head office, the files were
examined during 30 commission meetings.
459 applications were accepted, but the withdrawal rate,
which runs at between 27 and 30%, must be taken into consideration when giving provisional figures for 2006.
Children who come to France through Médecins du Monde are
monitored within their family for two years through 6 scheduled
contacts. Some of these contacts with a report are requested by
the countries of origin.
• In 2005, 1,441 post-adoption home visits to families were carried out, i.e. a 35% increase.
• 315 children were adopted by 281 families.
• 27 children came from European countries (Russia, Bulgaria,
Albania).
• 222 children came from Asia (China, Vietnam).
• 66 children came from Latin America (Colombia, Brazil).
• Administrative problems with Eastern Europe and difficulties
with Vietnam limited the number of children coming from those
countries.
In 2005, 3 major areas were worked on and implemented:
• the overhaul and updating of administrative procedures: creation of country reference systems and of performance indicators to monitor activities;
• more in-service training and setting up of an integration day for
adoption;
• the development of complex adoptions:siblings, older children,
children with specific medical needs.
Outlook:
Develop the distinctive
features of the Médecins
du Monde OAA: complex
adoptions and its
professionalism.
38/39
Afghanistan
Attempts at normalisation and providing security are continuing in Afghanistan. A new phase
in the political reconstruction process was completed with the parliamentary elections held in
September 2005, but many challenges still remain. The issues involved in institutional and
socio-economic reconstruction are still a real challenge for both the Afghan authorities and the
international community. In addition, the donors' plan involved sub-contracting primary healthcare to NGOs for reconstructing the health system. After a study which highlighted that this
devalued and removed responsibility from Afghan medical staff, MdM decided not to take part
Ensuring women have access to healthcare
Kaboul
Activities:
Outlook:
Progress bar at 31/12/2005
Pass the remaining two
MCHs to a local NGO
capable of maintaining
the level and quality of
current services. In April
2005, set up a pilot
harm reduction project
amongst drug users in
Kabul. Organise an
exploratory mental
health project in Kabul in
June 2006.
MdM supports 2 mother and child health centres in Kabul. Two of the four centres opened in 1995 have already
been transferred to another NGO (MSF Switzerland). There are 3
parts to the programme:
• ensuring women have access to healthcare (medical consultations in paediatrics, gynaecology and obstetrics, vaccination campaigns, basic health and hygiene education);
• training local healthcare staff;
o ensuring the renovation of health infrastructure and supplying drugs
and equipment.
Female doctors, nurses and midwives have been able to work unhindered since the Taliban left.
1995
2006
> Project
progress
Mother and child protection
MdM runs a mother and child health programme
in 3 clinics in the city of Herat around 4 areas of work:
• direct involvement with the population (consultations in paediatrics,
gynaecology, obstetrics, general medicine, vaccination campaigns,
basic health and hygiene education);
• training local health staff (including women doctors, nurses and midwives);
• renovating health infrastructure and supplying drugs and equipment;
• ongoing partnership with local health authorities.
1992
04/2006
\npro> Project
gress
Mortality
> infant: 115‰
> maternal: 1,600/100,000
Life expectancy
> at birth: years
HDI
> not known
Actual GDP/inhabitant ($)
> 206
International delegation
> MdM Canada
Beneficiaries
> directly project 1: 36,000
Staff
> local project 1: 18
> expatriate project 1: 2
Co-ordinators
> project 1: G. Causse
> field 1: F. Maurin
Herat
Activities:
Sources: Human Development Report 2005; MICS UNICEF
2003; The State of the World in 2006 (p. 238), “Securing
Afghanistan's Future”
in this form of privatisation.
Outlook:
MdM's withdrawal process
and the transfer to a local
NGO (Coordination of
Humanitarian Assistance),
which will take over running
our 3 clinics in partnership with
the Ministry of Health, have
been agreed. 2005 thus marked the end of thirteen years of
MdM's providing primary and
mother and child healthcare in
Herat.
M. Otambekova
> project 2: G. Causse
> field 2: F. Maurin
M. Otambekova
> HQ: N. Bréchet
Sources of funding
> project 1: MdM, Florindon
Foundation, Santa Devota, Isle of Man
Overseas Aid Committee
> project 2: MdM, SDC and
Florindon Foundation
Budget
> 2005 project 1: 216,309 euros
> 2005 project 2: 270,642 euros
Algeria
An unstable social environment, still very high unemployment and a lack of transparency in
the use of oil resources make Algeria a fragile country where there are many inequalities.
Despite the start of a programme aimed at containing the housing and infrastructure crisis
amongst other things, many Algerians continue to live in harsh conditions. Problems with
Mortality
> infant: 35‰
Life expectancy
> at birth: 71.1
HDI
> 0.722; ranked 103/177
PIB/habitant ($)
> 2,090
Beneficiaries
> directly: 1,200
> indirectly: 15,000
Co-ordinators
> project: R. Allemand
> follow-up: DR Rhône-Alpes Grenoble
Sources of funding>
Grenoble city council,
Isère department council, MdM,
concerts, dedicated gifts
Budget
> 2005: 36,446 euros
Rapport sur le développement humain 2005, PNUD
access to healthcare are real, especially for chronic diseases.
Community health project
Constantine (El Gamas district)
Activities: The project involves assistance for two local
organisations: the Constantine local committee of the Social
Development Agency (ADS) and the El Gamas district
residents' association. After consulting the local population
and health workers and after an epidemiology survey, the
demand that emerged was for asthma treatment, which had
been neglected for essentially economic reasons.
The following happened in 2005:
• February 2005: an agreement was signed between MdM
and the Algerian Republic's ADS in Constantine;
• June 2005: training on asthma was given to two local
committee doctors in Grenoble;
• a spirograph was supplied to the district polyclinic;
• two health educators worked amongst the population;
• a booklet explaining asthma was produced;
• basic drugs for chronic asthma were bought and supplied;
• swimming pool sessions for asthmatic children were organised;
• in October 2005, a seminar on community health was
organised in Constantine.
02/2005
12/2007
> Project
progress
Outlook:
The project is going to run for
two years and will only require
follow-up work. This will allow
us to focus our efforts in 3
directions:
• getting the health and political authorities to take full
charge of treating chronic
asthma to ensure the work
continues;
• asthma prevention and
housing improvements in the
district;
• work with the Constantine
health monitoring centre on
harm prevention campaigns,
campaigns against addiction
to smoking and HIV/AIDS
prevention.
40/41
Argentina
The fragile recovery of the Argentinian economy should not let us forget that 38 million
Argentinians are considered poor and are often excluded from the welfare protection system by the increase in moonlighting. The people have many demands in terms of health,
education and increased purchasing power. Rural populations are particularly concerned
Argentine
by healthcare access problems.
Abra Pampa, Puna Jujeña, Jujuy province
Activities:
This project helps improve the rural
population's access to healthcare through:
• mother and child treatment, protection and monitoring;
• monitoring women to reduce cervical cancer and sexually
transmitted infections;
• strengthening health prevention and promotion.
01/04/2003
31/08/2006
> Project
progress
Outlook:
MdM is particularly targeting community health
together with the indigenous NGO WARMI and is
continuing the project to
build a new maternity
hospital at Abra Pampa.
Mortality
> infant: 17‰
Human Development Report 2005, UNDP
Increasing access to care for women and
children
Life expectancy
> at birth: 74.5
HDI
> 0.863; ranked 34/177
PIB/habitant ($)
> 3,524
> MdM Argentina - local projects
Beneficiaries
> directly: women and children
> indirectly: general population,
health promoters and medical
staff (in hospital and health
centres)
Staff
> local : 5
> expatriate: 1
Co-ordinators
> project: B. Koepcke
> field: M. Idiart
> HQ: F. Stea (MdM France)
and R. Timpano (Buenos Aires)
Sources of funding> UE, MdM
Budget
> 2005: 195,751 euros
Angola
The civil war which lasted twenty-seven years is making the democratic process a
delicate one, even if the signing of peace agreements and ending of hostilities have
led to better prospects for international assistance, especially that aimed at children.
52% of children show signs of malnutrition and the illiteracy rate (58%) is one of the
highest in Africa. The aftermath of war and drought, especially in Huambo province
and part of Bie province, are not helping to improve one of the most difficult situa-
Life expectancy
> at birth: 40.8
HDI
> 0.445; ranked 160/177
> 975
> MdM Espagne
Beneficiaries
> directly: 3,500
Staff
> local : 30
> expatriate: 4
Co-ordinators
> project L. Jarrige
> general co-ordinator: D. Chappaz
> HQ: O. Mouzay
Sources of funding> FSD, MdM
Budget
> 2005: included in the mother and
child health project budget (see
opposite).
tions.
Rapport sur le développement humain 2005, PNUD.
Mortality
> infant: 154‰
Treating moderate malnutrition
North, Huambo province (Mungo and Bailundo towns)
Activities: As in 2004, the operation in Mungo involves:
• running, in conjunction with the WFP, a permanent
supplementary feeding centre and two mobile centres
(providing curative care, vaccinations and nutritional support);
• supporting the town's primary healthcare structures (staff
management, supplying drugs, vaccinations and supplies).
In Bailundo, the project focuses mainly on:
• support for Bailundo Ministry of Health's permanent supplementary feeding centre;
• staff training;
• curative care.
06/2003
12/2005
> Project
progress
Outlook:
The outlook for 2006 is identical in part to that for 2005.
MdM is continuing to transfer
specific renutrition structures
to the Ministry of Health by
integrating them with existing
health structures. The monthly
assessment of activities with
the Mungo health structures
through the involvement of the
mother and child health
(MCH) nurses from the
Huambo province mother and
child health programme will
also be included amongst the
activities for 2006.
42/43
Mother and child health
Beneficiaries
> directly: 80,000
North, Huambo province (Mungo and Bailundo towns)
Activities: We are continuing to develop the current integrated
Outlook:
mother and child health (MCH) programme in partnership with
the local network of traditional midwives and MCH nurses within the
peripheral health structures of the north of the province and in the
referral hospital at Bailundo. 2005 has seen the continuation of these
activities set up by MdM when the project started:
• monitoring the network of MCH nurses supervising all the traditional midwives;
• supervision of paediatric consultations and the vaccination programme;
• training in prevention and treatment of the main STIs;
• family planning;
• structural support and recycling of staff from the maternity unit to
the Bailundo referral hospital;
• renovation of an operating theatre, training a theatre medical team,
training doctors in emergency surgery techniques.
Continue to gradually increase
the quality of peripheral
actions and ensure their longterm continuity. Training and
support of Angolan medical
staff remain important aspects
which will allow them, in the
longer term, to move towards
efficient autonomy.
Staff
> local : 15
> expatriate: 6
Co-ordinators
> project: L. Jarrige
> general coordinator: D. Chappaz
> HQ: O. Mouzay
Sources of funding
> FSD, German Foreign Ministry
Budget
> 2005: 379,772 euros
01/12/2003
31/12/2006
> Project
progress
Care for street children
Lobito town, Benguela province
Activities: To increase the efficiency of the care given to
street children and their access to it, MdM is continuing its activities which include:
• building, equipping and supplying a health centre with drugs in
conjunction with the local authorities;
• agreements have been made with local hospitals to deal with
more serious diseases, with the objective of letting street children access the Angolan health system by themselves;
• six street educators are responsible for making a list of all the
street children, making contacts with their living places and carrying out surveys in order to plan joint activities with partners working more specifically in the education and professional training
of street children. The possibility of envisaging a process of family
reintegration has to be assessed with each child.
06/2004
12/2006
\npro> Project
gress
Outlook:
Continue the process of
complete autonomy for the
health centre, and best
management of all health
care for street children at the
health centre or in the hospitals.
Beneficiaries
> directly: 65,000
> indirectly: 2,000
Staff
> local : 10
> expatriate: 1
Co-ordinators
> project: L. Jarrige
> general coordinator: D. Chappaz
> HQ: O. Mouzay
Source of funding
> UBS
Budget
> 2005: 124,196 euros
Benin
Benin is one of the eighteen poorest countries which benefited from the debt cancellation agreed by the G8 countries in 2005. Benin's economy continues to struggle.
The cotton sector (the country's main resource) is in deficit. We are seeing the sad
growth of the HIV/AIDS epidemic. 68,000 people, including 5,700 children, are now
living with the infection. 34,000 children are orphans.
Life expectancy
> at birth: 54.0
HDI
> 0.431; ranked 162/177
> 517
Beneficiaries> directly: 600
Staff
> local: 5
> expatriate: 3
(1 medical co-ordinator)
Dealing with the HIV/AIDS epidemic
Mortality
> infant: 91‰
Ouidah and Come
Activities: Activities aim to respond to the AIDS epidemic
Outlook:
in Benin's particularly affected cities. We are continuing our
preventive measures in the fight against HIV/AIDS through
education and raising awareness (amongst women in particular) and support for those who are ill, with our local partner
Africare, who is skilled in involving the community. We are
continuing our voluntary, anonymous and free screening activities and treatment of AIDS patients. To do this, MdM is training Beninois staff and renovating health centres to increase
local capacity so that we can move towards Beninois staff gaining autonomy
In January 2006, the staff training programme ended, the
renovation is nearly complete,
and the first patients being
treated with ARVs will be
included in the active file.
01/2005
Co-ordinators
> project: P. Beze Beyrie
> HQ: A. Belaïd
Sources of funding
> Paris city council, French Foreign
Ministry, Dutch Foreign Ministry
Budget
> 2005: 366,157 euros
31/12/2006
> Project
progress
44/45
Byelorussia
Alexander Lukashenko's regime is becoming increasingly harsh: personal liberties are
restricted and the structural reforms needed have not been carried out. In addition,
the health consequences of the Chernobyl nuclear disaster have been rationalised by
the government whereas the number of cancers and other congenital deformities due
to radiation continues to increase. The people living in the area at risk have not been
evacuated. On top of that, as the soil affected by radioactivity is still being cultivated,
Preventing radioactive contamination
Chechersk district
Activities: MdM's work is aimed at improving the health
Outlook:
of women and children living in areas with radioactive
contamination. The CORE (Cooperation for Rehabilitation)
programme, in which the European Union is taking part, has
been set up with the aim of improving the living conditions of
those living in the contaminated districts. This project has
been set up by three partners (IRSN, ACRO and Médecins
du Monde) and is coordinated by Médecins du Monde. It
focuses on three areas:
• carrying out a health assessment of 2,800 children in
Chechersk district in partnership with the Institute for Nuclear
Radioprotection and Safety (IRSN);
• improving radiological quality, in partnership with ACRO
(Association for Controlling Radioactivity in the West), and
raising awareness about the risks of contamination through
radioactivity;
• maternal care, actions for and with women (supply of food
supplements, raising awareness of the risk of complications
during pregnancy, etc.).
The people are beginning to
take responsibility for themselves and exchanges have
led to noticeable changes in
risky eating habits. This programme should lead to further improvements in this
area.
12/08/2007
Mortality
> infant: 13‰
Life expectancy
> at birth: 68.1
HDI
> 0.786; ranked 67/177
> 1,770
Beneficiaries
> directly: 2,800 children between
3 and 15 years old and 400 pregnant
women and new-borns
> indirectly: local health
professionals, the whole population
of the district
Staff
> local: 1 half-time co-ordinator
Co-ordinators
> project: M. Costa,
C. Georgescauld (RT)
> field: T. Gloukhova
> HQ: A. Landaes
Sources of funding
> Tacis (EU), IRSN, DGSNR, MdM
Budget
> 2005: 10,221 euros
13/08/2005
the people are subject to chronic contamination through the food grown there.
> Project
progress
Bolivia
The still poverty-stricken Andean regions have welcomed the coming to power of
the Movement towards Socialism led by Evo Morales, the first indigenous president of Bolivia. As well as agrarian reform and the redistribution of natural resources, child labour is an important area of work in a country which is one of the poo-
Mortality
> infant: 53‰
Life expectancy
> at birth: 64.1
HDI
> 0.687; ranked 113/177
> 892
> MdM Spain
Beneficiaries
> directly: 1,100
> indirectly: 9,000
Staff
> local: 5
> expatriate: 0
Co-ordinators
> project: L. Liron, D. Masson
> field: I. Tapia
> follow-up: DR Rhône-Alpes
Bourgogne (S. Bret)
Sources of funding
> private partnerships, towns in
Rhône-Alpes, MdM
Budget
> 2005: 25,309 euros
rest on the continent.
Protecting the health of children at work
Potosí, San Cristobal district
Activities: Since 2002, MdM has been working in Potosi,
Outlook:
a mining town in the Andean cordillera, to ensure children
receive access to healthcare and to prevent work-related risks.
Several activities are being carried out:
• health education: workshops for child workers and nursery teachers in San Cristobal district;
• access to healthcare structures: material support and
raising awareness of staff concerning traditional medicine;
• accidents in the mines: training on emergency care and
treating the injured;
• depression amongst adolescents: creating a support
structure for adolescents facing problems;
• young children at work: raising awareness amongst institutions and the population of the consequences on 6-8 year
olds of working.
The long-term future of the
project after MdM leaves is
the team's major concern.
It involves working in partnership, which will be a
major issue in 2006: the training of college teachers to
run health education workshops, partnership with the
town council for the work
with young people, partnership with health structures to
replenish first aid kits, and
partnership with an Italian
NGO on the mine safety
project, etc.
Lastly, in partnership with a Lyons-based organisation, MdM
is supporting a group of local young people with its projects.
In the long term, the aim is to create a youth centre-type structure which would offer recreational activities as alternatives to
child work.
2002
12/2007
> Project progress
46/47
Brazil
The corruption scandals which have shaken the government of president Luiz Inácio
Lula da Silva have delayed the completion of the major reforms intended, amongst
other things, to redistribute cultivable land for the benefit of “landless” rural community. Despite the efforts made as part of the “Bourse Famille” (Family Purse) programme, the Nordeste continues to be a particularly disadvantaged and sensitive
Training healthcare workers
Ceará State
Activities: The programme is run amongst the landless
community in the rural districts of Tururu, Itapipoca,
Amontada, Trairi and Itarema in Ceará state in order to reduce
the morbidity and mortality rates for the most common
illnesses encountered in this population. As well as training
healthcare workers, the whole population of the area has been
given health, hygiene and prevention awareness training and
education and, alongside, has benefited from consultations. In
addition, the recognition of the landless community by the local
health structures has improved.
Through this work, MdM has concluded a cycle of projects
aimed at improving overall health in the communities undergoing agrarian reform, by training community health workers
(CHWs), the main people involved in prevention in the isolated
rural communities of Ceará.
12/2004
12/2005
> Project
progress
Outlook:
Our local partner, the
Landless Workers'
Movement (MST) will continue its activities in the following areas:
• encouraging the integration of the CHWs into the
local health services;
o allowing the 4 CHW trainers to continue training
• HWs in other rural communities with MST in Ceará
state and nationally;
• developing a series of
seminars on health, with the
trained trainers, under the
supervision of two Brazilian
MST doctors, trained in
Cuba.
region in health terms.
Mortality
> infant: 33‰
Life expectancy
> at birth: 70,5
HDI
> 0.792; ranked 63/177
GDP/inhabitant ($)
> 2,788
Beneficiaries
> directly: 5,000
Staff
> local: 3
> expatriate: 1
Co-ordinators
> project: J. Achouline, J. Guerrini
> field: G. Sekhniashvili
> HQ: M.-Y. de Penanster-Rosny, Y.
Le Corgne
Sources of funding
> Aquitaine regional council,
miscellaneous gifts, MdM
Budget
> 2005: 144,201 euros
Bulgaria
The economic situation in Bulgaria is improving gradually with the arrival of the new
government led by Sergei Stanichev but social inequalities persist: out of a total population of 8 million, 1.1 million Bulgarians are living below the poverty line. The health situation is precarious, and life in the specialist institutions (institutions for disabled people,
orphanages and prisons) is particularly difficult. In addition, the Roma community's situation is still worrying and Bulgaria's EU membership may well be delayed if efforts are not
Life expectancy
> at birth: 72.2
HDI
> 0.808; ranked 55/177
GDP/inhabitant ($)
> 2,539
Beneficiaries
> directly: Roma mothers
and children
> indirectly: Roma families
Staff
> local: 4
> expatriate: 1
Co-ordinators
> project: P. Contois
> field: L. Lamarque
(until end of 2005)
> follow-up: MIR RD Corsica
(until end of 2005,
then national project)
Sources of funding
> collectivité régionale de Corse,
MdM
Budget
> 2005: 78,089 euros
made in this area.
Mortality
> infant: 14‰
Mother and child protection
Roma district of Nadezhda, in Sliven
Activities: The programme has been set up in a former
Outlook:
ghetto, now a Roma district, where around 20,000 people
live. The population's sanitary conditions are deplorable (almost
complete lack of water, sewerage and electricity in the district). The Roma are victims of segregation and have a much
higher unemployment and illiteracy rate than the Bulgarian
average.
A Mother and Child Health clinic has been set up by
MdM's regional delegation in Corsica. It bears the name of
Dr Edouard Delahayes, the project co-ordinator who died in
a road accident on the way to Bulgaria. The team is made
up of an expatriate co-ordinator and Bulgarian staff: a paediatrician, midwife, nurse and social worker.
Mother and child consultations are organised to pick up
pregnancies at risk and childhood diseases, and to refer
patients needing it to the general Bulgarian health service.
Health information and training sessions are organised for
mothers and children and, in particular, a school for mothers
has been developed. A public health survey was carried out
in the poorest part of the district, known as the “district of the
naked”, to pick up the weakest people and support them.
Bearing in mind the size of
the problem this population
faces, the programme is
becoming national in 2006,
and will be supported by the
Eastern Europe desk.
International funding will be
sought to provide the clinic
with resources more appropriate to the situation: increasing the strength of the
team, sending an expatriate
medical co-ordinator for 18
to 24 months, seeking premises where child vaccination campaigns can be organised by local doctors, organising training and co-ordination meetings, setting up a
pre-hospitalisation hygiene
centre, etc.
03/2004
12/2009
> Project
progress
48/49
Help for children
Staff
> local: part-time secretary
Sofia
Activities: MdM 's activities have two aspects:
• contact with Bulgarian institutions and NGOs which
are involved with children, to distribute information on our
programme.
• support for the work of the “Child and his symptoms” project. MdM supports the “Development for
Children and Families” Foundation which funds the 6 training modules for paediatric institutions' staff. After selecting the institutions to receive this training, the Foundation
provides help in organising the modules. The lectures and
case studies examined during the different modules are
then published for each year of training in French and in
Bulgarian.
Co-ordinators
> project: F. Parrot
> follow-up: DR Aquitaine
Source de financement
> MdM
Budget
> 2005: 12,763 euros
03/2004
12/2009
> Project
progress
Training staff from
paediatric institutions
Beneficiaries
> directly: 150 professionals
> indirectly: 396 education or day
centre specialists,
360 families and 1,220 children
Throughout the country (+ training in Sofia)
Activities: The “Child and his symptoms” project is run in
Outlook:
two ways:
• each year six training modules are organised in Sofia for staff
from 8 institutions and 4 centres for disabled children. They are
given jointly by French volunteer trainers from the CIEN (Centre
interdisciplinaire de l'enfant) who are paediatric psychiatrists or
psychologists, and by members of the Belgian charity “Enfant
et Espace” (Child and Space). This training is followed up and
evaluated by a specific written programme and implemented by
the Social Activities and Practice Institute in Sofia;
• two visits per year are made to the institutions and centres, by “supporters” appointed by the Bulgarian project coordinator. They organise team meetings to prepare the modules
together with them. These visits provide specific training for the
whole staff of each institution.
In four and a half years, the
staff of most of the institutions for disabled children in
Bulgaria will be trained.
01/01/2005
30/06/2009
> Project
progress
Staff
> local: projects co-ordinator
1/2 FTE, secretary 1/4 FTE
Co-ordinators
> follow-up: DR Aquitaine
Sources of funding
> Aquitaine regional council, miscellaneous gifts
Budget
> 2005: 13,806 euros
Burkina Faso
Even though it has become the leading cotton producer in Africa for the first time, the
country, led by the same man for eighteen years (re-elected in November 2005), remains
very poor. As well as a disappointing economic assessment, the health situation is disastrous. Mothers' poor knowledge of how to monitor children (partial or total lack of
knowledge of childhood illnesses and the hygiene measures to avoid them), together
with difficult access to health centres, is behind the high infant mortality rate in this
Life expectancy
> at birth: 47,5
HDI
> 0.317; ranked 175/177
GDP/inhabitant ($)
> 345
country.
Mortality
> infant: 107‰
It should also be noted that the spread of HIV at all social levels, and the absence of
prevention and screening make an already worrying situation even worse.
Access to oral
healthcare programme
Diébougou (Sud-Ouest)
Activities: Having realised that no-one was providing
Beneficiaries
> directly: 60,000
(the whole of the province)
Staff
> local: 1 (dentist in training)
Co-ordinators
> project: F. Ben Soussan
> field: Abbé Séverin Dabbiré
> HQ: P. De Botton
> follow-up: DR PACA (M. Semat)
Sources of funding
> MdM and private partners
Budget
> 2005: 1,116 euros
oral healthcare in the region, MdM set up several activities. These include:
• setting up a dental surgery (refurbishing the
premises);
• staff training (training a dentist at the university);
• developing an oral ailments prevention programme
in schools and villages in Diebougou province with the
aim of improving the oral health of the population of this
region.
2005
2007
> Project
progress
Outlook:
Run the dental surgery and
continue to train the medical
staff. A dentist began work
in the dental surgery in
March 2006 while waiting for
a second dentist to complete his training.
50/51
Burma
Burma is going through a major socio-economic crisis and the government has reduced health spending to a minimum (0.4% of GDP). However, HIV is ravaging a country where prostitution and the use of injectable drugs are very widespread: more than
680,000 may be carrying the virus. The criminalisation of drug users and prostitutes
makes MdM's work more difficult. In addition, the withdrawal of the Global Fund
situation worse. Today, the HIV prevalence rate is up to 43% amongst prostitutes and
to 90% amongst drug users.
Preventing HIV transmission
Myitkyina (Kachin) and Yangon
Activities: MdM's work is focused on preventing HIV and
Outlook:
STI transmission in Myitkyina and Yangon in order to reduce
HIV/AIDS and STI transmission in the population and amongst
people at risk - prostitutes and intravenous drugs users - and to
offer access to healthcare and treatment of opportunistic infections.
Its work is concentrated amongst prostitutes (HIV/AIDS prevention sessions, free treatment of STIs and OIs, workshops in
drop-in centres and condom distribution) and drug addicts (promotion of harm reduction methods in shooting galleries, needle
distribution and prevention/ education sessions in drop-in centres).
In addition, MdM is continuing its welfare support and AIDS education/prevention activities in prisons, where prostitutes and drug
addicts can often be found in a country where the law is very
repressive against these groups of people. ARVs began to be
administered in Yangon in May 2005. At the end of December,
43 prostitutes were receiving treatment.
MdM hopes to continue
administering ARVs to prostitutes in Yangon and to
start methadone substitution
in Kachin state. We must
also strengthen links with the
vulnerable groups, and
continue to gather testimonies.
30/06/2010
Mortality
> infant: 76‰
Life expectancy
> at birth: 60.2
HDI
> 0.578; ranked 129/177
> not known
Beneficiaries
> directly: 9,000
Staff
> local: 100
> expatriate: 6
Co-ordinators
> project: F. Sivignon
> field: A. de Suremain
> HQ: V. Pardessus
Sources of funding
> MdM, Novib, UNODC/UE,
PSI/Usaid
Budget
> 2005: 577,703 euros
01/01/2002
(which had undertaken to pay 98 million dollars over five years) is making the current
> Project
progress
Cambodia
With growth of 6.3%, Cambodia's economic situation has gradually been improving
since the end of the civil war. But the AIDS endemic is widespread and the government has made it a public health priority. The HIV prevalence rate in Cambodia (2%)
is the highest in the region. International tourism, internal migration, poverty, human
trafficking and prostitution are all factors propagating HIV/AIDS in the country.
> infant: 97‰
Life expectancy
> at birth: 56.2
HDI
> 0.571; ranked 130/177
GDP/inhabitant ($)
> 315
Beneficiaries
> directly: 120,000
Staff
> local: 59
> expatriate: 4
Co-ordinators
> project: E. Peterman
> field: P.-R. Martin
> HQ: V. Pardessus
Sources of funding
> projet : Global Fund, Elton John
Aids Foundation, MdM
Budget
> 2005: 596,389 euros
Mortality
Priority to HIV
Phnom Penh
Activities: MdM's project is aimed at reducing the
transmission of STIs/HIV and caring for infected patients,
offering medical and welfare support to destitute patients suffering from HIV, raising the population's awareness and training medical staff.
In 2005, the project focused on:
• specialist consultations for the treatment of patients suffering from AIDS (OIs and ARVs);
• training doctors (ARVs and OIs);
• informing patients about the illness and the available treatment and services;
• hospital treatment of opportunistic infections;
• developing a continuum of care, assistance and support
networks for people living with HIV/AIDS;
• supporting Cambodian NGOs set up by people who are
HIV-positive.
The aim of treating opportunistic infections and providing
access to ARVs is to reduce the morbidity and mortality rates
linked to AIDS, and thus to provide patients with a better quality of life. That is, an active social life for a longer time, fighting against exclusion, and reducing the economic impact (on
family and society) of the illness.
01/04/1999
30/08/2010
> Project
progress
Outlook:
Between now and December
2006, 2,000 patients will be
regularly monitored in the
consultation centre. 521 of
them will receive ARVs.
A joint venture with
Pharmaciens Sans Frontières
should enable us to provide
450 additional people with
access to ARVs.
52/53
Chad
In this country where the local economy remains extremely dependent on external aid,
poverty has reached unsuspected levels. Even if the gross domestic product remains
one of the highest in the continent, the government is no longer managing to pay the
backlog of salaries or retirement pensions. The prevalence of certain diseases such
as malaria is not just due to lack of healthcare infrastructure but also to lack of hygiene and the permanent consumption of contaminated products, two risks to which
children are the most exposed (5,000 abandoned young people survive in the middle
sive influx of Sudanese refugees is adding to the insecurity.
Primary health for street children
N’Djamena
Activities: Medical treatment of wounds and traumas
Outlook:
suffered by children living in precarious situations and
picked up in the street. MdM's project has allowed welfare
workers to be trained and children to be educated in health
and hygiene matters:
• 64 workers from 20 local structures have been trained;
• 2,800 children have attended educational sessions;
• a suitable teaching tool has been produced by MdM and
made available to local structures.
In 2005, a medical and welfare support circuit, based on a
third-party paying system relying on local sponsors, was set
up on a permanent basis. It has provided access to primary
healthcare for more than 3,000 children, especially affected
by violence.
In partnership with UNICEF Chad, training and prevention work
involving 40 peers has reduced the incidence of HIV/AIDS
amongst young people living on the street.
MdM is withdrawing at the end of 2005 and will ensure the
continuity of the programme through an agreement signed
with a hand-over structure, the ITS (Institut Tropical Suisse).
MdM will support ITS (evaluation, help with running the
circuit) and will help find new
sponsors for 2007.
The project is due to end in
November 2006.
01/12/2001
12/2005
> Project
progress
of effluents). The political instability persists and, in the east of the country, the mas-
Mortality
> infant: 117‰
Life expectancy
> at birth: 43.6
HDI
> 0.341; ranked 173/177
> 304
Beneficiaries
> directly: 5,000 children including
30 leaders
> indirectly: 30 social workers and
20 health workers
Staff
> local: 5
> expatriate: 1
Co-ordinators
> project: P. Estecahandy,
J. Boncompain
> field: R. Lange
> follow-up: DR Midi-Pyrénées
Sources of funding
> MdM, FSD, private regional and
local partners (in N'Djamena,
and Midi-Pyrénées)
Budget
> 2005: 123,483 euros
Chechnya
2005 was a particularly violent year for Chechnya: repression against civilians remains
a daily occurrence, and this is in the name of Russia's fight against terrorism. In
response to that, several assassination attempts were carried out by Chechen guerrillas. The population lives in fear and poverty, hospitals are obsolete and many people
still do not have access to primary healthcare.
Mortality
Life expectancy
HDI
> no data specific to Chechnya
Beneficiaries
> directly: general population:
85,592 from February to October
2005
Staff
> local: 14
> expatriate: 2
Co-ordinators
> project 1: J. Dato
> field 1: P. Baril
> HQ: A. Landaes
Source of funding
> ECHO
Budget
> 2005: 971,912 euros
Supporting victims of conflict
Grozny, Gudermes, Urus-Martan, Argun, Kurchaloy
Nozhay-Iurt and Vedeno Districts
Activities: In 1999, for security reasons, MdM had to adopt
Outlook:
a “remote control” system for the project from its Moscow base.
MdM's work is focused on improving surgical care, primary
and secondary healthcare and setting up mental health
assistance. More specifically, our work involves:
• co-ordinating and supplying 7 hospitals in Chechnya's main
cities (medical and surgical equipment);
• co-ordinating and supplying 3 rural hospitals with essential
drugs and medical consumables;
• supplying 11 medical and obstetrics centres with essential
drugs and medical consumables;
• mental health awareness and training of medical staff in Grozny.
In 2006 we plan to extend
PHC activities into Vedeno
district, as well as to set up
a psychology consultation
surgery in a Grozny polyclinic from January 2006. In
addition, MdM is compiling a
publication, Chechen Words,
a collection of testimonies of
Chechens' lives since the
beginning of the war. At the
end of 2005, we also opened a similar programme in
Daghestan (Khassaviourt
district).
1995
> Project
progress
54/55
China
China is seeing strong economic growth, but there is still a lot of social inequality in the
country, and 2005 saw many protest movements: living conditions in rural areas are very
precarious. In addition, more than a million Chinese may be affected by the AIDS virus
which is spreading quickly across the country. The stigmatisation and discrimination
suffered by people living with HIV, along with a lack of awareness about the epidemic
are the two main obstacles to the fight against AIDS. Drug users, who are particularly
affected by AIDS and hepatitis C, are the subject of a policy of repression, and harm
Mortality
> infant: 32/43‰
Preventing the HIV/AIDS epidemic
and reducing risks amongst drug users
Chengdu (Sichuan)
Activities: The project began at the end of 2002 in partnership with the Centre of Disease Control (CDC) in Chengdu. The
first phase saw the implementation in three voluntary detox centres of awareness, information and education activities
on preventing HIV/AIDS and hepatitis C and on harm
reduction aimed at drug users and centre staff, but also at the
medical, administrative and political authorities. The new project, started at the beginning of November 2005, plans to open
three drop-in centres gradually in different districts. Each
will welcome users and provide information, basic hygiene services and a needle exchange programme (in the centre and on
the street with peers). At the same time, awareness, information, prevention and education activities will be carried out
amongst staff, drop-in centre volunteers and the medical, administrative and political authorities. These activities should mean
that a network focused on harm reduction amongst drug users
can be set up in the districts concerned, and that the people
and the authorities will start to have a different image of users
in their minds.
01/12/2002
31/12/2008
> Project
progress
Outlook:
The current political context is
favourable to setting up pilot
projects for caring for drug
addicts (the first trials with
needle exchanges and methadone treatment have been
authorised).
Plans for 2006:
• setting up 2 drop-in centres
in identified districts to give
drug users access to information and prevention of the different means of transmitting
HIV/AIDS and hepatitis C;
• setting up street work by
identifying peers;
• training medical staff, volunteers and providing information
to the public security forces of
the districts concerned to
ensure the work can continue.
reduction is still very under-developed in the country.
(male/female)
Life expectancy
> 70.0/73.0 (male/female)
HDI
> 0.755; ranked 85/177
GDP/inhabitant ($)
> 1,100
Beneficiaries
> directly: 500 (phase 1),
1,500 (phase 2) new project
Staff
> local: 1
> expatriate: 2
Co-ordinators
> project: B. Luminet, R. Baglioni
> field: D. Chamla puis
C. Montigny, N. Rennes
> HQ: V. Pardessus, E. Martinon
Source of funding
> MdM
Budget
> 2005: 79,936 euros
Colombia
The FARC and the paramilitary organisations maintain solid support in the provinces,
although internal security is the primary concern of Alvaro Uribe's government. At the
heart of the war zones, the civilian populations are often the first to suffer from changes in the balance of power and are subject to the full force of the violence as well as
its social and economic repercussions. In this context, uncertainty and inequalities
have a strong hold, especially with respect to access to healthcare, as the transformations of the Colombian health system are having consequences which are still dif-
Mortality
> infant: 18‰
HDI
> 0.785; ranked 69/177
GDP/inhabitant ($)
> 1,764
> MdM Spain
Beneficiaries
> directly: women and under 5s
> indirectly: civilian war victims
Staff
> local: 7
> staff expatriate: 3
Co-ordinators
> project: C. Raggioli, S. Sisco
> field: C. Escobar
> HQ: M. Ethvignot
Sources of funding
> French Foreign Ministry, MdM
Budget
> 2005: 298,373 euros
Life expectancy
> at birth: 72.4
ficult to assess.
Civilian populations' access to healthcare
Meta Region
Activities: The rural population of this region is stigmatised
by the simple fact of living in a war zone, which complicates
access to health centres for security reasons. MdM's aim is to
facilitate or restore access to healthcare for the most vulnerable through mobile health squads for mothers and children
and training of teachers on sexual and reproductive health.
01/11/2005
31/12/2006
> Project
progress
Outlook:
The south of the country,
where the FARC's economic
and military interests are
concentrated, is the object
of a vast government offensive aimed particularly at
penetrating the FARC's historic areas and at eradicating the coca crops. We can
expect movements of civilians leaving these areas
where tension is likely to
grow. In addition, the elections due in spring 2006 are
likely to lead to an escalation
in the conflict. MdM's health
response in an increasingly
unstable situation depends
on the team's capacity to
adapt to changes in the
situation.
56/57
Access to healthcare for the victims of armed conflicts
Rio Medio Atrato Region
Activities: In this strategic region, where the struggle to
Outlook:
control the access corridors to the Pacific, Panama and the
interior of the country is being played out, the paramilitaries' advance, the increasingly significant presence of the
Colombian navy and the FARC's resistance are again forcing the black and indigenous populations, the victims of
permanent blockades, to move in order to avoid further
repression for supposed collaboration with one of the armed
groups. Médecins du Monde is providing direct medical
assistance to the indigenous Emberas communities,
especially the women and children who find it difficult to get
access to healthcare as they live in the middle of the armed
confrontation.
The upsurge of the conflict,
which affects the entire
Colombian population, is
already causing new displacements of communities
living along the different tributaries of the Atrato. MdM's
permanent presence
amongst these doubly-stigmatised minorities is a guarantee of an appropriate
humanitarian response.
Beneficiaries
> directly: Emberas Indian
population, especially women
and children
Staff
> local: 13
> expatriate: 4
Co-ordinators
> project: C. Raggioli, S. Sisco
> field: V. Gavidia
> HQ: M. Ethvignot
Sources of funding
> ECHO, MdM
Budget
> 2005: 475,003 euros
01/05/2005
30/04/2006
> Project
progress
Promoting the right to health
Staff
> expatriate: 1
Bogota
Activities: As part of the “Access to healthcare” project,
MdM has carried out a study, from practices in the field, of
the consequences of privatising the Colombian health system
on access to healthcare for the populations monitored by
MdM.
01/09/2004
28/02/2005
> Project
progress
Outlook:
Presentation of report in
2005.
Co-ordinators
> project: C. Raggioli
> field: L. Muller, S. Zambrano
> HQ: F. Stea, M. Ethvignot
Sources of funding
> ECHO, MdM
Budget
> 2005: 10,810 euros
Cuba
Strategic links with Venezuela and an increasingly lucrative tourist economy have
allowed Cuba to maintain relative stability despite shortages and tropical storms.
On the other hand, the HIV/AIDS transmission prevention system, which made
Cuba the Caribbean state least affected by the epidemic, is being affected more
and more by the deepening inequalities and the explosion of prostitution.
Mortality
> infant: 6‰
HDI
> 0.817; ranked 52/177
PIB réel/habitant ($)
> nc
International delegation>
MdM Spain
Beneficiaries
> directly: 13,673,15
to 25 year olds
Staff
> expatriate: 1
Co-ordinators
> project: G. Robert
> field: I. Raud
> HQ: F. Stea, Y. Le Corgne
Sources de financement
> French Foreign Ministry, MdM,
Cuban partners
Budget
> 2005: 51,687 euros
Café Salud - HIV/AIDS prevention
Life expectancy
> at birth: 77.3
Centro Habana, Havana
Activities: The Café Salud project is aimed at preventing
HIV/AIDS and sexually transmitted infections (STIs) in the working-class areas of Centro Habana. It mainly targets 15 to 25
year olds, the group most affected by the epidemic in Cuba.
The project trains health promoters amongst young people
and they spread awareness, information and STD prevention
messages in the various districts. It is based on a reception
and activity centre, the Café Salud, which organises dynamic
epidemic prevention activities (theatre, karaoke, etc) and also
visits the different districts to raise awareness amongst the
whole population of Centro Habana. The Cuban public health
partners associated with the project are involved in the programmes so that it can continue in the long term.
01/02/2004
31/03/2005
> Project
progress
Outlook:
• Consolidate information,
education and communication activities in Café Salud
by reinforcing the promoters'
training.
• Make the project ongoing
by supporting the Cuban
partners already involved in
running Café Salud.
• Attempt to reproduce the
project in other provinces in
the country in partnership
with the health authorities.
58/59
Dominican Republic
The economic situation in Dominican Republic remains inconsistent and, although indicators are encouraging overall, the recovery has not had the expected effect on living conditions in the country. Politically, the serious crisis of its Haitian neighbour continues to lead
to an influx of illegal immigrants, who are taking refuge in the Dominican mountains under
the sometimes hostile eyes of the local population, and are very often in need of emergency
healthcare.
Mortality
> infant: 29 ‰
Bahoruco
Activities:
The programme aims to give access to
primary healthcare to the isolated Haitian population
living and working in the coffee growing areas of Bahoruco. It
involves training community health technicians (CHTs), giving
health education to leaders of the groups of sugar cane cutters, carrying out medical consultations and, finally, training
and developing a young people's theatre group as part of
HIV/AIDS prevention work.
01/2005
12/2005
>
Project
progress
Outlook:
MdM is withdrawing but is in
contact with several local
institutions, including the
Catholic Church and the
Dominican health authorities.
Promoting fundamental rights
Life expectancy
> at birth: 67.2
HDI
> 0.749; ranked 95/177
> 1.893
> MdM Espagne
Beneficiaries
> directly: 12,000 à 20,000
Staff
> local: 4
> expatriate: 1
Co-ordinators
> project: S. Châlons
> field: A. Nombela
> HQ: F. Stea, Y. Le Corgne
Sources of funding
> Catholic church and Actmon
locally, MdM
Budget
> 2005: 77,322 euros
DRC
After the pillaging of 1992, which led to the collapse of all public structures, this vast
country with impressive mineral wealth has been through two wars since 1996. This
is the largest humanitarian crisis since the Second World War: nearly 4 million
Congolese have died from common illnesses (malaria, diarrhoeic illnesses, measles, etc)
through lack of access to care in this widespread climate of insecurity; 20 million are
Mortality
> infant: 129‰
Life expectancy
> at birth: 43.1
HDI
> 0.385; ranked: 167/177
> 107
Beneficiaries
> directly: 43,200
Staff
> expatriate: 1
> expatriate rear base: 3
Co-ordinators
> project: F. Jacquet
> field: P. Sallah
> country: A. Talibo
> HQ: C. Courtin
Sources of funding
> Global Fund/UNDP, Dutch
Foreign Ministry, MdM
Budget
> 2005: 494,149 euros
malnourished. After three years of prevarication, the international community has been
mobilised in a big way to support the political transition through the United Nations' largest peacekeeping mission, which should make the next elections safe.
Programme for an integrated fight against HIV
Goma
Activities: The work aims to respond in an integrated
way to the AIDS epidemic in the eastern region of the
Democratic Republic of Congo which has been particularly
affected by the war. The activities are as follows:
• strengthening the capacities of those involved in local
institutions and in civil society in the fight against HIV,
strengthening co-ordination between the different parties;
• supporting social involvement and prevention activities;
• running three sexually transmitted infections treatment
services;
• running a voluntary, anonymous and free screening centre;
• running a treatment service for HIV-positive patients; medical and psychosocial monitoring, prevention and treatment of
opportunistic infections, access to antiretroviral drugs.
01/08/2003
31/07/2006
> Project
progress
Outlook:
Continue the activities
that have been started and
developed in order to
consolidate them.
60/61
Supporting street children
Beneficiaries
> directly: 2,500
Kinshasa
Activities: the programme is pursuing its objectives which
Outlook:
are to reintegrate and resocialise street children through:
• quality reception in a specialist centre: Pekabo;
• psychosocial support, educational activities (educational theatre: Tam-tam), reintegrating children into families, PHC. MdM is
extending its programme on STIs/AIDS amongst vulnerable children and especially street girls, through treating STIs and HIV
prevention. We are strengthening our networking with all the
child reintegration organisations working at the same time on
the fight against HIV/AIDS.
As well as continuing our current activities, organise night
visits for educators, extend the
STI/AIDS programme
amongst street children, make
the Pekabo reception centre
autonomous, and strengthen
the partnership with Africare
(make the network dynamic,
design work tools to deal better with the healthcare and
reintegration of street children
in DRC).
01/01/2004
31/12/2006
>
Project
progress
Kalemie and Kongolo - North Katanga Province, Tanganyika Province
01/01/2005
31/12/2005
> Project
progress
Co-ordinators
> project: D. Cannet
> field: N. Beaulieu
> country: X. Joubert, A. Talibo
> HQ: C. Courtin
Sources of funding
> Paris city council, French Foreign
Ministry
Budget
> 2005: 405,606 euros
Partnership
> Africare
Fighting against epidemics
Activities: Reacting to epidemic emergencies (cholera, measles, meningitis and shigellosis) is effective, and especially the prevention of cholera involving chlorinating water supply points in
Kongolo and Kalemie thanks to local chlorine production. This
novel activity was developed through a joint venture with a Swiss
company who supplied the equipment needed. The process has
been extended successfully to Kalemie.
The early warning system is in operation.
The curative treatment of cases is provided by cholera treatment
centres in Kongolo and Kalemie and in the health centres of Kalemie
health area, mainly thanks to staff training and the regular supply
of the necessary inputs.
Staff
> local: 35
> expatriate: 1
Outlook:
In the long term, continue to
develop the preventive and
curative activities so that
morbidity and mortality rates
improve for the epidemic diseases being monitored,
thanks especially to close
monitoring and the provision
of the necessary inputs.
Beneficiaries
> directly: 258,537
Staff
> local: 359
> expatriate: 9
Co-ordinators
> project: A. Thiriat
> field: K. Touré (Kongolo then
Kalemie), G. Kouplo (Kongolo)
> pays: X. Joubert, puis A. Talibo
> HQ: C. Courtin
Sources of funding
> MdM own funds (Kongolo:
response to epidemics) and
ECHO (Kalemie: “epidemics”
programme integrated with PHC)
Budget
> global 2005: 1,745,007 euros
(PHC programme Kalemie and
improvement of the Kongolo health
situation)
DRC
Beneficiaries
> directly: 180,000
Staff
> local:175
> expatriate: 4
Co-ordinators
> field: K. Touré
> country: X. Joubert
> HQ: C. Courtin
> ECHO 100%
Budget
> 2005: 849,457 euros
+ 53,748 euros allocated to the
fight against epidemics
Beneficiaries
> directly: 78,537
Staff
> local: 44 paid staff and
140 subsidised staff
> expatriate: 5
Co-ordinators
> field: K. Touré
> country: X. Joubert
and A. Talibo
>HQ: C. Courtin
> ECHO 100%
Budget
> 2005: 878,309 euros
Providing access to quality healthcare
Kongolo (North Katanga)
Activities: As part of community involvement, the project
Outlook:
aims to provide access to quality healthcare in 25 health
centres and 5 advance health posts in Kongolo area. Five
aspects are being developed:
• setting up a minimum set of activities in health training
responding to national PHC standards;
• providing essential drugs, consumables and equipment;
• strengthening the capacities of the area's central office;
• training health centre staff;
• epidemiological monitoring and fight against epidemics
including cholera.
Develop current activities
through strengthening existing work and as a stronger
response to epidemics and
treatment of STIs (sexually
transmitted infections)
01/01/2005
31/12/2005
> Project
progress
Developing medical services
Kalemie (North Katanga)
Activities: As part of this project, MdM is organising:
Outlook:
• the signing and implementation of a memorandum of understanding with the health authorities;
• light renovation/equipping and restoration of the technical side
of functional health structures;
• building and equipping of two health centres with the involvement of the population in the villages of Mulange and Fatuma
(Kalemie health area);
• monthly supply of mosquito nets treated with insecticides and
of drugs;
• replenishment of traditional midwives' kits;
• supervising activities to monitor the quality of healthcare, health
centre performance, and staff development with respect to rational instructions and treating cases;
• a workshop for monitoring health activities in the two health
areas each quarter;
o supplying screening tests, consumables for transfusions and
equipment for use in the fight against HIV.
Develop current activities by
strengthening existing work
and as a stronger response
to epidemics.
01/02/2005
31/12/2005
> Project
progress
62/63
Egypt
The Egyptian government's economic policy, despite being acclaimed by the World
Bank, cannot hide the social divisions within the country. Although the authorities and
civil society are more aware of the problem, a large number of women and children,
often thrown onto the street, are in effect deprived of access to care for social, economic or cultural reasons. The number of street children in Cairo is still unknown and
there is a worrying increase in the number of young mothers living on the street with
on a permanent basis.
Promoting reproductive health
Cairo
Activities:
Project supporting the Egyptian NGO Hope
Village to set up a reception and reintegration centre as well
as a mobile unit for young pregnant girls and adolescent
mothers living on the street.
The activities are aimed at organising and providing:
• training sessions on reproductive health;
o psychological support for Hope Village staff and for the young
girls taken in by the pilot centre;
• partnerships with the public hospitals;
• information, education and communication (IEC) sessions
on reproductive health for girls and boys taken in by the centre, as well as for street children leaders, the organisations
working with street children and traditional midwives;
• integrating MdM in the Street Children network to share and
communicate with the NGOs of the Street Children network.
Outlook:
Continue the project, which
effectively started in August
2005 after a six months'
pilot project.
their babies, while there are not enough reception structures to monitor these people
Mortality
> infant: 33‰
Life expectancy
> at birth: 69.8
HDI
> 0.659; ranked 119/177
PIB réel/habitant ($)
> 1,220
Beneficiaries
> directly: 800 young girls and 3,600
children, 150 medical staff, social
workers and psychologists.
> indirectly: 110,000 young girls
and 3,000 children
Staff
> expatriate: 2
> local: 6
Co-ordinators
> project: R. Heimann,
M.-A. Silicani
> field: I. Bruand
> HQ: S. Alary
01/08/2005
31/07/2008
> Project
progress
Sources of funding
> Drosos Foundation, MdM
Budget
> 2005: 35,625 euros
Ethiopia
With a population of 70 million inhabitants, Ethiopia's health indicators are far below the
average for Sub-Saharan Africa. The lack of specialist doctors and surgeons outside the
capital means access to surgical care is extremely low in the rural areas of the country
where 85% of the total population of the country actually live. A major proportion of maternal mortality is due to this shortage.
Life expectancy
> at birth: 47.6
HDI
> 0.367; ranked 170/177
> 97
Beneficiaries
> directe project 1: 179,000
> directe project 2: project 2: 200
HIV-positive mother-child pairs,
4,000 pregnant women
> indirecte project 1: 4,000,000
> indirecte project 2: 140,000
Staff
> expatrié project 1: 5
> expatrié project 2: 1
Co-ordinators
> mission project 1: G. Pascal
> mission project 2: M. Saada
> field 1: O. Evreux
> field 2: M. Gatumo,
O. Evreux
> siège projects 1 et 2: O. Mouzay
Sources de financement
> project 1: UNFPA
> project 2: French Foreign Ministry,
MdM, GSK Foundation,
Felissimo, Sternstunden
Budget
> 2005 project 1: 330,545 euros
> 2005 project 2: 176,808 euros
Surgery
Mortality
> infant: 112‰
Tigray/Axum
Activities: Having trained an operating theatre team, and a
Outlook:
health officer and anaesthetist nurse to provide emergency surgery,
we are transferring our training activities to Axum, where needs
are greater. Our work has 3 aspects:
• transfer of knowledge in surgery and obstetrics;
• training full operating theatre teams to work in peripheral health
centres;
• access to care for the most destitute people. This work is mainly
aimed at general emergency surgery and caesarian sections, to
reduce mother and child mortality and obstetrical trauma.
The first training session (3 teams) was completed at the end of
February 2006.
Training of teams, in conjunction
with trainers from Tigray, must
be continued for two years. A
new session started in March
2006 for nine months. The integration of the first session in
three health centres will be carried out with support from
MdM. This year MdM will look
at the possibility of an Ethiopian
team it has trained becoming
trainers.
01/10/2004
30/09/2007
> Project
progress
Preventing mother-to-child HIV transmission
Mekele
Activities: This project is based on seven aims:
Outlook:
• preventing mother-to-child transmission;
• training counsellors for screening centres, transfer of knowledge to the Mekele medical staff (one hospital and three health
centres);
• setting up an integrated voluntary HIV screening unit as part
of antenatal consultations;
• raising awareness amongst the community of HIV infection,
mother-to-child transmission, and its prevention;
• gradual rebuilding of the maternity unit;
• supplying drugs, consumables and equipment;
• advice and practices on infant feeding.
Changes in health policy in
Ethiopia mean ARV treatments can now be used and
they are available free of
charge at Mekele hospital.
The plan is to continue awareness, training and monitoring activities following this
initial phase.
01/08/2003
31/07/2006
> Project
progress
64/65
Georgia
Two years after the “Rose Revolution”, Mikhael Saakashvili is struggling to keep his
promises of change: Georgia is a poor state, with no energy resources and, despite
notable economic growth due to an energetic struggle against corruption, 52% of the
population still live below the poverty line. A health system reform has been started
Help for reproductive health
Mingrelia Region
Activities: Having assessed the needs, MdM decided to run
Outlook:
its reproductive health project in four districts of Mingrelia Region.
The project has several aspects:
• renovating health structures;
• providing medical equipment, drugs and consumables;
• setting up stock management systems;
• training medical staff: monitoring pregnancies, neonatal resuscitation, pregnancy-related diseases, etc.;
• improving data collection and epidemiological monitoring;
• improving therapeutic protocols and the referral system.
MdM is continuing its activities
in Mingrelia region and plans
to extend its project into
Abkhazia region.
09/04
08/2006
> Project
progress
but it is still quite muddled.
Mortality
> infant: 41‰
Life expectancy
> at birth: 70.5
HDI
> 0.732; ranked 100/177
> 778
Beneficiaries
> directly: 4,414
Staff
> local: 17
> MCH: 1
> expatriate: 2
Co-ordinators
> project: H. Lepoivre, I. Hermant
> field: S. Rogic
> HQ: A. Landaes
Sources of funding
> ECHO, MdM
Budget
> 2005: 453,244 euros
Guatemala
A country characterised by political instability, economic crisis and social and ethnic violence, at the end of the 1980s Guatemala decided on a method of economic development
integrated in the globalisation process within the new international division of labour, one of
whose main characteristics is getting an increasing number of women into work, especially in the factory sector.
Life expectancy
> at birth: 67.3
HDI
> 0.663; ranked 117/177
> 2,009
Beneficiaries
> directly: women from
Assessing the health of working women
Mortality
> infant: 35‰
Chimaltenango
Activities: Carrying out an assessment of the health of women
Outlook:
working in the factories and agricultural export businesses in the
town of Chimaltenango:
• field surveys, workplace visits, institutional contacts;
• carrying out medical consultations on the theme of women's
health/work;
• partnership with Guatemalan organisations working in the economic and social rights sector on prevention activities concerning
women's health and labour rights.
At the end of this assessment
work, in 2006 a three-year project will be set up on “women's
accessibility to healthcare in the
context of globalisation” in
Chimaltenango.
Chimaltenango
> indirectly: Guatemalan women
Staff
> expatriate: 1 doctor, 1 nurse
and 1 occasional administrator
Co-ordinators
> project: A. Baas
> field: C. Cipolla
> follow-up: RD PACA (I. Malaval)
Sources of funding
> PACA regional council, MdM
Budget
> 2005: 36,860 euros
24/01/2005
31/07/2005
> Project
progress
66/67
Guinea
In spite of ill health, President Conté continues to control the political chess board. In
March 2005, he carried out an extraordinary ministerial reshuffle, and the general economic situation remains dominated by hyperinflation and the impoverishment of the population. Human rights and fundamental freedoms are not respected. Living conditions are
extremely harsh, especially in prisons where sanitary and hygiene measures are repeatedly ignored and poor treatment is commonplace. The number of daily deaths continues
Improving health in prisons
Kindia
Activities: Kindia central prison houses around 200 inmates
Outlook:
living in very harsh conditions.
Since 2001, MdM has been supporting Kindianaise d'Assistance
aux Détenus (KAD, or Kindia Support for Prisoners), a Guinean
organisation made up of volunteers working directly in the prison
to improve health and hygiene. There are several aspects to their
work:
• training a prisoner in nursing care and running a pharmacy inside
the prison;
o a partnership with the health authorities to treat the most serious
cases in Kindia hospital;
• nutritional support for those suffering from malnutrition;
• renovation of health infrastructure;
• literacy work amongst prisoners;
• income-generating activities (sewing, weaving).
These activities are vital for improving prison conditions. As well as
the income they generate, for the prisoners they are the equivalent
of a regular job, acquiring skills and simply a regular outing from
their cells.
A major issue for 2006 is to
increase the income-generating activities begun in 2005.
There are two objectives: to
help KAD's financial autonomy
(by releasing local resources),
and to facilitate the reintegration of inmates when they
leave prison.
2000
fin 2006
> Project
progress
In 2006, MdM will help KAD to
launch new activities such as
making rattan furniture, as the
sewing and weaving activities
are proving successful.
to increase.
Mortality
> infant: 104‰
Life expectancy
> at birth: 53.7
HDI
> 0.466; ranked 156/177
> 459
Beneficiaries
> directly: approx 200 prisoners
(mixture of men, women and children)
Staff
> local: a Guinean charity
(Kindianaise d'assistance
aux détenus)
Co-ordinators
> project: P. Boucourt et T. Comte
> follow-up: RD Rhône-Alpes
Burgundy (S. Bret)
Sources of funding
> private partnerships, MdM
Budget
> 2005: 17,919 euros
Haiti
The postponement of the presidential and legislative elections to January 2006 has prolonged the climate of uncertainty and insecurity which has poisoned the country's political, economic and social life since the departure of President Aristide, in March 2004. With
a background of violence, Haiti continues to face enormous poverty. The health risks linked to lack of access to healthcare and the destitution of the population are still very great.
Caring for victims of violence
Mortality
> infant: 76‰
HDI
> 0.475; ranked 153/177
> 346
International delegations
> MdM Canada, MdM Switzerland
Beneficiaries
> directly project 1: 512 Haitian professionals
> iindirectly project 1: the victims of
violence
Port-au-Prince
Life expectancy
> at birth: 51.6
Activities: The programme aims to reduce the impact of
violence on individuals and promote the multi-disciplinary
care of victims by Haitians (health, justice system, communities). It is based on:
• training healthcare staff in 20 health structures in Port-au-Prince,
provided by MdM's team of trainers working in the intervention,
rehabilitation, research and expertise centre for victims of violence;
• training doctors and lawyers in giving expert forensic opinions
to contribute to the legal recognition of victims of violence;
• supporting URAMEL, MdM's Haitian local partner which is
fighting against impunity and for the construction of a state subject to the rule of law;
• strengthening capacity to deal with victims and to collect reliable data from at least 20 health structures.
01/12/2003
Co-ordinators
> project 1: A. Urtubia
> project 2: S. Lasserre
> field 1: M. Desmousseaux
> field 2: B. Deveaux
> HQ 1 and 2: M.-Y. de Penanster-
Grande-Anse Region
Sources of funding
> project 1: French Foreign Ministry,
MdM
> project 2: UNDP, MdM
Budget
> 2005 project 1: 301,359 euros
> 2005 project 2: 242,182 euros
MdM wishes to strengthen the
capacity and quality of the effective treatment of vicims of violence by working specifically in
seven health structures in and
around the main shanty towns
of Port-au-Prince. This work is
based on the work already
done in the current programme
and on close collaboration with
the health authorities and those
in civil society engaged in promoting the rule of law in Haiti.
Staff
Rosny, Y. Le Corgne
Outlook:
31/12/2005
> Project
progress
Revitalising the health system
Activities: Renovating and revitalising five clinics and one
health post to improve accessibility, quality of care and institutional management:
• training healthcare staff;
• mobilising and training communities to take part in the health
system;
• providing drugs and medical equipment;
• improving the health information system;
• renovating health structures;
• supporting the health authorities.
01/06/2004
01/04/2006
> Project
progress
Outlook:
The project meets specific
needs to update health centres which are not working
well.
There is a pressing need for
training in all the area's health
structures.
This work will be extended to
other health centres to provide
real health coherence in the
area.
68/69
Promoting health through hygiene
Grande-Anse Region
Activities: The general objective is to reduce the mortality
Outlook:
and morbidity rates caused by faecal related illnesses in
Roseaux district and to increase the coverage of latrines from 0 to
28% in eighteen months. Various objectives and activities are being
pursued by MdM: mobilising and raising awareness in the community, training benefiting families in how to use and maintain the latrines, supporting health committees, building latrines and carrying out
home visits. Lastly, MdM is making families aware of the problem of
deforestation by replanting trees with them for each latrine built in the
residential area.
Considerable community participation means that this project
will be able to continue. After
three years, it is reported that
99% of the latrines are used
and maintained. Requests
from other neighbouring districts or communities not yet
covered in Roseaux district
make us believe that there is a
real prospect of reproducing
this action locally.
01/07/2004
31/12/2005
> Project
progress
Training healthcare staff
Activities: Project supporting Pilate hospital, a semi-private insti-
Outlook:
tution run by Canadian nuns established in this area many years ago.
MdM's activity combines:
• a surgical project which sends a full team for fifteen days to carry
out around a hundred operations on patients selected by the nuns
throughout the year;
• a mother and child project via a malnutrition screening and treatment programme using health workers supervised by the nuns, and
by training officers, matrons and mothers;
• a psychiatric project training healthcare staff (nuns and nurses)
in the diagnosis and treatment of psychiatric illnesses.
Three projects are planned for
2006:
• in surgery;
• in psychiatry, for an extension
to Cap Haïtien;
• with a view to adapting the
mother and child project to
address the increase in malnutrition
Since 1980
> Project
progress
Staff
> local: 8
Co-ordinators
> project: S. Lasserre
> field: O. Naval
> HQ: M.-Y. de Penanster-Rosny, Y.
Le Corgne
Sources of funding
> EU, MdM
Budget
> 2005: 113,686 euros
Beneficiaries
> indirectly: 60, 000 inhabitants
Pilate
Beneficiaries
> directly: 8,400 (1,400 familles)
of Pilate spread over 157 km2
in 8 rural sections
Staff
> local: 31
> expatriate: 7
Co-ordinators
> project: C. Castaing,
P. Carbonnier
> follow-up: RD Aquitaine
Sources of funding
> MdM, Association of the friends
of Sister Madeleine, private donations
Budget
> 2005: 12,907 euros
Indonesia
In Indonesia, 240,000 people died or were reported missing as a result of the tsunami of 26
December 2004. It was the country most affected by the disaster, and the whole population
of Aceh province were hit hard with the destruction of medical infrastructure, a lack of healthcare staff, major population displacements and psychological suffering. The whole local health
system is being rebuilt. The Indonesian economy was weakened and 16 million households
still live below the poverty line. In addition, the AIDS epidemic is worsening fast especially
through the use of injectable drugs and prostitution, which are very widespread practices in
Mortality
> infant: 31‰
HDI
> 0.697; ranked 110/177
Actual GDP/inhabitant ($))
> 970
> MdM Spain, MdM Canada, MdM
Greece
Beneficiaries
> indirectly project 1: 40,000
Staff
>expatriate project 2: 2
Co-ordinators
> project 1: P. Gaillard-Olokose
> project 2: A. Bourdé
> field 1: A. Le Garnec
> field 2: V. Cauche
> HQ 1 and 2: V. Pardessus
Sources of funding
> project 1 Cordaid, MdM
> project 2: MdM
Budget
> 2005 project 1: 172,824 euros
> 2005 project 2: 19,498 euros
Life expectancy
> at birth: 66.8
Indonesia.
Preventing HIV/AIDS and STIs
Mulia, Puncak Jaya district, West Papua
Activities: The first phase of the project aims to reduce the pre-
Outlook:
valence of STIs and the incidence of HIV/AIDS by improving
the therapeutic treatment of STIs and the prevention of STI/HIV transmission in this district. 2005 was notable for prevention and social
involvement actions (the fight against the discrimination and stigmatisation patients are subject to). An evaluation of the programme carried out in September 2005 highlighted the decline in access to
healthcare mainly due to the decentralisation undertaken by the
government since 2002 and to the conflicts between independence
fighters and the army which prevent access to villages and prevent
healthcare workers from going there.
The first phase was completed at the end of February.
During the second phase, we
are going to refocus our programme on preventing infectious diseases and extending
the scope of our work to the
neighbouring sub-district subdistrict of Sinak.
01/08/2004
15/04/2009
> Project
progress
Caring for the marginalised population
Jakarta
Activities: MdMs work is aimed at helping the marginalised people of Jakarta. There are four aspects to the project:
• weekly medical consultations in partnership with the local NGO
Aulia;
• training Aulia's social workers and community health workers;
• setting up a referral system appropriate to this population;
• technical logistics assistance, fundraising and management of
the NGO partner Aulia.
05/2005
31/12/2008
> Project
progress
Outlook:
• Pursue access to primary
healthcare (especially for
women and under 5s) in
Jakarta's northern shanty
towns.
• Raise the population's awareness about prevention of the
predominant diseases.
• Strengthen Aulia's capacities
so that it can run its programmes autonomously.
70/71
Caring for the Punans
Kalimantan
Activities: The Punans, an indigenous Indonesian people, are lin-
Outlook:
ked to Malinau district, whose main town is experiencing major economic development (forestry exploitation) with negative consequences
for ecology, society and health. They have no access at all to primary
healthcare. The main health problems identified are malaria, respiratory diseases and high infant mortality.
We are involved in:
• mobile clinics lasting a month (3 times/year) in 4 sites;
• training 5 health workers from the Punan community for a week
before each medical project, with application on the field during the
project;
• support for the Adat Punan organisation, which represents
the interests of the Punans of Kalimantan.
• Continue medical consultations, in order to help improve
the Punans' health in three
years.
Aim: reduce the under 5s' mortality rate by 20%; it is estimated
to be 500‰.
• Planned theoretical and practical training of traditional matrons
by an experienced midwive and
community health workers (prevention of the predominant diseases).
• Recognition and protection of
the Punans' rights through the
Adat Punan organisation.
05/2004
31/12/2008
> Project
progress
Helping tsunami victims
Aceh Besar and Aceh Jaya districts (Aceh province / Sumatra)
Activities: After emergency work lasting three months following
Outlook:
the tsunami, during which MdM put a lot of effort into re-establishing access to primary healthcare for the population (permanent
and mobile clinics, vaccinations, nutritional and epidemiological
monitoring), the programme has developed around the following
focuses:
• getting the public primary healthcare system running again
in Aceh Besar and Aceh Jaya districts;
• rebuilding health structures: a district hospital (Lhoknga), two
dispensaries (Seulimeum and Jantho) and health centres;
• helping to get the internal medical service of Abidin hospital in Banda Aceh running again (supplying equipment and training teams of nurses);
• developing the treatment of psychological and psychiatric
problems (raising awareness and training medical staff in these
problems);
• reacting to emergencies (epidemics, natural disasters, etc) in
Sumatra (three week emergency project in Nias after the earthquake in March 2005).
In addition to substitution
work in the initial emergency
phase in the first months, it
is vital that we reorganise
and support local health
structures and healthcare
staff as they re-start their
medium-term activities.
Alongside the physical
reconstruction of buildings,
MdM is involved in training
and supporting medical staff
in order to guarantee access
to quality primary healthcare.
28/12/2004
09/2006
> Project
progress
Beneficiaries
> directly: 800
> indirectly: 9,000
Staff
> local: 12
> expatriate 1: 2 (based in Jakarta)
+ 2 doctors (occasional missions)
Co-ordinators
> project: R. Garrigue
> field: M.-L. Bry
> HQ: V. Pardessus
Source of funding
> MdM
Budget
> 2005: 11,822 euros
Beneficiaries
> directly: 30,000
Staff
> local: 20
> expatriate: 24
Co-ordinators
> project: P. Foldès
> field: V. Cauche
> HQ: Emergency desk
then E. Martinon
Sources of funding
> MdM, ECHO, territorial local
authorities
Budget
> 2005: 1,783,940 euros
Ivory Coast
The announcement of the appointment of Charles Konan Banny, hitherto the governor of
the Central Bank of West African States, to the post of Prime Minister, and the maintenance of the ceasefire by a major international military arrangement have given reason to
hope that the overall situation in the country will improve. But it remains divided in two: the
north, under the control of the New Forces, and the south, controlled by the loyalist forces. The social and economic situation is improverishing the population. In Abidjan, since
Life expectancy
> at birth: 45.9
HDI
> 0.420; ranked 163/177
GDP/inhabitant ($)
> 816
Beneficiaries
>directly: 2,500 street children
> indirectly: 25,000 children
and young people in great
difficulty
Staff
> local: 15 paid staff and
6 volunteers
Co-ordinators
> project: J. Martin
> field: K. Kouassi
> HQ: C. Courtin
Source of funding
> MdM
Budget
> 2005: 81,422 euros
the departure of a significant number of Europeans, economic activities have collapsed,
Mortality
> infant: 117‰
leading to disastrous unemployment and just as disastrous living conditions for under-age
children living on the streets.
Protecting street children
Abidjan
Activities: MdM has been working with minors since 1996.
The current project has three objectives:
• the protection and resocialisation of street children
and minors in prison;
• access to primary healthcare;
• support for a local NGO: MESAD, Movement for
Education, Health and Development.
Its work involves
• a process for resocialising children through street work,
accommodation in a reception centre, psychosocial monitoring, support for professional integration and schooling, and
re-establishing family contacts;
• offering primary healthcare to children on the street and support for medical treatment at the Treichville health centre;
• work amongst minors in Abidjan prison with the aim of improving their living conditions, providing physical, psychological
and legal protection for minors deprived of freedom, facilitating their reintegration on leaving prison;
• specific STI/HIV prevention activities.
Since July 2003
> Project
progress
Outlook:
With financial assistance from
Médecins du Monde, the
local NGO MESAD is continuing work developed by
MdM between December
1996 and June 2003.
Since July 2003, the local
NGO has been seeking funding to ensure it can provide
the full programme. The
country's instability does not
encourage funders to fund
such programmes.
72/73
Allowing access to healthcare
Beneficiaries
> directly: 120,000
Seguela
Activities: This post-emergency programme is aimed at pro-
Outlook:
viding support for the Seguela regional hospital which is in
a “rebel-held area”. The region is suffering from a breakdown in
the supply of drugs, especially as most senior medical staff have
left for the south. Thanks to supplies of drugs, small medical
equipment and to expatriate surgical teams (surgeons and anaesthetists), the Regional Hospital has been able to start working
again.
A new project in another
hospital is now being developed but will depend on how
the crisis develops and on
political stabilisation, vital
conditions for activities restarting throughout the country, and especially for receiving supplies of drugs and
medical staff returning to
their posts.
12/2002
05/2005
> Project
progress
Access to surgical and obstetric care
Touba
Activities: This post-emergency programme is aimed at
Outlook:
providing surgical support to Touba hospital in a “rebel-held
area”, cut off from the rest of the country since the disturbances of September 2002. Treatment of trauma and obstetric emergencies does not exist and most qualified senior
medical staff have left for the southern area.
MdM's involvement in providing specific drugs and small medical equipment and in renovating the operating theatre and surgery department, should allow local staff still in the area to
work in good conditions. The presence of an expatriate team
made up of an anaesthetist, doctor, logistician and administrator has allowed the hospital to re-start a minimum of its activities interrupted during the conflict. Working with local and
institutional staff, these activities should allow better care of
pregnant women and the injured, in the hospital as well as in
the supported health centres.
As the minimum operating
conditions required had not
been met due to lack of collaboration between the head
doctor and the nurses, the
project was terminated as of
31 December 2005.
14/09/2005
31/12/2005
> Project
progress
Staff
> local: 49
> expatriate: 3
Co-ordinators
> project: A.-J. Pocheron
> field: Luc Malingreau
> HQ: C. Courtin
Source of funding
> ECHO
Budget
> 2005: 154,806 euros
Beneficiaries
> directly: 4,500
Staff
> local: 10
> expatriate: 5
Co-ordinators
> project: A.-J. Pocheron
> field: L. Malingreau
> HQ: C. Courtin
Source of funding
> MdM's own funds
Budget
> 2005: 117,090 euros
Kosovo
The negotiations on the final status of Kosovo, which remains a province of Serbia and
Montenegro under international administration, are continually being postponed, whereas
inter-ethnic tensions remain high. Serbs and Albanians still have diametrically opposing
views on Kosovo's future status. The Serbs are unlikely to accept more than wide autonomy for the province, whereas the Albanians, who make up over 90% of the population, are
demanding independence. Socially, unemployment has reached 60%, and 65% of the
Mortality
Life expectancy
HDI
> No specific data for Kosovo
> MdM United States
Beneficiaries
> directly project 1:
+/- 250,000 young people
> > directly project 2:
between 70 and 100 people/day
> indirectly project 1: +/- 1 million
under 24s living in Kosovo province
Staff
Co-ordinators
> project: M. A. Chaud
> mission projet 2: P. Dupin
> field: G. Alliu
> follow-up project 1: DR PACA
> follow-up project 2: DR PACA
Sources of funding
> project 1: PACA local authorities,
MdM United States
> project 2: MdM
Budget
population live below the poverty line.
Listening to young people
Prishtina
Activities: MdM's project is aimed at health prevention amongst
young people aged between 13 and 24. It is run in partnership with Kosovo's Culture, Youth and Sports Ministry and a local
NGO (Vita Kosova). Its aim is to set up a reception centre for
young people which would be a place of welcoming, listening,
information, consultation and orientation. Direct (individual psychological support, integration in a treatment network, etc) and indirect assistance (training for youth organisations on the identified
health topics, and ongoing training of the young people's listening point team) is given.
Since 2004, the project has been sponsored by Salon-deProvence's 'Espace Santé Jeunes'.
2003
2006
Outlook:
At the same time as supporting the ministry in its first
year of financial commitment
to the programme, MdM
expects, on the one hand,
to develop activities outside
the centre and to promote
the Dëgjo Rininë Centre and,
on the other hand, to develop the local NGO Vita
Kosova in its role as programme manager.
> Project
progress
Improving oral health
Gllogovc
Activities: MdM's project aims to improve oral health in this
region through:
• installing two complete dental surgeries at the Gllogovc health
centre;
• training local practitioners in new dental care techniques.
The project ended in 2005 with an information activity in neighbouring schools on oral hygiene.
2004
2005
> Project
progress
Outlook:
Equivalent work in the Serb
enclave of Hocë e Madne.
74/75
Lebanon
Shaken by the assassination in February 2005 of former Prime Minister Rafik Hariri, which
led to the rushed withdrawal of Syrian troops, Lebanon remains an area of tensions. The
country is a genuine crossroads; it houses hundreds of thousands of foreign workers and
forms a transit place for people fleeing wars and dictatorial regimes in the Near East.
Lebanon has not signed the Geneva Convention of 1951 and still refuses to be a reception country. Migrant workers, refugees and asylum seekers are strongly discriminated
conditions.
Access to care for imprisoned migrants
Beirut
Activities: At the beginning of 2005 MdM started work in
Outlook:
Roumieh central prison in partnership with the Lebanese NGO,
Ajem. The work involves the following activities:
• welcoming new foreign inmates with welfare assistance, directing them towards the medical team and the welfare and legal
care organisations (including Ajem);
• medical triage in the wings;
• medical consultations three times a week and monitoring of
patients;
• welfare and legal follow-up;
• rehabilitation and supplying health equipment,
distribution of blankets and hygiene products;
• information sessions for prisoners, communicating IEC (information, education and communication) programmes/ sessions
on scabies and hygiene.
Continue the programme in
2006: start activities focused
on training and health education in other Lebanese prisons; set up information and
awareness activities on
imprisoned migrants' access
to rights amongst the
Lebanese authorities and
the general public.
10/01/2005
31/12/2008
> Project
progress
against and are often arbitrarily imprisoned; they suffer from extremely precarious living
Mortality
> infant:27‰
Life expectancy
> at birth: 72
HDI
> 0.759; ranked 81/177
> 4,224
Beneficiaries
> directly: at least 4,000 people
(already in prison or recently entering
prison) at Roumieh central prison.
> indirectly: approx. 5,500 Lebanese
prisoners in Roumieh prison, the
medical and non medical prison staff
at Roumieh, local teams, project
partners
Staff
> local: 8
> expatriate: 2
Co-ordinators
> project: B. Lambert
> field: F. Mawazini puis B. Martin
> HQ: S. Alary
Sources of funding
> French Foreign Ministry, UNHCR,
MdM
Budget
> 2005: 170,763 euros
Liberia
Liberia is emerging from a fourteen year conflict which has cost 250,000 lives, caused the
displacement of half the population, and completely devastated social and cultural life as
well as the infrastructure and economy. The ceasefire agreement, signed in 2003 by the
different factions, and the deployment of a civilian and military mission by the United
Nations have engaged the country in an attempt at peace and reconstruction, consolidated by a national programme to demobilise and disarm the former fighters. The presidential elections held in October 2005 are a crucial step towards the political stabilisation of
Mortality
> infant: 152‰
HDI
> not known
> 192
Beneficiaries
> directly: 124,678
Staff
> expatriate: 10
Co-ordinators
> project: P. Hirtz
> field: S. Pont Turco
> HQ: Emergency desk then project
transferred to Africa desk: B.
Contamin, A. Belaid
Sources of funding
> Echo, German and Dutch Foreign
Source: World Bank Report 2003
Life expectancy
> at birth: 46.8
the country and, for the international community, are an important challenge to make this
transition towards full and lasting autonomy successful.
Primary, community
and mental healthcare
Gbarnga, Bong province
Activities: In Bong county, MdM is training and supporting
Outlook:
national healthcare staff from 9 health centres in the following
activities:
• consultations in primary and reproductive healthcare including STI prevention;
• epidemiological surveillance (malaria, cholera, etc) and nutritional monitoring especially for under 5s;
• vaccination services;
• transferring emergencies towards referral hospitals.
MdM is also setting up psychological and psychiatric support
services for women and girls who have been the victims of
sexual violence.
In 2006, MdM plans to open
a 10th health centre,
Jorwah, on the Guinea border which will offer the same
primary healthcare services.
MdM also wants to be more
actively involved in addressing sexual violence against
women
(SGBV, sexual gender based
violence) in Liberia.
Ministries
Budget
> 2005: 1,065,691 euros
09/2003
poursuite du programme en 2006
> Project
progress
76/77
Mali
Mali is one of the transit countries for the migrant populations of Sub-Saharan origin
heading towards Europe. Its immigration policy allows nationals from other African
countries to enter the country without a visa. In addition, it is to Mali that the Algerian
authorities return illegal migrants apprehended on their territory. Women are subject to
the full force of the poor health conditions and the difficulty of accessing healthcare.
Therefore, the high maternal mortality rate (580‰) can be explained by the consequences of vesico-vaginal type fistulas.
Health watch amongst migrants
Tinzaouatene, then Gao
Activities: Started in September 2005, the pilot project aims
Outlook:
to set up a programme aimed at improving the health and welfare
conditions of the migrant populations in transit through Mali and
to bear witness to rights violations by:
• observing the living conditions and trajectories of the migrant
populations in transit;
• evaluating the conditions for migrant populations whereby they
have access to healthcare in Tinzaouatene and Gao regions;
• developing an information network and gathering testimonies of
violations of which the migrant populations are victims.
End the pilot project after
defining a suitable long-term
programme.
Mortality
> infant:122‰
Life expectancy
> at birth: 47.9
HDI
> 0.333; ranked 174/177
> 371
> MdM Belgium
Beneficiaries
> directly project 1: not defined
because pilot project
> directly project 2: women victims
of vesico-vaginal fistulas
09/2005
02/2006
>
Staff
Project
progress
Surgery of exclusion
Mopti Region
Activities: MdM is continuing its programme of prevention
Outlook:
and treatment of vesico-vaginal fistulas. This has four aspects
to it:
• surgical treatment of women;
• training local surgeons and the operating theatre team;
• spreading prevention messages (on local radio, through
theatre);
• literacy sessions for patients who want it.
Continue training surgeons and
a gynaecologist in fistula surgery
and set up a national project for
treating vesico-vaginal fistulas
integrating the work carried out
by Mopti hospital.
Support the growing autonomy
of Mopti hospital until the new
hospital is built in Sevare.
12/1999
06/2006
>
Project
progress
Co-ordinators
> project 1: D. Guerroudj
> project 2: J.-M. Colas
> field 1: A. Grousset
> field 2: J.-M. Zino
> HQ project 1: O. Mouzay
> HQ project 2: O. Mouzay
Sources of funding
> project 1: MdM
> project 2: MdM, Norwegian church,
AED
Budget
> 2005 project 2: 109,160 euros
Madagascar
Great poverty remains the lot of a large majority of Madagascans. Despite annual economic growth of 6% and debt cancellation in June 2005 by the G8, Madagascans
continue to fight for their survival. Awareness of HIV is still insufficient, and the number of people affected continues to grow. The obvious insufficiency of medical and
surgical care and difficulty accessing it are making an already alarming situation
Mortality
> infant: 78‰
Life expectancy
> at birth: 55.4
HDI
> 0,499; ranked 146/177
> 324
Beneficiaries
>directly project 1: local team from
NGO Sisal (7 people)
> directly project 2: at-risk groups
(1,200 sex workers, mining prospectors,
young people in or out of school and
Salfa Centrre consultants
> indirectly project 1: groups at risk
of STIs/HIV/AIDS and the general
population of Tulear
> indirectly project 2: 25,000 people
Staff
> local project 1: Sisal team
Co-ordinators
> project 1: C. Ottenwaelder,
C. Vichatzky
> project 2: C. Vichatzky
> field 1: X. Joubert
> field 2: Ben Aboubacar
> HQ project 1 and 2: O. Mouzay
Sources of funding
> project 1: MdM
> project 2: MdM, AFD
Budget
worse.
STI/AIDS prevention and education
Tulear
Activities: The joint venture between Sisal and MdM involves
Outlook:
technical support defined by the following activities:
• evaluating and supporting human resources and monitoring
the development of the Tulear centre. Training is also given;
• supporting and mentoring Sisal managers (national co-ordinator, technical manager, administrative and financial manager);
• providing group training and staff retraining;
• providing support for Sisal's institutional capacity;
• improving management skills
The Sisal team in Tulear has
done a good job in taking
over the centre and in developing the planned programme.
MdM will withdraw support at
the beginning of 2006 and will
thus allow Sisal to confirm its
autonomy. However, MdM
and Sisal will continue to work
together as privileged partners
in the fight against STIs/HIV in
Madagascar.
02/2004
02/2006
> Project
progress
Integrated project to fight against STIs/HIV/AIDS
Ilakaka
Activities: After a KAP survey and prior training of the Salfa
(Madagascan NGO) team, the activities will be as follows:
• IEC (Information, education, communication) and close
work amongst at-risk populations;
• prevention, screening and treatment of STIs;
• voluntary, anonymous and free HIV testing and treatment of
people living with HIV;
• strengthening local capacity in the fight against STIs/HIV/AIDS.
12/2004
12/2006
> Project
progress
Outlook:
MdM plans to provide technical support for 24 months,
after which MdM should
withdraw from the project
78/79
Support for health in prisons
Beneficiaries
> directly: 800 prisoners
Ambanja and Antsiranana
Activities: This programme is considered as a pilot project, as
Outlook:
this is the first time MdM has got involved in prison work in
Madagascar. The reference plan has six complementary aspects
in order to act on the many factors behind poor prison conditions:
• medical;
• nutritional;
• rehabilitation;
• sanitation (in partnership with the Swiss NGO Medair, with whom
MdM worked after the Gafilo cyclone);
• welfare and legal;
• co-ordination and continuation of the activities to ensure the
effectiveness of the aforementioned aspects.
Extend the pilot project to a
regional programme, by initiating and developing this project in other prisons.
Staff
> expatriate: 1 national co-ordinator
Co-ordinators
> project: S. de Carheil
> field: O. Bouron
> HQ: O. Mouzay
Sources of funding
> MdM, French embassy
Budget
> 2005: 91,114 euros
09/2005
08/2006
> Project
progress
Childhood Action, cardiopathy in children
Antananarivo
Activities: A team from Reunion made up of 2 heart surgeons, 2 paediatric cardiologists and 1 anaesthetist and resuscitation expert carry out 2 visits each year to Soavinadriana
hospital in Antananarivo. Each visit lasts a week. There are 3
aspects to the team's activities:
• consultations which in 2005 involved 454 patients, including
191 new cases, 15 cases of closed-heart surgery and 74
cases of open-heart surgery (medical evacuation).
• surgery, where MdM's surgeons in conjunction with Professor
Hubert Razafindramboa's local team carry out closed-heart
operations. 20 operations were carried out in Antananarivo
and 11 at the regional Félix Guyon Hospital in Saint-Denis,
Reunion, for the open-heart operations;
• skills transfer, which involves training a Madagascan heart
surgeon in Reunion and mentoring of the local team during
each visit.
1996
> Project
progress
Outlook:
MdM plans to continue its
work in 2006 and is considering a possible consortium
with other partners working in
cardiopathy so that this project can continue.
Beneficiaries
> directly: 600
> indirectly: families of children and
Madagascan medical staff
Staff
> local: 4
> expatriate: paediatric heart surgeons, paediatric cardiologists,
anaesthetists and resuscitation
experts, nurses (4 or 5 people for
each medical-surgical visit)
Co-ordinators
> project: J.-F. Delambre
> field: N. Ramamonjisoa
> follow-up: DR océan Indien
Sources of funding
> La Réunion general council, MdM
Indian Ocean donors
Budget
> 2005: 71,902 euros
Mexico
Social inequalitiies persist in Mexico despite good economic health and the fact that
this country is a real commercial power. In the south, Hurricanes Stan and Wilma hit
the regions hard where the marginalised Indian populations already live in situations
of extreme poverty. In the north, the linea, which many prospective illegal emigrants
to the United States cross each day, remains a very precarious at-risk area.
Mortality
> infant: 23‰
HDI
> 0.814; ranked 53/177
> 6,121
> MdM Spain, MdM Switzerland
Beneficiaries
> directly: indigenous population
Improving the community health system
Life expectancy
> at birth: 75.1
Chiapas Region
Activities: In Chiapas region, MdM's current programme
Outlook:
(it has been working in Mexico since 1998) aims to improve
the health of the Tzotzil population. With community support, MdM is working to train health promoters and to set up
four micro-clinics to allow these populations to have access
to healthcare.
More than 500 promoters who are responsible for the health
of their communities organise their work around three microclinics.
Setting up a self-managed
health system provides the
promise of greater autonomy
for the Indians, whereas
genuine negotiations between the government and
the Zapatista movement in
the south of Chiapas would
enable more lasting solutions
for managing their health to
be found.
01/01/2003
Staff
> expatriate: 2
Co-ordinators
> project: T. Brigaud
> field: C. Martin
> HQ: M. Ethvignot
Sources of funding
> EU, MdM
Budget
> 2005: 236,005 euros
31/06/2006
> Project
progress
80/81
Access to healthcare for the migrant population
Tijuana, Mexicali
Activities: MdM is implementing a project aimed at improving access to healthcare and respecting the right to health
of migrant populations on Mexico's northern border in the
towns of Tijuana and Mexicali.
It has the following objectives:
• facilitating healthcare for the migrant populations in Tijuana and
Mexicali;
• preventing the transmission of HIV/AIDS/STIs amongst the
migrant population;
• promoting and encouraging the respect of the right to health
of the migrant populations on the northern border.
Outlook:
The project will be continued
under the same terms in
2006.
03/2008
Staff
> local: 1
> expatriate: 1
Co-ordinators
> project: M.-D. Aguillon
et F. Giraud
> field: B. Ponçon
> HQ: M. Ethvignot
Sources of funding
> MdM, French Foreign Ministry
Budget
> 2005: 100,091 euros
04/2005
Beneficiaries
> directly: migrants
> Project
progress
Hurricane emergency
Chiapas (Escuintla, Mapastepec, Huixtla and Tapachula)
Activities: Hurricane Stan hit southern Mexico on 4 October.
Outlook:
The ensuing floods, rivers breaking their banks and landslides caused a lot of damage in Chiapas. After evaluating the
affected areas between 7 and 13 October and making contact
with the health authorities, the work focused on the town of
Escuintla, where 84% of the population were affected by the
hurricane.
The activities have involved:
• re-establishing access to healthcare for the affected
populations of the Sierra Madre Mediana and Alta of Escuintla;
• treatment of and surveillance of potential epidemics.
The emergency medical treatment programme ended in
December 2005.
Beneficiaries
> directly: 18,865 people
Staff
> local: 2
> expatriate: 1
Co-ordinators
> project: T. Brigaud
> field: C. Martin
> HQ: F. Stea
Sources of funding
> Mexican Chamber of Commerce
(Banamex); French Embassy,
MdM
Budget
> 2005: 106,207 euros
07/10/2005
15/12/2005
> Project
progress
Moldova
Today Moldova is one of the poorest countries in Europe. The very weak economic
situation and increasing inflation are pushing Moldovans to emigrate en masse to
more prosperous countries. Unfortunately, many of them have fallen into the hands of
human traffickers who insidiously profit from the despair and lack of prospects of
young Moldovans to feed their networks.
Life expectancy
> at birth: 67.7
HDI
> 0.671; ranked 115/177
> 463
> MdM Greece
Beneficiaries
> directly: nearly 8,000 young people
over two years, of whom around
1,500 are from the most vulnerable
sectors of the population, and the
beneficiaries of the training (team
from the ATIS centre in Balti - 8 people -, members of the victim identification network - approx. 60 people)
> indirectly: parents of young people
attending the centre and the whole
of the Moldovan population potentially affected by trafficking.
Staff
> local: 10
> expatriate: 1
Co-ordinators
> field: L. Ilie
> HQ: A. Landaes
Source of funding
> MdM
Budget
> 2005: 82,038 euros
Mortality
> infant: 26‰
Preventing trafficking
and caring for the victims
Balti Region, north Moldova
Activities: There are two aspects to MdM's work:
• increasing access to prevention services and to overall care for young people in general and young victims of
trafficking or those belonging to at-risk groups, particularly in
the context of a partnership with the ATIS Friend of Young
People Centre, run by the TDV organisation;
• help the Friend of Young People Centre to continue by
being integrated into the national health system and strengthening collaboration with the regional and national networks
fighting against human trafficking.
04/2005
12/2007
> Project
progress
Outlook:
Continue the activities.
82/83
Mongolia
A young Asian democracy, Mongolia's economy is gradually taking off but a third of its
population lives below the poverty line and corruption is endemic. In a country where life
has remained focused on a traditional nomadic way of life, alcoholism has become a
Fighting against alcoholism
and treating tuberculosis
Ulan Bator
Activities: MdM's project is focused on implementing a programme of alcoholism and tuberculosis prevention and
treatment amongst people living in a district of yurts (Ulan
Bator shanty towns), who are excluded from access to healthcare for administrative reasons.
Mongolia suffers from a lack of co-ordination and diversity with
respect to therapeutic models for alcoholism, as well as structural problems for treating tuberculosis. A local team, made up
of a doctor, nurse and social worker, has been formed. In addition, a partnership has been signed with the Ulan Bator addiction centre.
10/2005
2006
> Project
progress
Outlook:
In January 2006 a fifteen
day training seminar is planned, to be attended by three
alcohol dependency experts.
We have the following objectives for the coming year:
• screening people living in
the target yurt districts who
are affected by alcoholism
and tuberculosis and directing them towards suitable
structures, with mobile MdM
medical teams;
• supporting target populations in irregular situations
so that they recover their
right to health (working together with organisations);
• training and awareness
programmes amongst health
staff and target populations;
• lobbying of health, police
and political authorities with
the creation of a co-ordination platform.
serious problem. Women and children are the first victims of alcohol-induced violence.
Mortality
> infant: 56‰
Life expectancy
> at birth: 64
HDI
> 0,679; ranked 114/177
> 514
Beneficiaries
> directly: 1,500,000
> indirectly: 1,500,000
Staff
> local: 3
> expatriate: 2
Co-ordinators
> project: G. Lacaze and P. Guibé
> field: O. Delclos (non-med.)
and C. Durot (med.)
>HQ: E. Martinon
Sources of funding
> MdM, currently requested (ADB,
EU, JICA, etc.)
Budget
> 2005: 13,915 euros
Morocco
Moroccan society has been lastingly marked by the mass repression of the “Years of
Lead”. The Equity and Reconciliation Committee (IER), set up on 1 January 2004 by the
current monarch, Mohammed VI, has built up a large number of dossiers with a view to
rehabilitating and compensating the victims of Hassan II's regime. Most of the people who
were tortured and testified at that time have issued strong demands for medical treatment
Mortality
> infant: 36‰
Life expectancy
> at birth: 69.7
HDI
> 0.631; ranked 124/177
> 1,452
Beneficiaries
> directly: around thirty participants
in the training courses
> indirectly: 29,000 victims of
Moroccan jails
Staff
> expatriate: 2 psychiatrists, 1 doctor
and 1 psychologist monitor the
project and provide the training
Co-ordinators
> project: J. Beckouche
> HQ: S. Alary
Source of funding
> MdM
Budget
> 2005: 7,889 euros
as well as legal and moral support.
Supporting victims of torture
Casablanca, Marrakesh
Activities: At the request of organisations and the Reception
and Orientation Centre for Victims of Torture (CAOVT), MdM's
work involves organising two training sessions in psychological trauma for a multi-disciplinary team of doctors, psychologists, social workers and reception workers involved in various
Moroccan organisations dealing with the physical and mental care of victims of torture. This training should allow the
Moroccans to share practices and encourage the setting up
of a network for caring for victims across the whole of Morocco.
01/01/2005
fin 2006
> Project
progress
Outlook:
The first training was given
in June 2005. Two psychiatrists will evaluate this initial
training amongst participants
in March 2006. The second
training will then take place
during the second quarter of
2006.
84/85
Nepal
The coup of 1 February 2005 worsened an already very fragile military and political situation and most aid programmes were suspended because of the uncertainties over the
country's future. Today Nepal is one of the 10 poorest countries in the world, and no effective development can be considered in such a political context of conflict. In addition,
AIDS and tuberculosis are continuing to spread across the whole country.
Fighting tuberculosis and HIV
Mortality
> infant: 61‰
Activities: MdM has been working in Nepal since 1995.
Outlook:
The programme which began in 2002 aims to prevent and
control the spread of tuberculosis and AIDS in four districts in western Nepal: Palpa, Syangja, Gulmi and Argha
Kanchi.
During 2005, the work was refocused on the fight against
AIDS, and concentrated on the target populations only: intravenous drug users, migrants, prisoners, prostitutes and their
clients.
Awareness and information activities have been developed
using health educators in the villages, voluntary counselling
and testing centres (VCTs), prisons and hotels at the same
time, in conjunction with our local partners, Naulo Gumti and
Friends of Hope.
In 2006, MdM expects to finalise its HIV prevention project
and to explore the remote
western areas with a view to
running an emergency type
project on access to healthcare for the people in the Maoist
area, but also to develop a
project amongst migrant
populations.
28/02/2006
Life expectancy
> at birth: 61.6
HDI
> 0.526; ranked 136/177
> 237
> MdM United States, MdM
Switzerland
Beneficiaries
> directly: 1,150 and 50% of the
prostitutes in Syangja district
> indirectly: 1,200,000 (population
of 4 districts)
01/01/2002
Western Regions
> Project
progress
Staff
> local:25
> expatriate: 3
Co-ordinators
> project: P. Baguet and O. Lermet
> field: M. Piasecki
> HQ: E. Martinon
Sources of funding
> EU, ICCO, MdM
Budget
> 2005: 198,980 euros
Opération Sourire
Countries of intervention
in 2005
Benin
Cambodia
Eritrea
Madagascar
Mali
Mongolia
Niger
Pakistan
Rwanda
Co-ordinators
> project: F. Foussadier;
F. Lauwers
> HQ: A. Segard
Sources of funding
> private funds, businesses,
foundations
Budget
> 2005: 324,324 euros
Opération Sourire's aim is to put a smile back on the faces of those who have been disfigured by war, illness and malnutrition and to enable people excluded because of their
disability to have a social life again.
Plastic surgery still does not exist in the health system of many countries because of a
lack of qualified human resources, equipment and infrastructure. Due to the considerable demand for plastic surgery and the complete lack of treatment for patients, the doctors of Opération Sourire are working amongst this forgotten population.
Activities and salient points in 2005
Activities: 2005 was the year when the Opération Sourire
projects' long term future was confirmed. These projects
are more and more vital and becoming locally integrated. In
particular, they reinforce the training given to local teams.
Opération Sourire's work is thus gradually changing from
replacing local staff to strengthening the skills of local healthcare teams.
Outlook:
Opération Sourire's projects
are continuing, especially on
the training side, to ensure
that the local teams are integrating their new skills. In this
context, Opération Sourire
wants to take part in developing and setting up local
centres, with increased capacity in terms of recruiting
patients and post-operative
monitoring. Recruiting local
staff and strengthening
management capacity should
help achieve this objective.
Projects to build plastic surgery centres with the involvement of Opération Sourire
are being developed in
Benin, Cambodia and Niger.
86/87
Pakistan
The most violent earthquake in Central Asia since 1947 hit Pakistan on 8 October 2005. The
number of victims exceeded 73,000 dead and 70,000 injured, including many children and
young people. Nearly 70% of homes in Kashmir were destroyed, and help could only reach
the area by air until roads were cleared and repaired.
In this emergency situation, women continue to be deprived of their most basic human
Emergency help for earthquake victims
NWFP Province and Islamabad
Activities: The day after the earthquake, the work was organi-
Outlook:
sed around three sites:
• Mansehra (NWFP), where a surgical team came to support
Pakistani teams to operate on earthquake victims;
• Thakot and Balakot (NWFP), where permanent and mobile primary healthcare teams operated, thus providing an initial contact
with emergency services for the population in these two areas.
Once the immediate emergency had passed, Médecins du Monde
got involved in helping homeless and displaced people through the
winter by providing primary healthcare in Islamabad where a clinic
(for general consultations, reproductive health, community health,
etc.) was opened in camp H11, and in Mansehra, where a similar
structure was set up in Jabba camp.
In 2006 MdM will seek to
widen its work by getting
involved in mobile consultations in the smallest camps
which have sprung up in
NWFP and in Islamabad. The
need to support people as
they return to their home areas
will be assessed along with
the need for longer term support for rebuilding and reactivating health services.
09/10/2005
Helping women victims of domestic violence
Activities: A 9-month pilot project with the aim of providing
medical, psychological and legal assistance to women
victims of domestic violence was set up in the Dar-ul-Aman in
Sargodha (Punjab). The activity was then gradually extended to
three new refuges in Lahore, Faisalabad and Gujranwala. This programme stresses the involvement of civil society and government
authorities, and on training the Dar-ul-Aman staff, a guarantee of
the viability of such work.
2004
2008
> Project
progress
Mortality
> infant: 81‰
Life expectancy
> at birth: 63
HDI
> 0.527; ranked: 173/177
> 304
> MdM Greece, MdM Cyprus
This project is carried out in
partnership with MdM Spain
Beneficiaries
> directly project 2: 4,500 women
and 360 children
> Project
progress
Sargodha, Lahore, Faisalabad and Gujranwala
rights on a daily basis and are the victims of violence and killed, often for matters of honour.
Outlook:
Continue the activities and
extend to 8 Dar-ul-Aman in
the Punjab. The project has
7 aspects including medical
assistance, psychological
support, legal assistance
and training for the staff of
the Dar-ul-Aman and other
Punjabi institutions, and
government executives, etc.
Staff
Co-ordinators
> projects 1 and 2: B. Ten Kate
> field 1: D. Defrade
> field 2: M. Jactat / C. Buffet
> HQ 1: desk Urgence
> HQ 2: N. Bréchet
Sources of funding
> project 1: Dutch Foreign Ministry,
Memisa Belgium, MdM
> project 2: French Embassy in
Khartoum
Budget
> 2005 project 1: 490,736 euros
> 2005 project 2: 100,310 euros
The emergency continues in the Palestinian Territories despite the relative calm of 2005.
Although the settlements have been dismantled and the Israeli army does not intend to
penetrate inside the Gaza strip, it remains a hermetically sealed area, subject to considerable restrictions and air raids. In the West Bank, the Palestinian Authority, which is
bogged down in the difficult task of administration post-Arafat, is struggling to find solutions for healthcare and the fight against poverty, amongst other things, bearing in mind
Life expectancy
> at birth: 72.5
HDI
> 0.729; ranked 102/177
> 1,026
> MdM Cyprus, MdM Switzerland
Beneficiaries
> directly: 1,300 trainers, teachers,
school children and hospital staff
> indirectly: 1,400,000 people living
in the Gaza strip
Staff
> local: 8
> expatriate: 3 permanent
and doctors for short periods
Co-ordinators
> project: R. Garrigue, M. Rajablat
> field: V. Miollanay puis D. Trani
> country: P. Villedieu
> HQ: S. Alary
Sources of funding
> DAH, MdM
Budget
> 2005: 320,219 euros
the Israeli security pressure and the impact of the construction of the separation wall on
Mortality
> infant: 22‰
the people's access to healthcare.
Improving emergency treatment
Gaza Strip
Activities: There are three parts to the programme:
• improving the civilian population's knowledge of first
aid, and of how to treat emergencies before the emergency services arrive, in the Gaza strip between now and the
end of 2006 (training trainers amongst 74 paramedics from
the UNRWA health centres, 56 teachers, then training 1,200
school children in the UNRWA refugee camps, integration of
BLS in the UNRWA school curriculum from the start of the
2005-2006 academic year;
• a programme to train Emergency Medical Technician
(emergency ambulance EMTs) trainers in the two
Palestinian Red Crescent Society training institutions in Gaza
and Ramallah, and setting up a new initial and ongoing training programme;
• developing and setting up a reference “Plan for an
influx of injured or sick patients” within the emergency
department of Shiffa hospital (Gaza City).
01/01/2005
fin 2007
> Project
progress
Outlook:
MdM will continue all its activities in 2006.
88/89
Mental health
Beneficiaries
> directly: 3,000
> indirectly: 3,000
Nablus district in the West Bank
Activities: Nablus district is the most strictly sealed off dis-
Outlook:
trict of the Palestinian Territories. MdM is determined to improve
the treatment of mental health problems there through:
• a campaign amongst the Palestinian people to remove the
stigma of mental illness through booklets, posters, TV ads and
radio programmes;
• mental health training for medical and paramedical staff in
the primary healthcare centres and for mental health professionals;
• support for a “theatre in schools” activity, transferred to a
local organisation;
• mental health seminars;
• activities in two literary cafés for men in Nablus town centre and Balata refugee camp;
• setting up a mobile mental health consultation service in
eight villages in Nablus district, also providing awareness and
training sessions for primary healthcare staff in the dispensaries involved.
MdM is going to continue
the activities it was involved
in in 2005, start three listening points (reception centres with a therapeutic aim)
and especially help to set up
two medical and psychological community centres (one
in Nablus and one in Jenin)
in partnership with the
Palestinian Health Ministry.
Consultations will be taken
over by the Palestinian Red
Crescent Society.
Staff
> local:11
> expatriate: 2
Co-ordinators
> field: T. Groh, puis
L. Robin, puis C. Thévenot
> HQ: S. Alary
Sources of funding
Budget
> 2005: 333,058 euros
01/01/2005
fin 2007
> Project
progress
Access to healthcare and the Wall
West Bank
Activities: Since May 2004, MdM has been developing
Outlook:
activities aimed at providing medical support to the people affected by the Wall and bearing witness to its impact
on health:
• setting up an ambulance station in the Aizaria enclave, east
of Jerusalem, in partnership with the Palestinian Red Crescent
Society; training ambulance men;
• improving ante- and post-natal monitoring for women with
at-risk pregnancies; treatment of under 5s in 10 villages around
Jenin and Bethlehem;
• equipping a laboratory in Rantis village, in an enclave northeast of Ramallah.
The Wall programme ended
in April 2005.
30/04/2005
39,000 (Aizaria station)
Staff
> local: 3
> expatriate: 2
Co-ordinators
> field: K. Peters et L. Weisgerber
pour l’advocacy
> HQ: S. Alary
Sources of funding
> MdM, French Consulate in
Jerusalem
01/04/2004
Beneficiaries
> directly: 13,000 (mobile clinics),
> Project
progress
Budget
> 2005: 109,587 euros
Peru
As the 2006 elections approach, Alejandro Toledo's government is desperately trying
to appease the discontent and social movements, whose main demands in 2005 were
for a salary increase, a review of agricultural policy and improved living conditions.
However, unemployment and great poverty continue to cause deep disquiet in
Peruvian society, especially in Lima, where more than a third of the population live on
less than two dollars a day.
Mortality
> infant: 26‰
HDI
> 0.762; ranked 79/177
> 2,231
Délégation internationale
> MdM Espagne
Beneficiaries
> directly: 47,246,10
to 19 year olds
Staff
> local: 5
> expatriate: 1
Co-ordinators
> projects: M. Boscaméric,
C. Batard
> field: N. Gravier
> HQ: Y. Le Corgne
Sources of funding
> Annenberg Foundation
(United States), MdM
Budget
> 2005: 7,956 euros
Promoting sexual and reproductive health
Life expectancy
> at birth: 70
Lima
Activities: The project aims to improve access to preventive and curative care with respect to sexual and
reproductive health for 10 to 19 year olds. It works in three
districts of the southern cone of Lima, around 9 existing health
structures and through:
• community awareness through trained promoters working
within the districts to locate isolated young mothers and pregnant teenagers who do not have access to the health structures; a massive awareness campaign with more than two
campaigns per district; support for local health structures
through renovation and equipment, and healthcare staff training; work with schools;
• identifying reception and meeting places exclusively for teenagers. Supplied by the town councils, these are listening and
awareness centres which provide contact with local health professionals;
• developing a local network of those interested in caring for
teenage mothers: local government (town halls), basic welfare
organisations, and public and private institutions of civil society.
01/10/2005
30/09/2008
> Project
progress
Outlook:
The following activities will be
implemented:
• a mass awareness campaign (such as a concert for
young people);
• two awareness campaigns
per district (six in total);
• training 45 peer teenagers;
• opening nine centres for
young people;
• renovating and equipping
nine health structures;
• activating a network of key
people.
90/91
Russia
Despite a hardening of policy and its stated desire to strengthen control over civil society, Vladimir Putin's regime enjoys some popularity and this is because the Russian economy is prospering. However, the situation of the indigenous peoples is increasingly critical, and the arrival of thousands of migrants in these remote areas (thanks to the intensification of gas exploitation) has led to a demographic imbalance and an increase in ethnocultural stress. The lack of access to healthcare of these isolated indigenous peoples
is alarming: some previously contained illnesses such as tuberculosis and diphtheria are
Mortality
> infant: 16‰ (40.9‰ amongst the
reappearing, and their life expectancy is much lower than that of Russians.
Helping isolated indigenous peoples
Moscow
Activities: As it is concerned with improving the primary health
Outlook:
of the indigenous people without disturbing their way of life which
is often based on nomadism, MdM has sought to encourage the
training of indigenous nomadic health officers, to work in
support of the existing structures (dispensaries and the Sanaviation
programme sending doctors and emergency services to remote
areas).
MdM therefore organised a public health seminar with the aim
of training Russian doctors to run and evaluate community health
worker (CHW) programmes for these indigenous peoples.
Using MdM's expertise and experience, based on running CHW
programmes amongst Nenets nomads in the autonomous YamalNenets district between 1994 and 2001, this training seminar was
attended by 18 doctors from 6 regions.
It was divided into three main parts:
• presentation of features of CHW programmes;
• complete revision of the content of the booklets developed for
previous CHW programmes, with the addition of two sections on
alcoholism and tuberculosis;
• awareness of project management and programme evaluation
by MdM's teaching team writing a practical guide including “recommendations”.
The 6 participating regions
must implement CHW programmes in 2006-2007, for
which MdM will provide
training for the CHWs and
the booklet of training and
work and will support the
different stages as an
expert reference.
12/2005
2007
> Project
progress
indigenous Yamal peoples)
Life expectancy
> at birth: 65.3 (48 for the
indigenous Yamal people)
HDI
> 0.795; ranked 62/177
> 3,018
> MdM United States
Beneficiaries
Staff
> local: 3
> expatriate: 2
Co-ordinators
> project: F. et A. Desplanques
> field: P. Baril
> HQ: A. Landaes
Source of funding
> MdM
Budget
> 2005: 21.609 euros
El Salvador
The damage caused by Hurricane Stan and the violence of the maras (organised bands
whose income is mainly from drugs racketeering and trafficking) make it difficult to develop education systems, housing and access to healthcare, which are still insufficient,
especially in the regions most affected by the civil war. MdM is concentrating its work on
health assistance to the most vulnerable peoples of Morazán.
Mortality
> infant: 32 ‰
HDI
> 0.722; ranked 104/177
> 2,277
> MdM Spain
Beneficiaries
> directly: 7,000
Co-ordinators
> project: J.-L. Pesle
> suivi: DR Rhône-Alpes-Grenoble
Source of funding
> MdM
Budget
> 2005: 14,203 euros
A community health programme
Life expectancy
> at birth: 70.9
Morazán Region
Activities: The project involves providing support to our
Outlook:
local partner, Doctors for the Right to Health (MDS), to
implement programmes concerning basic health services, environmental decontamination, food security, nutrition, childhoodrelated healthcare and training of promoters. The support involves:
• management training for all MDS staff;
• developing the organisation's communication system;
• renewing IT equipment and software training;
• disinfection, training and prevention in 20 groups of houses,
as part of environmental decontamination campaigns;
• digging a well and a septic tank for the staff living quarters,
next to the El Tablon healthcare centre in Morazán.
The project was disturbed in October 2005 by hurricane Stan
which caused considerable damage and 72,000 victims in the
country. Doctors for the Right to Health put in a lot of work
during the emergency and was able to care for 572
people.
In 2006, the impact of the
management and IT training
of MDS staff will be evaluated
to decide if any changes are
needed. This training should
mean the organisation is better run and organised.
Developing the organisation's
communication system will
enhance the value of MDS's
work and make it easier to
find new financial backers.
10/2004
10/2007
> Project
progress
92/93
Serbia
The union of Serbia and Montenegro is politically unstable because of the uncertainties over
the status of the neighbouring regions - Bosnia-Herzegovina and Montenegro - and of certain Serbian regions such as Voivodine and Kosovo. Following the conflicts and socio-economic upsets which shook this region in the 1990s and the clear absence of significant
international cooperation, Serbia and Montenegro is also experiencing economic difficulties. The provision of healthcare has clearly deteriorated and the HIV epidemic is growing,
especially amongst injectable drug users, although it is not possible to obtain clear inforMortality
> infant: 14‰
mation on the epidemiological level.
Life expectancy
> at birth: 73
Belgrade
Activities: MdM's work amongst intravenous drug users has
several aspects:
• street work amongst drug users via a mobile unit; this
aspect of the work involves exchange of sterile equipment and
spreading prevention messages aimed at drug users, near where
they live while respecting their way of life (street work by peers and
professionals);
• setting up a drop-in centre for intravenous drug users;
• raising awareness about the health risks linked to drug use
and prevention activities;
• training those working with drug users.
10/2003
2009
> Project
progress
Outlook:
Support the local organisation VEZA as part of the
transfer of the needle
exchange programme which
began in 2005. Set up a
methadone programme.
WHO Report 2005
Harm reduction
HDI
> not known
> not known
Beneficiaries
> directly: 568
> indirectly: 1,704
Staff
> local: 7
> expatriate: 1
Co-ordinators
> project: P. Beauverie
> field: C. Debeaulieu
> HQ: A. Landaes
Sources of funding
Budget
> 2005: 232,418 euros
Veza support: 45,673 euros
Sri Lanka
Officially, a truce is in force between the government and the Liberation Tigers of Tamil
Eelam (LTTE), but the peace process is still blocked and violence is increasing. The tsunami in 2004 weakened the country's economy and the population, already weak, suffered the full consequences of this. The Sri Lankan health system, however, is still considered a model for developing countries despite a fall in expenditure. But the health indicators do not take account of the area under LTTE control, which suffers from a serious lack
of healthcare staff.
Mortality
> infant: 13 ‰
Renovating health structures
Life expectancy
> at birth: 74
> 948
Délégations internationales
> MdM Spain, MdM Portugal,
MdM Cyprus, MdM Greece,
MdM USA, MdM Belgium,
MdM Argentina
Beneficiaries
Mallavi, Tunukkai and Naadankandal - Mullaitivu district
HDI
> 0.751; ranked 93/177
Activities: MdM is responsible for renovating and sup-
Outlook:
porting health structures in the Manthal East and Tunukkai
divisions (Mullaitivu district).
The work in the Mallavi area is focused around 4 areas:
• renovating and re-equipping Mallavi hospital (opening a new
operating theatre and emergency department, reorganising the
out-patients consultation service, pharmacy, maternity unit, etc.;
• re-organising and training local medical staff;
• supplying the hospital and two health centres with drugs and
medical equipment;
• raising the authorities' awareness of problems encountered by
the hospital (funding, human and material resources).
Several exploratory projects
were carried out in the northern
area and showed that health
needs were covered. The work
in Mallavi hospital will be
suspended once the renovation
work is complete. The work will
be monitored from HQ (working
with a Sri Lankan co-ordinator
for any emergencies), as the
desire is to consider a longer
term project.
Staff
Co-ordinators
> project 1: C. Giboin, A. Cavey
> project 2: P. Foldès
> field 1: S. Brignano
> field 2: C. Giboin
> HQ 1: Emergency desk
then V. Pardessus
> HQ 2: Emergency desk
Source of funding
> projects 1 and 2: MdM
Budget
> 2005 projects 1 and 2:
15/01/2005
30/03/2006
> Project
progress
Emergency aid to tsunami victims
Kinnya Division - Trincomalee district
Activities: Kinnya hospital, the referral centre for some 80,000
Outlook:
people, was destroyed by the tsunami in December 2004. In conjunction with MdM Spain, the work has involved urgently re-establishing
access to primary healthcare for the people of Kinnya living in a
displacement camp, through mobile consultation services. More
than 2,000 consultations were carried out in this way by our teams
during the first weeks of the emergency amongst tsunami victims,
while epidemiological monitoring was re-established.
After the hospital had been
rebuilt and the Sri Lankan
authorities had re-established primary healthcare MdM
was able to gradually withdraw in February 2005. The
logistics and administrative
base in Colombo was retained to support the teams in
Mallavi, in northern Sri
Lanka.
631,944 euros
28/12/2004
20/02/2005
> Project
progress
94/95
Sudan
Following the Peace Agreements signed in January 2005 in southern Sudan, there have
been population movements in the region. These are of people who had fled during the
20 years of fighting in southern Sudan which ravaged these provinces and who are now
returning to their home areas. The consequences of the war are disastrous socially as
well as in terms of health and nutrition. The quality of healthcare is still deteriorating. In
addition, although the social and political recomposition of southern Sudan is a fairly
positive development, it is not happening without causing some local tensions between
Mortality
> infant: 63‰
Emergency medical care
Kalma, Dereij, Nyala - Southern Darfur
Activities: MdM has set up a PHC centre in Kalma camp, equip-
Outlook:
ped with a hospitalisation unit and delivery room, in conjunction
with the health agencies already working there including ACF which
is treating malnutrition. It includes 4 curative consultation posts,
ante- and post-natal healthcare consultations, vaccination services, a medical analysis laboratory, quick testing for malaria and a
pharmacy.
Outside the camp, MdM is also involved in mobile camps in Dereij
camp amongst groups of displaced people around Nyala.
Continue community healthcare
activities, occasional support
work (water distribution, installation of diarrhoea treatment
centres, nutritional screening,
vaccination), logistical and
human resources support and
setting up an isolation camp in
the event of a cholera epidemic.
14/07/2004
indéfini
> Project
progress
Primary healthcare and surgery
Malakal
Activities: The project aims to improve the quality of care
Outlook:
given by the surgery unit of Malakal general hospital and to
guarantee access to it for more people, focused on 4 main areas:
• renovating then equipping the surgery unit;
• training staff involved in surgical treatment;
• putting management systems for surgical consumables in place;
• putting a data collection and transmission system in place.
Continue training started in
November 2005 and
renovation work started in
September 2005.
the different communities in the area.
Life expectancy
> at birth: 56.4
HDI
> 0.512; ranked 139/177
> 412
> MdM Greece, MdM Canada
Beneficiaries
> directly project 2: 50,000 (town)
> indirectly project 2: 150,000 (region)
Staff
> expatriate project 2: 1 + surgical
teams
Co-ordinators
> projects 1 and 2: L. Joseph, J. Larché
(+ project 2: G. Isserlis)
> field 1: M. Pomarel, N. Seris
> field 2: F. Makpolo, N. Pilet
> HQ project 1: desk Urgence,
B. Contamin
> HQ project 2: O. Mouzay, B. Contamin
Sources of funding
> project 1: DAH, German Foreign
Ministry, DFID, ECHO
> project 2: French Embassy, MdM
25/11/2004
indéfini
> Project
progress
Budget
> 2005 project 1: 1,615,861 euros
> 2005 project 2: 204,952 euros
Tanzania
This is the East African country with the highest growth (6.9% in 2005), but, like a
certain number of African countries, poverty is not declining. The HIV prevalence
rate is one factor responsible for this failure. Around 7% of the adult mainland population lives with HIV and antenatal consultations have shown prevalence rates between 5% and 15% in certain regions, even if these rates have definitely fallen in the
last ten years. The number of AIDS orphans now stands at nearly 2 million.
Life expectancy
> at birth: 46
HDI
> 0.418; ranked 164/177
> 287
> MdM Belgium
Mortality
> infant: 104‰
Preventing mother-to-child transmission of HIV
Bukoba
Activities: The programme for preventing mother-to-foetus
transmission of HIV has 3 aspects to it:
• training hospital staff;
• monitoring women during pregnancy: screening, prescribing
AZT, information on transmission by breast-feeding;
• monitoring women and their babies after delivery.
Beneficiaries
> directly project 2: hospital staff and
their families, HIV-positive pregnant
women and their families, patients
with an advanced HIV infection
> iindirectly project 2: educators,
nurses
Staff
Co-ordinators
> projects 1 and 2:
P. Tattevin
> general co-ord projects 1 and 2:
S. Davies
> HQ 1 and 2: C. Courtin
Sources of funding
> project 1: MARC foundation,
AIDS Fund
> project 2: Columbia University
Budget
> 2005 project 1: 181,047 euros
> 2005 project 2: 179,878 euros
01/08/2002
30/06/2005
> Project
progress
Outlook:
Continue to transfer all activities to Bukoba regional
hospital. Strengthen the
assistance aimed at HIVpositive mothers so that they
can continue to benefit from
ARV treatments.
Access to effective antiretroviral
combinations
Bukoba
Activities: The aim is to allow HIV-positive pregnant women and
Outlook:
their families, patients with an advanced HIV infection, and hospital
staff and their families access to antiretrovirals. To facilitate access
to these treatments, MdM is using the HAART (Highly Active
Antiretroviral Therapy) programme. This therapy programme is intended to reduce the incidence of transmission, especially from mother
to child.
Continue all these
activities in 2006.
01/10/2004
2009
> Project
progress
96/97
Treating opportunistic infections
Bukoba
Activities: MdM is continuing its programme of HIV pre-
Outlook:
vention and treatment of opportunistic infections by supporting Tadepa. Three aspects have been developed:
• prevention (peer training, education by peers, access to
condoms);
• psychomedical (counselling, treating opportunistic diseases);
• transfer of skills.
Continue process of making
the local NGO Tadepa autonomous and gradual withdrawal of MdM.
01/08/2004
30/04/2005
>
Project
progress
Beneficiaries
> directly: 500
Staff
> local: 20
> expatriate: 1
Co-ordinators
> project: P. Tattevin
> general co-ord: S. Davies
> HQ: C. Courtin
Source of funding
> MdM, French Foreign Ministry
Budget
> 2005: 53,317 euros
Turkey
Le début des négociations concernant l’adhésion de la Turquie à l’Union européenne relance
la question du respect des droits de l’homme dans un pays où les minorités, les détenus, les
opposants politiques et les défenseurs des droits humains sont souvent victimes de mauvais
traitements. Malgré un réel effort législatif et des engagements concernant le traitement judiciaire des actes de torture, la persistance de certaines pratiques demeure préoccupante.
Mortality
> infant: 33‰
Life expectancy
> at birth: 68.7
HDI
> 0.750; ranked 94/177
> 3,399
Beneficiaries
> directly project 1: pregnant women
and infants
> directly project 2: human rights
defenders and prisoners who are
victims of state violence
De surcroît, le regain d’agitation kurde fait craindre de nouvelles tensions à l’intérieur du pays.
Caring for the most destitute
Ayasma shanty town
Activities: Medical and welfare care of the inhabitants, mainly
Outlook:
displaced Kurds, of Ayasma district:
• healthcare for women and children;
• social and educational activities aimed at children, young
people and women.
In partnership with Solidarité et Liberté (a Marseilles-based
organisation):
• local partnership implementing a medical and welfare project combining healthcare, education and training (pre-school
education, literacy);
• human rights monitoring , especially the right to health.
Monitor health, continue current activities and prepare to
close the centre at the end of
2006. Examine whether to
transfer the project to another
suburban area of Istanbul housing mainly displaced Kurds.
2004
2006
Staff
> local project 1: 5 paid staff and
occasional volunteer workers as it is
officially illegal to give permanent
assistance.
> expatriate project 2: 6 on
occasional projects
Co-ordinators
> project 1: G. de Castelnau
> project 2: B. Granjon
> follow-up projects 1 and 2:
DR PACA
Source of funding
> projects 1 and 2: Bouches-duRhône department council
Budget
> Project
progress
Supporting the victims of political violence
Istanbul
Activities:
MdM provides medical and psychosocial
assistance to human rights defenders fighting against Turkish
repression, through:
• supporting human rights defenders in three organisations (IHD,
Goc'Der, Tuhad);
• assistance in trials of human rights defenders;
• testifying; a second assessment of patients whose state of
health was judged compatible with their being reimprisoned by
doctors close to the government was sent to the European
Court of Human Rights, and led to suspension measures and
sanctions against the original doctors.
2002
2006
> Project
progress
Outlook:
Monitor how the situation
develops and adapt MdM'S
actions.
98/99
XX/99
Uganda
From the beginning of the devastation caused by the HIV epidemic, Uganda set up prevention programmes. However, even if the prevalence of HIV-positivite people seems to
have fallen, more than two million Ugandans, according to estimates, are infected by the
HIV virus, i.e. 10% of the population. It is true that many efforts have been made to reduce the epidemic but life expectancy (47 years) still shows the damage caused by this illness. Despite everything the country has maintained an astonishing growth rate of 7%
Supporting the local NGO CIPA in its fight
against HIV
Kooki County, Rakai District
Activities: A joint venture with local NGO CIPA has been
Outlook:
set up to ensure prevention activities such as education activities, raising awareness of community leaders and women,
and training sessions on STIs/AIDS will continue. It involves
promoting behavioural changes and condom use in rural areas,
improving treatment for AIDS patients and establishing a
referral system for screening and treating people who
are HIV positive.
With financial support from
MdM in 2005, the NGO
CIPA should be operationally
and technically autonomous
by 2006.
04/2001
31/12/2005
> Project
progress
per year, helped by a great deal of debt relief.
Mortality
> infant: 81‰
Life expectancy
> at birth: 47.3
HDI
> 0.508; ranked 144/177
> 249
Beneficiaries
Staff
> local: 4 (provision of 46 others to
the local NGO)
Co-ordinators
> project: D. Sevelinge
> field: C. Gulyetonda
> HQ: O. Mouzay
Source of funding
> MdM
Budget
> 2005: 48,676 euros
Vietnam
The Vietnamese economy is growing rapidly, posting growth of 8%. However, 8%
of the population, i.e. 1.4 million households, still live below the poverty line. In addition, 263,000 people carry the HIV virus in a country where the use of injectable
drugs and prostitution are common practices. Government policy on these issues
is repressive which does not help work amongst these at-risk groups.
Mortality
> infant: 19‰
HDI
> 0.704; ranked 108/177
> 482
> MdM Canada
Beneficiaries
> directly: 10,000
Staff
> local: 14
> expatriate: 1
Co-ordinators
> project: F. Novel
> field: A. Pinon
> HQ: V. Pardessus
Sources of funding
> EU, AESN, MdM
Budget
> 2005: 283,424 euros
Developing medical services
Life expectancy
> at birth: 70.5
Bac Kan and Thai Nguyen provinces
Activities: The liberalisation of the 1980s deeply affected
the Vietnamese primary healthcare system. Local health posts
found that they had been deprived of their traditional public
funding, and this had an effect on the quality of the service
and the access to healthcare of vulnerable groups. In this
context, promoting preventive health by village health workers
amongst the most disadvantaged groups (women, children
and ethnic minorities) is a priority.
In 2005, this preventive health programme developed the following activities:
• mother and child healthcare (health education, integrating the national programme at local level);
• improving health staff's skills;
• access to water and sanitation for homes in three local
authorities (construction of water distribution networks, pit
latrines, organisation and maintenance, education, etc.)
• nutrition and prevention of childhood illnesses (community development through mothers' groups).
• institutional development of the Hanoi Medical
University (HMU).
01/11/2000
31/10/2005
> Project
progress
Outlook:
This project was completed in
October 2005 and reached
its objectives. The joint venture with Hanoi Medical
University is continuing
through a community-based
access to healthcare programme for vulnerable
groups (including drug users
and prostitutes) in Tay Ho district in Hanoi.
100/101
Access to community-based healthcare
Hanoi
Activities: This access to community-based healthcare pro-
Outlook:
gramme for vulnerable groups (including drug users and prostitutes living with HIV/AIDS), in Tay Ho and surrounding districts,
is the result of a joint venture between Hanoi Medical University
(HMU), the people's committee and Tay Ho district health services, the sub-department for Social Affairs for the Prevention
of Social Ills (HSSEP) and MdM. At the request of HSSEP, HMU
and MdM proposed offering care, treatment and assistance for
people living with HIV/ AIDS at district level in the context of
public health services and social action.
At the end of 2005, the following activities had been set up:
• a day care centre was opened as part of a district healthcare centre (HIV testing, primary health consultations, STIs,
opportunistic infections, ARV treatment);
• 2 mobile teams (prevention, needle exchange, condom distribution, treatment at home);
• solidarity groups;
• training for healthcare staff and social workers.
Between now and the end of
2006, 300 patients will be
screened for HIV/AIDS, 50
patients will receive antiretrovirals and 25,000 people will
be contacted by the mobile
teams and clubs.
Beneficiaries
> directly: 4,000
> indirectly: 25.000
Staff
> local: 7
> expatriate: 2
Co-ordinators
> project: K. Lacombe
> field: A. Pinon
> HQ: V. Pardessus
Source of funding
> Usaid (PACT)
Budget
> 2005: 15.496 euros
08/2005
08/2008
> Project
progress
Preventing and treating HIV
Ho Chi Minh City
Activities: This new three-year programme is based on
Outlook:
the previous programme (PHC for the homeless including
prostitutes and drug users) and the existing structure (day
care centre and mobile teams) and is aimed at the same
groups of people.
During the first year of the project the focus was on:
• treating all cases of STIs screened in the day care centre;
• training local staff in HIV prevention and screening for HIV
infection;
• setting up an HIV screening centre within the day care centre.
Continue STI and HIV/AIDS
screening, increase access to
treatment for opportunistic
infections and STIs. Continue
training staff in HIV prevention,
diagnosis and treatment of
HIV-related illnesses and administering ARVs. Increase the
number of patients on ARV (53
patients on 31/12/05 150
expected on 31/12/06).
Baromètre au 31/12/2004
20/12/2004
19/12/2007
> Project
progress
Beneficiaries
> directly: 6,500
Staff
> local: 6
> expatriate: 3
Co-ordinators
> project: K. Lacombe
> field: V. Trias
> HQ: V. Pardessus
Source of funding
> Usaid (PACT)
Budget
> 2005: 526,990 euros
Zimbabwe
The economic situation in this southern African country is disastrous. Living conditions are increasingly harsh and the impact of the HV/AIDS pandemic is devastating.
26% of the population is HIV-positive. Since the explosion of the HIV/AIDS epidemic,
life expectancy has fallen from 52 years in 1990 to 36 years in 2005. A third of the
adult population is HIV-positive and each day around a hundred new born infants
become HIV-positive.
Mortality
> infant: 78‰
Out of a total population of 12 million inhabitants, there are around 800,000 orphan
Life expectancy
> at birth: 36.9
Zimbabweans affected by the virus and requiring antiretroviral treatment do not have
> 639
> MdM Spain and MdM Canada
Beneficiaries
> directly project 1: 350,000 inhabitants of Chipinge district
> indirectly project 1: 30 community
health workers in Chipinge
Staff
> local: 30
> expatriate: 5
Co-ordinators
> project: C. Moncorgé
> field: F. Azam
> HQ: N. Bréchet
Sources of funding
> MdM, EU, HIVOS
Budget
> 2005: 486,932 euros
HDI
> 0.505; ranked 145/177
children. It is estimated that nearly 20% of these are HIV-positive. In addition, 90% of
access to it.
Reducing the impact of HIV/AIDS
Chipinge
Activities: After a pilot phase of HIV/AIDS information and
Outlook:
prevention which began in May 2004, MdM France, in partnership with MdM Canada, MdM Spain and FACT (a local
NGO), is now developing a global approach for the whole of
Chipinge district combining:
• community information and awareness;
• running information and screening centres;
• running home assistance services for immobilised HIV-positive patients;
• psychosocial and therapeutic support for orphans and vulnerable children;
• support for the preventive and curative activities of 4 district hospitals and 44 dispensaries (preventing mother-to-child
transmission, reducing the incidence of STIs, preventing and
treating opportunistic illnesses, setting up and monitoring ARV
treatments);
• training staff and community health workers;
• perational analysis of this model designed on a global scale,
on a community basis, with a view to expanding and replicating it in other districts, provinces and countries.
In 2006, our teams will work
on consolidating our activities
and setting up antiretrovirals
in Chipinge hospital to bring
the possibility of treatment
closer to the communities.
05/2004
12/2007
> Project
progress
Future projects
102/103
> New projects 2006
Month
Country
Town/Region
Theme
January
Rwanda
Chad
Daghestan
Kigali
N'Djamena
Khassaviourt
• Mental health work amongst genocide survivors
• Street children
• Support for primary and secondary healthcare structures
March
Niger
Keita
EEritrea
Nicaragua
Nepal
Afabet
Puerto Cabezas
Dadeldhura
• Improving the population's health, especially for under 5s, pregnant women
and breast-feeding mothers
• Improving maternal health through obstetric surgery
• Domestic violence
• Access to healthcare programme
Bolivia
China
Afghanistan
Kosovo
Romania
Potosí and Sucre,
Pilco Mayo river
Shanxi
Kabul
Rahovec
Satu Mare
• Early, quality treatment of people living with HIV
• Harm reduction programme
• Dental project
• Preventing child abuse
June
Serbia
Guatemala
Belgrade
Chimaltenango
• Methadone project
• Project denouncing lack of access to healthcare for women working in the maquillas (factories)
September
Algeria
Algiers
• Sexual violence
April
• Access to diagnoses on environmental health
> Exploratory projects 2006
Month
Country
Town/Region
Theme
January
Brazil
Maranhao, Pernambuco and Para states
Upper Nile
(Koddok and Tonga)
Rabat
• Street children, rubbish tip sorters, people in Quilombos
• Mother and child health
India
Senegal
Nicaragua
Yemen
Xekhong and
Saravane provinces
Jaipur
Podor, Gamadji Saré
San Bartolo
-
March
Sri Lanka
Russia
Lebanon
Mallavi
Bekaa and Tyre
• Support for surgical activities
• Migrants
• Access to healthcare for elderly people in Palestinian refugee camps
April
Ecuador
Kosovo
China
Tungurahua
• Intercultural health project
South Serbia, Strepse • Access to healthcare for minorities in enclaves
Qinghai
• Access to healthcare for Tibetan people
May
Afghanistan
Kabul
Burundi
Uganda
Northern Uganda
South Sudan
Morocco
February
Laos
• Access to healthcare for returnees
• Access to healthcare for migrants
• Access to healthcare in the Jaipur shanty towns
• Access to health care for scattered rural populations
• Maternal health/cervical cancer screening
• Identifying a target population
• Mental health
• Primary healthcare amongst Kuchi nomads
• Access to healthcare
• Access to healthcare for IDPs (internally displaced persons)
Action in France
Calais
Free health-care
and guidance
centre
Local mobile
actions
People involved
in prostitution
Harm reduction
actions
Valenciennes
Le Havre
Rouen
Metz
Pl. St. Denis
Paris
Nancy
Strasbourg
Rennes
Nantes
Angers
Besanon
Saint-Denis
Poitiers
Runion
Lyons
Angoulme
Grenoble
Bordeaux
Cayenne
Guyanne
Bayonne
Pau
Toulouse
Montpellier
Aix-enProvence
Nice
Marseilles
Ajaccio
Introduction to Mission France
104/105
> A few steps forward, many steps back
Answers in the field of exclusion
For the 19th year, Mission France has managed to
considerably reduce the damage caused by legislators in the area of exclusion from healthcare. In
2005, the neediest people continued to be stigmatised, those without papers have become the scapegoats for the government and the poorest are now
perceived as profiteers or even fraudsters. The
increase in the number of checks, the suspicion and
arrests reinforce deep social decay shown by the
continual rise in the number on income support and
who are thrown out of rented accommodation.
Faced with this deterioration of social relationships, Médecins du Monde's Mission France has
responded in various ways.
• Migrants in the Calais area are not asylum seekers but want to migrate to the United Kingdom.
While waiting for the chance to cross the Channel,
they are forced to take refuge in woods or makeshift shelters. When tracked down by the police,
they are sometimes forced to leave duvets and
clothes which they had found hard to obtain.
A project involving healthcare and bearing witness
is ongoing, a forum has been organised in Paris,
and a strong call has been made to local health
authorities to provide the hospital at last with a
PASS (permanent service offering access to
healthcare).
• In Guyana, the law is ignored, reinterpreted and
not enforced. The shortage of medical staff is destroying the access to healthcare system. CMU (universal health insurance) and AME (state medical aid)
are widely refused by professionals. MdM's Mission
France has set up a healthcare centre and is focusing especially on pregnant teenagers.
• In the housing crisis, the strictly unacceptable
has become a daily occurrence. We meet families
with children on the street, who remain there! Urban
space has been reshaped so that it is no longer possible to lie down or take refuge there. Making the
unacceptable visible was what the Paris
Homelessness project did when it acquired tents for
the homeless: people could no longer ignore what
used to be just a shadow under a porch. We continue
our efforts to seek a reaction from the authorities.
• For sick homeless people, we have made a
major contribution to making healthcare hostel beds
more permanent. The working group led by the
Social Work Directorate General has drawn up clear
and ethical specifications. Definite progress.
Introduction aux missions France
• State medical assistance will once again
have been the government's focus in the middle of the summer… Decrees making access to
healthcare for those without papers even more
difficult were issued at the end of July. Hours of
discussions between associations and the
ministry were necessary before they agreed to
write a circular limiting the damage.
• The health insurance reform removes the
possibility of healthcare centres run by associations referring patients for additional examinations. On MdM's initiative, a collective sent 10
questions to the Health Ministry concerning the
consequences of this reform on the neediest
people. After seven months, we received an
answer the substance of which was that people
with problems should overcome them!
• Médecins du Monde in Europe decided to
bear witness to how difficult it is for those
without papers to get access to healthcare, and
to fight against the expulsions of seriously ill
foreigners to countries where they will not
receive care - to fight, therefore, against, a
death sentence which albeit administrative is
actually fatal! This is the purpose of the Access
to Healthcare Monitoring Centre in Europe set
up in 2005. It took some 900 letters, 50 meetings with MEPs and a cross-disciplinary investigation in 5 countries.
• Drug users are surrounded by new doubleedged institutional measures. Although some
advances have been made, RdR policies receive little funding and are burdened by a heavy
administrative yoke. Most of MdM's RdR workers will be forced to set up autonomous associations to meet these new requirements, but
are likely to find themselves in a federation
intended to bear witness to the advances needed in risk reduction related to the use of
psychoactive substances.
Our projects continue to provide these skills in
new and dynamic ways. In 2005, the biennial
meetings of those involved in Mission France
enriched the 212 participants and provided a
forum to think about how to improve the quality of our practices, and about the challenges
we need to take up in the area of prevention,
treating mental illnesses as well as the suffering
caused by living conditions and past trauma.
Nathalie Simonnot,
Mission France co-ordinator
The homeless and poorly housed
106/107
Housing is a fundamental right; however, many people do not have access to it.
Today in France there are approximately 100,000 homeless people and more than 3
million are in sub-standard housing. The fires in dilapidated Paris hotels (nearly 50
dead, most of them children) and the suburban riots have put the housing crisis back
at the heart of public debate. Nearly 61% of patients seen by Mission France are
homeless or live in sub-standard housing.
> Housing, a fundamental right
Number of homeless in
France
> 86,500 people (source Insee, institute
Since 1993
Activities: Faced with the problems of people living in the
Outlook:
street who are too marginalised and weakened to make use
of the public structures, MdM has developed mobile actions.
There are two objectives:
• to inform people of their rights to access to healthcare,
and refer and accompany them to public structures;
• to see those without sickness cover in healthcare centres until they regain their rights. Every year, MdM takes action,
in winter and in summer, requesting accommodation and longterm housing. From its experience on the ground, MdM is
continuing to bear witness to the harmful consequences
to health of the lack of housing as well as of poor housing. The discontinuity and unsuitability of accommodation
worsen the health of the neediest. Teams in France work throughout the year watching the situation in the context of patrols,
medical consultations in accommodation centres and nursing
beds, etc. In 2005, DGAS (the Social Work Directorate General)
asked MdM to take part in a thinktank and to draw up specifications formalising “healthcare hostel beds” and this led to
a circular on how these beds should operate and be funded.
In December 2005, the Paris homelessness project was heavily involved in distributing “igloo” tents to the homeless and
to alerting the authorities to the urgent need to overhaul their
accommodation provisions.
Continue field work amongst
the most needy people
(street work, welfare and
medical treatment, medical
consultations and nursing
care in accommodation hostels, work in partnership with
health and accommodation
structures, involvement in
the “cold weather plan”) and
political action (bearing witness, lobbying institutions to
set up long-term accommodation structures suitable to
the needs of the homeless).
Types of work
> > Medical and welfare consultations, patrols: Le Havre,
Marseilles, Metz, Nice, Paris, Strasbourg, Toulouse, Valenciennes.
> > Medical consultations for the homeless in “healthcare hostel beds”:
Bordeaux, Grenoble, Lyons, Strasbourg, Toulouse.
> Ecoute santé (Health Listening post): Angoulême.
> Consultations with other associations (Restos du cœur,
Salvation Army, Abbé Pierre centres, Secours catholique, Aides,
Point écoute santé jeunes…): Grenoble, Le Havre, Lyons, Metz,
Nancy, Nantes, Reunion, Toulouse, Valenciennes.
> Consultations in emergency accommodation centres: Lyons,
Metz, Nice, Toulouse.
> Welfare and health work in squats: Bordeaux, Paris.
for economic and statistical
information)
Number of poorly housed
> > 3.2 million (source Abbé Pierre
Foundation)
Most common conditions
> dermatology problems, trauma, psychiatric problems, psychological suffering,
ENT and respiratory infections
Number of projects
> 16
Number of volunteers
> 182
Contacts with homeless
> approx. 10,000
> 17.8% of people seen in CASOs are
homeless, and 43.4% live in insecure housing
Characteristics
of homeless seen in CASOs:
> 26% are women
> 60% are under 35
> 8.6% are minors
> 75% do not have the right to sickness cover
Sources of funding
> Local health authorities, town councils, department councils, etc.
Main partners
> Abbé Pierre Foundation, Secours
catholique, Emmaüs, Red Cross,
Restos du cœur, Samu social, DAL,
local charities (Péniche, Amis de la
rue, le Fournil, GAF, Enfants du
monde, Droit de l'homme EMDH),
etc.
Migrants
All projects (healthcare
centres, mobile projects)
see immigrants in their
programmes
(in healthcare centres,
30% are asylum seekers).
The 2003 law on immigration and the 2004 law on asylum have already made it harder to obtain a residence permit and refugee status, but the planned reform of the
rules for foreigners entering and staying in the country and the right of asylum risks
making a difficult situation even more difficult for prospective immigrants, asylum
seekers and sick foreigners. The state medical aid reform of 2004 and July 2005
makes it even harder for foreigners living irregularly in France to get access to health-
Beneficiaries
> 89% of patients seen for the first
time are foreigners
> 60% of them are illegal and 30%
have applied for asylum
Country of origin
> Algeria, Romania, Morocco, Cameroon,
Tunisia, etc. (Other nationalities turn up
in different centres)
Main conditions
> osteo-articular, ENT, gastro-enterology, psychiatry, dermatology, gynaecology-obstetrics, psychological
problems
> 88% of foreigners seen have not
acquired the right to health insurance when they are seen at a
healthcare centre for the first time
Number of projects
> all programmes (centres, mobile
actions and harm reduction programmes)
> nearly 2,000
Sources of funding
> Regional & local health authorities,
department councils, regional councils, regional and national health
insurance offices (CRAM, CPAM),
etc.
Partners
> CASP, Cimade, Gisti, LDH, Anafé
(National association helping foreigners
at borders), CFDA (Committee for the
right to asylum), Comede, involvement
in ODSE (European monitoring centre
for access to healthcare), local or regional association committees, etc.
care. The health insurance reform which requires people to choose a regular doctor
also penalises homeless people including migrants. More than 89% of patients in
Médecin du Monde's healthcare centres are foreigners: they have more problems in
getting sickness cover as they do not know their rights or how to acquire them.
> Facilitating access to healthcare
Since 1986…
Activities:
Outlook:
• Healthcare centres: In 2005, the 21 healthcare centres
saw 89% foreigners and carried out 45,783 medical consultations. The main obstacles to access to healthcare and rights
quoted by people are lack of access to an address, financial
difficulties, poor knowledge of rights and systems, administrative difficulties and the language barrier. MdM plays a bridging role and, where possible, refers people to the public health
and welfare systems. Journeys into exile, often the source of
major psychological and physical suffering, are taken into
account, and psychological support work is being developed.
The Paris and Marseilles CASOs have set up a specific
HIV/hepatitis/STI prevention and screening programme.
• CAFDA (Committee for asylum-seeking families)
Project: MdM has set up reception, health and referral consultations for newly-arrived asylum-seeking famlies with a partner, CAFDA. In 2005, CAFDA received and housed more than
5,000 people of 79 nationalities. 1,298 people (of 51 different
nationalities) newly arrived at CAFDA were seen by the MdM
team in 2005, i.e. 462 families.
MdM continues to work
towards each person, whatever his administrative status, having immediate
access to health insurance
and being referred to existing health structures.
Mission France is continuing
to develop HIV, hepatitis and
STI prevention and screening programmes, as well as
programmes for treating
migrants' psychological suffering. The European Access
to Healthcare Monitoring
Centre (started in 2004) lobbies European Union institutions and bears witness to
the difficulties of getting
access to healthcare for
people living in insecure
situations, on the basis of
data collected on the ground
(MdM works in 11 European
Union countries).
Types of work
> All the projects provide consultations, dispense prevention messa-
ges and refer migrants to partners and public health systems.
Testimonies on insecure living conditions linked to administartive status, the length of proceedings and housing difficulties are the basis
for specific work to restrict the decline in migrants' rights.
108/109
Children
Children are needier when faced with exclusion, poverty and illness. According to a
CERC (Council for Employment, Income and Social Cohesion) report, 2 million children
GUYANE
in France live below the poverty line and the number of isolated minors is estimated at
40,000. In addition, an INSEE (the national institute for economic and statistical information) survey shows that 16,000 children are homeless. As well as paediatric monitoring in healthcare centres, Médecins du Monde has initiated projects to fight against
lead poisoning, aimed at locating and protecting children from this. The Buddy project
provides support to children separated from their families by hospitalisation.
Beneficiaries
> 1,693 children (under 15s) were
seen in healthcare centres in 2005
> Protecting isolated victims
Main conditions
> ENT, pneumology, lead poisoning,
Buddy Project 1988 >… / Lead poisoning project 1993 >…
Activities:
Outlook:
• Hospital buddies: “an energy transfusion”. Buddies visit
the child they support three times a week, including once
during the weekend. The visits mean they can support isolated children while they are in hospital. They also help to break
down loneliness, the children's needs are listened to and they
are given the strength to fight on. The volunteer makes contact
with the nursing team and helps maintain the relationship with
the child's family in terms of respecting his or her identity and
culture. Buddies are monitored by experienced co-ordinators,
and always complement the nursing team. At the end of 2005,
the project was introduced in Cayenne hospital.
• Lead poisoning: lead poisoning affects the central nervous
system. The consequences are irreversible and there is no
treatment. Young girls who are poisoned pass the lead on to
their babies twenty years later.
MdM's work involves locating unhealthy housing so that families are warned and informed and affected children are protected. Child screening and protection activities are carried
out in connection with state services, health workers, MCW,
paediatricians, school doctors and local hygiene services.
MdM is calling for a voluntarist policy to fight against child lead
poisoning.
• Buddies:
Set up the project in the
provinces in MdM's regional
delegations in Marseilles and
Lyons. Make a link with
Saint-Denis hospital in
Reunion. Develop training for
volunteers and co-ordinators
to improve the quality of listening and presence
amongst the children in
hospital.
• Lead poisoning:
Despite withdrawing at the
end of 2004, Mission France
in Bordeaux is staying in
contact with the families
monitored for four years.
MdM's Suburbs project
wants to consolidate its network so that the fight
against child lead poisoning
can continue without MdM,
who will then be able to
work in other towns around
Paris. The Poitiers team is
continuing its work.
Types of work
> Lead poisoning project: seven towns in Hauts-de-Seine, Poitiers.
Locating, screening, protecting children, involvement of institutions
and medical staff.
> Hospital buddies: Paris and the Paris area; Guyana.
Personalised monitoring of hospitalised children away from their
families.
> Healthcare centres: paediatric consultations, referrals to MCW.
> All healthcare centres see children.
serious illnesses requiring long
periods of hospitalisation
Sources of funding
> Local health authorities, CPAM
(health insurance office),
department councils, etc
Buddies
> number of children with buddies in
2005: 111
> number of volunteers:
92 in Paris, 14 in Guyana
> buddy partners:
6 AP-HP (Paris) hospitals, 6 longstay centres in the Paris area,
Cayenne hospital in Guyana
Lead poisoning
> number of children affected:
85,000 poisoned, of which only
5% screened (Inserm (national
medical research institute) figures
1999)
> number of projects: 2
> number of volunteers: 21
> lead poisoning partners:
Association of lead poisoningaffected families, Pact Arim, local
health authorities, local hygiene
services, MCW, doctors, hospitals,
Roma
The Roma have suffered racial discrimination and poverty in their countries of origin
and are now living in deplorable conditions in France in shanty towns or squats.
Repeated expulsions make them ever needier and make their lives even more insecure. Often forced into acting clandestinely, the Roma are often refused access to
healthcare, and more generally, to their fundamental rights.
Main conditions
> illnesses linked to living conditions,
delay in accessing healthcare (in
France and in their country of
origin), and psychological trauma
caused by repeated expulsions
Epidemiological
characteristics
>Early neonatal mortality (0-1 month)
nine times higher, infant mortality
(0-1 year) five times
higher, life expectancy 15 to 20
years below that of the French
population
(Romeurope data, 1998)
Number of projects
>4
Number of beneficiaries
> approx. 3,500 of whom more than
2,000 in Ile-de-France (estimate)
> 76
Sources of funding
> Local health authorities,
department councils, etc.
Partenaires
> Alpil, ASAV, ATD Fourth World,
LDH, MRAP, Roma family support
collectives, Romeurope, sector
MCW, town councils, PASS (permanent access to healthcare service, etc.…
> Supporting expelled families
1992, Suburbs Project: the 1st programme amongst migrant Roma
Activities: MdM continues to visit places where the Roma
live to help them get access to healthcare and their rights (universal health insurance and state medical aid). This health
watch is aimed particularly at health education and promotion, schooling for children, help for access to drinking water
and mother and child health. The mobile project amongst
Roma in Lyon visited 17 places in 2005 and met nearly 1,000
people, 56% of them women. The expulsion policy to which
Roma are subject aggravates their already insecure living conditions even more. All their affairs are often destroyed, and
contacts with healthcare structures and schools broken, etc.
Their wandering forces them to settle in shanty towns, thus
making it harder to access their fundamental rights and delaying
or preventing the work of the medical and welfare teams working amongst them.
Types of work
> Health prevention and education, primary healthcare, help for chil-
dren's schooling, access to drinking water, implementing sanitary
measures, etc
> Antenatal work: preventing terminations, monitoring pregnancies,
information on contraception, child vaccinations, MCW support and
in family planning centres.
> Bearing witness to living conditions, repeated expulsions, obstacles
to access to healthcare and rights.
> Involvement of Roma family support committees, health workers,
town councils and state services.
Outlook:
Continue local health work
on the ground, with an
emphasis on children and
rights to health, and continue to develop mother and
child health work. As part of
the Romeurope collective,
MdM will continue to work
alongside other member
associations against the
discrimination and human
rights violations of which the
Roma are victims in France
(expulsions from living places, police harassment,
arrests, removals from the
area, etc) and to improve
access to fundamental rights
for migrant Roma in France
(right to health protection,
housing, work and education).
110/111
Travellers
Although the Besson law on travellers is not complied with, insofar as only 15% of
towns with more than 5,000 inhabitants have fulfilled their obligations concerning
sites for travellers, other plans do threaten them.
In December 2005, a French MP managed to have an amendment to the national
budget passed instituting a tax on caravans. This state tax (of several tens of euros
per m2), which is not in any way a housing tax, does not give any welfare rights for
housing. Associations defending travellers' rights are calling for this tax to be withdrawn as it is neither legitimate nor fair. They reaffirm the priority of having caravan
housing recognised with all the welfare rights related to housing, and are asking to
take part in the authorities laid down by the law, namely the National Consultative
Committee, for all subjects concerning travellers, and Halde (the high authority in the
> approx. 100 families
Main conditions
> depression, insomnia, cardiovascular diseases, addiction problems linked to living conditions
and life style
fight against discrimination and for equality).
> Facilitating access to fundamental rights
Social characteristics
> isolation, lack of schooling,
desocialisation
Since 1997…
Activities: MdM's mobile teams have two aims: to meet
Outlook:
travellers whre they live and help them to have their rights recognised.
In fact, there are very few sites for them, and where they exist,
the living conditions are very insecure: no sewers, poor access
to running water and electricity, the presence of rats, a lack
of toilets. MdM is carrying out the following activities:
• support, listening and referral activities;
• activities aimed at facilitating access to healthcare,
rights and schooling for children;
• lobbying the public administrations to ask for sites to be
created for travellers.
Continue activities to improve hygiene, living and health
conditions for travellers, facilitating their access to public
health and welfare structures
and more generally to citizenship. The expert status
acquired by the MdM
Bordeaux team has allowed
it, together with Gypsy associations and personalities
working with the traveller
community, to create a coordinating body whose aim
is to contribute to putting in
place suitable conditions for
the traveller community.
MdM's teams are involved
with several authorities
including the departmentlevel consultative committees for the plan to deal
with travellers.
Types of work
> Listening, psychological support, prevention and information messages.
> Primary healthcare, help for schooling and access to housing,
referral to other public welfare and health structures.
> Lobbying town councils, health institutions and professionals to
improve hygiene, living and health conditions; actions to recognise
citizenship.
> Involvement in department-level consultative committees for the
plan to deal with travellers.
Number of projects
>2
>7
Sources of funding
> Regional health authorities and
health insurance agencies
Partners
> Relais accueil gens du voyage,
co-ordinating body for work
amongst travellers, Centre social
des Alliers, LDH, CCAS (local
social work centres), schools,
town councils, etc.
People working in prostitution
The internal security law which created the offence of passive soliciting and the massive police presence contribute to the repressive situation which restricts access to
healthcare and to prevention material for people working in prostitution. These people are exposed to risks of sexually transmitted infections; they are sometimes drug
addicts and in certain cases the victims of trafficking. They are in an extremely vulnerable situation, made worse by being criminalised.
Characteristics
> people mainly from Eastern Europe,
Sub-Saharn Africa and China, either
holding tourist visas, applying for
asylum or staying illegally, sometimes the victims of trafficking.
Sex, age
> mainly 20 to 40 year old women,
transgendered people, men and
sometimes minors
Main conditions
> gynaecology conditions, illnesses
linked to street conditions, psychological illnesses linked to stress, isolation and ill-treatment, addictions
Number of projects
> 6 mobile teams/projects working
amongst people involved in prostitution, in the street, often in close
collaboration with CASOs and harm
reduction programmes linked to
drug use
> very hard to obtain data, probably
around 1,000
> 117
Partners
> Cabiria, Amis du bus des femmes,
Aides, local health authorities,
Gasprom, Platfrom for the fight
against human trafficking, anonymous screening centres (CDAG),
health insurance office (CPAM), town
councils, family planning centres,
psychiatric emergency care, Samu
social
> Support through prevention and information
Since 1999 as a theme in its own right
Activities: In a climate marked by a clear increase in vio-
Outlook:
lence against them, people working in prostitution find themselves in an extremely vulnerable situation with less access to
associations and prevention material. Accommodation difficulties and slow access to rights are additional obstacles to
getting healthcare. M éd eci ns du Monde 's work particularly involves mobile activities, health promotion and
harm reduction concerning prostitution practices, with
welfare, medical, administrative and legal support. The
teams are keen to give information, adapted and translated if
necessary, on risks linked to STIs, HIV, hepatitis and on rights.
• In Le Havre, MdM has had to stop its work, as the police
presence everywhere has led to the people working in prostitution disappearing completely from the streets.
• In Poitiers, as part of the Abri collective, MdM started work
amongst people working in prostitution in September 2005.
• In Rennes, the exploratory project carried out in 2005 did
not lead to setting up a specific programme.
The projects want to work
on and develop the testimony aspect, especially on the
consequences of the internal
security law on health and
welfare for people working in
prostitution.
Types of work
> All our programmes offer referrals to screening for HIV, VHB and
VHC, distribute prevention material, listen, promote people's rights,
inform and refer to public structures.
> Metz: an itinerant structure set up with Aides.
> Montpellier: as well as evening work in the city centre, a daytime
weekly visit is organised on the main roads.
> Nantes: physical accompaniment to hospitals and for any health
care, for access to rights, to file complaints, and to courts for cases
of soliciting. Help to register for literacy courses. Set up thematic
health workshops.
> Paris: information adapted and translated into Chinese, support
and referral with interpreters.
> Poitiers: patrols set up as part of a collective.
> Rouen: a rota for bus visits set up, thanks to synchronisation with
work of the Aides association and an infectious diseases screening
project.
HR & Needle Exchange
112/113
The decree of 14 April 2005 legally recognises the harm reduction (RdR) policy. It has
now been proved that needle exchange programmes are effective: they reduce needle and straw sharing, and therefore the risk of transmitting AIDS or hepatitis C. They
also greatly reduce the risk of overdoses and allow drug users to be referred to health
and welfare structures. This public health approach allows marginalised users to have
access to welfare, healthcare, information, referral and support systems.
> Going to a marginalised population
1996, granting of access prevention kit licence to Ministry of Health
Activities: The distribution of sterile equipment, which
Outlook:
is fundamental to reducing the risks of taking drugs,
means contact can be made with an often marginalised
population who, without these programmes, would not
have access to information and public treatment structures. Having made contact, the teams can pass on prevention messages, listen and refer drug users on medical, welfare
or legal matters such as accommodation, rights, regularising
legal situations, withdrawal, post-treatment care and substitution treatments. In Paris saliva tests to screen for hepatitis
C are offered and, as well as allowing medical treatment if the
result is positive, also mean that the team can talk to the person and give him more help. Other tools are used in this harm
reduction process according to the context: inhalation straws
for sniffers, crack pipe mouthpieces to avoid burns and VHC
contamination, Sterifilt to filter non-injectable substances at
the end of the needle. The field teams are continually involved
in research and survey work on tools and prevention messages to improve their effectiveness. The street work often complements the work carried out in the mobile units.
Encourage measures to
make exchanges with users
easier along the line of saliva
tests for screening hepatitis
C. The development of polyconsumption requires new
tools to be created, especially linked to crack consumption. Since January 2006,
needle exchange programmes have been recognised
as medical and welfare institutions and are funded by
health insurance as
CAARUDs (Centres for supporting harm reduction for
drug users) on condition that
they carry out specific work
(reception, referral, support,
etc).
As part of the move to becoming CAARUDs, the Paris,
Bordeaux and Marseille programmes must leave MdM in
2006 and become autonomous associations set up by
the field teams supported by
MdM.
Types of work
> 4 mobile structures: buses, vans and teams on foot amongst drug
users in the street or in squats.
> 1 permanent centre in Bordeaux, 1 permanent needle exchange
centre in Paris and Marseille.
> Sterile injection material made available in all CASOs
> 236,808 needles given, 36% used needles returned.
Most common conditions
> risks of infections linked to the
intravenous use of drugs (VHC, VIH,
VHB), abcesses, psychiatric co-morbidity, dental problems, psychological problems linked to exclusion
> risks of marginalisation, discrimination and social harm
Report from our programmes
> clear development towards polyconsumption of injected and noninjected products. Persistence of
strong prevalence of hepatitis C
amongst injecting users
> factive file of nearly 2,600 IVDUs
from 12,500 visits to mobile units
and permanent centres. More than
19,000 other contacts (for information, referrals and requests other
than for material)
> 35 in multidisciplinary teams
Sources of funding
> mainly the state via local health
authorities, local authorities, health
insurance offices (CPAM), the
National Fund for Health Prevention,
Education and Information (FNPEIS),
town councils, Ile de France regional
health insurance office (CRAMIF)
Partners
> Department of Health, MILDT
(Interdepartmental Committee for the
fight against drugs and drug addiction), OFDT (French monitoring centre for Drugs and Drug Addiction) and
all RdR structures in towns where we
work.
Methadone Buses
As methadone subsitution relieves withdrawal sensations, it reduces the risks linked
to drug use, as well as helping the social and health reintegration of drug users, who
are particularly vulnerable and often marginalised.
Drug users
> approx. 200,000 injectors
Main conditions
> HIV, VHB, VHC contamination
amongst injectors, psychiatric
co-morbidity, psychological
suffering linked to exclusion
Number of projects
> 2 methadone buses
> active file: 767 in 2 towns
Number of contacts
> an average of 100 contacts per
> Local work on a daily basis
Since 1998
Activities: The programmes are aimed at particularly marginalised users not covered by any other structure, and offer
services at the level of need suited to the user's situation. A
methadone dose is delivered daily to the patients on the programme. Patients are included from the day they request it,
in the permanent centre after a medical interview. The programmes are aimed at treating opiate dependency by starting and continuing methadone substitution treatment.
The programme includes monitoring the most problematic
users; the aim is to refer patients to other structures. The buses
act as bridges towards more permanent treatment systems.
They are parked close to places where drugs are taken and
provide a place where people can be seen and referred for
medical, psychological and social care.
day in Paris and 30 in Marseilles
> 23
Sources of funding
> CPAM (health insurance offices),
local health authorities, Solidarité
sida, Sidaction; MILDT
(Interdepartmental committee on
drugs and drug addiction), local
and regional authorities
Partners
> ASUD, TIPI, Aides Provence,
Sleep'in, HAS, emergency accommodation hostels, other drug addiction treatment centres (CSST) in
Marseilles and Paris
(especially Fernand-Vidal and
Marmottan), hospitals, treatment and
post-treatment institutions, etc.
Types of work
> Mobile healthcare unit manned 7 days a week.
> Local mobile teams.
> Reception in a permanent centre.
Outlook:
In Paris, the team has been
involved in a think-tank with
the help of a philosopher on
innovative therapeutic practices which should lead to a
written paper in 2006. In
Marseille, the team has formed an RdR platform which
offers, in connection with the
methadone bus's services,
several types of work adapted to the people encountered in squats, nightlife
venues, during street work,
etc by offering suitable tools.
These activities are run with
operational partners (ASUD,
TIPI, etc.).
On the other hand, during
2006, the 2 methadone
buses (as well as the NEPs)
are going to leave MdM. The
association GAIA Paris will
take over running the Paris
CSST (drug addiction centre) and the association BUS
31/32 will take over in
Marseilles. These 2 associations have been set up
especially for this purpose
by the field teams and will
continue to have strong links
with MdM.
114/115
Raves
Young people are taking more and more synthetic drugs. But the ban on raves forces
participants into clandestine behaviour with all the related risks: poor security conditions, no medical support, nobody present from associations or institutions to provide prevention messages. The decree of 14 April 2005 banning testing for drugs is a
real brake on our approach to these people. It was an essential tool for initiating
discussions about prevention and for making users take responsibility for their
drug-taking.
Types of products
> alcohol, ecstasy, cocaine, and
other hallucinogens, amphetamines, heroin, anaesthetic substances (GHB, ketamine)
> Informing about risks
Since 1997
Activities:
MdM's Raves project is involved in harm
reduction work linked to the use of psychoactive substances. It has two main aspects:
• health and prevention: offer places for medical care where
people can be seen and listened to. The teams deal with minor
cuts and bruises and emergencies. Prevention messages are
given concerning the risks of taking drugs, cultural practices
(tattoos, piercing, etc.), and STI, HIV and hepatitis transmission, etc;
• analysis, on site using TLC (thin-layer chromatography) and testing (until April 2005, when testing was banned), and in a laboratory, of the components of the
substances in circulation in order to adapt the prevention messages appropriately. Since 1999, MdM has been
involved in the SINTES (National system for identifying toxins
and substances) programme.
In 2005, the Paris Raves project redirected its activities to
squats. The team sets up RdR stands each Friday evening,
visits around three squats each week and practices TLC analysis to identify the substances contained in the drugs taken.
120 squats were visited and 36 RdR sessions were held in
Paris (in all, more than 3,400 RdR contacts). The Marseilles
RdR project also extended its activities into squats in 2005.
Types of work
> All the projects offer first aid, information and substance analysis in
a harm reduction approach linked to drug use.
> Work in places where young people gather such as free parties,
teknivals, discotheques, clubs, squats, etc.
> In 2005, 78 samples of synthetic drugs were collected, documented and analysed under the SINTES programme co-ordinated by
OFDT (French monitoring centre for drugs and drug addiction).
Outlook:
Adapt the types of work the
projects do to an increasingly difficult context where
young people are dispersed
and less and less accessible. Develop prevention
tools and flyers, appropriate
to the growing context of
polyconsumption.
Health problems
encountered
> headaches, vomiting, dizziness,
psychological problems, anxiety
attacks
Most common risks
> dehydration, bad trips,
hyperthermia, hypoglycaemia
Beneficiaries
> approximately 40,000
Sex, age
> mainly men, average age: 24
Number of instances of
treatment
> 75 including 3 joint projects
at teknivals
> 180
Sources of funding
> Ministry of Health, local health
authorities, MILDT (interministerial
committee on drugs and drug
addiction), OFDT (French monitoring centre for drugs and drug
addiction), local authorities
Partners
> Techno Plus, Aides, Orange
Bleue, ASUD, TIPI, Act Up,
Acothé, Nantes daytime reception
centre, Espace indépendance,
Sida paroles, Fratrie
>
Contacts
(CASOs - Free Healthcare and Guidance Centres)
> AIX-EN-PROVENCE
Philippe ROQUEJEOFFRE Médecins
du Monde Maison de la Solidarité
Rue Philippe-Solari
13100 Aix-en-Provence
Tel.: 04 42 21 45 84
Fax: 04 42 21 62 48
[email protected]
> AJACCIO
François PERNIN
Médecins du Monde c/o Secours
catholique
6, bd Casanova
20000 Ajaccio
Tel.: 04 95 51 28 93
Fax: 04 95 21 17 13
All mail: F. Pernin
La Gravona
20000 Ajaccio
Tel.: 04 95 29 90 75
Fax: 04 95 29 94 24
[email protected]
> ANGERS
Isabelle SALAUN, Frédéric VIE
Médecins du Monde
62, boulevard Saint-Michel
49100 Angers
Tel.: 02 41 43 65 66
Fax: 02 41 43 01 49
[email protected]
> BESANÇON
Violaine LLORCA
Médecins du Monde
Appartement 168003
7, rue du Languedoc
25000 Besançon
Tel.: 03 81 51 26 47
Fax: 03 81 52 70 28
[email protected]
> BORDEAUX
Christophe ADAM Médecins
du Monde
2, rue Charlevoix-de-Villiers
33000 Bordeaux
Tel.: 05 56 79 13 82
Fax: 05 56 52 77 69
[email protected]
> GUYANA
Sylvie CREGUT
Médecins du Monde
32, rue Vermont-Polycarpe
97300 Cayenne
Guyane
Tel./Fax: 05 94 28 36 77
[email protected]
> MONTPELLIER
Tony DA SILVA, Marie-Bernadette
CADILHAC, Margarita GONZALEZ
Médecins du Monde
18, rue Henri-Dunant
34090 Montpellier
Tel.: 04 99 23 27 17
[email protected]
> ROUEN
Agathe BONMARCHAND
Médecins du Monde
5, rue d'Elbeuf
76100 Rouen
Tel.: 02 35 72 56 66
Fax: 02 35 73 05 64
[email protected]
> GRENOBLE
Patrick BAGUET
Médecins du Monde
19, rue René-Thomas
38000 Grenoble
Tel.: 04 76 84 17 21
Fax: 04 76 84 17 58
[email protected]
> NANCY
Jean-Marie GILGENKRANTZ
Médecins du Monde
5, rue de l'Armée-Patton
54000 Nancy
Tel.: 03 83 27 87 84
Fax: 03 83 28 42 55
[email protected]
> STRASBOURG
Jean-Maurice SALEN
Médecins du Monde
24, rue du Maréchal-Foch
67000 Strasbourg
Tel.: 03 88 14 01 00/01
Fax: 03 88 14 01 02
[email protected]
> LA PLAINE-SAINT-DENIS
Florence SUZAN
Médecins du Monde
8-10, rue des Blés
93210 La Plaine-Saint-Denis
Tel.: 01 55 93 19 29
Fax: 01 55 93 19 30
[email protected]
> NANTES
Philippe JARROUSSE,
Jean Pierre CLAUZEL Médecins du
Monde
33, rue Fouré
44000 Nantes
Tel.: 02 40 47 36 99
Fax: 02 51 82 38 09
[email protected]
> TOULOUSE
Geneviève MOLINA Médecins du
Monde
5, boulevard de Bonrepos
31000 Toulouse
Tel.: 05 61 63 78 78
Fax: 05 61 62 04 15
[email protected]
> LYONS
Marc CUCHE, Karen FINSTERLE
Médecins du Monde
10, rue de Sévigné
69003 Lyon
Tel.: 04 78 89 99 99
Fax: 04 78 71 75 72
[email protected]
> LE HAVRE
Arlette SEIFFERT
Médecins du Monde
28, rue J.-B.-Eyriès
76000 Le Havre
Tel.: 02 35 21 68 66
Fax: 02 35 22 67 33
[email protected]
> MARSEILLES
Xavier CARRARD, Georgia COUFFIN
et Florence LARMAT Médecins du
Monde
4, avenue Rostand
13003 Marseille
Tel.: 04 95 04 56 00
Fax: 04 95 04 56 04
[email protected]
> NICE
Bernard AUBIN
Médecins du Monde
34, rue Rossini
06000 Nice
Tel.: 04 93 16 59 60
Fax: 04 93 16 59 61
[email protected]
> PARIS
Denis HERMAN, Marc LERICHE
Médecins du Monde
62 bis, avenue Parmentier
75011 Paris
Tel.: 01 43 14 81 81
Fax: 01 47 00 75 53
[email protected]
> PAU
Robert LAFOURCADE
Médecins du Monde
12 bis, place de la Monnaie
64000 Pau
Tel.: 05 59 83 74 28
Fax: 05 59 27 22 32
[email protected]
> VALENCIENNES
Eliane LAMORISSE Médecins du
Monde
10-12, rue du Grand-Fossart
59300 Valenciennes
Tel.: 03 27 47 40 08
Fax: 03 27 30 19 16
[email protected]
116/117
>
Contacts
(mobile activities) - Community Medicine
MOBILE PROJECTS
STREET WORK
> LYONS
Françoise MICHAUD
Médecins du Monde
1, place du Griffon
69001 Lyon
Tel.: 04 78 29 59 14
Fax: 04 78 29 55 91
[email protected]
> METZ
René MOUTIER
Médecins du Monde
11, rue Saint-Pierre
57000 Metz
Tel.: 03 87 63 55 91
Fax: 03 87 66 60 93
[email protected]
> POITIERS
La Caravane
Marie-Thérèse RAYMOND Médecins
du Monde
21, rue Boncenne
86000 Poitiers
Tel.: 05 49 01 77 77
Fax: 05 49 60 28 93
Back-up/Tel.: 05 49 38 45 10
Fax: 05 49 38 45 11
> SAINT-DENIS DE LA RÉUNION
Médecins du Monde
250 bis, rue Général-Rolland - bât. K
SHLMR Bouvet - BP 964
97479 Saint-Denis de la Réunion
Cedex
Tel.: 02 62 21 71 66
Fax: 02 62 41 19 46
medecinsdumonde.reunion
@wanadoo.fr
PROSTITUTION PREVENTION
> LE HAVRE
Arlette SEIFFERT
Médecins du Monde
28, rue J.-B.-Eyriès
76000 Le Havre
Tél. : 02 35 21 68 66
Fax : 02 35 22 67 33
[email protected]
> METZ
René MOUTIER, Frédérique CARRIE
Médecins du Monde
11, rue Saint-Pierre
57000 Metz
Tél. : 03 87 63 55 91
Fax : 03 87 66 60 93
[email protected]
> MONTPELLIER
Damien CHERET, Clélia VENTURINI
Médecins du Monde
18, rue Henri-Dunant
34090 Montpellier
Tél. : 04 99 23 27 17
Fax : 04 99 23 27 18
[email protected]
> NANTES
Funambus
Paul BOLO
Médecins du Monde
33, rue Fouré
44000 Nantes
Tél. : 02 40 47 36 99
Fax : 02 51 82 38 09
[email protected]
> PARIS
Lotus Bus
Chloé CATTELAIN, Marie DEBRUS
Médecins du Monde
75011 Paris
Tél. : 01 43 14 81 61
Fax : 01 47 00 80 70
[email protected]
> ROUEN
Bus prévention
Jean-Jacques PREY
Médecins du Monde
5, rue d’Elbeuf
76100 Rouen
Tél. : 02 35 72 56 66
Fax : 02 35 73 05 64
[email protected]
TRAVELLERS' PROJECTS
> STRASBOURG
Catherine FRAPARD
Médecins du Monde
24, rue du Maréchal-Foch
67000 Strasbourg
Tél. : 03 88 14 01 01
Fax : 03 88 14 01 02
[email protected]
CHILDREN'S PROJECTS
Child lead poisoning
Claude CHAUDIERES
Mission Banlieue
Médecins du Monde
8-10, rue des Blés
Tél. : 01 55 93 19 29
Fax : 01 55 93 19 30
[email protected]
Hospital buddies
> PARIS
Catherine PETERMAN
c/o coordination Mission France
Médecins du Monde
62, rue Marcadet
75018 Paris
Tél. : 01 44 92 13 10
Fax : 01 44 92 99 92
[email protected]
ROMA-GYPSY PROJECT
Sylvie MONIN
Médecins du Monde
8-10, rue des Blés
Tél. : 01 55 93 19 38
Fax : 01 55 93 19 30
[email protected]
POORLY HOUSED PROJECT
Squats Project
> BORDEAUX
Liane and Guy MAYER
Médecins du Monde
33000 Bordeaux
Tél. : 05 56 79 13 82
Fax : 05 56 52 77 69
[email protected]
> TOULOUSE
Marie-Pierre BUTTIGIEG
Médecins du Monde
31000 Toulouse
Tél. : 05 61 63 78 78
Fax : 05 61 62 04 15
[email protected]
Homelessness Project
> MARSEILLE
Denise CLÉMENT
Médecins du Monde
4, avenue Rostand
13003 Marseille
Tél. : 04 95 04 56 03
Fax : 04 95 04 56 04
[email protected]
> PARIS
Graciela ROBERT,
Paul ZYLBERBERG
Médecins du Monde
75011 Paris
Tél. (en journée pour mess.) :
01 44 92 14 98
Tél. (de 21 h à 23 h) :
01 43 14 81 74
Fax : 01 43 14 81 51
[email protected]
CAFDA Project
> PARIS
Fabrice GIRAUX, Marc LERICHE
Médecins du Monde
44, rue Planchat
75020 Paris
Tél./ Fax : 01 45 49 03 80
[email protected]
WELFARE
SUPPORT PROJECT
> BORDEAUX
Arnaud WIEHN
Médecins du Monde
33000 Bordeaux
Tél. : 05 56 79 13 82
Fax : 05 56 52 77 69
[email protected]
>
Contacts
(Harm Reduction)
NEEDLE EXCHANGE BUS
> ANGOULÊME
Valérie PATRIER
Médecins du Monde
22, allée du Champ-Brun
16000 Angoulême
Tél. : 05 45 65 11 82 (unit)
Tél. : 05 45 65 07 47 (office)
Fax : 05 45 61 18 85
(unit and office)
[email protected]
HEALTH LISTENING BUS
> ANGOULÊME
Marie-Laure FERRARI
Médecins du Monde
22, allée du Champ-Brun
16000 Angoulême
Tél. : 05 45 65 11 82 (unit)
Tél. : 05 45 65 07 47 (office)
Fax : 05 45 61 18 85
(unit and office)
HARM REDUCTION
> MARSEILLE
Béatrice STAMBUL
Médecins du Monde
4, avenue Rostand
13003 Marseille
Tél. : 04 95 04 56 06/08
Fax : 04 95 04 56 07
[email protected]
NEEDLE EXCHANGE BUS
METHADONE BUS
> PARIS
Jean-Pierre LHOMME
Médecins du Monde
75011 Paris
Tél. : 01 43 14 81 61
Fax : 01 47 00 80 70
secrpes.parmentier
@medecinsdumonde.net
bus.methadone
@medecinsdumonde.net
NEEDLE EXCHANGE BUS
> BORDEAUX
Jean-Pierre DAULOUEDE,
Guy MAYER
Médecins du Monde
2, rue des Etables
33800 Bordeaux
Tél. : 05 56 92 51 89
Fax : 05 56 92 03 59
[email protected]
RAVES
> BAYONNE
Jean-Pierre DALOUEDE
Médecins du Monde - Bizia
(centre méthadone)
Centre hospitalier Côte basque BP 8
64106 Bayonne
Tél. Bizia : 05 59 44 31 00
Raves port. : 06 03 21 21 05
Tél. Raves : 05 59 44 31 05
Fax : 05 59 44 31 03
[email protected]
> NANTES
Anne-Lise GUEGUEN
Médecins du Monde
33, rue Fouré
44000 Nantes
Tél. : 02 40 47 36 99
Fax : 02 51 82 38 09
[email protected]
> NICE
Philippe de BOTTON
Médecins du Monde
34, rue Rossini
06000 Nice
Tél. : 06 08 27 20 94
[email protected]
> PARIS
Valère ROGISSART
Médecins du Monde
75011 Paris
Tél./ Fax : 01 43 14 81 69
[email protected]
> TOULOUSE
Olivier DROUAULT, Julien SANCHEZ
Médecins du Monde
31000 Toulouse
Tél. : 05 61 63 78 78
Fax : 05 61 62 04 15
[email protected]
XBT PROJECT
National SINTES
co-ordinating body
> PARIS
Stéphane LE VU
Médecins du Monde
75011 Paris
Tél./ Fax : 01 43 14 81 69
[email protected]
[email protected]
> MdM mobilisation
CÉDRIC HELSLY
119/128
CATHERINE HENRIETTE
JULIEN DE WECK
mdm
MICHEL REDONDO
LAHCÈNE ABIB
mdm
VALÉRIE DUPONT
CÉDRIC HELSLY
VALÉRIE DUPONT
120/121
JOËL ROBINE
VALÉRIE DUPONT
January-February
GÉRARD RONDEAU
>
The tsunami struck South-East Asia on 26 December 2004.
“Children and War” conference in the Senate.
Mobilisation following the building of the wall in Palestine.
lopment and the attacks on their most fundamental rights, so that their suffering, needs
and rights can at last be recognised. More than
forty speakers (humanitarian workers, lawyers,
sociologists, psychologists, etc.) took part in the
conference talking to an audience of over 210
people and trying to call on the public authorities to act by apleading for better protection for
children in armed conflicts.
physical and mental health, and freedom of movement, and for the Geneva Convention to be
respected. At the same time, fourteen Israeli and
Palestinian artists raised awareness amongst
Israeli and Palestinian public opinion through their
pictures of the security barrier and its consequences. The campaign was publicised locally
by the Israeli magazine Ha'ir and the Palestinian
paper Al Quds; the report was distributed to the
authorities of Israel and the Palestinian Territories.
> Key events
Tsunami: After this unprecedented humanitarian disaster, MdM got involved through its international network in providing emergency
medical assistance to tsunami victims, reactivating healthcare systems in the stricken
areas and dealing with risks of epidemics. At
the same time, at head office, the doors were
opened two Sundays in a row to welcome people affected by this drama and provide them with
comfort and support.
11 and 12 February: “Children and war, violence, trauma and rehabilitation” conference
in the Senate. War is the main cause of infant
mortality in the world. Wars almost always involve
the whole population directly, so children are killed,
wounded or displaced. They are witnesses of
atrocious violence or forced to take part in it as
soldiers, servants or sex slaves. The conference
was organised together with Défenseur des
enfants, Enfants réfugiés du monde and the Centre
de recherches sur la paix, and was the opportunity to denounce the hindrances to child deve-
14 and 15 February: campaign on the Wall
and health in Palestine. . Two press conferences in Tel Aviv and Ramallah, in association
with Physicians for Human Rights (an Israeli medical organisation) and the Palestinian Red Crescent
Society, denounced the destructive effects of
building the Separation Wall in the West
Bank on Palestinians' access to healthcare
and living conditions in the territories. The
publication of the report, “The ultimate barrier:
the Wall's impact on the Palestinian health system”, reaffirms MdM's fight to defend the civilian population's right to healthcare, right to
> And also
February: Publication of the book by Dr. Jacqueline
Ferreira, “Caring for the poorly cared for Ethnology of a free healthcare centre”, which
carefully dissects the medical and social care given
to patients by Médecins du Monde's teams.
An exhibition of photos illustrating Roma
living conditions in Romania had been touring
France for a year and continued its tour in 2005.
>
March
>
And also
DR
SAMUEL BOLLENDORFF
/ L’OEIL PUBLIC
7 March: MdM was involved in a day of reflection on the human rights situation in the
Kurdish South-East. The “Human Rights in
Turkey: a growing reality?” conference was organised by the Group for Human Rights in Turkey
with the support of FIDH (International Human
Rights Federation).
Project amongst women prostitutes.
Day of meetings on humanitarian surgery.
> Key events
15 March: open letter to the President of
France on the harmful consequences of the
internal security law on people involved in
prostitution.
The internal security law, which represses all,
even passive, soliciting, puts a lot on pressure
on people involved in prostitution, who must
now hide to avoid police repression. These people, exposed to violence and risk of STIs, and
suffering from an increasing feeling of insecurity, have in fact become even more vulnerable
since this law was introduced, and the work of
the Association has become very difficult as
access to people involved in prostitution is now
so restricted.
20 March: MdM started lobbying MEPs to ask
for an amendment to be added to the proposed European directive on procedures for deporting illegal migrants which will be passed in 2006.
The text does not take into account the state
of health of those to be deported, except to
avoid their dying during the transport for their
deportion. As M d M has noted the very poor
health of a large number of migrants, we
are calling for an amendment to be added
banning the expulsion of seriously ill people and guaranteeing access to healthcare in
the country, unless it can be proved that these
people will have effective access to appropriate
treatment and medical care in their countries of
origin.
11 March: Médecins du Monde, Médecins
Sans Frontières (MSF) and Aide Médicale
Internationale (AMI) called on the French National
Medical Association (CNOM) to act in the case
of Dr Michele d'Auria, a doctor with the Abbé
Pierre Foundation and a former expatriate volunteer of MdM, so that he can practise as a doctor in France. He had been accused in Italy of
acts for which he has since
19 March: M d M 's surgery meetings.
Surgeons on humanitarian missions are called
to act quickly and to adapt to circumstances
using the means available. This day of meetings was an opportunity to compare field experiences, exchange ideas and techniques and
try together to find answers to all the questions
which a surgeon on a project faces.
122/123
mdm
PASCAL DELOCHE
>
Chechnya: MdM provides support to the victims
of a continuous political and military crisis.
H u m a n i t a i re Magazine No.12: “The Kurdish
question and humanitarian workers.”
5 April: “Perspectives - Chechnya, Northern
Caucasus: the Kremlin's calculations in the
region”. This meeting organised at MdM's
head office was a time for discussions and
reflection on the political and humanitarian
future of Chechnya after the assassination of
the Chechen President Maskhadov.
19 April: organisation of a meeting to support Florence Aubenas and Hussein
Hanoun, in conjunction with all the French
international solidarity organisations. Those
involved in international solidarity, who are independent witnesses and just as threatened in
certain areas, could not do other than stand
by the hostages and work for their liberation,
which took place on 12 June.
Displaced people in Rwanda.
28 April: «Tuez-les tous» (Kill them all), a
documentary on the Rwandan genocide (made
by R. Glucksman, D. Hazan and P. Mezerette).
Screening and discussion on Rwanda organised by MdM at the Cinéma des Cinéastes.
The quarterly magazine Humanitaire.
April
May-June
with Cinéma des Cinéastes, MdM organised
an exhibition on the theme “Victims and/or
killers? The child soldiers of Liberia”. Valérie
Dupont exhibited her photos and François
Margolin presented “Les petits soldats” (The
Little Soldiers), a documentary which he made
on the tragic situation of children enrolled in the
Liberian army. Since January 2005, through its
mental health programme, Médecins du Monde,
has been involved in helping these child soldiers to rebuild their lives and reintegrate into
society
DR
VALÉRIE DUPONT
>
MdM's new publicity campaign.
Teenager in Liberia.
> Key events
19 May: launch of MdM's new campaign
on behalf of forgotten crises. During a press
conference, MdM launched its new campaign,
which highlights what it is doing amongst populations who have been forgotten. Rather than
seeking to make people feel guilty, it is encouraging collective awareness that we are all
responsible for their being forgotten. The deliberately aged photo from Rwanda, which illustrates the theme, symbolises the deterioration
of collective memory. The campaign won first
prize in the press category in the awards for
solidarity publicity.
The people living in Kalma are gradually becoming completely dependent on international
aid, especially for food, even though the humanitarian organisations having problems in getting supplies.
At the same time, the area surrounding the
camp where MdM is working is becoming very
dangerous: roaming militias are involved in more
and more violence, pillaging and rape. Insecurity
reigns, the camp is less and less viable, and
everything is being done to force the displaced
to leave, exposing them to even greater dangers than in the “open-air prison” that is Kalma
camp.
13 May: MdM's general assembly was the opportunity to re-launch our involvement in Darfur,
because of the increased pressures on the displaced in Kalma camp. The Sudanese authorities
are pushing displaced people to leave the camp
against their will, by trying to “suffocate” them.
Trade is hindered, and the freedom of movement
of the displaced seriously curtailed.
>
And also
19 May: MdM's new Internet site was set
up. The site at www.medecinsdumonde.org
gives a new image, providing better information to the general public concerning MdM's
projects. On the fringe of the national
Humanitarian Action Exhibition, in partnership
18 June: Lyon Migrants Day, meetings,
exchanges and dialogue between the people
of Lyons and the migrant population.
23 June: MdM jointly signed the declaration
calling on the G8 country leaders to quickly expand measures to eradicate poverty, give
access to healthcare and education, and for
sustainable development in developing countries.
24-25 June: International day in support of victims of torture: MdM was involved in the conference organised by the Primo Levi Association,
entitled “Wanderings and loneliness, the
effects of torture and political violence”.
Médecins du Monde has been involved in the
Primo Levi Association's work for ten years. Its
main aim is to offer care and support to victims
of torture and political violence living in exile in
France.
124/125
>
July
AME-CMU (State medical aid - universal
health insurance): MdM got involved against
the reforms restricting access to healthcare
for people on low income and illegal foreigners and, at a joint press conference, denounced the aberration of the situation which involves
requesting proof of identity and residence from
those without papers in order to receive care,
which leads to the most destitute being excluded from healthcare. Two decrees complicating
access to AME still further were issued by the
government on 28 July 2005: from now on,
migrants with irregular status must provide proof
they have lived in France for three months. This
makes it almost impossible for these highly insecure and vulnerable people to get access to
healthcare. An appeal to withdraw these decrees
was made to the Council of State by MdM, Aides,
LDH (Human Rights League), MRAP (Movement
against Racism and for Friendship between
Peoples) and GISTI (Immigrant Information and
Support Group). Moreover, the Council of Europe's
DR
mdm
> Key events
Global action against poverty: as part of the
“2005: no more excuses” platform, MdM was
involved in “Action Mondiale contre la Pauvreté”
(Global Action against Poverty). This international campaign aims to put pressure on Northern
and Southern governments so that they take
concrete and ambitious measures to reach the
MDGs (Millennium Development Goals) adopted
by the United Nations in 2000 to reduce extreme
poverty. Throughout 2005, there was a campaign
to call on political decision-makers with respect
to the international agenda, especially on 1 July
2005, World White Band Day, on the eve of
the G8 conference. That day, people in over 100
countries wore white bands and thereby answered yes to our call. Meetings were also organised throughout France.
The campaign for White Band Day.
Free healthcare and guidance centre (CASO).
Committee of Social Rights ruled against France
in its decision of 3 November 2004 in which it
recalled that those without papers and their children must receive effective medical assistance
in accordance with the European Social Charter.
Humanitaire magazine, special edition No.
2 “What health for migrants in Europe?”,
which took up the proceedings of the Migrants
Workshops held in December 2004 at MdM's
head office, attended by Didier Fassin and Louis
Mermaz.
> And also
People's Health Assembly: M é d e c i n s d u
Monde took part in the 2nd People's Health
Assembly which took place in Cuenca
(Ecuador). The issues of access to health worldwide, and especially in poor countries, were
presented and discussed in their diversity by
health professionals and beneficiaries from the
whole world (1,500 people from 82 countries):
the right to health, HIV-AIDS, gender and women's health, environmental health, militarisation
and territorial occupation, health system reforms,
traditional medicine, etc.
11 July: Françoise Jeanson and Bernard
Granjon's opinion column in the Libération newspaper: “11 July 1995: a day of shame”, for
the ten years since the Srebrenica massacre.
MdM has associated itself with the «Contrôlez
les armes», the French section of the worldwide platform “Control Arms” campaign (launched by Amnesty International), which calls for
an international treaty on the arms trade.
Each year, over 500,000 people across the world
are killed by bullets, and no effective control is
exercised on the arms trade. It is estimated that
80 to 90% of the small arms in circulation were
originally traded legally.
>
August-September
> Key events
“Chill Août Tour” (Chill August Tour): organised by the Paris squats project, this tour started on 8 August 2005 and had several aims,
including strengthening the existing set-up for
MdM's different squats projects (Paris, Poitiers,
Marseilles, etc) and starting squats projects in
other towns, sharing and transferring harm reduction knowledge, organising workshops on drugs
analysis and distribution of harm reduction material, and testimonies. The tour ended at the teknival organised between 25 and 29 August
attended by 45,000 people.
6 September: urgent appeal for real solutions to be provided for the problem of substandard housing.
In the face of the inadequate housing policies
proposed, MdM again called on the govern-
>
ment to act, in an open letter to the Minister for
the Interior, Nicolas Sarkozy.
Reacting to further expulsions which threw
already destitute families on to the streets, MdM
again denounced the insecure living conditions
of thousands of homeless people or those occupying unhealthy and insecure housing. MdM
also linked up with the group “Pour un droit au
logement opposable” (For a binding right to
housing), so that people suffering from substandard housing can excercise their right to
housing before the competent authorities.
> And also
Palestinian Territories: during the withdrawal from the Gaza strip, , Florence Traullé. a
journalist on Nord Eclair, followed MdM's teams
in Gaza for two weeks, reporting on their
actions amongst the most destitute in daily
accounts in a log published on MdM's website.
15 August: alongside strong association involvement during 2005, F. Jeanson denounced
the new reforms to the AME system which restrict access to healthcare for highly vulnerable
people in an opinion column in L'Express
magazine, “Save state medical aid”
16 August: opinion column by F. Jeanson
and D. Cannet in the La Croix newspaper:
“Mothers weep for their children”, on the
postponement of high-risk elections in
Democratic Republic of Congo.
26 August: opinion column by P. Micheletti
“The end of the without frontiers”, in the
Libération newspaper.
October
> Key events
17 October: on the International Day for the
Eradication of Poverty, MdM's Mission
France organised a testimony day. This event
was firstly an opportunity to hear about the difficulties faced by the patients helped by MdM
(extreme poverty, lack of access to housing and
healthcare, etc) and the undeniable effects on
their health. It was also an opportunity to argue
for access to healthcare for everyone, hindered
by restrictive changes to the law which prevent
the most vulnerable people from receiving proper care. Today, the fundamental right that is
the right of access to healthcare is flouted to
the detriment of the weakest.
21 October: MdM denounced the withdrawal of the Global Fund, which had been
working in Burma since April 2005. This coordinated multilateral funding device fighting
against AIDS, tuberculosis and malaria was
due to fund several programmes to the tune
of 98 M$ over five years. However, for the first
time, the Global Fund decided to withdraw
from a country to which it had made commitments, justifying this reversal on the weight
of constraints imposed by the military junta
on humanitarian organisations. In actual fact,
the Fund's managers seem to have yielded
to pressure from one of its main funders, the
United States, whose Congress had been cri-
ticising the funding funding provided by the
Fund for several months. Meanwhile, MdM,
which has been working for fifteen years in
Burma, has noticed that its work (especially
amongst prostitutes and drug addicts), together with that of other NGOs was having a
significant impact on the HIV epidemic. By
stopping all its funding, the Global Fund is
preventing us from responding actively to an
endemic disease which is ravaging this country, and is annihilating all local initiatives.
7 October: the first stage of MdM's 25th anniversary, the exhibition of photos by Gérard
Rondeau was presented in a national preview by the Provence-Alpes-Côte d'Azur
126/127
>
October (cont'd)
region, in Marseilles. “Missions : Médecins
[jusqu'au bout] du Monde”, (Missions :
Doctors {to the ends} of the World) highlights
the daily work of MdM's teams throughout
the world. It provides a subjective view of
MdM's work and history. G. Rondeau has followed teams of French doctors for many years
from Niger to Russia, Iraqi Kurdistan to besieged Sarajevo, and from New York (where
Doctors of the World USA is based) to Paris,
and pays homage to them in this exhibition.
A book containing these photographs has
also been published.
> And also
MdM's teams which went to Pakistan after
the earthquake which ravaged the north of the
country shared their experience in a blog published on the Le Monde newspaper's website.
After the first emergency phase, devoted to
providing relief to the injured in the remote areas
north of Islamabad, MdM extended its work by
getting involved with the displaced gathered in
makeshift camps.
The book
of photographs by
Gérard Rondeau:
“Missions: médecins
[jusqu'au bout] du
monde”.
Novembre
> Key events
M dM celebrates its 25th birthday!
MdM's 25th birthday was an opportunity for all
the Association's staff and volunteers to look
back over a quarter of a century of humanitarian experience and to renew everyone's commitment to damaged populations. Interventions
in crises which receive little or no media attention make up a large part of MdM's activities.
By placing its anniversary under the banner of the forgotten crises and commitment, MdM wishes to recall that humanitarian
crises persist well after the media disappear
and that our NGO's role is to bring them out of
this often criminal oblivion. So, civilian involvement is essential so that these crises are dealt
with on a political level in the long term.
Through forums, open days, exhibitions and
film screenings, the whole network was involved in bearing witness, and proposing and
reflecting on new perspectives, without forgetting to pay homage to the field workers and
their efforts.
CÉDRIC HELSLY
>
MdM's 25th birthday party.
ving over 120 public health experts, health workers and academics and over 70 NGOs and
community groups. More than a report on health
inequalities, it offers an assessment by civil
society of the actions and policies of the
main institutions which influence health
worldwide. The report was supplemented by
Global Action for Health, an advocacy document which proposes a timetable for actions
that health associations can develop as of now.
On 4 and 5 November, humanitarian workers, sociologists, academics and health professionals gathered at MdM's head office to
exchange views on the direction and issues at
stake for humanitarian action. Three forums
were organised: “Humanitarian aid: views from
elsewhere”, led by Didier Fassin, “Humanitarian
action in disasters”, attended by Rony Brauman
and Jean-François Mattéi, and “Prospects for
the humanitarian action of tomorrow”, attended by Olivier Weber.
> And also
5 November: launch of the first report from
the Global Health Watch. Médecins du Monde
organised the launch in France of Global Health
Watch 2005-2006. This alternative report to
that published each year by the WHO is the
fruit of a vast international joint venture invol-
25 November: Opération Sourire celebrated
its 15th birthday in Phnom Penh. 200 people,
including former patients and the first surgeons,
gathered for this anniversary, recalling the importance of plastic surgery for children who can
have a normal life again and regain the desire
to smile.
December
CÉDRIC HELSLY
>
Operation “Coup de Poing” (Punch) on 21 December in Paris.
> Key events
15 December: assessment of aid given to
tsunami victims. At the request of the “Comité
de la Charte” (Charter Committee), MdM reported on its post-tsunami activities in South-East
Asia. After the relief work in the first weeks, MdM
got involved in medium-term work, by helping
to re-organise local health structures and
supporting health staff in Indonesia and Sri
Lanka. In all, MdM received over 9.75 million
euros in the form of donations to help tsunami
victims.
21 December: for lack of a roof, a tent. Living
on the street means being in danger of death.
Reacting to the public authorities' lack of action
concerning emergency accommo-dation, despite
several homeless people having died of cold at
the beginning of the winter, MdM took action by
demanding concrete measures so that the homeless can have permanent accommodation and
get off the street. MdM asked for a ban on putting anyone who has been offered accommodation back on the street. Since the morning of
21 December when MdM launched Operation
“Coup de Poing” (Punch), teams have been
criss-crossing Paris offering tents to people
living on the street. These tents are distress
beacons and symbolise the roof which society
should be capable of supplying to everyone. They
are not solutions to the homelessness problem:
on the contrary, they represent the current absence
of a practical solution. This is why MdM called on
members of parliament to act by sending the press
file to each of them. On 31 December, MdM and
Restos du Cœur jointly organised a patrol through
Paris. Four buses criss-crossed the capital offering homeless people meals, presents as well as
igloo tents.
9 December: creation of the French group
supporting the adoption of an additional
optional protocol to the United Nations
Covenant on Economic, Social and Cultural
rights (1966) of which MdM is a part, so that
these rights (including the right to health) can be
the object of legal appeal, including at international level. The Group is calling for the imminent
adoption of a text which will offer real guarantees
to victims by including a non-derogable right of
appeal to international law.
>
And also
1 December: “The international community
must keep its promises!” On World AIDS Day,
MdM's international network again launched an
appeal having noted the considerable gap between states' commitments on AIDS and the situation in the field, and the major impact of the
shortage of doctors and nurses on the treatment
of patients.
9 December: international call for the right
to health. MdM supported the initiative by Mary
Robinson (the former United Nations High
Commissioner for Human Rights) and Paul Hunt
(the United Nation's Special Reporter on the
Right to Health) who launched a call for the right
to health, signed by over 30 former heads of
state and government then open for NGOs to
sign. In particular, the text asked for governments to act to promote access for everyone to healthcare, water and food, and
to strengthen health systems and abolish
user fees for basic healthcare.
10 December: organisation of a photo exhibition at MdM's head office, entitled “Calais ou
l'inhumanitaire au quotidian” (Calais or inhumanitarian action on a daily basis), along
with a forum bearing witness to the situation of
migrants in transit in Calais.
13 December: Françoise Sivignon's opinion
column denouncing the withdrawal of the Global
Fund from Burma was published in the La Croix
newspaper.
Humanitaire Magazine No. 13:
“Humanitarian action in disasters”.
Forum on “Violence against women, here
and over there”. On Human Rights Day on 10
December, MdM organised a forum to denounce
violence against women, illustrated especially by
the Darfur crisis in Sudan, where rape is commonly used as a weapon.
>The representation network
129/142
>
>
Alsace
Contact details
> Regional delegation:
24, rue du Maréchal Foch
67000 Strasbourg
Tél. : 03 88 14 01 00
Fax : 03 88 14 01 02
Mission France :
03 88 14 01 01
[email protected]
http://medecinsdumondealsace.org/
Board Members
> Regional Representative:
Dr Maryvonne Le Gac
> Secretary:
Dr Paul-André Befort
> Key events
Publicity events
and activities
• Local Internet site: presentation of
the delegation and its activities.
• Information for students and
secondary school pupils.
• Concert by the Soroptimist
Club-Service for a collection of
hygiene products and blankets.
• Screening of the film Caravan 55
at the Odyssée cinema.
• Presentation of Gérard Rondeau's
book, 25 ans de Mission, at FNAC.
• Concert by the Obernai choir with
proceeds going to MdM.
Jean Litzler
Aloyse Kriegel
Catherine Frapard
Dr Pierre Rosenstiel
Dr Jean-Maurice Salen
> Secretary of the delegation:
Brigitte Fanteguzzi
> Section Adoption :
Colette Minard-Rosenstiel
> Number of Members:
71
Contact details
2, rue Charlevoix-de-Villers
33300 Bordeaux
Tél. : 05 56 79 13 82
Fax : 05 56 52 77 69
medecinsdumonde.bx
@wanadoo.fr
Board Members>
Regional Representative:
Françoise Parrot
> Secretary:
Savine Baudet
> Treasurer:
Marc Denise
> Other Members:
> Treasurer:
> Other Members:
Aquitaine
Partnerships
• Group of psychiatrists and general
practitioners on exclusion from health
care and AME (state medical aid) and
CMU (universal health insurance) restrictions.
• Group of organisations working
with people involved in prostitution.
• 115 and its partners: Maraude
Ville (Town Patrol), Restos du Cœur,
etc.
• Illkirch town.
• Alerte group.
Other activities
• Adoption: 8 children arrived in
Alsace; work with ASE (state
childcare services) to give better
information to couples seeking
approval.
• Setting up a trial exploratory
project in Gamadji Saré, Senegal,
started in the context of meetings
with the town of Illkirch.
Patrice Billecocq
François Cougoul
Jean-Pierre Daulouède
Marie-Germaine Mazeran
> Secretary of the delegation:
Marie-Christine Chauveau
133
> Pau branch:
Contract:
Robert Lafourcade
Tel.: 05 59 83 74 28
> Key events
Publicity events
and activities
• Participation in the regional meetings of the Aquitaine regional council's decentralised co-operation and
solidarity development body.
• Local social forum with MdM
stand.
• Exhibition and sale of pictures with
proceeds going to MdM.
• Meeting with the Réseau Santé
Solidarité (Health and Solidarity
Network) and Secours Catholique on
the topic of “the new poor in
France”.
• Global action “2005 no more
excuses”: white band operation
organised by MdM in Bordeaux with
involvement of other organisations.
• Organisation of Mission France's
national days on 7, 8 and 9 October
(around 220 participants).
• International Day for the
Eradication of Poverty.
• Day to meet with all adopting
families or in the process of adopting.
• Lecture and debate on “Tsunami Pakistan” with invitation to donors
from Gironde: a hundred participants
at Bordeaux 2 university.
130/131
>
>
Brittany
Contact details
19, rue Balzac
56270 Ploemeur
Tél. : 02 97 86 27 50
[email protected]
Board Members
Marie-Elizabeth Hochet
> Secretary:
Valérie Bergeron
> Treasurer:
Christophe Perron
> Other Members:
> Key events
Publicity events
and activities
• Presentation of MdM in information
centres: Lorient, Vannes.
• Work in partnership with other
Breton associations to raise funds for
South-East Asia after the tsunami.
• Participation in association forums.
• Involvement in the International Day
for the Eradication of Poverty and
signature of petitions.
• Publicity work to set up a new
press campaign: “We care for those
whom the world is slowly forgetting.”
Xavier Guillery,
Jean Godefroy
37
Corsica
Contact details
Résidence «La Gravona» bât. A
Rue des Romarins
20090 Ajaccio
Tél. : 08 75 33 18 99
Tél./Fax : 04 95 10 25 49
[email protected]
http://perso.wanadoo.fr/
mdmcorse
Board Members
François Pernin
> Secretary:
Catherine Contois
> Trésorière :
Other activities
• Adoption: three teams in Ille-etVilaine and Morbihan.
• Harm reduction: work at four
raves.
• Setting up the Regional
International Project in Mali.
• Exploratory project in Romania.
• Exploratory vulnerability project in
Lorient and Vannes.
Corinne Girardin
> Other Members:
Anne Galeani,
Denise Giacomoni
Michèle Iborra,
Jean-Pierre Lucciani,
Isabelle Serain,
Myrtha de Tollenaere
30
> Key events
Publicity events
and activities
• Participation in “Nurse” day.
• Participation in associations' forum.
• Participation, with testimony, in
Regional International Project in
Bulgaria, and fund raising at Young
People's Market.
Partnerships
• With Ajaccio town council's CCAS
(social work centre), MCH and
Education Inspectorate in the
context of the Regional International
Project in Bulgaria.
• Co-founder of an inter-association
platform, setting up a winter night
shelter with medical and
psychological consultations. Plan for
a permanent day centre is being
developed.
>
Franche-Comté
Contact details
7, rue du Languedoc
Appt 168 003
25000 Besançon
Tél. : 03 81 51 26 47
Fax : 03 81 52 70 28
[email protected]
Board Members
Jacques Guitard
> Secretary:
Violaine Llorca
> Treasurer:
Bernard Badey
> Other Members:
Philippe Boulhaut
Marie-Claire Tisserand
Jean-François Viel
> Key events
Publicity events
and activities
• Meeting with Franche-Comté
Solidarité to assess the position of
each participant in the association
created for tsunami victims.
• Participation in a regional press
conference to defend a mother of
Iranian origin, whose two children
have been taken away from her.
• Invitation by FR3 Franche-Comté to
speak about MdM's 25 years.
• Presence at MdM's 25th birthday
celebrations in Paris and discussion
on the possibility of setting up a
Regional International Project in
Franche-Comté.
>
Ile-de-France
Contact details
75011 Paris
Tél. : 01 43 14 81 99
Fax : 01 48 06 68 54
[email protected]
Board Members
Philippe Pluvinage
> Secretary:
Karen Segas
> Treasurer:
Claude Martine
> Other Members:
Maria Melchior
Marie Debrus
Catherine Peterman
> Key events
Publicity events
and activities
• Work in high schools and training
schools for nurses and other
paramedic professions.
• Stands at national events in Paris, in
conjunction with the publicity
department at head office, and at
local events in Ile-de-France.
• Involvement in the International Day
for the Eradication of Poverty at Paris
City Hall
• Organisation of a forum on “Calais:
inhumanitarian action on a daily
basis.”
• Participation in the forum “An equal
right to health for foreign residents?”
at the XIXth arrondissement town hall.
> Secrétaire
de la Regional delegation:
Anne Le Guelec
400
Publications
• Three issues of the Le Fil,
newspaper each with 600 copies.
Partnerships
• MdM's Nord-Pas-de-Calais office
for the Calais project.
Other activities
• Organising recruitment of new
volunteers for projects in
Ile-de-France.
• Exploratory project in Moroccan
access to healthcare for
Sub-Saharan migrants in the context
of a Regional International Project.
132/133
>
Languedoc-Roussillon
Contact details
18, rue Henri Dunant
34090 Montpellier
Tél. : 04 99 23 27 17
Fax : 04 99 23 27 18
[email protected]
Board Members
Mady Mercier
> Secretary:
Claude Aiguesvives
> Treasurer:
Françoise Jourdan
> Other Members:
Antonio Da Silva
Delphine Peronne
Mansoureh Yaghmaie-Astruc
> Secretary
of the delegation:
Magali Ibanez
87
> Key events
Publicity events and activities
• Participation in the International
Day for the Eradication of Poverty in
Montpellier.
• Presentation of MdM and its
projects in the nurse preparatory
school at the Red Cross school in
Grabels.
• Participation in an evening
organised by children's choir in
Castries with proceeds going to
tsunami victims.
• Day of involvement in “2005, no
more excuses” against poverty in
Montpellier amongst drivers.
• Stand at the associations' fair in
Montpellier.
Partnerships
• Proposed partnership with the
Dentistry School in Montpellier,
amongst 5th and 6th year dentistry
students.
Other activities
• Presentation of projects 'here and
over there': training for going to
projects abroad, recruitment of state
nurses for international projects, job
descriptions.
>
Lorraine
Contact details
5, rue de l’Armée Patton
54000 Nancy
Tél. : 03 83 27 87 84
Fax : 03 83 28 42 55
[email protected]
Board Members>
Anne-Marie Worms
> Secretary:
Monique Ulrich
> Treasurer:
Anne-Marie Marchetto
> Other Members:
Lucien Gbetro
Véronique Gorsic
Marie-Pascale Verdenal
Jean-Marie Gilgenkrantz
> Key events
• Information evening for donors.
• Participation in meetings on the
following subjects:
- Town Health Project in the Haut du
Lièvre district of Nancy;
- Student health: meetings with the
university health service and social
workers;
- project to work with the Sonacotra
hostels in partnership with the Nancy
preventive medicine centre.
• Meeting with the Strasbourg office
on 9 December.
• Television interview on M6 in
October 2005.
• Article in L'Est républicain
(Est Magazine) on 12 December
2005.
> Lorraine Regional
Projects:
Nancy RM :
Jean-Marie Gilgenkrantz
Metz RM :
René Moutier
Mission Adoption RM :
René Moutier
Partnerships
• University medicine (several
meetings).
• Nancy town council (reflection on
the Town Health Workshop).
• Sonacotra hostels, Nancy
(prevention).
• Nancy preventive medicine centre.
Other activities
• Plan for a Regional International
Project in Burkina Faso: exploratory
project in January 2005. The project,
modified during the process, is still at
the planning stage.
>
Midi-Pyrenees
Contact details
31000 Toulouse
Tél. : 05 61 63 78 78
Fax : 05 61 62 04 15
mdmmidipy.delegation
@laposte.net
Board Members
Dr Florence Rigal
> Secretary:
Marie-Pierre Buttigieg
> Treasurer:
Luis Garcia
> Other Members:
Dr Pascale Estecahandy
Monique Drevon
Dr Frédéric Sananes
> Project Co-ordinator:
Tom Wingefeld
> Secretary
of the delegation:
Isabelle Malet
> Albi branch:
Contact: Nicole Cany
Tel.: 05 63 45 08 15
> Key events
Publicity events
and activities
• Various activities in secondary
schools, nursing colleges, schools,
etc; visit by nursing students to the
office.
• Organisation of a public meeting
on the “Asia Emergency”.
• Stands at the associations' day.
• Organisation with Amnesty of a
conference on violence against
women.
• Participation in a drama activity,
forum in Mirail district for Women's
Day.
• Participation in a lunch-debate in
a centre for the unemployed.
• Participation in “2005, no more
excuses” and the International Day
for the Eradication of Poverty.
• Internal meetings: Opération
Sourire, working meeting on
“improving CASO (free healthcare
and guidance centre) practices”,
meeting on articles of association,
meeting on Pakistan.
Editions et publications
• Quarterly newspaper Lettre et
débats.
Exhibitions
• Photo exhibition on Chad and
Opération Sourire, Cambodia.
Other activities
• Various events with proceeds
going to MdM: cross-country race
(with Foulée pour la Vie, Solidarité
en pays de Save), drama, concert,
gala, tennis competition, auction,
craft exhibition and sale, fashion
parade, etc
• Organisation of “6 hours for
Chechnya” by Albi branch.
• Adoption: someone on duty
Mondays between 2 and 6 p.m.
• Sorting drugs: 14 tonnes of
unused drugs collected.
134/135
>
Nord-Pas-de-Calais
Contact details
10-12, rue du Grand Fossart
59300 Valenciennes
Tél. : 03 27 47 40 08
Fax : 03 27 30 19 16
[email protected]
Board Members>
Guy Dehaut
> Project co-ordinator:
> Key events
Publicity events
and activities
• International Day for the
Eradication of Poverty in partnership
with local organisations.
• Participation in area health
programme in Valenciennes.
• Presentations in nursing schools.
• Participation in associations' forum
for Valenciennes area.
Fabienne Ducatez
> Treasurer:
Christiane Ficheroulle
> Other Members:
Elisabeth Dusart
Charles Lejeune
Claudine Leleu
33
Normandy
Contact details
5, rue d’Elbeuf
76100 Rouen
Tél. : 02 35 72 56 66
Fax : 02 35 73 05 64
[email protected]
Board Members
Christian Cartier
> Secretary:
Agathe Bonmarchand
Eliane Lamorisse
> Secretary:
>
Partnerships
• Emergency accommodation associations, CHRS (Accommoda-tion
and Social Reintegration Centre), day
centres: AJAR, APE, Midi-Partage,
POSE, etc.
• Rimbaud mobile team
• PASS (healthcare access centres)
(Espace Baudelaire).
• Boutique Solidarité (drop-in
centre).
• SOS Bébé - assistance for families
in financial difficulty.
• Avenir et Coopération
- humanitarian action logistics.
Other activities
• Assistance to Calais refugees
(drugs, sleeping bags, medical
consultations).
• Collection of glasses reconditioned
by an optician.
• Collection and sorting of drugs (as
part of Cyclamed) to run our centre.
Surplus sent to Africa through Avenir
et Coopération according to
demand.
> Treasurer:
Michel Joly
> Other Members:
Arlette Seiffert
Jean-Jacques Prey
Mireille Vache-Picat
> Secretary
of the delegation:
Claudie Hauduc
> Antenne du Havre :
Responsable : Arlette Seiffert
Tél. : 02 35 21 68 66
[email protected]
> Key events
Publicity events
and activities
• JRegional day Rouen-Le Havre on
19 November 2005.
New activity:
• Setting up a Mediation-Health
space in the Hauts de Rouen area of
Rouen.
>
Indian Ocean
Contact details
250 bis, rue du Général Rolland
Bât. K - SHLMR Bouvet
BP 964
97479 Saint-Denis Cedex
Réunion
Tél. : 02 62 21 71 66
Fax : 02 62 41 19 46
medecinsdumonde.reunion
@wanadoo.fr
Board Members
> Key events
Publicity events
and activities
• Mailing for Childhood Action: press
releases, fundraising appeal.
• Mission France: organisation of a
Christmas meal for the homeless.
Publications
• Newspaper Mission n° 38.
Mireille Beaufils
> Trésorière :
Agnès Rovere
> Other Members:
Blandine Megroian
Gilles Bourdiol
Christophe Ottenwaelder
(RM Tuléar)
> Secrétaire
de la Regional delegation:
Claudie Pante
> Autres membres actifs :
Philippe de Chazournes
Marie-Claude Castex
Sophie Agbaglo
Mélanie Maillot
Pascale Lehoucq
Frédéric Le Bot
Jean-Luc Michel
Dominique Rabouille
Jean-François Delambre
(RM Action Enfance)
Philippe Jeu (Indonesia RP)
Arnaud Bourde (Tsunami RP)
Sylvie de Carheil (Prison RPs)
Claudia Vichatzky
(Ilakaka RP)
36
PACA (Provence-Alpes-Côte d’Azur)
Contact details
4, avenue Rostand
13003 Marseille
Tél. : 04 95 04 59 60
Fax : 04 95 04 59 61
mdmpaca@medecinsdu
monde.net
Board Members
Ariane Junca
> General Secretary:
Gilbert Potier
> Secretary:
>
Training
• Training for the post of administrator
for the Antananarivo secretariat.
• University diploma on “treating HIV
infection and hepatitis B and C”
obtained by Dr. C. Ralaivao, a paid
member of staff of the Ilakaka project.
Other activities
• Mission France: medical and social
consultations at the Boutique
Solidarité (drop-in centre)
(Abbé-Pierre Foundation)
in Saint-Denis and Saint-Pierre.
Simone Varenne Blanc
> Treasurer:
Philippe Dupin
> Other Members:
Denise Clément
Marie-Agnès Chaud
Olivier Bernard
Pierre-François Pernet
Isabelle Bouju Malaval
> Accounts:
Ghislaine Vincenti
> Secretaries
of the delegation
Anne-Marie Combe
Martine Semat
Daniel Imbert
158
> Key events
Publicity events
and activities
• Organisation of monthly
conferences on MdM's international
and national work:
- International projects: Colombia,
Burkina Faso;
- Tsunami emergency;
- Health for all Africans, in Africa and
in France;
- The tsunami, one year on.
• Lecture and discussion on peace
for Israel-Palestine with Stéphane
Hessel, a former French ambassador
to the United Nations, Mr. François
Roux, a lawyer practising in
Montpellier, and Blandine
Chelini-Pont, a historian.
• Participation in a round-table on
local radio: “The tsunami one year
on”.
• 25 years of Médecins du Monde:
exhibition of photographs by Gérard
Rondeau at the regional council,
press conference, round table and
running 5 “citizens' cafés” for two
months based around national and
international projects, for an
audience of schoolchildren and
students.
136/137
>
Pays de la Loire
Contact details
33, rue Fouré
44000 Nantes
Tél. : 02 40 47 36 99
Fax : 02 51 82 38 09
[email protected]
Board Members
Paul Bolo
> Secretary:
Anne-Lise Guéguen
> Trésorière :
Nicole Neyrat
> Other Members:
Philippe Jarrousse
Hélène Lepoivre
Jean-Pierre Clauzel
Marion Gassiot
> Secretary
of the delegation:
Corinne Lepert
80
> Key events
Publicity events
and activities
• Talks in secondary schools,
nursing schools and the nursing
college of Nantes and Lorient.
• Talk at the conference organised
by the Paris ASTI (Solidarity with
Immigrant Workers Association) on
prostitution.
• Participation in the National
Congress of notaries in Nantes
(stand).
• Organisation of short courses for
spring at Nantes University.
• Presentation of MdM to the
Institut de Formation de Santé
dans l'Ouest (IFSO) (Western
France Health Training Institute).
• Open days at the Nantes office
and mobile units on the
International Day for the
Eradication of Poverty.
• Talk at a meeting of the Rennes
co-ordinating body on prostitution.
• Day of action as part of World
AIDS Day.
• Visit of the Prostitution project by
two members of the Donors'
Committee for two days.
Other activities
• Involvement in many
conferences, in France, on
prostitution, trafficking and violence
against women.
>
Poitou-Charentes
Contact details
22, allée du Champ Brun
16000 Angoulême
Tél. : 05 45 65 07 47
Fax : 05 45 61 18 85
[email protected]
Board Members
Marie-Laure Ferrari
> Secretary and Deputy
Daniel Reiss
> Treasurer:
Hubert Lacombe
> Deputy Treasurer:
Philippe Boulanger
> International Project
Co-ordinators + CCN
(National Advisory
Committee)
Fabienne Drieu,
Patrick Bouet
(représentant au CCN)
> Other Member:
Myriam Massé
> Secretary
of the delegation:
Paule de Sède
> Angoulême branch
(outside centre
project):
Contact: Marie-Laure Ferrari
Tel.: 05 45 65 11 82
Needle exchange programme
co-ordinator: Valérie Patrier
> Poitiers branch:
Contact: Patrick Bouet
Tel.: 05 49 01 77 77
> Key events
Publicity events
and activities
• ”Musiques métisses” (mixed-race
music): with the bus present.
• Partnership with the lycée
Marguerite.
• Performance of the play Ils
s'aiment (They love each other), with
proceeds going to MdM, in
Angoulême supported by a radio
programme with Radio Attitude.
• Tea party on 31 December 2005
for the most destitute.
• Concert in Poitiers with proceeds
going to MdM.
• Radio programme with Radio
Accord in Angoulême on the
“Journée de la précarité” (Day of
Poverty).
• MdM stand in Poitiers during
Solidarity Week.
• Exhibition of drawings by child
tsunami victims, in Poitiers.
>
Rhône-Alpes–Bourgogne
Contact details
1, place du Griffon
69001 Lyon
Tél. : 04 78 29 59 14
Fax : 04 78 29 55 91
[email protected]
Board Members
Michèle Roelens
> Secretary:
Isabelle Hermant
> Treasurer:
Pierre Micheletti
> Other Members:
André-Jean Pocheron
Robert Allemand
Félicie Monneret
Edith Chabal
> Secretary
of the delegation:
Clothilde Guillerm
Sophie Bret
Partnerships
In Angoulême:
• Les gens du voyage (Travellers)
association;
• Omega (town council - CCAS
(local social work centre));
• PASS (Access to healthcare centre)
Angoulême and EMAPASS (PASS +
mobile addictions team) Ruffec.
In Poitiers:
• Restos du Cœur;
• CRI;
• Town Hospital Network.
environ 160
> Antenne de Grenoble :
Responsable : Jean-Pierre Vidal
Tél. : 04 76 84 17 31
[email protected]
Coordinateur : Pierre Bourgey
> Key events
Publicity events
and activities
• In Grenoble, organisation and
involvement in the International Day
for the Eradication of Poverty.
• In Lyon, organisation of a day of
testimony on the health of migrants.
• Testimonies and various talks
concerning the problems of getting
access to healthcare for highly
vulnerable people.
• Conferences on humanitarian
action, emergency projects,
development, the media and
humanitarian work.
• Meetings with primary and
secondary pupils in Villeurbanne:
testimonies of childhood in war, in
partnership with the Maison du Livre,
de l'Image et du Son (Book, Image
and Sound Centre) in Villeurbanne.
• In Grenoble, support for the
national publicity campaign “We care
for those whom the world is
gradually forgetting” (more than 500
display spaces offered).
• Golf competitions, concerts,
picture sales, partnerships with local
businesses.
Exhibitions
• Touring photo exhibition on the
Bolivia project: “The child workers of
Potosí”.
• Touring photo exhibition on the
health of migrant people.
• Touring photo exhibition on
Afghanistan, Chechnya and “Street
people in Grenoble”, South-East Asia,
Indonesia - Tsunami: beyond death is
life”.
138/139
>
Germany
Contact details
> Bureau international
Aerzte der Welt
Thalkirchner Str 81
Kontorhaus 1
81371 München
Allemagne
Tél. : 00 49 89 62 42 09 55
Fax : 00 49 89 65 30 99 72
[email protected]
www.aerztederwelt.org
Contacts :
Dr Lecia Feszczak, Monika
Kleck, Gertrud Wimmer
Association under German
law, constituted 19 March
1999
> Key events
Financial support for projects
• Afghanistan: mother and child
protection programme.
• Angola: mother and child health
programme in Huambo North
province.
• Ethiopia: prevention of mother-tochild HIV transmission programme
in Mekele.
• Pakistan: programmes
supporting government refuges for
women victims of domestic
violence and emergency aid for
earthquake victims.
• Niger: Opération Sourire project.
Board of directors
> President:
Pr Wilfried Schilli
> Vice-President:
Dr Pierre Rosenstiel
> Treasurer:
Human Resources support
for projects
• 10 German expatriate volunteers
went out to international projects.
Publicity events
and activities
• Celebration of 5 years of Aerzte
der Welt in Germany and collection
of two cheques from Sternstunden
for Cambodia and Ethiopia.
• “23 artists for Médecins du
Monde” - sale of lithographs with
proceeds going to MdM France,
organised by the Oppenheim bank
in Munich.
• Three information letters made
available on the internet and sent
to donors, volunteers and partners.
• Articles in national and regional
newspapers on projects in
Cambodia and Sri Lanka.
• Sternstunden TV on Bavarian TV
(short film on the project in
Batticaloa in Sri Lanka).
Projects:
• Two Opération Sourire projects in
Cambodia (Kampong Cham and
Phnom Penh).
• Planning a local project in Munich
(primary healthcare for people
without medical insurance such as
migrants and those without
papers):
- redefining the concept;
- beginning to build up a network
of volunteers;
- co-operation with other partners
in the field.
• Three exploratory projects in
Batticaloa in Sri Lanka:
assessment of an idea to improve
the local hospitals' surgical
structures, through training
orthopaedic surgeons to comply
with hygiene standards and
surgery techniques.
Rolf-Michael Schlegtendal
> Other Members:
Dr Klaus Wieners
Dr Béatrice Stambul
Dr François Scheffer
Pr Albrecht Pfleiderer
Pr Norbert Schwenzer
Andreas Jungk
> Acknowledgements: The German Foreign Ministry, the City of Munich, Johanniter, Freiburg University, Tübingen University, The Munich European Patent Office, Martin
Medizintechnik, mibeg Verlag, Sueddeutsche Zeitung, Stethosglobe, Munich Eine-Welt-Zentrum, Munich Nord-Sued-Forum, Bayerischer Rundfunk, Sternstunden e.V., M-Net
Munich, Sofa-lx-systems, Sonja Schultes & Hersberger, www.helpdirect.org, www.malinet.de, www.zdf.de/zdfde/inhalt (ZDF Spendenforum), Ansell Healthcare Europe, Ansell
GmbH, Excognito Agentur für Public Realtions, Internationale Spedition Heinz Huber, O.D.C. Fruchthandels GmbH, Alter Hof, Gastronomie Firma Paul Hartmann AG, Euro
RSCG LIFE Munich, Neumeister - Kunstauktionshaus München, Oppenheim jr. & Cie Bank. KGaA, Vermop - Professional Cleaning Systems, Vogtland Philharmonie Greiz
Reichenbach, Tagesheimschule an der Hochstraße Munich
>
Japan
Contact details
> International Office:
Médecins du Monde Japon
PMC Building 6F
1-23-5 Higashi-Azabu,
Minato-ku, Tokyo 106, Japon
Tél. : 00 81 3 35 85 64 36
Fax : 00 81 3 35 85 11 34
[email protected]
http://www.mdm.or.jp
Contacts :
Prune Helfter, Kehko
Takayama, Nao Kuroyanagi,
Tatsuya Kishi ( all staff)
Association under Japanese
law, constituted 10 October
2000
Board Members
> Board of Directors
President:
Gaël Austin
> Other Members:
Yasuko Arai
Dr Arnaud Bourde
Dr Patrick David
Dr François Foussadier
Masako Harada
Akitane Kiuchi
Dr Norihiko Oura
Dr Satoshi Yoza
> Key events
• Bolivia: Health and child workers
in Potosi project.
• Cambodia: Opération Sourire
project in Phnom Penh.
• China: Chengdu project - AIDS
prevention
• Ethiopia: mother-to-child HIV
transmission prevention
programme.
• Indonesia: emergency and posttsunami reconstruction
programme.
• Madagascar: Opération Sourire
project in Antananarivo.
• Pakistan: emergency
programme.
• DRC: programme supporting
street children.
• Sudan: emergency programme
in Darfur province.
• Sri Lanka: emergency and
post-tsunami reconstruction
programme.
Human resources support
for projects
• 12 Japanese expatriate workers
Publicity events
and activities
• Organisation of photo exhibitions
presenting MdM's HIV projects and
emergency programmes in
Indonesia and Pakistan in very
busy places such as the corridors
of the Tokyo underground.
• Presentation of MdM's HIV
projects on a stand at the
international AIDS conference in
Kobe.
• Organisation of a charity dinner
at the French embassy attended
by over 200 people, with the
voluntary involvement of renowned
chefs and artists.
• Publication of articles on
Médecins du Monde and
Opération Sourire in national and
regional newspapers, and high
circulation weeklies, and a short
spot in a programme on the state
radio station NHK.
• Publication of a newsletter
distributed to donors, volunteers
and partners.
> Acknowledgements: Air France, Air Tahiti Nui, Akebono Brake, Alsok, Aman Resorts, Asahi Pretec, Bristol Meyers Squibb Group, Chanel, Cn-Intervoice, French
Chamber of Commerce and Industry in Japan, French Embassy in Japan, Felissimo Corporation, Ferris University, Flos, French Blue Meeting, French Food Culture Center, Ginza
Gallery (Circle Club), Global Tank, Greeting life, Hyogo International Association, Impresario, JANIC, JICA, Members of the Agricultural Order of Merit in Japan, Å@Mitsui
Sumitomo Insurance, Nippon Koa Insurance, NTT Data, Sanyu Network, Shibaura Institute of Technology, Shiseido, Sompo Japan Insurance, Sonia Rykiel, Tanabé Seiyaku, The
TIE Corp. Tout le monde vœux, Yokohama French Film Festival.
140/141
>
The Netherlands
Contact details
> International Office:
Dokters van de Wereld
Rijswijkstraat 141 A
1062 ES Amsterdam
Pays-Bas
Tél. : 00 31 20 465 2866
Fax : 00 31 20 463 1775
[email protected]
www.doktersvandewereld.org
Contacts :
Nadjehda BrouwerRichardson, Reinier Spruit,
Resy Arts, Anna Miranda
Scholten, Arianne de Jong,
Sacha Godschalk,
Corinne Eisma ( all staff).
Marian van Keuk, Gerd
Beckers (co-ordinators)
Association under Dutch law
constituted 28 April 1997
Board of directors
> President:
> Key events
Financial support for 10 programmes
(through direct marketing) and the following projects, by project funders:
• Burma: harm reduction for risks linked to drug addiction programme
• Indonesia (West Papua):
minorities' access to healthcare programme.
• Tanzania: AZT programme.
• Benin: AIDS programme.
• DRC Goma: AIDS programme.
• Madagascar: HIV/AIDS prevention
programme.
• Zimbabwe: financial support for
FACT for HIV/AIDS prevention.
• Indonesia (Papua Paniai): HIV/AIDS
prevention programme in Primari.
• Pakistan: emergency
programmes.
• Liberia: primary healthcare
programme.
Dr Barbara ten Kate
> Secretary:
Dr Dirkjan Pot
> Treasurer:
Casper van Rijn
for projects
• 10 Dutch expatriate volunteers went
out to work on international projects.
Publicity events
and activities
• Interviews with Dutch volunteers in
the Dutch media (radio,
newspapers and magazines).
• Organisation of a press trip to
Papua, Indonesia and publication of
articles in four magazines.
• Transparency Prize won for the
publication of Dokters van de
Wereld's 2004 annual report.
• Three publications on Dokters van
de Wereld's international
activities, aimed at donors, sponsors
and volunteers.
gramme to improve access to health
care for those without papers in
Amsterdam. Distribution of medical
documents to those without papers
(Medoc) and
information campaign amongst those
without papers and health professionals on access to
healthcare.
National projects
• Roma and Sinti: health
programme for Roma and Sinti,
especially women. Training and
health education in Roma and Sinti
communities in the Netherlands.
Partnerships with LSRO (Dutch organisation for Roma and Sinti) and
other organisations.
• Undocumented migrants: pilot pro-
> Other Members:
Howard Teunisse
Bernard Juan
Françoise Sivignon
> Acknowledgements: Aids Fund, Cordaid, Dutch Ministry for Development Cooperation, ICCO, Oxfam Novib, NCDO, Nora Tol Virtual Publishing, Stichting Lions, STOP
AIDS NOW, Zicht nieuwe media ontwerpers, Sandra van Noord - Bureau voor tekst en redactie, Ordina, Haute Finance, Paradiso, Tom van der Leij, Capi Lux Vak, and all our
volunteers, trainees and thousands of private donors.
>
United Kingdom
Contact details
> International office:
Médecins du Monde UK
34th Floor
One Canada Square
Londres E14 5AA
Royaume-Uni
Tél. : 020 7516 9103
Fax : 020 7516 9104
[email protected]
www.medecinsdumonde.org.uk
Contacts :
Karen McColl, Michelle
Hawkins, Isabelle Raymond,
Claire Loussouarn,
Dorothy Muthuri,
Elinor Middleton ( all staff). .
Association under English law,
constituted 13 January 1998
> Key events
• Cambodia: antiretroviral therapy
programme in Phnom Penh.
• Sudan Darfur: programme of
medical aid to displaced people.
• Sudan: surgery programme at
Malakal.
• Afghanistan: mother and child
health programme in Kabul.
• Tsunami: emergency programme.
• Cuba: Café Salud programme in
Havana.
for projects
• 21 MdM UK expatriate volunteers
to celebrate Médecins du Monde's
25th birthday and raise awareness
amongst the French community in
London of the work of Médecins
du Monde UK.
• Launch of the web site
www.medecinsdumonde.org.uk
• Publication of News (twice), an
information newsletter on MdM
UK's activities, distributed to
donors and volunteers.
• Publicity: preparation of a press
pack for the launch of a national
project: “Project: London”, and
organisation of a press conference
in January 2006.
Projects
• Development of a national project
to improve access to healthcare for
vulnerable people groups in East
London: registration with the
Healthcare Commission (regulatory
body), recruitment and training of a
team of 33 volunteers, refurbishment of premises to create two
medical rooms, creation of a
network of local partners,
fundraising to fund the project.
• Participation in the European
survey on access to healthcare for
undocumented migrants in Europe.
Board Members
> Board of directors:
Dr David Barnes
Dr Laurence Bioteau
Janice Hughes
Robert Lion
Dr Sarah Pickworth
Lord Rogers of Riverside
Roo Rogers
• Interviews with MdM UK
volunteers in the British media and
publication of articles on Médecins
du Monde (newspapers,
magazines, online, radio, TV).
• Reception at the French
Ambassador to the UK's residence
> Acknowledgements: Alliance Pharmacy, Department For International Development (DFID), the Elton John AIDS Foundation, Isle of Man Overseas Aid Committee,
Canary Wharf Group, Clifford Chance, Chubb Insurance, Cubana, the French Embassy, the Frontline Club, Lonely Planet, MEDSIN, Nomad Travel Stores, Richard Rogers
Settlement, SS Robin, the Sahara Trekkers, Sylvan Technical Services, Thames Wharf Charity, Tower Hamlets Primary Care Trust and all our volunteers and donors.
> The organisation
143/153
> Médecins du Monde
and its management
Médecins du Monde's organisation is based on board members with experience overseas, volunteers in France, voluntary workers for international operations, and a permanent paid staff. The support of hundreds of thousands of
donors ensures Médecins d u M onde's financial independence. Thanks to this diversity, MdM operates permanently on the basis of debate, the views of civil society and the operational efficiency of its programmes for beneficiaries. As a result there is a strong and original organisational structure which is distinctive amongst large NGOs.
> Decision-making
management.
analysing contexts, modes of
To carry out its task properly the Board
intervention, and drawing on the
Once a year, MdM's members (1,562 in
relies on:
experience of projects. The Association
2005) meet in the General Assembly
• an advisory structure of Association
has five continental groups, eight
(GA), the highest decision-making body
members;
thematic groups and a France group
and the only one with the authority to
• a permanent operational structure;
including the Mission France and Harm
amend the articles of association. The
• joint decision-making bodies bringing
Reduction steering committees. The
GA elects the twelve members of the
together permanent staff and Association
members of the advisory groups are
Board of Management for three years,
members;
elected according to the internal
to which are added three substitutes.
• the regional offices.
regulations.
From amongst its members, the Board
elects the President and the
> The advisory structure
> The permanent
organisation's Officers for one year: the
This includes the continental groups
Vice-Presidents, Treasurer, Deputy
and thematic groups. Each of these
This is led by two Directorates. The
Treasurer, General Secretary and Deputy
groups, made up of volunteer members
Humanitarian Aid Directorate includes
General Secretary and a Representative.
with overseas experience involved in
the international operations
The Board, the organisation's executive
projects, proposes or issues an opinion
department, the Mission France
body, meets monthly and takes any
on the continent or theme for which it is
co-ordinating body, project logistics,
decisions concerning the organisation's
responsible. Their role is vital in terms of
the adoption department and the
authorities
operational structure
144/145
communication department. The
each week and examines strategic
> The Donor Committee
Management Directorate includes the
decisions concerning projects, passe
The Donor Committee is made up of a
human resources department, the
au crible les décisions bearing witness,
dozen co-opted members and it provi-
development department, the finance
political lobbying and publicity. Other
des constructive criticism and consen-
and IT systems department and the
joint decision-making bodies are the
sual analysis on MdM''s projects, ratios
legal department. Non-strategic
human resources group and the
or communication strategy. It is given
operational decisions are made each
management group who meet each
funding to go and evaluate projects in
week during a project meeting for
month to define human resources and
France and abroad. Through its presi-
project-related decisions and at a
management policies which are
dent, it can express its views to the
management meeting for other
finalised and ratified by the Board.
Board and the general assembly.
aspects. International programmes are
> The regional
managed by the programme's medical
co-ordinator, who is responsible to the
delegations
This specific set-up encourages debate
Head of Project who deals with aspects
In the regions, MdM has set up regio-
at all levels. It allows MdM to be an acti-
of policy or specific expertise and is in
nal delegations. Elected every two
ve association which is both politically
operational contact with the desk
years, the regional colleges represent
and financially independent. It encoura-
officer at head office or the project
the Association in the regions. The
ges voluntary commitment by health
officer in some regional offices. Heads
delegations carry out international or
workers in the service of the most
of Projects are proposed by the
regional projects, within the overall
destitute and vulnerable people, and has
different internal bodies and ratified by
framework defined by the Board. All the
a constant concern for the quality and
the Board.
board members, Heads of Projects,
effectiveness of its international or local
> The joint decision-
group co-ordinators, regional and
projects.
making bodies
They include the Management
Committee, which brings together the
staff members involved in management
board representatives meet three times
a year for a National Advisory Council
meeting.
> Department news
All the head office departments support the programmes run by the organisation amongst the most vulnerable people in
France and abroad. These departments must be run in a way which guarantees effective institutional, human, logistical, financial and budget support for projects, but also makes them answerable to our funders and donors. In 2005, work was developed in the humanitarian action, human resources and management areas.
> Humanitarian action
> HR
• The year was marked by emergency and
The response to the emergencies in Asia and
relationship between MdM France and the
reconstruction work as a result of the earthqua-
Pakistan translated into a 50% rise in the
international secretariat was strengthened
kes in Asia and Pakistan. MdM demonstrated
number of expatriate volunteers sent on
during the year.
how reactive its emergency department is, as it
international projects in 2005. Moreover, the
was among the first teams to intervene on
number of paid staff on the international
several sites. This was possible by the
projects increased significantly.
presence of long-term projects in Indonesia
> Management
and Pakistan at the time of the disasters.
>Management up to
31/12/2005
Humanitarian Action Directorate:
• In this context, the humanitarian action
• The start of the year was marked by a large
Dr Michel Brugière
directorate and the international operations
influx of gifts (due to the Asian tsunami). In
Management and HR Directorate:
department continued to develop international
addition, the plan to reduce appeals, tested in
François Dupré
projects which increased in number and
2004, yielded significant results as did the syste-
International Operations Department:
financial volume (higher volume of activity than
matic offer to set up standing orders as a better
Dr Gilles Raguin (until 1 August 2005)
the Association's in 2000, which means finan-
way for donors to support MdM.
Mission France Co-ordinating Body:
cial growth of over 30% compared to 2004).
• The policy of partnership with businesses was
Nathalie Simonnot
• The institutional development department
reinforced.
Finance and I.T. Systems Department:
increased and diversified programmes' financial
• The setting up of a financial monitoring tool
Catherine Duffau
resources through representation offices and
and a budget plan common to all MdM's
Administration and Legal Department:
actions in the field. These resources increased
projects was completed in 2005.
François Rubio
by 50% between 2004 and 2005.
• The international offices continued to
Publicity and Development Department:
• The MdM Europe project expanded with the
develop in the United Kingdom and the
Isabelle Finkelstein
construction of the European Observatory and
Netherlands, and were reorganised in
Adoption Dept :
the launch of national projects in the United
Japan and Germany. In addition, the
Dr Geneviève André-Trevennec
Kingdom and the Netherlands.
146/147
> Médecins du Monde's
International Network
Twelve delegations, nine in Europe (Belgium, Cyprus, France, Greece, Italy, Portugal, Spain, Sweden and
Switzerland) and three in the Americas (Argentina, Canada and the United States) were members of Médecins du
Monde's international network in 2005.
The International Board (IB), whose task is to
provide the international network with an overall
set the network's main policy directions, met
and exhaustive view of the offices and their
twice in 2005. The presidents or vice-presidents
activities by the end of 2006.
> Operational
co-ordination
The international network worked together to
provide aid to tsunami victims and then to
of eleven of the network's twelve international
delegations took part in the discussions.
The Presidents:
victims of the earthquake which hit Pakistan. The
The International Executive Committee (IEC),
Argentina: Dr Silvana Reinoso
co-ordination of operations implemented by the
which is responsible for drawing up an annual
then Dr Alicia Luna
different international offices was provided in
action plan based on the IB's policy directions,
Belgium: Dr Michel Degueldre
both cases by the International Secretariat.
and for monitoring its operations, met five times
Canada: Dr Réjean Thomas
The joint pilot programme in Zimbabwe aimed at
in 2005.
Cyprus: Dr Elias Papadopoulos
“reducing the impact of the HIV/AIDS epidemic
The International Secretariat (IS), led by a
France: Dr Françoise Jeanson
on vulnerable orphans and children” in Chipinge
new director from January 2005, continued to
Greece: Dr Socrates Mitsiadis
district, implemented as a partnership between
ensure the network ran well and to co-ordinate
then Dr Eleftheria Parthenopoulou
MdM Canada, MdM Spain and MdM France,
the delegations' activities. The IS, made up of a
Italy: Dr Faustino Boioli
entered its operational phase.
team of five people, also worked on improving
Portugal: Dr Mario de Sousa
the network's organisation, especially by
(temporarily Mrs Claudia Amaral)
> Priorities for 2005
carrying out work on the operational co-ordina-
then Dr Rui Portugal
In accordance with the decisions made in 2004
tion of emergency projects and on harmonising
Spain: Dr Teresa Gonzalez
by the International Board, the themes of
tools and security rules. In accordance with the
Sweden: Dr Anders Bjorkman
HIV/AIDS and migrants were the subject of
decisions made in 2004 by the International
Switzerland: Dr Nago Humbert
considerable sharing and consultation across
Board, 2005 saw the launch of the process of
United States: Dr Victoria L. Sharp
the network.
evaluating the international delegations.
This fair, standardised and planned process will
> Sister organisations
and local partners
Médecins du Monde bases its work around local partners to provide links that will ensure the work will continue.
If no partners exist, MdM supports the setting up of sister organisations, which are often formed on the initiative
of, and based around, MdM's local team. They gradually become autonomous and are supported for one to two
years on average. The structures thus created remain MdM's natural partners in the region.
> In Europe
• Russia, Saint-Petersburg
Activities: fight against AIDS, harm
• Bosnia-Herzegovina, Sarajevo
Humanitarian Action Foundation
reduction.
DUGA (Drop-in and psychological
Set up in 1993, autonomous for its
• Uganda, Kyotera
support centre for children and young
street children's work since 2003 and
CIPA (Community Initiative for the
people). Set up in 1994, autonomous
for harm reduction since 2005.
Prevention of HIV-AIDS/STIs).
since 2002. [email protected]
www.humanitarianaction.org
Set up in October 2003, autonomous
Activities: assistance to children, fight
since December 2005.
against AIDS.
against AIDS, harm reduction.
[email protected]
Nobody's Children Foundation
> In Africa
Activities: fight against AIDS.
Set up in 1990, autonomous since 2003.
• Mozambique, Maputo
www.fdn.pl
Meninos de Moçambique
Activities: assistance to children.
(Children of Mozambique)
• Romania, Bucharest
Set up in 2000, autonomous since 2001.
FICF (International Foundation for
Fax: + 258 30 41 16
Children and Families). Set up in 1993,
Activities: Assistance to children.
autonomous since 2003.
• Madagascar, Tulear
Fax: + 40 21 311 19 15 / 23 05
Sisal Association (Doctors for the
Right to Health). Set up in 2002, auto-
• Poland, Warsaw
nomous since 2005.
ORGANISATIONS REQUIRING
SUPPORT FROM MDM
> In Latin America
• El Salvador
MDS (Doctors for the Right to Health).
Set up in 1998.
www.mds.org.sv
Activities: promoting the right to health.
148/149
> In Africa
Set up in 2000.
Set up in 1988.
• Tanzania, Bukoba
Activities: assistance to prisoners
www.egyhopevillage.com
Tadepa (Tanzania Development
• Rwanda, Kigali
Activities: assistance to children
and Prevention of AIDS). Set up in
Ibuka (Remembrance and Justice)
• Lebanon, Antelias
2001.
Set up in 1995.
Ajem (Justice and Mercy Association)
Activities: defending the rights of
Set up in January 1998.
• Ivory Coast, Abidjan
genocide victims.
[email protected]
Mesad (Movement for Education,
• DRC, Kinshasa
Activities: assistance to refugees, asylum
Health and Development).
AED (Assistance to disadvantaged
seekers and imprisoned migrants.
Set up in 2001.
children)
• Morocco, Casablanca
[email protected]
Set up in 1966.
Medical Association for the
Activities: assistance to young people.
Rehabilitation of Victims of Torture.
against AIDS.
• Zimbabwe, Chipinge
Set up in January 2001.
> In Europe
FACT (Family Aids Caring Trust).
[email protected]
Set up in 1987.
Activities: assistance to victims of torture.
• Bulgaria, Sofia
Association Enfant et Espace (Child
• Madagascar, Antananarivo, Ilakaka
> In Europe
and Space Association).
Salfa (Malagasy Lutheran Church)
• Moldova, Balti
Set up in July 2005.
TDV (Youth for the Right to Live)
Activities: primary healthcare.
[email protected]
[email protected]
> In Latin America
Activities: assistance to children
• Serbia, Belgrade
VEZA. Set up in June 2005.
• Haiti, Port-au-Prince
Fondation pour la Santé du Peuple
[email protected]
URAMEL (Medico-legal research
Rrom (Roma Health Foundation). Set
Activities: fight against AIDS, harm
and action unit).
up in 1999. [email protected]
reduction.
Activities: primary healthcare.
www.uramel.net
Activities: promoting justice in
> In Asia
partnership with health professionals.
• Indonesia, Jakarta
> In the Middle East
Yayasan Aulia. Set up in 1984.
• Egypt, Cairo
Activities: right to health and education
Hope Village
and community organisation.
SOUTHERN
PARTNER ASSOCIATIONS
> In Africa
• Guinea, Kindia
KAD (Kindia Prisoner Assistance).
• Bulgaria, Sliven
[email protected]
> Médecins du Monde
and civil society in France
MdM
Leadership and
co-ordination groups
> SUD co-ordinating body - CCD
> CNVA
> FONJEP
> Charter Committee
> UNOGEP
> Leadership and
Thematic platforms
> Health and social
• UNIOPSS - Alerte Group
• CNLE
• Foreigners' right to health monitoring centre
• Platform for the fight against human trafficking
• French co-ordinating body for the right to asylum
• Romeurope
• International Harm Reduction Association
> Funding
• AFTA
> Human rights
• CNCDH
> International action
• URD
• Clong Volontariat
Geographical platforms
> Mixed commissions
> Palestine platform (observer)
(Development Co-operation
the Prime Minister. MdM monitors
Commission), a joint body informing
issues related to humanitarian action.
SUD (Solidarity Emergency
NGOs of the public authorities'
FONJEP (Youth and popular
Development) Co-ordinating body.
co-operation policy.
education co-operation fund)
A co-ordinating body for French
CNVA (National
A jointly-managed association bringing
humanitarian and development NGOs
Council of Associations)
together public administrations and asso-
which it represents in France and
An independent authority attached to
ciations. It helps associations by making
internationally. As a Board member,
the Prime Minister's office, through
it easier to do voluntary work. MdM
MdM represents the group in the CCD
which all French associations relate to
monitors the issue of volunteers.
co-ordination groups
150/151
Comité de la Charte
ask questions about the reception of
(Charter Committee)
asylum seekers and refugees.
A committee bringing together
• ODSE (Foreigners' Right to Health
associations that call on the public's
Monitoring Centre)
generosity, in accordance with a
• Platform for the Fight against
charter and previously established
Human Trafficking.
recommendations.
• French Co-ordinating body for the
UNOGEP (National Union of
Right to Asylum.
Fundraising Organisations).
• Romeurope.
> Thematic platforms
• International Harm Reduction
Health and social
Funding
• UNIOPSS (National Inter-federal
• AFTA (French Association for
Union of Private Health and Social
Association Treasurers).
Bodies).
Human rights
It works with institutions to have the
• CNCDH (National Advisory
health and social association sector
Committee on Human Rights). It
recognised by European social policy.
formulates opinions and
MdM belongs to the poverty and
recommendations on human rights
exclusion commission of the health
for the Prime Minister.
and Europe groups. Link with the
International action
Alerte group.
• URD (Emergency Rehabilitation
• CNLE (The National Council for
Development Group): group of relief work
Anti-Exclusion Policy).
associations working through the
It checks that the government is
humanitarian action quality process.
enforcing all measures in the fight
• Volunteer NGO liaison committee
against exclusion.
(effective from 2004).
MdM has set up a group to monitor
CMU (universal health insurance), and
Association.
> Geographical
platforms
• Mixed commissions:
Joint body of NGOs and public
authorities. Exchanges on ways and
means of working in a country.
• The Palestine platform: Group of
associations. MdM has observer
status.
> Médecins du Monde and
international institutions
NGOs that are active in the humanitarian area cannot ignore the international institutions, which are both important
funders and front-line political authorities. Many decisions these days go beyond the national context and relate to
European or global decisions. In order to fully understand this complex situation, Médecins du Monde is involved in
different groups which facilitate access to the international decision-making authorities. At the same time, MdM is
developing partnerships with other international organisations and has kept specific articles of association allowing
it to intervene immediately.
> European Union (EU)
Concord (the European NGO
the revision of ECHO's Framework
• The task of ECHO (the European
Confederation for Relief and
Partnership Agreement (FPA) through
Commission's Humanitarian Aid Office)
Development), which provides group
the group set up by Voice to monitor
is to provide assistance and relief to
lobbying of the European Union's insti-
the FPA.
victims of natural disasters or conflicts
tutions and takes part in developing
• MdM France and other member
outside the EU. ECHO has intervened
common positions on European deve-
delegations of the international
in over 85 countries since 1982 and
lopment policy and the major issues in
network regularly attend ECHO's inter-
has an annual budget of over 500
North-South relations.
vention strategy planning meetings.
million euros.
• For several years, and especially in
• EuropeAid (Co-operation Office) has
2005, MdM has been very active in
> Council of Europe
the job of implementing the European
Voice, an interface between associa-
Commission's external aid. The
tions and ECHO which brings together
• The Council of Europe brings toge-
Commission is one of the main contri-
90 relief NGOs. MdM France is a mem-
ther 46 European states. Set up in
butors of public aid for development.
ber of the “Task Force” in charge of
1949 to defend human rights, its parti-
Over 150 countries, territories or orga-
negotiating with ECHO in the name of
cular focus since 1989 has been to
nisations receive this aid which is
the partner NGOs which are members
help the Central and Eastern European
managed by the Office.
of Voice. Thus, during the last few
(PECO) countries to implement and
• MdM relates to EuropeAid through
years, MdM has played a large part in
consolidate political reforms.
(COE)
152/153
• MdM's international network has
This political representation is sup-
consultative status with the COE and
plemented by an operational part-
is part of OING Service, a liaison
nership agreement which MdM has
group for NGOs with this status.
with the HCR. There is an information
> United Nations (UN)
exchange partnership between OCHA
• The Economic and Social Council
eye on Reliefweb.
(ECOSOC) is the main organ of the UN
• Some MdM projects are in contact
co-ordinating the economic and social
with the United Nations Development
activities of the UN and its specialist
Programme (UNDP) through operatio-
bodies and institutions. MdM's interna-
nal collaboration and a policy, notably
tional network has special consultati-
on the theme of children in conflicts.
ve status which means that it can
The same occurs with the United
carry out lobbying activities, especially
Nations Children's Fund (UNICEF) with
of the Human Rights Commission.
which MdM works on several projects.
It has observer status in this subsidiary
• MdM is a member of the
organ of ECOSOC and is one of the
International Council of Voluntary
few medical NGOs present in this
Agencies (ICVA), a network of NGOs
public arena classifying human rights
involved in human rights, which
breaches. At the commission's annual
concentrates on humanitarian issues
meeting, MdM can intervene on each
relating to refugees.
agenda item and submit texts.
ICVA brings together over 80 internatio-
• MdM's international network has
nal NGOs. The Council relates to the UN
and MdM and keeps an operational
representation at the World Health
authorities, especially as an interface
Organisation (WHO) and the Office for
with the HCR by tackling different the-
the Co-ordination of Humanitarian
mes such as the link between humanita-
Affairs (OCHA) in the High
rian workers and the military, or the pro-
Commission for Refugees (HCR)
tection of civilians in armed conflicts.
> World Bank (WB)
The World Bank (WB) is one of the
most important sources of aid for
development, especially for the AIDS
issue.
It works in 100 client countries with the
aim of assisting the poorest peoples
and countries.
WE CARE FOR THOSE WHO THE WORLD IS GRADUALLY FORGETTING.
Head office: 62 rue Marcadet 75018 Paris – Tel. +331 44 92 15 15 – Fax: +331 44 92 99 99 – www.medecinsdumonde.org – Publication manager: Dr. Françoise Jeanson – Chief editor: Giselda Gargano
Editorial committee: Dr. Michel Brugière, Martine Mikolajczyk, Stéphanie Senet – Editorial staff: Raluca Gheorlan, Emmanuelle Harang, Germain Richard, Mame-Seynabou Sall
Acknowledgements: to all participants to the 2005 edition – Design:
Tel. 01 55 34 46 00 (ref. 2MDMRAP005) Copyright: any reproduction of this document is subject to a prior written request.

médecins du monde

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