annual report 2006

Transcription

annual report 2006

ANNUAL
REPORT 2006
Médecins du Monde
ANNUAL REPORT 2006
1
‘
We do not inherit the
Earth from our parents,
we borrow it from our
children...
’
Native American proverb
Quoted by Jean-Pierre Dupuy in ‘Petite métaphysique des tsunamis’
Contents
4
OUR AIM
12
2006 FIGURES
16
18
46
62
82
96
INTERNATIONAL PROJECTS
Map of international projects
Africa
Latin America
Asia
Eastern Europe
Middle East
109
110
112
Future projects
Adoption
Operation Sourire
116
117
134
MISSION FRANCE
Map
Programmes
Contacts
137
MOBILISATION
147
REPRESENTATION NETWORK
157
OUR ORGANISATION
175
ACKNOWLEDGEMENTS
176
GLOSSARY
Cover photo credits :
Josselin Amalfi - Sophie Brändström - Véronique Burger/Phanie - Paskal Chelet-Roux - David Delaporte - Thierry Dudoit/L’Express - Sébastien Duijndam - Valérie Dupont - Isabelle Eshraghi Franck Ferreira - Bruno Fert - Catherine Henriette - G. Herbaut/L’Oeil public - Stéphane Lehr - Jacky - Naegelen/Reuters - Michel Redondo - Elisabeth Rull/Item - Lizzie Sadin
¨ OUR AIM
03/13
> CONTENTS
Facing up to the
challenges
In a global context where humanitarian action
becomes more complex and more dangerous
by the day, it is worth emphasising three principles:
Médecins du Monde is an association, independent of party political or religious influence. It is therefore important to repeat that our activities are quite separate from governmental
foreign policy and also to be watchful that they are, as they should be, dissociated from all types of
armed intervention.This is critical to the credibility of our identity and our position and, therefore,
to our capacity to reduce the risks associated with being manipulated for the purpose of any form
of ethnic, political or religious radicalisation.
Médecins du Monde must maintain an ‘innovative’ and challenging approach, in France
and overseas. Our activities are driven by our concern to work in areas neglected by national and
international authorities. They are also driven by a desire to remind institutional decision-makers,
whenever possible, of their duties and responsibilities, particularly by encouraging them to take over
the activities initiated by our teams.
‘It is on this basis, that we have the best
chance of being able to access victims and to
monitor the security of our teams and our
local partners.’
Médecins du Monde is an association and,as such,our actions reflect the diverse
concerns of our members. However, this does not prevent us from taking on projects which are innovative, or which focus on particular geographic areas, at the instigation of the Board of Directors.
Guided by these principles,our activities in France and overseas combine medical practice with advocacy, which is achieved through testimony or by lobbying for change on behalf of the populations we
work with.
> CONTENTS
ANNUAL REPORT 2006
5
>INTERNATIONAL CRISES
Fortunately, there were few natural disasters in 2006. In Indonesia, Java and Sumatra were hit by
earthquakes and floods and these were our main emergency programmes of this type. Our teams
already working in Indonesia, with support from headquarters, were able to respond quickly and effectively. Similarly, the teams in Madagascar were able to respond to the recent floods.
There are also chronic crises and other emergencies which are perpetuated by man.
The solutions are always political and require the involvement of all the protagonists.
Experience has taught us that real peace cannot be imposed from outside. It has also helped us realise
how often it is unrealistic, even dangerous, in these contexts to support humanitarian action which would
only serve as an excuse for political paralysis. It is within these narrow constraints that we have to be
able to work and to establish our position.
INDONÉSIA
Our team in Indonesia reacted immediately to the announcement of an
earthquake and mobilised human
resources and supplies from the MdM
programme in Jakarta for an evaluation and provision of primary care.At
the same time,the MdM international delegations and offices were on
standby to provide support.
Two places are particularly representative of the tensions which create such restrictive operating conditions and limit what we can do.
Darfur, is a longstanding and deadly conflict that reached the height of its violence in 2003. It is a conflict with many, complex origins including rivalry between sedentary farmers and nomadic pastoralists,
exacerbated by climate change. It is a conflict fanned by ancient tensions, and dependent on the indifference and inaction of the central government in Khartoum as well as acts of repression towards the
population of this distant province. It is also the result of many foreign interventions, particularly from politically turbulent neighbouring countries, such as Chad and Libya. Finally, given the mix of communities present, it is a conflict which stirs up ethnic tension and
‘Every day our
hatred.
We cannot look at this as simply an ethnic or religious conflict.To
do so would be to ignore the political responsibilities and economic interests which are also implicated in this violence.We cannot only view events through the prism of religious radicalisation
at the expense of detailed analysis of the local situation.
teams face these elements of complexity according to the changing situation, which
makes or breaks alliances between groups, witnessing the unstable and opportunistic nature of
agreements between different armed factions.’
> CONTENTS
¨ OUR AIM
Natural disasters, however, are not the only emergencies.Although these are often lethal and can be
overwhelming in the scale of their destruction, in most cases they receive immediate aid without question. Until the tsunami, we had never questioned the role of humanitarian organisations in this type
of emergency response.Today, we must step back and assess whether this unprecedented event was
a definitive turning point or a major exception in humanitarian aid.
DARFUR
We are currently studying the conditions for a potential return. If such
conditions are reached, we will take
a position and assess the opportunity, and the possibility to speak out,
taking into account the possible consequences for the NGOs who have
chosen to stay. Given the complexity of the local situation,there is a delicate balance between ineffective,and
even dangerous, declarations and
resigned acceptance of violence
which, as well as targeting humanitarian workers, may signal a return
to the massacres of 2003.By the time
the General Assembly meets, we will
certainly have clarified our position
concerning a possible return to
the field.
‘GAZA STRIP – The impact of the
international embargo and Israeli army
attacks on the health of the population’
Médecins du Monde, Survey 2006
This study provided evidence of the
ongoing deterioration in the health
system, the economic collapse and
the destruction of a large part of
the essential infrastructure.
SOUTH LEBANON REPORT:
“Consequences of the summer 2006
conflict on the living conditions and
health of civilians in South Lebanon”
Decisions about military intervention cannot be based on discussions with humanitarian organisations
or on testimonies which we are no longer in a position to provide, while modern communications
systems enable observation of the slightest details on the planet. Should we risk the present and future
work of NGOs by making them play the role of detonator in international conflicts when such communication systems exist? This relates to our long-term capacity to intervene throughout the ArabIslamic world and risks adding to the list of places which are inaccessible or very dangerous for
humanitarian organisations, such as Iraq, Afghanistan and Sri Lanka
In January 2007, we decided to withdraw our teams from Darfur because we considered that
the risks were no longer acceptable when compared with our limited access to the populations living outside the camps near Nyala, where our programme was based.
We challenge dogmatic posturing and we are careful to ensure that our own analyses are always put
into context.
In contrast to Darfur, where the context makes public discussion difficult, in relation to the Gaza Strip
we made strong representations to the different political actors responsible for the deterioration in the
living conditions and the health of the population since the embargo which followed Hamas election
victory in January and the resumption of Israeli incursions in June. In order to confirm what we suspected, and before speaking out to denounce the deterioration in access to healthcare, it was vital to document the medical facts.Through a survey carried out both before and after the Israeli incursion of 28
June, the M decins du Monde team documented the rapid deterioration in access to water, food and
healthcare and the presence of symptoms linked to the psychological suffering of residents.Taking
account of the risk of destabilisation which could accelerate this deterioration, and given the quality and
impartiality of our data, we made some recommendations to the members of the Quartet (EU, Russia,
US and UN), the Palestinian authorities and the Israeli government calling for a resumption of financial
support.The reliability of this research, taken on board by several institutions, enabled us to directly alert
the European Commission to problems with the temporary mechanism implemented to compensate
for the loss of international aid.
The war between Israel and Lebanon also took place in the same region in 2006.The team working on the long-term project in Lebanon played an essential role in setting up the work, with local
actors, to help the most vulnerable populations in south Lebanon. MdM published a report on the
consequences of this conflict.
> CONTENTS
Political lobbying for a resumption of European emergency funding (ECHO) for programmes in Iraq was another important issue
during the year. In cooperation with other NGOs, this enabled us
to release major funding for the refugee population. In addition, we
are continuing discussions with European representatives in order
to obtain funding for aid to the population still in Iraq.
Regarding long-term programmes, access to healthcare
and prevention for all is still the issue central to all our projects.All
over the world, against a background of privatisation of health
services, we always work with the same vulnerable groups.Within
this context, our projects and our medical activities must also seek
to question and to highlight the deficiencies of, or even damage done
by, governments and international institutions. A medical NGO
cannot ignore the economic or trade mechanisms which
insidiously undermine health systems and the health of
the most vulnerable populations.
‘The political interpretation of our healthcare
activities should be systematic in all of our programmes, in order to provide material for our
testimony and advocacy work.The conditions for
disseminating this information, however, have to
be carefully considered and weighed up.
Chechnya,Afghanistan and Colombia,
among others, illustrate the difficulties.’
From now on, our activities in Haiti,Niger,Liberia and the Democratic Republic of Congo,will
combine healthcare with advocating for stronger health systems. M decins du Monde takes a position on
issues such as cost-recovery, the shortage of health professionals and financing health systems.The solutions to problems affecting access to healthcare for the most vulnerable populations in developing countries lie in the north and, because of globalisation, health is now a global issue. For these reasons, we can no longer be content to restrict ourselves to only providing healthcare, if we really want to
be effective.We must adapt our medical activities to take into account the political and financiall realities
that impact on the long-term sustainability of these activities.This is why we have helped to create the
European network ‘Action for Global Health’ which will work towards the achievement of the
Millennium Development Goals (MDGs) for health by 2015. Goals which western governments, including France, are already committed to striving to achieve for developing countries.
Although the reconstruction of health systems is a priority for M decins du Monde, we should also
take a stronger stand on a number of issues relevant to our current and future programmes: women s
health, environmental health and migration and health (including for migrants, refugees or internally
displaced people).
> CONTENTS
¨ OUR AIM
On such issues, advocacy is important work and is complementary to healthcare which treats the
symptoms but not the causes of problems. By highlighting the mechanisms which lead to crisis situations, advocacy helps protect affected populations and raises public awareness of these issues.
ANNUAL REPORT 2006
7
MDGs
We are working with organisations
representing Germany,Italy,Spain and
the United Kingdom along with a secretariat in Brussels, to lobby governments for the achievement of the
health-related MDGs (maternal
health,infant mortality,infectious disease) promoting a global approach
to health.
Our messages are always based on our field experience.The quality of our medical activities must be
exemplary and we aim for this standard by rigorously monitoring our practices.As part of this work,
a project on the quality of pharmaceuticals used in our programmes began in 2006 and this
is an important step forward.
>IN FRANCE
When it comes to caring for vulnerable groups, MdM has a strong public image built on 20 years
of action.The operation ‘For lack of a roof, a tent’ last winter was a symbolic programme which
mobilised citizens and brought results.
M decins du Monde contributed to the electoral debate at the time of the presidential and
parliamentary elections, just as we had done in 1995 and 2002. We put forward a number
of proposals to improve access to healthcare for the most disadvantaged.These included: access to
healthcare for the most vulnerable (CMU,AME, PASS), action to tackle health affected by homelessness and poor accommodation (rough sleepers, lead poisoning), the mental health of people living
on the streets, and tackling stigma among scapegoat groups (Roma, sex workers, asylum seekers, undocumented migrants and drug users).
We can further strengthen our role in these issues, while staying faithful to our vocation to change
practices, by getting involved in the academic sector. Specifically, we can contribute to the development of course content for the initial and optional training of medical students.Today we
should be able to change practice in French medical faculties, while taking the opportunity to open
these places to other professional groups, such as other health
professionals and social workers.
‘20 years after the opening of the first reception,
care and orientation centres (CASOs) we would
have liked to see the Mission France programmes
declining. On the contrary, they are expanding.’
TRAINING
This involves strengthening skills
around caring for the most disadvantaged, social and health inequalities
and geographical inequalities in healthcare provision.
The 2006 review of health professionals’ freedom to
practice, a mechanism which we now know resulted in a desertification of disadvantaged urban areas and isolated rural areas, has
revealed a unanimous desire from health professionals to modify
these conditions. In France, as elsewhere, it is important to address
the root causes of problems, not just their effects.
Concerning harm reduction activities, M decins du Monde
handed over a number of activities and programmes in 2006.The previous year, the Board decided to
provide technical and financial support, which enabled smooth handover of these projects to partner
organisations created for this purpose.We will play a full part in the co-ordination of harm reduction
organisations, demonstrating our commitment to this issue in which we have always led the way.This is
even more necessary as there are growing signs that the government is withdrawing from this issue and
> CONTENTS
ANNUAL REPORT 2006
9
is implementing more repressive policies.We will remain vigilant, reactive and innovative in these areas
which continue to be within our remit. Our interest in this issue is also demonstrated by a number of
our international projects — such as Afghanistan, China and Serbia — where we have taken advantage of
the expertise that M decins du Monde has built up in harm reduction.
‘Following the results of presidential elections and, considering the programme of
the elected candidate, MdM will stay vigilant on the question of access to healthcare for all and to the situation of the most vulnerable, particularly migrants.’
>ADOPTION
With the recent changes in the law in France, we are beginning to consider new questions such as
adoption by single parents or by same-sex couples. Beyond the changes in the law, we will
also have to discuss the issues internally and manage the issues arising from this very specific action
within our organisation.
SAME-SEX COUPLES AND
ADOPTION
In order to take a position, we are
holding meetings with relevant
experts, for example during the conference on types of parenting, and
reviewing existing analysis on these
issues.
>THE INTERNATIONAL NETWORK
The development and strengthening of Médecins du Monde’s international network is another main area of development for our organisation. We do not always take full
advantage of our international representation. Nonetheless, some progress has been made
throughout the year, particularly with closer collaboration between the French and Spanish delegations on advocacy issues (Palestinian Territories and the MDGs).There is similar collaboration
with the International Representative Offices.
The Averroes project also contributes to strengthening operational and policy links. Some of
our main themes, such as migrants or harm reduction, make this kind of arrangement essential.
AVERROES
We must, however, do more work on the emergence of a European M decins du Monde entity.
It seems desirable to take a pragmatic approach, which aims to support the emergence of delegations where there are strong human resources.The question of opening international delegations or representative offices in southern countries must also be considered, but, once again, where
there are strong human resources.
> CONTENTS
The Averroes project aims to ensure
equitable access to healthcare for
migrants throughout Europe by
establishing a European network
across the 25 EU member states.
¨ OUR AIM
In 2006, the Board confirmed its desire to continue with the international adoption activities.This programme constitutes a particular form of international solidarity towards an especially vulnerable
group, abandoned children. In the same spirit, M decins du Monde has also confirmed its desire to emphasise the adoption of siblings or of children with particular health needs.
>WITHIN MÉDECINS DU MONDE
REGIONAL STRATEGIES
We note that in 2006, the regular
presence of desk officers and the
Director of International Operations
at the continental group meetings has
reinforced the coherence of our activities and enhanced co-ordination.
We are working towards the implementation in 2008 of resouces for the continental groups
to help them produce analyses and regional strategies. However, we also need to address the
poor participation in the recent election for continental group representatives.
In recent months, a working group, made up of M decins du Monde members, has been charged with
looking at the question of our regional delegations and our model of decentralisation.Their
conclusions will then be debated in the different consultative and decision-making groups within
the organisation.
At the same time, a process has been launched to open a new regional delegation in ClermontFerrand and discussions are currently underway.
In a similar vein, we proposed that the possibility of an active property acquisition policy
should be seriously reviewed. Every year we spend sizeable sums on rent for our different activities in France and for the regional delegations premises. It is clear that M decins du Monde will
have long-term involvement in issues relating to healthcare, poverty and exclusion.The purchase
of premises does not signify any change in our decision to, wherever possible, handover to public services.This proposal aims to reduce, in the meantime, our running costs in France so that we
can do more and do it better, both at home and abroad .This confirms, our desire to build strong
regional foundations for M decins du Monde.
>THE ORGANISATION
Our organisation, and all those who are involved in it, are there to serve our projects. Growth,
through the reinforcement of M decins du Monde France and by the development of the international network, should therefore be seen as a means to reach the volume of activities which
makes our work in the health domain more effective and more transparent.This depends on two
factors: human resources (including volunteers) and the development of our financial resources.
Concerning human resources, various mechanisms have been put in place, including the recruitment of overseas volunteers from both northern and southern countries (with a view to southsouth solidarity). Our presence and our visibility must be strengthened in universities and the contribution of our international network needs to be enhanced. Other options, such as mentoring
of less experienced volunteers by former field volunteers, should also be explored.These issues
relating to human resources for field programmes have all been included in the portfolio of the
new human resources director.
> CONTENTS
Increasing and diversifying our financial resources is equally crucial for reasons of operational effectiveness, independence and security. Given the current polarisation of humanitarian
contexts, money is often associated with a particular country. M decins du Monde must be able
to access sufficient private funds and must also have geographic and institutional diversification of
funders.This project started at the end of 2005, and efforts in this direction have continued and
have been strengthened. On another financial issue, the previous General Assembly asked us to
evaluate options for investing our financial reserves in ethical funds . Future partners have been
identified.
ANNUAL REPORT 2006
11
At the end of this first year as President, I want to tell you how much of a pleasure it has been
to work with the Board and with each of you in the implementation of these different projects.
I have confidence that the strong dynamic which we have at our disposal will enable us to face
up to the challenges ahead and to ensure coherence and cohesion of our organisation towards
all those who have the confidence to support us or to be involved in our actions.
¨ OUR AIM
Dr Pierre Micheletti
President, Médecins du Monde
7 May 2007
> CONTENTS
2006 in
figures
>HUMAN RESOURCES
219
paid staff in
France
127
1,600
350
1,400
field volunteers
430
monitoring and
technical
support
missions
volunteers
went to the
field
>BUDGET
53.2
volunteers in
France
16
regional
delegations
> INTERNATIONAL
NETWORK
million euros in
2006
11
Expenditure
1%
8%
20%
71%
local staff
working on
international
projects
international delegations
Argentina, Belgium, Canada, Cyprus,
France, Greece, Portugal, Spain,
Sweden, Switzerland, United States
communication
administration
development
programmes
90.25
million euros
Income
59%
35%
4%
2%
5 representative offices:
public generosity
institutional grants
private grants
other
Germany, Italy (office of MdMSpain), Japan, Netherlands,
United Kingdom
Value of volunteer contributions and gifts in kind:
20
million euros
> CONTENTS
ANNUAL REPORT 2006
13
>INTERNATIONAL PROGRAMMES
programmes in 51 countries
Geographical distribution
of programmes:
Africa
Asia
Latin America
Eastern Europe
Middle East/North Africa
Central Asia
Geographical distribution of international
programme expenditure:
34
Africa
Asia
Latin America
Eastern Europe
Middle East/North Africa
Central Asia
20
14
13
10
5
>MISSION FRANCE
33,148
5,342
medical consultations in 21
CASOs (Healthcare and Guidance
Centres) for16,948 patients
10 towns for 2,254 patients
84
14
mobile community projects in 23
towns, carried out by 655 volunteers, including 6 programmes
among people working in prostitution, with more than 10,700 contacts.
38,490
dental consultations carried out in
medical consultations
harm reduction programmes linked to
drug use, carried out by 269 volunteers. More than 82,700 harm reduction contacts.
> CONTENTS
50
18
10
9
8
5
¨ 2006 FIGURES
91
INTERNATIONAL
PROGRAMMES
14/108
> CONTENTS
> CONTENTS
Thierry Duboit/L’express
Haïti
Mexique
3
2
Guatemala
1
Salvador
Nicaragua 1
1
Colombie
2
Pérou
Emergency: a situation where people’s lives and livelihoods
are in immediate danger (natural disaster, armed conflict etc.).
*
x
Response: substitution programme.
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.
1
Bolivie
Argentine
2
1
Development: support for meeting the needs or carrying out the
policies expressed by local partners, communities or authorities in a
x*
situation where there are insufficient resources.
Response: partnership and capacity building.
* X – number of projects per country.
> CONTENTS
>
Biélorussie
1
Moldavie
Roumanie
Bulgarie
Serbie
1
Kosovo
2
1
Turquie
2
2
Tchétchénie
1
Ouzbékistan
1
Afghanistan
Egypte
2
Algérie
Burkina Faso
Guinée
2
1
Irak
1
Ter. Palestiniens
1
3
Népal
1
Niger 1
1
Pakistan
Mali
1
1
Erythrée
1
Tchad
Vietnam
Cambodge
1
Sri Lanka
Rwanda
1
1 1
1
1
Ethiopie
2
Rép. dém.
du Congo
3 1
1
Birmanie
Yémen
1
1 1
1
1
Soudan
Côte d’ivoire
Géorgie
1 1
2
Bénin
Libéria
3
Chine
Liban
Maroc
1
Mongolie
1
1
1
1
1
Angola
Tanzanie
1
Zimbabwé
1
Indonésie
4
Madagascar
3
> CONTENTS
5
AFRICA »
» EMERGENCY:
Situation where people’s lives and livelihoods are in immediate danger (natural
disaster, armed conflict etc). Response: substitution programme.
» CRISIS:
Situation where people’s basic needs are not being met in the long-term (civil
war, forgotten conflict, HIV pandemic). Response: technical assistance and
mobilisation of local resources.
» DEVELOPMENT:
support for meeting the needs or carrying out the policies expressed by local
partners, communities or authorities in a situation where there are insufficient
resources. Response: partnership and capacity building.
> CONTENTS
19
INTERNATIONAL PROGRAMMES ¨ AFRICA
ANNUAL REPORT 2006
ANGOLA p.24>25
ALGERIA p.26
BENIN p.27
BURKINA FASO p.28
CHAD p.29
DRC p.30>31
ERITREA p.32
ETHIOPIA p.33
GUINEA p.34
IVORY COAST p.35
LIBERIA p.36
MALI p.37
MADAGASCAR p.38>39
MOROCCO p.40
NIGER p.41
RWANDA p.42
SUDAN p.43
TANZANIA p.44
ZIMBABWE p.45
> CONTENTS
MADAGASCAR
Lepela, 16 years old, has been
in Ambanja prison since
2 May 2005.
‘At 13, I fell in love and married a man
who was over 30 years old. He started
to beat me regularly. One day he
wanted to strangle me but I defended
myself with a knife.
Since then, I’ve been locked up here
and I don’t have any contact with my
family.The thing that I find hardest is
the food.We have manioc for every
meal.The other prisoners share the
food their families bring with me,
maybe because I am the youngest
here.We also need clothes, soap and
things to do. In the rooms, the heat is
unbearable during the day and at night
we have to protect ourselves from
rats. I had a bad cough but its better
now. I still have terrible toothache.
> CONTENTS
Lizzie Sadim
For now, I still haven’t had a trial and I
don’t know what is happening with my
case. Nobody tells me anything. I know
that there is risk that I’ll get a life
sentence but I don’t have any way to
pay for a lawyer.’
> CONTENTS
ANNUAL REPORT 2006
21
(2) Paolo Pellegrin/Magnum photos
(1) Alexandre Godard
» In 2006, MdM carried
out community health
projects and supported
periodic water
distribution and
vaccination campaigns in
the Darfur region of
southern Sudan (1 and
7) which has been
devastated by conflict.
Despite the end of
hostilities, the treatment
of malnutrition in
Angola (3 and 9),
primary care and
mental health care in
Liberia (2), AIDS
treatment in the
Democratic Republic of
Congo (5) and the
protection of street
children in Ivory Coast
(8) are essential for the
survival of civilian
populations. In Mali (4),
it is not war that
isolates, but obstetric
fistulas which affect
many women.They then
become excluded
because of their
resulting incontinence,
but the training of
Malian surgeons enables
these women to have
better access to
treatment today (6).
> CONTENTS
(8) Stéphane Lehr
(3) Stéphane Lehr
(5) Jacky Naegelen/Reuteurs
> CONTENTS
(6) Jean Achache
(9) Stéphane Lehr
(7) MdM
(4) Véronique Burger/Phanie
ANNUAL REPORT 2006
23
ANGOLA
Four consecutive years of peace, following 27 years of civil war, have enabled Angola to open up
again to international aid, so the government is now in a position to build up social services. More
than three million refugees, mainly women and children, have returned home since the end of the
civil war in 2002.The children show signs of malnutrition. Unexploded bombs, left over from the
war, presents a major security threat which prevents people in some parts of the country from
returning to agriculture.
CHOLERA
EMERGENCY
Benguela and Huambo Provinces
Activities
Outlook
Prevention and health education activities began with the
first phase of the project (April 2006) and continued until
the end of August. These were carried out in rural and
urban areas in Benguela province (Lobito town) and
Huambo provinvce (Mungo and Bailundo towns) in
collaboration with the regional and town health authorities.
Project closed at the end of August 2006.
CARING
Mortality
> infant: 154 ‰
Life expectancy
> at birth: 40.7
Progress bar at 31/12/2006
04/2006
08/2006
HDI
> 0.439; rank: 161/177
GNP/capita ($)
> 1,258
> Project progress
International delegations
> project 1: MdM Spain
FOR STREET CHILDREN
> project 2: MdM France
Lobito town – Benguela Province
Activities
Outlook
To improve the quality of care for street children and their
access to it, MdM’s activities include:
• training and awareness-raising of health professionals in
Lobito about conditions affecting street children;
• setting up a monitoring system in health facilities to
ensure that street children are being cared for by the
Angolan health system;
• ongoing training for six street educators responsible for
linking children with the network of private,
governmental and voluntary organisations which support
children in the process of re-socialisation;
• improving access to literacy classes, school education
and vocational training in partnership with local
institutions;
• access to administrative status for recognition of the
children’s citizenship;
• individual assessments for the process of family
reintegration.
Individual support and medical care for
street children in the town’s health posts
and hospitals.
06/2004
> Project progress
12/2008
Beneficiaries
> direct, project1: 594,260
> direct, project 2: 350
> indirect, project 1: 1,188,522
> indirect, project 2: 2,000
Staff
> local, project 1: 10
> expatriates, project 1: 5
Co-ordinators
> programme: L.Jarrige
> general co-ordinator: D.Chappaz
> headquarters: O.Mouzay
Funding
> project 1: ECHO
> project 2: UBS, MdM
Budget
> 2006 project 1: 203,608 euros
> 2006 project 2: 208,678 euros
> CONTENTS
25
TREATING
MODERATE MALNUTRITION
Outlook
In Mungo town:
• in collaboration with the World Food Programme,
running a supplementary feeding centre and two
mobile feeding centres;
• supporting the primary healthcare structures in the
town.
In Bailundo town:
• supporting the Bailundo Ministry of Health’s
supplementary feeding centre;
• staff training.
Following the handover of the feeding
centres to the Ministry of Health, MdM
withdrew from this part of the programme
in September 2006. The 2007 activities
include monthly evaluation of Mungo
health services activities by mother and
child health nurses from the Huambo
province programme.
06/2003
31/01/2007
> MdM Spain
Beneficiaries
> direct: 3,500
> indirect: 20,000
Staff
> local: 30
> expatriate: 4
Co-ordinators
> field: D. Chappaz
Funding
> FSD, MdM France
> Project progress
Budget
> 2006: 50,000 euros
MOTHER
AND CHILD HEALTH
North Huambo province (Bailundo town)
Activities
Outlook
In 2006, the activities continued, including:
• monitoring the network of mother and child health
(MCH) nurses who supervise the traditional
midwives;
• paediatric consultations and a vaccination
programme;
• training on prevention and treatment of sexually
transmitted infections (STIs);
• family planning;
• logistics support and the transfer of staff from the
maternity unit to the Bailundo referral hospital.
Continue to gradually improve the
quality of peripheral actions and
ensure their long-term continuity by
training and mentoring Angolan
medical staff.
01/12/2003
> Project progress
31/12/2006
> MdM Spain
Beneficiaries
> direct: 80,000
> indirect: 325,000
Staff
> local: 15
> expatriate: 6
Co-ordinators
> field: D. Chappaz
Funding
> FSD, German Ministry of Foreign Affairs,
MdM
Budget
> 2006: 543,360 euros
> CONTENTS
Activities
ANNUAL REPORT 2006
Bailundo and Mungo
ALGERIA
Despite considerable economic growth and a sizeable reduction in external debt,
Algeria remains a fragile country. There are widespread inequalities, and poverty and
unemployment endure. Expansion of the oil trade, which is the main source of wealth
in the country, has not been accompanied by structural reforms for the population.
Problems with access to healthcare, particularly for chronic diseases, and violence
against women, still exist.
CARING
FOR WOMEN AFFECTED BY VIOLENCE
Mortality
> infant: 35‰
Algiers
Life expectancy
> at birth: 71.0
Activities
Outlook
In 2006, MdM focused on preventing and treating
physical and psychological problems affecting women
and children who are victims of violence. The programme
consists of:
• ensuring the smooth running of a free and anonymous
telephone help line and supporting a multi-disciplinary
listening network;
• strengthening the knowledge and skills of people
working on the issue of violence and promoting
exchange of knowledge and practices;
• improving and developing prevention and
awareness-raising activities;
• supporting lobbying of the authorities.
This programme will enable MdM to
establish a reliable picture of the legal
processes and the capacity of the
shelters, but also to create a network
of voluntary and institutional partners.
COMMUNITY
HDI
> 0.728; rank: 102/177
GDP/capita ($)
> 2,616
Source: Human Development Report 2006, UNDP
> projects 1 and 2: MdM Spain
07/2006
07/2009
> Project progress
Beneficiaries
> for the whole project: 1,060
> direct, project 2: 1,200
Staff
> local. project 1: 3
> expatriate. project 1: 1
HEALTH PROJECT
Co-ordinators
> project 1 : J. Masson, M. Bruyns
> project 2 : R. Allemand
> monitoring project 2 : Rhône-Alpes DR -
Constantine (El Gamas district)
Grenoble
Activities
Outlook
This ongoing programme supports the outreach team
of Constantine Social Development Agency and the El
Gamas residents’ association in relation to asthma
treatment.The programme aims to:
• examine, diagnose and treat screened children;
• enable a group of children to benefit from sport in
the swimming pool;
• provide medicines.
Efforts will focus on:
• treating 100% of the serious asthma
cases;
• preventing asthma and improving living
conditions;
• working with Constantine health
observatory on the prevention of HIV
and smoking prevention
02/2005
> CONTENTS
> Project progress
07/2008
Funding
> project 1 : French Ministry of Foreign
Affairs, MdM
> project 2 : Grenoble council; Isère
Regional Council; MdM; specific donations
Budget
> 2006 project 1: 68,813 euros
BENIN
THE MAJOR EPIDEMICS
– HIV/AIDS
Ouidah and Comé
Mortality
> infant: 90‰
Activities
Outlook
The programme’s activities include:
• prevention/awareness-raising on HIV in partnership
with 10 Beninese associations and the American
NGO Africare;
• training on screening and testing programmes for
staff of two hospitals in the area and the health
centres of seven villages;
• staff training on comprehensive HIV treatment.
Continued prevention and awarenessraising activities with the Beninese
associations. Decentralisation of
access to HIV testing in 55 district
health centres.
Increasing access to anti-retrovirals
(ARV) for 1,750 patients on treatment
programmes and a further 700 on
ARV treatment by the end of 2008
and the introduction of new
treatments.
Development of prevention of mother
to child transmission (PMTCT)
activities
01/2005
> Project progress
ongoing in 2007
Life expectancy
> at birth: 53.8
HDI
> 0.428; rank: 163/177
GDP/capita ($)
> 498
Beneficiaries
> direct: 476 (comprehensive HIV
treatment)
> indirect: 100,000 (awareness-raising)
Staff
> local: 20
> expatriate: 3
Co-ordinators
> programme: P. B. Beyrie
> field: L. H. Pourteau
> headquarters: H. Barroy
Funding
> MdM, Paris City Council, French Ministry
of Foreign Affairs, Dutch Ministry of
Foreign Affairs
Budget
> 2006: 438,372 euros
> CONTENTS
TACKLING
ANNUAL REPORT 2006
27
Benin has one of the few democratic governments in Africa and has achieved relative
economic stability.Thomas Boni Yayi has been president of the Republic since 6 April 2006,
having obtained 75% of the votes in the second round of the presidential elections. He has
undertaken to reform this mismanaged and poor country into an emerging state.
Nevertheless, the HIV/AIDS epidemic spread in 2006.Today 87,000 people, including 9,800
children, live with HIV and 62,000 children are orphans.
BURKINA FASO
This landlocked African country has some of the worst health statistics in West Africa.
The crisis in the Ivory Coast seriously affected the country, which depended on
Abidjan port for more than two-thirds of its foreign trade. Access to primary care
remains almost impossible for most of the population.
ACCESS
TO ORAL HEALTHCARE
Diebougou
Mortality
> infant: 97‰
Activities
Outlook
Given the lack of dental and oral health care in the
region, MdM implemented a range of activities:
• setting up a dental surgery (refurbishing the
premises) and professional training (training a
dentist at university);
• development of an oral health education programme
in schools and villages in Diebougou province;
• the dental surgery has been operational since July
2006, with two sessions per week;
• staff training for the awareness-raising programme.
Autonomous running of the dental
surgery;
Training of a nurse priest in dentistry
at Ouagadougou university (currently
in second year);
Creation of a mobile clinic for initial
care to visit the most remote villages.
2006
>
2008
Project progress
Life expectancy
> at birth: 47.4
HDI
> 0.342; rank: 173/177
GDP/capita ($)
> 376
Beneficiaries
> direct: 60,000
> indirect: 180,000
Staff
> local: 2 specialist dental nurses and one
undergoing training
Co-ordinators
> programme: F. Ben Soussan
> field: S. Dabbiré
> country director: P. de Botton
Funding
> MdM and private partners
Budget
> 2006: 10,362 euros
> CONTENTS
CHAD
TREATING
STREET CHILDREN
Life expectancy
> at birth: 43.7
N’Djamena
HDO
> 0.368; rank: 171/177
GDP/capita ($)
> 447
Activities
Outlook
MdM has been working in Chad since 2001, this year
the programme included:
• training on HIV prevention for 64 local workers
and 40 peer educators from the street children
community, in partnership with Unicef Chad;
• educational sessions with 2,800 children;
• producing an educational tool and a list of 7,500
street children contacts in the healthcare circuit.
Because of the critical situation in
recent months, MdM has had to
continue its support of the Swiss Tropical
Institute and to delay withdrawal until the
end of 2007. MdM provides support to
local associations for micro-projects
which benefit street children
(vocational training).
A medical and welfare support network, with a
system of third-party payments dependent on local
funders, is run by our partner the Swiss Tropical
Institute with operational and financial support from
MdM. In 2006, this circuit enabled access to more
than 2,300 primary healthcare consultations for
street children.
Beneficiaries
> direct: 5,000 children including 30
‘leaders’
> indirect: 50
Staff
> local: 1
Co-ordinators
> programme: P. Estecahandy,
J. Boncompain
> monitoring: Midi-Pyrenees Regional
Delegation
01/12/2001
> Project progress
12/2007
Funding
> MdM,Toulouse Council and private
partners in N’Djamena and in the MidiPyrenees
Budget
> 2006: 28,930 euros
> CONTENTS
Mortality
> infant: 117 ‰
ANNUAL REPORT 2006
29
In 2006, several factors threatened political stability in Chad: the effects of the flow of
refugees and militias in the east as a result of the crisis in Darfur, the attempts by Chadian
rebels to oust President D by from power after 15 years, a severe fiscal crisis and a long
conflict over the use of oil revenues.The presidential election in May 2006, boycotted by
the opposition and won by D by after the first round following a constitutional
amendment which enabled him to present himself for a third mandate, contributed to
discontent in the country. Health indicators are poor because infrastructure and health
personnel are lacking, but also because of poor hygiene. Children living on the streets are
the most exposed.
DEMOCRATIC REPUBLIC OF CONGO
The war in DRC is one of the bloodiest the world has seen since the end of the Second World
War. In less than five years, 4 million people will have died. In May 2003, fighting in Ituri province
quickly spread to Bunia forcing women and children to flee. After three years of transition and
an exceptional mobilisation by the international community, J. Kabila was re-elected on 29
October 2006.Today, the government is involved in managing the post-conflict reconstruction
and the importance of civil society has been confirmed.
FIGHTING HIV
EFFECTIVELY
Mortality
> infant: 129 ‰
Goma
Activities
Outlook
Our programme, aimed at an integrated response
to the AIDS epidemic, consists of:
• strengthening the capacity of local authorities in
the fight against AIDS and in caring for victims of
sexual violence;
• improving care for at-risk populations and
improving the understanding of the epidemiology of
STIs and HIV among local actors;
• facilitating anonymous and voluntary testing;
• providing medical, psychological and social support
to people living with HIV;
• in coordination with local partners, developing a
prevention and care policy for adolescents in
relation to reproductive health, STIs and HIV.
Continuation of activities, institutional
capacity building and partnership
building. In addition, setting up special
units to tackle violence against
women.
PROTECTING
IDH
> 0.391; rank: 167/177
GDP/capita ($)
> 114
International Delegations
> projects 1 and 2: MdM Belgium
01/08/2003
31/12/2010
> Project progress
Beneficiaries
Staff
> expatriate, project 1: 1
STREET CHILDREN
Kinshasa
Activities
Outlook
The objectives of the project are to reintegrate and
resocialise street children by:
• distributing condoms at the sexual health centre
and during IEC sessions;
• maintaining a consultation and referral service for
STIs and an information and counselling service in
the PEKABO centre;
• facilitating access to primary healthcare for street
children supported by 45 NGOs.
Reinforcing current activities by
supporting two day centres for girls
living on the streets and expanding the
care network by supporting seven
health facilities.
> CONTENTS
Life expectancy
> at birth: 43.1
Co-ordinators
> project 1: F.Jacquet
> project 2: A.Thiriat
> field, project 1 : P. Sallah
> field, project 2 : J. Romué
> country co-ordinator, projects 1 and 2:
D. Cannet
> country co-ordinator, project 2: A.Talibo
> HQ projects 1 and 2: C.Courtin
Funding
> project 1: Global Fund/UNDP, Dutch
11/01/1999
> Project progress
31/12/2008
Ministry of Foreign Affairs, UNICEF, MdM
> project 2 : ECHO
Budget
> 2006 project 1: 553,668 euros
> 2006 project 2: 505,185 euros
31
SUPPORTING
THE HEALTH SYSTEM AND BUILDING LOCAL CAPACITY
Outlook
The programme aims to improve the quality of
health services and their accessibility for the
population of Tanganyika district, by:
• implementing an action plan focusing on training and
the accessibility of services for the beneficiary
populations;
• involving the communities in the management of
health programmes through strengthening the capacity
of local community organisations, health education
sessions and training;
• involving the Central Area Offices in the management
of ‘health areas’;
• consolidating data collection and epidemiological
surveillance systems and management tools;
• training the different actors involved;
• providing technical support to the management
teams of the health areas and the medical inspectors of
the district.
To help improve the population’s health in
the 11 health areas of Tanganyika health
district by improving the quality of health
services
in
the
long-term
by
implementing an efficient health system.
IMPROVING
01/10/2006
30/08/2009
> Project progress
Beneficiaries
> direct: 1,092,270
> indirect: 1,922,863
Staff
> local: 90
> expatriate: 9
Co-ordinators
> country: D. Cannet
> field: A.Talibo/K.Touré
> headquarters: C.Courtin
Funding
e
> 9 FED, MdM
Budget
> 2006: 233,350 euros
> MdM Belgium
ACCESS TO HEALTHCARE
Kalemie and Kongolo (North Katanga)
Beneficiaries
> direct: Kalemie – 53,591
Activities
Outlook
The programme aims to ensure access to quality
healthcare in 28 health centres in Kalemie and 25
health centres and five health posts in Kongolo.There are
five aspects:
• implementing a Minimum Package of Activities (MPA)
in the health centres and supporting the maternity unit
in the general hospital for obstetric emergencies;
• providing essential medicines and medical equipment
supplies;
• strengthening the capacities of the Central Area
Offices;
• training healthcare staff;
• epidemiological surveillance and tackling epidemics,
including cholera.
In 2007, MdM will be monitoring the
post-conflict phase, particularly in
Tanganyika where ensuring the health
of nearly two million Congolese is one of
the challenges within the programme
which we have been developing there
since October 2006.
> CONTENTS
> MdM Belgium
Kalemie: 01/2/2005/Kongolo: 01/4/2002
> Project progress
30/09/2006
Kongolo – 121,918
> indirect: Kalemie – 143,334
Kongolo – 236,000
Staff
> local: Kalemie – 29/Kongolo – 37
> expatriate: Kalemie – 5/Kongolo – 4
Co-ordinator
> country: D. Cannet
> programme: A.Thiriat
> field: K.Touré
> country co-ordinator: A.Talibo
> headquarters: C.Courtin
Funding
> Kalemie: ECHO, French Ministry of
Foreign Affairs, Paris Council, MdM
Kongolo: ECHO, MdM
Budget
> 2006: Kalemie – 520,709 euros
Kongolo – 605,972 euros
Source : Human Development Report 2006, UNDP
Activities
ANNUAL REPORT 2006
Tanganyika district – Katanga province
ERITREA
Eritrea is one of the poorest countries in the world and several consecutive years of
drought have contributed to food shortages.The disputed border between Eritrea and
Ethiopia ensures that relations between the two countries remain tense.This situation,
described as neither war, nor peace , is a constant source of security problems. In this
context, children and pregnant women are the most vulnerable.
PRIMARY
HEALTHCARE
Mortality
> infant: 52 ‰
Afabet
Life expectancy
> at birth: 53.5
Activities
Outlook
The programme includes:
• providing primary healthcare in three health
facilities and in the communities;
• health education;
• supervising Afabet hospital;
• refurbishing a surgical unit in Afabet hospital along
with providing equipment and mentoring surgical
staff.
Continuing the training of midwives
and community health workers in
Afabet region and the mentoring of
surgical staff in the surgical unit at
Afabet hospital.
HDI
> 0.454; rank: 157/177
Beneficiaries
> direct: 7,490
> indirect: 7,520
01/07/2006
> Project progress
31/05/2008
GDP/capita ($)
> 219
Staff
> local: Asmara base – one administrator
and one logistician.Afabet base – 1 co-ordinator
and 1 logistician
> expatriate: 1 permanent general coordinator and rotating medical staff,
1 obstetrician-gynaecologist, 1 nurse
anaesthetist, 1 theatre nurse,1 midwife and
1 primary care nurse
Co-ordinators
> programme: N. Raffort
> headquarters: O. Mouzay
> general co-ordinator: J. Amalfi
Funding
> ECHO, MdM
Budget
> 2006: 246,294 euros
> CONTENTS
ETHIOPIA
MOTHER-TO-CHILD TRANSMISSION OF
HIV
Mortality
> infant: 110 ‰
Mekele
Activities
Outlook
The programme has eight components:
• prevention of mother-to-child transmission (currently
with Viramune);
• referral of pregnant women to the antiretroviral access
programme at the hospital;
• training counsellors for screening centres and transfer
of skills;
• voluntary HIV testing;
• awareness-raising/prevention on HIV and mother-tochild transmission;
• rebuilding the maternity unit;
• provision of medicines, baby milk and other supplies;
• information and practical advice on infant feeding.
Changes in health policy mean that use of ARV
treatments is now permitted and they are
available free of charge at Mekele hospital.
Women enrolled in the prevention of motherto-child transmission programme are
systematically referred to the ARV unit for
treatment. An extension of the awarenessraising activities, training and monitoring is
underway to follow on from the first phase.
TRAINING
01/08/2003
31/01/2007
> Project progress
Tigray/Axum
Activities
Outlook
The programme aims to reduce maternal and infant
mortality with three main activities:
• capacity building through transfer of knowledge;
• training complete surgical teams for the peripheral
health centres;
• access to healthcare for the most disadvantaged
groups, particularly access to general emergency surgery
and to caesarian sections.
The training of teams by the Tigray trainers
will continue for one year. A third training
session began in February 2007 for nine
months. The training of an Ethiopian trainer
for the surgery programme, due to start in
March, will last for a year.
> CONTENTS
> Project progress
HDI
> 0.371; rank: 170/177
GDP/capita ($)
> 114
Beneficiaries
> direct, project 1: 200 HIV positive
mothers and their babies, 4,000 pregnant
women
> indirect, project 2: 4,000,000
Staff
IN OBSTETRIC AND SURGICAL CARE
01/10/2004
Life expectancy
> at birth: 47.6
31/12/2007
Co-ordinators
> project 1: M.Saada
> project 2: G. Pascal
> field, project 1: O.Evreux
> field, project 2: D. Getachew/
O. Evreux
Funding
> project 1: French Ministry of Foreign
Affairs, MdM
> project 2: UNFPA, MdM
Budget
> 2006 project 1: 227,313 euros
> 2006 project 2: 401,968 euros
PREVENTING
ANNUAL REPORT 2006
33
The disputed border with Eritrea and the increasingly precarious situation in Somalia
threaten the political stability of Ethiopia. Health indicators in this country of 75 million
inhabitants are way below average for sub-Saharan Africa.The shortage of specialist doctors
and surgeons outside the capital make access to surgery difficult in rural areas where more
than 85% of the population lives. A considerable proportion of maternal mortality is
attributed to poor access to healthcare in these areas.
GUINEA
On top of the disastrous economic situation, Guinea has been experiencing increasing
political instability with ministerial reshuffles and the dismissal of the Prime Minister.The
mass discontent has driven the unions to call several general strikes. The nomination
of one of President Cont s supporters as Prime Minister provoked a rebellion. In
February 2007, intervention by the army to re-establish order following a state of
siege decreed by the President resulted in 112 deaths and a thousand people were
injured. Disowned by the Parliament because of the state of siege, the President was
forced to nominate a consensus Prime Minister with wider powers.
IMPROVING
Mortality
> infant: 101‰
HEALTH IN PRISONS
Life expectancy
> at birth: 53.6
Kindia
HDI
> 0.445; rank: 160/177
Activities
Outlook
The prisoners of Kindia central prison live in
extremely harsh conditions. Since 2001, MdM has
supported Kindianaise d’Assistance aux Detenus
(KAD, or Kindia Support for Prisoners) which is
made up of volunteers who try to improve health and
hygiene in prisons.
The very fragile political situation has
prompted MdM to extend its support
of KAD.The objective for 2007 will be
twofold: to enable KAD to continue
its work with prisoners, while taking
steps to increase its financial
autonomy.
There are several aspects to this work:
• training a prisoner in nursing care and the running
of a pharmacy within the prison;
• partnership with the health authorities for
treatment of the most seriously ill;
• nutritional support;
• refurbishing health facilities;
• hygiene and sanitation in the prison;
• literacy training for prisoners;
• income generating activities enabling the prisoners
to acquire skills as well as enabling regular outings
from their cells.
2000
end 2007
> Project progress
GDP/capita ($)
> 421
Beneficiaries
> direct: 200 prisoners (men, women and
children)
Staff
> local: members of KAD
Co-ordinators
> programme: P. Boucourt and T. Comte
> monitoring: Rhône-Alpes Bourgogne
Regional Delegation (S. Bret)
Funding
> private partnerships, MdM
Budget
> 2006: 18,086 euros
> CONTENTS
IVORY COAST
PROTECTING
STREET CHILDREN
Mortality
> infant: 117 ‰
Abidjan
Life expectancy
> at birth: 46
Activities
Outlook
Supporting the local NGO MESAD (Movement for
Education, Health and Development), the programme
has two objectives:
• the protection and re-socialisation of street
children and minors in prison;
• access to primary healthcare in the streets and at
the NGO’s medical centre.
With financial support from MdM,
MESAD is continuing the activities
developed between December 1996
and June 2003. The instability of the
country has not helped MESAD’s
fundraising, which is important to
ensure the continuity of the whole
programme.
The work involves:
• a process of re-socialisation of street children with
the creation of a drop-in centre, psychosocial
monitoring, support in finding employment, reschooling and re-establishing family links;
• providing primary healthcare and supporting the
medical activities of Treichville health centre;
• work amongst minors in Abidjan prison to improve
their living conditions, and provide some physical,
psychological and legal support to facilitate their
reintegration when they leave the facility;
• specific STI/HIV prevention activities.
12/1996
31/12/2007
HDI
> 0.421; rank: 164/177
GDP/capita($)
> 866
Source: Human Developement Report 2006, UNDP
UNICEF office before the conflict: CI = 175,000 street
children/Abidjan = 35,000 street children
Beneficiaries
> direct: 2,500 street children
> indirect: 25,000 street children and
youth in great difficulty
> Project progress
Staff
> local: 15 employees and 6 volunteers
Co-ordinators
> programme: J.Martin
> president of the local NGO: K.Kouassi
Funding
> MdM, MESAD
Budget
> 2006: 90,578 euros
> CONTENTS
Despite the consensual nomination of a Prime Minister and a cease-fire maintained by
a considerable international military presence, the country remains divided.The north
is controlled by the New Forces and the south is under the control of the Loyalist
Forces. There is increasing poverty and unemployment among the population of
Abidjan. Many health centres have had to reduce their services after many of their staff
left and because of the falling stocks of essential medical supplies.
ANNUAL REPORT 2006
35
LIBERIA
Almost 300,000 refugees and internally displaced people returned to their homes in
2005, after a ferocious civil war that lasted 14 years and took 250,000 lives.The national
elections in 2005 went smoothly but the re-establishment of the authority of the state,
of law and order has hardly started. Social services are in a much worse state than they
were before the war. More than one third of the Liberian population lives on less than
one dollar a day.
PRIMARY, COMMUNITY
AND MENTAL HEALTHCARE
Mortality
> infant: 157‰
Gbarnga
Activities
Outlook
In Bong county, MdM trains and mentors the health
staff of 10 clinics to carry out a range of activities:
• consultations in primary and reproductive
healthcare, including prevention of STIs;
• epidemiological surveillance (malaria, cholera etc)
and nutritional monitoring, particularly for under 5s;
• vaccination programmes;
• transferring emergency cases to referral hospitals;
• psychological and psychiatric support for women
who have been victims of sexual violence and
training ‘traditional women’ to deal with psychological
problems;
• compilation of a teaching manual for educators on
the positive effect of psychological treatment for
former child soldiers;
• development of a community health programme
including information, education and communication
(IEC) activities.
Introduction of prevention of motherto-child transmission of HIV in the 10
clinics. Supporting the medical training
given by Phebe nursing and midwifery
school to ensure that there is an
ongoing supply of trained medical staff
for the health facilities.
2010
> Project progress
HDI
> not known
GDP/capita ($)
> 130
Source: World Bank Report 2006
Beneficiaries
> direct: 124,678
> indirect: 208,761
09/2003
Life expectancy
> at birth: 42.5
Staff
> local: 70
> expatriate: 9
Co-ordinators
> programme: P. Hirtz
> field: A. Devort
Funding
> ECHO, German Ministry of Foreign
Affairs, MdM
Budget
> 2006: 952,712 euros
> CONTENTS
MALI
37
Mortality
> infant: 121‰
SURGERY
TO HELP COMBAT EXCLUSION
Life expectancy
> at birth: 47.8
Mopti Region
HDI
> 0.338; rank: 175/177
Activities
Outlook
MdM is continuing its programme of prevention
and treatment of vesico-vaginal fistulas. The
programme has four aspects:
• surgical treatment of women;
• training local surgeons and an operating theatre
team;
• spreading prevention messages (on local radio,
through theatre);
• literacy classes for those patients who want them.
In 2007, the project will continue
without any expatriates in the field.
The three local surgeons who have
been trained are now autonomous
and can continue the activities. A
representative of MdM in Mopti will
maintain the link with headquarters.
The project will continue until the
fistula work is integrated into the
construction of the new hospital at
Mopti.
12/1999
> Project progress
2007
GDP/capita ($)
> 371
> MdM Belgium
Beneficiaries
> direct: women affected by vesico-vaginal
fistulas
Staff
> local: 7
> expatriate: 1(until October 2006)
Co-ordinators
> programme: J-M.Colas
> field: J-M.Zino
Monitored in co-operation with the Brittany regional
delegation
Funding
> MdM, Norwegian Church Association
Budget
> 2006: 101,933 euros
> CONTENTS
ANNUAL REPORT 2006
Landlocked Mali is heavily dependent on international aid and on an agricultural sector
which is completely at the mercy of the climate. Because of the crisis in Ivory Coast,
the Malian government and its partners have had to re-allocate considerable
resources to humanitarian aid for returnees, asylum seekers and populations in transit.
In addition, Algeria returns clandestine sub-Saharan African migrants to Mali.The health
situation in the country remains poor. Access to healthcare is particularly difficult for
women and there is a high maternal mortality rate linked to vesico-vaginal fistulas.
MADAGASCAR
More than half of Madagascar s 18 million inhabitants live on less than a dollar per day.
Despite annual economic growth of six percent and the cancellation of debt in June 2005
by the G8, Madagascans continue to fight for their survival.There is still a lack of awareness
about HIV and the number of people infected continues to rise. Respect of human rights
is considered to be relatively satisfactory, except in prisons where the situation has been
subject to increasing attention from the authorities and development partners.
CHILD
Mortality
> infant: 76‰
CARDIAC SURGERY
Life expectancy
> at birth: 55.3
Antananarivo
Activities
Outlook
HDI
> 0.509; rank: 143/177
Two cardiac medical teams from Reunion, each
composed of two cardiac surgeons, two paediatric
cardiologists and one anaesthetist and resuscitation
expert, carried out week-long visits.There were four
aspects to their activities in 2006:
> paediatric consultations;
> closed-heart surgery in Soavinadriana hospital and
nine other cases were transferred to F Guyon Hospital
in St Denis, Reunion, for open-heart surgery;
> transfer of skills by training two cardiac surgeons in
Reunion and mentoring the local team;
> collaboration between the MdM teams and
Soavinadriana hospital.
MdM plans to continue its activities
with other partners so that this work
can continue in the long-term.
GDP/capita ($)
> 241
Beneficiaries
> direct: 12 children operated on and 45
1994
ongoing
> Project progress
seen in consultation
> indirect: skills transfer to Madagascan
practitioners and partner NGOs
Staff
> local: 4 to 5 per mission
> expatriate: 4
Co-ordinators
> programme: J-F. Delambre
> field: N. Ramamonjisoa
> headquarters: Indian Ocean Regional
Delegation
Funding
> La Réunion Council, MdM
Budget
> CONTENTS
39
PREVENTION
AND TREATMENT OF
STIS
AND
HIV/AIDS
Outlook
Following the training of the Salfa (Madagascan NGO)
team and a Knowledge,Attitudes and Practices (KAP)
survey, the focus in 2006 was on:
• Outreach IEC (information, education and
communication) activities amongst the groups at
risk, and strengthening local capacity in the fight
against STIs and HIV/AIDS;
• Prevention activities, anonymous and free
voluntary testing and treatment for people living
with STIs and HIV/AIDS.
Evaluation of the programme is planned
in 2007 in order to determine the next
steps.
workers, mining prospectors, lorry drivers
and travelling workers, young people and
SALFA Centre clients)
> indirect: 25,000
12/2004
01/2007
> Project progress
Beneficiaries
> direct: at risk groups (1,200 sex
Staff
> local: 6
> expatriate: 1
Co-ordinators
> programme: C.Vichatzky
> field: B. Aboubacar
Funding
> MdM, French Development Agency
Budget
> 2006: 124,397 euros
SUPPORT
FOR HEALTH IN PRISONS
Ambanja and Antsiranana
Activities
Outlook
In collaboration with the Ministry of Justice, MdM has
been working in prisons since 2005 on a pilot
programme within two central prisons in Antsiranana
province.The programme has three dimensions:
> health;
> malnutrition;
> sanitation and refurbishment.
Extension of the activities to five
central prisons within 24 months,
incorporating a strong socio-legal
dimension.
09/2005
> Project progress
12/2006
Beneficiaries
> direct: 800 prisoners
Staff
> expatriates: 1 co-ordinator
Co-ordinators
> programme: P. Lehoucq
> field: O. Bouron
Funding
> MdM, French Embassy
Budget
> 2006: 219,431 euros
> CONTENTS
Activities
ANNUAL REPORT 2006
Ilakaka
MOROCCO
Despite growing tourism, the thriving property market and the reforms which have
started, Morocco still has insufficient growth to deal with the demographic pressures
and poverty. Several challenges remain, particularly unemployment, access to drinking
water and healthcare for the rural populations. Other problems include the issue of
care for victims of the Years of Lead and for sub-Saharan migrants trapped by the
closure of routes of passage to Europe. However, the country is involved in a
democratic process and parliamentary elections are planned for 2007.
SUPPORTING VICTIMS
OF TORTURE
Mortality
> infant: 38‰
Casablanca
Life expectancy
> at birth: 69.5
Activities
Outlook
As part of a programme of medical care for the victims
of mass repression during the ‘Years of Lead’, MdM
continues its support to the health centre in Casablanca
put in place by the medical association for victims of
torture. MdM organises training workshops on
psychological trauma and a series of exchanges
encouraging the creation of a network for the care of
victims across Morocco.
In partnership with our Moroccan
partner, we will continue with training
and exchange sessions and setting up a
medical network for torture survivors
who find themselves without any access
to health services when they are freed.
end 2007
> Project progress
ACCESS
TO HEALTHCARE FOR SUB-SAHARAN MIGRANTS
training;
> direct, project 2: Sub-Saharan migrants in
Rabat, between 5,000 and 7,000 people
> indirect, project 1: 29,000 victims of
Moroccan jails
Staff
> local staff (partner organisations, Caritas
and ALCS): 16
> expatriates, project 1: 2 psychiatrists and
1 doctor
Rabat
Activities
Outlook
MdM, in partnership with Caritas Morocco and an AIDS
association, supports a Migrants Reception Centre in
Rabat to implement a medical programme:
• reception, orientation, prevention activities, health/
hygiene education and management of essential medicines;
• referral and accompaniment to public health services.
The reception centre for migrants will
function independently. MdM plans to
develop two types of activities: AIDS
prevention and treatment, as well as a
mother-and-child programme.
Support to ALCS, the association fighting AIDS:
• prevention activities, support to a screening centre
and providing medical and social care for people living
with HIV.
GDP/capita ($)
> 1,678
Beneficiaries
> direct, project 1: about 30 participants in
01/2005
HDI
>0.640; rank: 123/177
Co-ordinators
> project 1: J. Beckouche
> project 2: D.Guerroudj
> field, project 2: P.Tainturier
> headquarters, projects 1 and 2: S. Alary
Funding
> project 1: MdM
> project 2: MdM, Drosos, Swiss
Cooperation
01/07/2006
> Project progress
> CONTENTS
end 2007
Budget
> 2006 project 2: 107,530 euros
NIGER
HEALTHCARE
Keita
Mortality
> infant: 152‰
Activities
Outlook
The programme includes several activities:
• refurbishment, provision of equipment, training and
mentoring of staff in nine integrated health centres;
• facilitating access to primary healthcare by
removing the financial barrier for children under five
and pregnant women, putting in place exemptions
from payments for healthcare;
• supporting the implementation of the new national
protocol for treating malaria;
• development of a common protocol with Action
Against Hunger Spain for screening and treating
malnutrition.
Continuing the project in Keita by
expanding the support to Tahoua
maternity unit to improve care for
high-risk pregnancies.
Start of a new ‘research-actionadvocacy’ project on nutrition and
demography in Tahoua region, in
partnership with Action Against
Hunger Spain and with European
Union financial support.
01/03/2006
ongoing in 2007
> Project progress
Life expectancy
> at birth: 44.3
HDI
> 0.311; rank: 177/177
GDP/capita($)
> 228
Beneficiaries
> direct: 40,501
> indirect: 167,401
Staff
> local: 21
> expatriate: 5
Co-ordinators
> programme: O. Bernard
> field: J. F. Caremel
Funding
> ECHO
Budget
> 2006: 578,782 euros
> CONTENTS
PRIMARY
ANNUAL REPORT 2006
41
According to the UN Development Programme, Niger is the poorest country in the
world, with more than 63% of the population living below the poverty line.Two-thirds of
those living in poverty are women.The health situation is characterised by a high fertility
rate, high maternal and infant mortality rates and large gaps between men and women in
terms of health, education and literacy.
RWANDA
The aim of the 1994 genocide in Rwanda was to exterminate the Tutsi population. In less
than 100 days, nearly a million people were killed in horrible conditions. Thirteen years
later, the country is trying to push forward its economic reconstruction.The government s
strategy tends towards a policy of unity and reconciliation. Around 283,000 survivors of
the genocide live in Rwanda, often in isolation and extreme deprivation. Many victims
remain haunted by the atrocities that they experienced. The signs of trauma are more
visible than ever, particularly during the hearings of the gachacha village tribunals in which
the whole population is invited to participate.
Mortality
> infant: 118‰
MEDICAL
AND PSYCHOLOGICAL SUPPORT TO GENOCIDE SURVIVORS
Life expectancy
> at birth: 43.6
HDI
> 0.450; rank: 158/177
Kigali
GDP/capita ($)
> 208
Activities
Outlook
The programme has three main aspects:
• developing a joint action plan for accompaniment
and psychological care across the country with 34
trauma counsellors and three psychologists from
IBUKA as well as para-legals;
• supporting survivors going before the gachacha,
with an analysis of the therapeutic effects linked to
the process of these local jurisdictions (actionresearch);
• institutional support for our partner IBUKA on
technical, financial and institutional communication
issues.
The first phase of the project is planned
to take place from September 2006 to
May 2007. It includes a major element
of experimentation, research, additional
diagnosis with a view to more general
support and mentoring in the longer
term in partnership with IBUKA. The
following phase will begin in June 2007.
>
05/2007
Project progress
> CONTENTS
Beneficiaries
> direct: 283 000
Staff
> local: 90 (staff of IBUKA)
Co-ordinators
> programme: G. Foucaud/F. Jacquet
> headquarters: C. Courtin
Funding
> MdM
09/2006
Budget
> 2006: 88,853 euros
SUDAN
THE QUALITY OF SURGICAL CARE AND PRIMARY
HEALTHCARE
Mortality
> infant: 63‰
Malakal, South Sudan
Life expectancy
> at birth: 56.3
Activities
Outlook
• Surgery/Hospital: completion of the project to
renovate and equip the surgical unit, as well as
training the staff;
• Primary healthcare: opening five mobile clinics in
the Tonga corridor along the White Nile;
• Responding to a cholera epidemic by installing a
cholera treatment centre in Kaldak in November.
The fighting in Malakal at the end of
November highlights how unstable the
situation is and has slowed the
reconstruction efforts.The objective is
to develop the project, adapting it to
the constantly changing context.
25/11/2004
2007
> Project progress
EMERGENCY
MEDICAL CARE
GDP/capita ($)
> 594
International Delegations
> project 2: MdM Greece, in El Fasher
(West Darfur)
Beneficiaries
> direct, project 1: 50,000 (Malakal town) +
35,000 (neighbouring rural populations)
> indirect, project 1: 150,000 (High Nile region)
Staff
> expatriate, project 1: 5 + surgical teams
South Darfur – Nyala (Kalma, Dereij, Kass, Djebel Mara)
Activities
Outlook
• The primary healthcare centre (Kalma camp)
carried out medical consultations, care for women
who are victims of violence, health education
sessions and oral rehydration therapy. From June to
October, the cholera treatment centre was active in
response to an epidemic.
• Between April and December, mobile clinics
provided healthcare to the isolated populations in
Thur, Kass and in the Djebel Mara.These clinics
were suspended because of security reasons.
The deterioration in security conditions
generated fears of a reduction in humanitarian
aid and in access to the most vulnerable
populations, leading to predictions of an
unprecedented humanitarian crisis.
Co-ordinators
> project 1:J.Larché,G.Isserlis (RT),G.Lang
> project 2: J. Larché/G. Lang
> field, project 1:A. Neveu/A. Rego
> field,co-ordinator Nyala:N.Seris/P.Villedieu
> country co-ordinator, Khartoum : F. Mawazini
> HQ,projects 1 and 2:emergency desk/B.Contamin
Funding
> project 1: French Embassy in Khartoum,
MAAIONG, Renzo Piano
> project 2 : DFID, ECHO
14/07/2004
> CONTENTS
HDI
> 0.516; rank: 141/177
> Project progress
2007
Budget
> 2006 project 1:243,556 euros (surgery) +
205 ,726 (primary care) + 170,043 (Cholera
November)
> 2006 project 2: 1,970,197 euros
IMPROVING
ANNUAL REPORT 2006
43
After 20 years of conflict between government forces and rebels, the population in South Sudan
has returned home after the peace process, but the socio-political make-up of the region causes
tensions which hinder reconstruction. In the west, the humanitarian situation has deteriorated
in Darfur with a climate of widespread violence particularly due to the increasing number of
parties involved in the conflict. Access to aid for the populations is diminishing, generating fears
of an alarming deterioration in the health situation.
TANZANIA
Considered as an island of stability in the region, Tanzania has welcomed more
refugees than any other country in Africa following the conflicts suffered by its
neighbours Rwanda, Burundi and Democratic Republic of Congo.The last decade has
been notable for the introduction of reforms and relatively sustained economic
growth.The remaining challenges are to slow the spread of HIV/AIDS and to improve
living conditions for the most disadvantaged groups.Around seven percent of the adult
population lives with HIV and antenatal consultations have shown prevalence rates
ranging from five to fifteen percent in some regions, even though these rates have
fallen in the last ten years.
ACCESS
TO EFFECTIVE ANTI-RETROVIRAL COMBINATIONS
Bukoba
Outlook
• MdM supports the clinic run by TADEPA, a local
organisation, with treatment and prevention of
opportunistic infections in people living with AIDS
and with prevention campaigns which actively
involve the communities.
Continuation of all these activities in
2007 and the development of access to
effective anti-retroviral combinations in
rural areas by providing support to
three district hospitals.
02/10/2004
> Project progress
Life expectancy
> at birth: 46
HDI
> 0.430; rank: 162/177
Activities
• Since 2004, an ambitious Highly Active
Antiretroviral Therapy (HAART) programme has
enabled more than 1,500 patients to access tritherapies. In particular, HIV-positive pregnant
women, patients with advanced, life-threatening HIV
infection and hospital staff and their families have
benefited.
Mortality
> infant: 78‰
28/02/2010
GDP/capita ($)
> 288
> MdM Spain
Beneficiaries
> direct: hospital personnel and their
families, HIV-positive pregnant women and
their families, patients presenting with
advanced HIV infection
> indirect: educators, nurses
Staff
> local: 10
> expatriates: 2
Co-ordinators
> programme: P.Tattevin
> general co-ordinator: A. Billy
> headquarters: C. Courtin
Funding
> Columbia University
Budget
> 2006: 222,857 euros
> CONTENTS
ZIMBABWE
45
THE IMPACT OF HIV/AIDS
Chipinge
Mortality
> infant: 79‰
Activities
Outlook
In partnership with MdM Canada, MdM Spain and a
local NGO called FACT, MdM France is developing a
comprehensive approach across Chipinge district
combining:
• community information and awareness-raising;
• training community health agents;
• running home-based care services for housebound
HIV-positive patients;
• psycho-social and therapeutic support to orphans
and vulnerable children;
• training health personnel;
• running information and testing centres;
• supporting prevention activities and treatment in
four hospitals and 44 clinics in the district;
• setting up monitoring and evaluation tools.
In 2007, our teams will work on
consolidating our activities and
strengthening access to antiretrovirals
in Chipinge hospital and potentially
another hospital in the district.
Life expectancy
> at birth: 36.6
HDI
> 0.491; rank: 151/177
GDP/capita ($)
> 363
05/2004 (pilot project) – 01/2005 (overall project)
> Project progress
12/2010
> MdM Spain and MdM Canada
Beneficiaries
> direct: 350,000 inhabitants of Chipinge
district
> indirect: 204 community health workers
in Chipinge
Staff
> local: 33
> expatriate: 5
Co-ordinators
> programme: C.Moncorgé
> field: C. Garro
> headquarters: N. Bréchet
Funding
> MdM France, European Union, Hivos
Budget
> 2006: 913,659 euros
> CONTENTS
REDUCING
ANNUAL REPORT 2006
In 2006, a third of Zimbabwe s adults were HIV positive and life expectancy was barely
over 36 years.The health situation in Zimbabwe is one of the most disastrous in Africa.
The controversial policies of the government have driven the country into isolation
and have resulted in an overall reduction in international aid. On top of this, an acute
food crisis and an economy in decline contribute to a considerable rise in infant
mortality, the highest the country has even known.
LATIN
AMERICA
»
»EMERGENCY:
a situation where people’s lives and livelihoods are in immediate danger (natural
disaster, armed conflict etc.). Response: substitution programme.
»CRISIS:
situation where people’s basic needs are not being met in the long-term (civil war,
forgotten conflict, HIV pandemic). Response: technical assistance and
mobilisation of local resources.
»DEVELOPMENT:
> CONTENTS
INTERNATIONAL PROGRAMMES ¨ LATIN AMERICA
ANNUAL REPORT 2006
47
ARGENTINA p.52
BOLIVIA p.53
COLOMBIA p.54
EL SALVADOR p.55
GUATEMALA p.56
MEXICO p.57
HAITI p.58>59
NICARAGUA p.60
PERU p.61
> CONTENTS
PERU
Maria, 14 years old
‘I live with my mother and my
two brothers in a shanty town in
the south of Lima. My father left
when I was six years old. He
was an alcoholic and used to
beat my mother. I came to the
teenage centre in August 2006
with my friends and I quickly
became a group leader.’
Jérôme Denni
MdM
In October, Maria did not
turn up on two Sundays in a
row, supposedly because she
had been in an accident and
had been hit by a mototaxi.
The following Sunday she
came accompanied by her
mother who warned that the
girl had become sad, would
not speak and no longer
wanted to go to school. In
fact, one Monday Maria woke
up in the emergency
department of a health
centre with signs of having
been cut and raped. She had
been taken by two mototaxis
at the school exit.They beat
her until she lost
consciousness, then they
raped her. MdM helped her
mother to press charges and
Maria continues to be
monitored in our centre
where, little by little, she is
starting to smile again.
> CONTENTS
(3) MdM
> CONTENTS
(4) MdM
ANNUAL REPORT 2006
49
> CONTENTS
(5) Wilfried Maisy
(7) Michel Redondo
(6) Michel Redondo
» While in Guatemala (3 and
4) women’s health is harmed
by globalisation, in Haiti it is
violence which puts women
in the position of being
victims: in both cases,
multidisciplinary care – both
medical and legal – is vital.
Migrants in Mexico (6), trying
to emigrate clandestinely to
the United States, are a
population at risk, particularly
in terms of HIV. Respecting
their right to health is still a
priority. In Bolivia (5), a team
has been working since 2002
on prevention of workrelated risks for child
labourers and improving
these children’s access to
healthcare.The sustainability
of this project involves
working in partnership with
teachers, local institutions and
health services. In Colombia,
the women and children of
the indigenous Emberas
community (7), in the midst
of the conflict which plagues
the country, still have difficulty
accessing healthcare.
> CONTENTS
ANNUAL REPORT 2006
51
ARGENTINA
Although the country is heading back to economic prosperity, the government s social
policy initiatives have not managed to tackle the extreme poverty of the population. In
effect, only some Argentines can access the health and welfare system. Others, including
the indigenous communities, do not have access to healthcare because of cultural and
economic barriers. Women and children are included in this extremely vulnerable
category.
IMPROVING
ACCESS TO CARE FOR WOMEN AND CHILDREN
Abra Pampa, Puna Jujena, Jujuy Province
Mortality
> infant: 16 ‰
Life expectancy
> at birth: 74.6
HDI
> 0.863; rank: 36/177
Activities
Outlook
MdM contributes to improving access to
healthcare for the rural population through:
• mother and child healthcare;
• monitoring women to prevent cervical cancer and
sexually transmitted infections;
• health education and health promotion;
• constructing a maternity unit.
MdM Argentina will continue MdMFrance’s work, through managing
social and health activities in
partnership with Warmi.
01/04/2003
> Project progress
31/08/2006
GDP/capita ($)
> 3,988
> MdM Argentina - local projects
Beneficiaries
> direct: women and children
> indirect: general population, health
promoters and healthcare staff (hospital
and health posts)
Staff
> local: 1
> expatriate: 1
Staff
> project:T. Brigaud
> field: H. Solis, R.Timpano
> headquarters: E. Herrera
Funding
> EU, MdM France
Budget
> 2006: 109,980 euros
> CONTENTS
BOLIVIA
53
ENVIRONMENTAL HEALTH
Four communities living along the Pilcomayo river in Chuquisaca
and Potosi provinces
Activities
Outlook
The support provided by MdM is aimed at:
• facilitating exchanges between communities,
local health authorities and researchers;
• promoting provision of healthcare, particularly
in relation to psychological issues;
• strengthening the capacity of the farmers’
organisation CODERIP (Council for the Protection
of the Pilcomayo River).
In 8 months, MdM will: carry out four
feedback sessions on the research findings
in each community; organise a meeting
between researchers, local authorities and
CODERIP; train 10 healthcare staff and 25
community health promoters; organise six
free discussion sessions in each community;
carry out a community assessment in the
river basin and will put a monthly
information system in place.
09/2006
>
PROTECTING
12/2007
Project progress
THE HEALTH OF CHILD WORKERS
Mortality
> infant, project 1: 54‰
Life expectancy
> at birth: 64.4
HDI
> 0.692; rank: 115/177
GDP/capita ($)
> 974
Beneficiaries
> direct, project 1: 10 healthcare staff and
25 community health promoters
> indirect, project 1: 3,000 families
Personnel
Potosi, San Cristobal district
Activities
Outlook
MdM’s activities include:
• promoting health education and access to healthcare
through workshops with children and educators, as well as
providing support materials and raising awareness of traditional
medicine and of the effects of work on children aged
between six and eight years old;
• activities aimed at tackling depression among adolescents
in difficulty;
• creation of a youth club, in partnership with an association
from Lyon, offering recreational activities, alternatives to child
labour;
• training in basic life saving knowledge and treatment of those
who are injured in mining accidents.
The year 2007 will be a crucial year for the
sustainability of the programme and the
handover to local partners. MdM will train
schoolteachers in health education and will
also evaluate whether it is necessary to
extend MdM’s presence throughout 2008
to support the handover.
Co-ordinators
> project 1: S. Lagardère
> project 2: L. Liron, D. Masson
> field, project 1: O. Barras
> field, project 2: I.Tapia
> headquarters, project 1:Y. Le Corgne
> headquarters, project 2: Rhône-Alpes
Bourgogne Regional Delegation (S. Bret)
Funding
> project 1: MdM
> project 2: private partnerships, RhôneAlpes council, MdM
2002
> Project progress
12/2007
Budget
> CONTENTS
PROMOTING
ANNUAL REPORT 2006
Potosi (altitude 4,000m) is a mining town employing large numbers of children.The rise in mineral prices
on the international markets has lead to over-exploitation of these deposits. Huge quantities of water
and numerous pollutants, needed to process the minerals, are discharged directly into the river.This
contamination has resulted in a drop in agricultural production and worries the rural population who
fear for their health. MdM is working on a project with the Institute for Research and Development
which is studying the impact of mining contamination on children.
COLOMBIA
President Urib was re-elected in an election with a high abstention rate. Despite an
aggressive policy towards the armed factions and the demobilisation of paramilitaries,
the FARC has gone back onto the offensive, particularly in the south where massive
fumigations carried out by the government have affected the population and the
economy. In Choco, the indigenous Embera community have been doubly penalised:
as an ethnic minority group and as victims of conflict.
ACCESS
TO HEALTHCARE FOR VULNERABLE CIVILIANS
Mortality
> infant: 18‰
Meta Region
Life expectancy
> at birth: 72.6
Activities
Outlook
MdM’s objective is to ensure access to healthcare for
civilians in the area and to respond to emergency
situations linked to the conflict. Replacement medical
support is provided to health posts which are lacking
doctors because of the situation.
Continue our work with victims of
conflict in a way which improves our
capacity to respond to humanitarian
emergencies. At the request of local
communities, to extend access to
healthcare to include adults who are ill.
01/05/2006
GDP/capita ($)
> 2,176
> projects 1 and 2: MdM Spain
30/06/2008
Beneficiaries
> direct, project 1: women and children
> Project progress
ACCESS
HDI
> 0.790; rank: 70/177
under five
> direct, project 2: embera population and
afro-colombian population
> indirect, project 1: civilian victims of
conflict
TO HEALTHCARE FOR VICTIMS OF CONFLICT
Medio Atrato Region
Activities
Outlook
MdM facilitates access to healthcare for the
communities when they are displaced due to the civil
war. Our mobile medical teams provide healthcare,
particularly to children and women who are
especially vulnerable. These teams also train health
promoters. With a view to improving the image of
traditional medicine, MdM, in partnership with the
jaibanas (traditional healers), has launched a project
harvesting medicinal plants and based on an animist
culture.
To continue our collaboration with
the herbal therapists and the jaibanas.
To continue to ensure access to
healthcare for the adult population.
Staff
Co-ordinators
> projects 1 and 2: C. Raggioli
> field, project 1: K. Morales
> field, project 2:V. Gavidia
> HQ projects 1 and 2: E. Herrera
Funding
> projects 1 and 2: ECHO, MdM
01/07/2006
> Project progress
> CONTENTS
30/06/2008
Budget
> 2006 project 1: 313,890 euros
> 2006 project 2: 459,350 euros
EL SALVADOR
55
A COMMUNITY HEALTH PROGRAMME
Morazan region
Mortality
> infant: 24‰
Life expectancy
> at birth: 71.1
Activities
Outlook
In partnership with the Salvadorian NGO MDS, MdM
continues its health programme working with
vulnerable populations in the remote rural areas of
Morazan region. Activities in Ahuachapan and
Cuscatlan regions have been added to the
programme.
2007 will be the final year of
management and IT training for the
MDS staff. This training will enable
better management and organisation
of the association.
Our programmes involve:
• training all the staff in management;
• developing a communication system for the association;
• renewing IT equipment and software training;
• disinfection, training and prevention in 20 groups of
houses, as part of environmental decontamination
campaigns;
• construction of a well and a septic tank for the staff
accommodation beside El Tablon health centre in
Morazan.
HDI
> 0.729; rank: 101/177
GDP/capita ($)
> 2,340
> MdM Spain
The development of a communication
system for the association will enable
them to improve the profile of MDS
and its activities which, in turn, will
help with fundraising.
Beneficiaries
> direct: 7,000
> indirect: 42,000
Responsables
> project: J.-L. Pesle
> headquarters: Grenoble branch
10/2004
>
Project progress
end 2007
Funding
> MdM
Budget
> 2006: 13,290 dollars
> CONTENTS
DEVELOPING
ANNUAL REPORT 2006
El Salvador is the smallest and most densely populated Central American country.
Around a third of the population has left for the United States and the country is
badly affected by poverty, underemployment and crime. Although one of the
government s priorities is to tackle these social problems, the situation remains very
critical.
GUATEMALA
Maquilas are export-producing factories which are linked to foreign investment.These
sub-contracting factories appeared throughout central America in the 1990s.They are
exempt from some taxes and legal obligations and they create jobs. However, abuse,
poor treatment and irregularities are common. The victims are mainly women from
the indigenous communities, with little education and from extremely disadvantaged
circumstances.
HEALTH
OF WOMEN WORKING IN FACTORIES
Chimaltenango and Sacatepequez regions
Mortality
> infant: 33‰
Life expectancy
> at birth: 67.6
Activities
Outlook
In 2006, MdM set up easy-access medical and welfare
consultations, enabling the recording and analysis of
working conditions of these women. The first
awareness-raising workshops on the Right to Health
were organised with CEADEL, one of our local
partners. MdM resumed its involvement in the
organisation for preventing conflict in the maquilas in
order to develop advocacy work on workers’ rights.
In 2007, MdM plans to disseminate
widely the findings of the analysis
based on the medical and welfare
consultations, to organise several
awareness-raising workshops for
women working in the factories and
to identify and train leaders within this
group. Finally, if the project is
extended until 2009, a regional
meeting on the rights of women
working in maquilas will take place
then, involving the Latin American
Social Medicine Association (ALAMES), the
central American network of women
working in maquilas, our Guatemalan
partners and the relevant ministries.
06/2010
09/2006
> Project progress
HDI
> 0.673; rank: 118/177
GDP/capita ($)
> 2,233
> MdM Spain
Beneficiaries
> direct: 4,800 factory workers, including
25 leaders
> indirect: 100,000 to 150,000 workers in
the export industries
Staff
> local: 2
> expatriate: 1
Co-ordinators
> project: P. Giraux
> field: G. Sekhniachvili
> headquarters:Y. Le Corgne
Funding
> MdM
Budget
> 2006: 29,360 euros
> CONTENTS
MEXICO
57
RIGHT TO HEALTH OF INDIGENOUS POPULATIONS
Chiapas
Mortality
> infant: 23‰
Life expectancy
> at birth: 75.3
Activities
Outlook
MdM France has been working in Mexico since 1998.
The current programme aims to improve the
health of the indigenous populations. With the
support of the communities, MdM is training health
promoters and is setting up four micro-clinics to
enable access to healthcare for these populations.
More than 500 promoters look after their communities’
health and work with the three reference microclinics.
The implementation of a health
system managed by the indigenous
community will enable them to
become more autonomous. Real
negotiations between the government
and the Zapatista movement would
enable more lasting solutions for
managing their health to be found.
HDI
> 0.821; rank: 53/177
Beneficiaries
> direct, project 1:Tzotzil,Tzetzal,Tojolabal
01/07/2006
>
MIGRANT
31/12/2010
Project progress
Tijuana and Mexicali
Activities
Outlook
MdM aims to improve access to healthcare and
respecting the right to health of migrants in Tijuana
and Mexicali.The programme’s objectives are:
• to facilitate the provision of healthcare for migrant
populations;
• to prevent the transmission of HIV/AIDS and
other sexually transmitted infections;
• to promote and encourage the respect of the right
to health for the migrant populations on the
northern border.
The project will continue along the
same lines in 2007.
03/2008
> CONTENTS
> MdM Spain, MdM Switzerland
and Chol communities
> direct, project 2: migrants expelled from
the US to Mexico, migrants trying to cross
the border into the US
Co-ordinators
> project 1:T. Brigaud, F. Stea
> project 2: F. Giraux, M-D Aguillon
> field, project 1: C. Escobar
> field, project 2: B. Ponçon
> HQ, projects 1 and 2: E. Herrera
Funding
> projects 1 and 2: French Ministry of
> Project progress
Staff
RIGHTS AND ACCESS TO HEALTHCARE
04/2006
GDP/capita ($)
> 6,518
Foreign Affairs, MdM
Budget
> 2006 project 1: 233,550 euros
> 2006 project 2: 165,600 euros
PROMOTING THE
ANNUAL REPORT 2006
Mexico s economic growth in the last ten years has not reduced the inequalities or
social exclusion which drive a large number of Mexicans to choose clandestine
emigration to the United States.They are forced to cross the border in unsure or highrisk situations, particularly at Tijuana and Mexicali. With this background, the
marginalisation of indigenous populations in southern Mexico also remains a problem.
HAITI
The poorest country in the northern hemisphere, Haiti is emerging from a long political
crisis and trying to reconstruct a state of law, which would respect the fundamental
rights of its citizens.
MdM is working in disadvantaged rural areas, characterised by a weak government
presence and a subsistence economy that is vulnerable to changing weather conditions.
MdM is also working in poor areas of Port-au-Prince which are blighted by crime and
violence.
CARING
FOR VICTIMS OF VIOLENCE
Mortality
> infant: 74‰
Disadvantaged districts in Port-au-Prince
Life expectancy
> at birth: 52
Activities
Outlook
MdM organised awareness-raising sessions on
violence in five health facilities, began a training
programme for healthcare staff and has defined an
outline methodology for psychological care. In
addition, in collaboration with its partner URAMEL,
MdM has rejoined the institutional consultation
forums on the rights of victims. At the same time,
MdM has lobbied for the use of a single registration
form for cases of violence and for free medical
certificates for victims of violence.
MdM will train leaders and community
health agents, will manage mass media
awareness-raising activities on violence,
will refurbish five health facilities, will
develop a psychotherapy programme
and will increase its involvement in multidisciplinary networks and in advocacy
activities.
HDI
> 0.482; rank: 154/177
GDP/capita ($)
> 420
> MdM Canada, MdM Switzerland
Beneficiaries
> direct: 800 professionals: 20 community
01/07/2006
> Project progress
30/06/2009
groups (800 people including 60 leaders)
> indirect: 500,000 victims of violence
(domestic, societal, state)
Staff
> local: 8
> expatriate: 2
Co-ordinators
> programme: A. Urtubia, J. Boggino
> field: C. Martin
Funding
> French Ministry of Foreign Affairs, MdM
Budget
> 2006: 243,233 euros
> CONTENTS
59
Grande Anse
Activities
Outlook
Primary healthcare:
• trials of a cost-recovery system in two health
facilities, with exemptions for pregnant women and
under fives;
• a study of the social, economic and health situation
of the population of Roseaux;
• supporting the Communal Health Unit 2 (UCS2)
with supervision of 15 decentralised health facilities;
• improving the equipment and the electrical system
at Jeremie reference hospital.
MdM will demonstrate the relevance of the
programme to the Haitian institutions as a way
of extending it to all the facilities of UCS2.We will
lobby the institutions concerned with access to
primary care in Haiti. Periodic support will be
provided to the hospital to improve the referral
and cross-referral systems. In relation to the
latrines, after three years, the vast majority of
them will be in use and maintained.MdM would
respond to requests from neighbouring
communities if ad hoc funding were found.
Latrines:
• reducing mortality and morbidity linked to faecal
contamination in Roseaux, by increasing access to
latrines from 0 to 28% in 18 months;
• raising community awareness on latrine construction, use
and maintenance;
• carrying out home follow-up visits.
Primary healthcare
01/07/2006
>
31/06/2008
Project progress
01/07/2004
Beneficiaries
> direct: 3,400 residents: UCS n°2
healthcare staff (primary care) + 8,400
(beneficiaries of the latrines)
> indirect: 179,000 (total population of the
UCS 2)
Staff
> local: 26
> expatriate: 1
Co-ordinators
> programme: S. Lasserre
> field: B. Deveaux / J. Pfaffmann / O. Naval
Funding
> UNDP, Ministry of Foreign Affairs,
MdM, EU
Latrines
> MdM Canada, MdM Switzerland
31/01/2006
Budget
> 2006: 240,027 euros
> Project progress
TRAINING
HOSPITAL STAFF
Pilate
Activities
Outlook
Programme supporting Pilate hospital which has been
run by Canadian nuns for several decades.
MdM’s action combines:
• a surgical project: sending a full team for two weeks
to carry out a hundred operations on patients selected
by the nuns throughout the year;
• a mother and child project: using ‘health agents’ to
screen and treat chronic malnutrition and training health
agents, matrons and mothers;
• a psychiatric project: training Pilate healthcare staff
in treatment of psychiatric illness and training Haitian
medical personnel, with the head of the psychiatry
department at Port-au-Prince University Hospital.
In 2007, MdM will continue these
activities. In order to adapt the
mother and child health programme,
there will be an emphasis on
treatment for acute malnutrition,
training the nuns and other staff in
nutrition protocols developed by
Action Against Hunger.
1980
>
Project progress
> CONTENTS
Beneficiaries
> direct: 60,000
Personnel
> local: 31 health agents
> expatriate: 7
Co-ordinators
> project: C. Castaing
> headquarters: Aquitaine Regional
Delegation
Funding
> MdM, Amis de Sœur Madeleine
Association, private donations
Ongoing
ANNUAL REPORT 2006
ACCESS TO PRIMARY HEALTH CARE AND HYGIENE
Budget
> 2006: 1,274 euros
PROMOTING
NICARAGUA
Politically and economically unstable, Nicaragua is a country where tensions were
exacerbated in the run up to the elections in November 2006. Poverty affects 2.3
million people. Societal violence, alcohol and drug use are major concerns. In 2001, the
government designated the struggle against violence, including domestic and sexual
violence, as a public health priority. However, these issues continue to affect a large
number of women and children.
CARING
FOR VICTIMS OF VIOLENCE
Autonomous North-Atlantic Region (RAAN), Puerto Cabezas town
Mortality
> infant: 31‰
Life expectancy
> at birth: 70
Activities
Outlook
HDI
> 0.698; rank: 112/177
MdM’s activities include:
• improving prevention and multidisciplinary care
(health, legal and social) for victims of domestic and
sexual violence;
• integration into the network of the national plan
for prevention of domestic and sexual violence
(2001-2006);
• refurbishment, provision of equipment, and
management of a drop-in centre, in close
collaboration with local partners;
• consultations and screening for STIs, cervical and
other cancers;
• gynaecological and psychological treatment;
• legal and administrative support;
• raising awareness of all those who are potentially
involved, including the male population.
To develop the programme over a
four year period.
GDP/capita ($)
> 847
Beneficiaries
> direct: around 4,000 female victims of
01/07/2006
> Project progress
30/06/2010
domestic or sexual violence. Children under
15 who are victims of domestic or sexual
violence: 20,000 children considered to be
at risk. 3,650 men aged between 15 and 54
years.
> indirect: 80% of the healthcare staff of PC
town (160 people), 45 ‘relay women’ in Bilwi
district, 16 members of local NGOs and
partner organisations. General population in
PC (60,500 inhabitants)
Staff
> local: 1
> expatriate: 1
Co-ordinators
> project: B.Tilmont and M-L. Deneffe
> field: L. Muller
> headquarters: E. Herrera
Funding
> French Ministry of Foreign Affairs,
Andalusian autonomous community
Budget
> 2006: 68,400 euros
> CONTENTS
PERU
61
SEXUAL AND REPRODUCTIVE HEALTH OF
Mortality
> infant: 24‰
ADOLESCENTS
Life expectancy
> at birth: 70.2
Three disadvantaged districts on the outskirts of Lima
HDI
> 0.767; rank: 82/177
Activities
Outlook
The project aims to improve access to prevention
and treatment in relation to reproductive and sexual
health for 10 to 19 year olds. It is being developed
around nine Teenage Centres and in schools and
colleges. In 2006, the premises of the Teenage Centres
– places where young people can come and receive
guidance – were identified and refurbished. Local
psychologists have begun individual consultations and
awareness-raising seminars. General communication
campaigns have been carried out in the three districts
and collaboration with the three councils has been
established in order to create a working network
around these Teenage Centres.
In 2007, the community awarenessraising will be reinforced by trained
adolescent promoters. Care for
adolescent girls must be improved by
stronger links between the Teenage
Centres and local health centres.
Training of healthcare staff is planned,
as well as a campaign to have sexual
and reproductive health recognised as
a public health priority.
10/2005
09/2008
> Project progress
GDP/capita ($)
> 2,490
> MdM Spain
Beneficiaries
> direct: 47,000 vulnerable adolescents
> indirect: 210,000 adolescents in the 3
programme districts
Staff
> local: 13
> expatriate: 1 administrator
Co-ordinators
> project: M. Boscaméric, C. Batard
> field: Z. Gambirazio
Funding
> Annenberg Foundation (USA), French
Ministry for Foreign Affairs, Air France
Foundation, MdM
Budget
> 2006: 237,680 euros
> CONTENTS
PROMOTING
ANNUAL REPORT 2006
Each year, there are high rates of unwanted teenage pregnancies and illegal abortions
in Peru. Pregnant teenagers are heavily stigmatised. Maternal mortality is high in this age
group and the transmission of HIV/AIDS and sexually transmitted infections is
increasing. However, sexual and reproductive health policy in this country is not very
specific and lacks coherence. The government s response to the real needs of
adolescents remains ineffective.
ASIA »
Rép. dém.
du Congo
3 1
» EMERGENCY:
a situation
Angola
4
where people’s lives and livelihoods are in immediate danger (natural
» CRISIS:
forgotten conflict, HIV pandemic). Response: technical assistance and mobilisation
of local resources.
» DEVELOPMENT:
> CONTENTS
INTERNATIONAL PROGRAMMES ¨ ASIA
ANNUAL REPORT 2006
63
AFGHANISTAN p.68>69
BURMA p.70
CAMBODIA p.71
CHINA p.72
MONGOLIA p.73
INDONESIA p.74>76
NEPAL p.77
PAKISTAN p.78
SRI LANKA p.79
UZBEKISTAN p.80
VIETNAM p.81
> CONTENTS
Afghanistan
Harm reduction programme
Said Aziz, 38, has been going to the centre
for two months.
‘Twenty years ago I went to live in Iran. I was a tailor
and my boss gave me drugs so that I could work day
and night.That’s where I became dependent on drugs.
After the fall of the Taliban regime, I returned to Kabul.
On the way back, however, thieves took everything from
me. Here, I have no work and I am unhappy. On the
radio, they said that the situation was getting better but
if I had known that life in Afghanistan was like this, I
would not have come back.When I lived in Iran, I was
drug-dependent but my family did not reject me because I had a job and I could provide for their needs.
Since I’ve been living here, I have no fixed job and, because of my drug dependence, I had to leave my family. I
have now been living on the streets with other users
for one year and two months. I do not want to go back
and live with my sister, my wife and four children because I’m ashamed. I just heard from a friend that my
family will be evicted because they haven’t been able to
pay the rent for seven months. I don’t know what to do.
Some days, I work unloading sacks of cement and bricks
from lorries. I earn around 150 afghanis per day (2.37
euros) and I work four days a week.With this money, or
some that I borrow from friends, I spend 100 afghanis
on drugs each day.That does not leave much, so I only
eat on 20 days each month, usually bread and tea. Sometimes, I feel so weak that I can’t work. On the top of
this, in the streets we are hassled and extorted by the
police.They protect drug dealers even in the places
where we go to buy drugs.’
> CONTENTS
> CONTENTS
Jacky Naegelen/Reuters
ANNUAL REPORT 2006
65
(2) Isabelle Eshraghi
> CONTENTS
(3) Franck Ferreira
(1) Stéphane Lehr
(6) MdM
(7) David Delaporte
» Women and ethnic minorities are often the first victims of obstacles to healthcare: in Afghanistan (1) Pakistan (2) and among the Punan
people of Indonesia (6), our teams try to remedy this situation. Elsewhere, the most disadvantaged, least educated and most excluded groups
feel the full force of epidemics. In Cambodia (4), more than 2,000 people affected by HIV are regularly monitored and more than 500 of them
now have access to anti-retrovirals. In Vietnam (5) and Nepal (3), the struggle against AIDS is focused on drug users and prostitutes, while in
Mongolia (7) the focus is on stopping the spread of tuberculosis in shanty towns.
> CONTENTS
(4) Lahcène Abib
(5) Lahcène Abib
ANNUAL REPORT 2006
67
AFGHANISTAN
Despite the democratisation process which is underway and the attempts to normalise
and secure the situation, institutional and socio-economic reconstruction remain a
challenge for the Afghan authorities. The return of millions of refugees from Iran and
Pakistan, mostly to Kabul, accentuates this new impoverishment process. In addition, the
government is not yet in a position to be able to protect public health and access to
healthcare for the population, particularly women and children, remains poor.
MOTHER
AND CHILD HEALTH
Mortality
> infant: 165‰
> under five mortality: 257‰
> maternal mortality: 1,900/100,000
Kabul
Activities
Outlook
MdM supports two mother and child health
centres in Kabul.The programme involves four areas
of work:
• access to healthcare for women (paediatric,
gynaecological and obstetric consultations,
immunisation, basic health and hygiene education);
• training of local healthcare staff;
• refurbishment of healthcare facilities and provision
of drugs and equipment;
• development of a stable partnership with local
health authorities.
Ensure handover of the two mother
and child health centres to a local
NGO which will maintain the level
and quality of services. Focus again on
the issues of mental health and harm
reduction, so far left out of the health
system under reconstruction.
The training component of the programme has
become particularly important since the departure of
the Taliban, with the training of female doctors, nurses
and midwives.
>
2007
Project progress
HDI
> Not known
GDP/capita ($)
> 430
Sources: Human Development Report 2006, UNDP,
WHO 2004
Beneficiaries
> direct: 36,000
> indirect: 92,000
1995
Life expectancy
> at birth: 46
Staff
> local: 18
> expatriate: 1
> mother and child health: 30
Co-ordinators
> project: G. Caussé – M-L.Tournieroux
> field: M. Otambekova
Funding
> MdM, Florindon Foundation,
State of Guernsey
Budget
> 2006: 197,425 euros
> CONTENTS
69
MOTHER
AND CHILD HEALTH
Outlook
In three clinics in Herat, MdM is involved in four areas
of work:
• working directly with the population (paediatric,
gynaecological, obstetric, nutritional and general
medical consultations; vaccination campaigns; medical
follow-up; basic health and hygiene education);
• training local healthcare staff;
• refurbishing health facilities and supplying medicines
and equipment;
• establishing a partnership with local health
authorities.
MdM continued to support the handover
of its activities to the NGO Coordination
of Humanitarian Assistance through
technical and financial support for the
first four months of 2006. Since May
2006, we have seen the activities continue
and the quality has been maintained.
1992
05/2006
Beneficiaries
> direct: 415,000
Staff
> local: 30
> MCH staff: 52
> expatriate: 1
Co-ordinators
> programme: G. Caussé – ML.Tournieroux
> field: Dr M. Otambekova
Funding
> MdM, SDC
> Project progress
Budget
> 2006: 188,970 euros
HARM
REDUCTION WITH DRUG USERS
Kabul
Activities
The harm reduction pilot programme ran from 1
April until 31 December 2006 and enabled:
• building up and training a local team;
• development and feasibility testing of procedures for
working on the streets and at the drop-in centre;
• definition of the harm reduction programme longterm objectives;
• consolidation of the budget and financial framework
of the programme;
• registration of MdM as a local actor in the field of drug
dependency.
Outlook
Consolidate the implementation of
the harm reduction programme in
Kabul by strengthening the capacity of
the target groups to reduce the risks
associated with their drug use.
Encourage the development of specific
governmental responses to treating
problems linked to drug use.
2006
>
2006
Project progress
A three-year harm reduction programme (2007-2009)
will follow on from the pilot programme, subject to
funding.
> CONTENTS
Beneficiaries
> direct: 14,000 injecting drug users
(minimum)
> indirect: 50,000 heroin users and their
families
Staff
> local: 8
> expatriate: 1
Co-ordinators
> programme: G. Caussé – O. Maguet
> field: G. Rafatian
Funding
> MdM
Budget
> 2006: 56,327 euros
Sources: Human Development Report 2006,WHO 2004
Activities
ANNUAL REPORT 2006
Herat
BURMA
The political situation in Burma is at an impasse and the economy has difficulty taking
off. Because of the lack of progress in the democratic process, diplomatic and trade
relations with western countries have continued to deteriorate. At the same time, crossborder exports of Burmese raw materials to China, India and Thailand have been
steadily increasing since 2004. In relation to health, HIV continues to ravage this country
where intravenous drug use and prostitution are the main modes of transmission.
PREVENTION
AND TREATMENT OF
STIS
AND
Mortality
> infant: 76‰
HIV
Life expectancy
> at birth: 60.1
Myitkyina (Kachin) and Yangon
HDI
> 0.581; rank: 130/177
Activities
Outlook
MdM is focusing on prevention and access to
treatment for STIs and HIV/AIDS among people
working in prostitution and drug users. The work
with prostitutes includes: prevention sessions on
HIV/AIDS, free treatment for STIs and opportunistic
infections, recreational workshops in our day centres,
and condom distribution. By the end of December,
102 prostitutes were receiving anti-retroviral therapy.
In Yangon, MdM will continue with
comprehensive
care
for
the
beneficiaries. Despite facing increasing
operational constraints, all our efforts
in Kachin will focus on methadone
substitution coupled with ARV
administration (objective: 100 users
on the substitution programme).
The main activities with drug users are: promotion of
harm reduction techniques in injecting places,
distribution of needles and syringes, educational
sessions and recreational workshops in our day
centres.
01/01/02
31/12/2010
> Project progress
GDP/capita ($)
> 498
Beneficiaries
> direct: 9,000
> indirect: 50,000
Staff
> local: 130
> expatriate: 6
Co-ordinators
> project: F. Sivignon
> field: A. Pinon
> headquarters:V. Pardessus
Funding
> NOVIB, UNODC/EU, PSI/USAID, Global
Anti-retroviral therapy for eligible patients has not
yet started. The key event has been the introduction
of methadone substitution for seven drug users.
Fund, MdM
Budget
> 2006: 1,012,540 euros
> CONTENTS
CAMBODIA
71
AS A PRIORITY
Mortality
> infant: 97‰
Phnom Penh
Life expectancy
> at birth: 56.5
Activities
Outlook
MdM’s project focuses on medical and psychosocial care for destitute people living with
HIV/AIDS.The programme includes:
• specialist treatment for patients infected with HIV;
• training doctors;
• information sessions for patients about the virus
and the treatment;
• hospital treatment on opportunistic infections;
• development of a continuum of care, a network of
help and support for people living with HIV/AIDS;
• support for Cambodian NGOs involving people
living with HIV/AIDS.
It will be most important to
participate in building up SEAD and
training its members to ensure that
the NGO will be operational and able
to continue the activities after
handover.
In 2006, the key event was the creation of a local
NGO called SEAD (Sharing Experience for Adapted
Development) by MdM staff.This NGO will gradually
take over the whole programme between 2008 and
2009.
By December 2007, 2,000 patients will
be regularly monitored in the
consultation centre.
HDI
> 0.583; rank: 129/177
GDP/capita ($)
> 354
Beneficiaries
> direct: 3,000
> indirect: 400,000
Staff
> local: 59
> expatriate: 4
01/04/1999
> Project progress
30/09/2009
Co-ordinators
> project: E. Peterman
> field: P-R. Martin
> country coordinator:V. Pardessus
Funding
> Global Fund, Elton John Aids Foundation,
MdM
Budget
> 2006: 553,110 euros
> CONTENTS
HIV
ANNUAL REPORT 2006
Despite Norodom Sihamoni s recent succession to the throne after the abdication of
his father Norodom Sihanouk, who had been monarch since 1941, the Phnom Penh
regime continues to be characterised by authoritarianism and corruption. The
influence of religion and the widespread system of prebends, particularly in relation to
natural resources, puts the economic future of the kingdom at risk. More than a third
of the population lives below the poverty line and AIDS is endemic, with a prevalence
rate of two percent.The government has recognised this as a public health priority.
CHINA
China s economic performance cannot mask the social inequalities within the country. Natural
disasters and the damage caused by industry weaken those who have been overlooked by
economic growth, particularly in the western provinces and in the countryside. Discrimination
against people living with HIV/AIDS (almost one million people according to UNICEF) and
the lack of awareness about the epidemic hinder the effectiveness of humanitarian
organisations work.
HARM
REDUCTION PROGRAMME AMONGST DRUG USERS
Chengdu (Sichuan)
Mortality
> infant: 23‰
Activities
Outlook
The current project plans gradual opening of needle
exchange drop-in centres in three districts of Chengdu.
Users receive a warm welcome from the team,which has
been strengthened by the involvement of volunteers, and
are provided with training in harm reduction practices.At
the same time, awareness-raising, prevention and
advocacy activities are carried out amongst the medical,
political and administrative authorities.
The challenges for 2007:
• opening two further drop-in centres in
Chengdu;
• working on the streets and identifying peer
educators;
• training medical staff, volunteers and
disseminating information to the Public Security
forces of the districts concerned to ensure the
work can continue.
01/07/2005
31/12/2008
> Project progress
REINFORCING
PREVENTION, IDENTIFYING AND TREATING
PEOPLE LIVING WITH
HIV
Shanxi (Changzhi)
Activities
Prevention and information activities and encouraging
testing in mines, places where prostitution takes
place, villages where blood is sold and amongst
private clinics which are illegally treating sexually
transmitted infections.
Outlook
In 2007, the following activities are planned:
• introduction of a mobile monitoring system for
Changzi county patients;
• setting up a telephone helpline on AIDS and a
volunteer association;
• adoption of a regional policy.
Strengthening the three screening centres of Changzhi
council: training and introduction of rapid tests.
Training of Changzhi health professionals.
> CONTENTS
09/2006
> Project progress
09/2007
Life expectancy
> at birth: 71.5
HDI
> 0.768; rank: 81/177
GDP/capita ($)
> 1,740
Sources: Human Development Report 2006, UNDP;World
Bank Report, 2005
Beneficiaries
Staff
Co-ordinators
> project 1: B. Luminet- R. Baglioni
> project 2: B. Silbermann
> field, project 1: N. Rennes – H. Peters
> field, project 2: N. Rennes
> HQ, projet 1: M. Ethvignot, E. Martinon
> HQ, projet 2 : M. Ethvignot
Funding
> project 1: MdM
> project 2: MdM
Budget
> 2006 project 1: 130,800 euros
MONGOLIA
73
ALCOHOLISM AND TREATING TUBERCULOSIS
Mortality
> infant: 41‰
Ulan Bator
Life expectancy
> at birth: 64
Activities
Outlook
To manage its activities in Mongolia effectively, MdM
focuses on two areas of work:
• implementing a mobile health and welfare team to
screen for alcoholism and tuberculosis and to analyse
the social situation in Uliastai district;
• referring the population to existing services and
building capacity of these services’ across Ulan Bator.
The priority for 2007 is to define an
effective strategy for working with the
population:
• provision of screening and treatment
for those affected by alcohol or TB in
Uliastai;
• training in alcoholism treatment at
the national level (around 40 doctors);
• restructuring the addiction medicine
sector at the national level.
Training on running prevention sessions, based on an
exchange of practices between MdM and an
employee from a local organisation.
> Project progress
GDP/capita ($)
> 690
Source: Human Development Report 2006, UNDP;World Bank
Report, 2005
Beneficiaries
> direct: 55,000
> indirect: 325,000
Staff
> local: 3
> expatriate: 2
10/2005
HDI
> 0.691; rank: 116/177
12/2007
Co-ordinators
>project: G. Lacaze and B. Juan
>field: O. Delclos (non-medical) & C. Durot
(medical)
> headquarters: M.Ethvignot
Funding
> MdM
Budget
> 2006: 76,420 euros
> CONTENTS
TACKLING
ANNUAL REPORT 2006
After seven decades of a single party regime, the process of democratisation is
ongoing in Mongolia although one third of the population still lives below the poverty
line. The country has been characterised by a heavy rural exodus and by the settling
of nomadic populations. Alcoholism is one of the biggest public health problems in
urban areas. Over half (51%) of the Mongolian population could be affected and
mortality linked to alcohol has reached 27.5%. Sixty percent of domestic violence
incidents take place under the influence of alcohol.
INDONESIA
With more than 15 million households living below the poverty line, the socioeconomic situation in Indonesia remains fragile. Access to healthcare for those living in
shanty towns or the isolated populations of many islands in the archipelago, continues
to be difficult. Given the growth in the AIDS epidemic and the appearance of new
epidemics as a result of the massive displacement of populations fleeing threatened
areas, the presence of humanitarian organisations is needed now more than ever.
PRIMARY
HEALTHCARE AND PREVENTING INFECTIOUS DISEASE
Mulia and Sinak, Puncak Jaya district, West Papua
Life expectancy
> at birth: 67.2
Activities
Outlook
The first phase of MdM’s project, aimed at reducing
the prevalence of STIs and the incidence of HIV/AIDS
in Puncak Jaya district, took place between August
2004 and February 2006. This year has seen the
reorientation of the programme towards primary
healthcare and prevention of infectious diseases. We
have also extended our activities to the neighbouring
sub-district of Sinak and introduced training
programmes for community health workers.
To develop the activities in Mulia subdistrict and work in Sinak sub-district
with our local partner PRIMARI. In
liaison with the local health
authorities and community leaders,
the main activities will focus on
training medical staff in primary
healthcare and prevention.
01/08/2004
> Project progress
Mortality
> infant: 28‰
31/12/2009
HDI
> 0.711; rank: 108/177
GDP/capita ($)
> 1,184
Beneficiaries
> direct: 20,000
> indirect: 40,000
Staff
> local: 6
> expatriate: 2
Co-ordinators
>project: P. Gaillard Olokose
>field: A. Le Garnec/A. Ronsse/
F. Fombeur
>headquarters:V. Pardessus
Funding
> CORDAID, MdM
Budget
> 2006: 208,180 euros
> CONTENTS
75
CARING
FOR PEOPLE LIVING IN URBAN SHANTY TOWNS
Outlook
MdM’s work helps the marginalised urban population
of Jakarta.There are four areas to this work:
• weekly medical consultations in four MdM clinics in
shanty towns;
• supporting the welfare activities of AULIA (local
NGO partner);
• setting up a referral system adaptated to this
population’s needs;
• helping our local NGO partner with logistics,
fundraising and management.
In 2007, MdM will expand its activities to
six clinics and will focus on access to
primary healthcare, particularly for
women and children under five, in the
shanty towns in north Jakarta. The
objective is to strengthen the capacity of
AULIA, our partner NGO, so that these
health activities can be incorporated into
its programmes.
05/2005
31/12/2008
> Project progress
CARING
FOR THE
PUNAN
OF
Beneficiaries
> direct: 8,230 medical consultation
service users
> indirect: 30,000 inhabitants estimated to
be within the project area
Staff
> local: 12
> expatriate: 2
Co-ordinators
> project: A.Bourdé
> field:V. Cauche/O.Valverde
> headquarters:V.Pardessus
Funding
> MdM
Budget
> 2006: 146,900 euros
TUBU FOREST
Kalimantan
Activities
Outlook
The Punan, an indigenous Indonesian people, are
linked to Malinau district, whose main town has been
experiencing major economic development with
negative consequences for the environment, society
and health. Because they live so far from health
services, the Punan people do not receive any
primary healthcare. Malaria, respiratory infections and
high infant mortality are the main health problems
identified.
In addition to medical consultations
and community health worker
training, 2007 will see a child
immunisation campaign and the
distribution of insecticide impregnated
mosquito nets. We will continue to
support
the
recognition
and
protection of the Punan’s rights
through the Adat Punan Foundation.
MdM runs several activities:
• mobile clinics lasting a month (three times a year) in
four sites along the Tubu river;
• training Punan community health workers for one
week before each clinic, with practice in the field
during the clinic;
• supporting the local organisation Adat Punan which
represents the interests of the Punan of Kalimantan.
Beneficiaries
> direct: 850 inhabitants of Tubu valley
> indirect: 9,000 Punan in East Kalimantan
Staff
> local: 12
> expatriate: 2 (based in Jakarta) + 2
doctors (periodic missions)
Co-ordinators
> project: R.Garrigue
> field: M.-L. Bry / B. Pedrique
> headquarters:V. Pardessus
Funding
> MdM, Isle of Man Overseas Aid
Committee
05/2005
> Project progress
> CONTENTS
31/12/2008
Budget
> 2006: 36,260 euros
Activities
ANNUAL REPORT 2006
Jakarta
HELPING
TSUNAMI VICTIMS
Aceh Besar and Aceh Jaya districts (Aceh Province/Sumatra)
Activities
Outlook
After a three-month emergency programme, the
programme developed around four areas of work:
• getting the public healthcare system
working again in Aceh Besar and Aceh Jaya
districts;
• reconstruction of health facilities: one district
hospital, two clinics, health centres;
• helping to get the internal medicine
department in Abidin Hospital, Banda Aceh
running again;
• providing care for psychological and
psychiatric problems as well as dealing with the
emergency in Sumatra.
The ‘Caring for Tsunami Victims’ programme
finished in September 2006.
> MdM Spain, MdM Canada, MdM Greece
Beneficiaries
> direct: 30,000
> indirect: n/a
Staff
> local: 20
> expatriate: 24
28/12/2004
30/09/2006
> Project progress
Co-ordinators
> project: P. Foldès
> field:V. Cauche
> headquarters: emergency desk
Funding
> MdM
Budget
> 2006: 770,000 euros
EMERGENCY
AID TO EARTHQUAKE VICTIMS
Yogyakarta (Java) / Pundong, Imogiri, Dlingo, Purwosari and
Panggang sub-districts
Activities
Outlook
The programme following the earthquake in
Yogyakarta ran in two phases.
Since the public health services were
reactivated relatively quickly, our
programme was completed on 26
August 2006. In order to be able to
respond quickly to natural disasters in
Indonesia, our emergency medical
stores have been restocked in Jakarta.
An initial three-week phase:
• intervention by MdM surgical teams providing
human resources support and equipment to
Indonesian teams;
• intervention by mobile teams to enable access to
primary healthcare for victims in rural areas.
A second six-week phase:
• supporting the local health authorities to ensure
that access to primary healthcare was quickly
restored to the area.
22/05/2006
> Project progress
28/08/2006
> MdM Cyprus, MdM Greece, MdM Spain
Beneficiaries
> direct: 10,000
> indirect: n/a
Staff
> local: 20
> expatriate: 8
Co-ordinators
> project: G. Pascal
> field:V. Cauche
> headquarters: emergency desk
Funding
> ECHO, MdM
Budget
> 2006: 303,310 euros
> CONTENTS
NEPAL
77
TUBERCULOSIS AND
HIV
Mortality
> infant: 59‰
Western regions
Life expectancy
> at birth: 62
Activities
Outlook
The programme aims to prevent and control the
spread of tuberculosis and AIDS in four districts
in western Nepal through:
• awareness-raising and information sessions
developed using health educators in villages, health
centres and screening centres, prisons and hotels;
• a primary healthcare programme in prisons in
Pokhara, which finished at the end of summer 2006.
MdM is preparing a funding proposal
for a mother and child health
programme and a micro-credit
mentoring programme in the same
region from 2007.
01/01/2002
> Project progress
IDH
> 0.527; rank: 138/177
GDP/capita ($)
> 270
> MdM USA; MdM Switzerland
28/02/2006
Beneficiaries
> direct: 1,150 and 50% of the prostitutes
in Syangia district
> indirect: 1,200,000 (population of 4
districts)
Staff
> local: 25
> expatriate: 3
Co-ordinators
> project: P. Baguet and O. Lermet
> field: M. Piasecki
> headquarters: E. Martinon
Funding
> EU, ICCO, MdM
Budget
> 2006: 204,980 euros
> CONTENTS
FIGHTING
ANNUAL REPORT 2006
On 21 April 2006, after many months of rioting, the Nepali King Gyanendra
announced that he was returning power to the people . The Maoist rebels agreed to
enter a new parliament in Kathmandu and on 21 November 2006, they signed a peace
agreement with seven coalition parties bringing the civil war to an end and limiting the
powers of the monarch. Although 2006 has been a historic year which brought hope
to Nepal, the country suffers from a harsh shortage of aid in relation to health. In
particular, help is needed to tackle the AIDS and tuberculosis epidemics which are
rapidly spreading throughout the country.
PAKISTAN
Although the human and structural damage caused by the earthquake on 8 October 2005 meant
that the continued presence of international organisations on the ground was essential, the
diplomatic and regional position of Pakistan made the internal political situation very delicate.The
government has made major commitments to improve public services. However, women
continue to be deprived of access to their basic human rights and domestic violence remains a
daily reality for many women.
HELPING
FEMALE VICTIMS OF DOMESTIC VIOLENCE
Lahore, Faisalabad and Gujranwala
Mortality
> infant, project 1: 80 ‰
Activities
Outlook
In 2004, MdM began a nine-month pilot project with
the objective of providing medical, psychological
and legal support to women who are victims
of domestic violence and who have taken refuge in
the Dar-ul-Aman in Sarghoda. This activity was then
expanded to three new refuges: Lahore, Faisalabad
and Gujranwala. The feasibility of this programme
depends on the mobilisation of civil society and on
the governmental authorities, as well as on the
training of Dar-ul-Aman staff.
In 2007, MdM will continue its
activities in three directions:
• access to healthcare,rights and education;
• informing and mobilising civil society;
• mobilising, informing and training staff..
Life expectancy
> at birth: 63
HDI
> 0.539; rank: 134/177
GDP/capita ($)
> project 1: 632
2004/2005*
2008
> project 2: MdM Greece, MdM Cyprus,
MdM Spain
> Project progress
* 2004 (Sargodha pilot project) - 2005 (project in 8 Dar-ul-Amans in Punjab)
Beneficiaries
> direct, project 1: 4,500 women and 360
EMERGENCY
children
> indirect, project 1 and 2: n/a
HELP FOR EARTHQUAKE VICTIMS
North West Frontier Province and Islamabad
Activities
Outlook
The programme was rolled out in three distinct phases:
• Phase 1: initial medical care for the victims of the
earthquake (a surgical team and two static and mobile
primary healthcare teams);
• Phase 2: support for displaced homeless people
throughout the winter (primary healthcare in Islamabad,
clinics and mobile teams);
• Phase 3: continuation of primary healthcare in the places
which displaced persons returned to.
Efforts were also focused on the protection and
promotion of the victims’ rights, in discussion with
Pakistani and international decision-makers.
As we realised the health needs of
mothers and children were considerable, a
programme will be dedicated to
improving their health during 2007.
Staff
Co-ordinators
> project 1: B.Ten Kate/M. Jactat
> project 2: B.Ten Kate
> field, project 1: C. Jeannot/C. Lambert
> field, project 2: D. Defrade/M. Pomarel
/M.Van Der Mullen
> HQ, projects 1 and 2: N. Bréchet
09/10/2005
> Project progress
> CONTENTS
09/12/2006
Funding
> project 1: MdM, private partners
> project 2: Dutch Ministry of Foreign Affairs,
MEMISA Belgium, MdM
Budget
> 2006 project 1: 134,520 euros
> 2006 project 2: 660,360 euros
SRI LANKA
79
HEALTH FACILITIES
Mortality
> infant: 12‰
Mallavi, Tunukkai and Naadankandal – Mullaitivu District
Life expectancy
> at birth: 74.3
Activities
Outlook
The are four areas of work which take place in the
Mallavi area:
• renovating and equipping Mallavi hospital (opening
a new surgical unit and an emergency centre, refitting the outpatient consultation department, the
pharmacy, the inpatient department and the
maternity unit);
• reorganisation and training of local medical staff;
• providing medicines and medical equipment to the
hospital and two health centres;
• raising awareness amongst local and national
authorities of the problems the hospital faces in
terms of finance, human resources and equipment.
It was decided to suspend the
programme once the renovation of
Mallavi hospital was completed.
Despite MdM’s desire to run a longer
term programme, it has not been
possible to keep a co-ordinator in
Colombo to respond to potential
emergencies.
15/01/2005
> Project progress
30/03/2006
HDI
> 0.755; rank: 93/177
GDP/capita ($)
> 1,160
Sources: Human Development Report, 2006 UNDP;World
Bank, 2005
> MdM Spain, MdM Portugal, MdM Cyprus,
MdM Greece, MdM USA, MdM Belgium,
MdM Argentina
Beneficiaries
> direct: 35,900
> indirect: n/a
Staff
> local: 20
> expatriate: 7
Co-ordinators
> project: C. Giboin, A. Cavey
> field: S. Brignano
> headquarters: emergency desk then
V. Pardessus
Funding
> MdM
Budget
> 2006: 211,540 euros
> CONTENTS
RENOVATING
ANNUAL REPORT 2006
Despite the cease fire between the Colombo government and the Tamil Tigers declared
at the beginning of 2002, the management of post-tsunami financial aid revived political
and community tensions. Material losses have been estimated to be worth US$1 billion,
affecting both main sectors of the economy: fishing and tourism. The population has
suffered greatly from the repercussions of the tsunami. In addition, although the Sri
Lankan health system is still seen as an example for developing countries, it is patchy
across the country.
UZBEKISTAN
The Republic of Uzbekistan has been independent since 31 August 1991. With 26 million
inhabitants it is the most populated country in Central Asia.The pillar of its economy is the
cultivation of cotton which has contributed to the shrinking of the Aral sea, one of the worst
environmental disasters of the Twentieth Century. Despite considerable natural resources
(eg gas, uranium), 27% of the population lives below the poverty line.Two years after the
populist uprising in Andijan, which was bloodily suppressed by the army, Islam Karimov s
regime is still very authoritarian.
MOTHER
AND CHILD HEALTH
Mortality
> infant: 57‰
Bakhmal and Zamin districts, Djizzak region
Life expectancy
> at birth: 66.6
Activities
Outlook
An exploratory mission assessing the potential for a
mother and child health programme took place in
spring 2006.
MdM will keep a co-ordinator post in
place until June 2007 to try to obtain
our registration in Uzbekistan. The
prospects
for
beginning
our
programme remain very uncertain.
In the context of national health system reforms, our
project would contribute to the implementation of
the national Safe Motherhood Programme which
aims to reduce maternal and neonatal mortality and
to improve perinatal care, emergency obstetric care
and neonatal care.The official registration of an MdM
representative in Uzbekistan was a necessary prerequisite before any activities could begin. The
application was prepared with the help of a lawyer,
but we have not succeeded in obtaining this
registration to date.
04/2006
31/06/2007
> Project progress
HDI
> 0.696; rank: 113/177
GDP/capita ($)
> 456
Beneficiaries
> direct: 40
> indirect: 8,500 newborns per year and as
many pregnant women
Personnel
> local: 1
> expatriate: 1
Co-ordinators
> project: L. Zamponi
> field: E. Becquer
> headquarters: A. Landaës
Funding
> MdM
Budget
> 2006: 22,880 euros
> CONTENTS
VIETNAM
81
AND TREATING
HIV
Mortality
Ho Chi Minh City
Life expectancy
> at birth: 70.8
Activities
Outlook
The second year of the project continued screening
for STIs and HIV/AIDS, strengthening access to
treatment of opportunistic infections and STIs, as well
as continuing to train staff in HIV prevention,
diagnosis and treatment of conditions linked to HIV
and the administration of ARV.At the end of 2006, 308
patients were on ARV treatment.
A pilot project of methadone
substitution for intravenous drug
users is due to start by the end of June
2007. The number of patients on ARV
treatment should reach 485 and the
number of beneficiaries on the
methadone programme should be 200
by the end of December 2007.
20/12/2004
31/03/2008
> Project progress
ACCESS
GDP/capita ($)
> project 1: 550
> projects 1 and 2: MdM Canada (withdrew
March 2006)
> project 2: MdM Canada
Beneficiaries
TO COMMUNITY HEALTHCARE
Staff
> local staff allocated to the day care
Hanoi
Activities
Outlook
In 2006, the following activities were carried out:
• providing HIV tests, consultations for primary
healthcare, STIs, opportunistic infections and ARV
treatment in our Day Care Centre (district clinic);
• prevention, needle exchange, condom distribution
and home-based care by two mobile teams;
• promotion of income-generating activities within
solidarity groups;
• training for healthcare and social welfare staff.
By the end of 2007, 160 patients will be
receiving anti-retrovirals and 25,000
people will have been contacted by the
mobile teams and the clubs.
At the end of 2006, 78 patients were on ARV therapy.
HDI
> project 1: 0.709; rank: 109/177
centre, project 1: 36
Co-ordinators
> projects 1 and 2: K.Lacombe
> field, project 1:V.Trias
> field, project 2: R. Jourdain
> HQ projects 1 and 2:V. Pardessus
Funding
> projects 1 and 2: PACT/USAID
01/08/2005
> Project progress
31/07/2008
Budget
> 2006 project 1: 401,550 euros
> 2006 project 2: 323,550 euros
> CONTENTS
PREVENTING
ANNUAL REPORT 2006
In November 2006, Vietnam became the 150th member of the World Trade
Organization.With 9.5% growth in 2006, the Vietnamese economy may be thriving but
1.4 million households live below the poverty line. Vietnam s economic development
is deepening inequalities: the poverty rate is 18.3% in urban areas and 44.9% in rural
areas. Drug use and prostitution, which are both criminalised by the government,
promote the spread of HIV which, according to UNICEF, could affect around 300,000
people.
EASTERN »
EUROPE
Guinée
» EMERGENCY:
1
» CRISIS:
of local resources.
» DEVELOPMENT:
> CONTENTS
BELARUS p.88
BULGARIA p.89
CHECHNYA/DAGESTAN p.90
GEORGIA p.91
KOSOVO p.92
MOLDOVA p.93
ROMANIA p.94
SERBIA p.95
> CONTENTS
INTERNATIONAL PROGRAMMES ¨ EASTERN EUROPE
ANNUAL REPORT 2006
83
Moldova
Lavinia Ilie,programme co-ordinator
‘The case which affected me most is the story
of Oxana, a young girl who had been a victim
of trafficking in Saudi Arabia for two years. She
was only 20 at the time. She met a woman
who promised her a job as a waitress but once
she was there her papers were taken and she
was made to work as a prostitute. She lived
with about 10 other girls in the basement of a
building.They were not allowed to go out or
even to see a doctor. In the end, it was a client
who helped her to return to Moldova. She is
very psychologically distressed and she comes
to the centre, but for now she only wants to
talk to a social worker and will not see a
psychologist…
This victim of trafficking is one of around 700
young men and women who come regularly to
the health centre for young people aged
between 14 and 25 in Balti, the second biggest
town in the country.The team works there in
partnership with a Moldovan organisation.
Most NGOs are based in the capital, Chisinau.
Therefore,this centre is very much appreciated. In
Moldova, it is very unusual to go and see a
psychologist and trafficking is not spoken of. By
working in a centre which is open to all young
people, we manage to reach victims without
stigmatising them.Young women ask to see a
gynaecologist and it is often a pretext to speak
about what they have been through.’
> CONTENTS
Adrien Duquesnel
> CONTENTS
Adrien Duquesnel
Adrien Duquesnel
ANNUAL REPORT 2006
85
(1) Maryvonne Arnaud
(2) Sébastien Georges
» In Chechnya (1 and 2),
the conflict continues
and isolates the civilian
population more with
every day that passes.
Tackling problems with
access to healthcare
remains a priority for
MdM —we continue to
supply several health
facilities from our base in
Moscow. In Bulgaria (3
and 5) and in Georgia
(4), M decins du Monde
directs its work towards
mother and child health
or reproductive health
programmes in order to
improve antenatal
monitoring, particularly
by training healthcare
staff.
> CONTENTS
(4) MdM
(3) MdM
> CONTENTS
(5) MdM
ANNUAL REPORT 2006
87
BELARUS
Alexander Lukashenko s regime does not change: individual liberties remain limited and
structural reforms have not been carried out. The health consequences of the
Chernobyl nuclear disaster are minimised by the government, even though the number
of cancers and congenital malformations due to radiation continues to increase. People
living in at-risk areas have not been evacuated and continue to suffer from chronic
contamination because the soil affected by radioactivity is still being cultivated and food
is grown there.
PREVENTING
RADIOACTIVE CONTAMINATION
Mortality
> infant: 9‰
Chechersk district
Life expectancy
> at birth: 68.1
Activities
Outlook
MdM’s activities aim to improve the health of women
and children living in areas contaminated by
radioactivity.The CORE programme, supported by
the EU, was set up to improve the living conditions of
those living in the contaminated districts.This project,
coordinated by MdM,is implemented by three partners:
IRSN (Radioprotection and nuclear safety institute),
ACRO (Western Association for Radioactivity Control)
and MdM.
MdM had to abandon efforts to
implement this programme in
December 2006, after more than 18
months spent trying to find a way to
operate satisfactorily within all the
constraints.
In 2006,ACRO kept in contact with our local partners
in order to begin the radiological quality control activities.
Thus,radioactivity measuring laboratories were installed
in three villages,thanks to a donation of new dosimeters
by the Belarus Women’s Club.This will enable people
to measure the radiological quality of their environment
in order to adapt their diets or their homes.
13/08/2005
>
Project progress
12/2006
HDI
> 0.794; rank: 67/177
GDP/capita ($)
> 2,330
Beneficiaries
> direct: 2,800 children between 3 and 15
years/400 pregnant women and newborn
babies
> indirect: local health professionals, whole
population of the district
Staff
> local: 1 part-time co-ordinator
Co-ordinators
> project: M. Costa
> field:T. Gloukhova
> headquarters: A. Landaës
Funding
> Tacis (EU), IRSN, DGSNR, MdM
However, the entire programme has not been able to
get off the ground because the rules governing the
implementation of an EU-financed project are very
difficult to comply with in the current Belarussian
context.
Budget
> 2006: 16,992 euros
> CONTENTS
BULGARIA
89
AND
CHILD HEALTH
Roma district of Nadezhda, in Sliven
Mortality
> infant: 12‰
Activities
Outlook
MdM continues to support the Roma population, within
the framework of a mother and child health programme
created by MdM’s regional delegation in Corsica.
The programme continues to organise and provide:
• mother and child health consultations;
• information and health education sessions for mothers
and children, as well as the development of a mothers’
school;
• a public health survey in the ‘district of the naked’, to
identify and accompany the most vulnerable people.
In addition, the programme became national in 2006.
To rethink this project and to define a
partnership with private and public
doctors in the town, we need to:
• refocus activities on access to
healthcare and health training;
• strengthen the team by organising
training and coordination meetings, to
encourage setting up of a ‘hygiene point’
prior to hospital admission and to
disseminate documents and publications.
03/2004
12/2009
> Project progress
TRAINING
STAFF IN INSTITUTIONS FOR DISABLED CHILDREN
Throughout the country (training courses in Sofia)
Activities
Outlook
MdM is supporting a Bulgarian association called ‘Child
and Space’ as part of the ‘Child and his symptoms’ project
which is run in two ways:
• training the staff of eight institutions, four disabled
children’s centres and the social workers of the child
protection agency;
• a training programme for all the staff in the institutions
and centres delivered by ‘supporters’ appointed by the
Bulgarian project co-ordinator.
• Training the staff of the majority of
Bulgarian institutions for disabled
children.
Life expectancy
> at birth: 72.1
HDI
> 0.816; rank: 54/177
GDP/capita ($)
> 8,078
Beneficiaries
> direct, project 1: Roma mothers and
children
> direct, project 2: 150 professionals
> indirect, project 1: Roma families
> indirect, project 2: 396 education
specialists, 360 families and 1,220 children
Staff
> expatriate, project 2: none
Co-ordinators
> project 1: P. Contois
> project 2: F. Parrot
> field, project 1:V. Harutyunyan
> HQ, project 1: East European desk
> HQ, project 2: Aquitaine Regional
Delegation
01/01/2005
> Project progress
> CONTENTS
30/06/2009
Funding
> project 1: MdM
> project 2: Gironde council, various
donations, MdM
Budget
MOTHER
ANNUAL REPORT 2006
In the period leading up to EU accession, Bulgaria has seen sizeable economic growth.
However, despite the government s commitment to carry out reforms immediately,
the European Union has pointed to three weaknesses: efforts to tackle corruption, the
management of regional aid, and food security.The gradual social improvements mask
deep regional disparities and major social inequalities, in particular for the Roma
community whose situation remains worrying and whose health status is appalling.
CHECHNYA/DAGESTAN
Although there is now less fighting between the separatist forces and the federal
forces, confrontations continue in the southern mountainous regions and in
neighbouring republics (Dagestan, Ingushetia). Despite the reconstruction in the area
controlled by federal forces — now handed over to R. Kadyrov s forces — the
population still lives in poor conditions and human rights violations still occur. In
addition, many Chechens still do not have access to primary healthcare and hospital
facilities are sorely lacking in both resources and personnel.
SUPPORTING VICTIMS
Mortality
>
OF CONFLICT
Grozny, Gudermes, Urus-Martan, Argun, Kurchaloy, Nozhay-Lurt and
Vedeno districts
Life expectancy
>
Activities
Outlook
MdM’s experienced Chechen team, managed by
‘remote-control’, continues to focus on improving
surgical treatment, primary and secondary care and
has set up mental health support. The activities
include:
• co-ordination and supply of five urban hospitals, five
rural hospitals and 32 medical and obstetric centres;
• awareness-raising and training in mental health for
Chechen healthcare staff.
Expansion of the primary care
activities in the Kurchaloy district of
Chechnya; Collaboration with the
republic’s centre for medical and
psychological rehabilitation of Grozny’s
children; Publication during 2007 of
Chechen Voices, a collection of
testimonies from Chechnya during the war,
edited by Blenenn Islambard.
GDP/capita ($)
>
In addition, MdM has set up a primary healthcare
assistance programme in Khassaviourt district in
Dagestan.
1995
Ongoing
> Project progress
> CONTENTS
HDI
>
No data for Chechnya
Beneficiaries
> direct: general population, 65,450 from
11/2005 to 06/2006
Staff
> local: 14
> expatriate: 2
Co-ordinators
> project: J. Dato
> field: I. Shihab
> headquarters: A. Landaes
Funding
> ECHO, MdM, Solidarité Tchétchénie,
Adonix (for the programme in Dagestan).
Budget
> 2006: 1,095,090 euros
GEORGIA
91
FOR REPRODUCTIVE HEALTH
Mortality
> infant: 41‰
Mingrelia Region
Activities
Life expectancy
> at birth: 70.5
Outlook
MdM continued its mother and child health
In 2007, there will be needs
programme in Mingrelia with four main areas of
assessments on harm reduction and
work:
on the situation of minorities.
• providing medical equipment, medicines and
supplies;
• renovation and maintenance of health facilities;
• training healthcare staff;
• monitoring health services and beneficiaries.
09/2004
01/2007
> Project progress
HDI
> 0.743; rank: 97/177
GDP/capita ($)
> 2,844
Beneficiaries
> direct: 44,414
> indirect: 50,000
Staff
> local: 17
> mother and child healthcare staff: 1
> expatriate: 1.5
Co-ordinators
> project: H. Lepoivre/I. Hermant
> field: S. Rogic/V. Miollany
Funding
> ECHO, MdM
Budget
> 2006: 367,385 euros
> CONTENTS
AID
ANNUAL REPORT 2006
Three years after the Rose Revolution and Mikhail Saakashvili s rise to power, Georgia
has experienced serious tensions, particularly in the secessionist territories of Abkhazia
and Ossetia. Relations with the Russian Federation have also deteriorated. In relation to
health, the government s new reforms of the health system have not succeeded in
ensuring access to healthcare for the most vulnerable.
KOSOVO
Kosovo, which has been a Serbian province under international administration since
1999, has experienced real inter-ethnic tensions. The Albanian majority, representing
more than 90% of the population, is massively pro-independence while Belgrade
remains opposed to such independence. In January 2006, the UN started negotiations
on the long-term future of the province. Western diplomats agree on the principal of
autonomy, conditional on respect for multi-ethnicity. In addition, the unemployment
rate is 60% and 65% of the population lives below the poverty line.
IMPROVING
ORAL HEALTH OF THE
ALBANIAN
AND
SERBIAN
POPULATIONS
Mortality
> infant:
Gllogovc, Hoce e Madne village (Serb enclave near Rahovec)
Activities
Life expectancy
> at birth:
Outlook
MdM’s PACA regional delegation is running a project to Continuing to implement the
improve access to oral healthcare for people living in the programme, in Hoce e Madne village.
region,irrespective of which ethnic group they belong to.For
this reason, two health centres have been chosen, one in
Gllogovc and one in Hoce e Madne.The programme includes:
• installing complete, functional dental surgeries in each
health centre;
12/2007
• training local practitioners in new dental techniques and 05/2004
setting up oral health education activities in schools.
Project progress
>
LISTENING
TO YOUNG PEOPLE
Pristina
Activities
In partnership with the Kosovan Ministry of Culture,
Youth and Sports and with Vita Kosovo, a local NGO,
MdM runs a prevention programme with young
people (13 - 24 years).The activities include:
• creating a place of welcome, listening, information,
consultation and advice for young people;
• direct support (individual psychological support,
integration into a care network) and indirect support
(ongoing training for the Listening Point team…).
Since 2004, the programme has been sponsored by
Salon-de-Provence’s young people’s health space
(Espace Santé Jeunes).
HDI
>
GDP/capita ($)
>
No data for Kosovo
Beneficiaries
> direct, project 1: health professionals in two
clinics, two Albanian dental practices in
Gllogovc and one Serbian practice in Hoce e
Madne.
> direct, project 2: +/-250,000 young people
> indirect, project 1: the Albanian and Serbian
population in the catchment area
> indirect, project 2: +/-1 million young
people under 24 living in Kosovo
Staff
> expatriate, project 1: no permanent
Outlook
MdM hopes to develop outreach
activities and promote the Degjo
Rinine centre, to develop the NGO
Vita Kosovo in its role as programme
manager.
2003
>
12/2007
Project progress
> CONTENTS
presence; regular visits by two dentists from
the PACA region.
Co-ordinators
> project 1: P. Dupin
> project 2: M.A. Chaud
> field, project 1: regular support of the Pristina
‘Listening Point’ team
> field, project 2: G.Alliu
> HQ, project 1: PACA regional delegation:
I. Bouju Malaval
> HQ, project 2: PACA regional delegation
Funding
> project 1: private partnership
> project 2: PACA collectivity
Budget
MOLDOVA
93
HUMAN TRAFFICKING AND CARING FOR THE
VICTIMS
Life expectancy
> at birth: 67.5
Balti region, Floresti, Folesti, Glodeni, Râscani, Sângerei
HDI
> 0.694; rank: 114/177
Activities
Outlook
MdM supports the Friends of Young People Health
Centre (ATIS), run by the NGO Young People for the
Right to Live (TDV). This support is for prevention
and care for victims of trafficking through access to
healthcare, welfare and legal services.
The programme includes:
• encouraging the long term sustainability of the ATIS
centre by integrating it into the national health
system;
• promoting coordination between those involved at
the regional and national levels;
• participating in the working groups on prevention
and protection, set up by the National Committee
Against Trafficking;
• participating in national and international networks
on prevention and advocacy.
To integrate the ATIS centre into the
regional health system with complete
handover to TDV. To develop outreach
activities among the vulnerable populations
in the ‘raions’.To extend the MdM/TDV
partnership into a consortium which
includes CPTW, NPW and the medical
and social services of Balti council.
07/2009
> Project progress
GDP/capita ($)
> 1,729
Beneficiaries
> direct: service users of the ATIS centre
in Balti
- young people from 14 to 25 who use the
health centre or who are reached by
outreach activities
- victims of trafficking
Staff
> local: ATIS centre team of 8 (co-ordinator,
10/2005
Mortality
> infant: 23‰
doctor, gynaecologist, dermatologist, 2
psychologists, social workers, secretary)
> MdM staff: 3
> expatriate: 1
Co-ordinators
> project: F. Parrot
> field: L. Ilie, C. Ferrier
Funding
> French Embassy/MdM/ Adonix
Budget
> 2006: 76,422 euros
> CONTENTS
PREVENTING
ANNUAL REPORT 2006
With a very high inflation rate and a very low rate of investment, Moldova remains in a
difficult economic position. The extreme poverty encourages mass emigration and
increases the risks linked to human trafficking, particularly for women, victims of sexual
exploitation. Most of these victims do not have access to any healthcare and suffer from
serious problems: sexually transmitted infections, reproductive health problems,
psychological or nervous problems and difficulties with reintegration.
ROMANIA
In the period leading up to EU accession, Romania has seen sustained growth. Since
1997 many reforms have been undertaken, particularly in the social and child
protection sectors.The process specifically dealt with the role and participation of civil
society organisations in relation to child welfare. Currently, of six million children in the
country, 45 000 are still in institutional care. Because of the weaknesses of the Romanian
system, de-institutionalisation has not been evaluated, particularly in relation to
mistreatment and abuse of children.
PROTECTING
CHILDREN, SUPPORTING THE ORGANISATION
COPII
Satu Mare
Outlook
In the absence of any Romanian child abuse
prevention experts, MdM’s PACA regional delegation
is monitoring the supervision of new childcare
professionals by working with the Romanian
organisation COPII.
• Carry on with the continuing
professional development programme;
• Organise specific training sessions
for AMPs who look after abandoned
children under one year old;
• Work in collaboration with the
management of child protection
services in order to facilitate contact
between the AMPs and birth families.
COPII will participate in the child
protection reforms, particuarly in
order to obtain authorisation to be a
training organisation.
01/04/2006
> Project progress
Life expectancy
> at birth: 71.3
HDI
> 0.805; rank: 60/177
Activities
There are two parts to this work:
• Continuing professional education for professional
childcare assistants (AMPs) and organising support
groups;
• Supporting the Romanian association, COPII.
Mortality
> infant: 17‰
31/03/2008
GDP/capita ($)
> 8,480
Beneficiaries
> direct: all the childcare assistants (c280)
in the area
> indirect: children under the care of
childcare assistants – about 350 children
Staff
> local: 1 co-ordinator (part-time) and the
volunteers of COPII
Co-ordinators
> project: H. Picon
> field: M.Veres
> PACA delegation HQ: I. Bouju Malaval
Funding
> private partnerships and PACA regional
council
Budget
> 2006: 6,326 euros
> CONTENTS
SERBIA
95
REDUCTION PROGRAMME WITH DRUG USERS
Mortality
> infant: 13‰
Belgrade
Life expectancy
> at birth: 73.2
Activities
Outlook
At the end of 2005, MdM transferred its harm
reduction programme to Veza, a local Serbian
association. However, the MdM team supports this
association with fundraising, development and project
management. MdM has also started a project towards
the opening of a specialist addiction medicine unit
within a primary healthcare structure.
The programme started in Autumn
2006 will lead to the opening of a
specialist addiction medicine unit and
the start of an opiate substitution
programme within a primary healthcare
centre in Belgrade in the first six
months of 2007.
01/12/2006
> Project progress
2009
HDI
> not known
GDP/capita ($)
> 2,946
Staff
programme transferred to Veza (needle
exchange and information tools for
injecting drug users):
> direct: 823
> indirect: 1,900; needles/year: 270,000;
collection rate: 40%
MdM programme (access to opiate
substitution treatment):
> direct: 60 by mid-2008
> indirect: around 900
Staff
> local: 0.5 fte
> expatriate: 1
Co-ordinators
> project: P. Beauverie, P. Gassmann
> field: C. Debeaulieu
Funding
> French Ministry of Foreign Affairs/MdM
/Global Fund
Budget
> 2006: 224,500 euros (all funding)
> CONTENTS
HARM
ANNUAL REPORT 2006
After the separation from Montenegro, Serbia remains politically unstable because of the
issue of Kosovo s future and changing internal political alliances. Since the conflicts and
disturbances of the 90s and the lack of significant international cooperation, Serbia has
experienced economic difficulties, despite growing aid from the Serbian diaspora.
Provision of healthcare has clearly deteriorated and the HIV epidemic is spreading,
particularly among injecting drug users, although it is not possible to obtain a clear
picture of the epidemiological situation.
MIDDLE
EAST
» EMERGENCY:
» CRISIS:
of local resources.
» DEVELOPMENT:
> CONTENTS
EGYPT p.102
IRAQ p.103
PALESTINIAN TERRITORIES p.104>105
LEBANON p.106
TURKEY p.107
YEMEN p.108
> CONTENTS
INTERNATIONAL PROGRAMMES ¨ MIDDLE EAST
ANNUAL REPORT 2006
97
Elisabeth Rull/Item
Lebanon
Testimony recounted in South Lebanon in September 2006
Nazek, 44 years old, lives in Khiam
‘My car was destroyed with the first bombings. So it wasn’t possible to flee, because my mother and my brother both suffer from a
nervous condition and can’t travel easily.We spent the whole war here.When my house was hit, we hid at my aunt’s place.There
were also two older neighbours with us, and the woman could no longer walk.We endured bombings day and night and, each time,
we thought we were going to die! As a nurse, I was able to care for my mother and brother while we had enough medicines. But,
with all the fear my mother became even sicker.And I no longer had any way to treat her… Since then, her health has got even
worse.And we all have to live crammed into my brother’s house because mine was totally destroyed…’
> CONTENTS
> CONTENTS
Elisabeth Rull/Item
ANNUAL REPORT 2006
99
(2) Bruno Fert
> CONTENTS
(3) Bruno Fert
(1) François Moura
(5) MdM
» In Constantine, Algeria
(2), treatment of asthma,
which is neglected for
cost reasons, is provided
by two local health
facilities supported and
trained by MdM. In the
Palestinian Territories (4
and 5) and in Iraq (1 and
3) problems linked to the
conflicts severely limit
access to healthcare for
civilians, particularly in
emergency cases. So, for
example, first aid training
for teachers, students
and paramedics has been
carried out in the Gaza
strip.
> CONTENTS
(4) MdM
ANNUAL REPORT 2006
101
EGYPT
Today, 60% of the urban population of Cairo lives in unhealthy conditions and,
according to UNICEF and the Egyptian NGO Hope Village Society, the number of
children living on the streets in Cairo varies between 15,000 and 20,000. Although the
fact that these children are always moving around makes it difficult to have reliable
data, one thing is sure: there are more and more of them.The sight of young mothers
living on the streets with their babies is a recent and growing phenomenon in Cairo.
These teenage pregnancies are most often a consequence of life on the streets.
Particularly poorly regarded by the community, these girls wander about without any
medical check-ups, increasing the risk of maternal and infant mortality.
PROMOTING
ACCESS TO HEALTHCARE FOR PREGNANT GIRLS
AND YOUNG MOTHERS LIVING ON THE STREETS
Mortality
> infant: 33‰
Life expectancy
> at birth: 69.8
Cairo
HDI
> 0.659; rank: 119/177
Activities
Outlook
MdM supports the NGO Hope Village Society in
running a reception and re-integration centre and a
mobile unit caring for pregnant teenagers and
adolescent mothers living on the streets. The
programme organises and provides:
• psychological support for the girls coming to the
pilot centre;
• a care network with the public hospitals enabling
access to healthcare for pregnant girls and young
mothers living on the streets;
• Information, Education and Communication (IEC)
sessions on reproductive health, first aid, hygiene and
nutrition for girls and boys attending the centre,
street children leaders, educators and care staff of
Hope Village Society as well as for staff of other
organisations working with street children;
• support to the network of Egyptian NGOs caring
for street children.
Continuation of the project and
support to other NGOs working with
young girls living on the streets.
01/08/2005
> Project progress
31/12/2008
GDP/capita ($)
> 1,220
Beneficiaries
> direct: 800 adolescent girls and 3,600
children; around 70 healthcare staff, social
workers and psychologists
> indirect: 10,000 adolescent girls and
3,000 children
Staff
> local: 11
> expatriate: 4
Staff
> project: R. Heimann / M. A. Silicani
> field: I. Bruand
> headquarters: S. Alary
Funding
> Drosos Foundation, EU, MdM
Budget
> 2006: 189,650 euros
> CONTENTS
IRAQ
103
Mortality
> infant: 102‰
MEDICAL EMERGENCY CARE
Several Iraqi governorates with support from the base in Amman
and with Iraqi medical teams in Baghdad
Life expectancy
> at birth: 58.8
HDI
> not known
GDP/capita ($)
> not known
Activities
Outlook
In May 2006, MdM launched a pilot programme in
Amman with the following objectives:
• to identify the determinants of access to healthcare
for the Iraqi population and prioritise the problems
identified;
• to define the strategies, objectives and activities for
a programme proposal;
• to develop a network of contacts (NGO and Iraqi
institutions) from Amman;
• to participate in a collective NGO advocacy project
towards European institutional funders;
• the programme themes identified are: (i) emergency
medical care for civilian victims of conflict, (ii)
pregnant women and (iii) a mental health programme.
From January 2007 a multi-faceted
programme will be managed by
‘remote-control’ from Amman in liaison
with an Iraqi medical co-ordinator in
the field, supporting Iraqi associations
and partners.The activities will include
first aid training and training on home
births, as well as supporting the
integration of mental health into
primary healthcare. This will be done
in partnership with WHO and the
Iraqi Ministry of Health. A project
working with Iraqi refugees in Syria is
also planned.
01/2007
> Project progress
> CONTENTS
31/12/2007
Beneficiaries
> direct: n/a
> indirect: n/a
Staff
> local: 1
> expatriate: 2
Co-ordinators
> project: M. A. Silicani
> general co-ordinator: J. Lobel
> medical co-ordinator: M. Bennour
Funding
> MdM
Budget
> 2006: 57,665 euros
IMPROVING
ANNUAL REPORT 2006
In the grip of growing violence and insecurity, the situation in Iraq remains extremely
worrying. Because of the great confusion between military and humanitarian
operations, national and international NGOs are adapting to the volatile context where
their teams are not respected. In such a situation, access to healthcare becomes very
difficult and insecurity drives many Iraqi healthcare staff, who are particularly threatened
by kidnappings, to abandon their work. Having closed its programme in 2004, MdM
France is setting up maternal health and mental health activities, which will be managed
from a distance, to get round the fact that it is impossible to have a direct presence in
Iraq.
PALESTINIAN TERRITORIES
Since February 2006, the occupied Palestinian Territories have been suffering the effects
of an international economic embargo introduced by western donors following Hamas
election victory. The destruction of infrastructure and the main transport routes by
Operation Summer Rain has considerably hampered the distribution of essential goods
and movement within the Gaza strip. In the West Bank, the strike of unpaid government
workers, particularly those from the Ministry of Health, resulted in the almost total
closure of health facilities and a deterioration in the health system. In addition, the
construction of the Wall and the expansion of settlements continue in Jerusalem, in
parallel with deepening intra-palestinian tensions.
Mortality
IMPROVING
Life expectancy
> at birth: 72.4
EMERGENCY CARE
HDI
> 0.736; rank: 100/177
Gaza Strip
Activities
Outlook
MdM aims to improve emergency medical treatment
by:
• first aid training, particularly schoolchildren of the
United National Relief and Work Agency (UNRWA)
schools;
• a ‘training for trainers’ course for 74 paramedics from
UNRWA health centres
• a ‘training for trainers’ programme with the
Palestinian Red Crescent ambulance staff in Gaza and
Ramallah;
• development of a reference ‘Plan for an influx of sick
or injured patients’ with the emergency department of
Shifa Hospital;
• exceptional donations of medicines to Shifa Hospital
and of hospital surgical equipment to the Ministry of
Health.
GDP/capita ($)
> 1,026
To continue the programme and
develop primary healthcare activities,
supporting the Ministry of Health and
local NGOs.
Beneficiaries
> direct: 1,300 trainers, teachers,
2002
2008
> Project progress
schoolchildren and hospital staff
> indirect: 1,400,000
Staff
> local: 6
> expatriate: 1 and doctors for short
periods
Co-ordinators
> project: R. Garrigue, M. Rajablat
> field: D.Trani then R. Guzman
> country co-ordinator:W. Dufourcq
Funding
> DAH, ECHO, MdM
Budget
> 2006: 222,480 euros
> CONTENTS
105
MENTAL
HEALTH
Outlook
Continuing the activities and setting up
two medical psychology community
centres (Nablus and Jenin) in
partnership with the Palestinian
Ministry of Health and partially funded
by the French Development Agency.
mid 2003
end 2009
> Project progress
Mortality
> infant: 22‰
Life expectancy
> at birth: 72.4
HDI
> 0.736; rank: 100/177
GDP/capita ($)
> 1,026
> project 2: MdM Switzerland, MdM
Greece, MdM Spain
ACCESS
TO
Beneficiaries
HEALTHCARE
Jerusalem
Activities
Outlook
The co-ordination team in Jerusalem ensures daily
monitoring and running of the projects from the
Nablus and Gaza bases.
MdM would like to develop a primary
healthcare project to support the
Ministry of Health and local NGOs.
Staff
> expatriate, project 1: mental health coordinator: C. Dugarin
Co-ordinators
> project 1: R. Garrigue
> field, project 1: C.Thévenot;
from March 2006 local team.
> field, project 2: R. Garrigue
> country, project 1:W. Dufourcq
> country, project 2: R. Garrigue
> headquarters, project 1: S. Alary
Funding
> projects 1 and 2: MdM
Budget
> 2006 project 1: 207,080 euros
> 2006 project 2: 245,145 euros
> CONTENTS
In co-operation with the Palestinian Ministry of
Health and in partnership with several local services,
MdM works to improve the treatment of
psychological problems, through:
• a de-stigmatisation campaign amongst the
Palestinian population (leaflets, adverts, TV and radio
programmes);
• supervision of a programme identifying
psychological problems in children (theatre in
schools) which has been transferred to a local
partner;
• support for therapeutic activities including literary
cafés, a ‘Listening Point’ and two psychological
consultation services in a Nablus clinic;
• technical support to primary healthcare staff and
mental health professionals (training courses and
seminars on mental health).
ANNUAL REPORT 2006
Nablus district in the West Bank
LEBANON
Lebanon experienced a major political crisis, exacerbated by the assassination of the former
Prime Minister R. Hariri, and a deep socio-economic crisis aggravated by the war of July
2006. Despite the end of hostilities and the deployment of UNIFIL forces alongside the
Lebanese army, Israeli air incursions tend to produce tensions. In addition, Lebanon is a
crossroads for thousands of migrants who face severe discrimination. The country is not
party to the 1951 Geneva Convention and refuses to be a reception country.
EMERGENCY
MEDICAL ACCESS FOR CONFLICT VICTIMS
Beirut and its suburbs, South Lebanon
Activities
Outlook
MdM, in partnership with the Lebanese NGO Amel
targeted displaced people in and around Beirut. Later,
the activities were refocused on people returning to
their towns and villages in South Lebanon. In all the
supported areas the activities included:
• monitoring patients suffering from chronic disease and
epidemiological surveillance;
• health promotion, provision of information and
improving hygiene conditions;
• a needs assessment and distribution of medicines and
other medical/surgical supplies to the places people
were returning to.
The programme finished on 12
October 2006.
Mortality
> infant: 27‰
Life expectancy
> at birth: 71.9
HDI
> 0.774; rank: 78/177
GDP/capita ($)
> 6,149
12/07/2006
> Project progress
ACCESS
TO HEALTHCARE AND FUNDAMENTAL RIGHTS FOR
REFUGEES, ASYLUM SEEKERS AND MIGRANTS
Lebanon (13 prisons across the country)
Activities
Outlook
MdM continues its activities in Roumeih central prison, in
partnership with the Lebanese NGO Ajem, and has been
working since mid-2006 in other prisons across Lebanon.
In Roumieh prison: medical, social and legal follow-up for
newly detained foreigners;
In Roumieh prison and other prisons:
• refurbishing and providing sanitation equipment and
hygiene products;
• Information,Education and Communication (IEC) sessions;
• training in health and rights for healthcare staff, detainees,
prison guards and voluntary organisations;
• lobbying the prison authorities, health authorities and
politicians;
• creation of a network of NGOs working in prisons and/or
with refugees, asylum seekers and migrants.
Continuing the programme in 2007:
developing activities focused on
training and health education in other
Lebanese prisons as well as advocacy
activities.
01/01/2005
> Project progress
> CONTENTS
12/10/2006
31/12/2008
Beneficiaries
> direct, project 1: 62,510 people
> direct, project 2: at least 2,000
people/year
> indirect, project 2: around 5,500
Lebanese prisoners in 13 prisons including
4 women’s prisons; prison medical and
non-medical staff; local project partners
Staff
Co-ordinators
> project 1: B. Lambert/M.A. Silicani
> project 2: B. Lambert
> field, project 1: N. Séris
> field, project 2: B. Martin
> headquarters, projects 1 and 2: S. Alary
Funding
> project 1: ECHO, PACA Regional
Council
> project 2: French Ministry of Foreign
Affairs, EU
Budget
> 2006 project 1: 322,270 euros
> 2006 project 2: 260,000 euros
TURKEY
107
OF POLITICAL VIOLENCE
Mortality
> infant: 28‰
Istanbul
Life expectancy
> at birth: 68.6
Activities
Outlook
With the help of several human rights organisations,
MdM aims to:
• produce an expert report on the medical and
psychological consequences of torture on former
prisoners and the effects of solitary confinement;
• to observe legal proceedings defending human
rights;
• to testify about exactions to the European Court on
Human Rights using the ‘counter-expertise model’
which was used two years ago with patients whose
health status had been wrongly judged to be
compatible with their reincarceration.
To adapt MdM’s activities to the
changing context.
CARING
GDP/capita ($)
> 7,753
2002
HDI
> 0.757; rank: 92/177
2007
> Project progress
Beneficiaries
> direct, project 1: political prisoners,
victims of state violence (torture, solitary
confinement)
> direct, project 2: pregnant women and
young children
> indirect, project 1: defending human
rights and minorities
FOR THE MOST DISADVANTAGED
Staff
Disadvantaged area of Ayasma
Activities
Outlook
As part of primary healthcare, MdM continues to
provide medical and welfare services to people living
in Ayasma, mainly displaced Kurds. The activities
include:
• healthcare and socio-educational activities for
children, adolescents and women;
• a local partnership and implementation of a medicosocial project combining healthcare, education and
training;
• monitoring the respect of rights, particularly the
right to health.
Set up a health observatory, continue
the current activities, prepare the
closure of the centre which is
scheduled for the end of 2007. Study
the possibility of transferring the
project to another area of Istanbul.
> Project progress
> CONTENTS
Co-ordinators
> project 1: B. Granjon
> project 2: G. Couffin Guerin
> HQ projects 1 and 2: PACA Regional
Delegation
Funding
> project 1: Bouches-du-Rhône Council
> project 2: Bouches-du-Rhône Council,
MdM
2005
> local, project 2: 5 employees and
volunteers
> expatriate, project 1: 6 on regular visits
> expatriate, project 2: 2 on regular visits, it
is illegal to provide permanent assistance.
2007
Budget
SUPPORTING VICTIMS
ANNUAL REPORT 2006
The economic situation in Turkey has been positive, with a budget deficit that has been
largely contained and ongoing liberalising structural reforms. However, this progress is still
fragile, and social and regional inequalities are widening.With the opening of negotiations
for membership of the EU, major questions remain: the question of Cyprus and respect
of human rights, including those of minorities, prisoners or political opponents. Despite
legislative efforts, people are still repressed because of their opinions.
YEMEN
One of the most populated and the poorest countries in the Arab world, Yemen has
particularly alarming development indicators. In order to strengthen capacity since
reunification in 1990, the country has sought to mobilise foreign and national
investments. But this is proving slow to get off the ground, mainly because of the unsure
political and legal environment. The primary healthcare system only covers 58% of the
population s needs. Within this, 80% of the urban population s needs are covered
compared to only 20% in rural areas.
IMPROVING
PRIMARY HEALTH CARE
Mortality
> infant: 82‰
Hajjah Governorat, Beni Kays district
Life expectancy
> at birth: 60.3
Activities
Outlook
With the aim of improving medical care for
disadvantaged populations and the Yemeni health
system in general, MdM carried out a three-month
needs assessment in April 2006 focusing on the
feasibility of a structured programme. The assessment
included:
• building up knowledge of the general health context
in Yemen;
• evaluating the health needs of the population and
their current access to healthcare;
• determining a framework for MdM’s operations in
Yemen.
MdM will:
• provide equipment to seven health
units and the Toor health centre
laboratory and help these units to
become operational;
• set up training, in collaboration with
the Ministry of Health, for the staff of
the units, the health centres and
community health workers;
• develop prevention and awarenessraising activities on health and hygiene
issues, in partnership with community
networks and Yemeni associations;
• identify solutions to help improve
the health system, in collaboration
with the health and political
authorities.
In December 2006, MdM started a two-year project
intended to support primary healthcare facilities in this
district.
12/2006
11/2008
> Project progress
> CONTENTS
HDI
> 0.492; rank: 150 /177
GDP/capita ($)
> 879
Beneficiaries
> for the whole project: 53,000
Staff
> local: 0
> expatriate: 1
Co-ordinators
> project: F. Jeanson, J. Dato
Funding
> MdM
Budget
> 2006: 33,780 euros
FUTURE PROJECTS
FEBRUARY
MARCH
Country
Town / Region
Ethiopia
Somalia
Improving access to healthcare: support to Kebri Dehar hospital and primary care in Korahe
Indonesia
Jakarta
Emergency medical programme for people living in East and North Jakarta affected by flooding
Haiti
Jeremie
Renovation of Saint-Antione hospital in Jeremie following flooding in November 2006
India
Jaipur
Reproductive and primary healthcare programme in 10 shanty towns around Jaipur
Madagascar
Nord Madagascar,
Majunga
Malta
APRIL
MAY
JUNE
Access to healthcare in prisons
Promoting respect for the right to health and the dignity of migrants enclosed or living in camps
Indonesia
Sumatra
Emergency medical programme for earthquake victims
Russia
Moscow
Access to healthcare for migrants
Senegal
Podor, Gamadji,
Saré
Primary healthcare
Morocco
Casablanca
Street children / Training social workers
Niger
Tahoua
Research-action-advocacy project on nutrition and family planning
Nepal
Sindhupalchowk
district
Mother and child health programme
Ivory Coast
Tenegrela, Dabakala,
Mankono districts
Improving access to healthcare and quality of care by supporting three health facilities
India
Kashmir
Reproductive health programme
Burma
Mokens
Access to healthcare
Laos
Champassak, Saravane
Reproductive health programme
China
Qinghai
Mother and child health programme
Ecuador
Tungurahua
Intercultural health
Madagascar
Tulear
HIV/Technical training
Somalia
SEPTEMBER
Theme
NEEDS ASSESSMENTS 2007
Month
Country
Town / Region
Theme
APRIL
Somalia
Bossasso
Primary healthcare
MAY
Georgia
Tbilissi / Zugdidi
JUNE
Tajikistan/
Kyrgyzstan
Afghanistan
Harm reduction / Minorities
Access to healthcare
Kabul
Mental health
> CONTENTS
INTERNATIONAL PROGRAMMES
Month
ANNUAL REPORT 2006
109
NEW PROJECTS 2007
ADOPTION
M decins du Monde is the only organisation medical humanitarian organisation in France to have incorporated
adoption into its original statutes and created an International Adoption Programme. The status of authorised
adoption organisation (OAA) was obtained in 1988. As an OAA, the objective is to remain faithful to the NGO s
commitment: to defend the most vulnerable, such as children — who are often the first victims of crises or
conflicts — and to defend their fundamental rights to healthcare, education and a family life.
In 2006, M decins du Monde s adoption programme is the leading OAA in France. The programme prioritises
finding families for children who have not been able to be adopted in their own country, siblings and children
with special medical needs. In 2006, of 240 children adopted through Médecins du Monde, 109
children (45% of all the children) met these criteria.
CHILDREN, OUR PRIORITY
Activities
Outlook
More than 1,800 applications were sent to MdM and 452
applications were accepted. However, it is important to
remember that between 27 and 30% of applicants normally
withdraw from the process.
Preparing requests for accreditation for
fragile states, having carried out a geopolitical analysis.
In 2006, 1,259 post-adoption home visits were carried out in
line with our commitments to do so for at least two years after the
child arrives, and longer if needs be.
Associated countries in
2006
> Albania, Brazil, Bulgaria, China, Colombia,
Haiti, Russia,Vietnam.
Bolivia, Ecuador and Romania were not
operational in 2006.
Co-ordinators
> project: G. André-Trevennec
> members of the Adoption Committee
representing MdM’s Board of Directors:
O. Bernard (MdM vice-president), P. Kempf
(MdM deputy treasurer)
240 children were adopted in France in 2006 by 216 families.
2,965 children have been adopted since 1990.
Funding
> adopting families, MAI, MdM
38 children from Eastern European (Albania, Bulgaria and Russia)
136 children from Asia (China,Vietnam)
66 children from Latin America (Brazil, Colombia)
Budget
> 2006: 408,771 euros (provisional)
MdM is continuing to improve the adoption procedures in legal and
medical terms. Four major themes have been identified:
• adapting the number of adoptions to respond to the international
trend for a reduction in the number of children proposed for
adoption in the countries of origin;
• updating procedural manuals;
• professionalisation and training of human resources (237 people);
• restructuring the organisation, with programme correspondents
being placed under the authority of the MdM country co-ordinator.
Local synergies between the programme and monitoring the
procedures in the country are possible.
> CONTENTS
MdM
> CONTENTS
Stéphane Lehr
MdM
ANNUAL REPORT 2006
111
INTERNATIONAL PROGRAMMES ¨ ADOPTION
OPERATION SOURIRE
Operation Sourire aims to put a smile back on the faces of those who have been
disfigured by war, illness or malnutrition. This enables people excluded because of their
disability to find their place in society again. Reparatory surgery still does not exist in
many countries because of a lack qualified human resources, equipment and
infrastructure. Due to the considerable demand for plastic surgery and the complete
lack of treatment for patients, the Operation Sourire teams are working amongst this
forgotten population.
PROGRAMME
COUNTRIES IN
2006
Benin/Togo, Cambodia, Eritrea, Ethiopia, Laos (needs assessment), Madagascar,
Mali, Mongolia, Niger, Pakistan, Rwanda.
Activities
Outlook
Operation Sourire’s long term future was confirmed in
2006 and the programme continues to adapt to
evolving needs and changing local circumstances in the
10 countries involved.
Operation Sourire plans to carry out
30 projects in 12 countries throughout
2007.
The work to create a network of partners is ongoing
and enables better overall treatment for patients, from
a medical point of view (operation, re-education) as
well as from a social perspective (accompaniment
during the integration process).
These projects will continue those
already in place, including directly
operating on patients and training
local teams. Several local surgeons, on
completion of their training, will be
able to deal with these conditions.
The 25 teams who participated in Operation Sourire
projects in 2006, operated on 670 patients.This brings
it to more than 5,000 who have been operated on since
1989 in 12 countries in Africa and Asia.
A new project will be developed in
Laos and a team should also travel to
Chad.
In addition, the training of local teams is ongoing and
several local surgeons, on completion of their training,
are treating some of these specific conditions.
This activity is developing thanks to the participation of
more than 80 volunteer health professionals –
surgeons, anaesthetists and nurses.The time which they
invested on Operation Sourire programmes
represented more than 1,500 volunteer days in 2006.
> CONTENTS
Co-ordinators
> project: F. Foussadier
> headquarters: A. Segard
Funding
> private funds, businesses, foundations
Budget
> 2006: 360,000 euros
(3) Catherine Henriette
» In Chechnya, Cambodia (1), Madagascar (2), Niger (3) and Pakistan
(4), facial disfigurement, burns whether resulting from a domestic
accident or from honour crimes as in Pakistan, only have one solution:
surgery.This enables faces and bodies to be repaired, but also treats
souls destroyed by exclusion. Once treated, people can begin to
reintegrate into their communities.This can often seem like being reborn.
> CONTENTS
INTERNATIONAL PROGRAMMES ¨ OPERATION SOURIRE
(4) Isabelle Eshraghi
ANNUAL REPORT 2006
113
MISSION
FRANCE
114/136
> CONTENTS
> CONTENTS
Bruno Fert/Invisu
ANNUAL REPORT 2006
115
¨ MISSION FRANCE
> CONTENTS
ANNUAL REPORT 2006
117
p.124
MIGRANTS p.125
LEAD POISONING IN CHILDREN p.126
ROMA p.127
TRAVELLERS p.128
PEOPLE WORKING IN PROSTITUTION p.129
HARM REDUCTION AND NEEDLE EXCHANGE
METHADONE BUS p.131
RAVES p.132
BUDDYING CHILDREN IN HOSPITAL p.133
> CONTENTS
¨ MISSION FRANCE
THE HOMELESS AND POORLY HOUSED
p.130
Introduction
BRAVERY
IS TO SEEK AND SPEAK THE TRUTH
AND NOT TO FALL VICTIM OR PERPETUATE
THE POWERFUL LIES WHICH REIGN
TRIUMPHANT
JEAN JAURÈS
In order to fight discrimination in providing access to healthcare and to work daily to improve access to
care for the most vulnerable it is essential to address common misperceptions and distorted reporting.
That is why the team at MdM’s Mission France are committed to recording facts and figures and collecting
case studies from everyday life across 27 French towns.
We won’t allow the weakest to be treated as guilty, we won’t accept constant reports of fraud, crime and
illegal activities about people who, as they try to survive, face rejection, condemnation and endless
obstacles. Pushed out of their caravan or squat, losing their belongings, being separated from their family
(biological or chosen), facing prejudice and not knowing where to find shelter, they live off charitable hand
outs and stand accused of wasting their resources, they work when they can and often in dangerous jobs,
without always being paid.
The current trend of criminalising poverty, and in turn, the poor, is taking root in people’s minds as much
as it is in law.The neediest are forced to comply with tortuous bureaucracy, in spite of the fact they have
no office and often find that the authorities keep their papers. New rules that increase obstacles are issued
and are presented to the general public as a way of having more control over the population.
When will our society refuse to become a society based on fear? Fear of the unknown, different and
therefore dangerous, fear of risks. The panic arising from the bird flu epidemic is a good example. The
omnipresent sense of fear leads to a society in the grip of databases where the freedom of world citizens
> CONTENTS
is curbed by laws. Recent action around undocumented children in their neighbourhoods and at school is
perhaps the beginning of a wake-up call that human rights are more important than electoral speeches.
That our society will be better off when we respect the rights of the most vulnerable and redress existing
inequalities rather than forcing people to disappear, excluded from the few places where they found
refuge, by chasing them underground and on to baron wastelands on the edge of town.
How is your health? Are you well? Oh yes, its true you are sitting in front of your demolished caravan,
with all your documents inside, alongside the toys and your children’s clothes and your medicine.You were
granted a charitable ten minutes to retrieve your belongings before the bulldozer demolished your home.
Tonight you will sleep in the rain with your three children...The land won’t be used but it is better without
you.The kids were frightened, you too. But your health is ok, isn’t it?
Nathalie Simonnot, 20 August 2006
Mission France Co-ordination
> CONTENTS
¨ MISSION FRANCE
Stéphane Lehr
ANNUAL REPORT 2006
119
Calais
S, 22 years old, and his 20
year old brother are originally
from Eritrea
Martin Mazurkiewicz
Martin Mazurkiewicz
‘I left Eritrea when I was 16 after a year
in the army. I went to Libya, then three
years later decided to come to Europe. I
wanted to go from Italy on to Great
Britain where one of my relatives lives.
But I was arrested before I got there
because I didn’t have any official
documents. I came to Calais by train. I
slept in the forest from the first evening,
without any roof over my head. I tried to
cross the Channel every day, without
really knowing how to. After one failed
attempt, I was detained for two or three
days in a police station near the Gare du
Nord in Paris where an Arabic
interpreter told me that I had to leave
the country within five days. One week
after I arrived in Calais, during an
attempt to pass through the transit zone,
a Kurdish trafficker claimed 500 euros
from me. Because I refused to pay him,
he stabbed me in the thigh. I haven’t had
any treatment for my leg. I made another
attempt to cross at Gravelines port
between Calais and Dunkirk but failed
again. Since some migrants were taken
for questioning in Calais at the end of
October, I have not gone to the evening
soup kitchen in case I am arrested.
Around thirty Eritreans are in a similar
situation here in Calais.’
> CONTENTS
(2) Sophie Brändström
> CONTENTS
(3) Sébastien Duijndam
ANNUAL REPORT 2006
121
¨ MISSION FRANCE
(4) David Delaporte
» In France, Médecins
du Monde’s
programmes often
involve mobile health
promotion and access
to rights activities
among Roma (4) or
homeless people (3).
Harm reduction linked
to prostitution (1),
drug use in raves (7)
or among marginalised
young people (5) is
also a priority.This
requires social, medical,
administrative and legal
support. Our teams
find it unacceptable
that 2 million children
live below the poverty
line. So, in addition to
paediatric check-ups
carried out in our
centres, they also fight
against lead poisoning
(2) by identifying and
protecting affected
children. Finally, the
buddying programme
supports children who
are in hospital and
separated from their
families (6).
> CONTENTS
> CONTENTS
(7) MdM
(5) Stéphane Deneuville
ANNUAL REPORT 2006
123
¨ MISSION FRANCE
THE HOMELESS AND POORLY HOUSED
Housing is a fundamental right. However, many people still do not have access to this right. In
France, there are almost 3,261,600 people who are homeless or very poorly housed. In 2006,
our distribution of more than 400 tents to people living in very precarious conditions, was one
of the detonators of the current public debate on this issue.The large majority of patients seen
by MdM-France are homeless or live in insecure accommodation.
REALISING THE
RIGHT TO HOUSING
Since 1993
Activities
Outlook
Our mobile teams go out to meet people living in the
street or in shelters.They support this vulnerable and
marginalised population, who have difficulty making
contact with public services.
To continue field work amongst the
most disadvantaged (street rounds,
welfare and medical care, medical
consultations and nursing care in
accommodation hostels, work in
partnership
with
health
and
homelessness services, participation in
the ‘cold weather plan’) and political
action (bearing witness, lobbying
institutions to set up long term
accommodation structures adapted to
the needs of homeless people).
There are three objectives:
• to identify emergency cases in the street and
take those cases to hospital;
• to inform people of their rights to access
healthcare, and to point them towards public
services and accompany them if necessary;
• in the health centres, to see those who do not
have access to healthcare and help them to reclaim
their rights and access healthcare.
Each year, MdM runs programmes throughout the
year which aim to increase access to accommodation
and long term housing. MdM bears witness to the
harmful health effects of homelessness or unfit
housing. People who are already vulnerable see
their health deteriorate because of the uncertainty
and the unsuitability of their living conditions.
All the teams in France work all year round watching
the situation through outreach street patrols, medical
consultations in shelters, and ‘nursing beds’…
Number of homeless people
in France
> 86,500 people (source: Insee - 2001)
Number of poorly housed
> 3.2 million (source: 2006 Annual report
on poor housing in France, Abbé Pierre
Foundation)
Most common conditions
> skin complaints, trauma, psychiatric
problems, psychological difficulties, ENT
and respiratory infections
Number of projects
> 18
Number of volunteers
> 301
Contacts with homeless
people
> more than 23,000
> 19% of people seen in CASOs are
Types of work
Medical and welfare consultations, street patrols:
Ajaccio, Angoulême, Le Havre, Lyons, Marseilles, Metz, Nice,
Paris, Poitiers, Strasbourg,Toulouse,Valenciennes.
Medical consultations for the homeless in ‘hostel
healthcare beds’: Bordeaux, Grenoble, Lyons, Strasbourg,
Toulouse.
Consultations in the premises of other
organisations: (Restos du Coeur, Salvation Army, Abbé
Pierre Centres, Secours Catholique, Aides, Pointe Ecoute
Sante Jeunes): Grenoble, Le Havre, Lyons, Metz, Nancy,
Nantes, La Reunion,Toulouse,Valenciennes.
Consultations in emergency accommodation
centres: Lyons, Metz, Nantes, Nice,Toulouse.
Health and welfare work in squats: Bordeaux, Calais,
Paris.
> CONTENTS
homeless
> 43% live in insecure accommodation
Characteristics of homeless
people seen in CASOs
> 32% are women
> 70% are under 40 years old
> 7% are under 18
> 75% do not have access to healthcare
Funding
> local health and welfare authorities,
town councils, regional councils
Main partners
> Abbé Pierre Foundation, Secours
Catholique, Emmaüs, Red Cross, Restos du
Cœur, Samu Social, DAL, local voluntary
organisations (Péniche, Amis de la rue,
Fournil, GAF, Enfants du Monde Droits de
l’Homme)
MIGRANTS
FACILITATING
All the programmes
(mobile and CASOs) see
immigrant populations
(in centres, asylum
seekers)
Beneficiaries
> 90% of patients seen for the first time in
the CASOs are migrants
> 73% of them have irregular or uncertain
immigration status and 20% have applied
for asylum
Key countries of origin
> Algeria, Cameroon, Morocco, Romania,
ACCESS TO HEALTHCARE
Tunisia
Since 1986
Activities
Outlook
Healthcare centres: 90% of the people seen in the 21
healthcare centres were migrants.The centres carried out
39,490 medical consultations. MdM forms a bridge, linking
people to public services. Migration pathways, generating
physical and psychological problems, are taken into
account and psychological support programmes are being
developed. In 2006, following the Paris and Marseilles
CASOs, the centres in Lyons, Rouen, Saint Denis and
Toulouse set up specific HIV/STI prevention and screening
programmes.
CAFDA (Committee for Asylum-Seeking
Families) Project: MdM has set up reception,
healthcare and referral consultations with newly-arrived
asylum-seeking families in the premises of our partner,
CAFDA. In 2006, MdM saw 356 families, equivalent to
59% of the families coming to CAFDA.
Medical project in Calais: In order to facilitate access
to healthcare for migrants in transit, MdM offers five
afternoon consultation sessions per week. More than
2,400 medical or nursing consultations were carried out
in 2006.At the beginning of 2006, some preliminary work
with local partners towards the creation of a PASS (health
care access office) paid off: it was opened in December
2006.
MdM continues to work so that anyone
can access healthcare and be referred to
public services, irrespective of their
status. Mission France continues to
develop prevention, HIV, hepatitis and
STI screening programmes as well as
psychological services. Active in 11
European countries,MdM has created an
European Observatory on Access to
Healthcare which is committed to
improving access to healthcare for
vulnerable migrants in Europe as well as
bearing witness to the difficulties they
experience. In addition, it lobbies EU
institutions.
Types of work
Our programmes offer consultations, disseminate prevention
messages and refer migrants to partners and public health
services. Testimony on the living conditions of this population
can help to slow down the process which sees their rights being
taken away from them.Closely linked to the analysis of social and
medical data recorded by each healthcare centre, these
testimonies contribute to the project activity reports and to our
lobbying of relevant institutions.
> CONTENTS
ANNUAL REPORT 2006
125
> osteo-arthritis, respiratory infections,
gastro-enterology, psychiatric, skin
complaints, obstetric-gynaecological and
psychological problems
> 88% of migrants seen do not have
access to healthcare when they come
to an MdM CASO for the first time
Number of projects
> all programmes
> more than 2,000
Funding
Regional councils,Town councils, Regional
and national health insurances (CRAM,
CPAM)
Partners
> CASP, Cimade, Gisti, LDH, Anafé, CFDA,
Comede, involvement in ODSE
(Observatory on Migrants’ Right to
Health), local and regional voluntary
sector organisations
¨ MISSION FRANCE
Migrants, particularly as the elections approached, have become scapegoats, held
responsible for all the economic ills and social tensions. Recent legislation on immigration
makes life on French soil harder: cancelling the right to regularisation of immigration status
after 10 years in France, a hardening of the policy on family reunification, a dramatic drop
in the numbers of people awarded refugee status, increasing requirements for asylum
requests, reversal of the policy permitting regularisation for medical reasons, difficulties in
renewing residency permits and edicts recommending questioning of irregular migrants
even in health services or when called to the prefecture. Although the legislation on
regularisation of families with children in school raised great hopes, it also brought arrests
and excluded many who should have been included.Access to free healthcare in hospitals
is still a dream: many PASS (healthcare access offices) are not working, the regulation
enabling urgent treatment excludes a considerable number of people who cannot
therefore access healthcare.
LEAD POISONING IN CHILDREN
Children are more vulnerable when faced with exclusion, poverty and illness. According to
the report by the Council on Employment, Revenue and Social Cohesion (CERC), two
million children live below the poverty line. The number of children affected by lead
poisoning in France is estimated at around 85,000. On top of the lead poisoning
programmes, paediatric monitoring is carried out in the healthcare centres. Since 1993,
M decins du Monde has been running programmes to tackle lead poisoning, which aim to
identify and protect children. The lead poisoning project has been working in Hauts-deSeine since 2003 as part of the mission banlieue. In Poitiers, the team has been working
since 1997, in cooperation with the hospital, to initiate screening and awareness-raising
amongst families.
IDENTIFYING
AND CARING FOR EXPOSED CHILDREN
Child lead poisoning programme since 1993
Beneficiaries
> 1,756 children under 18 years (8% of
patients seen in CASOs) were seen in
CASOs in 2006
> ENT, respiratory conditions...
Activities
Outlook
Lead Poisoning results from ingestion of lead from the
paint on the walls of buildings built before 1948. When a
building is very run down the paint flakes and its dust can be
ingested by children, causing poisoning which affects the
central nervous system.The effects are irreversible and there
is no treatment.The only solution for child lead poisoning is
prevention.
MdM’s project involves three areas of work:
• identifying unsafe housing and informing families to increase
take-up of screening;
• following up with affected families to ensure protection of
the children,whether by improvements in the building or by
re-housing;
• mobilising all those involved in local health, housing, and
rights to develop a more effective network.
These activities are done in collaboration with the public
services, including health authorities and medical
professionals,mother and child health services,paediatricians,
school doctors and town environmental health services.
Lead poisoning: MdM’s mission
banlieu wants to consolidate the
network set up in Hauts-de-Seine to
ensure a long-term approach to
tackling child lead poisoning, and in
order to take action in the other
departments of the Parisian suburbs.
The Poitiers programme continues its
activities in co-operation with the
town hospital services.
Funding
> local health authorities, health insurance
offices (CPAM), regional councils
Number of children
potentially affected by lead
poisoning
> 85,000 (source: INSERM study 1999)
Number of projects
>2
>9
Main partners
> Association of families who are victims
Types of work
Lead poisoning programme: identification of unsafe
buildings, informing families, screening children, following up
families of affected children, mobilisation of those working
locally in health, housing and rights.
CASO: paediatric consultations, referral to mother and
child health services. All healthcare centres see children.
The mission banlieue organised a conference at the Ministry
of Health on 7 November 2006, in partnership with the
Abbé Pierre Foundation.The aim was for all those working
in health,housing,and social policy to work together to tackle
lead poisoning more effectively.
> CONTENTS
of lead poisoning, local health and social
authorities, Abbé Pierre Foundation, Pact
Arim 92, ADIL, Mother and Child Health
Protection service, ASDES, Poitiers
environmental health service, Poitiers
medical and social services
ROMA
127
1992,
1994,
2001,
2002,
EXPELLED FAMILIES
mission banlieue in Ile de France: first project with Roma migrants
opening of a Roma project in Strasbourg
opening of a Roma project in squats and shanty towns in Lyons
Roma project in Nantes opens
Activities
Outlook
MdM teams visit places where Roma live to help
them get access to healthcare and their rights. This
health monitoring is aimed particularly at health
education and promotion, schooling for children,
access to drinking water and mother and child health.
Continue our activities, focusing
attention on children, monitoring for
tuberculosis, improving access to
immunisation, defending the right to
health. Develop mother and child
health activities. Strengthen our
testimony on the health consequences
of expulsions and raise awareness
among those working locally. As part
of the Romeurope collective, MdM
will continue to mobilise against the
discrimination which Roma face in
France and to promote access to their
rights.
The Ile de France Roma project carried out 65 visits,
88 paediatric and 57 obstetric-gynaecological
consultations and 25 information campaigns on
reproductive health. Thirty-nine children were
enrolled at school and, of these, 23 stayed.
The mobile Roma project in Lyons went to eight
places and saw almost 900 people, of which 58.8%
were women. Despite a major partnership with the
mother and child health services and the
Departmental social hygiene service, several
expulsions took place and both the inhabitants and
the people working in the field felt the effects:
belongings destroyed, links with health services and
schools broken…
The Lyons programme participated in the CLASSES
collective to promote child schooling. Collaboration
with midwives for the CASO improved the care for
pregnant women.
A partnership with the Vinci Foundation enabled
improvement works to be carried out on a site
occupied by Roma in Villeurbanne.
Types of work
• Health monitoring: primary care and referral to public
health services;
• Facilitating child schooling: raising awareness, administrative
procedures and vaccination;
• Sanitation: lobbying local councils for improvements to
hygiene conditions on sites;
• Partnership with the Vinci Foundation to improve a site in
Villeurbanne;
• Perinatal health: preventing terminations, monitoring
pregnancies, providing information on contraception, child
immunisation, accompaniment to mother and child health
services and family planning centres;
• Bearing witness to living conditions, repeated expulsions,
obstacles impeding access to healthcare and other rights;
• Mobilising Roma family support committees, and those
working in health services, councils and other government
services.
Main conditions
> illness linked to living conditions, delays
in accessing healthcare in France and in
country of origin, and to psychological
trauma due to repeated expulsions
Epidemiological
characteristics
> early neonatal mortality (0–1month): 9
times higher
> infant mortality (0–1 year): 5 times
higher
> life expectancy: 15 to 20 years lower
than for the French population in general
(Romeurope data, 2000)
Number of projects
>4
Number of project
beneficiaries
>more than 3,500, including 2,700 in Ile de
France
> 39
Funding
Regional councils, town councils
Partners
> Alpil, ASAV, ATD Quart Monde LDH,
MRAP, support networks for Roma
families, Romeurope, municipal mother and
child health protection services, healthcare
access offices (PASS), CLASSES collective
> CONTENTS
¨ MISSION FRANCE
SUPPORTING
ANNUAL REPORT 2006
Roma leave their country of origin to flee racial discrimination and poverty. In France,
however, they still face extreme living conditions, surviving in shanty towns or in squats.
The increase in expulsions weakens them and makes their lives even more insecure.
These expulsions often lead to a break in continuity of care, a fundamental principle
for medical practice. Often forced into living clandestinely, many Roma are refused
access to healthcare and, more generally, to their fundamental rights.
TRAVELLERS
The rights of travellers are under threat.These violations have physical and psychological
repercussions. The Besson law on travellers is ignored, because only 15% of town
councils of more than 5,000 inhabitants really comply with their obligation to provide
reception sites reserved for travellers. In addition, the 2006 finance law introduced a plan
to tax mobile homes (several tens of euros per square metre) even though they are not
recognised as accommodation.
FACILITATING
ACCESS TO FUNDAMENTAL RIGHTS
Since 1997
Activities
Outlook
MdM’s mobile teams have two aims: to meet
travellers where they live and to help them to have
their rights recognised.
Continue activities aimed at improving
hygiene, living conditions and health of
travellers and at facilitating their
access to public health and welfare
services and, more generally, to
citizenship. MdM’s teams are
represented on several authorities,
including the Departmental Consultative
Commissions on the reception plans
for travellers. The stigmatisation that
they are subjected to is hard to bear.
Identifying delicate psychological
situations and cases which are likely to
get worse is also a priority when
supporting travellers.
In fact, there are few reception sites and when they
do exist, the living conditions on these sites are very
insecure: no sewage system, poor access to running
water and electricity, rats, a lack of toilets. These
regular site visits also enable the team to establish
contacts and to encourage dialogue and listening.
MdM is carrying out the following activities:
• support, counselling and referral activities;
• facilitating access to healthcare, to rights and to
school for children;
• lobbying the public authorities to create reception
sites for travellers. Organisations defending travellers’
rights, are calling for this illegitimate and unfair tax to
be dropped. Their priority is the recognition of
caravans as accommodation and the associated social
rights. In addition, they want to participate in the
institutions dealing with travellers’ issues, such as the
National Consultative Commission and the HALDE
(High Authority Fighting Discrimination and
Promoting Equality) for discrimination cases and to
promote equality.
Types of work
Listening, psychological support, prevention and information
messages.
Primary healthcare, help with access to schooling and to
housing, referral to other public welfare and health services
Lobbying town councils, health institutions and health
professionals to improve hygiene, living and health
conditions; promoting the recognition of citizenship.
Participation in the departmental consultative commissions
on the reception plan for travellers.
> CONTENTS
Beneficiaries
> in 2005: approximately 100
Main conditions
> depression, cardiovascular disease, drug
or alcohol dependency
Social characteristics
> isolation, poor education, social
exclusion
Number of projects
>2
>4
Funding
URCAM (Union of Regional Health
Insurance Offices)
Partners
> Relais Accueil Gens du Voyage, co-
ordinating body for travellers, Alliers Social
Centre, LDH, CCAS, schools, town
councils
PEOPLE WORKING IN PROSTITUTION
SUPPORT THROUGH
PREVENTION AND INFORMATION
Since 1999
Activities
Outlook
Promoting the health and the rights of people
working in prostitution. Mobile units do night
rounds of prostitution sites, and they distribute
prevention
materials
and
provide
an
environment for listening and answering
questions from the women.There are also sessions
inside premises to allow more detailed individual
check-ups (consultations, screening, listening…) and
health workshops. The teams offer physical
accompaniment when necessary, to go with the
women to the public services they have been referred
to and facilitate communication if they do not speak
French. Working groups adapt and translate, if
necessary, information on risks linked to
HIV/STIs/hepatitis and on rights. Our regular visits to
prostitution sites, enable us to build up relationships
of trust with people working in prostitution, allowing
us to take steps together to address medical and
social issues.
The Internal Security Law has displaced
prostitution sites. Today, the teams know
that they can’t reach all the people working
in prostitution. It is important, therefore, to
be able to map the current situation so that
we can reach people who are not working
in street prostitution, but have the same
needs in terms of access to prevention, to
healthcare and to their rights. The
programmes want to continue to improve
their advocacy work, particularly on the
health and social consequences of this law.
ANNUAL REPORT 2006
129
Beneficiaries’
characteristics
> often from Eastern Europe, sub-Saharan
Africa and rural China. Either holding
tourist visas, applying for asylum or staying
illegally, sometimes the victims of
trafficking
> Main conditions
gynaecological conditions; illness linked to
conditions on the street, psychological
problems linked to stress, isolation and
abuse; drug or alcohol dependency
Number of projects
> 6 mobile street teams, closely linked to
CASOs and to harm reduction projects
working with drug users
Number of beneficiaries
> data is very hard to obtain, more than
800 individuals
> 98
Partners
> Arcat, Cabiria, Friends of the Women’s
Bus, AIDES, Gasprom, Anti Human
Trafficking Platform, anonymous screening
centres (CDAG), town councils, Moulin
Joly, family planning
Types of work
Metz: creation of a mobile service with the organisation Aides. The programme finished in the last quarter.
Montpellier: on top of its evening activities in the town centre, the programme set up a weekly day-time session on the
main national roads.
Nantes: the bus goes round the town two or three nights per week. Physical accompaniment to the hospital and to
access healthcare, rights, registering complaints and at hearings on soliciting. Help to enrol in literacy courses. Running
themed health workshops.
Paris: three sessions per week on the streets. Adapted and translated information in Chinese, referrals and
accompaniment with interpreters if needed. Running themed health workshops.
Poitiers: two sessions per week; day and night patrols once a week with the L’Abri collective.
Rouen: bus visits once a fortnight, alternating with the Aides association, and an infectious diseases screening programme.
> CONTENTS
¨ MISSION FRANCE
Since the Internal Security Law was implemented in 2003, life has generally become
harder for people working in prostitution. In addition to the criminalisation of passive
soliciting which is largely arbritary, the majority, who have irregular immigration status,
have also experienced the current repressive context for foreigners. People working in
prostitution, who are particularly at risk of sexually transmitted infections, encounter
many obstacles to healthcare and their other rights. For example, they are subjected to
violence and abusive arrests, and often have housing problems. The need to remain
invisible, since the Internal Security Law came into force, drives people to work in
hidden areas, distancing them from support organisations. In addition, clients take
advantage of the criminalisation of passive soliciting and threaten to report people
working in prostitution and robbery, rape and other forms of violence are becoming
more common.
HARM REDUCTION AND NEEDLE EXCHANGE
Since 2006, the needle exchange programmes have been recognised as medical-social
establishments and are financed by health insurance, as CAARUDs (Centres for support and
harm reduction among drug users) on condition that they carry out specific work (reception,
referral, accompaniment...).As part of the move to becoming CAARUDs, the Paris, Bordeaux
and Marseilles programmes left MdM at the end of 2006 and Bordeaux left at the very
beginning of 2007.They have now become autonomous associations set up by the field teams,
supported by MdM. Negotiations with the government and health insurance on the transition
of these programmes to medical-social establishments were a key part of the work in 2006.
SUPPORTING
A MARGINALISED POPULATION
Activities
Outlook
Providing sterile equipment reduces the risks
associated with drug use. This also allows
direct contact with a population which is often
pushed to the margins and facilitates access
to information and to existing public services
for this population. Once the link is established, the
teams can also spread prevention messages, listen to
drug users and give guidance on medical, social or
legal issues. These include accommodation, rights,
resolving legal issues, withdrawal, post-treatment care
and substitution treatment.
Improving prevention and access to treatment
for hepatitis C for drug users is a priority. The
increase in polydrug use and the new users we
meet show that we need to update our tools
and skills to adapt our prevention work to the
changing context.
As part of the transition to CAARUDs,three of
our five needle exchange programmes were
autonomous by the end of 2006:
•The Paris programme transferred to the GAIA
Paris association;
• The Bordeaux programme transferred to the
La Case association;
• The Marseilles programme transferred to the
Bus 31-32 association.
The Angoulême programme also became a
CAARUD supported administratively and
financially by the organisation Aides which has a
signed partnership with MdM.
The teams stay in contact with MdM and are
involved in the Harm Reduction Collective
which brings together the harm reduction
programmes which have been transferred from
MdM as well as the ongoing MdM harm
reduction programmes.
Hepatitis C screening takes place in Paris and
Bordeaux (saliva tests in Paris and blood testing in
Bordeaux). If the results are positive, drug users are
then offered treatment. The harm reduction
programmes are implemented depending on the
context: inhalation straws for ‘sniffers’, crack pipe
mouthpieces to avoid burns and hepatitis C
transmission, sterifilts which enable filtration of noninjectable substances at the end of the syringe…The
field teams are continually involved in research and
survey work to improve the quality of their activities.
Street work often complements the work carried out
in the mobile units.
Types of work
Five mobile units:bus, vans and outreach teams visit drug users on the
streets or in squats.
Three day-centres in Bordeaux,Paris and Marseilles for needle exchange.
Provision of sterile injecting equipment in all the CASOs.
229,319 needles distributed, 41.5% of used needles were returned in 2006.
> CONTENTS
Common conditions
> infections linked to drug use (Hep C,
HIV, Hep B), abscesses, psychiatric
problems, dental problems, psychological
difficulties linked to social exclusion.
Marginalisation,
discrimination and social
damage: our findings
> poly drug use and new consumption
habits (injection, sniffing, ingestion etc)
> high prevalence of hepatitis C in drug
users
> increasing numbers of young users seen
(under 25), with a high proportion of
young women
> dossier of almost 3,700 drug users for
more than 12,000 contacts at the mobile
units and centres. More than 15,000 other
visits (provision of information, signposting
and other needs)
> 84 within mulit-disciplinary teams
Funding
> mainly government funding through local
health and welfare services, territorial
collectives, health insurance offices
(CPAM),the National Fund for Health
Prevention, Education and Information
(FNPEIS), town councils, regional health
insurance offices (CRAM)
Partners
> Ministry of Health, Inter-ministerial task
force on drug use and addiction (MILDT),
French Observatory on Drugs and Drug
Dependence (OFDT) and all the harm
reduction services of the towns where we
work
METHADONE BUSES
131
ANNUAL REPORT 2006
Methadone is an opiate substitution treatment. It relieves withdrawal sensations and
reduces the risks linked to drug use. Within a substitution programme, we can also
accompany drug users towards social re-integration and monitor their health. This is
extremely important for this population who are extremely vulnerable and often
marginalised and who have very often lost all links with health and social services.
DAILY OUTREACH WORK
Since 1998
Outlook
We aim to treat opiate dependency by
introducing and monitoring substitution
treatment with methadone. Set up in drug use
sites, our buses create a space to welcome
drug users and provide guidance on medical,
social and psychological issues. All drug users can
benefit, although the programmes particularly focus
on the most marginalised people who will not
approach mainstream services. Our teams offer
personalised services, depending on each user’s needs
and deliver a daily dose of methadone to each patient.
Patients are included from the day they request it,
with treatment provided in a healthcare centre after
a medical interview. Supporting the most problematic
users is a integral part of our activities.We refer them
to other services and the bus becomes a bridge
between the users and mainstream medical services.
To date, these are the only methadone buses in
France: by going to users and having a very low
threshold to access the programme, they are able to
treat a very vulnerable group of users.
In Paris, the methadone bus has been
a medical-social establishment since
September 2003. This programme,
combined with the needle exchange
programme
which
became
a
CAARUD in September 2006, was
transferred to the association GAIA
Paris on 1 December 2006.
In Marseilles, the methadone bus
transferred its activities to the
association Bus 31-32 on 1 December
2006.
These programmes are still linked to
MdM and are involved in the Harm
Reduction Collective which brings
together all the harm reduction
programmes which have been
transferred from MdM as well as the
ongoing MdM harm reduction
programmes.
Types of work
Mobile healthcare units on duty seven days a week.
Local outreach teams.
Reception in centres.
> CONTENTS
Drug users
> more than 100,000 estimated injecting
drug users (source: OFDT – BEH N° 33
september 2006)
Common conditions
> HIV, hepatitis B and hepatitis C infection
in injecting drug users, psychiatric
problems (dual diagnosis), psychological
problems linked to social exclusion
> 213 in Marseilles and 484 in Paris,
equivalent to a total of 697 individuals
> 28
Number of contacts
>nearly 40,000
Funding
> health insurance offices (CPAM),local
health and welfare authorities (DDASS),
Solidarité Sida, Sidaction, local and regional
authorities
Partners
> ASUD (Drug users’ self-help group), Le
Tipi, Sleep’ in, drug addiction treatment
centres (CSST) in Marseilles and Paris,
hospitals, treatment and post-treatment
services etc
¨ MISSION FRANCE
Activities
RAVES
The policy towards raves has lead to a fall in the number of medium-sized free parties .
Now parties with a maximum of 500 people are more common. However, because of
the legislation around these events and the media hype, a massive increase has been
seen in the number of participants at Teknivals.
During these festival days, we have faced co-ordination difficulties with the public
authorities, whose approach is more oppressive than health oriented. Testing or RPP
(presumptive identification of products) is still banned (Decree of 14 April 2005) and
this restricts the preventive approach.
PROVIDING
Beneficiaries
> more than 31,000
INFORMATION ABOUT RISKS
Sex, age
> mainly young men (average age, 25)
Since 1997
Activities
Outlook
Harm reduction activities linked to use of psychoactive substances. We have had to change our
activities to respond to the changing context.
To adapt the programmes’ working
methods (in squats for example).
To maintain our lobbying for the
authorisation of RPP as a relevant
tool.
To develop prevention tools and
flyers, adapted to the polydrug use
culture which is evolving.
To adapt our working methods to the
public needs (reduced-risk injection
spaces).
In squats: to ensure sustainability of
the project and to strengthen the
current approach, particularly in terms
of medical-psychological-social sessions.
At Teknival, our programme includes five activities:
• welcome (prevention table, making harm reduction
documents and equipment available, injection kits,‘roll
your straw’…);
• healthcare (doctor and nursing care);
• reassurance (supervised chill-out area, coming down
from bad trips, space for receiving and diagnosing
breakdowns);
• analysis of drugs using TLC (thin layer
chromatography - the only analysis legally permitted)
At the Teknival on 1 May, RPP (presumptive
identification of products) was also carried out in
order to raise public awareness and convince
legislators on the legitimacy of this tool.
and other halucinogens, amphetamines,
heroin, anaesthetic substances (GHB,
ketamine)
Common conditions
> HIV/hepatitis C, withdrawal, psychiatric
problems, anxiety, bad trip, dependency,
different physical conditions, headaches,
vomiting
Most common risks
> HIV/hepatitis C, bad trips, dehydration,
hypothermia/overheating, hypoglycaemia
Number of interventions
> 92 including 3 joint projects at Teknivals
> 172
Funding
> Ministry of Health, local health
Types of work
In free parties and cross-border clubs.
In squats, during parties but also, importantly, on
other days. The Rave programme in Paris has
redirected some of its activities towards squats. The
team sets up harm reduction stands each Friday
evening, and visits around three squats each week and
carries out TLC analysis.
Substances
> alcohol, cannabis, ecstasy, cocaine, LSD
All the programmes practise first aid, provide information
and product analysis to reduce the risks linked with drug
use.
Activities in places where young people get together: free
parties,Teknivals, discotheques, clubs, squats…
In 2006, 12 samples (all drugs) were collected, documented
and analysed under the SINTES programme co-ordinated by
OFDT (French monitoring centre for drugs and drug
addiction).
> CONTENTS
authorities (DDASS), Inter-ministerial task
force on drug use and addiction (MILDT),
French Observatory and Drugs and Drug
Dependence (OFDT), local and regional
authorities
Partners
> Techno Plus, Aides, Blue Orange, drug
users self help group (ASUD),Tipi, Act Up,
Acothé, Nantes daycentre, Espace
Indépendance, Sida Paroles, Association
Liberté, Bizia, La Fratrie
BUDDYING CHILDREN IN HOSPITAL
ANNUAL REPORT 2006
133
The psychological balance of a sick child is important,or rather essential,for his or her recovery.
From babies to teenagers, all paediatricians confirm that emotional support is fundamental for
the process of fighting illness.
Many children, often from disadvantaged areas, are regularly hospitalised in or near Paris to
receive treatment for illnesses which are very difficult or impossible to treat near their home.
They come from sub-Saharan Africa, North Africa, La Reunion, Mayotte and Guiana and also
from the regions in France. Many of them arrive alone in the unknown and hostile universe of
the hospital.Their parents are unable to accompany them for financial or practical reasons.
SICK AND ISOLATED CHILDREN
Since 1988, the buddying programme has supported 1,400 isolated children
during their hospital stay
Activities
Perspectives
Buddying is launched like an emergency programme.To ease
the emotional pain of separation, to help the child to deal
with his or her illness and to promote recovery, the
relationship has to be created quickly. It is like an energy
transfusion for the children in psychological distress,who are
sometimes at risk of severe depression or institutionalisation.
Three visits per week are essential to establish this bonding
with the child which,according to the neuropsychiatrist Boris
Cyrulnik,will help the child to draw on its own resources to
survive.
Sadly, in 10 percent of cases the volunteers accompany the
child to the end of his or her life.These children will also have
experienced a solidarity that goes beyond race and culture.
The volunteers always try to maintain, or even restore,
contact with the parents.It is vital to completely respect the
child’s identity.
In French Guiana,half of the buddying begins in the neo-natal
department where premature children benefit from the daily
presence of MdM volunteers.
The partnerships developed with the hospital teams goes
from strength to strength.
The buddying programme is now actively involved,alongside
care staff, in the project to humanise hospitals by creating
social links with this group of isolated, and usually very
disadvantaged, children.
Propose the implementation of a
programme in regional delegations:
Lyons, Marseilles…
Recruit and train new volunteers in
French Guiana so that we can respond
better to the needs.
Training in listening and providing
support to improve the quality of the
support given to children.
Types of work
Paris and the Paris area
French Guiana
At least three visits per week to children, including one at
the weekend (the rhythm and length of the visits depends on
the age of the child and his or her illness).
Possible outings from hospital, health status permitting.
Repatriation of children according to the medical team’s
requests.
MdM undertakes to carry out the recruitment and training
of volunteers, to organise discussion groups and ongoing
training.Volunteer co-ordinators supervise the buddies.
> CONTENTS
Number of children:
> 187
> In the Parisian region: 146
Country of origin: France (La Reunion,
Mayotte, Antilles), Africa, north Africa
> In French Guiana in 2006: 41
> 104
> Parisian region: 91
> In French Guiana: 13
Partners
Paris:
> Paediatric services in AP-HP hospitals:
Necker Enfants Malades,Trousseau, Robert
Debré, Saint-Louis
> Paul Parquet creche
> 3 long stay Centres: Margency Red
Cross Centre, Côtes à Jouy-en-Josas
Centre, Paediatric Re-education Centre in
Bullion
French Guiana:
> Cayenne paediatric hospital
¨ MISSION FRANCE
ACCOMPANYING
Health and deprivation
Contacts (harm reduction)
Reforming medical education
Strasbourg
Nancy
Clermont Ferrand
Grenoble
METHADONE BUS/
HARM REDUCTION,
SQUATS,
RAVES
NICE
Philippe de BOTTON
Médecins du Monde
34, rue Rossini
06000 NICE
Tel: 04 93 28 80 08
[email protected]
MARSEILLES
Béatrice STAMBUL
Médecins du Monde
4 avenue Rostand
13 003 MARSEILLES
Tel: 04 95 04 56 06/08
Fax: 04 95 04 56 07
[email protected]
Bordeaux
Montpellier
RAVES
ANGOULEME
Valérie PATRIER
Health listening bus - ANGOULEME
Marie-Laure FERRARI
Médecins du Monde
22,Allée du Champ Brun
16000 ANGOULEME
Tel: 05 45 65 11 82 ou 05 45 65 07 47
Fax: 05 45 61 18 85
Mobile: 06 25 64 63 14
[email protected]
Lille
Paris
NEEDLE EXCHANGE
BUS
Nice
PPMU /
METHADONE BUS
University Degree, 3rd cycle
Optional module, 2rd cycle
Lobbying and ministerial meetings / training curriculum
The part of the medical curriculum dedicated to the physical, social
and psychological aspects of health and deprivation has been
reduced.The medical profession, especially general practitioners
because of their close knowledge of families and the environments
they live in, have a vitally important role to play in prevention,
screening and early treatment of disease. However, initial medical
training has very little content relating to public health or, more
specifically, relating to poverty and exclusion.
In several regional delegations, new initiatives have been launched.
Activities at the national level have been set up in order to reform
national programmes.To date, six University Degrees dealing with
issues relating to health and deprivation have been introduced.
PARIS
Jean-Pierre LHOMME
Médecins du Monde
62 bis avenue Parmentier
75011 PARIS
Tel: 01 43 14 81 61
Fax: 01 47 00 80 70
Tel methadone bus: 06 15 45 46 71
Tel van: 06 15 02 65 12
[email protected]
[email protected]
HARM REDUCTION
BORDEAUX
Jean-Pierre DAULOUEDE
Guy MAYER
Médecins du Monde
2 rue des Etables
33800 BORDEAUX
Tel: 05 56 92 51 89
Fax: 05 56 92 03 59
[email protected]
> CONTENTS
BAYONNE
Jean-Pierre DAULOUEDE /
Jean-Luc PRADEILLE
Médecins du Monde/BIZIA (methadone
centre)
Centre Hospitalier Côte Basque – Bât.
Zabal
BP 8 - 64108 BAYONNE Cedex
Rave port 06 03 21 21 57
Tel: 05 59 44 31 05
Fax: 05 59 44 31 03
[email protected]
TOULOUSE
Olivier DROUAULT
Julien SANCHEZ
Médecins du Monde
5, boulevard de Bonrepos
31000 TOULOUSE
Tel: 05 61 63 78 78
Fax: 05 61 62 04 15
[email protected]
RAVES / SQUATS PROGRAMME
PARIS
Benoit DELAVAULT
Alexandre PEYRE
Médecins du Monde
75011 PARIS
Tel: 01 43 14 81 68 / 81 54
Fax: 01 47 00 80 70
[email protected]
XBT PROGRAMME/
DRUG ANALYSIS
PARIS
Stéphane LE VU
Médecins du Monde
75011 PARIS
Tel/Fax: 01 43 14 81 69
[email protected]
Contacts (mobile projects) – medical outreach
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
SAINT-DENIS IN REUNION
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
[email protected]
STRASBOURG
Catherine FRAPPARD
Médecins du Monde
24 rue du Maréchal Foch
67000 STRASBOURG
Tel: 03 88 14 01 01
Fax: 03 88 14 01 02
[email protected]
PREVENTION WITH
PEOPLE WORKING IN
PROSTITUTION
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]
MONTPELLIER
Frédérique CARRIE
Médecins du Monde
18, rue Henri Dunant
34090 MONTPELLIER
Tel: 04 99 23 27 17
Fax: 04 99 23 27 18
[email protected]
HOMELESS AND
POORLY HOUSED
STRASBOURG
Catherine FRAPARD
Médecins du Monde
24, rue du Maréchal FOCH
67000 STRASBOURG
Tel: 03 88 14 01 01
Fax: 03 88 14 01 02
[email protected]
PARIS
Graciela ROBERT
Paul ZYLBERBERG
Médecins du Monde
62 bis Avenue Parmentier
75011 PARIS
Tel (from 9-11pm): 01 43 14 81 74
Fax: 01 43 14 81 51
[email protected]
CHILDREN
Child lead poisoning
BANLIEUE
Claude CHAUDIERES
Mission Banlieue
Médecins du Monde
8-10, rue des Blés
93210 La Plaine Saint Denis
Tel: 01 55 93 19 37
Fax: 01 55 93 19 30
[email protected]
NANTES
FUNAMBUS
Paul BOLO
Médecins du Monde
33, rue Fouré
44000 NANTES
Tel: 02 40 47 36 99
Fax: 02 51 82 38 09
[email protected]
BUDDYING
PARIS
LOTUS BUS
Marie DEBRUS
Médecins du Monde
62 bis, avenue Parmentier
75011 PARIS
Tel: 01 43 14 81 61
Fax: 01 47 00 80 70
[email protected]
POITIERS
Magali CATHALIFAUD
Médecins du Monde
21 rue Boncenne
86000 POITIERS
Tel: 05 45 65 07 47
Fax: 05 45 61 18 85
[email protected]
ROUEN
Jean-Jacques PREY
Médecins du Monde
5, rue d’Elbeuf
76000 ROUEN
Tel: 02 35 72 56 66
Fax: 02 35 73 05 64
[email protected]
TRAVELLERS
PROGRAMME
Catherine PETERMAN
Médecins du Monde
62, rue Marcadet
75018 PARIS
Tel: 01 44 92 13 10
Fax: 01 44 92 99 92
[email protected]
ROMA/TZIGANES
BANLIEUE
Bernard MORIAU
Médecins du Monde
8-10, rue des Blés
Tel: 01 55 93 19 38
Fax: 01 55 93 19 30
[email protected]
Squats project
LYONS
Monique Ardiet
Thérèse Nandagobalou,
Maïeule Nouvellet
le bus – LYONS
Médecins du Monde
13 rue Sainte Catherine
69001 LYONS
Tel: 04 78 29 59 14
Fax: 04 78 29 55 91
[email protected]
> CONTENTS
135
ANNUAL REPORT 2006
LYONS
Françoise MICHAUD
Médecins du Monde
1, place du Grffon
69001 LYONS
Tel: 04 78 29 59 14
Fax: 04 78 29 55 91
[email protected]
METZ
René MOUTIER, Frédérique CARRIE
Médecins du Monde
11, rue Saint-Pierre
57000 METZ
Tel: 03 87 63 55 91
Fax: 03 87 66 60 93
[email protected]
Squats project
BORDEAUX
Guy and Liane MAYER
Médecins du Monde
2 rue Charlevoix de Villers
33000 BORDEAUX
Tel: 05 56 48 52 52
Fax: 05 56 52 77 69
[email protected]
TOULOUSE
Marie-Pierre BUTTIGIEG
Médecins du Monde
31000 TOULOUSE
Tel: 05 61 63 78 78 /
Fax: 05 61 62 04 15
[email protected]
CAFDA PROGRAMME
PARIS
Fabrice GIRAUX
Marc LERICHE
44, rue Planchat – 75020 Paris
Tel / Fax: 01 45 49 03 80
Mobile: 06 09 68 02 33
[email protected]
HEALTHCARE FOR
MIGRANTS
CALAIS
Philippe PLUVINAGE
Guy DEHAUT
Martine DEVRIES
Médecins du Monde c/o Dr Martine
DEVRIES
12 rue des Soupirants
62100 CALAIS
Contact: Martine DEVRIES 06 88 75 18 85
[email protected]
Contact: Philippe PLUVINAGE 06 75 54 96 14
[email protected]
¨ MISSION FRANCE
MOBILE PROJECTS
STREET ACTIVITIES
Contacts (CASOs - 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 Sec.Cath. 6 bd Casanova
Tel: 04 95 51 28 93
fax: 04 95 21 17 13
postal address: 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]
BANLIEUE
Jeanine ROCHEFORT
Médecins du Monde
8-10, rue des Blés
Tel: 01 55 93 19 29 /
Fax: 01 55 93 19 30
Michael: 01 55 93 19 32
[email protected]
BESANCON
Violaine LLORCA
Médecins du Monde
Appartement 168003
7 rue du Languedoc
25000 BESANCON
Tel: 03 81 51 26 47
Fax: 03 81 52 70 28
[email protected]
BORDEAUX
Christophe ADAM
Médecins du Monde
2 rue Charlevoix de Villers
33000 BORDEAUX
Tel: 05 56 79 13 82 /
Fax: 05 56 52 77 69
[email protected]
CAYENNE
Sylvie CREGUT
Stéphane GARNIER
Médecins du Monde
32 rue Vermont Polycarpe
97300 CAYENNE
Tel/Fax: 05 94 28 36 77
[email protected]
NANCY
Jean-François LE CORVOISIER
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]
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]
NANTES
Anne LIBEAU
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]
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]
NICE
Michel de SWARTE
Médecins du Monde
34 rue Rossini
06000 NICE
Tel: 04 93 16 59 60
Fax: 04 93 16 59 61
[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]
LYONS
Karen FINSTERLE
Marc CUCHE
Médecins du Monde
13, rue Sainte-Catherine
69001 LYONS
Tel: 04 78 89 99 99
Fax: 04 78 71 75 72
[email protected]
PARIS
Claude MARTINE
Médecins du Monde
75011 PARIS
Tel: 01 43 14 81 81
Fax: 01 47 00 75 53
[email protected]
MARSEILLES
Georgia COUFFIN GUERIN
Michel GLASS
Médecins du Monde
4 avenue Rostand
13003 MARSEILLES
Tel: 04 95 04 56 00 ou 03
Fax: 04 95 04 56 04
[email protected]
MONTPELLIER
Fabien BEZEL
Marie Bernadette CADILHAC
Margarita GONZALEZ
Eve MOINEAU-QUENT
Médecins du Monde
34090 MONTPELLIER
Tel: 04 99 23 27 10
Fax: 04 99 23 27 18
[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]
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]
> CONTENTS
» MOBILISATION
137/146
> CONTENTS
Isabelle Eshraghi
Wilfried Maisy
MdM
Nicolas Lainez
Robert Mulder
David Delaporte
Meura
> CONTENTS
Elisabeth Rull/Item
Project: London
Palestinian territories
JANUARY
FEBRUARY
Key Events
Key Events
16 January: Project: London, Médecins
du Monde UK’s first project on access
to healthcare in East London was
launched. Nine doctors, 12 nurses and 15
other volunteers, work in partnership with
three local organisations (Praxis, Providence
Row and U-Turn). The teams provide advice
and primary healthcare to vulnerable people
and help them to access mainstream
services.
MdM criticised the international
economic embargo of the occupied
Palestinian Territories introduced by the
main Western donors after Hamas’
election victory. Severely affected and
weakened since 2000, the Palestinian population
will have to experience the suspension of all
direct aid from the European Union and the
United States.This measure, on top of existing
poverty and unemployment, hastens the
deterioration in the health system. Having
supported the health services in the Territories
for 10 years, MdM warned of an emergency and
the direct and immediate humanitarian
consequences of this sanction on health
services.Although we decided to ensure
continuity of care by donating medicines to
Gaza and Nablus hospitals, we are conscious
that humanitarian action should not hide the
responsibilities of international donors who
should respond to the fundamental needs of the
civilian population.
> CONTENTS
» MOBILISATION
Bruno Fert
Andrew Aitchison
ANNUAL REPORT 2006
139
Véronique Burger/Phanie
D.R
Isabelle Eshraghi
Dar-ul-Aman, in Pakistan
Seminar on humanitarian surgery
Healthcare and guidance centre (CASO)
MARCH
commitments of the Pakistani government,
to be deprived of their most basic rights.The
only NGO working with local actors, MdM
supports, in partnership with the Ministry of
Social Affairs, several Dar-ul-Aman ‘safe
houses’. Provision of medical, psychological
and legal support enables us to help these
women in distress and to mobilise all the
institutional and voluntary sector actors to
take action.
play in the context of natural disasters.
Key events
28 March: Called for a repeal of the
Circular of 21 February on the
conditions for questioning migrants
and holding them in police custody.
This regulation, which listed exhaustively the
reception or healthcare premises, even
operating theatres, which could be seen as
places where people without residency
permits could be questioned, violates the
fundamental principles of medical ethics and
infringes the right to health. The petition
launched by MdM reiterates that the right to
healthcare should never by used for other
purposes apart from protecting health and
that all patients must be welcomed and
cared for. MdM, supported by health
professionals, confirmed its refusal to let law
enforcement officers enter its health centres
to prevent these centres from becoming
immigration control places.
8 March: International Women’s Day.
MdM highlighted the situation of women
victims of domestic violence in Pakistan and
the support it has been providing to the
governmental refuges in Punjab since 2004.
In 80% of Pakistani households women suffer
from daily domestic violence, are victims of
honour crimes and continue, despite the
And also...
8 March: MdM welcomed the Liberian
President, Ellen Johnson-Sirleaf ’s visit
to France, and solemnly called on the
international community to support the
reconstruction of the health sector in this
country where MdM has been working since
1992.
14 March: Two expatriate volunteers in
the Gaza Strip programme were
kidnapped then released the same
evening. Despite the deterioration in the
humanitarian and security situation in Gaza,
MdM resumed activities on 22 March, because
of the worsening humanitarian crisis.
22 March: Humanitarian Review No 13.
Humanitarian work in disasters. In this
issue, the contributors reflect on the role
which humanitarian NGOs can, or should,
> CONTENTS
25 March: MdM’s second surgery
seminar. This second meeting on
humanitarian surgery, was the opportunity
to share experience and to capitalise on the
different experiences of the various hospital
practitioners in the programmes in differing
contexts and with extremely complex needs.
DR
ANNUAL REPORT 2006
141
APRIL
And also...
Key events
4 April: MdM joined with the Overseas
Collective to highlight the exceptional
situation in Mayotte. In effect, migration
law applicable in French overseas
departments legalises an action plan against
immigration. This is turning Mayotte into an
experiment in the fight against clandestine
immigration and restriction of access to
citizenship. As a result, migrants have very
limited access to state medical help, support
for re-settlement, health insurance or even
work. The collective also issued a report
highlighting the difficulties of access to
healthcare in the overseas departments.
7 April: Launch of a campaign ‘Health
professionals in southern countries: a
fatal shortage’. On World Health Day,
MdM, Agir Ici, Aide Medicale Internationale
and Secours-Catholique-Caritas France
called on WHO member states to take
action to address the gap of almost 4.3
million healthcare personnel, affecting the
health systems of more than 57 countries, 36
of which are in sub-Saharan Africa. With no
solution having been proposed, the
organisations involved in this campaign called
on the French government to focus on this
issue during the World Health Assembly and
on WHO member states to support national
policies to reinforce human resources.
12 April: MdM denounced the daily
violence in Gaza and in Nablus on top
of
the
international
economic
embargo.
> CONTENTS
» MOBILISATION
Campaign on the shortage of health professionals in
southern countries
Stéphane Lehr
MdM
Teknival on 1 May
Emergency programme: earthquake on Java
MAY
And also...
Key events
15 May: Change of Presidency at MdM.
During the Annual General Meeting, MdM
elected a new Board of Directors. Dr Pierre
Micheletti was elected President. As a
doctor, qualified at ENSP, Dr Micheletti
joined the Board of Directors in 2002. He is
director of the public and environmental
health service in Grenoble.
1May: During the Teknival, MdM
decided to restart the testing which
has been banned since April 2005. This
‘presumptive recognition of products’ is a means
of prevention which enables a discussion
with drug users to be started.There are now
major threats to the harm reduction
approach that MdM has adopted for 17
years, which involves close contact and is
both caring and pragmatic. MdM calls for an
open debate on harm reduction and the use
of testing, in order to increase understanding
of the public health impact of this nonrepressive approach.
27 May: Earthquake on Java. MdM sent
an emergency team of 30 professionals
from its programme in Indonesia and
from headquarters in Paris, Madrid
and Athens. The earthquake, which
registered 6.2 on the Richter scale, killed
5,100 people, injured 20,000 and made
nearly 200,000 people homeless. Two first
teams identified the needs which had not
been met and provided initial medical care,
before expanding their activities to surgical
emergencies.
22 May: National education campaign
on development and international
solidarity. Within the framework of
‘Tomorrow the world…migration in order to live
together’ the LDH, MdM and secular
Solidarité organised a press conference
followed by the presentation of the
exhibition, ‘Opre Roma! Tomorrow the
world…our Roma citizens’. This campaign
brought together 35 organisations whose
objective is to tackle prejudice and promote
the recognition of the rights of migrants as
citizens and operators in their own right in
the development process of southern
countries. As part of this, the Opre Roma!
exhibition retraced the specific routes which
several thousand Roma were forced to take.
> CONTENTS
Humanitarian Review
May: Humanitarian Review No 14,
‘Emergencies and Sustainable Action’.
This issue took a clear and impartial look at
what remains for humanitarian action when
the emergency has passed. The issue also
considered the importance of focusing
attention on the populations who received
aid and the fragile and complex contexts in
which humanitarian organisations work.
David Delaporte
Elisabeter Rull/item
ANNUAL REPORT 2006
143
8th Solidays festival
JUNE
And also...
Key events
8 June to 7 July: Exhibition ‘Missions,
Medecins [jusqu’au bout] du Monde’ of
Gerard Rondeau photographs. On the
occasion of MdM’s 25th Anniversary, the
Paris City Hall hosted this exhibition of 100
photographs along with extracts from the
book of the same title, edited for the
occasion. Gerard Rondeau, loyal companion
to the ‘French Doctors’ movement, helped us
to discover the places and the people of
MdM’s work and tell the story of our
ongoing commitment.
2 June: Inauguration of MdM’s Mission
France in Guiana. The French department
of Guiana is experiencing a difficult time with
demographic, economic, migratory and
health problems. Difficulties with access to
healthcare, particularly for migrants, have
prompted MdM to set up activities in this
Department. The programme will include
consultations in the MdM centre as well as a
programme of ‘buddying’ for isolated children
in hospital.
27 June: Internal Security Law, two
years on. MdM called for the repeal of
measures which criminalise people working
in prostitution because of the harmful effects
of such measures, particularly on migrants.
Namely, a deterioration in their living
conditions in terms of violence, abusive
arrests, distancing from prevention services,
use of condoms as proof of soliciting… An
exhibition of photos and testimonies
illustrated the difficulties seen in six French
towns.
8 June to 7 July: MdM participated in
the 8th Solidays festival. MdM had a 40m2
stand with the objective of raising awareness
of two issues. The first related to harm
reduction through the needle exchange and
methadone bus and an interactive game
called ‘Risk or no risk?’. The other issue was
the campaign on ‘Health professionals in the
south: a fatal shortage’.
> CONTENTS
Poster for the 20th anniversary of MdM Grenoble
16 June – 2 July: MdM’s Grenoble
branch commemorated its 20th
anniversary, by organising a large
exhibition and an information day for
donors on Saturday 24 June.
Since 1986, this branch has developed many
programmes in the town with more than
2,800 medical and social consultations. It has
also developed overseas programmes in
Algeria, Afghanistan, Nepal, Salvador and
Chechnya as well as participating in the
international adoption programme.
» MOBILISATION
Project with women working in prostitution
Elisabeter Rull/item
Emergency programme: humanitarian crisis in Lebanon
JULY/AUGUST
Key events
Poster for Médecins du Monde
at Visa pour l’image, Perpignan
profile.As part of this struggle, MdM members
distributed a pamphlet with a collection of
opinion pieces on this issue from those working
in the media or in humanitarian affairs.
12 July /12 August: From the beginning
of the Israeli offensive,and given the scale
of the humanitarian crisis that Lebanon
faced, MdM launched an emergency
programme.Five mobile clinics were set up in
Beirut among the populations fleeing south
Lebanon.The MdM teams, along with the NGO
Amel, ran consultations in 12 centres for
displaced people and distributed essential
medicines. In South Lebanon, MdM distributed
medicines and medical equipment in clinics. Like
many other NGOs, MdM denounced the nearimpossibility of reaching the civilian populations
and violations of international humanitarian law.
After the ceasefire on 14 August,MdM redeployed
its programme to support displaced people
returning to their villages.
4 September: Publication of the 3rd
special edition of the Humanitarian
Review dedicated to ‘Media and Advocacy:
how NGO voices can be heard’, a debate
extended to MdM’s blog. This special
edition dealt with the relationship between the
media and humanitarian organisations, who
both need each other in order to inform, exist
or bear witness. More generally, the issue
focused on methods of communication for
NGOs, particularly for advocacy, a new tool for
influencing opinions and putting pressure on
leaders. MdM put this debate on its blog under
the theme ‘The media and humanitarian
organisations: enemies or brothers?’.
SEPTEMBER
OCTOBER
Key events
Key events
2 – 17 September: MdM participated in
the 18th film festival,‘Visa pour l’image’ in
Perpignan. For more than a year, MdM
strengthened its commitment to so-called
‘forgotten’ populations and to fight for more
media attention for serious humanitarian
disasters which currently have a low public
5 October: In Pakistan, one year after the
earthquake which killed 80,000 people
and injured more than 70,000 people,
MdM carried out a survey aimed at
preventing another medical emergency.
On 8 October 2005,MdM set up an emergency
medical programme, helping the earthquake
victims and six months later we denounced the
> CONTENTS
Humanitarian Review (special issue)
pressures put on the displaced persons to
return home prematurely.The camps in which
they were living were effectively closed before
the end of the winter, forcing refugees to return
to their devastated villages, deprived of the
most basic essential services. Data collection
(statistics and testimonies) carried out in areas
where populations are returning to enabled us
to alert the authorities to the difficulties facing
the Pakistani population and to prevent the
consequences.
6 October: Conference on ‘Post-conflict
reconstruction of health systems: DRC as
a case study’. People from all the different
sectors involved in this reconstruction
(government, public institutions, international
institutions, private sector, diaspora, NGOs and
Congolese civil society) participated in this day
entitled ‘Reconstruction after war: hope in DRC’,
initiated by MdM a year before. Having come
through a very serious humanitarian crisis,
which killed 4 million Congolese through
different recent armed conflicts, DRC is a
country emerging from conflict. The debate
throughout this day was complementary to the
field work of MdM and other humanitarian
organisations. The Congolese health director
presented the ‘Strategy for strengthening the
health system’, to be put in place after the
elections. This strategy was applauded for its
relevance, overall approach to health problems,
and decentralised implementation.The themes
One year after the earthquake
Health centre in Goma, DRC
Poster for the conference on unfit housing and health
tackled were: the political challenges after the
transition, an overview of the health situation
after the conflict, the challenges of
reconstructing the health system.
And also...
NOVEMBER
27 October: MdM is a member of the
European network on Global Health is a
coalition of NGOs. This advocacy network
aims to improve health in developing countries
in line with the Millennium Development Goals
(MDGs).The network, set up at the same time
in Germany, Belgium, Spain, France and the UK,
brings together 15 organisations to call on
NGOs, the private sector and governments to
improve health in developing countries. The
MDGs anticipate that child mortality rates
should fall by two-thirds and that deaths linked
to pregnancy and childbirth should fall by threequarters by 2015. Yet, 10.6 million children
under five die each year and in some countries
one women in six dies as a result of pregnancy
or childbirth.A reduction in the number of new
cases of HIV infection, malaria and tuberculosis
is also far from being a reality. MdM and Avocats
pour la Santé dans le Monde (Global Health
Advocates) will work together in France as
members of the European network for global
health.
Key events
17 October: International day for the
eradication of poverty. MdM aims to enable
the voices of the most disadvantaged patients
encountered in its 120 programmes in France
to be heard. To do this, MdM relies on the
statistical information collected by the
Observatory on access to healthcare in France, and
also on a survey of 725 doctors in 10 cities, and
focusing on the refusal of healthcare for people
entitled to the CMU (Universal healthcare
insurance) and the AME (state medical aid).The
evidence of a worrying rate of refusals by health
professionals to provide treatment resulted in
the publication of a report ‘I won’t deal with these
patients’ aiming to alert policy makers,
institutions and health professionals to this legal
and medical responsibility. MdM also called for
the AME to be merged with the CMU so that
anyone in a vulnerable situation would be able
to access healthcare.
> CONTENTS
7 November: MdM and the Abbé Pierre
Foundation organised a conference ‘Unfit
housing and health: ending child lead
poisoning’. Through their field activities and
testimony, the two organisations witness the
real risks health posed by unfit housing every
day. Although the importance of child lead
poisoning in France has now been recognised
for 20 years, further progress is needed in the
struggle against this and other health problems
linked to housing. The conference brought
together the key players in health, housing and
rights in Ile-de-France, in order to develop a
dialogue and a network in order to take more
effective action and capitalise on existing
experience.
DECEMBER
Key events
1 December: World AIDS Day. MdM called
for action and highlighted our work on
prevention, screening and access to antiretroviral
therapy.We are lobbying for an overall approach
to the illness, and also emphasise the control of
this pandemic through the defense of individuals’
rights as well as by tackling stigmatisation and
exclusion. Since 1987, MdM’s approach in
» MOBILISATION
DR
MdM
Bruno Fert
ANNUAL REPORT 2006
145
Bruno Fert
Martin Mazurkiewicz
Lancène Abib
Vietnam: access to anti-retroviral therapy for people
living with HIV programme
Migrants programme in Calais
Tents given to homeless people in Paris
fighting against HIV/AIDS has been innovative
and forward-thinking, with the opening of the
first anonymous, free testing programme in
Paris. Since 1989, MdM has positioned itself in
France as a major player in the field of harm
reduction and prevention of HIV and hepatitis
transmission linked to intravenous drug use.
Since 1992, MdM has built on this experience
and expertise to extend our harm reduction
programmes internationally, particularly to
Eastern Europe and to Asia (six programmes in
Afghanistan, Burma, China and Vietnam).
immediate stop to the dismantling of the tents
and repeated its position.
And also...
21 December: One year of activism with
‘For lack of a roof,a tent’. Last year,MdM gave
tents to homeless people in Paris who would
not go to emergency shelters. Since then, more
than 400 tents have been distributed. MdM has
continued with this activity, despite the summer
polemic and threats that the tents would be
taken down.This activism was accompanied by
positive government measures: the Winter Plan
presented in November by the Ministry for
Social Cohesion proposed creation of 1,100 24hour, unlimited stay ‘stabilisation accommodation’
places in the Ile-de-France area. Nonetheless,
MdM highlighted the lack of transparency in the
how these places are run and their insufficient
number to be able to respond to the needs on
a national scale. Despite these measures, the
occupants of the tents were asked to move to
the city’s periphery without any alternative
options or support.MdM therefore called for an
8 December: Four years after the closure
of Sangatte, migrants are in a vulnerable
situation. In its report entitled, ‘After Sangatte,
daily inhumanity’, MdM highlighted the worrying
humanitarian situation of migrants since the
closure of the Calais centre. These homeless
migrants, including pregnant women, children
and people who are ill, are largely dependent on
help from humanitarian organisations and are
subject to permanent pressure from the police.
Since the centre was closed, MdM has carried
out occasional medical consultations amongst
this group, but the fact that this situation is
ongoing has lead us to set up a long-term
project. Thus, in March 2005 the Ile-de-France
delegation and the Nord-Pas-de-Calais delegation
started a programme to facilitate access to
healthcare for these people in transit. Despite
MdM’s advocacy and action to improve the living
conditions of these migrants, their situation is
worsening in light of the repressive approach of
the national authorities, who refuse to hear the
arguments and remain intransigent.
> CONTENTS
8 December: As part of humanitarian
meetings, MdM participated in the
conference ‘Humanitarian organisations in
danger’ organised at the political studies
institute in Paris. Eric Chevallier, Director of
International Operations, spoke on the question
of ‘What risks do humanitarian workers face in the
field?’’ and Michel Brugière, MdM’s Director
General spoke on the theme ‘Sri Lanka, DRC and
Afghanistan: the shrinking humanitarian space’.
5 December: Publication of the new issue
of Humanitarian Review dedicated to the
relationship between humanitarian
organisations and the anti-globalisation
movement. With the World Social Forum
taking place in Nairobi from 20 to 25 January,
the Review focused on relationships between
the two movements. A round table discussion
summarised the differences, the common
points, the objectives and the respective
cultures.
» THE REPRESENTATION
NETWORK
147/156
> CONTENTS
» ALSACE
Contact details
> Delegation:
24, rue du Maréchal Foch
67000 Strasbourg
Tel: 03 88 14 01 00
Fax: 03 88 14 01 02
Mission France:
03 88 14 01 01
[email protected]
Board Members
> Representative:
Dr Maryvonne Le Gac
> Secretary:
Aloyse Kriegel
> Treasurer:
Sophie Py
> Other members:
Catherine Frapard
Marie-Luce Arbogast
Dr Paul-André Befort
Dr Jean-Maurice Salen
> Secretary of the delegation:
Brigitte Fanteguzzi
> Adoption:
Colette Minard-Rosenstiel
> Number of members:
72
> CONTENTS
» AQUITAINE
Key Events
Publicity events and activities
• Provision of information to medical
students – participation in the optional
module on Health and Deprivation;
• Information days in colleges and high
schools, the IFSI (the national nursing
training institute), at ESTES (education and
social work college);
• A Soroptimist concert for donations
(hygiene products);
• Participation in the ‘African Week-end’ in
Illkirch (partnership with Senegal);
• Dissemination of an internal newsletter.
Partnerships
• Alerte group, a local network;
• Participation in the European Social Forum
(Council of Europe);
• Participation in the National Congress of
FNARS (National federation of reception
and social integration organisations);
• Regional health conference;
• GPs and psychiatrists group, think-tank on
exclusion, testimony on the restrictions on
access to CMU and AME;
• Collective working with people working in
prostitution (one meeting a month);
• Meetings with the partners of 115.
Other activities
Regionally-managed international
project:
• Health programme in Gamadju Saré region
of Senegal with recruitment of an expatriate
for three months and a set-up mission by
the delegation from Alsace.
Adoption
Contact:Colette Minard-Rosenstiel
• The group of eight people is still involved;
• A 10% increase in the number of
applications received and in couples
interviewed;
• With the opening of Haiti: more
proposals to offer couples for older
children;
• Four special needs children this year;
• Improving the meetings to help couples
prepare for parenthood (in preparation of
the agreement).
Contact details
> Delegation:
2, rue Charlevoix-de-Villers
33300 Bordeaux
Tel. 05 56 79 13 82
Fax: 05 56 52 77 69
medecinsdumonde.bx
@wanadoo.fr
Board Members
> Representative:
François Cougoul
> Secretary:
Philippe Gavout
> Treasurer:
Christine Suraud
> Other members:
Pierre Beze-Beyrie
Jean-Pierre Daulouede
Fabienne Favarel-Garrigues
Anne-Marie Jouves
Marie-Christine Chauveau
133
> Pau branch:
Co-ordinator: Robert Lafourcade
Tel. 05 59 83 74 28
Key Events
• Commitment to set up ‘health rest
beds’ in Leydet hostel;
• Campaign ‘Health professionals in the
south: a fatal shortage’ – stand and
petitions;
• Global action against poverty. Stand
in partnership with Promofemmes,
ATD Fourth World and Secours
Catholique;
• For the 20th Anniversary of Mission
France: exhibition – conference
Rondeau organised in partnership
with the Regional Council,
debate–Round-Table–Citizens cafés;
• Partnership with the training centre
of Bordeaux University Hospital for
four days of volunteer training;
• 2007 presidential election campaign:
two-day visit of the MdM campaign
bus in Bordeaux;
• Participation in the local Social
Forum ‘Health, a right for everyone’;
• Partnership with Acquitaine Image
Cinema in conjunction with the
Regional Council;
• Open day with families who have
adopted or are in the process of
adopting in the region;
• Opre Roma: exhibition in a hall in
Bordeaux and in schools. Organisation
of a round table.
Other activities
Proposal for a regionally-managed
international programme in Nicaragua.
> Delegation:
19, rue Balzac
56270 Ploemeur
Tel. 02 97 86 27 50
[email protected]
Board Members
> Representative:
Marie-Elizabeth Hochet
> Secretary:
Valérie Bergeron
Key Events
• Presentation of MdM in information
centres in Lorient and Vannes;
• MdM presentations in colleges, high
schools and to groups of young
people;
• Participation in association forums;
• Mobilisation for the International
Day for the Eradication of Poverty;
• Participation in the network of
associations in Ile,Vilaine and
Morbihan.
> Treasurer:
Christophe Perron
> Other members:
Jean Godefroy
37
Other activities
Adoption: three teams in Ile,Vilaine
and Morbihan;
International: handover of the Mali
programme to become a regionallymanaged programme;
France: needs assessment on
vulnerability in Lorient and Vannes
during 2006. At the end of this
assessment in December a project
proposal is being developed for
approval.
Contact details
> Delegation:
Résidence «La Gravona» bât. A
Rue des Romarins
20090 Ajaccio
Tel: 08 75 33 18 99
Tel./Fax: 04 95 10 25 49
[email protected]
http://perso.wanadoo.fr/
mdmcorse
Board Members
Catherine Contois
Corinne Girardin
Michèle Iborra
Jean-Pierre Lucciani
François Pernin
Isabelle Serain
Myrtha de Tollenaere
> Representative:
Jean-Pierre Lucciani
> Secretary:
Catherine Contois
> Treasurer:
Corinne Girardin
> Other members:
Anne Galeani
Denise Giacomoni
34
> CONTENTS
Key Events
• Meeting with partner
organisations in order to identify
new activities to reflect changing
public needs;
• Participation in the associations
forum;
• Publication of a newsletter;
• Sale of Regis Arrighi’s book
‘Smile of Saigon’ whose profits will
go to MdM, Presence Bis, Mekong
and Corse Vietnam.
Partnerships
• Founding member of interassocation Collective Fighting
against Exclusion (CLE);
• With the CLE and other
partner organisations: setting up
of a winter night shelter,
improvised in 2004, but from
now on an activity managed by
professionals and volunteers;
• Weekly medical and nursing
consultations in the premises of
Stella Maris day centre;
• Restoring links with
pharmacies;
• Collecting food for Aiutu Corsu
(fighting AIDS).
149
ANNUAL REPORT 2006
Contact details
» CORSICA
» REPRESENTATION NETWORK
» BRITTANY
» FRANCHE-COMTE
Contact details
» ILE-DE-FRANCE
Key Events
Contact details
> Delegation:
7, rue du Languedoc
Appt 168 003
25000 Besançon
Tel. 03 81 51 26 47
Fax: 03 81 52 70 28
[email protected]
• Participation in health days in
colleges and high schools;
• Participation in the associations’
forum;
• Participation in the International Day
for the Eradication of Poverty.
Board Members
> Representative:
Partnerships
• Red Cross;
• PASS (Access to Healthcare Office);
• CCAS (Central Social Activities
Desk).
Board Members
> Representative:
Jacques Guitard
> Secretary:
Violaine Llorca
> Treasurer:
Bernard Badey
> Other members:
Marie-Claire Tisserand
M.Thérèse Vernier
> Delegation:
62 bis, avenue Parmentier
75011 Paris
Tel. 01 43 14 81 99
Fax: 01 48 06 68 54
[email protected]
Graciela Robert
> Secretary:
Dominique Kunst
> Treasurer:
Marc Leriche
> Other members:
Philippe Pluvinage
Benoit Hénaut
Alexandre Peyré
Maria Melchior
> Contact:
Johanna Boucher
400
> CONTENTS
Key Events
• Nine presentations to schools and
IFSIs (Nursing Training Institutions);
• Three presentations to the CRESIF
(Regional Health Education
Committee for Ile-de-France);
• Round table ‘How do we welcome
migrants today in Ile-de-France
programmes?’;
• Participation in the press conference
on ‘Calais, daily inhumanity’;
• Participation in the Solidays festival.
Publications
• Three issues of the newsletter ‘Le Fil’
(700 copies).
Partnerships
• MdM’s Nord-Pas-de-Calais
delegation for the Calais programme.
Other activities
• Running the recruitment of new
volunteers for Ile-de-France
programmes;
• Regionally-managed international
programme: Exploratory mission in
Morocco. Project proposal under
development;
• IdF elections, new Board in June
2006;
• Meetings of the Heads of Projects
and co-ordinators for Ile-de-France
programmes.
» LANGUEDOC-ROUSSILLON » LORRAINE
Board Members
> Representative:
Mady Mercier
• Presentations in high schools and
training colleges for nurses and other
health professions;
• Stand at an Associations’ fair in
Montpellier;
• Participation in the ‘Visa pour l’Image’
festival at Perpignan;
for the Eradication of Poverty at
Montpellier.
> Secretary:
Claude Aiguesvives
> Treasurer:
Françoise Jourdan
> Other members:
Marie Bernadette Cadilhac
Robert Chaluleau
Valérie Vandermesch
Mansoureh Yaghmaie-Astruc
> Secretary:
Magali Ibanez
87
Contact details
> Delegation:
5, rue de l’Armée Patton
54000 Nancy
Tel. 03 83 27 87 84
Fax: 03 83 28 42 55
[email protected]
Board Members
> Representative:
Anne-Marie Worms
> Secretary:
Monique Ulrich
Partnerships
• PHI 34;
• Herault food bank;
• La Babotte;
• Harm reduction organisations
(Passerelles – Axes);
• Cimade;
• Halte Solidarité;
• Global Health collective.
Other activities
• Recruitment of new volunteers for
the delegation’s programmes;
• Start of an outreach programme,
linked to the CASO, with a mobile
unit which goes out two evenings a
week and works with homeless
people;
• Set-up of a training programme for
members;
• Harm reduction: Participation at the
Teknivals with other MdM harm
reduction teams (Angouleme, Larzac
and Vannes);
• Participation in NGO Council
training: presentation of our work on
street fundraising in Montpellier.
> Treasurer:
Anne-Marie Marchetto
> Other members:
Lucien Gbetro
Véronique Gorsic
Marie-Pascale Verdenal
Jean-Marie Gilgenkrantz
> Lorraine regional
programmes:
Nancy Head of Project (HP):
Jean-Marie Gilgenkrantz
Metz HP:
René Moutier
Adoption HP:
René Moutier
> CONTENTS
Regional assembly in January to
renew the Board. Regional
Representative, Secretary and
Treasurer remain in post.
Organisation of a roundtable
on ‘Forgotten Crises’ with
presentations by J.M.
Gilgenkrantz on those who are
forgotten in France, J. Larché on
Darfur and J. Dato on Chechnya.
Displaying the MdM Roma
exhibition in Longwy during a
week of solidarity with Eastern
countries, supported by the town
council.
Contacts with Amities tsiganes and
the urban community of greater
Nancy around travellers. Several
meetings with the Council and
other organisations about a
group of Roma.
Meetings on the theme of
decentralisation, in liaison with
Christian Carter.
Participation in ‘Market of the
World’ and meetings with several
partners on ‘Healthcare
professionals in the south: A fatal
shortage’.
Informal meeting with
MdM’s Alsace delegation in
Strasbourg.
Continued efforts to set up a
regionally-managed
international project in
Burkina-Faso: Support for
the improvement of
maternal healthcare in
Gnanga province.Veronique,
Marc and Carlos carried out an
exploratory mission in June.
Approval from the Africa Group,
then the Management
Committee in September. Budget
update, partnership with
ICODEV, our partner British
NGO, remains outstanding.
Veronique and Carlos went to
the field in December.
151
ANNUAL REPORT 2006
> Delegation:
34090 Montpellier
Tel. 04 99 23 27 17
Fax: 04 99 23 27 18
[email protected]
Key Events
Contact details
Key Events
» MIDI-PYRENEES
Contact details
> Delegation:
31000 Toulouse
Tel: 05 61 63 78 78
Fax: 05 61 62 04 15
mdmmidipy.delegation
@laposte.net
Board Members
> Representative:
Dr Florence Rigal
> Secretary:
Marie-Pierre Buttigieg
> Treasurer:
Luis Garcia
> Other members:
Dr Hélène Bonnet
Dr Geneviève Molina
Christine Remiot
> Programme Officer:
Tom Wingefeld
Isabelle Malet
> Albi branch:
Contact: Nicole Cany
Tel. 05 63 45 08 15
Key Events
• Various presentations in colleges,
high schools, IFSI (Nurse Training
Institute), schools, welcoming IFSI
students to the delegation;
• Meeting with several members of
parliament for ‘An overhaul of the
accommodation system’;
• Stands at the associations’ open day
and on 1 December at Paul Sabatier
University;
for the Eradication of Poverty;
• Participation in the presentation of
the prizes – bronze medal – the
‘Affichades’ at the ESC (business
school);
• Public conference on the 20th
Anniversary of ‘La Foulé pour la Vie’
• Internal meetings: Lebanon; working
meeting on ‘improving practice at the
CASO’;
• Supporting families whose
accommodation is no longer provide
by the government (removals help,
one night stay at Capitole, and moving
in);
• Co-ordinating the monitoring of a
hunger strike by 89 people for 26
days.
Exhibitions
• Exhibition of photos from Chad at
Communauté Municipal de Santé de
Toulouse, at Cepiere training;
• Roma exhibition from 30/10 to
22/11 in St Orens college.
Other activities
• Various events organised for MdM
(with Foulée pour la Vie, Solidarity en
pays de Save);
• Presentation during the street
fundraising training;
• Adoption, sessions on Mondays from
2-6pm: 1-2 public information
meetings per month;
• Tri-therapies: 14 tonnes unused
medicines collected.
Financial partners
• General Council,Toulouse City
Council;
• CPAM Haute Garonne, Ddass Haute
Garonne, Drass Midi Pyrenees.
Publications
• Quarterly newsletter ‘Lettre et debats’.
> CONTENTS
> Delegation:
10-12, rue du Grand Fossart
59300 Valenciennes
Tel. 03 27 47 40 08
Fax: 03 27 30 19 16
[email protected]
Board Members
> Representative:
Guy Dehaut
> Head of Programme:
Eliane Lamorisse
> Secretary:
Fabienne Ducatez
> Treasurer:
Christiane Ficheroulle
> Other members:
Elisabeth Dusart
Charles Lejeune
Claudine Leleu
33
• 17 October: International Day for
the Eradication of Poverty with local
associations;
• Participation in regional health
programme.
Partnerships
• Emergency shelter associations, the
CHRSs (Accommodation and Social
Reintegration Centres) in Valenciennes
district, drop-in day centres including
AJAR, APE, Midi-Partage, La Pose;
• Rimbaud mobile team;
• PASS (Healthcare access centre) –
Espace Baudelaire;
• Boutique Solidarité;
• Social services CCAS, CPAM;
• SOS Bébé (assistance to families in
financial difficulty);
• Avenir et Cooperation Logistique –
humanitarian logistics.
Other activities
• Supporting refugees in Calais
(medicines, sleeping bags, Dr Dehaut’s
involvement in the Calais programme);
• Participation in the mobile team’s
activities (accompaniment twice a
month in their sessions);
• Distributing blankets, sleeping bags
and other help to homeless people
(gloves, socks, hats, shoes, Christmas
presents at the Boutique Solidarité);
• Outreach consultations twice a
week at the Boutique Solidarité;
• Flu vaccination sessions in
accommodation centres and in our
clinics (more than 100 vaccinations);
• Collecting and sorting medicines as
part of Cyclamed (eight tonnes
sorted, two tonnes validated for our
own programmes, the surplus sent to
Africa through Avenir et Cooperation,
according to demand);
• Collecting glasses which have been
refurbished by an optician.
Contact details
> Delegation:
5, rue d’Elbeuf
76100 Rouen
Tel. 02 35 72 56 66
Fax: 02 35 73 05 64
[email protected]
Board Members
> Representative:
Key Events
• Opening of the PASS
(Healthcare access centre) at the
hospital in October 2006 (this
resulted in the closure of the Le
Havre branch of Mission France);
• Regional day at Rouen-Le Havre
on 11 November 2006.
153
ANNUAL REPORT 2006
Contact details
Key Events
» NORMANDY
Christian Cartier
> Secretary:
Valérie Scetbon
> Treasurer:
Michel Joly
> Other members:
Agathe Bonmarchand
Arlette Seiffert
Mireille Vache-Picat
Claudie Hauduc
Rouen branch:
Contact: Agathe Bonmarchand
Tel. 02.35.72.56.66
[email protected]
Le Havre branch:
Contact: Arlette Seiffert
Tel. 02.35.21.68.66
[email protected]
> CONTENTS
» NORD-PAS-DE-CALAIS
» INDIAN OCEAN
Contact details
> Delegation:
250 bis, rue du Général Rolland
Bât. K - SHLMR Bouvet
BP 964
97479 Saint-Denis Cedex Réunion
Tel. 02 62 21 71 66
Fax: 02 62 41 19 46
medecinsdumonde.reunion
@wanadoo.fr
Board Members
> Representative:
Gilbert Potier
> Secretary:
Mireille Beaufils
> Treasurer:
Agnès Jean-Marie
> Other members:
Blandine Megroian
Gilles Bourdiol
Christophe Ottenwaelder (Head of
Programme:Tuléar)
Claudie Pante
> Other active members:
Arnaud Bourde (Tsunami)
Jean-François Delambre (Children’s
projects)
Philippe Jeu (Indonesia)
Sophie Louys (Mission France,
Mayotte)
Jean-Luc Michel (vascular surgery)
Jean Aribaud
Philippe Benaich
Gilles Bourdiol
Marie-Claude Castex
Philippe de Chazournes
Raymonde Grosse
King Soon Cynthia
Frédéric Le Bot
Dominique Rabouille
Martine Rajzman
Dominique Rivas
Corine Sayag
Claudia Vichatzky (Ilakaka)
» PACA (Provence-Alpes-Côte d’Azur)
Key Events
• Fundraising mailing for Action
Enfance;
• Mission France - organisation of a
Christmas meal for homeless people.
Training
• The medical co-ordinator of the
‘Action Enfance’ project;
• Dr Ramamonjisoa Nivohanta
received fast-track training in
paediatric cardiology, from 29 May to
1 June 2006 in Paris.
Other activities
• Mission France: medical and welfare
consultations at the Boutique
Solidarité (Abbé Pierre Foundation at
St Denis and St Pierre);
• Mission France: medical
consultations at EDSI for people in
Saint-Denis who have difficulty
accessing healthcare;
• Mission France: ‘Mayotte – supporting
irregular migrants to access healthcare’,
proposal submitted to the
Management Committee for approval
in May 2006, having already been
reviewed positively by the France
Group. Start date for project, January
2007.
Contact details
> Delegation:
4, avenue Rostand
13003 Marseilles
Tel. 04 95 04 59 60
Fax: 04 95 04 59 61
[email protected]
Board Members
> Representative
Xavier Carrard
> General Secretary:
Denise Clément
> Treasurer:
Serge Rumin
> Other members:
Olivier Bernard
Vincent Girard,
Philippe Dupin,
Philippe de Botton
> Programme officer:
Isabelle Malaval
> Accounts:
Ghislaine Vincenti
Anne-Marie Combe
Martine Semat
Daniel Imbert
167
39
> CONTENTS
Key Events
• 18 and 19 May exhibition:‘100 families,
children placed, displaced, adopted and migrants’
in the Salon-des-Provence as part of the 9th
International Conference on Resilience;
• 8 June debate: programmes in Pakistan;
• 29 June, private view: Francois Moura
photography on ‘Reconstruction: testimony from
the MdM programme in Algeria after the
earthquake in Boumerdes’ at the new Gare
Maritime de la Major;
• 1 July, demonstration: at the old harbour
with the Marseillais collective LogementSanté;
• 17 October: International Day for the
Eradication of Poverty – press conference
with the management of the public hospital
in Marseilles.Aim: to remind this institution
of its obligation to set up a medical/welfare
PASS (healthcare access centre);
• 22 October: Provence Philharmonic
Orchestra held a concert at Marseilles
Opera House in aid of MdM;
• 23 October: opening of the Opre Roma!
exhibition in the migrants’ centre with
screening of a film,‘Who is afraid of Romanian
tsiganes?’;
• 16 November: private view of the ‘Tijuana
– Wall of Shame’ exhibition in the migrants’
centre;
• 16 November: Provencale day for
humanitarian health,‘Between desire and
power’;
• 22 November: visit to Marseilles of the
‘Humanitarian organisations meet young people’
Tour de France with Bioforce in partnership
with MdM;
• 26 November: discussion day with the
Mediterranean Ethnic Forum,Timone
hospital;
• 21 December: homeless people
demonstrate and question politicians at the
old harbour.
> Delegation:
33, rue Fouré
44000 Nantes
Tel. 02 40 47 36 99
Fax: 02 51 82 38 09
[email protected]
Board Members
> Representative:
Paul Bolo
> Secretary:
Anne-Lise Guéguen
> Treasurer:
Nicole Neyrat
> Other members:
Philippe Jarrousse
Hélène Lepoivre
Jean-Pierre Clauzel
Marion Gassiot
Corinne Lepert
70
Key Events
• Presentations in schools, colleges
and nursing schools in and around
Nantes;
• Participation in a Franco-GermanRomanian seminar on health and
exclusion;
• Participation in a careers forum;
• Participation in the humanitarian
Tour de France organised in
partnership with Bioforce;
• Organisation of open days for our
mobile clinics at medical and
pharmacy schools on the International
Day for the Eradication of Poverty;
• Organisation of the Autumn
University at Clisson;
• Organisation of a press conference
on the Sarkozy law;
• Participation in a seminar organised
by TAMPEP (European Network for
HIV and STI Prevention among
Migrant Sex Workers);
• Participation in seminars on human
trafficking.
Other activities
• Several presentations on the
prostitution programme to partners or
to other MdM programmes;
• Numerous presentations and
meetings with voluntary sector
partners on issues relating to women,
health and deprivation.
Contact details
> Delegation:
22, allée du Champ Brun
16000 Angoulême
Tel. 05 45 65 07 47
Fax: 05 45 61 18 85
[email protected]
Board Members
> Representative:
Marie-Laure Ferrari
> Treasurer:
Hubert Lacombe
> Deputy treasurer:
Philippe Boulanger
> International programmes
officer + CCN:
Patrick Bouet
> Other members:
Myriam Massé
Daniel Reiss
Fabienne Drieu
> Secretary of the
delegation:
Paule de Sède
Angoulême branch
(mobile project):
> Contact:
Marie Laure Ferrari
Tel. 05 45 65 11 82
Co-ordinator of needle exchange
programme:
Marie-Laure Ferrari
Valérie Patrier
Poitiers branch:
> Contact:
Patrick Bouet
Tel. 05 49 01 77 77
> CONTENTS
Key Events
Angoulême centre
• Successful partnership with Jean
Rostand secondary school;
• Tea party for the most destitute
on 31 December;
• Creation of a voluntary sector
collective (AFUS 16 – Emergency
Platform);
• Setting up the CAARUD (harm
reduction centre) – an enormous
task;
• Beginnings of a partnership with
the Bellevue de Saintes secondary
school (17000);
• Winter outreach patrols with
media coverage (in partnership
with OMEGA).
Poitiers centre
• Thematic workshop en
partnership with Toit du Monde,
Secours Catholique, CADA, Relais
Charbonnier;
• Mother and child health
programme;
• Prostitution outreach sessions in
partnership with the DDASS,
CCAS, town hospital network,
International Red Cross;
• Sessions at the caravan: increase
in social vulnerability.
Partnerships:
Angoulême
Angoulême PASS (healthcare
access centre), OMEGA,
International Red Cross, local
social work centre, Aides,
Eclaircie.
Poitiers
Toit du Monde, Secours
Catholique, Red Cross, CADA,
Relais Charbonnier, Mother and
Child Health Protection, DDASS,
CCAS, town hospital network.
155
ANNUAL REPORT 2006
Contact details
» POITOU-CHARENTES
» PAYS DE LA LOIRE
» RHONE-ALPES–BOURGOGNE
Contact details
> Delegation:
13, rue Sainte Catherine
69001 Lyons
Tel. 04 78 29 59 14
Fax: 04 26 84 78 08
[email protected]
Board Members
> Representative:
Michèle Roelens
> Secretary:
Lionel Liron
> Treasurer:
Gilbert Faizant
> Other members:
Patricia Le Goff
Gérard Collombel
Robert Allemand
Roland Filopon
>Secretary of the delegation:
Clothilde Guillerm
> Programme officer:
Sophie Bret
approximately 160
Grenoble branch:
> Co-ordinators:
Guy Caussé and Robert Allemand
Tel. 04 76 84 17 31
[email protected]
> Secretary
Angélique Giannini
Key events
• Participation in conferences and
round-table discussions on
humanitarian activities, access to
healthcare for vulnerable groups,
emergency and long-term
programmes;
• Three weeks of events to mark the
20th anniversary of MdM in Grenoble:
exhibition, debates, film screenings,
meal, concerts;
• In Grenoble and Lyons, participation
in the International Day for the
Eradication of Poverty.
Partnerships
• Golf competitions, plays and
partnerships with local businesses to
support the regional activities;
• Concert with Andean musical and
Trail des Cabornis in aid of the
programme in Bolivia;
• Concert as part of a humanitarian
festival in aid of the programme in El
Salvador.
Exhibitions
• Photo exhibition on the health of
migrants;
• Mobile photo exhibition on child
workers in Potosi (Bolivia).
> CONTENTS
» OUR ORGANISATION
157/178
> CONTENTS
Médecins du Monde and its
management
Médecins du Monde is dependent on member professionals with field experience, volunteers in France,
voluntary workers for international operations and a permanent paid staff. The support of hundreds of
thousands on donors ensures Médecins du Monde’s financial independence. Thanks to this diversity, MdM
always operates on the basis of debate, the views of civil society and the operational efficiency of its
programmes for beneficiaries. As a result MdM has an original organisational structure which is strong and
distinctive amongst large NGOs.
DECISION-MAKING AUTHORITIES
Once a year, MdM members (1,269 in 2006) come together at the
General Assembly (GA), the highest decision-making body and the
only one with the authority to modify the organisation’s statutes.The
GA elects 12 members of the Board of Directors, and three
substitute Directors.
From amongst its members, the Board elects the President and the
organisation’s Officers for one year: the Vice-Presidents, Treasurer,
Deputy Treasurer, General Secretary and Deputy General Secretary
and a Representative. The Board, the organisation’s executive body,
meets monthly and takes any decisions concerning the organisation’s
management.
To carry out its tasks properly the Board relies on:
• an advisory structure of MdM members;
• a permanent operational structure;
• joint decision-making bodies bringing together the staff and MdM
members;
• the regional offices.
of projects. MdM has five continental groups, eight thematic groups
and a France group which includes the Mission France and Harm
Reduction steering committees.The members of the advisory groups
are elected according to the internal regulations.
THE PERMANENT OPERATIONAL STRUCTURE
This is led by two Directorates. The Humanitarian Aid Directorate
includes the international operations department, the Mission France
co-ordinating office, project logistics, the adoption department and
the communications department.
The Management Directorate includes the human resources
department, the development department, the finance and IT
department and the legal department. Non-strategic operational
decisions are made each week during a ‘project meeting’ for projectrelated decisions and at a ‘management meeting’ for other aspects.
International programmes are managed by the programme’s medical
co-ordinator, reporting to the Head of Project who, in turn, deals
with aspects of policy or specific expertise and is in operational
contact with the desk officer at Head Office or the project officer in
some regional offices. Heads of Projects are nominated by the
different internal bodies and ratified by the Board.
THE ADVISORY STRUCTURE
This includes the continental groups and thematic groups. Each of
these groups, made up of volunteer members with project
experience or involved in projects, advises on the continent or
theme for which it is responsible. Their role is vital in terms of
analysing contexts, working methods and drawing on the experience
> CONTENTS
THE JOINT DECISION-MAKING BODIES
THE DONOR COMMITTEE
These include the Management Committee, which brings
together the staff members involved in management each week and
examines strategic decisions concerning projects and takes a close
look at decisions about bearing witness, political lobbying and
publicity.
The Donor Committee is made up of 12 co-opted members and
it provides constructive criticism and consensual analysis of MdM’s
projects, ratios or communication strategy. It is given funding to go
and evaluate projects in France and abroad.Through its Chair, it can
express its views to the Board and to the General Assembly.
Other joint decision-making bodies are the human resources
group which meets monthly to define human resources and
management policies which are then finalised and ratified by the
Board.
This specific set-up encourages debate at all levels. It allows MdM to
be an active association which is both politically and financially
independent. It encourages voluntary commitment by health workers
in the service of the most destitute and vulnerable people, and has a
constant concern for the quality and effectiveness of its international
or local projects.
THE REGIONAL DELEGATIONS
Across France, Médecins du Monde has set up regional
delegations. Elected every two years, the regional colleges
represent the regions within MdM. The delegations carry out
international or regional projects, within the overall framework
defined by the Board.
All of the Board members, Heads of Project, group co-ordinators,
regional and board representatives meet three times a year for a
National Advisory Council meeting.
> CONTENTS
» OUR ORGANISATION
ANNUAL REPORT 2006
159
Departmental News
The departments of the MdM France headquarters have three main aims. Firstly, to support programmes
run by the organisation amongst the most vulnerable people in France and abroad. Secondly, to provide
institutional, human resources, logistic and financial support to the programmes.The final objective is to
account for, and report on, the programmes to our funders and donors.
HUMANITARIAN ACTION
At the international level, the year was marked by the end of the
programmes in Indonesia and the continued development of
international programmes. Our programmes budget has increased by
60% in three years. Our presence in post-conflict areas intensified,
such as in Democratic Republic of Congo, which is the country with
our largest programmes.
In France, the key event was the fact that our main harm reduction
programmes became autonomous. With the changes in the
legislation, and the fact that health insurance now pays for these
activities, the two methadone buses (in Paris and Marseille) and the
two main needle exchange programmes (in Paris and Bordeaux)
were transferred to independent organisations.These organisations,
based on the programme staff and volunteer teams, will still be linked
to Médecins du Monde via a collective created for that purpose.
HUMAN RESOURCES
The creation of a Human Resources Directorate, whose remit
covers all human resources – both staff and volunteers – is the key
element of 2006. One of the key areas of work for this new
directorate is to explore what innovation is required for
recruitment, retention and development of MdM’s international field
personnel.
form of donation. These are the most regular and least costly to
manage;
• Introduction of street fundraising, with immediate sign-up to
standing orders, with satisfactory results;
• Development of resources from major donors, individual donors,
businesses and foundations;
• Development of funding from the Médecins du Monde
international network, through the Representative Offices in
Germany, Japan, Netherlands and the UK. Also, through some
international delegations such as Canada, Spain or Switzerland.
MANAGEMENT (UNTIL 31 DECEMBER 2006)
Director General of Humanitarian Action: Dr Michel Brugière
Director General of Management and Human Resources:François Dupré
International Operations Directorate: Dr Eric Chevallier
Finance and IT systems Directorate: Catherine Duffau
Administration and Legal Directorate: François Rubio
Human Resources Directorate:Thomas Durieux
Communications and Development Directorate: Isabelle Finkelstein
until April 2006, Juliette Chevalier since December 2006
Adoption Directorate: Dr Geneviève André-Trévennec.
MANAGEMENT
In relation to private donations, which are essential for the financial
independence of the organisation, several areas of work have been
carried out:
• For private individual donors, a step reduction in requests to loyal
donors (-15% in one year) and emphasis on standing orders as a
> CONTENTS
MdM’s International Network
Since December 1996, Médecins du Monde has had consultative status with the Economic and Social
Council of the United Nations.
INTERNATIONAL DELEGATIONS AND
REPRESENTATIVE OFFICES
161
ANNUAL REPORT 2006
The Médecins du Monde international network was created in 1989 and is today comprised of 16 associations.
MdM makes a distinction between international delegations (11) and representative offices (5). All the
members of the network, are committed to respecting the MdM international associative model, which
confirms the values and fundamental principles of the network.
An international delegation is an autonomous organisation, based on
the associative model of MdM:
• which implements international and national projects;
• which has its own independent communication policy;
• which participates in the International Board of MdM.
A representative bureau is an organisation based on the associative
model of MdM:
• which has a partnership agreement with one specific delegation;
• whose operation is directly supervised by the partner delegation;
• which benefits from financial support from the partner delegation;
• which carries out fundraising and overseas volunteer recruitment
for the partner delegation;
• which runs national programmes after validation by the partner
delegation.
But, which does not implement international programmes and does
not participate in the International Board.
NETWORK INSTITUTIONS
The International Board
The presidents of the 11 delegations meet at least twice a year in the
International Board.This deals with political and ethical issues, is the
authority on ethics for the network, decides on measures to take in
the event of serious misdemeanours by one of the international
delegations, determines the general policy approaches of the
network, elects non-permanent members of the International
Executive Committee, approves the accounts and provisional budget
The International Executive Committee
This meets at least four times a year, bringing together the presidents
of MdM France and MdM Spain (members by right) and the
presidents of two other delegations elected for two years. The
Committee monitors the implementation of the annual action plan,
developed with the International Secretariat on the basis of the
decisions taken by the International Board. It also monitors
compliance with the ethics and principles of the network, advises on
membership or sanctions, acts a mediator when there are problems
between delegations, and ensuring the institutional representation of
the network.
The International Secretariat
Implements the political decisions of the International Board and the
International Executive Committee. The six areas of work of the
International Secretariat include:
• leading, administrating and organising the network;
• co-ordinating delegations’ international programmes (emergency
or development programmes);
• supporting institutional fundraising;
• developing co-ordinated network communication activities;
• representing Médecins du Monde at international organisations;
• monitoring and evaluation visits to delegations under the
Executive Committee’s mandate.
The International Secretariat has its own budget, based on pro-rata
contributions from the various delegations, based on their
penultimate financial results.
> CONTENTS
» OUR ORGANISATION
of the International Secretariat and appoints the director of the
International Secretariat.
PRIORITIES FOR 2006
Operational Co-ordination
The International Secretariat continued to centralise and disseminate
information on activities carried out by the different delegations,
emphasising those areas where several delegations are working
(Haiti, Palestine, Sri Lanka, Sudan etc) and information relating to
security issues.
The International Secretariat acted as the interdelegation coordinating mechanism during the emergency programmes in
Lebanon.
The Directors of Operations of the international delegations had
their annual meeting in November 2006.This meeting enabled them
to draw some lessons from their experience and to improve coordination and operational synergy.
Supporting fundraising
Throughout the year, the International Secretariat has disseminated
information on donors grant application processes to the
international network. The Secretariat supported some delegations
in their fundraising and clarified the rules and procedures relating to
fundraising through the Representative Offices.
Thematic groups
The International Secretariat continued to promote information
exchange between the international delegations by running some
thematic groups.
AIDS group
The international network participated in the 26th international AIDS
conference in Toronto in August 2006. The delegations developed
joint communication materials which were displayed on the
international network’s stand at the conference.
Health and Migration group
Work has continued on this theme, including the work of the
European Observatory, the development of the Averroes project and
efforts towards creating a network of European organisations
working for access to healthcare for migrants.
Communication group
The International Secretariat has been developing a new website
which is due to go live in the first half of 2007.The site, a portal for
the websites of the delegations and offices, will give an overview of
activities across the whole network.
In addition, a communications steering committee has been set-up.
This will work on harmonisation of key communication tools across
the network.
THE MdM INTERNATIONAL NETWORK
THE 11 DELEGATIONS & THEIR PRESIDENTS
Médecins du Monde-Argentina / Médicos del Mundo-Argentina
President: Dr Alicia Luna then M. Gonzalo Basile
Médecins du Monde-Belgium / Dokters van de Wereld-Belgie
President: Dr Michel Degueldre
Médecins du Monde-Canada
President: Dr Réjean Thomas then Dr Nicolas Bergeron
Médecins du Monde-Cyprus/Giatri Tou Kosmou-Cyprus
President: Dr Elias Papadopoulos
Médecins du Monde-France
President: Dr Françoise Jeanson then Dr Pierre Micheletti
Médecins du Monde-Greece / Giatri Tou Kosmou- Greece
President: Dr Elefteria Parthenopoulos
Médecins du Monde-Portugal / Médicos do Mundo-Portugal
President: Dr Rui de Portugal
> CONTENTS
Médecins du Monde-Spain / Médicos del Mundo-España
President: Dr Teresa Gonzales
ANNUAL REPORT 2006
163
Médecins du Monde-Sweden/Läkare i Världen-Sverige
President: Pr Anders Bjorkman
Médecins du Monde-Switzerland
President: Dr Nago Humbert
» OUR ORGANISATION
Médecins du Monde- United States/Doctors of the World-USA
President: Dr Vicky Sharp
THE 5 REPRESENTATIVE OFFICES
MdM-Germany (Representative office of MdM-France)
MdM-Italy (Representative office of MdM-Spain)
MdM-Japan (Representative office of MdM-France)
MdM-Netherlands (Representative office of MdM-France)
MdM-United Kingdom (Representative office of MdM-France)
> CONTENTS
>INTERNATIONAL OFFICES
GERMANY
Key events
Contact details
> International Office
Ärzte der Welt
Thalkirchner Str 81/Kontorhaus 1
81371 Munich
Germany
Tel. 0049 89 62 42 09 55
Fax: 0049 89 65 30 99 72
[email protected]
www.aerztederwelt.org
Contacts
Dr Lecia Feszczak, Gertrud
Wimmer, Dr Monika Kleck
Association under German law,
constituted 19 March 1999
Board of Directors
> President:
Pr Wilfried Schilli
> Vice-President :
Dr Pierre Rosenstiel
> Treasurer:
Rolf-Michael Schlegtendal
> Other members:
Dr Klaus Wieners
Dr Béatrice Stambul
Dr Francois Scheffer
Pr Albrecht Pfleiderer
Pr Norbert Schwenzer
Andreas Jungk
Financial support for projects:
• Angola: mother and child health programme in North
Huambo region;
• Liberia: primary healthcare, community and mental
healthcare;
• Pakistan: supporting government refuges for women
who are victims of domestic violence and emergency aid
to the victims of the earthquake;
• Indonesia: supporting victims of the earthquake in
Yogyakarta;
• Lebanon: supporting victims of conflict;
• Sri Lanka: preparing to refurbish the operating theatre
at Batticaloa hospital.
Human resources support for projects:
• 12 participants in Operation Sourire;
• 1 expatriate in Sudan.
Events:
• Newspaper articles on Operation Sourire and the
programmes in Liberia, Sri Lanka, Pakistan, Mexico and
Lebanon as well as other coverage;
• Four email newsletters;
• Radio Lora broadcast on the Liberia project, the local
project and Arzte der Welt;
• MDR – Leipzig TV invited Dr Lauer and Dr Pinzer to
speak about Operation Sourire on the ‘4 to 4’ show.
• RTL broadcast a film on Operation Sourire.
Events:
• Four conferences on Operation Sourire;
• Screening a film on child soldiers;
• Participation at the Volunteers Fair and the ‘Out in the
World’ day in Munich;
• Presentation of Arzte der Welt with the children of
Pinocchio circus in Aachen;
• Participation in the Munich council photography
exhibition on Batticaloa, Sri Lanka;
• Humanitarian conference in Berlin in October 2006;
• ’23 artists for Médecins du Monde’ auction of prints in
aid of MdM by the Neumeister auction house
Supporting the European lobbying campaign for an
amendment to the new EU Directives.
> CONTENTS
Projects:
• Three Operation Sourire missions to Cambodia
(Kampong Cham, O Reang Ov and Phnom Penh);
• Launch of a local project in Munich on ‘Access to
healthcare for people without health insurance’;
• In partnership with Munich council and the
organisation Help from Germany, we worked on the
refurbishment of Batticaloa hospital in Sri Lanka.
Acknowledgements:
German Ministry of Foreign Affairs, the City of Munich,
Süeddeutsche Zeitung, Eine-Welt-Haus de Munich,
Munich North-South Forum, Stadtsparkasse Munich,
Kulturreferat der Landeshauptstadt Munich, Bayerischer
Rundfunk, Sternstunden e.V., M-Net Munich, Sofa-lxsystems, Sonja Schultes & Hersberger,
www.helpdirect.org, www.malinet.de,
www.zdf.de/zdfde/inhalt, ARD, MDR-Leipzig, RTL Explosiv, SWR Freiburg, Radio Lora, Cafe 104,
Bayerischer Flüchtlingsrat, Neumeister –
Kunstauktionshaus Munich; Munich, Charity Label,
Aachen Children Circus ‘Pinocchio’, Excognito Agentur
für Public Realtions, Euro RSCG LIFE Munich, D 8 DigitalLab, Barbara Harmann Fotografie,
Communications and Design - Nikolaus Teixera, Bar-MFabian Hickethier, AstraZenesa GmbH, AthosUnternehmensberatung, Bausch, Lomb & Dr Mann
Pharma, DekaBank Deutsche Girozentrale, Dornier
E.U.C., Zug, Firma Schwemmhuber, Fresenius KABI,
Munidpharma Vertriebs-GmbH & Co. KG, Pfizer Pharma
GmbH, Rath-Schwind Verwaltungsgesellschaft mbH,
Steigerwald Arzneimittelwerk GmbH,WIT-Stiftung für
sozial Zwecke,Widder-Apotheke Warngau; Grünental
GmbH, Firma Paul Hartmann AG
JAPAN
Médecins du Monde-Japan
PMC Building
1-23-5 Higashi-Azabu,
Minato-ku,Tokyo 106-0044, Japan
Tel. 0081 3 3585 6436
Fax: 0081 3 3586 7746
[email protected]
http://www.mdm.or.jp
Contacts
Prune Helfter
Yu Kumano
Nao Kuroyanagi
Tatsuya Kishi (employees)
Association under Japanese law,
constituted 10 October 2000
Board of Directors
> President:
Gaël Austin
> Other members:
Dr Arnaud Bourde
Dr Patrick David
Dr Francois Foussadier
Masako Harada
Akitane Kiuchi
Dr Norihiko Oura
Dr Satoshi Yoza
• Operation Sourire programmes;
• Angola: mother and child health;
• China: AIDS prevention in Chengdu;
• Ethiopia: prevention of mother to child transmission of
HIV;
• Haiti: caring for victims of violence and revitalising the
health service;
• Indonesia: healthcare for the Punan people;
• Indonesia: emergency programme after earthquake in
Java;
• Niger: malnutrition emergency;
• DRC: supporting street children;
• Sudan: emergency programme in Darfur.
Seventeen Japanese volunteers went to the field with
Operation Sourire to three different countries: Niger,
Cambodia, Ethiopia.
Publicity events and activities:
Events
• Gala evening in aid of MdM organised in the Residence
de France: more than 260 participants;
• French Blue meeting: collecting donations from more
than 6,000 visitors;
• Global Festa: MdM stand at this general public event
(66,700 visitors over two days);
• Presentations on MdM’s work to several hundred
students;
• Link to three gala evenings which gave a proportion of
the profits to MdM;
• Photo exhibitions in the Tokyo Metro.
Advocacy: Speeches at conferences on tuberculosis,
innovative development finance mechanisms and
homelessness.
Recruitment: Organising five information meetings on
volunteering. Stand at two recruitment fairs and during
the general assembly of the Tropical Medicine
Association.
> CONTENTS
Commercial partnerships: Sales of greeting cards,
decorative plates, patisserie and designer clothes in aid
of MdM.
ANNUAL REPORT 2006
Contact details
165
Press: 30 minute TV programme on Operation Sourire
in Niger. Several long articles on MdM’s activities in high
circulation daily and weekly newspapers.
Other communication tools: Presentation of MdM’s
activities to donors, volunteers and partners through
the new website, blog, a printed newsletter and an enewsletter.
Acknowledgements:
Air France, Akebono Brake, Alsok, French Embassy in
Japan, Asahi Pretec, Céline, Chanel, Châteaux & Hôtels
de France, Christofle, Oiso College, Creator’s Next,
Daboo, Dominique Doucet, Expert Alliance, Exprime,
Fund Creation (FC Reit Advisors), Felissimo
Corporation, French Blue Meeting, French Food Culture
Center, Givenchy, Ginza Gallery (Circle Club), Grand
Hyatt Tokyo, Greeting life, Impresario,French Institute in
Tokyo, Johnson & Johnson, LVMH, Mainichi Social
Welfare Foundation, Marijoli, Mitsui Sumitomo
Insurance, Oka Tetsuya, Osaka Suminoe Rotary Club,
Patrick Nugier, Seiyu Shoji, Sompo Japan Insurance,
Tokyo University of Agriculture, Daiichi Junior High
School.
» OUR ORGANISATION
Key events
THE NETHERLANDS
Key events
Contact details
Dokters van de Wereld
Rijswijkstraat 141 A
1062 ES Amsterdam
The Netherlands
Tel. 0031 20 465 2866
Fax: 0031 20 463 1775
[email protected]
Internet:
http://www.doktersvandewereld.org
Contacts
José Utrera
Nadjehda Brouwer-Richardson
Sacha Godschalk
Monica Reulink
Letteke Swartjes
Anna Miranda Scholten
Sabrina Langerak
Arianne de Jong (employees)
Marian van Keuk
Gerd Beckers (co-ordinators)
Association under Dutch law,
constituted 28 April 1997
Board of Directors
> President:
Dr Barbara ten Kate
> Secretary:
Dr Dirk Jan Pot
> Treasurer:
Casper van Rijn
> Other members:
Dr Howard Teunisse
Bernard Juan
Dr Françoise Sivignon
Financial support for projects (through direct marketing
and grants):
• Benin: fighting epidemics – HIV/AIDS;
• Burma: harm reduction programmes linked to drug
use;
• Colombia (Meta): access to healthcare for civilian
populations;
• Guatemala: right to health for women working in the
maquilas in Chimaltenango;
• Indonesia: Central Aceh;
• Indonesia,Western papua: access to healthcare for
minorities;
• Liberia: primary healthcare, community and mental
healthcare;
• Operation Sourire;
• Pakistan: earthquake emergency programme;
• DRC (Goma): fighting HIV/AIDS;
• Sudan: emergency medical care;
• Zimbabwe: AIDS programme;
• China, Chengdu (Sichuan): HIV/AIDS prevention and
harm reduction among drug users;
• West Bank, Palestinian Territories: mental health.
Human resources support to programmes:
20 expatriate volunteers in the field (1 General Coordinator, 3 Medical Co-ordinators, 5 doctors, 4
midwives, 1 psychologist and 1 trainer) for the following
missions: Papua New Guinea, China, Banda Aceh, Sudan,
Liberia, Zimbabwe, Pakistan and Java.
• Media interviews with Dutch volunteers;
• Launch of a new publicity campaign on forgotten
populations for Dokters van de Wereld;
• Press trip to Pakistan and publication of articles;
• Three newsletters (on Dokters van de Wereld’s
international programmes) for donors and volunteers;
• Exhibition on Papua in the Arena Hotel in Amsterdam
and media interviews with Dutch volunteers (radio,
newspapers).
> CONTENTS
National projects
• Roma and Sinti populations: health programme,
focusing on women. Health education among the Roma
and Sinti communities in the Netherlands;
• Irregular migrants: pilot programme to improve access
to healthcare for irregular migrants in Amsterdam;
• Distribution of medical documents (MEDOC) to
irregular migrants and information campaign amongst
health professionals about access to healthcare.
International projects:
• Curacao: pilot programme on improving access to
reproductive health, and HIV/AIDS;
• Indonesia, Central Aceh: pilot programme to improve
access to healthcare for mothers and children.
Acknowledgements:
Aids Fund, Cordaid, ICCO, Oxfam Novib, Dutch
Ministry of Co-operation and Development, 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, EURO
RSCG, MEMISA Belgium, PIN, SKAN Foundation,
Ministry of Social Affairs and Science, Hotel ArenA,
Jeroen van Loon, and all our volunteers, interns and
thousands of individual donors.
UNITED KINGDOM
Médecins du Monde UK
14 Heron Quays
London E14 4JB
Tel. +44(0)20 7517 7534
Fax: +44(0)20 7515 7560
[email protected]
www.medecinsdumonde.org.uk
Contacts
Susan Wright (new Director),
Karen McColl (Director until end of
2006)
Frank Dixon, Michelle Hawkins,
Elinor Middleton, Dorothy Muthuri,
Fizza Qureshi, Isabelle Raymond,
Macarena Yarza (employees)
Association under English law,
constituted 13 January 1998
Board of Directors
Dr David Barnes
Dr Laurence Bioteau
Ms Janice Hughes
Mr Robert Lion
Dr Sarah Pickworth
Lord Rogers of Riverside
Mr Roo Rogers
• Cambodia: Antiretroviral therapy programme in Phnom
Penh;
• Sudan (Darfur): Medical aid for the displaced
population;
• Afghanistan: Mother and child healthcare programme in
Kabul;
• Indonesia: Caring for the Punan population.
UK volunteers sent to international projects.
• Advocacy: preparation of first year report on Project:
London;
• Charity Challenge: MdM UK’s London to Paris Bike
Ride 2006 – An event to raise funds for MdM UK,
cyclists travelled to Paris (293km) from Tower Bridge to
the Eiffel Tower.Then they visited MdM headquarters;
• MdM UK volunteers gave interviews to British press
and articles on Médecins du Monde were published
(Internet, magazines, newspapers, radio,TV);
• Publication of NEWS, newsletter detailing MdM UK’s
activities, for volunteers and donors;
• Raising awareness: 24 forums to engage doctors,
nurses, midwives, psychologists, surgeons, logisticians,
administrators and students who may wish to volunteer
in the future;
• Nine presentations to the general public for potential
volunteers and donors;
• Fundraising evening: music event ‘Musique du Monde’ at
SOAS featuring five international groups;
• Bearing witness:10th Luis Valtuena Humanitarian
Photography Exhibition was launched at the Scottish
French Institute in Edinburgh. The exhibition will tour
throughout 2007.
Projects:
• Launch of Project: London, national project to facilitate
access to healthcare for the most vulnerable (migrants,
homeless people, street sex workers);
• Twice weekly sessions offering medical consultations
and advice on accessing healthcare;
• Recruitment and training of a team of 80 volunteers;
> CONTENTS
Acknowledgements:
Action for Bow; Alliance Pharmacy; Cabot Hall; Canary
Wharf Group; Clifford Chance; Coutts; Department For
International Development (DfID); Elton John AIDS
Foundation; French Huguenot Church of London
Charitable Trust; GLA; Grazia; Guernsey Overseas Aid
Commission; Hewlett Packard Computers; Isle of Man
Overseas Aid Committee; Jeune Chambre de
Commerce Franco-Brittanique; London to Paris Bike
Riders 2006; Lonely Planet Foundation; MEDSIN;
Microsoft; MVM Charitable Trust; Pauffley; Paul & Joe;
staff of the Prisons & Probations Ombudsman office;
Quire;The Rawhides; Rayne Foundation; Richard Rogers
Settlement;Thames Wharf Charity; SOAS;Tudor Trust;
London Catalyst.
Thanks to all our donors and particularly to Michael
Watt for his generosity and support. Special thanks, as
always, to all our volunteers.
167
ANNUAL REPORT 2006
Contact details
• Participation in the European survey on Access to
Healthcare for Undocumented Migrants in Europe.
» OUR ORGANISATION
Key events
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, on average, one to two years.The structures created in this way remain MdM’s natural
partners in the region.
> IN EUROPE
> IN AFRICA
• Bosnia-Herzegovina, Sarajevo
DUGA (Reception and Psychological
Support Centre for Children and
Adolescents)
Established 1994, independent since 2002.
[email protected]
Activities: supporting children, preventing
HIV/AIDS.
• Poland,Warsaw
Nobody’s Children
www.fdn.pl
Activities: supporting children.
• Romania, Bucharest
FICF (International Foundation for
Children and Families).
Established 1993,
independent since 2003.
Fax: + 40 21 311 19 15 / 23 05
Activities: fighting AIDS, harm reduction.
• Mozambique, Maputo
Meninos de Moçambique
(Children of Mozambique)
Fax: + 258 30 41 16
• Madagascar,Tuléar
Association Sisal (Doctors for the
Right to Health).
• Uganda, Kyotera
CIPA (Community Initiative for
the Prevention of HIV/AIDS/STIs).
Established October 2003,
independent since December 2005.
[email protected]
Activities: fighting HIV/AIDS.
> IN LATIN AMERICA
• El Salvador
MDS (Doctors for the Right to
Health).
Established in1998.
www.mds.org.sv
Activities: promoting the right to health.
> CONTENTS
ORGANISATIONS REQUIRING
SUPPORT FROM MDM
> IN AFRICA
• Tanzania, Bukoba
Tadepa (Tanzania Development
and Prevention of Aids).
Established 2001.
• Ivory Coast, Abidjan
Mesad (Movement for Education,
Health and Development).
Established 2001.
[email protected]
Activities: supporting children, fighting
HIV/AIDS.
> IN EUROPE
• Bulgaria, Sofia
Child and Space Association.
Established July 2005.
[email protected]
• Serbia, Belgrade
VEZA. Established June 2005.
[email protected]
Activities: fighting HIV/AIDS, harm
reduction.
SOUTHERN PARTNER
ORGANISATIONS
> AFRICA
• Guinea, Kindia
KAD (Kindianese Assistance to
Prisoners).
Established 2000.
Activities: supporting prisoners.
• Rwanda, Kigali
Ibuka (Memory and Justice).
Established 1995.
Activities: defending the rights of genocide
victims.
• DRC, Kinshasa
AED (Aid to Disadvantaged Children).
Established 1966.
Activities: assisting children.
• Zimbabwe, Chipinge
FACT (Family aids caring trust).
Established in 1987.
• Madagascar, Antananarivo, Ilakaka
Salfa (Madagascan lutheran church).
Established July1987.
Activities: primary health care.
> LATIN AMERICA
> EUROPE
• Haiti, Port-au-Prince
Uramel (Medico-legal Research and
Action Unit).
Established July 2002.
www.uramel.net
Activities: promoting justice in partnership
with health professionals.
• Moldova, Balti
TDV (Tinerii Pentru Dreptul la Viata).
[email protected]
• Bulgaria, Sliven
Foundation for Roma Health.
Established 1999.
[email protected]
Activities: primary healthcare.
> MIDDLE EAST
• Egypt, Cairo
Hope Village.
Established 1988.
www.egyhopevillage.com
[email protected]
• Lebanon, Antelias
Ajem (Justice and Mercy Association).
Established January 1998.
[email protected]
Activities: aid to refugees, asylum seekers
and imprisoned migrants.
• Morocco, Casablanca
Medical Association for the
Rehabilitation of Victims of Torture.
Established January 2001.
[email protected]
Activities: supporting victims of torture.
> CONTENTS
> ASIA
• Indonesia, Jakarta
Yayasan Aulia.
Established 1984.
[email protected]
Activities: right to health and education
and community organisation.
» OUR ORGANISATION
ANNUAL REPORT 2006
169
Médecins du Monde
and civil society in France
MdM
Co-ordination groups
> SUD co-ordinating body – CCD
> CNVA
> Fonjep
> Charter committee
> Unogep
> VOICE
> CO-ORDINATION GROUPS
SUD (Solidarity Emergency
Development) Co-ordinating body
A co-ordinating body for French
humanitarian and development NGOs
which it represents in France and
internationally. As a Board Member, MdM
represents the group in:
• the CCD (Development Co-operation
Commission), a joint body informing NGOs
of the public authorities’ co-operation
Thematic platforms
> Health and Welfare
• Uniopss - Alerte collective
• CNLE
• ODSE (Observatory on Migrants’
Right to Health)
• 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
policy.
CNVA (National Council of Voluntary
Organisations)
An independent authority attached to the
Prime Minister’s office, through which all
French associations relate to the Prime
Minister. MdM monitors issues related to
humanitarian activities.
• FONJEP (Youth and popular education cooperation fund). A jointly-managed
organisation bringing together public
> CONTENTS
Geographical platforms
> Mixed Commissions
> Palestine Platform (observer)
authorities and voluntary organisations to
facilitate voluntary work. MdM monitors
volunteering issues.
• Comité de la Charte (Charter
Committee). A committee bringing together
organisations which fundraise from the
general public, in accordance with the
Charter and previous recommendations.
• UNOGEP (National Union of Fundraising
Organisations)
ANNUAL REPORT 2006
171
Health and Welfare
• UNIOPSS (National Inter-federal Union of
Private Health and Welfare organisations).
It works with institutions promoting the
recognition of the voluntary sector in
health and welfare in European social policy.
MdM belongs to the poverty and exclusion
commission of the health and europe
groups. Link with the Alerte group.
• CNLE (The National Council for AntiExclusion Policy). It checks that the
government is enforcing all measures in the
fight against exclusion. MdM has set up a
group to monitor the CMU (universal
health insurance), investigating issues
relating to asylum seekers and refugees.
• ODSE (Observatory on Migrants’ Right to
Health)
• Platform for the Fight Against Human
Trafficking
• French Co-ordinating body for the Right
to Asylum
• Romeurope
• International Harm Reduction Association
International Action
• URD (Emergency Rehabilitation
Development Group): group of relief
organisations working on quality assurance
in humanitarian activities
• Volunteering NGO liaison committee
(effective from 2004).
> GEOGRAPHICAL PLATFORMS
• Mixed commissions: Joint body of NGOs
and public authorities. Exchanges on
working methods in a country.
• The Palestine platform: Group of
voluntary organisations. MdM has observer
status.
Funding
• AFTA (French Association of Voluntary
Organisation Treasurers)
Human rights
• CNCDH (National Advisory Committee
on Human Rights). It delivers opinions and
recommendations on human rights to the
Prime Minister.
> CONTENTS
» OUR ORGANISATION
> THEMATIC PLATFORMS
Médecins du Monde and
international institutions
NGOs that are active in the humanitarian field cannot ignore international institutions, which are both
major 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 status which allows it to intervene immediately.
> EUROPEAN UNION (EU)
• The task of ECHO (the European
Commission’s Humanitarian Aid Office) is
to provide aid and emergency relief to
populations affected by natural disasters or
conflicts outside the EU. ECHO has
intervened in more than 85 countries since
1982 and has an annual budget or more
than 500 million euros.
EuropeAid (Co-operation Office) is
charged with implementing the European
Commission’s external aid mechanisms.The
EU is one of the main institutional donors
for development. More than 150 countries,
territories or organisations receive this aid
which is managed by the EuropeAid office.
MdM relates to EuropeAid through
Concord (the Confederation of European
Relief and Development NGOs), which
carries out collective lobbying of the
European Union’s institutions and facilitates
development of common positions on
European development policy and the
major issues in north-south relations.
For several years, MdM has been
particularly active in VOICE, the interface
between aid organisations and ECHO,
which brings together 90 European
emergency relief NGOs. MdM France is a
member of the Task Force which negotiates
with ECHO on behalf of VOICE’s NGO
members.Thus, during the last few years,
MdM has played a large part in the revision
of ECHO’s framework partnership
agreement through the group set up by
VOICE to monitor the partnership
agreement.
MdM France and other MdM delegations
participate in ECHO’s strategic planning
meetings.
> UNITED NATIONS (UN)
• The Economic and Social Council
(ECOSOC) is the main co-ordinating
body for the economic and social activities
of the UN and its specialist bodies and
institutions. MdM’s international network
has special consultative status which
means that it can carry out lobbying
activities, especially of the Human Rights
Commission. It has observer status in this
subsidiary body of ECOSOC and is one of
the few medical NGOs present in this
public arena addressing human rights
violations. At the Commission’s annual
meeting, MdM can intervene on each
agenda item and submit texts.
> COUNCIL OF EUROPE (COE)
• The Council of Europe brings together 46
European states. Set up in 1949 to defend
human rights, its particular focus since 1989
has been to help the Central and Eastern
European countries to implement and
consolidate political reforms.
MdM’s international network has
consultative status with the CoE and is part
of OING Service, a liaison group for NGOs
with this status.
> CONTENTS
• MdM’s international network has
representation at the World Health
Organization (WHO) and the Office
for the Co-ordination of
Humanitarian Affairs (OCHA) in the
High Commission for Refugees
(UNHCR).This political representation is
supplemented by an operational
agreement which MdM has with UNHCR.
There is an information exchange
partnership between OCHA and MdM and
operational monitoring through Reliefweb.
ANNUAL REPORT 2006
173
» OUR ORGANISATION
• Some MdM programmes are in contact
with the United Nations Development
Programme (UNDP) through
operational collaboration and a policy,
notably on the theme of children in
conflicts.
The same occurs with the United
Nations Children’s Fund (UNICEF)
with which MdM works on several projects.
• MdM is a member of the International
Council of Voluntary Organisations
(ICVA), a network of NGOs involved in
human rights, which concentrates on
humanitarian issues relating to refugees.
ICVA brings together over 80 international
NGOs.The Council relates to the UN
authorities, especially as an interface with
UNHCR by tackling different themes such
as the relationship between humanitarian
workers and the military, or the protection
of civilians in armed conflicts.
> CONTENTS
The Board of Directors and Executive
Committee of Médecins du Monde
General Assembly and Board Meeting on 13 May 2006
PRÉSIDENT
Dr Pierre Micheletti
Public health doctor
GA 2007
DEPUTY GENERAL SECRETARY
DEPUTY BOARD MEMBERS
Dr Thierry Brigaud
General Practitioner
GA 2009
Dr Arnaud Bourdé
Anaesthetist-resuscitation specialist
GA 2007
VICE-PRESIDENTS
INTERNATIONAL PROJECTS
REPRESENTATIVE
Dr Didier Cannet
AG 2009
Dr Olivier Bernard
Paediatric
GA 2007
Dr Patrick David
Anaesthetist-resuscitation specialist
GA 2008
TREASURER
Catherine Giboin
University Lecturer
GA 2009
DEPUTY TREASURER
Joseph Dato
Associate Professor at Grenoble University
GA 2007
BOARD MEMBERS
Dr Pascale Estecahandy
Hospital doctor
GA 2008
Dr Françoise Jeanson
GA 2007
Pierre Kempf
Hospital deputy director
GA 2009
Dr Jérôme Larché
Resuscitation doctor
GA 2009
GENERAL SECRETARY
Dr Françoise Sivignon
Radiologist
GA 2008
Dr Fabrice Giraux
GA 2008
> CONTENTS
Dr Régis Garrigue
Emergency care doctor
GA 2008
OUR THANKS TO:
Public partners:
For our international projects: académie de Lille, Administration des biens et des majeurs protégés, Canadian Agency for International Development (ACDI), Canadian embassy,
Association des régions de France, World Bank, Centers for Disease Control And Prevention, Chaîne du bonheur (Switzerland), Rouen chambre of commerce, Columbia University, Cordaid,
communauté d’agglomération du bassin d’Aurillac, Department for International Development, the Swiss Directorate for Development and Cooperation, ECHO, Europeaid, Global Fund to
fight AIDS,Tuberculosis and Malaria, Institut de radioprotection et de sûreté nucléaire, Joint United Nations Programme on HIV/AIDS, German, French and Japanese Ministries of Foreign
Affairs, Dutch Ministry for Cooperation and Development, IOM, PACT, UNDP, Population Services International, PACA region, Rhône-Alpes region, Safer de l’Ile-de-France, UNHCR, UNFPA,
UNICEF, UNOCHA, United Nations Office on Drugs and Crime, USAID,Villes unies contre la pauvreté.
Town councils: Aigremont, Audincourt, Bassens, Behren-lès-Forbach, Bonnelles, Bourg-lès-Valence, Brioux-sur-Boutonne, Chilly-Mazarin, Drancy, Garlin, Goussainville, Lacroix-Falgarde, 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,Le Tréport,Val-d’Isère.
For our regionally managed international projects:Department councils – Bouches-du-Rhône,Alpes-de-Haute-Provence, Gironde, Charente-Maritime,Vosges, Doubs, La Réunion, MidiPyrénées ; regional councils – Provence-Alpes-Côte d’Azur and Rhône-Alpes; presidency of the regions, Guadeloupe region prefecture.
For Mission France: CNAM (National Health Insurance Office), CAF (Family Allowance Fund), CMR (Regional Health Offices), CPAM (Local Health Insurances Office), CRAM (Regional
Health Insurance Offices), CCAS (Communal Social Action Centres), district councils, regional councils, town inter-ministerial delegations (DIV), General Department of Health, General
Department of Social Affairs, regional and district health and welfare services (Drass and Ddass), prefectures, Healthcare acccess offices (PASS), Armée de terre, DASES (Department of Social
Action, Children and Health), Abbé Pierre Foundation, MILDT (Interministerial platform against drugs and drug dependency), la DSS (Health and Society Department) , CTC (Corsican regional
collective), URCAM (Union of Regional Health insurance offices), Mutualité agricole de Normandie,Valenciennes Hospital, CGSS (Guiana social security office), COMAGA (Communauté
d’agglomération du Grand Angoulême), MSA (Mutualité Sociale Agricole), OFDT (French Observatory on Drugs and Drug Dependence).
Our partner associations:
Aides,ALC Nice,Amnesty International,ANEF, Association of communication and action for access to treatment,Association of French Regions, AFR, Association of Families Victims of Child
Lead Poisoning, Self-help association and harm reduction for drug users,Travellers association, Health without borders association,Association les Mondes solidaires,Association des Inadaptés
des Po, Pays de Retz doctors’ association, le Foyer, Setton Association, Sanatatea Association, ATD Fourth World, Avenir et Coopération, Banque humanitaire, Bus 31-32, Pays de la Loire
planning centre, CFDA,Alsace collective of organisations working with sex workers,Alerte Collective, Collective supporting victims of Bam, Friends of Emmaüs Committee, Communauté
mariste, Congrégation des soeurs augustines, Red Cross, CSF, French Co-ordinating Body for the Right to Asylum, CNR (National Coordinating Body for Networks), Cyclamed, Droit Au
Logement (Right to Housing), D’une rive à l’autre, DHL Liens, Emmaüs, Ensemble contre le Sida, Entraide majolane, Equipe mobile Rimbaud, FAPIL (Federation of Associations for the
Promotion and Integration through Housing), FIDH, FNARS (National Federation of Associations for Reception and Social Reintegration), Sonacotra foyer, St-Benoît foyer, GAIA Paris, Gisti,
International Harm Reduction Association (IHRA), the Order of Malta, LA CASE, Friends of the Women’s Bus, Mondes solidaires, Restos du Coeur, Stade rennais FC, Brittany Football League
and the clubs in Brittany, Ligue des Droits de l’Homme, Max Havelaar, Mouvement du Nid, ODSE (Observatory on the Right to Health for Foreigners), OIP (International Observatory on
Prisons), Passerelle la santé sans frontières, PHI, Platform against human trafficking, Secours catholique, Sid’espoir, Solidarité Sida, SOS Drogue internationale (SOS DI), SOS Femmes, Rasko,
Techno Plus, Uniopss,Veille sociale,Vialtis.*
And all our partners who have supported our work in France and abroad during 2006, as well as our individual donors.
> CONTENTS
ANNUAL REPORT 2006
175
» OUR ORGANISATION
Our private partners:
A 13,A2P and associates,Adonix application and services,A Novo,Abbaye de Pradines,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 artistepeintre,Axalto international SAS, Beat SA,
Beaulieu sports, Begon Bonneau, Herbert Bouchard SCP, BHV, bibliothèque scolaire Peep Ass, Bretagne Enchères, Brossard - Saveurs de France, Camif solidarité, Capa television, Carrefour
DMG, Carte et Services, CGMI, chambre départementale des huissiers de la Nièvre, Champion, Charpentier travaux publics, Chercheminippes, chorale Risle-Gospel, Club Méditerranée, Club
Soroptimist, CMP, Codara SA, Cofiroute, Comanaging SAS, Comité des oeuvres sociales de Meyzieu, Comptoir des voyages, Consort Netcom, Construction mécanique de l’Isère, Crédit
coopératif, 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, groupe SNPE, 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, librairie le Coin du feu, 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, Pierson Meunier export SA, Polypore Europe SA, Prima Solutions, Production La Prade SARL,
Renzo Piano Building Workshop, Readers Digest Selection, Reuters, Rotary Club de Gordes, de Toulouse Ouest, de Papeete-Tahiti, Rousseau, RS Com SA, SACD, SAFI, SA IFB, Sagone SA,
SANOFI- Aventis, Saulnier Blache SARL, See Velado, Sers, SFR, Sham, Smith And Nephew SAS, 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, Croissy-sur-Seine tennis club,TF1,Théâtre de La Michaudière,
Théâtre 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, Florindon Stiftung,Air France Foundation,Arradon Foundation, Bois Brillou Foundation, Caisse d’Epargne Foundation, Club Méditerranée Foundation,
Drosos Foundation, Fondation de France, Lille Foundation, Deniber Foundation, 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.
Staff committees 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.
GLOSSARY
A
ACF: Action Contre la Faim (Action against
Hunger)
ACRO: Association pour le Contrôle de la
Radioactivité de l’Ouest (Western Association for
Radioactivity Control)
ADIL: Agence Départementale d’Information sur le
Logement (District Office on Housing Information)
ADS: Agence du Développement Social (Social
Development Agency)
AED: Aide à l ‘Enfance Défavorisée (Aid for
Disadvantaged Children)
AFD: Agence Française de Développement (French
Development Agency)
AFR: Association Française de Réduction des
Risques (French Harm Reduction Association)
AFTA: Association Française des Trésoriers et
responsables d’Associations (French Association of
Treasurers and Managers of Voluntary Organisations)
AFUS: Association of former staff members
(UNESCO)
AFVS: Association des Familles Victimes du
Saturnisme (Association of Families Victims of Lead
Poisoning)
AIDES: Association fighting AIDS
AJAR: Association of Young Anaesthetists and
Resuscitation Specialists
AJEM: Association for Justice and Mercy
ALPIL: Action Lyonnaise pour l’Insertion par le
Logement (Lyons Action for Inclusion through
Housing)
ALS: Association fighting aids
AME: Aide Médicale de l’Etat (State Medical
Assistance)
AMP: Childcare assistants
ANIT: Association Nationale des Intervenants en
Toxicomanie (National Assocation of People
Working on Drug Dependency)
ANPAA: Association Nationale de Prévention en
Alcoologie et Addictologie (National Association for
the Prevention and Addictions)
APE: Agence des Participations de l’État (State
participation agency)
APHP: Assistance Public - Hopitaux de Paris (Social
services – Paris Hospitals)
ARV: Antiretroviral
ASAV: Association pour l’accueil des gens du
voyage (Association for Welcoming Travellers)
ASC: Agent de Santé Communautaire (Community
Health Workers)
ASDES: Accès aux Soins, aux Droits et Education à
la Santé (Access to Healthcare, Rights and Health
Education)
ASUD: Auto-Support des Usagers de Drogues
(Drug Users Self-help Group)
ATD-Quart Monde: Aide à Toute Détresse (Help
to All Distressed- Fourth World)
ATIS: Centre de Santé Ami des Jeunes (Friend of
Young People - health centre)
AULIA: Indonesian foundation for street children
B
BCZ: Bureau Central de la Zone (Central Area
Office)
BEI: Bureau Exécutif International (International
Executive Committee)
C
CA: Conseil d’Administration (Board of Directors)
CAARUD: Centre d’Accueil et d’Accompagnement
de Réduction des Risques pour les Usagers de
Drogues (Harm Reduction Centre for Drug Users)
CADA: Centre d’Accueil des Demandeurs d’Asile
(Asylum Seekers Centre)
CAFDA: Coordination d’Accueil des Familles
Demandeuses d’Asile (Coordinating body for
Asylum Seeking Families)
CAI: International Board of Directors
CAM: Centre for Migrants in Rabat
CASO: Centre d’Accueil, de Soins et d’Orientation
(Healthcare and Guidance Centre)
CASP: Centre d’Action Sociale Protestant
(Protestant Social Action Centre)
CCAS: Caisse Centrale d’Activités Sociales (Social
Activties Central Office)
CCD: Commission Coopération Développement
(Development and Cooperation Commission)
CCN: Convention Collective Nationale (National
Collective Convention)
> CONTENTS
CDC: Centers for Disease Control
CEADEL: Centro de Apoyo al Desarrollo Local
(Centre Supporting Local Development)
CENHOSOA: Soavinandriana Hospital
CERC: Conseil de l’Emploi, des Revenus et de la
Cohésion sociale (Council for Employment, Income
and Social Cohesion)
CFDA: Coordination Française pour le Droit d’Asile
(French Co-ordinating Body for the Right to Asylum)
CHRS: Centre d’Hébergement et de Réinsertion
Sociale (Accommodation and Social Re-integration
Centre)
CIMADE: Service oecuménique d’entraide
(Ecumenical Mutual Aid Service)
CIPA: Community Initiative for the Prevention of
HIV/AIDS/STIs
CLE: Collectif inter-associatif de Lutte contre les
Exclusions (Inter-association Group Tackling
Exclusion)
CMU: Couverture Maladie Universelle (Universal
Health Insurance)
CNCDH: Commission Nationale Consultative des
Droits de l’Homme (National Consultative
Commission on Human Rights)
CNLE: Conseil National des politiques de Lutte
contre l’Exclusion (National Council on Social
Exclusion)
CNVA: Conseil National de la Vie Associative
(National Council of Voluntary Organisations)
COE: Council of Europe
COMEDE: Comité Médical pour les Exilés
(Medical Committee for Exiles)
CONCORD: European Confederation of Relief
and Development NGOs
CORE: Co-operation for Rehabilitation
CORDAID: Catholic Organisation for Relief and
Development Aid
CPAM: Caisse Primaire d’Assurance Maladie (Local
Health Insurance Office)
CRAM: Caisse Régionale d’Assurance Maladie
(Regional Health Insurance Office)
CRAMIF: Caisse Régionale d’Assurance Maladie
d’Ile-de-France (Ile de France Regional Health
Insurance Office)
CRESIF: Comité Régional d’Education pour la
Santé d’Ile de France (Ile de France Regional Health
D
DAL: Droit Au Logement (Right to Housing)
DDASS: Direction Départementale des Affaires
Sanitaires et Sociales (District Department of Health
and Social Affairs)
DG: Direction Générale (Department of Health and
Social Services)
DGS: Direction Générale de la Santé (Ministry of
Health)
DGSNR: Direction Générale de la Sûreté
Nucléaire et de la Radioprotection (Department of
Nuclear Security and Radioprotection)
DRASS: Direction Régionale des Affaires Sanitaires
et Sociales (Regional Department of Health and
Social Affairs)
DRC: Democratic Republic of Congo
DRDJS: Direction Régionale et Départementale de
la Jeunesse et des Sports (Regional and District
Office for Youth and Sports)
DUGA: Children and Young People’s Psychological
Support Centre
E
ECHO: European Commission Humanitarian Office
ECOSOC: UN Economic and Social Council
EDSI: Espace Dionysien de Solidarité et d’Insertion
(Dyionesien Space for Solidarity and Integration)
EGO: Association Espoir Goutte d’Or (Goutte
d’Or Hope Association)
ENSP: Ecole Nationale de la Santé Publique
(National Public Health School)
ENT: Ear, Nose and Throat
ESC: École Supérieure de Commerce (Business
School)
ESTES: Ecole Supérieure en Travail Educatif et
Social (Educational and Social Work College)
EU: European Union
EuropeAid: European Commission Development
Office
F
FACT: Family Aids Caring Trust.
FAP: Fondation Abbé Pierre (Abbé Pierre
Foundation)
FARC: Armed Revolutionary Forces in Colombia
FED : Fonds Européen de Développement
(European Development Fund)
FICF: Fondation Internationale pour l’Enfant et la
Famille (International Foundation for the Child and
the Family)
FNARS: Fédération Nationale des Associations
d’Accueil et de Réinsertion Sociale (National
Federation of Reception and Social Reintegration
Organisations)
FNPEIS: Fonds National de Prévention, d’Education
et d’Information en Santé (National Prevention,
Education, Health Education and Information Fund)
FONJEP: Fonds de Coopération de la Jeunesse et
de l’Education Populaire (Youth and Popular
Education Co-operation Fund)
FTE: Full time equivalent
G
GAF: Groupe Amitié Fraternité (Friendship and
Brotherhood Group)
GHB: Gamma-Hydroxybutyrate acid (rape drug)
GISTI: Groupe d’Information et de Soutien des
Immigrés (Immigrants Information and Support
Group)
H
HALDE: Haute Autorité de Lutte contre les
Discriminations et pour l’Egalité (High Authority
Fighting Against Discrimination and Promoting
Equality)
HDI: Human Development Index
HIV: Human Immunodeficiency Virus
> CONTENTS
HJRA: Joseph Ravoahangy Andrianavalona Hospital
(Madagascar)
HMU: Hanoi Medical University
HSSEP: Sous Département des affaires sociales
pour la prévention des maux sociaux (SubDepartment of Social Affairs for the Prevention of
Social Problems)
I
IBUKA: Memory and Justice (literally, Remember!)
ICODEV: Community Initiatives for Development
IdF: Ile de France
IDU: Injecting drug user
IEC: Information, Education and Communication
IFSI: Institut de Formation aux Soins Infirmiers
(Nurse Training Institute)
INSEE: Institut National de la Statistiques et des
Etudes Economique (National Institute for Statistics
and Economic Studies)
INSERM: Institut National de la Santé et de la
Recherche Médicale (National Institute for Health
and Medical Research)
IRD: Institute for Research and Development
IRSN: Institut de Radioprotection et de Sûreté
Nucléaire (Institute for Radioprotection and
Nuclear Security)
ITS: Swiss Tropical Institute
IVDU: Intravenous drug users
K
KAD: Kindianaise d’Assistance aux Détenus (Kindi
anese Support for Prisoners)
KAP: Knowledge,Attitudes and Practices survey
L
LDH: Ligue des Droits de l’Homme (Human Rights
League)
LSD: Lysergic Acid Diethylamide
LSI: Internal Security Law
» OUR ORGANISATION
Education Committee)
CRIPS: Centre Régionaux d’Information et de
Prévention du Sida (Regional Centre for Prevention
and Information on AIDS)
CSCAD: Chambre Syndicale des Cabarets
Artistiques et Discothèques (Union of Cabarets and
NightClubs)
CSST: Centre Spécialisé de Soin aux Toxicomanes
(Specialist Drug Treatment Centre)
ANNUAL REPORT 2006
177
M
MAAIONG: Mission d’Appui à l’Action
Internationale des ONG (International Support for
NGOs International Programmes)
MAE: Ministère des Affaires Etrangères (Ministry of
Foreign Affairs)
MAI: Mission Adoption Internationale (International
Adoption Programme)
MCH: Mother and Child Health
MdM: Médecins du Monde
MDGs: Millennium Development Goals
MDS: Doctors for the Right to Health
MESAD: Movement for Education, Health and
Development
MF: Mission France
MILDT: Mission Interministérielle de Lutte contre
la Drogue et la Toxicomanie (Inter-Ministerial Task
Force on Drugs and Addictions)
MTCT: Mother To Child Transmission
MRAP: Mouvement contre le Racisme et pour
l’Amitié entre les Peuples (Movement against racism
and for friendship between people)
N
voluntary organisations
PASS: Permanence d’Accès aux Soins de Santé
(Healthcare Access Office)
PEKABO: Perma Kanisa pe Bongwana
PPMU: Programme de Proximité en Milieu Urbain
(Urban outreach programme)
PROSES: Programme Science, Environnement et
Société (Science, Environment and Society
Programme)
PMTCT: Prevention of Mother to Child
Transmission
S
SALFA: Sampanasa Loterana momban’ny
Fahasalamana (Health Department of the Lutheran
Church in Madagascar)
SDC: Swiss Development Cooperation
SEAD: Sharing Experience for Adapted
Development
SNEG: Syndicat National des Entreprises Gaies
(National Union of Gay Businesses)
SRH: Sexual and Reproductive Health
STI: Sexually Transmitted Infections
STEP: Network and Fair Trade label
UNIOPSS: Union Nationale Interfédérale des
Oeuvres et des Organismes Privés Sanitaires et
Sociaux (National Inter-Federal Union of Private
Health and Social Organisations)
UNOGEP: Union Nationale des Organismes
faisant appel à la Générosité du Public (National
Union of Fundraising Organisations)
UNRWA: United Nations Relief and Work Agency
URAMEL: Unité de Recherche et d’Action
Médico-légale (Medico-legal Research and Action
Unit)
URCAM: Regional Union of Health Insurance
Offices
URD: Groupe Urgence Réhabilitation
Développement (Emergency Rehabilitation
Development Group)
USA: United States of America
USAID: United States Agency for International
Development
UTC: Unité de Traitement du Choléra (Cholera
Treatment Centre)
V
VOICE: NGO Collective
NOVIB: Oxfam Novib
T
W
O
TADEPA: Tanzania Development and Prevention of
Aids
TAMPEP: European Network for HIV Prevention
of HIV and STIs and for Health Promotion amongst
Migrant Sex Workers
TB: Tuberculosis
TDV: Tinerii Pentru Dreptul la Viata (Young People
for the Right to Live)
TLC: Thin Layer Chromotography
WFP: World Food Program
WHO: World Health Organization
OAA: Organisme Autorisé pour
l’Adoption(Authorised Adoption Agency)
OCHA: UN Office for Co-ordination of
Humanitarian Affairs
ODSE: Observatoire du Droit à la Santé des
Etrangers (Observatory on the Right to Health of
Migrants)
OFDT: Observatoire Français des Drogues et des
Toxicomanies (French Observatory on Drugs and
Drug Dependence
OS: Opération Sourire
OXFAM: Oxford Commitee for Famine Relief
P
PACA: Provence- Alpes-Côte d’Azur
PACT: American consortium of NGOs and private
U
UCS: Unité Communale de Santé (Communal
Health Unit)
UK: United Kingdom
UNDP: United Nations Development Programme
UNFPA: United Nations Population Fund
UNHCR: UN High Commissioner for Refugees
UNICEF: UN Children’s Fund
> CONTENTS
Publication Director: Dr Pierre Micheletti - Editor in Chief: Giselda Gargano Editorial Committee: Dr Michel Brugière, Martine Mikolajczyk, Hélène Valls - Editorial Staff: Samira Clady,
Daouda Dia, Cyril Gouiffes, Céline Marvie - Editorial Secretary: Emmanuelle Weiss Picture Editor:
Aurore Voet - Acknowledgements: thanks to all those who participated in the 2006 edition
Design: François Despas

annual report 2006

Transcription

Similar documents

Brussels Healthcare and Advice Centre Centre d`accueil, de soins et

DOWNLOAD: "Pharma-Industry"

A 3-STEP PLAN FOR MOBILE SECURITY

G azzette - CHIJ Our Lady Queen of Peace

P1 Orientation Slides - Gongshang Primary School

EnWin Utilities - Rogers Enterprise Business Solutions

chimb.ca

Bayside Dance January Newsletter 2016

Welcome to TKP Open House - Tanjong Katong Primary School

FestusManor Good News Gazette Update