MÉDECINS DU MONDE
MÉDECINS DU MONDE
MÉDECINS DU MONDE
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05<br />
<strong>MÉDECINS</strong> <strong>DU</strong> <strong>MONDE</strong><br />
A N N U A L R E P O R T 2 0 0 5
,,<br />
I do not ask your race or<br />
your religion, I ask you what<br />
your pain is.<br />
”<br />
Louis Pasteur<br />
02/03
Composition of the Board and Executive<br />
Committee of Médecins du Monde<br />
General Assembly and Board Meeting held on 14 and 15 May 2005<br />
President<br />
> Dr Françoise JEANSON,<br />
General practitioner, Bordeaux<br />
Vice-Presidents<br />
> Dr Olivier BERNARD,<br />
Paediatrician, Marseille<br />
> Dr Patrick DAVID,<br />
Anaesthetist-resuscitation specialist, Reims<br />
General Secretary<br />
> Dr Bernard JUAN,<br />
Company director, Montpellier<br />
Deputy General Secretary<br />
> Dr Fabrice Giraux<br />
General practitioner, Paris<br />
Treasurer<br />
> Pierre KEMPF,<br />
Assistant hospital director, Vichy<br />
Deputy Treasurer<br />
> Dr Pierre MICHELETTI,<br />
Public health doctor, Grenoble<br />
International projects representative<br />
reporting to the President<br />
> Joseph DATO,<br />
Nurse, associate professor at Grenoble<br />
University<br />
Board Members<br />
> Dr Thierry BRIGAUD,<br />
General practitioner, Paris<br />
> Dr Frédérique DROGOUL,<br />
Psychiatrist, Paris<br />
> Dr Pascale ESTECAHANDY,<br />
Hospital doctor, Toulouse<br />
> Dr Françoise SIVIGNON,<br />
Radiologist, Paris, Amsterdam<br />
Deputy Board Members<br />
> Dr Arnaud BOURDÉ,<br />
Anaesthetist-resuscitation specialist,<br />
Saint-Denis de la Réunion<br />
> Dr Laurence BOURGEOIS-GENET,<br />
Hospital doctor, Château-Thierry<br />
> Dr Régis GARRIGUE,<br />
Emergency doctor, Lille<br />
Former Presidents<br />
> Dr Bernard GRANJON,<br />
Gastroenterologist, Marseille<br />
> Dr Jacky MAMOU,<br />
Paediatrician, Paris<br />
> Dr Claude MONCORGÉ,<br />
Anaesthetist-resuscitation specialist, Paris
Table of Contents<br />
03<br />
04<br />
06<br />
07<br />
17<br />
19<br />
35<br />
36<br />
38<br />
104<br />
104<br />
105<br />
107<br />
116<br />
119<br />
129<br />
130<br />
139<br />
143<br />
144<br />
146<br />
147<br />
148<br />
150<br />
152<br />
WELCOME<br />
BOARD MEMBERS<br />
ACKNOWLEDGEMENTS<br />
POLITICAL STANDPOINT<br />
OUR AIM<br />
2005 IN FIGURES<br />
TESTIMONIES<br />
<strong>MÉDECINS</strong> <strong>DU</strong> <strong>MONDE</strong> IN PICTURES<br />
PROJECTS<br />
ATLAS OF INTERNATIONAL PROJECTS<br />
Map of international projects<br />
Country files<br />
ATLAS OF MISSION FRANCE<br />
Map of French actions<br />
Introduction to Mission France<br />
Action files<br />
Contacts<br />
PROJECT SUPPORT<br />
MdM MOBILISATION<br />
THE REPRESENTATION NETWORK<br />
REGIONAL OFFICES<br />
INTERNATIONAL OFFICES<br />
OPERATIONS<br />
ORGANISATION<br />
Association Life<br />
Department news<br />
The Médecins du Monde International network<br />
Sister associations and local partners<br />
Médecins du Monde and civil society in France<br />
Médecins du Monde and international institutions<br />
04/05
Acknowledgements:<br />
Our private : A 13, A2P et associés, Adonix application et services, A Novo, Pradines Abbey, ACB Xerox, ADCS, Affival, Aladin, AMCM, Amicale cardiologue de Paris, Amicale des<br />
sapeurs-pompiers de Poitiers, Amitiés loisirs Gouvernes, Antin résidences, Arasim, Arche promotion groupe Arcade, Assurances médicales Ales, Arrfliv, Aubry artist and painter, Axalto<br />
international SAS, Beat SA, Beaulieu sports, Begon Bonneau, Herbert Bouchard SCP, BHV, Bretagne Enchères, Brossard - Saveurs de France, Camif solidarité, Capa télévision,<br />
Carrefour DMG, Carte et Services, CGMI, Champion, Charpentier travaux publics, Chercheminippes, Risle-Gospel choir, Club Méditerranée, Soroptimist Club, CMP, Codara SA,<br />
Cofiroute, Comanaging SAS, Meyzieu Social Work Committee, Comptoir des voyages, Consort Netcom, Construction mécanique de l'Isère, Crédit coopératif, Croissy-sur-Seine tennis<br />
club, Decobat SARL, Desmarez SA, Diager SA, Divers et Imprévus, Eberle SA, Echanges & Solidarités, En apparence, Entraide majolane, Equus SA, Eric Bompard SA, Euro Assurance,<br />
Euro information service, Eurofeu SA, Factum finance, Fermod, Finaler Friedrich, Football breton solidaire, Heilbronn Fiszer FHF, Geste, GFS SA, Go Voyages, Goéland productions,<br />
Grands Moulins de Strasbourg, Hammerson France, Hilti France, Hydrosystem, ING fixations, Ifcic, Impact Immo, Intermed exportation, Iveco France, JP Chaussures, Kahn et associés,<br />
Keyrus, la Baguetterie, la Boutik, la Mimetaine, la Ronde des âges, le Canard enchaîné, Leclerc Siplec, Leo Pharma, l'Esprit de sel, le Coin du feu bookshop, Logicacmg SAS, Lowendal<br />
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,<br />
New Deal Sarl, Oddo, Olives Arnaud Sa, Opera Paris, Orange Réunion, Optimege, Ouest Affiche, Peugeot Citroën automobile, Peep Ass school library, Pierson Meunier export SA, Nièvre<br />
département bailiffs office, Polypore Europe SA, Prima Solutions, Production La Prade SARL, Renzo Piano Building Workshop, Readers Digest Selection, Reuters, Rotary Clubs of<br />
Gordes, Toulouse Ouest and Papeete-Tahiti, Rousseau, RS Com SA, SACD, SAFI, SA IFB, Sagone SA, Saulnier Blache SARL, See Velado, Sers, SFR, Sham, Smith And Nephew SAS,<br />
SNPE group, Sodang, Sofisol, Solutys, Sonia Rykiel SA, Sopag Maine Parking, Stade Rennais FC, Stratégie investissement, Suzuki France, TAP Services, Taxi Jocelyne Perree, TBWA,<br />
Techmo Systems SA, Techni Alarme, Tele2 France, Temex, TF1, La Michaudière Theatre, Théatre de la Tête noire, Top Famille, TV5 monde, UFG, ULIF, UNIM, Vialtis Fournisseurs, Vivendi,<br />
Voyageurs du monde, Wargny Katz (SCP), Wegener DM.<br />
Foundations: Annenberg Foundation, Arradon Foundation, Bois Brillou Foundation, Club Méditerranée Foundation, Deniber Foundation, Drosos Foundation, Florindon Stiftung, Fondation<br />
de France, Fondation de Lille, GlaxoSmithKline Foundation, Johaniter Foundation, Mantegna Stiftung Foundation, Niarchos Foundation, Sancta Devota Foundation, Seviajer Foundation,<br />
Sternstunden Foundation, Vinci Foundation, Union des blessés de la face et de la tête.<br />
The works councils and employees of: Agefi, Banque de France, Caisse d'épargne Ile-de-France Paris, CCSO social, Cetim Senlis, Georges Dumas Clinic, CPAM Sélestat, CPR, Crédit<br />
agricole Centre France, Crédit coopératif, Crédit foncier de France, Galeries Lafayette, GlaxoSmithKline, IBM Eurocoordination, Marsh, Natexis Banques populaires, Nestlé Waters, Vosges<br />
Prolabo, PTC Nestlé, Réel, Thalès, UES LCF, UFG, Screg Sud-Ouest, Wyeth Pharmaceuticals.<br />
Public partners:<br />
Of our international projects: Administration des biens et des majeurs protégés, Association des régions de France, Canadian International Development Agency (CIDA),<br />
Centre For Disease Control And Prevention, Chaîne du bonheur (Suisse), Columbia University, communauté d'agglomération du bassin d'Aurillac, Cordaid, Department For<br />
International Development, Dutch ministry for Development Cooperation, ECHO, Embassy of Canada, Europeaid, German, French and Japanese Foreign Affairs ministries,<br />
Global Fund to fight Aids, tuberculosis and malaria, Ile-de-France SAFER Joint United Nations Programme on HIV/Aids, IOM, Lille education authority, PACT, Population services<br />
international, PACA region, Radio-protection and Nuclear Safety Institute, Rhône-Alpes region, Rouen chamber of commerce and industry, Swiss Development and<br />
Cooperation Department, United Cities againsy Poverty, UNDP, UNICEF, UNFPA, UNOCHA, United Nations Office on Drugs and Crime, USAID, World Bank.<br />
Town halls: Aigremont, Audincourt, Bassens, Behren-lès-Forbach, Bonnelles, Bourg-lès-Valence, Brioux-sur-Boutonne, Chilly-Mazarin, Drancy, Garlin, Goussainville, Lacroix-<br />
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,<br />
Toulouse, Tréport, Val-d'Isère.<br />
Of our regional international projects: département councils: Bouches-du-Rhône, Alpes-de-Haute-Provence, Gironde, Charente-Maritime, Vosges, Doubs, La Réunion, Midi-<br />
Pyrénées, PACA ; regional councils: Provence-Alpes-Côte d'Azur and Rhône-Alpes; Presidency of the Regions, prefecture of the Guadeloupe region.<br />
Of our French projects: the Army, CNAM (National Health Insurance Office), CAF (Family Allowance Fund), CMR (Regional health offices), CPAM (health insurance offices),<br />
CRAM (regional health insurance offices), CCAS (Social Action Community Centres), Rouen CHU (University Hospital) CDAG (free anonymous screening centre), Nantes PASS<br />
(access to healthcare service), CDAG, CISIH (HIV treatment and information centre) CHUl and CHRS (Accommodation and Social Rehabilitation Centre), département-level<br />
councils, FNPEIS (regional health education and information councils), DIV (Interdepartmental Delegation to the City), DGS (Directorate General of Health), DGAS (Directorate<br />
General for Social Action), DDTEFP (Département-level labour departments), DRASS and DDASS (regional and département-level branches of Ministry of Health), Fonds national<br />
de prévention (National prevention fund), town halls, ministries, MILDT (Interdepartmental Mission for the Fight against Drugs and Drug Addiction), OFDT (French Monitoring<br />
Centre for Drugs and Drug Addiction), prefectures, Rouen reception centre for travellers, Poitier town-hospital network, URCAM (Regional unions of health insurance offices).<br />
Our partner associations: Aides, ALC Nice, Alerte Group, Alsace group of associations working with people involved in prostitution, les Amis du Bus des femmes, Amnesty<br />
International, ANEF, Association of French regions, ATD Fourth World, Avenir et Coopération, Brittany Football League (and the clubs of Brittany), Communication and Action<br />
for Access to Treatment Association, Congregation of the Augustinian Sisters, CSF, DAL, DHL Liens, Drug Users Self-Support and Harm Reduction Association, D'une rive à<br />
l'autre, Emmaüs, Emmaus Committee, Entraide majolane, Federation of associations for housing provision (Fapil), le Foyer association, French Campaign for the Right of Asylum,<br />
French Harm Reduction Association, Friends of Marist Community, Gisti, Health Networks Coordination Initiative (CNR), Health Without Frontiers, Humanitarian Bank,<br />
Humanvillage, IFHR, Inadaptés des Po association, International Harm Reduction Association (IHRA), IOP (International Prison Monitoring Centre), LDH, Max Havelaar,<br />
Mouvement du Nid, National Union of the Associations of Reception and Social Reintegration (Fnars), ODSE (Foreigners' Right to Health Monitoring Centre), Passerelle la santé<br />
sans frontières, Pays de la Loire Planning Centre, Pays de Retz Doctors' Association, Pharmacie humanitaire internationale, Platform against Trafficking in Human Beings, Rasko,<br />
the Red Cross, Rimbaud Mobile Team, Restos du Cœur, St-Benoît hostel, Sanatatea association, Stade Rennais FC, Secours catholique, Sid'espoir, Sonacotra hostel, SOS<br />
Drogue internationale (SOS DI), SOS Femmes, Strasbourg Psychiatrists and General Practitioners' Collective on exclusion from health care, Support for the Victims of Bam<br />
Group, Techno Plus, Travellers' Association, UNIOPSS, Veille sociale, Vialtis.<br />
And all our other partners who have supported our work in France and abroad during 2005, as well as our individual donors.
07/16<br />
><br />
Our aim
Combating oblivion<br />
After twenty-five years of providing care to the most vulnerable populations, of fighting against the dictatorship<br />
of violence, inhumanity and abandonment, 2005 gave us the opportunity to give a dual focus to<br />
Médecins du Monde's anniversary: commitment and forgotten crises. By changing our slogan to highlight<br />
again our objective of bringing the populations we support out of oblivion, we are pointing out our distinctiveness<br />
in the confusion lying in wait for international humanitarian action today.<br />
UN Reform<br />
We are paying particular<br />
attention to the replacement<br />
of the Commission on<br />
Human Rights, which has<br />
lost all power and<br />
credibility, with a Human<br />
Rights Council which would<br />
sit permanently.<br />
Post-crisis contexts<br />
Amongst these regions,<br />
MdM is working in DRC,<br />
Liberia, Angola,<br />
Afghanistan, Kosovo and<br />
Serbia.<br />
> Consider the context …<br />
In a context of global struggle against terrorism, the pursuit of murderous conflicts<br />
as in Darfur or Chechnya or enduring political crises as in Haiti, the 60th birthday<br />
of the UN saw the drawing up of a mixed assessment of a vital multilateral policy<br />
whose credibility and real impact require reform which the states were incapable of<br />
adopting in its entirety.<br />
Ten years after the Srebrenica massacre, the slow reconstruction of the Balkans illustrates<br />
how fragile the return to peace between its peoples is, although this is a vital<br />
prerequisite to a stable and lasting reconstruction. The same can be said for many<br />
regions in the world where there is a great temptation for the international community to<br />
speed up the reconciliation process. However, no peace is lastingly viable unless it is<br />
shared and anchored in the communities involved.<br />
The cancellation of the multilateral debt of the poorest countries by the G8 states in<br />
July was accompanied by a promise to double aid to Africa between now and 2010.<br />
However, against that good news, we need to set the distressing assessment of the<br />
progress towards the Millennium Development Goals (MDGs) after 5 years. The gap<br />
between rich and poor is increasing everywhere, burdening the future of more than a<br />
billion people in the world, whereas radicalism of all kinds feeds on the sources of<br />
poverty and real or perceived injustice.
In October, contrary to generally accepted ideas, the Human Security Centre announced a<br />
fall in the number of conflicts in the world since the end of the cold war, although it said<br />
that violence experienced by civilians now came more from internal conflicts, state<br />
repression or poor governance, phenomena which exacerbate poverty, hunger and lack<br />
of access to healthcare. Because of its distinctive medical focus, Médecins du Monde<br />
must respond to violence of this kind.<br />
> ... Respond to it with care and<br />
testimony<br />
In disasters<br />
The start of the year was marked by the tsunami which ravaged South East Asia<br />
in December 2004. Right from the start, we were working in Indonesia and Sri Lanka,<br />
caring for victims and survivors, and we then supported the rebuilding of health systems.<br />
In the face of the enormous number of agencies involved and the resulting confusion,<br />
and the ruthless competition of some of those involved who were more interested in<br />
gaining a higher profile than providing rational and quality support for the populations,<br />
we took pains to carry out our work according to our principles, and based on survivors'<br />
needs rather than the money we had available. At Mallavi, as well as dealing with the<br />
consequences of the tsunami, our aim was to ensure we were in place should the<br />
conflict between the rebels and the government army break out again. Our project there<br />
was extended for a minimal period so that we would be on the spot should the situation<br />
deteriorate. These principles were presented clearly to our donors who then authorised<br />
their gifts to be reallocated to other projects, thus enabling us to open programmes in<br />
areas which were just as legitimate, but forgotten by the media, such as the suburbs of<br />
Jakarta or the prisons of Madagascar.<br />
It was because of these principles that we could respond in a major way to the aftermath<br />
of the violent earthquake which devastated Pakistan. Getting aid to those living<br />
in the deep-sided and isolated valleys was particularly complex and to begin with many<br />
victims were unable to get any aid. We were present from the very first<br />
,,<br />
Tsunami<br />
impartiality,<br />
proximity<br />
and partnership<br />
In Indonesia and Sri Lanka,<br />
we chose to intervene in<br />
areas which were in danger of<br />
being overlooked by<br />
international aid, either<br />
because they were hard to<br />
reach (such as Calang in<br />
Aceh) or because they were<br />
subject to political<br />
disturbances (such as Mallavi<br />
in Sri Lanka); our projects<br />
were set up to support local<br />
workers.<br />
08/09<br />
“It is through, and thanks<br />
to, medical work that we can<br />
denounce and bear witness<br />
to injustice, and we try to<br />
treat its consequences as<br />
well as its causes.”<br />
”
,,<br />
Pakistan<br />
At Mansehra, more than<br />
2,000 operations were carried<br />
out in precarious<br />
conditions; at Thakot, our<br />
health post received between<br />
50 and 100 patients<br />
each day; at Kaghan, our<br />
mobile clinics saw between<br />
40 and 70 people per day.<br />
In Pakistan, the<br />
teams' living and<br />
working conditions<br />
were particularly<br />
difficult, with<br />
uninterrupted work,<br />
housing in tents and<br />
long walks at<br />
altitude to reach<br />
isolated villages<br />
”<br />
Putin's Law<br />
Openly opposing this antifreedom<br />
law, MdM has started<br />
a joint mobilisation bringing<br />
together the medical<br />
charities working in Russia<br />
together with human rights<br />
charities. In conjunction<br />
with partners from Russian<br />
civil society, this coalition<br />
has lobbied the European<br />
authorities to get President<br />
Putin to withdraw the law.<br />
days, and our surgical and medical teams were able to cope with the influx of injured<br />
whose health was worsened by the previous lack of access to healthcare in these<br />
neglected regions. Once the first emergency phase was over, we followed the victims to<br />
the camps set up on the outskirts of the major cities, then into more distant camps that<br />
had sprung up and which had received no aid at all.<br />
Today, we are being very vigilant about the conditions survivors are returning to, as these<br />
must respect people's rights and choices. We are particularly concerned about<br />
the situation of women, who have been made even more vulnerable in a country where<br />
their rights are flouted on a daily basis and where impunity prevails for those subjecting<br />
these women to violence. In the Dar-ul-Aman (refuges), our care for women who are the<br />
victims of domestic violence is also aimed at fighting for their protection and their rights.<br />
In conflicts<br />
Although 2005 was marked by these disasters, as an NGO we have a legitimate role in<br />
conflicts and this must be strengthened, especially in Darfur, where our programme in<br />
Kalma has been supplemented by mobile clinics in isolated villages inhabited by the<br />
different ethnic groups involved in the conflict. In the face of this human disaster which is<br />
becoming entrenched and to which no one can see an end, we have denounced, alone<br />
and in partnership with others, the crimes committed by the Janjaweeds, the violence<br />
against women, and the pressure put on those involved in humanitarian action, which<br />
endangers our work and the local staff working alongside us. Beyond humanitarian aid,<br />
only the massive political commitment of the international community, going beyond the<br />
interests of individual states, and strong resolutions from the Security Council will be able<br />
to bring an end to this neglected war.<br />
In Chechnya, the normalisation displayed is totally fictitious. So that nobody can dispute<br />
it, President Putin has introduced a law in the name of Russian national security condemning<br />
local organisations and expelling international NGOs “guilty” of freedom of speech.<br />
In Iraq, civil war has followed the failure of the American and British intervention. The<br />
human rights in the name of which the armies intervened are flouted by those supposed to<br />
defend and protect them while terrorism kills more people each day and the humanitarian<br />
situation is now disastrous. In this situation, where an expatriate presence is impossible,<br />
Médecins du Monde wants to find a response appropriate to the health needs
without endangering those involved. Our past involvement in the region means we can<br />
consider action directed from outside the country, relying on a trusted local network. This<br />
is possible operationally and support at a distance must, amongst other<br />
things, allow us to respond to the main request of doctors who have stayed<br />
in Iraq which is to bear witness to the humanitarian disaster which the Iraqi<br />
population is living through today.<br />
Despite the reconstruction process which has begun, the end of the war in DRC is still<br />
accompanied by dozens of deaths each day of victims of the ongoing humanitarian crisis,<br />
the armed bands who continue to hold sway in the east of the country, and of social<br />
breakdown. We have strengthened our presence in the abandoned areas, and have begun<br />
work in Kalemie, where we are treating, amongst others, countless women who are<br />
victims of rape.<br />
Whether it is the death of Arafat or the election of Hamas, the construction of the Wall or<br />
the evacuation of the Gaza settlements, the Palestinian people continually face one<br />
emergency or another. Where we used to support high-tech medicine, we are now caring<br />
for diseases caused by poverty. We are supporting a bloodless health service for a population<br />
which is suffering the harsh health consequences of the political situation, despite<br />
amazing resilience. We must bear witness to the health of populations, the lack<br />
of access to healthcare and the shortage of structures and healthcare staff.<br />
In lasting crises<br />
The urgency of intervening in Niger divided the Association, setting those supporting an<br />
economic analysis of the famine against those supporting a structural analysis. Media and<br />
humanitarian frenzy followed the “revelation” of this food crisis which is now being forgotten<br />
once again. At the end of 2005, we started paediatric medical work in partnership with<br />
Action Against Hunger, each bringing our skills to give overall, quality care to children. The<br />
principle of repeating this partnership in other programmes has been launched within the<br />
association.<br />
Other areas, less reported in the news, have caught our attention. Liberia, Angola,<br />
Afghanistan and DRC are all countries devastated by long conflicts, states that have<br />
Iraq<br />
As part of its support for the<br />
journalist Florence Aubenas,<br />
kidnapped with her team<br />
member in December 2004,<br />
MdM has become a<br />
spokesperson for<br />
humanitarian workers who,<br />
together with journalists, are<br />
being led to intervene in<br />
contexts which are all the<br />
more dangerous in that their<br />
activities are often confused<br />
with civilian and military<br />
operations.<br />
Palestinian Territories<br />
MdM is involved in primary<br />
health care, preparations for<br />
emergency situations and<br />
mental health work.<br />
Liberia<br />
MdM is involved in primary<br />
health care, mental health<br />
care, and the shortage of<br />
healthcare staff.<br />
10/11
Colombia<br />
MdM is involved in primary<br />
healthcare, maternal and<br />
infant health and amongst<br />
minorities.<br />
The People's<br />
Health Movement<br />
A global network of health<br />
workers and organisations<br />
(mainly from southern<br />
countries) fighting for access<br />
to health care for everyone.<br />
Working closely with<br />
vulnerable populations and<br />
the daily experience of<br />
access to care are at the<br />
basis of this movement,<br />
which aims to make the right<br />
to health recognised as a<br />
priority in health policies at<br />
local, national and<br />
international levels.<br />
Support for<br />
involvement<br />
of the South<br />
It is for this purpose that we<br />
are currently taking part in<br />
the “Health personnel in the<br />
South: a fatal shortage”<br />
campaign to ask the French<br />
state to strengthen its<br />
support for health policies.<br />
completely broken down, with health systems which do not exist for the majority of<br />
the population who cannot pay for private healthcare. NGOs provide the majority of<br />
healthcare due to a lack of staff and health structures.<br />
In Colombia, the last country in conflict in Latin America, the most vulnerable<br />
civilian populations are the hostages of violence but they have also been totally<br />
abandoned by a privatised health system which offers little access to the poorest.<br />
In addition to its medical activities and in order to carry out advocacy<br />
work, Médecins du Monde is studying the actual access to care from<br />
which the most vulnerable populations will benefit in the reconstructions<br />
planned by international donors and private companies.<br />
The number of new projects, regional international projects (Guatemala, Burkina<br />
Faso, Algeria and Bulgaria) or wider programmes (Mongolia, Borneo, Peru, etc),<br />
continues to grow. Although each one involves a specific population, the problem of<br />
financial exclusion from healthcare is systematic. In this area, it is vital that we<br />
involve southern healthcare staff in promoting access to healthcare for everyone.<br />
Our presence at the People's Health Assembly, organised by the People's Health<br />
Movement at Cuenca, allowed southern doctors to identify us as a partner committed<br />
to the most vulnerable and supporting existing initiatives. The nature of our work<br />
shows clearly that we are committed to medical care for the most vulnerable and<br />
that we support involvement in favour of healthcare workers in the South. These<br />
networks encourage partnerships which will make it easier to get involved in new<br />
regions.<br />
In the fight against infectious diseases, 2005 will have been marked by<br />
the withdrawal of the Global Fund to fight Aids, tuberculosis and malaria<br />
from Burma as a result of the constraints imposed by the ruling military junta on<br />
humanitarian organisations, sadly symbolising the subordination of health to political<br />
issues. A whole vulnerable population, which had benefited from long-term<br />
psychological and therapeutic care, has been abandoned, and local workers, trained<br />
with the prospect of a pull-out, have been forsaken. We condemned this decision<br />
and have asked the Global Fund to reconsider its position or to put alternative
funding mechanisms in place. We have called on the French Minister for Foreign<br />
Affairs to vehemently make known French protests with respect to the human rights<br />
violations suffered by the Burmese population.<br />
Another disappointment with regard to Aids has been the integration in Indian law of<br />
the WTO-imposed constraint in a law guaranteeing the preservation of patents for<br />
pharmaceutical products. Despite amendments softening the law, the possibility<br />
of supplying southern countries with effective treatments at affordable prices remains<br />
a vital issue.<br />
In Asia, as in Africa, fifteen years of experience amongst peoples affected by<br />
HIV/Aids provide experiences of differences but also of constraints overcome<br />
as regards feasibility, operational methods and social and anthropological approaches.<br />
After fighting for access to medication and setting up clinical and technical reference<br />
programmes, and in the face of the expansion of the epidemic, we must now devise and<br />
apply means for dealing with Aids as part of primary healthcare, and strengthen<br />
the testimony of MdM's international network in this direction.<br />
In access to healthcare for migrants<br />
Although the western media revealed the dramas of Ceuta and Melilla, the<br />
identical conditions experienced by migrants on the Mexican-American border<br />
have passed unreported. We have been working in a reception centre for<br />
expelled migrants in Tijuana for a year and have gathered testimonies which echo<br />
those collected in France and in Europe. Physical or regulatory barriers are being<br />
erected everywhere to protect wealth which has never been so poorly distributed<br />
across the world. This major question should be more of an issue for us<br />
as a northern organisation, and we should be committed to protecting<br />
these people whose only crime is to seek a better life.<br />
Lobbying for an amendment to the European directive “on the return of foreigners<br />
in an irregular situation” that condemns sick foreigners expelled without a<br />
guarantee of healthcare in their country of origin, to a certain death, setting up the<br />
,,<br />
Pharmaceutical<br />
patents in India<br />
Amendments allow generics<br />
already produced in the<br />
country to be exempt from<br />
this law, in exchange for the<br />
payment of “reasonable<br />
royalties” to licence holders.<br />
New medicines which have<br />
not yet been copied will be<br />
protected but subject to<br />
“compulsory licensing” in the<br />
event of a health crisis.<br />
12/13<br />
In Morocco, a health<br />
project amongst African<br />
migrants is due to start in<br />
the coming weeks.<br />
”
Averroès Project<br />
The aim is to build a network<br />
of field medical organisations<br />
covering the 25 European<br />
Union states asking, amongst<br />
other things, all the states that<br />
are signatories to the<br />
European convention to<br />
ensure access to healthcare<br />
and preventive medicine to all<br />
foreign residents, regardless<br />
of whether they are in the<br />
country legally or illegally,<br />
under the same conditions -<br />
and with the same level of<br />
resources - as those offered<br />
to nationals.<br />
Advocacy<br />
Launched this year, the<br />
advocacy service will let us<br />
compile statements and<br />
proposals to strengthen our<br />
capacity to put pressure on<br />
the authorities.<br />
Averroès project, and the progress with the French access to healthcare monitoring<br />
centre, and more recently the European monitoring centre, are all initiatives which<br />
embody the reality of migration, too often reduced to a statistical phenomenon<br />
grossly overused by politicians searching for a scapegoat. In the coming years we<br />
will continue this work in favour of human rights.<br />
Today, access to care, reconstruction, migrants' health, violence against<br />
women; tomorrow, street children, indigenous peoples, health in<br />
prisons. The same themes are emerging from our international activity<br />
as those which we are involved with in France and in Europe.<br />
Understanding them in a cross-disciplinary way helps us to analyse their<br />
many aspects and to develop clear advocacy, which is more convincing,<br />
and therefore more effective in modifying in a lasting way the scandals<br />
to which we bear witness.<br />
> In France too<br />
Health policy for the most vulnerable populations has continued to decline<br />
this year. Although the public health act perpetuates the harm reduction programmes, it<br />
constrains them financially and prohibits testing, the only approach that effectively creates<br />
a link with individuals. Although the health insurance reform encourages access to mutual<br />
insurance for people living just above the CMU (Universal Health Insurance) threshold, we<br />
are now seeing how it complicates access to healthcare for those excluded and increases<br />
the cost of care and hospitalisation for them. Even though the “access to emergency<br />
care” circular slightly lessens the health and human consequences of the decrees limiting<br />
access to AME (state medical aid) for those without residence papers, it is quite useless<br />
when a new law encourages the police to pursue these people even in hospitals and<br />
healthcare and reception centres. Finally, although the Ceseda law (on foreigners entering<br />
and staying in the country and the right of asylum) retains regularisation for healthcare, it<br />
makes access to health for foreigners much more difficult. Whether through the media or<br />
legal proceedings, we will continue to fight against these laws of suspicion and inhumanity<br />
which weigh on the most vulnerable.
Our reception, care and orientation centres (CASOs), like our projects<br />
outside centres, measure the decline in access to healthcare on a daily<br />
basis. With the setting up of the ICPC (International Classification of Primary Care),<br />
we are hoping to bear witness more to the impact of exclusion and poverty on<br />
health. We are careful observers; however, it is by preserving our calling to<br />
disappear that we will be able to avoid the pitfalls of our work being institutionalised.<br />
The autonomy of the “methadone buses” and the harm reduction projects<br />
under conditions which allow them to continue their work was won<br />
after a major struggle in 2005. A federation bringing together the organisations<br />
born out of these actions allows Médecins du Monde to continue to be active and to<br />
be a forerunner, observing, in particular, the growth in the consumption of products<br />
and fighting for the health of users and for their recognition, in France and abroad.<br />
Life on the streets is torture. Sleep deprivation and lack of food ruin health.<br />
Despite the belated recognition by the law of health-stop beds this summer, and<br />
despite some magnificent community initiatives, all our teams have noticed how the<br />
number of people living on the streets is increasing and how their health is deteriorating.<br />
The expulsions without re-housing last summer are just making the situation<br />
worse. It was to oppose a policy which manages misery instead of combating<br />
it that the Paris homelessness project called on public opinion and the<br />
government by making the homeless visible by distributing tents, symbols<br />
of the shortages of which they are the victims.<br />
No health without a roof, no health under an insalubrious roof or within walls<br />
containing lead. This is another motivation for our commitment to the fight for a<br />
binding right to housing. Our presence amongst squatters, who organise a parallel<br />
life to society in alternative places, once again marks Médecins du Monde's ability<br />
to adapt and our desire to leave no-one on the margins of society.<br />
,,<br />
14/15<br />
This policy is<br />
repressive, complex and<br />
incoherent at the same<br />
time and is undoubtedly<br />
made at the expense of<br />
the health of the poorest.<br />
As our country is not<br />
choosing to give care to<br />
everyone, we will<br />
continue to fight against<br />
this injustice, which is<br />
unworthy of the country<br />
of the rights of man.<br />
”<br />
Community<br />
initiatives<br />
For the last three years, the<br />
Night Hostel in Bordeaux, for<br />
example, has welcomed<br />
those who have nowhere<br />
else to stay, without<br />
conditions.
,,<br />
Echoing the twenty-five<br />
years of commitment brought<br />
to light by the Rondeau<br />
exhibition, the theme of<br />
forgotten crises, the slogan of<br />
our new campaign, was<br />
embodied in the<br />
presentations made by local<br />
workers on that occasion.<br />
”<br />
Finally, between here and over there, Médecins du Monde's adoption<br />
service has enabled 315 children this year to find a family. Amongst them,<br />
28 suffer from curable diseases, and only the distinctive medical work of Médecins<br />
du Monde means they can leave the orphanages. It is the stated desire of the<br />
Association to encourage the adoption of these children with specific needs who<br />
were not able to be adopted in their country of origin.<br />
> The organisation<br />
We celebrated our 25th birthday in a very warm atmosphere. The general assembly<br />
was a time of celebration, but the proposal to reform our articles of association<br />
meant that it was also a time of reflection. Although it was not passed, it led to many<br />
discussions focussed on our healthcare work and the importance of volunteers, on<br />
our medical identity and on the perspectives in which we wished to commit a charity<br />
born out of both humanitarian action and political debate.<br />
I would like to thank everyone who, by their work in the field or support, here and<br />
over there, provide care, protect populations and advocate the cause of the victims.<br />
It is the commitment of each one of us which makes Médecins du Monde a credible,<br />
independent and innovative NGO.<br />
Dr Françoise Jeanson<br />
President of Médecins du Monde<br />
21 April 2006
2005 in figures<br />
• MdM's structure<br />
(at 31/12/2005, in FTE):<br />
415 volunteers went out to the field<br />
150 short-term field staff (full time equivalents)<br />
1,300 volunteers at head office, in the provinces and Mission France<br />
16 regional offices<br />
4 international representation offices<br />
1,556 members<br />
153 paid staff (full time equivalent) at head office and 17 paid field staff<br />
13 paid staff in regional delegations<br />
66 paid staff on Mission France and Harm Reduction projects<br />
� i.e. 249<br />
paid staff in total<br />
• The MdM international<br />
network:<br />
12 international offices<br />
Argentina, Belgium, Canada, Cyprus, France, Greece, Italy, Portugal,<br />
Spain, Sweden, Switzerland, United States<br />
73 million Euros budget<br />
in 2004 (budget N-2)<br />
• MdM's balance:<br />
48.2million Euros<br />
in 2005<br />
Distribution of expenses by<br />
department (excludes exceptional items):<br />
Origin of resources<br />
(excludes exceptional items):<br />
1.0% Communication<br />
and information costs<br />
7.1% Administration/head office costs<br />
18.2% Fundraising costs<br />
73.1% International<br />
and domestic projects<br />
0.2% Costs of seeking sponsors<br />
0.4% Costs of other forms of appeal<br />
62% Public generosity<br />
35% Public grants<br />
2% Private grants<br />
1% Other<br />
16/17
2005 in figures<br />
• International: • France:<br />
93<br />
international projects<br />
in 51 countries<br />
(excluding new bases and<br />
projects, and excluding adoption)<br />
Geographical distribution<br />
of MdM's programmes:<br />
Africa<br />
Latin America<br />
Asia<br />
Eastern Europe<br />
Middle East<br />
Central Asia<br />
13<br />
12<br />
Geographical distribution of<br />
expenses of international<br />
projects:<br />
Africa<br />
Asia<br />
Latin America<br />
Eastern Europe<br />
Middle East<br />
Central Asia<br />
4<br />
4<br />
6<br />
5<br />
12<br />
10<br />
18<br />
24<br />
38<br />
43<br />
40,039<br />
5,744<br />
�<br />
85<br />
medical consultations in<br />
CASOs for 20,324 patients<br />
dental consultations carried out in<br />
10 towns for 2,576 patients<br />
45,783<br />
i.e.<br />
consultations in total in 21 Reception,<br />
Care and Orientation Centres (CASOs)<br />
mobile community projects<br />
in 23 towns, carried out by<br />
761 volunteers<br />
14 Harm Reduction programmes<br />
More than 70,000 HR contacts<br />
10,000 contacts with people<br />
involved in prostitution, through 6 projects<br />
Distribution of Mission France<br />
expenses in 2005:<br />
41% Harm Reduction<br />
39% CASOs<br />
11% Outside centres<br />
8% Mission France co-ordination<br />
1% Hospital sponsorship
HENK VISSCHER<br />
19/34<br />
><br />
MdM in pictures
South-East Asia<br />
Rebuilding after<br />
the tsunami<br />
Six months after the tidal wave<br />
which affected Indonesia and<br />
Sri Lanka in December 2004,<br />
MdM's teams have gradually<br />
brought their emergency<br />
projects to an end.<br />
“Our desire is not to replace<br />
the health staff in the long term<br />
but, on the contrary, to help<br />
them to get hospitals, health<br />
centres and health posts back<br />
on their feet,” says Frédéric<br />
Penard, the programme coordinator<br />
in South-East Asia for<br />
the Emergency desk. The<br />
Indonesian and Sri Lankan<br />
health structures are<br />
recovering.<br />
Mexico<br />
In transit,<br />
in danger<br />
“I am a doctor in Tijuana,<br />
where the Association is<br />
carrying out an access to<br />
health programme among the<br />
migrant population,” explains<br />
Jorge Arellano Estrada, a<br />
local doctor. “I do prevention<br />
work amongst migrants. Each<br />
afternoon I go to Casa del<br />
Migrante, the largest<br />
migrants' hostel in the town,<br />
and to Casa Madre Assunta,<br />
for women and their children.<br />
I hold consultations and<br />
answer their questions. As I<br />
am in contact with them on a<br />
daily basis, friendships have<br />
developed. Each week, I also<br />
give a talk on AIDS<br />
awareness and prevention. I<br />
am trying to identify migrants<br />
who are at risk because of<br />
their behaviour and I tell them<br />
about the different ways HIV<br />
can be transmitted. I am also<br />
trying to remove the taboos<br />
and help change attitudes<br />
about this disease.”<br />
MdM<br />
MdM<br />
MICHEL REDONDO
MdM<br />
HENK VISSCHER<br />
MdM<br />
Pakistan<br />
Adapting<br />
day by day<br />
20/21<br />
Following the earthquake<br />
which struck Pakistan on 8<br />
October 2005, an emergency<br />
project was set up to provide<br />
aid to the victims. “The first<br />
three weeks were devoted to<br />
giving medical care to the<br />
injured, in particularly difficult<br />
conditions,” explains José<br />
Luis, a general practitioner.<br />
The work was then continued<br />
by setting up permanent<br />
consultations in several camps<br />
for displaced persons, in the<br />
outskirts of Islamabad for<br />
displaced people from<br />
Kashmir, and around<br />
Mansehra for displaced<br />
people from the Kaghan valley.<br />
Women<br />
taken for targets<br />
In addition to the postearthquake<br />
project, MdM is<br />
running a project to help<br />
women seeking help in<br />
refuges called Dar-ul-Aman.<br />
Each year, in the Punjab<br />
region alone, hundreds of<br />
women are burned by fire or<br />
acid. The programme plans to<br />
provide global care for these<br />
women within three refuges. It<br />
includes medical help,<br />
hygiene awareness sessions,<br />
psychological support and<br />
legal help. Practical training<br />
also helps social and<br />
economic reintegration. For<br />
example, the Association<br />
organises therapeutic theatre<br />
sessions during which the<br />
women act out their own<br />
stories in front of the other<br />
residents and the Pakistani<br />
staff in the refuges.
Forgotten faces<br />
Long protected by their<br />
isolation, indigenous people<br />
today are the victims of<br />
their confrontation with the<br />
modern world. Their<br />
habitat, environment and<br />
culture are threatened. And<br />
they are now affected by<br />
many infections or diseases<br />
related to ethno-stress<br />
(alcohol or drugs). The<br />
Association's objective is to<br />
support these little-known<br />
people, who are forgotten<br />
by the international<br />
authorities more often than<br />
not. Projects aimed at them<br />
are usually organised in<br />
difficult conditions and<br />
workers have to adapt to<br />
very specific ways of life.<br />
“To carry out a project, we<br />
must first of all know the<br />
social and cultural<br />
environment well. This<br />
approach is specific to<br />
MdM's ethnic minority<br />
group,” explains Franck<br />
Desplanques, the group coordinator.<br />
“This leads us to<br />
begin our medical work by<br />
sending an ethnologist or<br />
anthropologist to study the<br />
distinctive features of these<br />
communities,” he adds. In<br />
Indonesia for example,<br />
projects have been built<br />
around two indigenous<br />
peoples: the Dani tribe,<br />
living in West Papua, who<br />
make up 1% of the<br />
population but more than<br />
42% of cases of AIDS<br />
nationally, and the Punan<br />
on the island of Borneo,<br />
who receive no healthcare<br />
in the heart of the forests,<br />
and who are exposed to<br />
many diseases when they<br />
emigrate to the cities.<br />
REINER SPRUIT/MdM<br />
DAVID DELAPORTE
FRANCK DESPLANQUES<br />
FRANCK DESPLANQUES<br />
Russia, Nenets people<br />
,,<br />
Before intervening,<br />
we tried to understand<br />
the codes, taboos and marks of respect of this<br />
society, as well as how they view the body and<br />
illness. The Nenets people are just as much at<br />
ease with a lassoo for capturing reindeer as with<br />
a computer keyboard. They know that their<br />
survival involves opening up to modernity. It was<br />
therefore essential to understand the whole of<br />
that culture. A farmer cannot consider leaving his<br />
herd for six months to receive hospital treatment.<br />
It would endanger his whole family's survival. We<br />
must keep this in mind when we consider long<br />
treatments such as for tuberculosis. In terms of<br />
training, we have developed a very pragmatic<br />
educational approach. We have trained health<br />
technicians in the remotest corners of the region.<br />
Some have continued to work well, others not. It<br />
depends greatly on the involvement of the<br />
doctors in each district. Without support from the<br />
local authorities, this work would not have been<br />
effective. Now the Russians have taken over<br />
,,<br />
the<br />
the programme and we are trying to build on<br />
this experience in other regions of Siberia.<br />
ARMELLE DESPLANQUES-LEPERRE,<br />
Project Co-ordinator<br />
22/23
Opération Sourire<br />
Reconstructive<br />
surgery<br />
Each year, some thirty shortterm<br />
projects across Africa<br />
and Asia are involved in<br />
putting the smile back on<br />
children's faces. Volunteer<br />
surgeons, nurses and<br />
anaesthetists perform<br />
operations to cure congenital<br />
deformities, harelips, burns<br />
or the after-effects of war<br />
trauma. Opération Sourire<br />
has just celebrated its 15th<br />
birthday. In 2005, teams<br />
worked in 12 countries:<br />
Benin, Cambodia, Chad,<br />
Eritrea, Ethiopia, Laos,<br />
Madagascar, Mali, Niger,<br />
Mongolia, Pakistan and<br />
Rwanda. “In the countries<br />
where we work, surgery is<br />
often only used in<br />
emergencies,” explains Dr.<br />
François Foussadier, the<br />
project co-ordinator.<br />
“Performing operations for<br />
functional and morphological<br />
reasons was sometimes<br />
considered worthless by our<br />
local colleagues. It was only<br />
after they had seen the<br />
results that they understood<br />
how much these operations<br />
transformed patients' lives.”<br />
The Opération Sourire<br />
volunteers also train local<br />
teams. “When the Opération<br />
Sourire surgeons arrived in<br />
Niger in 1996, they made me<br />
aware of reconstructive<br />
surgery as they knew that I<br />
was interested,” says Issa, a<br />
young 29-year old Nigerian<br />
surgeon. “They taught me to<br />
carry out skin grafts, and<br />
today, I am the only one in<br />
Niamey who knows how to<br />
do them.”<br />
CATHERINE HENRIETTE
MdM<br />
CÉDRIC HELSLY<br />
MdM<br />
24/25<br />
The Homeless<br />
Re-establishing<br />
access<br />
to healthcare<br />
In 2005, 80% of the work<br />
carried out in France was<br />
through mobile<br />
programmes which allowed<br />
teams to go out and meet<br />
the most deprived people,<br />
and especially the<br />
homeless. “We met<br />
Béatrice at the station<br />
during one of our rounds,”<br />
says Marie-Thérèse<br />
Raymond, a psychologist<br />
and co-ordinator of the<br />
homelessness project in<br />
Poitiers. “She was pregnant<br />
but she did not know<br />
exactly how far on she was<br />
and had never been<br />
monitored. What struck me<br />
was that her arms were all<br />
scratched. Our doctor<br />
thought that it was a mental<br />
illness. As I talked with<br />
Béatrice, I realised that it<br />
was simply her way of<br />
expressing her anguish. She<br />
had just arrived in Poitiers,<br />
not knowing anyone, with<br />
nowhere to live, no income,<br />
no papers, and she was<br />
expecting a baby. Who<br />
wouldn't be distressed in<br />
such a situation? It was<br />
one of the worst situations<br />
of distress that I have ever<br />
come across. I directed<br />
Béatrice to our care centre.<br />
With the project's midwife<br />
and social worker, we got<br />
her back on her feet.<br />
Recently, she came to thank<br />
us. She had somewhere to<br />
live, a job and papers and<br />
she had a wonderful baby in<br />
her arms. It is by people like<br />
her that I measure how<br />
valuable our project to the<br />
homeless is.”
Sudan, Darfur<br />
Forgotten crisis<br />
As the conflict between the<br />
rebel movements and the<br />
governments intensifies, the<br />
health situation in Darfur<br />
continues to worsen.<br />
Refugees, most of them<br />
women and children, are<br />
fleeing the fighting and<br />
heading for the camps where<br />
the living conditions remain<br />
extremely precarious. In the<br />
Kalma camp, MdM''s care<br />
centre includes a<br />
hospitalisation unit, delivery<br />
room, 4 consultation rooms for<br />
curative care, vaccination<br />
services, etc.<br />
“Sudan is set for a lasting<br />
crisis. The south is fading from<br />
our memories, but Darfur in<br />
the west is being violently<br />
shaken while tensions have<br />
grown in the east,” says a<br />
worried Laurent Joseph, the<br />
project co-ordinator. The<br />
Association is also denouncing<br />
the worsening of security<br />
conditions and the obstacles<br />
the population faces to have<br />
access to healthcare.<br />
Afghanistan<br />
Hope in midwives<br />
“The role of NGOs is to<br />
encourage sufficient<br />
autonomy amongst the<br />
Afghans so that they don't<br />
need us any more,” explains<br />
Florence Maurin, medical coordinator<br />
of the project<br />
supporting mother-and-child<br />
health centres in Kabul and<br />
Herat. “In addition, when I<br />
see the student midwives<br />
being trained in our clinics, I<br />
am very hopeful. I am<br />
convinced that we must build<br />
using these generations. I<br />
believe that it is thanks to<br />
them that we will see a real<br />
reconstruction process in this<br />
country which has become in<br />
some way my own.”<br />
THIERRY <strong>DU</strong>DOIT/L’EXPRESS<br />
JANE BIRMANT / mdm
SÉBASTIEN GEORGES<br />
DR<br />
Chechnya<br />
,,<br />
Our country is<br />
devastated and<br />
occupied<br />
by an army that carries out many acts of<br />
repression against civilians. Houses are<br />
looted, people are faced with many acts of<br />
violence, humiliations, arrests or even total<br />
disappearances. Psychological trauma<br />
affects young and old. As a psychologist,<br />
my work involves training doctors at Grozny<br />
hospital so that they can detect its<br />
symptoms in their patients. Then they send<br />
these people to me so that we can start<br />
one-to-one work. This initial contact<br />
sometimes also lets us reach other family<br />
members who would not have come to the<br />
hospital, but who are also suffering serious<br />
problems. Drawing is my main means of<br />
getting children to talk about and express<br />
the trauma they have been through, as they<br />
are often haunted by tragic scenes. These<br />
scenes often re-emerge through their<br />
behaviour, in nightmares, aggressiveness,<br />
withdrawal into themselves, and memory<br />
problems. In this way, we can reconstruct<br />
,,<br />
each child's story.<br />
KHAPTA, Chechen psychologist<br />
for the project at Grozny hospital<br />
26/27
AIDS<br />
Prevention,<br />
care and training<br />
Every six weeks, AIDS<br />
produces as many victims as<br />
the tsunami did. In 2005, the<br />
Association carried out a<br />
study in 20 countries where<br />
the MdM international<br />
network works. This study<br />
showed that the lack of<br />
availability of medicines is not<br />
the only obstacle to access<br />
to antiretroviral treatments<br />
(ARVs). Some countries are<br />
incapable of coping with the<br />
epidemic even when they<br />
have ARVs. In effect, there<br />
are far too few health<br />
professionals with AIDS<br />
training and the treatments<br />
offered in hospitals are often<br />
a very long way from the<br />
primary health centres.<br />
Prevention, care and training<br />
are therefore the three main<br />
objectives of these projects,<br />
which are being carried out in<br />
about ten countries across<br />
the world.<br />
Setting up programmes to<br />
fight AIDS is not always easy.<br />
For example, Burma devotes<br />
only 2.2% of its health<br />
budget whereas 45% is<br />
destined for the army. How<br />
can this gap be reduced?<br />
“Our aim is to make civil<br />
society more aware of this<br />
epidemic,” explains<br />
Françoise Sivignon, the<br />
project co-ordinator in<br />
Burma. Thirteen years after<br />
the project began, attitudes<br />
have begun to change as the<br />
epidemic is now considered<br />
the 3 rd public health priority<br />
nationally.<br />
MdM<br />
LAHCÈNE ABIB<br />
BRUNO FERT / VOUS ÊTES ICI
LAHCÈNE ABIB<br />
LAHCÈNE ABIB<br />
Cambodia<br />
Treatment<br />
gives hope<br />
28/29<br />
More than 400 million<br />
people across the world<br />
suffer from mental,<br />
neurological or psychosocial<br />
problems. These<br />
invisible evils have many<br />
causes: armed conflicts,<br />
political violence, forced<br />
displacements, exclusion<br />
from healthcare systems,<br />
etc. These complex<br />
situations do not make<br />
treatment easy, especially<br />
as these problems are often<br />
stigmatised. “Because of<br />
very strong cultural<br />
pressure, people are<br />
ashamed to talk about<br />
psychological illnesses,”<br />
says Emmanuel Dignonnet,<br />
co-ordinator of the mental<br />
health programme in the<br />
Palestinian Territories. In<br />
Nablus, living conditions<br />
have deteriorated strongly.<br />
“The check points, the<br />
repeated incursions, the<br />
occupation and destruction<br />
of houses are all traumatic<br />
events.” In this sensitive<br />
area, teams have set up<br />
information campaigns,<br />
training and theatre projects<br />
in schools with a view to<br />
breaking the isolation. In<br />
Liberia, another country<br />
scarred by fourteen years of<br />
war, it was necessary to<br />
open a mental health<br />
programme. “The body<br />
cannot be well if the mind is<br />
ill, especially when you are<br />
dealing with children<br />
traumatised by war,” says<br />
Akemoh Maroe, a mental<br />
health worker. Boys have<br />
seen scenes where close<br />
relatives were killed; girls<br />
have been used as sex<br />
slaves… Today these young<br />
people are receiving<br />
psychological treatment.
The Roma<br />
Deep-rooted<br />
discrimination<br />
There are more than 2 million<br />
Roma throughout the<br />
European Union and they have<br />
a history of great<br />
discrimination against them<br />
since their arrival in the 14th<br />
and 15th centuries. Is this<br />
simple misunderstanding of<br />
this population or is it racism?<br />
In France, their life expectancy<br />
is 15 to 20 times lower than<br />
that of the French population<br />
and their infant mortality rate is<br />
5 times higher. Each year,<br />
many families are expelled<br />
from sites where they have<br />
settled. Their illnesses are<br />
related to poor living<br />
conditions and to their lack of<br />
access to healthcare in<br />
France. The Association is<br />
continuing its community<br />
health work in sites, with a<br />
particular focus on children<br />
and mother-and-child health. It<br />
deals with more than 3,000<br />
people in France.<br />
DRC<br />
Rebuilding health<br />
War, poverty, malnutrition and<br />
lack of healthcare have<br />
caused the death and<br />
displacement of millions of<br />
people in Democratic<br />
Republic of Congo. Many<br />
initiatives are being carried out<br />
in the country to put the health<br />
system back on its feet,<br />
especially in North Katanga,<br />
with a view to fighting AIDS. In<br />
Goma, specialist<br />
consultations, anonymous<br />
and free screening and ARV<br />
treatments are now available.<br />
In Kinshasa, a programme to<br />
help reintegration has been<br />
set up for street children.<br />
JULIEN DE WECK<br />
BRUNO FERT / VOUS ÊTES ICI
SÉBASTIEN GEORGES VALÉRIE <strong>DU</strong>PONT<br />
VALÉRIE <strong>DU</strong>PONT<br />
Mental Health<br />
Caring for<br />
invisible evils<br />
30/31<br />
More than 400 million people<br />
across the world suffer from<br />
mental, neurological or<br />
psycho-social problems.<br />
These invisible evils have<br />
many causes: armed<br />
conflicts, political violence,<br />
forced displacements,<br />
exclusion from healthcare<br />
systems, etc. These complex<br />
situations do not make<br />
treatment easy, especially as<br />
these problems are often<br />
stigmatised. “Because of very<br />
strong cultural pressure,<br />
people are ashamed to talk<br />
about psychological<br />
illnesses,” says Emmanuel<br />
Dignonnet, co-ordinator of the<br />
mental health programme in<br />
the Palestinian Territories. In<br />
Nablus, living conditions have<br />
deteriorated strongly. “The<br />
check points, the repeated<br />
incursions, the occupation<br />
and destruction of houses are<br />
all traumatic events.” In this<br />
sensitive area, teams have set<br />
up information campaigns,<br />
training and theatre projects<br />
in schools with a view to<br />
breaking the isolation. In<br />
Liberia, another country<br />
scarred by fourteen years of<br />
war, it was necessary to open<br />
a mental health programme.<br />
“The body cannot be well if<br />
the mind is ill, especially when<br />
you are dealing with children<br />
traumatised by war,” says<br />
Akemoh Maroe, a mental<br />
health worker. Boys have<br />
seen scenes where close<br />
relatives were killed; girls have<br />
been used as sex slaves…<br />
Today these young people are<br />
receiving psychological<br />
treatment.
Haiti<br />
Escalation<br />
of violence<br />
“Like all human beings, we<br />
are dreamers. He who stops<br />
dreaming can sink into<br />
violence,” says Professor<br />
Toussaint, a Haitian<br />
sociologist. Currently, the<br />
country is seeing an<br />
escalation of violence<br />
politically and socially. That is<br />
why, in Port-au-Prince in<br />
particular, the Association is<br />
treating victims of this<br />
violence by providing them<br />
with medical, psychological<br />
and legal support, but also by<br />
training local staff.<br />
Angola<br />
Street children<br />
Since the end of the civil war,<br />
MdM has been providing<br />
medical support to the<br />
weakest populations in<br />
Huambo province and in<br />
Lobito. “It was becoming<br />
urgent to open a programme<br />
giving street children access to<br />
hygiene and healthcare,”<br />
explains Luc Jarrige, the<br />
project co-ordinator. “The<br />
beneficiaries, aged between 7<br />
and 15, form a population who<br />
has been totally forgotten by<br />
the health authorities and the<br />
main sponsors.” In Huambo<br />
province, another programme<br />
is aimed at children suffering<br />
from malnutrition.<br />
Népal<br />
Fighting against<br />
HIV<br />
Nearly half the Nepalese<br />
population lives below the<br />
poverty line. This is the first of<br />
a long list of alarming<br />
indicators (life expectancy,<br />
infant mortality, illiteracy). For<br />
the past ten years, MdM has<br />
been running a programme<br />
against STIs and HIV.<br />
STÉPHANE LEHR VÉRONIQUE BURGER / PHANIE<br />
MdM
PASCAL DELOCHE<br />
SOPHIE BRANDSTROM / L’OEIL PUBLIC<br />
PASCAL DELOCHE<br />
32/33<br />
Child Buddy Scheme<br />
Energy<br />
transfusion<br />
Since 1988, a project has<br />
been aimed at isolated<br />
children in hospitals in Paris<br />
and the surrounding area. It is<br />
run by volunteers who provide<br />
emotional support to these<br />
weakened children, who are<br />
separated from their families<br />
while they are hospitalised.<br />
“One day, a buddy noticed<br />
that a child would not answer<br />
to his first name,” recalls<br />
Catherine Peterman, the<br />
project co-ordinator. “A long<br />
telephone conversation with<br />
the parents made her realise<br />
that the first name on his<br />
passport that the hospital was<br />
using was not his usual name.<br />
The next day, the child's face<br />
finally lit up. This support is all<br />
the more valuable as a nurse is<br />
not always available to do this<br />
job.” More than 1,500 children<br />
from foreign countries, the<br />
provinces or a DDASS (local<br />
health authority) have already<br />
benefited from it.<br />
Lead poisoning<br />
Illness of poverty<br />
Child lead poisoning is a littleknown<br />
scourge. Yet, 150,000<br />
to 300,000 children are<br />
potentially exposed to this<br />
risk in France. This lead<br />
poisoning, caused by<br />
absorbing or inhaling paint<br />
dust in dilapidated or<br />
unhealthy housing, leads to<br />
disasters. It stunts a child's<br />
psychomotor development.<br />
Since 1993, there has been a<br />
specific project fighting<br />
against this disease by<br />
finding and protecting these<br />
children.
,,<br />
Colombia<br />
The war here cannot<br />
always be seen.<br />
However, there is definitely a guerrilla war<br />
going on between the FARC and the United<br />
Self-Defence Forces of Colombia (AUC).<br />
These armed groups carry out drugs<br />
trafficking on a large scale. One group claims<br />
to protect small coca producers against large<br />
capital, while others profit from this manna to<br />
build up their presence outside the urban<br />
areas they control. The population is not free<br />
to choose which side it supports. It just<br />
submits! On top of selective executions there<br />
is repression from one side and assassination<br />
attempts and attacks on police stations by the<br />
other which leave the civilian population<br />
undefended and victims of this war most of<br />
the time. Security measures for the team are<br />
drastic: boats are clearly identified, flags fly<br />
over accommodation centres, and T-shirts<br />
and jackets with the Médecins du Monde<br />
dove emblem are worn at all times. Travel<br />
outside the villages or at nights is not allowed.<br />
,,<br />
Logistical self-sufficiency is total. The danger is<br />
not seen, but it is felt and it is permanent.<br />
CHRISTIAN RAGGIOLI,<br />
Project Co-ordinator<br />
MICHEL REDONDO<br />
MICHEL REDONDO
Atlas of international projects<br />
35/118
Les Médecins missions du internationales<br />
Monde’s<br />
x*<br />
x*<br />
x*<br />
Emergency: a situation where people's lives<br />
and livelihoods are in immediate danger<br />
(natural disaster, armed conflict, etc.)<br />
Response: involvement through substitution.<br />
Crisis: situation where people's basic needs are<br />
not being met in the long term (civil war, forgotten<br />
conflict, HIV pandemic).<br />
Response: technical assistance and mobilisation<br />
of local resources.<br />
Development: support for meeting the needs or<br />
carrying out the policies expressed by local<br />
partners, community or administration in a<br />
situation where there are insufficient resources.<br />
Response: partenarship and transfer of skills.<br />
* X: number of projects per country.<br />
Mexico<br />
2 1<br />
Guatemala<br />
1<br />
El Salvador<br />
1<br />
Colombia l<br />
Cuba<br />
2<br />
1<br />
Peru 1<br />
1<br />
Bolivia<br />
Argentina<br />
1<br />
1<br />
Haiti<br />
1<br />
3<br />
Dominican Republic<br />
1<br />
Brazil<br />
1
deinternational Médecins du projects<br />
Monde<br />
Morocco<br />
Equatorial Guinea<br />
Liberia<br />
1<br />
1<br />
Ivory Coast<br />
1<br />
Burkina Faso 1<br />
Democratic Republic of Congo<br />
3<br />
Algeria<br />
Mali<br />
4<br />
Angola<br />
Serbia<br />
Kosovo<br />
1<br />
Benin<br />
1<br />
1<br />
1<br />
3<br />
1<br />
2<br />
1<br />
Belarus 1<br />
Bulgaria<br />
3<br />
Lebanon<br />
Egypt<br />
Chad<br />
1<br />
Moldavia<br />
Turkey<br />
Sudan 1 1<br />
Zimbabwe<br />
1<br />
Georgi orgia<br />
1<br />
Russia<br />
2<br />
1<br />
Uganda<br />
1<br />
Chechnya<br />
Ethiopia<br />
1<br />
1<br />
1<br />
Afghanistan<br />
Palestinian Territories 3<br />
Nepal<br />
1<br />
1<br />
Tanzania<br />
3<br />
Madagascar<br />
4<br />
1<br />
Pakistan<br />
1 1<br />
2<br />
1<br />
Sri Lanka<br />
Mongolia 1<br />
Burma<br />
1 1<br />
1<br />
China<br />
1<br />
Cambodia<br />
Vietnam<br />
1<br />
2<br />
1<br />
Indonesia<br />
42/37 36/37<br />
4
Adoption<br />
Countries of intervention<br />
and associated<br />
countries in 2005<br />
Albania<br />
Brazil<br />
Bulgaria<br />
China<br />
Colombia<br />
Russia<br />
Vietnam<br />
Co-ordinators<br />
> Project: M. Brugière, F. Giraud<br />
> HQ: G. André-Trevennec<br />
Sources of funding<br />
> adopting families, MAI, MdM<br />
Budget<br />
> 2005: 374,000 euros<br />
In 2005 adoption work was carried out by 212 staff and volunteers at head office and<br />
14 regional offices. As the leading authorised adoption body (OAA) in France and the<br />
only OAA integrated in a medical NGO, the aims of Médecins du Monde's adoption project<br />
are to affirm its humanitarian purpose by defending the most vulnerable people (children,<br />
the first victims of economic and environmental crises, insecurity or geopolitical<br />
conflicts), to defend their fundamental rights (the right to a family to grow up in, access<br />
to healthcare and the right to education), to find families for children who have not been<br />
able to be adopted in their country of origin, and to facilitate the adoption of children<br />
with special needs (i.e. 119 children, that is to say 37.7% of the children adopted in<br />
2005).<br />
Families for children<br />
Activities: 1,634 letters received at head office, the files were<br />
examined during 30 commission meetings.<br />
459 applications were accepted, but the withdrawal rate,<br />
which runs at between 27 and 30%, must be taken into consideration<br />
when giving provisional figures for 2006.<br />
Children who come to France through Médecins du Monde are<br />
monitored within their family for two years through 6 scheduled<br />
contacts. Some of these contacts with a report are requested by<br />
the countries of origin.<br />
• In 2005, 1,441 post-adoption home visits to families were carried<br />
out, i.e. a 35% increase.<br />
• 315 children were adopted by 281 families.<br />
• 27 children came from European countries (Russia, Bulgaria,<br />
Albania).<br />
• 222 children came from Asia (China, Vietnam).<br />
• 66 children came from Latin America (Colombia, Brazil).<br />
• Administrative problems with Eastern Europe and difficulties<br />
with Vietnam limited the number of children coming from those<br />
countries.<br />
In 2005, 3 major areas were worked on and implemented:<br />
• the overhaul and updating of administrative procedures: creation<br />
of country reference systems and of performance indicators<br />
to monitor activities;<br />
• more in-service training and setting up of an integration day for<br />
adoption;<br />
• the development of complex adoptions:siblings, older children,<br />
children with specific medical needs.<br />
Outlook:<br />
Develop the distinctive<br />
features of the Médecins<br />
du Monde OAA: complex<br />
adoptions and its<br />
professionalism.
Afghanistan<br />
Attempts at normalisation and providing security are continuing in Afghanistan. A new phase<br />
in the political reconstruction process was completed with the parliamentary elections held in<br />
September 2005, but many challenges still remain. The issues involved in institutional and<br />
socio-economic reconstruction are still a real challenge for both the Afghan authorities and the<br />
international community. In addition, the donors' plan involved sub-contracting primary healthcare<br />
to NGOs for reconstructing the health system. After a study which highlighted that this<br />
devalued and removed responsibility from Afghan medical staff, MdM decided not to take part<br />
in this form of privatisation.<br />
Ensuring women have access to healthcare<br />
Kaboul<br />
Activities: MdM supports 2 mother and child health centres<br />
in Kabul. Two of the four centres opened in 1995 have already<br />
been transferred to another NGO (MSF Switzerland). There are 3<br />
parts to the programme:<br />
• ensuring women have access to healthcare (medical consultations<br />
in paediatrics, gynaecology and obstetrics, vaccination campaigns,<br />
basic health and hygiene education);<br />
• training local healthcare staff;<br />
o ensuring the renovation of health infrastructure and supplying drugs<br />
and equipment.<br />
Female doctors, nurses and midwives have been able to work unhindered<br />
since the Taliban left.<br />
Progress bar at 31/12/2005<br />
1995 2006<br />
Project > progress<br />
Mother and child protection<br />
Herat<br />
Activities: MdM runs a mother and child health programme<br />
in 3 clinics in the city of Herat around 4 areas of work:<br />
• direct involvement with the population (consultations in paediatrics,<br />
gynaecology, obstetrics, general medicine, vaccination campaigns,<br />
basic health and hygiene education);<br />
• training local health staff (including women doctors, nurses and midwives);<br />
• renovating health infrastructure and supplying drugs and equipment;<br />
• ongoing partnership with local health authorities.<br />
Progress bar at 31/12/2005<br />
1992 04/2006<br />
Project \npro- > gress<br />
Outlook:<br />
Pass the remaining two<br />
MCHs to a local NGO<br />
capable of maintaining<br />
the level and quality of<br />
current services. In April<br />
2005, set up a pilot<br />
harm reduction project<br />
amongst drug users in<br />
Kabul. Organise an<br />
exploratory mental<br />
health project in Kabul in<br />
June 2006.<br />
Outlook:<br />
MdM's withdrawal process<br />
and the transfer to a local<br />
NGO (Coordination of<br />
Humanitarian Assistance),<br />
which will take over running<br />
our 3 clinics in partnership with<br />
the Ministry of Health, have<br />
been agreed. 2005 thus marked<br />
the end of thirteen years of<br />
MdM's providing primary and<br />
mother and child healthcare in<br />
Herat.<br />
Sources: Human Development Report 2005; MICS UNICEF<br />
2003; The State of the World in 2006 (p. 238), “Securing<br />
Afghanistan's Future”<br />
Mortality<br />
> infant: 115‰<br />
> maternal: 1,600/100,000<br />
Life expectancy<br />
> at birth: years<br />
HDI<br />
> not known<br />
Beneficiaries<br />
> directly project 1: 36,000<br />
> directly project 2: 415,000<br />
Staff<br />
> local project 1: 18<br />
> expatriate project 1: 2<br />
> local project 2: 30<br />
> expatriate project 2: 2<br />
Co-ordinators<br />
> project 1: G. Causse<br />
> field 1: F. Maurin<br />
M. Otambekova<br />
> project 2: G. Causse<br />
> field 2: F. Maurin<br />
M. Otambekova<br />
> HQ: N. Bréchet<br />
38/39<br />
Actual GDP/inhabitant ($)<br />
> 206<br />
International delegation<br />
> MdM Canada<br />
Sources of funding<br />
> project 1: MdM, Florindon<br />
Foundation, Santa Devota, Isle of Man<br />
Overseas Aid Committee<br />
> project 2: MdM, SDC and<br />
Florindon Foundation<br />
Budget<br />
> 2005 project 1: 216,309 euros<br />
> 2005 project 2: 270,642 euros
Algeria<br />
Mortality<br />
> infant: 35‰<br />
Life expectancy<br />
> at birth: 71.1<br />
HDI<br />
> 0.722; ranked 103/177<br />
PIB/habitant ($)<br />
> 2,090<br />
Beneficiaries<br />
> directly: 1,200<br />
> indirectly: 15,000<br />
Co-ordinators<br />
> project: R. Allemand<br />
> follow-up: DR Rhône-Alpes -<br />
Grenoble<br />
Sources of funding><br />
Grenoble city council,<br />
Isère department council, MdM,<br />
concerts, dedicated gifts<br />
Budget<br />
> 2005: 36,446 euros<br />
Rapport sur le développement humain 2005, PNUD<br />
An unstable social environment, still very high unemployment and a lack of transparency in<br />
the use of oil resources make Algeria a fragile country where there are many inequalities.<br />
Despite the start of a programme aimed at containing the housing and infrastructure crisis<br />
amongst other things, many Algerians continue to live in harsh conditions. Problems with<br />
access to healthcare are real, especially for chronic diseases.<br />
Community health project<br />
Constantine (El Gamas district)<br />
Activities: The project involves assistance for two local<br />
organisations: the Constantine local committee of the Social<br />
Development Agency (ADS) and the El Gamas district<br />
residents' association. After consulting the local population<br />
and health workers and after an epidemiology survey, the<br />
demand that emerged was for asthma treatment, which had<br />
been neglected for essentially economic reasons.<br />
The following happened in 2005:<br />
• February 2005: an agreement was signed between MdM<br />
and the Algerian Republic's ADS in Constantine;<br />
• June 2005: training on asthma was given to two local<br />
committee doctors in Grenoble;<br />
• a spirograph was supplied to the district polyclinic;<br />
• two health educators worked amongst the population;<br />
• a booklet explaining asthma was produced;<br />
• basic drugs for chronic asthma were bought and supplied;<br />
• swimming pool sessions for asthmatic children were organised;<br />
• in October 2005, a seminar on community health was<br />
organised in Constantine.<br />
Progress bar at 31/12/2005<br />
02/2005 12/2007<br />
Project > progress<br />
Outlook:<br />
The project is going to run for<br />
two years and will only require<br />
follow-up work. This will allow<br />
us to focus our efforts in 3<br />
directions:<br />
• getting the health and political<br />
authorities to take full<br />
charge of treating chronic<br />
asthma to ensure the work<br />
continues;<br />
• asthma prevention and<br />
housing improvements in the<br />
district;<br />
• work with the Constantine<br />
health monitoring centre on<br />
harm prevention campaigns,<br />
campaigns against addiction<br />
to smoking and HIV/AIDS<br />
prevention.
Argentina<br />
The fragile recovery of the Argentinian economy should not let us forget that 38 million<br />
Argentinians are considered poor and are often excluded from the welfare protection sys-<br />
tem by the increase in moonlighting. The people have many demands in terms of health,<br />
Argentine<br />
education and increased purchasing power. Rural populations are particularly concerned<br />
by healthcare access problems.<br />
Increasing access to care for women and<br />
children<br />
Abra Pampa, Puna Jujeña, Jujuy province<br />
Activities: This project helps improve the rural<br />
population's access to healthcare through:<br />
• mother and child treatment, protection and monitoring;<br />
• monitoring women to reduce cervical cancer and sexually<br />
transmitted infections;<br />
• strengthening health prevention and promotion.<br />
Progress bar at 31/12/2005<br />
01/04/2003 31/08/2006<br />
Project > progress<br />
Outlook:<br />
MdM is particularly targeting<br />
community health<br />
together with the indigenous<br />
NGO WARMI and is<br />
continuing the project to<br />
build a new maternity<br />
hospital at Abra Pampa.<br />
Human Development Report 2005, UNDP<br />
Mortality<br />
> infant: 17‰<br />
Life expectancy<br />
> at birth: 74.5<br />
HDI<br />
> 0.863; ranked 34/177<br />
PIB/habitant ($)<br />
> 3,524<br />
International delegation<br />
> MdM Argentina - local projects<br />
Beneficiaries<br />
> directly: women and children<br />
> indirectly: general population,<br />
health promoters and medical<br />
staff (in hospital and health<br />
centres)<br />
Staff<br />
> local : 5<br />
> expatriate: 1<br />
Co-ordinators<br />
> project: B. Koepcke<br />
> field: M. Idiart<br />
> HQ: F. Stea (MdM France)<br />
and R. Timpano (Buenos Aires)<br />
Sources of funding> UE, MdM<br />
Budget<br />
> 2005: 195,751 euros<br />
40/41
Angola<br />
Mortality<br />
> infant: 154‰<br />
Life expectancy<br />
> at birth: 40.8<br />
HDI<br />
> 0.445; ranked 160/177<br />
Actual GDP/inhabitant ($)<br />
> 975<br />
International delegation<br />
> MdM Espagne<br />
Beneficiaries<br />
> directly: 3,500<br />
> indirectly: 20,000<br />
Staff<br />
> local : 30<br />
> expatriate: 4<br />
Co-ordinators<br />
> project L. Jarrige<br />
> general co-ordinator: D. Chappaz<br />
> HQ: O. Mouzay<br />
Sources of funding> FSD, MdM<br />
Budget<br />
> 2005: included in the mother and<br />
child health project budget (see<br />
opposite).<br />
Rapport sur le développement humain 2005, PNUD.<br />
The civil war which lasted twenty-seven years is making the democratic process a<br />
delicate one, even if the signing of peace agreements and ending of hostilities have<br />
led to better prospects for international assistance, especially that aimed at children.<br />
52% of children show signs of malnutrition and the illiteracy rate (58%) is one of the<br />
highest in Africa. The aftermath of war and drought, especially in Huambo province<br />
and part of Bie province, are not helping to improve one of the most difficult situations.<br />
Treating moderate malnutrition<br />
North, Huambo province (Mungo and Bailundo towns)<br />
Activities: As in 2004, the operation in Mungo involves:<br />
• running, in conjunction with the WFP, a permanent<br />
supplementary feeding centre and two mobile centres<br />
(providing curative care, vaccinations and nutritional support);<br />
• supporting the town's primary healthcare structures (staff<br />
management, supplying drugs, vaccinations and supplies).<br />
In Bailundo, the project focuses mainly on:<br />
• support for Bailundo Ministry of Health's permanent supplementary<br />
feeding centre;<br />
• staff training;<br />
• curative care.<br />
Progress bar at 31/12/2005<br />
06/2003 12/2005<br />
Project > progress<br />
Outlook:<br />
The outlook for 2006 is identical<br />
in part to that for 2005.<br />
MdM is continuing to transfer<br />
specific renutrition structures<br />
to the Ministry of Health by<br />
integrating them with existing<br />
health structures. The monthly<br />
assessment of activities with<br />
the Mungo health structures<br />
through the involvement of the<br />
mother and child health<br />
(MCH) nurses from the<br />
Huambo province mother and<br />
child health programme will<br />
also be included amongst the<br />
activities for 2006.
Mother and child health<br />
North, Huambo province (Mungo and Bailundo towns)<br />
Activities: We are continuing to develop the current integrated<br />
mother and child health (MCH) programme in partnership with<br />
the local network of traditional midwives and MCH nurses within the<br />
peripheral health structures of the north of the province and in the<br />
referral hospital at Bailundo. 2005 has seen the continuation of these<br />
activities set up by MdM when the project started:<br />
• monitoring the network of MCH nurses supervising all the traditional<br />
midwives;<br />
• supervision of paediatric consultations and the vaccination programme;<br />
• training in prevention and treatment of the main STIs;<br />
• family planning;<br />
• structural support and recycling of staff from the maternity unit to<br />
the Bailundo referral hospital;<br />
•renovation of an operating theatre, training a theatre medical team,<br />
training doctors in emergency surgery techniques.<br />
Progress bar at 31/12/2005<br />
01/12/2003 31/12/2006<br />
Care for street children<br />
Lobito town, Benguela province<br />
Activities: To increase the efficiency of the care given to<br />
street children and their access to it, MdM is continuing its activities<br />
which include:<br />
• building, equipping and supplying a health centre with drugs in<br />
conjunction with the local authorities;<br />
• agreements have been made with local hospitals to deal with<br />
more serious diseases, with the objective of letting street children<br />
access the Angolan health system by themselves;<br />
• six street educators are responsible for making a list of all the<br />
street children, making contacts with their living places and carrying<br />
out surveys in order to plan joint activities with partners working<br />
more specifically in the education and professional training<br />
of street children. The possibility of envisaging a process of family<br />
reintegration has to be assessed with each child.<br />
Progress bar at 31/12/2005<br />
06/2004 12/2006<br />
Project > progress<br />
Project \npro- > gress<br />
Outlook:<br />
Continue to gradually increase<br />
the quality of peripheral<br />
actions and ensure their longterm<br />
continuity. Training and<br />
support of Angolan medical<br />
staff remain important aspects<br />
which will allow them, in the<br />
longer term, to move towards<br />
efficient autonomy.<br />
Outlook:<br />
Continue the process of<br />
complete autonomy for the<br />
health centre, and best<br />
management of all health<br />
care for street children at the<br />
health centre or in the hospitals.<br />
Beneficiaries<br />
> directly: 80,000<br />
> indirectly: 325,000<br />
Staff<br />
> local : 15<br />
> expatriate: 6<br />
42/43<br />
Co-ordinators<br />
> project: L. Jarrige<br />
> general coordinator: D. Chappaz<br />
> HQ: O. Mouzay<br />
Sources of funding<br />
> FSD, German Foreign Ministry<br />
Budget<br />
> 2005: 379,772 euros<br />
Beneficiaries<br />
> directly: 65,000<br />
> indirectly: 2,000<br />
Staff<br />
> local : 10<br />
> expatriate: 1<br />
Co-ordinators<br />
> project: L. Jarrige<br />
> general coordinator: D. Chappaz<br />
> HQ: O. Mouzay<br />
Source of funding<br />
> UBS<br />
Budget<br />
> 2005: 124,196 euros
Benin<br />
Mortality<br />
> infant: 91‰<br />
Life expectancy<br />
> at birth: 54.0<br />
HDI<br />
> 0.431; ranked 162/177<br />
Actual GDP/inhabitant ($)<br />
> 517<br />
Beneficiaries> directly: 600<br />
Staff<br />
> local: 5<br />
> expatriate: 3<br />
(1 medical co-ordinator)<br />
Co-ordinators<br />
> project: P. Beze Beyrie<br />
> HQ: A. Belaïd<br />
Sources of funding<br />
> Paris city council, French Foreign<br />
Ministry, Dutch Foreign Ministry<br />
Budget<br />
> 2005: 366,157 euros<br />
Human Development Report 2005, UNDP<br />
Benin is one of the eighteen poorest countries which benefited from the debt cancellation<br />
agreed by the G8 countries in 2005. Benin's economy continues to struggle.<br />
The cotton sector (the country's main resource) is in deficit. We are seeing the sad<br />
growth of the HIV/AIDS epidemic. 68,000 people, including 5,700 children, are now<br />
living with the infection. 34,000 children are orphans.<br />
Dealing with the HIV/AIDS epidemic<br />
Ouidah and Come<br />
Activities: Activities aim to respond to the AIDS epidemic<br />
in Benin's particularly affected cities. We are continuing our<br />
preventive measures in the fight against HIV/AIDS through<br />
education and raising awareness (amongst women in particular)<br />
and support for those who are ill, with our local partner<br />
Africare, who is skilled in involving the community. We are<br />
continuing our voluntary, anonymous and free screening activities<br />
and treatment of AIDS patients. To do this, MdM is training<br />
Beninois staff and renovating health centres to increase<br />
local capacity so that we can move towards Beninois staff gaining<br />
autonomy<br />
Progress bar at 31/12/2005<br />
01/2005 31/12/2006<br />
Project > progress<br />
Outlook:<br />
In January 2006, the staff training<br />
programme ended, the<br />
renovation is nearly complete,<br />
and the first patients being<br />
treated with ARVs will be<br />
included in the active file.
Byelorussia<br />
Alexander Lukashenko's regime is becoming increasingly harsh: personal liberties are<br />
restricted and the structural reforms needed have not been carried out. In addition,<br />
the health consequences of the Chernobyl nuclear disaster have been rationalised by<br />
the government whereas the number of cancers and other congenital deformities due<br />
to radiation continues to increase. The people living in the area at risk have not been<br />
evacuated. On top of that, as the soil affected by radioactivity is still being cultivated,<br />
the people are subject to chronic contamination through the food grown there.<br />
Preventing radioactive contamination<br />
Chechersk district<br />
Activities: MdM's work is aimed at improving the health<br />
of women and children living in areas with radioactive<br />
contamination. The CORE (Cooperation for Rehabilitation)<br />
programme, in which the European Union is taking part, has<br />
been set up with the aim of improving the living conditions of<br />
those living in the contaminated districts. This project has<br />
been set up by three partners (IRSN, ACRO and Médecins<br />
du Monde) and is coordinated by Médecins du Monde. It<br />
focuses on three areas:<br />
• carrying out a health assessment of 2,800 children in<br />
Chechersk district in partnership with the Institute for Nuclear<br />
Radioprotection and Safety (IRSN);<br />
• improving radiological quality, in partnership with ACRO<br />
(Association for Controlling Radioactivity in the West), and<br />
raising awareness about the risks of contamination through<br />
radioactivity;<br />
• maternal care, actions for and with women (supply of food<br />
supplements, raising awareness of the risk of complications<br />
during pregnancy, etc.).<br />
Progress bar at 31/12/2005<br />
13/08/2005 12/08/2007<br />
Project > progress<br />
Outlook:<br />
The people are beginning to<br />
take responsibility for themselves<br />
and exchanges have<br />
led to noticeable changes in<br />
risky eating habits. This programme<br />
should lead to further<br />
improvements in this<br />
area.<br />
Human Development Report 2005, UNDP<br />
Mortality<br />
> infant: 13‰<br />
Life expectancy<br />
> at birth: 68.1<br />
HDI<br />
> 0.786; ranked 67/177<br />
44/45<br />
Actual GDP/inhabitant ($)<br />
> 1,770<br />
Beneficiaries<br />
> directly: 2,800 children between<br />
3 and 15 years old and 400 pregnant<br />
women and new-borns<br />
> indirectly: local health<br />
professionals, the whole population<br />
of the district<br />
Staff<br />
> local: 1 half-time co-ordinator<br />
Co-ordinators<br />
> project: M. Costa,<br />
C. Georgescauld (RT)<br />
> field: T. Gloukhova<br />
> HQ: A. Landaes<br />
Sources of funding<br />
> Tacis (EU), IRSN, DGSNR, MdM<br />
Budget<br />
> 2005: 10,221 euros
Bolivia<br />
Mortality<br />
> infant: 53‰<br />
Life expectancy<br />
> at birth: 64.1<br />
HDI<br />
> 0.687; ranked 113/177<br />
Actual GDP/inhabitant ($)<br />
> 892<br />
International delegation<br />
> MdM Spain<br />
Beneficiaries<br />
> directly: 1,100<br />
> indirectly: 9,000<br />
Staff<br />
> local: 5<br />
> expatriate: 0<br />
Co-ordinators<br />
> project: L. Liron, D. Masson<br />
> field: I. Tapia<br />
> follow-up: DR Rhône-Alpes<br />
Bourgogne (S. Bret)<br />
Sources of funding<br />
> private partnerships, towns in<br />
Rhône-Alpes, MdM<br />
Budget<br />
> 2005: 25,309 euros<br />
Human Development Report 2005, UNDP<br />
The still poverty-stricken Andean regions have welcomed the coming to power of<br />
the Movement towards Socialism led by Evo Morales, the first indigenous president<br />
of Bolivia. As well as agrarian reform and the redistribution of natural resources,<br />
child labour is an important area of work in a country which is one of the poorest<br />
on the continent.<br />
Protecting the health of children at work<br />
Potosí, San Cristobal district<br />
Activities: Since 2002, MdM has been working in Potosi,<br />
a mining town in the Andean cordillera, to ensure children<br />
receive access to healthcare and to prevent work-related risks.<br />
Several activities are being carried out:<br />
• health education: workshops for child workers and nursery<br />
teachers in San Cristobal district;<br />
• access to healthcare structures: material support and<br />
raising awareness of staff concerning traditional medicine;<br />
• accidents in the mines: training on emergency care and<br />
treating the injured;<br />
• depression amongst adolescents: creating a support<br />
structure for adolescents facing problems;<br />
• young children at work: raising awareness amongst institutions<br />
and the population of the consequences on 6-8 year<br />
olds of working.<br />
Lastly, in partnership with a Lyons-based organisation, MdM<br />
is supporting a group of local young people with its projects.<br />
In the long term, the aim is to create a youth centre-type structure<br />
which would offer recreational activities as alternatives to<br />
child work.<br />
Progress bar at 31/12/2005<br />
2002 12/2007<br />
Project progress ><br />
Outlook:<br />
The long-term future of the<br />
project after MdM leaves is<br />
the team's major concern.<br />
It involves working in partnership,<br />
which will be a<br />
major issue in 2006: the training<br />
of college teachers to<br />
run health education workshops,<br />
partnership with the<br />
town council for the work<br />
with young people, partnership<br />
with health structures to<br />
replenish first aid kits, and<br />
partnership with an Italian<br />
NGO on the mine safety<br />
project, etc.
Brazil<br />
The corruption scandals which have shaken the government of president Luiz Inácio<br />
Lula da Silva have delayed the completion of the major reforms intended, amongst<br />
other things, to redistribute cultivable land for the benefit of “landless” rural community.<br />
Despite the efforts made as part of the “Bourse Famille” (Family Purse) programme,<br />
the Nordeste continues to be a particularly disadvantaged and sensitive<br />
region in health terms.<br />
Training healthcare workers<br />
Ceará State<br />
Activities: The programme is run amongst the landless<br />
community in the rural districts of Tururu, Itapipoca,<br />
Amontada, Trairi and Itarema in Ceará state in order to reduce<br />
the morbidity and mortality rates for the most common<br />
illnesses encountered in this population. As well as training<br />
healthcare workers, the whole population of the area has been<br />
given health, hygiene and prevention awareness training and<br />
education and, alongside, has benefited from consultations. In<br />
addition, the recognition of the landless community by the local<br />
health structures has improved.<br />
Through this work, MdM has concluded a cycle of projects<br />
aimed at improving overall health in the communities undergoing<br />
agrarian reform, by training community health workers<br />
(CHWs), the main people involved in prevention in the isolated<br />
rural communities of Ceará.<br />
Progress bar at 31/12/2005<br />
12/2004 12/2005<br />
Project > progress<br />
Outlook:<br />
Our local partner, the<br />
Landless Workers'<br />
Movement (MST) will continue<br />
its activities in the following<br />
areas:<br />
• encouraging the integration<br />
of the CHWs into the<br />
local health services;<br />
o allowing the 4 CHW trainers<br />
to continue training<br />
• HWs in other rural communities<br />
with MST in Ceará<br />
state and nationally;<br />
• developing a series of<br />
seminars on health, with the<br />
trained trainers, under the<br />
supervision of two Brazilian<br />
MST doctors, trained in<br />
Cuba.<br />
Human Development Report 2005, UNDP<br />
Mortality<br />
> infant: 33‰<br />
Life expectancy<br />
> at birth: 70,5<br />
HDI<br />
> 0.792; ranked 63/177<br />
GDP/inhabitant ($)<br />
> 2,788<br />
Beneficiaries<br />
> directly: 5,000<br />
Staff<br />
> local: 3<br />
> expatriate: 1<br />
46/47<br />
Co-ordinators<br />
> project: J. Achouline, J. Guerrini<br />
> field: G. Sekhniashvili<br />
> HQ: M.-Y. de Penanster-Rosny, Y.<br />
Le Corgne<br />
Sources of funding<br />
> Aquitaine regional council,<br />
miscellaneous gifts, MdM<br />
Budget<br />
> 2005: 144,201 euros
Bulgaria<br />
Mortality<br />
> infant: 14‰<br />
Life expectancy<br />
> at birth: 72.2<br />
HDI<br />
> 0.808; ranked 55/177<br />
GDP/inhabitant ($)<br />
> 2,539<br />
Beneficiaries<br />
> directly: Roma mothers<br />
and children<br />
> indirectly: Roma families<br />
Staff<br />
> local: 4<br />
> expatriate: 1<br />
Co-ordinators<br />
> project: P. Contois<br />
> field: L. Lamarque<br />
(until end of 2005)<br />
> follow-up: MIR RD Corsica<br />
(until end of 2005,<br />
then national project)<br />
Sources of funding<br />
> collectivité régionale de Corse,<br />
MdM<br />
Budget<br />
> 2005: 78,089 euros<br />
Human Development Report 2005, UNDP<br />
The economic situation in Bulgaria is improving gradually with the arrival of the new<br />
government led by Sergei Stanichev but social inequalities persist: out of a total population<br />
of 8 million, 1.1 million Bulgarians are living below the poverty line. The health situation<br />
is precarious, and life in the specialist institutions (institutions for disabled people,<br />
orphanages and prisons) is particularly difficult. In addition, the Roma community's situation<br />
is still worrying and Bulgaria's EU membership may well be delayed if efforts are not<br />
made in this area.<br />
Mother and child protection<br />
Roma district of Nadezhda, in Sliven<br />
Activities: The programme has been set up in a former<br />
ghetto, now a Roma district, where around 20,000 people<br />
live. The population's sanitary conditions are deplorable (almost<br />
complete lack of water, sewerage and electricity in the district).<br />
The Roma are victims of segregation and have a much<br />
higher unemployment and illiteracy rate than the Bulgarian<br />
average.<br />
A Mother and Child Health clinic has been set up by<br />
MdM's regional delegation in Corsica. It bears the name of<br />
Dr Edouard Delahayes, the project co-ordinator who died in<br />
a road accident on the way to Bulgaria. The team is made<br />
up of an expatriate co-ordinator and Bulgarian staff: a paediatrician,<br />
midwife, nurse and social worker.<br />
Mother and child consultations are organised to pick up<br />
pregnancies at risk and childhood diseases, and to refer<br />
patients needing it to the general Bulgarian health service.<br />
Health information and training sessions are organised for<br />
mothers and children and, in particular, a school for mothers<br />
has been developed. A public health survey was carried out<br />
in the poorest part of the district, known as the “district of the<br />
naked”, to pick up the weakest people and support them.<br />
Progress bar at 31/12/2005<br />
03/2004 12/2009<br />
Project > progress<br />
Outlook:<br />
Bearing in mind the size of<br />
the problem this population<br />
faces, the programme is<br />
becoming national in 2006,<br />
and will be supported by the<br />
Eastern Europe desk.<br />
International funding will be<br />
sought to provide the clinic<br />
with resources more appropriate<br />
to the situation: increasing<br />
the strength of the<br />
team, sending an expatriate<br />
medical co-ordinator for 18<br />
to 24 months, seeking premises<br />
where child vaccination<br />
campaigns can be organised<br />
by local doctors, organising<br />
training and co-ordination<br />
meetings, setting up a<br />
pre-hospitalisation hygiene<br />
centre, etc.
Help for children Staff<br />
Sofia<br />
> local: part-time secretary<br />
Activities: MdM 's activities have two aspects:<br />
• contact with Bulgarian institutions and NGOs which<br />
are involved with children, to distribute information on our<br />
programme.<br />
• support for the work of the “Child and his symptoms”<br />
project. MdM supports the “Development for<br />
Children and Families” Foundation which funds the 6 training<br />
modules for paediatric institutions' staff. After selecting<br />
the institutions to receive this training, the Foundation<br />
provides help in organising the modules. The lectures and<br />
case studies examined during the different modules are<br />
then published for each year of training in French and in<br />
Bulgarian.<br />
Progress bar at 31/12/2005<br />
03/2004 12/2009<br />
Training staff from<br />
paediatric institutions<br />
Throughout the country (+ training in Sofia)<br />
Activities: The “Child and his symptoms” project is run in<br />
two ways:<br />
• each year six training modules are organised in Sofia for staff<br />
from 8 institutions and 4 centres for disabled children. They are<br />
given jointly by French volunteer trainers from the CIEN (Centre<br />
interdisciplinaire de l'enfant) who are paediatric psychiatrists or<br />
psychologists, and by members of the Belgian charity “Enfant<br />
et Espace” (Child and Space). This training is followed up and<br />
evaluated by a specific written programme and implemented by<br />
the Social Activities and Practice Institute in Sofia;<br />
• two visits per year are made to the institutions and centres,<br />
by “supporters” appointed by the Bulgarian project coordinator.<br />
They organise team meetings to prepare the modules<br />
together with them. These visits provide specific training for the<br />
whole staff of each institution.<br />
Progress bar at 31/12/2005<br />
01/01/2005 30/06/2009<br />
Project > progress<br />
Project > progress<br />
Outlook:<br />
In four and a half years, the<br />
staff of most of the institutions<br />
for disabled children in<br />
Bulgaria will be trained.<br />
Co-ordinators<br />
> project: F. Parrot<br />
> follow-up: DR Aquitaine<br />
48/49<br />
Source de financement<br />
> MdM<br />
Budget<br />
> 2005: 12,763 euros<br />
Beneficiaries<br />
> directly: 150 professionals<br />
> indirectly: 396 education or day<br />
centre specialists,<br />
360 families and 1,220 children<br />
Staff<br />
> local: projects co-ordinator<br />
1/2 FTE, secretary 1/4 FTE<br />
Co-ordinators<br />
> project: F. Parrot<br />
> follow-up: DR Aquitaine<br />
Sources of funding<br />
> Aquitaine regional council, miscellaneous<br />
gifts<br />
Budget<br />
> 2005: 13,806 euros
Burkina Faso<br />
Mortality<br />
> infant: 107‰<br />
UNDP<br />
Life expectancy<br />
2005,<br />
> at birth: 47,5<br />
Report<br />
HDI<br />
> 0.317; ranked 175/177<br />
Development<br />
GDP/inhabitant ($)<br />
> 345 Human<br />
Beneficiaries<br />
> directly: 60,000<br />
> indirectly: 180,000<br />
(the whole of the province)<br />
Staff<br />
> local: 1 (dentist in training)<br />
Co-ordinators<br />
> project: F. Ben Soussan<br />
> field: Abbé Séverin Dabbiré<br />
> HQ: P. De Botton<br />
> follow-up: DR PACA (M. Semat)<br />
Sources of funding<br />
> MdM and private partners<br />
Budget<br />
> 2005: 1,116 euros<br />
Even though it has become the leading cotton producer in Africa for the first time, the<br />
country, led by the same man for eighteen years (re-elected in November 2005), remains<br />
very poor. As well as a disappointing economic assessment, the health situation is disastrous.<br />
Mothers' poor knowledge of how to monitor children (partial or total lack of<br />
knowledge of childhood illnesses and the hygiene measures to avoid them), together<br />
with difficult access to health centres, is behind the high infant mortality rate in this<br />
country.<br />
It should also be noted that the spread of HIV at all social levels, and the absence of<br />
prevention and screening make an already worrying situation even worse.<br />
Access to oral<br />
healthcare programme<br />
Diébougou (Sud-Ouest)<br />
Activities: Having realised that no-one was providing<br />
oral healthcare in the region, MdM set up several activities.<br />
These include:<br />
• setting up a dental surgery (refurbishing the<br />
premises);<br />
• staff training (training a dentist at the university);<br />
• developing an oral ailments prevention programme<br />
in schools and villages in Diebougou province with the<br />
aim of improving the oral health of the population of this<br />
region.<br />
Progress bar at 31/12/2005<br />
2005 2007<br />
Project > progress<br />
Outlook:<br />
Run the dental surgery and<br />
continue to train the medical<br />
staff. A dentist began work<br />
in the dental surgery in<br />
March 2006 while waiting for<br />
a second dentist to complete<br />
his training.
Burma<br />
Burma is going through a major socio-economic crisis and the government has reduced<br />
health spending to a minimum (0.4% of GDP). However, HIV is ravaging a country<br />
where prostitution and the use of injectable drugs are very widespread: more than<br />
680,000 may be carrying the virus. The criminalisation of drug users and prostitutes<br />
makes MdM's work more difficult. In addition, the withdrawal of the Global Fund<br />
(which had undertaken to pay 98 million dollars over five years) is making the current<br />
situation worse. Today, the HIV prevalence rate is up to 43% amongst prostitutes and<br />
to 90% amongst drug users.<br />
Preventing HIV transmission<br />
Myitkyina (Kachin) and Yangon<br />
Activities: MdM's work is focused on preventing HIV and<br />
STI transmission in Myitkyina and Yangon in order to reduce<br />
HIV/AIDS and STI transmission in the population and amongst<br />
people at risk - prostitutes and intravenous drugs users - and to<br />
offer access to healthcare and treatment of opportunistic infections.<br />
Its work is concentrated amongst prostitutes (HIV/AIDS prevention<br />
sessions, free treatment of STIs and OIs, workshops in<br />
drop-in centres and condom distribution) and drug addicts (promotion<br />
of harm reduction methods in shooting galleries, needle<br />
distribution and prevention/ education sessions in drop-in centres).<br />
In addition, MdM is continuing its welfare support and AIDS education/prevention<br />
activities in prisons, where prostitutes and drug<br />
addicts can often be found in a country where the law is very<br />
repressive against these groups of people. ARVs began to be<br />
administered in Yangon in May 2005. At the end of December,<br />
43 prostitutes were receiving treatment.<br />
Progress bar at 31/12/2005<br />
01/01/2002 30/06/2010<br />
Project > progress<br />
Outlook:<br />
MdM hopes to continue<br />
administering ARVs to prostitutes<br />
in Yangon and to<br />
start methadone substitution<br />
in Kachin state. We must<br />
also strengthen links with the<br />
vulnerable groups, and<br />
continue to gather testimonies.<br />
Human Development Report 2005, UNDP<br />
Mortality<br />
> infant: 76‰<br />
Life expectancy<br />
> at birth: 60.2<br />
HDI<br />
> 0.578; ranked 129/177<br />
50/51<br />
Actual GDP/inhabitant ($)<br />
> not known<br />
Beneficiaries<br />
> directly: 9,000<br />
> indirectly: 50,000<br />
Staff<br />
> local: 100<br />
> expatriate: 6<br />
Co-ordinators<br />
> project: F. Sivignon<br />
> field: A. de Suremain<br />
> HQ: V. Pardessus<br />
Sources of funding<br />
> MdM, Novib, UNODC/UE,<br />
PSI/Usaid<br />
Budget<br />
> 2005: 577,703 euros
Cambodia<br />
Mortality<br />
> infant: 97‰<br />
Life expectancy<br />
>> at birth: 56.2<br />
HDI<br />
> 0.571; ranked 130/177<br />
GDP/inhabitant ($)<br />
> 315<br />
Beneficiaries<br />
> directly: 120,000<br />
> indirectly: 400,000<br />
Staff<br />
> local: 59<br />
> expatriate: 4<br />
Co-ordinators<br />
> project: E. Peterman<br />
> field: P.-R. Martin<br />
> HQ: V. Pardessus<br />
Sources of funding<br />
> projet : Global Fund, Elton John<br />
Aids Foundation, MdM<br />
Budget<br />
> 2005: 596,389 euros<br />
Human Development Report 2005, UNDP<br />
With growth of 6.3%, Cambodia's economic situation has gradually been improving<br />
since the end of the civil war. But the AIDS endemic is widespread and the government<br />
has made it a public health priority. The HIV prevalence rate in Cambodia (2%)<br />
is the highest in the region. International tourism, internal migration, poverty, human<br />
trafficking and prostitution are all factors propagating HIV/AIDS in the country.<br />
Priority to HIV<br />
Phnom Penh<br />
Activities: MdM's project is aimed at reducing the<br />
transmission of STIs/HIV and caring for infected patients,<br />
offering medical and welfare support to destitute patients suffering<br />
from HIV, raising the population's awareness and training<br />
medical staff.<br />
In 2005, the project focused on:<br />
• specialist consultations for the treatment of patients suffering<br />
from AIDS (OIs and ARVs);<br />
• training doctors (ARVs and OIs);<br />
• informing patients about the illness and the available treatment<br />
and services;<br />
• hospital treatment of opportunistic infections;<br />
• developing a continuum of care, assistance and support<br />
networks for people living with HIV/AIDS;<br />
• supporting Cambodian NGOs set up by people who are<br />
HIV-positive.<br />
The aim of treating opportunistic infections and providing<br />
access to ARVs is to reduce the morbidity and mortality rates<br />
linked to AIDS, and thus to provide patients with a better quality<br />
of life. That is, an active social life for a longer time, fighting<br />
against exclusion, and reducing the economic impact (on<br />
family and society) of the illness.<br />
Progress bar at 31/12/2005<br />
01/04/1999 30/08/2010<br />
Project > progress<br />
Outlook:<br />
Between now and December<br />
2006, 2,000 patients will be<br />
regularly monitored in the<br />
consultation centre. 521 of<br />
them will receive ARVs.<br />
A joint venture with<br />
Pharmaciens Sans Frontières<br />
should enable us to provide<br />
450 additional people with<br />
access to ARVs.
Chad<br />
In this country where the local economy remains extremely dependent on external aid,<br />
poverty has reached unsuspected levels. Even if the gross domestic product remains<br />
one of the highest in the continent, the government is no longer managing to pay the<br />
backlog of salaries or retirement pensions. The prevalence of certain diseases such<br />
as malaria is not just due to lack of healthcare infrastructure but also to lack of hygiene<br />
and the permanent consumption of contaminated products, two risks to which<br />
children are the most exposed (5,000 abandoned young people survive in the middle<br />
of effluents). The political instability persists and, in the east of the country, the massive<br />
influx of Sudanese refugees is adding to the insecurity.<br />
Primary health for street children<br />
N’Djamena<br />
Activities: Medical treatment of wounds and traumas<br />
suffered by children living in precarious situations and<br />
picked up in the street. MdM's project has allowed welfare<br />
workers to be trained and children to be educated in health<br />
and hygiene matters:<br />
• 64 workers from 20 local structures have been trained;<br />
• 2,800 children have attended educational sessions;<br />
• a suitable teaching tool has been produced by MdM and<br />
made available to local structures.<br />
In 2005, a medical and welfare support circuit, based on a<br />
third-party paying system relying on local sponsors, was set<br />
up on a permanent basis. It has provided access to primary<br />
healthcare for more than 3,000 children, especially affected<br />
by violence.<br />
In partnership with UNICEF Chad, training and prevention work<br />
involving 40 peers has reduced the incidence of HIV/AIDS<br />
amongst young people living on the street.<br />
MdM is withdrawing at the end of 2005 and will ensure the<br />
continuity of the programme through an agreement signed<br />
with a hand-over structure, the ITS (Institut Tropical Suisse).<br />
Progress bar at 31/12/2005<br />
01/12/2001 12/2005<br />
Project > progress<br />
Outlook:<br />
MdM will support ITS (evaluation,<br />
help with running the<br />
circuit) and will help find new<br />
sponsors for 2007.<br />
The project is due to end in<br />
November 2006.<br />
Human Development Report 2005, UNDP<br />
Mortality<br />
> infant: 117‰<br />
Life expectancy<br />
> at birth: 43.6<br />
HDI<br />
> 0.341; ranked 173/177<br />
52/53<br />
Actual GDP/inhabitant ($)<br />
> 304<br />
Beneficiaries<br />
> directly: 5,000 children including<br />
30 leaders<br />
> indirectly: 30 social workers and<br />
20 health workers<br />
Staff<br />
> local: 5<br />
> expatriate: 1<br />
Co-ordinators<br />
> project: P. Estecahandy,<br />
J. Boncompain<br />
> field: R. Lange<br />
> follow-up: DR Midi-Pyrénées<br />
Sources of funding<br />
> MdM, FSD, private regional and<br />
local partners (in N'Djamena,<br />
and Midi-Pyrénées)<br />
Budget<br />
> 2005: 123,483 euros
Chechnya<br />
Mortality<br />
Life expectancy<br />
HDI<br />
Actual GDP/inhabitant ($)<br />
International delegation<br />
> no data specific to Chechnya<br />
Beneficiaries<br />
> directly: general population:<br />
85,592 from February to October<br />
2005<br />
Staff<br />
> local: 14<br />
> expatriate: 2<br />
Co-ordinators<br />
> project 1: J. Dato<br />
> field 1: P. Baril<br />
> HQ: A. Landaes<br />
Source of funding<br />
> ECHO<br />
Budget<br />
> 2005: 971,912 euros<br />
2005 was a particularly violent year for Chechnya: repression against civilians remains<br />
a daily occurrence, and this is in the name of Russia's fight against terrorism. In<br />
response to that, several assassination attempts were carried out by Chechen guerrillas.<br />
The population lives in fear and poverty, hospitals are obsolete and many people<br />
still do not have access to primary healthcare.<br />
Supporting victims of conflict<br />
Grozny, Gudermes, Urus-Martan, Argun, Kurchaloy<br />
Nozhay-Iurt and Vedeno Districts<br />
Activities: In 1999, for security reasons, MdM had to adopt<br />
a “remote control” system for the project from its Moscow base.<br />
MdM's work is focused on improving surgical care, primary<br />
and secondary healthcare and setting up mental health<br />
assistance. More specifically, our work involves:<br />
• co-ordinating and supplying 7 hospitals in Chechnya's main<br />
cities (medical and surgical equipment);<br />
• co-ordinating and supplying 3 rural hospitals with essential<br />
drugs and medical consumables;<br />
• supplying 11 medical and obstetrics centres with essential<br />
drugs and medical consumables;<br />
• mental health awareness and training of medical staff in Grozny.<br />
Progress bar at 31/12/2005<br />
1995<br />
Project ><br />
progress<br />
Outlook:<br />
In 2006 we plan to extend<br />
PHC activities into Vedeno<br />
district, as well as to set up<br />
a psychology consultation<br />
surgery in a Grozny polyclinic<br />
from January 2006. In<br />
addition, MdM is compiling a<br />
publication, Chechen Words,<br />
a collection of testimonies of<br />
Chechens' lives since the<br />
beginning of the war. At the<br />
end of 2005, we also opened<br />
a similar programme in<br />
Daghestan (Khassaviourt<br />
district).
China<br />
China is seeing strong economic growth, but there is still a lot of social inequality in the<br />
country, and 2005 saw many protest movements: living conditions in rural areas are very<br />
precarious. In addition, more than a million Chinese may be affected by the AIDS virus<br />
which is spreading quickly across the country. The stigmatisation and discrimination<br />
suffered by people living with HIV, along with a lack of awareness about the epidemic<br />
are the two main obstacles to the fight against AIDS. Drug users, who are particularly<br />
affected by AIDS and hepatitis C, are the subject of a policy of repression, and harm<br />
reduction is still very under-developed in the country.<br />
Preventing the HIV/AIDS epidemic<br />
and reducing risks amongst drug users<br />
Chengdu (Sichuan)<br />
Activities: The project began at the end of 2002 in partnership<br />
with the Centre of Disease Control (CDC) in Chengdu. The<br />
first phase saw the implementation in three voluntary detox centres<br />
of awareness, information and education activities<br />
on preventing HIV/AIDS and hepatitis C and on harm<br />
reduction aimed at drug users and centre staff, but also at the<br />
medical, administrative and political authorities. The new project,<br />
started at the beginning of November 2005, plans to open<br />
three drop-in centres gradually in different districts. Each<br />
will welcome users and provide information, basic hygiene services<br />
and a needle exchange programme (in the centre and on<br />
the street with peers). At the same time, awareness, information,<br />
prevention and education activities will be carried out<br />
amongst staff, drop-in centre volunteers and the medical, administrative<br />
and political authorities. These activities should mean<br />
that a network focused on harm reduction amongst drug users<br />
can be set up in the districts concerned, and that the people<br />
and the authorities will start to have a different image of users<br />
in their minds.<br />
Progress bar at 31/12/2005<br />
01/12/2002 31/12/2008<br />
Project > progress<br />
Outlook:<br />
The current political context is<br />
favourable to setting up pilot<br />
projects for caring for drug<br />
addicts (the first trials with<br />
needle exchanges and methadone<br />
treatment have been<br />
authorised).<br />
Plans for 2006:<br />
• setting up 2 drop-in centres<br />
in identified districts to give<br />
drug users access to information<br />
and prevention of the different<br />
means of transmitting<br />
HIV/AIDS and hepatitis C;<br />
• setting up street work by<br />
identifying peers;<br />
• training medical staff, volunteers<br />
and providing information<br />
to the public security forces of<br />
the districts concerned to<br />
ensure the work can continue.<br />
Human Development Report 2005, UNDP<br />
Mortality<br />
> infant: 32/43‰<br />
(male/female)<br />
Life expectancy<br />
> 70.0/73.0 (male/female)<br />
HDI<br />
> 0.755; ranked 85/177<br />
GDP/inhabitant ($)<br />
> 1,100<br />
Beneficiaries<br />
> directly: 500 (phase 1),<br />
1,500 (phase 2) new project<br />
> indirectly: 30,000<br />
Staff<br />
> local: 1<br />
> expatriate: 2<br />
54/55<br />
Co-ordinators<br />
> project: B. Luminet, R. Baglioni<br />
> field: D. Chamla puis<br />
C. Montigny, N. Rennes<br />
> HQ: V. Pardessus, E. Martinon<br />
Source of funding<br />
> MdM<br />
Budget<br />
> 2005: 79,936 euros
Colombia<br />
Mortality<br />
> infant: 18‰<br />
Life expectancy<br />
> at birth: 72.4<br />
HDI<br />
> 0.785; ranked 69/177<br />
GDP/inhabitant ($)<br />
> 1,764<br />
International delegation<br />
> MdM Spain<br />
Beneficiaries<br />
> directly: women and under 5s<br />
> indirectly: civilian war victims<br />
Staff<br />
> local: 7<br />
> staff expatriate: 3<br />
Co-ordinators<br />
> project: C. Raggioli, S. Sisco<br />
> field: C. Escobar<br />
> HQ: M. Ethvignot<br />
Sources of funding<br />
> French Foreign Ministry, MdM<br />
Budget<br />
> 2005: 298,373 euros<br />
Human Development Report 2005, UNDP<br />
The FARC and the paramilitary organisations maintain solid support in the provinces,<br />
although internal security is the primary concern of Alvaro Uribe's government. At the<br />
heart of the war zones, the civilian populations are often the first to suffer from changes<br />
in the balance of power and are subject to the full force of the violence as well as<br />
its social and economic repercussions. In this context, uncertainty and inequalities<br />
have a strong hold, especially with respect to access to healthcare, as the transformations<br />
of the Colombian health system are having consequences which are still difficult<br />
to assess.<br />
Civilian populations' access to healthcare<br />
Meta Region<br />
Activities: The rural population of this region is stigmatised<br />
by the simple fact of living in a war zone, which complicates<br />
access to health centres for security reasons. MdM's aim is to<br />
facilitate or restore access to healthcare for the most vulnerable<br />
through mobile health squads for mothers and children<br />
and training of teachers on sexual and reproductive health.<br />
Progress bar at 31/12/2005<br />
01/11/2005 31/12/2006<br />
Project > progress<br />
Outlook:<br />
The south of the country,<br />
where the FARC's economic<br />
and military interests are<br />
concentrated, is the object<br />
of a vast government offensive<br />
aimed particularly at<br />
penetrating the FARC's historic<br />
areas and at eradicating<br />
the coca crops. We can<br />
expect movements of civilians<br />
leaving these areas<br />
where tension is likely to<br />
grow. In addition, the elections<br />
due in spring 2006 are<br />
likely to lead to an escalation<br />
in the conflict. MdM's health<br />
response in an increasingly<br />
unstable situation depends<br />
on the team's capacity to<br />
adapt to changes in the<br />
situation.
Access to healthcare for the victims of armed conflicts Beneficiaries<br />
Rio Medio Atrato Region<br />
Activities: In this strategic region, where the struggle to<br />
control the access corridors to the Pacific, Panama and the<br />
interior of the country is being played out, the paramilitaries'<br />
advance, the increasingly significant presence of the<br />
Colombian navy and the FARC's resistance are again forcing<br />
the black and indigenous populations, the victims of<br />
permanent blockades, to move in order to avoid further<br />
repression for supposed collaboration with one of the armed<br />
groups. Médecins du Monde is providing direct medical<br />
assistance to the indigenous Emberas communities,<br />
especially the women and children who find it difficult to get<br />
access to healthcare as they live in the middle of the armed<br />
confrontation.<br />
Progress bar at 31/12/2005<br />
01/05/2005 30/04/2006<br />
Project > progress<br />
Promoting the right to health<br />
Bogota<br />
Activities: As part of the “Access to healthcare” project,<br />
MdM has carried out a study, from practices in the field, of<br />
the consequences of privatising the Colombian health system<br />
on access to healthcare for the populations monitored by<br />
MdM.<br />
Progress bar at 31/12/2005<br />
01/09/2004 28/02/2005<br />
Project > progress<br />
Outlook:<br />
The upsurge of the conflict,<br />
which affects the entire<br />
Colombian population, is<br />
already causing new displacements<br />
of communities<br />
living along the different tributaries<br />
of the Atrato. MdM's<br />
permanent presence<br />
amongst these doubly-stigmatised<br />
minorities is a guarantee<br />
of an appropriate<br />
humanitarian response.<br />
Outlook:<br />
Presentation of report in<br />
2005.<br />
56/57<br />
> directly: Emberas Indian<br />
population, especially women<br />
and children<br />
Staff<br />
> local: 13<br />
> expatriate: 4<br />
Co-ordinators<br />
> project: C. Raggioli, S. Sisco<br />
> field: V. Gavidia<br />
> HQ: M. Ethvignot<br />
Sources of funding<br />
> ECHO, MdM<br />
Budget<br />
> 2005: 475,003 euros<br />
Staff<br />
> expatriate: 1<br />
Co-ordinators<br />
> project: C. Raggioli<br />
> field: L. Muller, S. Zambrano<br />
> HQ: F. Stea, M. Ethvignot<br />
Sources of funding<br />
> ECHO, MdM<br />
Budget<br />
> 2005: 10,810 euros
Cuba<br />
Mortality<br />
> infant: 6‰<br />
Life expectancy<br />
> at birth: 77.3<br />
HDI<br />
> 0.817; ranked 52/177<br />
PIB réel/habitant ($)<br />
> nc<br />
International delegation><br />
MdM Spain<br />
Beneficiaries<br />
> directly: 13,673,15<br />
to 25 year olds<br />
Staff<br />
> expatriate: 1<br />
Co-ordinators<br />
> project: G. Robert<br />
> field: I. Raud<br />
> HQ: F. Stea, Y. Le Corgne<br />
Sources de financement<br />
> French Foreign Ministry, MdM,<br />
Cuban partners<br />
Budget<br />
> 2005: 51,687 euros<br />
Human Development Report 2005, UNDP<br />
Strategic links with Venezuela and an increasingly lucrative tourist economy have<br />
allowed Cuba to maintain relative stability despite shortages and tropical storms.<br />
On the other hand, the HIV/AIDS transmission prevention system, which made<br />
Cuba the Caribbean state least affected by the epidemic, is being affected more<br />
and more by the deepening inequalities and the explosion of prostitution.<br />
Café Salud - HIV/AIDS prevention<br />
Centro Habana, Havana<br />
Activities: The Café Salud project is aimed at preventing<br />
HIV/AIDS and sexually transmitted infections (STIs) in the working-class<br />
areas of Centro Habana. It mainly targets 15 to 25<br />
year olds, the group most affected by the epidemic in Cuba.<br />
The project trains health promoters amongst young people<br />
and they spread awareness, information and STD prevention<br />
messages in the various districts. It is based on a reception<br />
and activity centre, the Café Salud, which organises dynamic<br />
epidemic prevention activities (theatre, karaoke, etc) and also<br />
visits the different districts to raise awareness amongst the<br />
whole population of Centro Habana. The Cuban public health<br />
partners associated with the project are involved in the programmes<br />
so that it can continue in the long term.<br />
Progress bar at 31/12/2005<br />
01/02/2004 31/03/2005<br />
Project > progress<br />
Outlook:<br />
• Consolidate information,<br />
education and communication<br />
activities in Café Salud<br />
by reinforcing the promoters'<br />
training.<br />
• Make the project ongoing<br />
by supporting the Cuban<br />
partners already involved in<br />
running Café Salud.<br />
• Attempt to reproduce the<br />
project in other provinces in<br />
the country in partnership<br />
with the health authorities.
Dominican Republic<br />
The economic situation in Dominican Republic remains inconsistent and, although indicators<br />
are encouraging overall, the recovery has not had the expected effect on living conditions<br />
in the country. Politically, the serious crisis of its Haitian neighbour continues to lead<br />
to an influx of illegal immigrants, who are taking refuge in the Dominican mountains under<br />
the sometimes hostile eyes of the local population, and are very often in need of emergency<br />
healthcare.<br />
Promoting fundamental rights<br />
Bahoruco<br />
Activities: The programme aims to give access to<br />
primary healthcare to the isolated Haitian population<br />
living and working in the coffee growing areas of Bahoruco. It<br />
involves training community health technicians (CHTs), giving<br />
health education to leaders of the groups of sugar cane cutters,<br />
carrying out medical consultations and, finally, training<br />
and developing a young people's theatre group as part of<br />
HIV/AIDS prevention work.<br />
Progress bar at 31/12/2005<br />
01/2005 12/2005<br />
Project > progress<br />
Outlook:<br />
MdM is withdrawing but is in<br />
contact with several local<br />
institutions, including the<br />
Catholic Church and the<br />
Dominican health authorities.<br />
Human Development Report 2005, UNDP<br />
Mortality<br />
> infant: 29 ‰<br />
Life expectancy<br />
> at birth: 67.2<br />
HDI<br />
> 0.749; ranked 95/177<br />
58/59<br />
Actual GDP/inhabitant ($)<br />
> 1.893<br />
International delegation<br />
> MdM Espagne<br />
Beneficiaries<br />
> directly: 12,000 à 20,000<br />
Staff<br />
> local: 4<br />
> expatriate: 1<br />
Co-ordinators<br />
> project: S. Châlons<br />
> field: A. Nombela<br />
> HQ: F. Stea, Y. Le Corgne<br />
Sources of funding<br />
> Catholic church and Actmon<br />
locally, MdM<br />
Budget<br />
> 2005: 77,322 euros
DRC<br />
Mortality<br />
> infant: 129‰<br />
Life expectancy<br />
> at birth: 43.1<br />
HDI<br />
> 0.385; ranked: 167/177<br />
Actual GDP/inhabitant ($)<br />
> 107<br />
Beneficiaries<br />
> directly: 43,200<br />
> indirectly: 480,000<br />
Staff<br />
> local project 1: 46<br />
> expatriate: 1<br />
> expatriate rear base: 3<br />
Co-ordinators<br />
> project: F. Jacquet<br />
> field: P. Sallah<br />
> country: A. Talibo<br />
> HQ: C. Courtin<br />
Sources of funding<br />
> Global Fund/UNDP, Dutch<br />
Foreign Ministry, MdM<br />
Budget<br />
> 2005: 494,149 euros<br />
Human Development Report 2005, UNDP<br />
After the pillaging of 1992, which led to the collapse of all public structures, this vast<br />
country with impressive mineral wealth has been through two wars since 1996. This<br />
is the largest humanitarian crisis since the Second World War: nearly 4 million<br />
Congolese have died from common illnesses (malaria, diarrhoeic illnesses, measles, etc)<br />
through lack of access to care in this widespread climate of insecurity; 20 million are<br />
malnourished. After three years of prevarication, the international community has been<br />
mobilised in a big way to support the political transition through the United Nations' largest<br />
peacekeeping mission, which should make the next elections safe.<br />
Programme for an integrated fight against HIV<br />
Goma<br />
Activities: The work aims to respond in an integrated<br />
way to the AIDS epidemic in the eastern region of the<br />
Democratic Republic of Congo which has been particularly<br />
affected by the war. The activities are as follows:<br />
• strengthening the capacities of those involved in local<br />
institutions and in civil society in the fight against HIV,<br />
strengthening co-ordination between the different parties;<br />
• supporting social involvement and prevention activities;<br />
• running three sexually transmitted infections treatment<br />
services;<br />
• running a voluntary, anonymous and free screening centre;<br />
• running a treatment service for HIV-positive patients; medical<br />
and psychosocial monitoring, prevention and treatment of<br />
opportunistic infections, access to antiretroviral drugs.<br />
Progress bar at 31/12/2005<br />
01/08/2003 31/07/2006<br />
Project > progress<br />
Outlook:<br />
Continue the activities<br />
that have been started and<br />
developed in order to<br />
consolidate them.
Supporting street children<br />
Kinshasa<br />
Activities: the programme is pursuing its objectives which<br />
are to reintegrate and resocialise street children through:<br />
• quality reception in a specialist centre: Pekabo;<br />
• psychosocial support, educational activities (educational theatre:<br />
Tam-tam), reintegrating children into families, PHC. MdM is<br />
extending its programme on STIs/AIDS amongst vulnerable children<br />
and especially street girls, through treating STIs and HIV<br />
prevention. We are strengthening our networking with all the<br />
child reintegration organisations working at the same time on<br />
the fight against HIV/AIDS.<br />
Progress bar at 31/12/2005<br />
01/01/2004 31/12/2006<br />
Project > progress<br />
Outlook:<br />
As well as continuing our current<br />
activities, organise night<br />
visits for educators, extend the<br />
STI/AIDS programme<br />
amongst street children, make<br />
the Pekabo reception centre<br />
autonomous, and strengthen<br />
the partnership with Africare<br />
(make the network dynamic,<br />
design work tools to deal better<br />
with the healthcare and<br />
reintegration of street children<br />
in DRC).<br />
Kalemie and Kongolo - North Katanga Province, Tanganyika Province<br />
Activities: Reacting to epidemic emergencies (cholera, measles,<br />
meningitis and shigellosis) is effective, and especially the prevention<br />
of cholera involving chlorinating water supply points in<br />
Kongolo and Kalemie thanks to local chlorine production. This<br />
novel activity was developed through a joint venture with a Swiss<br />
company who supplied the equipment needed. The process has<br />
been extended successfully to Kalemie.<br />
The early warning system is in operation.<br />
The curative treatment of cases is provided by cholera treatment<br />
centres in Kongolo and Kalemie and in the health centres of Kalemie<br />
health area, mainly thanks to staff training and the regular supply<br />
of the necessary inputs.<br />
Progress bar at 31/12/2005<br />
01/01/2005 31/12/2005<br />
Project > progress<br />
Outlook:<br />
In the long term, continue to<br />
develop the preventive and<br />
curative activities so that<br />
morbidity and mortality rates<br />
improve for the epidemic diseases<br />
being monitored,<br />
thanks especially to close<br />
monitoring and the provision<br />
of the necessary inputs.<br />
Beneficiaries<br />
> directly: 2,500<br />
Staff<br />
> local: 35<br />
> expatriate: 1<br />
60/61<br />
Co-ordinators<br />
> project: D. Cannet<br />
> field: N. Beaulieu<br />
> country: X. Joubert, A. Talibo<br />
> HQ: C. Courtin<br />
Sources of funding<br />
> Paris city council, French Foreign<br />
Ministry<br />
Budget<br />
> 2005: 405,606 euros<br />
Partnership<br />
> Africare<br />
Fighting against epidemics Beneficiaries<br />
> directly: 258,537<br />
> indirectly: 561,182<br />
Staff<br />
> local: 359<br />
> expatriate: 9<br />
Co-ordinators<br />
> project: A. Thiriat<br />
> field: K. Touré (Kongolo then<br />
Kalemie), G. Kouplo (Kongolo)<br />
> pays: X. Joubert, puis A. Talibo<br />
> HQ: C. Courtin<br />
Sources of funding<br />
> MdM own funds (Kongolo:<br />
response to epidemics) and<br />
ECHO (Kalemie: “epidemics”<br />
programme integrated with PHC)<br />
Budget<br />
> global 2005: 1,745,007 euros<br />
(PHC programme Kalemie and<br />
improvement of the Kongolo health<br />
situation)
DRC<br />
Beneficiaries<br />
> directly: 180,000<br />
> indirectly: 350,000<br />
Staff<br />
> local:175<br />
> expatriate: 4<br />
Co-ordinators<br />
> project: A. Thiriat<br />
> field: K. Touré<br />
> country: X. Joubert<br />
> HQ: C. Courtin<br />
Source de financement<br />
> ECHO 100%<br />
Budget<br />
> 2005: 849,457 euros<br />
+ 53,748 euros allocated to the<br />
fight against epidemics<br />
Beneficiaries<br />
> directly: 78,537<br />
> indirectly: 211,182<br />
Staff<br />
> local: 44 paid staff and<br />
140 subsidised staff<br />
> expatriate: 5<br />
Co-ordinators<br />
> project: A. Thiriat<br />
> field: K. Touré<br />
> country: X. Joubert<br />
and A. Talibo<br />
>HQ: C. Courtin<br />
Source de financement<br />
> ECHO 100%<br />
Budget<br />
> 2005: 878,309 euros<br />
Providing access to quality healthcare<br />
Kongolo (North Katanga)<br />
Activities: As part of community involvement, the project<br />
aims to provide access to quality healthcare in 25 health<br />
centres and 5 advance health posts in Kongolo area. Five<br />
aspects are being developed:<br />
• setting up a minimum set of activities in health training<br />
responding to national PHC standards;<br />
• providing essential drugs, consumables and equipment;<br />
• strengthening the capacities of the area's central office;<br />
• training health centre staff;<br />
• epidemiological monitoring and fight against epidemics<br />
including cholera.<br />
Progress bar at 31/12/2005<br />
01/01/2005 31/12/2005<br />
Project > progress<br />
Developing medical services<br />
Kalemie (North Katanga)<br />
Activities: As part of this project, MdM is organising:<br />
• the signing and implementation of a memorandum of understanding<br />
with the health authorities;<br />
• light renovation/equipping and restoration of the technical side<br />
of functional health structures;<br />
• building and equipping of two health centres with the involvement<br />
of the population in the villages of Mulange and Fatuma<br />
(Kalemie health area);<br />
• monthly supply of mosquito nets treated with insecticides and<br />
of drugs;<br />
• replenishment of traditional midwives' kits;<br />
• supervising activities to monitor the quality of healthcare, health<br />
centre performance, and staff development with respect to rational<br />
instructions and treating cases;<br />
• a workshop for monitoring health activities in the two health<br />
areas each quarter;<br />
o supplying screening tests, consumables for transfusions and<br />
equipment for use in the fight against HIV.<br />
Progress bar at 31/12/2005<br />
01/02/2005 31/12/2005<br />
Project > progress<br />
Outlook:<br />
Develop current activities<br />
through strengthening existing<br />
work and as a stronger<br />
response to epidemics and<br />
treatment of STIs (sexually<br />
transmitted infections)<br />
Outlook:<br />
Develop current activities by<br />
strengthening existing work<br />
and as a stronger response<br />
to epidemics.
Egypt<br />
The Egyptian government's economic policy, despite being acclaimed by the World<br />
Bank, cannot hide the social divisions within the country. Although the authorities and<br />
civil society are more aware of the problem, a large number of women and children,<br />
often thrown onto the street, are in effect deprived of access to care for social, economic<br />
or cultural reasons. The number of street children in Cairo is still unknown and<br />
there is a worrying increase in the number of young mothers living on the street with<br />
their babies, while there are not enough reception structures to monitor these people<br />
on a permanent basis.<br />
Promoting reproductive health<br />
Cairo<br />
Activities: Project supporting the Egyptian NGO Hope<br />
Village to set up a reception and reintegration centre as well<br />
as a mobile unit for young pregnant girls and adolescent<br />
mothers living on the street.<br />
The activities are aimed at organising and providing:<br />
• training sessions on reproductive health;<br />
o psychological support for Hope Village staff and for the young<br />
girls taken in by the pilot centre;<br />
• partnerships with the public hospitals;<br />
• information, education and communication (IEC) sessions<br />
on reproductive health for girls and boys taken in by the centre,<br />
as well as for street children leaders, the organisations<br />
working with street children and traditional midwives;<br />
• integrating MdM in the Street Children network to share and<br />
communicate with the NGOs of the Street Children network.<br />
Progress bar at 31/12/2005<br />
01/08/2005 31/07/2008<br />
Project > progress<br />
Outlook:<br />
Continue the project, which<br />
effectively started in August<br />
2005 after a six months'<br />
pilot project.<br />
Human Development Report 2005, UNDP<br />
Mortality<br />
> infant: 33‰<br />
Life expectancy<br />
> at birth: 69.8<br />
HDI<br />
> 0.659; ranked 119/177<br />
PIB réel/habitant ($)<br />
> 1,220<br />
62/63<br />
Beneficiaries<br />
> directly: 800 young girls and 3,600<br />
children, 150 medical staff, social<br />
workers and psychologists.<br />
> indirectly: 110,000 young girls<br />
and 3,000 children<br />
Staff<br />
> expatriate: 2<br />
> local: 6<br />
Co-ordinators<br />
> project: R. Heimann,<br />
M.-A. Silicani<br />
> field: I. Bruand<br />
> HQ: S. Alary<br />
Sources of funding<br />
> Drosos Foundation, MdM<br />
Budget<br />
> 2005: 35,625 euros
Ethiopia<br />
Mortality<br />
> infant: 112‰<br />
Life expectancy<br />
> at birth: 47.6<br />
HDI<br />
> 0.367; ranked 170/177<br />
Actual GDP/inhabitant ($)<br />
> 97<br />
Beneficiaries<br />
> directe project 1: 179,000<br />
> directe project 2: project 2: 200<br />
HIV-positive mother-child pairs,<br />
4,000 pregnant women<br />
> indirecte project 1: 4,000,000<br />
> indirecte project 2: 140,000<br />
Staff<br />
> local project 1: 4<br />
> local project 2: 6<br />
> expatrié project 1: 5<br />
> expatrié project 2: 1<br />
Co-ordinators<br />
> mission project 1: G. Pascal<br />
> mission project 2: M. Saada<br />
> field 1: O. Evreux<br />
> field 2: M. Gatumo,<br />
O. Evreux<br />
> siège projects 1 et 2: O. Mouzay<br />
Sources de financement<br />
> project 1: UNFPA<br />
> project 2: French Foreign Ministry,<br />
MdM, GSK Foundation,<br />
Felissimo, Sternstunden<br />
Budget<br />
> 2005 project 1: 330,545 euros<br />
> 2005 project 2: 176,808 euros<br />
Human Development Report 2005, UNDP<br />
With a population of 70 million inhabitants, Ethiopia's health indicators are far below the<br />
average for Sub-Saharan Africa. The lack of specialist doctors and surgeons outside the<br />
capital means access to surgical care is extremely low in the rural areas of the country<br />
where 85% of the total population of the country actually live. A major proportion of maternal<br />
mortality is due to this shortage.<br />
Surgery<br />
Tigray/Axum<br />
Activities: Having trained an operating theatre team, and a<br />
health officer and anaesthetist nurse to provide emergency surgery,<br />
we are transferring our training activities to Axum, where needs<br />
are greater. Our work has 3 aspects:<br />
• transfer of knowledge in surgery and obstetrics;<br />
• training full operating theatre teams to work in peripheral health<br />
centres;<br />
• access to care for the most destitute people. This work is mainly<br />
aimed at general emergency surgery and caesarian sections, to<br />
reduce mother and child mortality and obstetrical trauma.<br />
The first training session (3 teams) was completed at the end of<br />
February 2006.<br />
Progress bar at 31/12/2005<br />
01/10/2004 30/09/2007<br />
Project > progress<br />
Mekele<br />
Activities: This project is based on seven aims:<br />
• preventing mother-to-child transmission;<br />
• training counsellors for screening centres, transfer of knowledge<br />
to the Mekele medical staff (one hospital and three health<br />
centres);<br />
• setting up an integrated voluntary HIV screening unit as part<br />
of antenatal consultations;<br />
• raising awareness amongst the community of HIV infection,<br />
mother-to-child transmission, and its prevention;<br />
• gradual rebuilding of the maternity unit;<br />
• supplying drugs, consumables and equipment;<br />
• advice and practices on infant feeding.<br />
Progress bar at 31/12/2005<br />
01/08/2003 31/07/2006<br />
Project > progress<br />
Outlook:<br />
Training of teams, in conjunction<br />
with trainers from Tigray, must<br />
be continued for two years. A<br />
new session started in March<br />
2006 for nine months. The integration<br />
of the first session in<br />
three health centres will be carried<br />
out with support from<br />
MdM. This year MdM will look<br />
at the possibility of an Ethiopian<br />
team it has trained becoming<br />
trainers.<br />
Preventing mother-to-child HIV transmission<br />
Outlook:<br />
Changes in health policy in<br />
Ethiopia mean ARV treatments<br />
can now be used and<br />
they are available free of<br />
charge at Mekele hospital.<br />
The plan is to continue awareness,<br />
training and monitoring<br />
activities following this<br />
initial phase.
Georgia<br />
Two years after the “Rose Revolution”, Mikhael Saakashvili is struggling to keep his<br />
promises of change: Georgia is a poor state, with no energy resources and, despite<br />
notable economic growth due to an energetic struggle against corruption, 52% of the<br />
population still live below the poverty line. A health system reform has been started<br />
but it is still quite muddled.<br />
Help for reproductive health<br />
Mingrelia Region<br />
Activities: Having assessed the needs, MdM decided to run<br />
its reproductive health project in four districts of Mingrelia Region.<br />
The project has several aspects:<br />
• renovating health structures;<br />
• providing medical equipment, drugs and consumables;<br />
• setting up stock management systems;<br />
• training medical staff: monitoring pregnancies, neonatal resuscitation,<br />
pregnancy-related diseases, etc.;<br />
• improving data collection and epidemiological monitoring;<br />
• improving therapeutic protocols and the referral system.<br />
Progress bar at 31/12/2005<br />
09/04 08/2006<br />
Project > progress<br />
Outlook:<br />
MdM is continuing its activities<br />
in Mingrelia region and plans<br />
to extend its project into<br />
Abkhazia region.<br />
Human Development Report 2005, UNDP<br />
Mortality<br />
> infant: 41‰<br />
Life expectancy<br />
> at birth: 70.5<br />
HDI<br />
> 0.732; ranked 100/177<br />
Beneficiaries<br />
> directly: 4,414<br />
> indirectly: 50,000<br />
Staff<br />
> local: 17<br />
> MCH: 1<br />
> expatriate: 2<br />
64/65<br />
Actual GDP/inhabitant ($)<br />
> 778<br />
Co-ordinators<br />
> project: H. Lepoivre, I. Hermant<br />
> field: S. Rogic<br />
> HQ: A. Landaes<br />
Sources of funding<br />
> ECHO, MdM<br />
Budget<br />
> 2005: 453,244 euros
Guatemala<br />
Mortality<br />
> infant: 35‰<br />
Life expectancy<br />
> at birth: 67.3<br />
HDI<br />
> 0.663; ranked 117/177<br />
Actual GDP/inhabitant ($)<br />
> 2,009<br />
Beneficiaries<br />
> directly: women from<br />
Chimaltenango<br />
> indirectly: Guatemalan women<br />
Staff<br />
> expatriate: 1 doctor, 1 nurse<br />
and 1 occasional administrator<br />
Co-ordinators<br />
> project: A. Baas<br />
> field: C. Cipolla<br />
> follow-up: RD PACA (I. Malaval)<br />
Sources of funding<br />
> PACA regional council, MdM<br />
Budget<br />
> 2005: 36,860 euros<br />
Human Development Report 2005, UNDP<br />
A country characterised by political instability, economic crisis and social and ethnic violence,<br />
at the end of the 1980s Guatemala decided on a method of economic development<br />
integrated in the globalisation process within the new international division of labour, one of<br />
whose main characteristics is getting an increasing number of women into work, especially<br />
in the factory sector.<br />
Assessing the health of working women<br />
Chimaltenango<br />
Activities: Carrying out an assessment of the health of women<br />
working in the factories and agricultural export businesses in the<br />
town of Chimaltenango:<br />
• field surveys, workplace visits, institutional contacts;<br />
• carrying out medical consultations on the theme of women's<br />
health/work;<br />
• partnership with Guatemalan organisations working in the economic<br />
and social rights sector on prevention activities concerning<br />
women's health and labour rights.<br />
Progress bar at 31/12/2005<br />
24/01/2005 31/07/2005<br />
Project > progress<br />
Outlook:<br />
At the end of this assessment<br />
work, in 2006 a three-year project<br />
will be set up on “women's<br />
accessibility to healthcare in the<br />
context of globalisation” in<br />
Chimaltenango.
Guinea<br />
In spite of ill health, President Conté continues to control the political chess board. In<br />
March 2005, he carried out an extraordinary ministerial reshuffle, and the general economic<br />
situation remains dominated by hyperinflation and the impoverishment of the population.<br />
Human rights and fundamental freedoms are not respected. Living conditions are<br />
extremely harsh, especially in prisons where sanitary and hygiene measures are repeatedly<br />
ignored and poor treatment is commonplace. The number of daily deaths continues<br />
to increase.<br />
Improving health in prisons<br />
Kindia<br />
Activities: Kindia central prison houses around 200 inmates<br />
living in very harsh conditions.<br />
Since 2001, MdM has been supporting Kindianaise d'Assistance<br />
aux Détenus (KAD, or Kindia Support for Prisoners), a Guinean<br />
organisation made up of volunteers working directly in the prison<br />
to improve health and hygiene. There are several aspects to their<br />
work:<br />
• training a prisoner in nursing care and running a pharmacy inside<br />
the prison;<br />
o a partnership with the health authorities to treat the most serious<br />
cases in Kindia hospital;<br />
• nutritional support for those suffering from malnutrition;<br />
• renovation of health infrastructure;<br />
• literacy work amongst prisoners;<br />
• income-generating activities (sewing, weaving).<br />
These activities are vital for improving prison conditions. As well as<br />
the income they generate, for the prisoners they are the equivalent<br />
of a regular job, acquiring skills and simply a regular outing from<br />
their cells.<br />
Progress bar at 31/12/2005<br />
2000 fin 2006<br />
Project > progress<br />
Outlook:<br />
A major issue for 2006 is to<br />
increase the income-generating<br />
activities begun in 2005.<br />
There are two objectives: to<br />
help KAD's financial autonomy<br />
(by releasing local resources),<br />
and to facilitate the reintegration<br />
of inmates when they<br />
leave prison.<br />
In 2006, MdM will help KAD to<br />
launch new activities such as<br />
making rattan furniture, as the<br />
sewing and weaving activities<br />
are proving successful.<br />
Human Development Report 2005, UNDP<br />
Mortality<br />
> infant: 104‰<br />
Life expectancy<br />
> at birth: 53.7<br />
HDI<br />
> 0.466; ranked 156/177<br />
66/67<br />
Actual GDP/inhabitant ($)<br />
> 459<br />
Beneficiaries<br />
> directly: approx 200 prisoners<br />
(mixture of men, women and children)<br />
Staff<br />
> local: a Guinean charity<br />
(Kindianaise d'assistance<br />
aux détenus)<br />
Co-ordinators<br />
> project: P. Boucourt et T. Comte<br />
> follow-up: RD Rhône-Alpes<br />
Burgundy (S. Bret)<br />
Sources of funding<br />
> private partnerships, MdM<br />
Budget<br />
> 2005: 17,919 euros
Haiti<br />
Mortality<br />
> infant: 76‰<br />
Life expectancy<br />
> at birth: 51.6<br />
HDI<br />
> 0.475; ranked 153/177<br />
Actual GDP/inhabitant ($)<br />
> 346<br />
International delegations<br />
> MdM Canada, MdM Switzerland<br />
Beneficiaries<br />
> directly project 1: 512 Haitian professionals<br />
> directly project 2: 15,000<br />
> iindirectly project 1: the victims of<br />
violence<br />
Staff<br />
> local project 1: 15<br />
> local project 2: 15<br />
> expatriate project 1: 2<br />
> expatriate project 2: 1<br />
Co-ordinators<br />
> project 1: A. Urtubia<br />
> project 2: S. Lasserre<br />
> field 1: M. Desmousseaux<br />
> field 2: B. Deveaux<br />
> HQ 1 and 2: M.-Y. de Penanster-<br />
Rosny, Y. Le Corgne<br />
Sources of funding<br />
> project 1: French Foreign Ministry,<br />
MdM<br />
> project 2: UNDP, MdM<br />
Budget<br />
> 2005 project 1: 301,359 euros<br />
> 2005 project 2: 242,182 euros<br />
Human Development Report 2005, UNDP<br />
The postponement of the presidential and legislative elections to January 2006 has prolonged<br />
the climate of uncertainty and insecurity which has poisoned the country's political,<br />
economic and social life since the departure of President Aristide, in March 2004. With<br />
a background of violence, Haiti continues to face enormous poverty. The health risks linked<br />
to lack of access to healthcare and the destitution of the population are still very great.<br />
Caring for victims of violence<br />
Port-au-Prince<br />
Activities: The programme aims to reduce the impact of<br />
violence on individuals and promote the multi-disciplinary<br />
care of victims by Haitians (health, justice system, communities).<br />
It is based on:<br />
• training healthcare staff in 20 health structures in Port-au-Prince,<br />
provided by MdM's team of trainers working in the intervention,<br />
rehabilitation, research and expertise centre for victims of violence;<br />
• training doctors and lawyers in giving expert forensic opinions<br />
to contribute to the legal recognition of victims of violence;<br />
• supporting URAMEL, MdM's Haitian local partner which is<br />
fighting against impunity and for the construction of a state subject<br />
to the rule of law;<br />
• strengthening capacity to deal with victims and to collect reliable<br />
data from at least 20 health structures.<br />
Progress bar at 31/12/2005<br />
01/12/2003 31/12/2005<br />
Progress bar at 31/12/2005<br />
01/06/2004 01/04/2006<br />
Project > progress<br />
Revitalising the health system<br />
Grande-Anse Region<br />
Activities: Renovating and revitalising five clinics and one<br />
health post to improve accessibility, quality of care and institutional<br />
management:<br />
• training healthcare staff;<br />
• mobilising and training communities to take part in the health<br />
system;<br />
• providing drugs and medical equipment;<br />
• improving the health information system;<br />
• renovating health structures;<br />
• supporting the health authorities.<br />
Project > progress<br />
Outlook:<br />
MdM wishes to strengthen the<br />
capacity and quality of the effective<br />
treatment of vicims of violence<br />
by working specifically in<br />
seven health structures in and<br />
around the main shanty towns<br />
of Port-au-Prince. This work is<br />
based on the work already<br />
done in the current programme<br />
and on close collaboration with<br />
the health authorities and those<br />
in civil society engaged in promoting<br />
the rule of law in Haiti.<br />
Outlook:<br />
The project meets specific<br />
needs to update health centres<br />
which are not working<br />
well.<br />
There is a pressing need for<br />
training in all the area's health<br />
structures.<br />
This work will be extended to<br />
other health centres to provide<br />
real health coherence in the<br />
area.
Promoting health through hygiene Beneficiaries<br />
Grande-Anse Region<br />
Activities: The general objective is to reduce the mortality<br />
and morbidity rates caused by faecal related illnesses in<br />
Roseaux district and to increase the coverage of latrines from 0 to<br />
28% in eighteen months. Various objectives and activities are being<br />
pursued by MdM: mobilising and raising awareness in the community,<br />
training benefiting families in how to use and maintain the latrines,<br />
supporting health committees, building latrines and carrying out<br />
home visits. Lastly, MdM is making families aware of the problem of<br />
deforestation by replanting trees with them for each latrine built in the<br />
residential area.<br />
Progress bar at 31/12/2005<br />
01/07/2004 31/12/2005<br />
Project > progress<br />
Training healthcare staff<br />
Pilate<br />
Activities: Project supporting Pilate hospital, a semi-private institution<br />
run by Canadian nuns established in this area many years ago.<br />
MdM's activity combines:<br />
• a surgical project which sends a full team for fifteen days to carry<br />
out around a hundred operations on patients selected by the nuns<br />
throughout the year;<br />
• a mother and child project via a malnutrition screening and treatment<br />
programme using health workers supervised by the nuns, and<br />
by training officers, matrons and mothers;<br />
• a psychiatric project training healthcare staff (nuns and nurses)<br />
in the diagnosis and treatment of psychiatric illnesses.<br />
Progress bar at 31/12/2005<br />
Since 1980<br />
Project > progress<br />
Outlook:<br />
Considerable community participation<br />
means that this project<br />
will be able to continue. After<br />
three years, it is reported that<br />
99% of the latrines are used<br />
and maintained. Requests<br />
from other neighbouring districts<br />
or communities not yet<br />
covered in Roseaux district<br />
make us believe that there is a<br />
real prospect of reproducing<br />
this action locally.<br />
Outlook:<br />
Three projects are planned for<br />
2006:<br />
• in surgery;<br />
• in psychiatry, for an extension<br />
to Cap Haïtien;<br />
• with a view to adapting the<br />
mother and child project to<br />
address the increase in malnutrition<br />
> directly: 8,400 (1,400 familles)<br />
Staff<br />
> local: 8<br />
68/69<br />
Co-ordinators<br />
> project: S. Lasserre<br />
> field: O. Naval<br />
> HQ: M.-Y. de Penanster-Rosny, Y.<br />
Le Corgne<br />
Sources of funding<br />
> EU, MdM<br />
Budget<br />
> 2005: 113,686 euros<br />
Beneficiaries<br />
> indirectly: 60, 000 inhabitants<br />
of Pilate spread over 157 km2<br />
in 8 rural sections<br />
Staff<br />
> local: 31<br />
> expatriate: 7<br />
Co-ordinators<br />
> project: C. Castaing,<br />
P. Carbonnier<br />
> follow-up: RD Aquitaine<br />
Sources of funding<br />
> MdM, Association of the friends<br />
of Sister Madeleine, private donations<br />
Budget<br />
> 2005: 12,907 euros
Indonesia<br />
Mortality<br />
> infant: 31‰<br />
Life expectancy<br />
> at birth: 66.8<br />
HDI<br />
> 0.697; ranked 110/177<br />
Actual GDP/inhabitant ($))<br />
> 970<br />
International delegations<br />
> MdM Spain, MdM Canada, MdM<br />
Greece<br />
Beneficiaries<br />
> directly project 1: 20,000<br />
> directly project 2: 12,000<br />
> indirectly project 1: 40,000<br />
> indirectly project 2: 90,000<br />
Staff<br />
> local project 1: 9<br />
> local project 2: 12<br />
> expatriate project 1: 4<br />
>expatriate project 2: 2<br />
Co-ordinators<br />
> project 1: P. Gaillard-Olokose<br />
> project 2: A. Bourdé<br />
> field 1: A. Le Garnec<br />
> field 2: V. Cauche<br />
> HQ 1 and 2: V. Pardessus<br />
Sources of funding<br />
> project 1 Cordaid, MdM<br />
> project 2: MdM<br />
Budget<br />
> 2005 project 1: 172,824 euros<br />
> 2005 project 2: 19,498 euros<br />
Human Development Report 2005, UNDP<br />
In Indonesia, 240,000 people died or were reported missing as a result of the tsunami of 26<br />
December 2004. It was the country most affected by the disaster, and the whole population<br />
of Aceh province were hit hard with the destruction of medical infrastructure, a lack of healthcare<br />
staff, major population displacements and psychological suffering. The whole local health<br />
system is being rebuilt. The Indonesian economy was weakened and 16 million households<br />
still live below the poverty line. In addition, the AIDS epidemic is worsening fast especially<br />
through the use of injectable drugs and prostitution, which are very widespread practices in<br />
Indonesia.<br />
Preventing HIV/AIDS and STIs<br />
Mulia, Puncak Jaya district, West Papua<br />
Activities: The first phase of the project aims to reduce the prevalence<br />
of STIs and the incidence of HIV/AIDS by improving<br />
the therapeutic treatment of STIs and the prevention of STI/HIV transmission<br />
in this district. 2005 was notable for prevention and social<br />
involvement actions (the fight against the discrimination and stigmatisation<br />
patients are subject to). An evaluation of the programme carried<br />
out in September 2005 highlighted the decline in access to<br />
healthcare mainly due to the decentralisation undertaken by the<br />
government since 2002 and to the conflicts between independence<br />
fighters and the army which prevent access to villages and prevent<br />
healthcare workers from going there.<br />
Progress bar at 31/12/2005<br />
01/08/2004 15/04/2009<br />
Progress bar at 31/12/2005<br />
05/2005 31/12/2008<br />
Project > progress<br />
Jakarta<br />
Activities: MdMs work is aimed at helping the marginalised<br />
people of Jakarta. There are four aspects to the project:<br />
• weekly medical consultations in partnership with the local NGO<br />
Aulia;<br />
• training Aulia's social workers and community health workers;<br />
• setting up a referral system appropriate to this population;<br />
• technical logistics assistance, fundraising and management of<br />
the NGO partner Aulia.<br />
Project > progress<br />
Outlook:<br />
The first phase was completed<br />
at the end of February.<br />
During the second phase, we<br />
are going to refocus our programme<br />
on preventing infectious<br />
diseases and extending<br />
the scope of our work to the<br />
neighbouring sub-district subdistrict<br />
of Sinak.<br />
Caring for the marginalised population<br />
Outlook:<br />
• Pursue access to primary<br />
healthcare (especially for<br />
women and under 5s) in<br />
Jakarta's northern shanty<br />
towns.<br />
• Raise the population's awareness<br />
about prevention of the<br />
predominant diseases.<br />
• Strengthen Aulia's capacities<br />
so that it can run its programmes<br />
autonomously.
Caring for the Punans<br />
Kalimantan<br />
Activities: The Punans, an indigenous Indonesian people, are linked<br />
to Malinau district, whose main town is experiencing major economic<br />
development (forestry exploitation) with negative consequences<br />
for ecology, society and health. They have no access at all to primary<br />
healthcare. The main health problems identified are malaria, respiratory<br />
diseases and high infant mortality.<br />
We are involved in:<br />
• mobile clinics lasting a month (3 times/year) in 4 sites;<br />
•training 5 health workers from the Punan community for a week<br />
before each medical project, with application on the field during the<br />
project;<br />
• support for the Adat Punan organisation, which represents<br />
the interests of the Punans of Kalimantan.<br />
Progress bar at 31/12/2005<br />
05/2004 31/12/2008<br />
Helping tsunami victims<br />
Aceh Besar and Aceh Jaya districts (Aceh province / Sumatra)<br />
Activities: After emergency work lasting three months following<br />
the tsunami, during which MdM put a lot of effort into re-establishing<br />
access to primary healthcare for the population (permanent<br />
and mobile clinics, vaccinations, nutritional and epidemiological<br />
monitoring), the programme has developed around the following<br />
focuses:<br />
•getting the public primary healthcare system running again<br />
in Aceh Besar and Aceh Jaya districts;<br />
• rebuilding health structures: a district hospital (Lhoknga), two<br />
dispensaries (Seulimeum and Jantho) and health centres;<br />
• helping to get the internal medical service of Abidin hospital<br />
in Banda Aceh running again (supplying equipment and training<br />
teams of nurses);<br />
• developing the treatment of psychological and psychiatric<br />
problems (raising awareness and training medical staff in these<br />
problems);<br />
• reacting to emergencies (epidemics, natural disasters, etc) in<br />
Sumatra (three week emergency project in Nias after the earthquake<br />
in March 2005).<br />
Progress bar at 31/12/2005<br />
28/12/2004 09/2006<br />
Project ><br />
progress<br />
Project > progress<br />
Outlook:<br />
• Continue medical consultations,<br />
in order to help improve<br />
the Punans' health in three<br />
years.<br />
Aim: reduce the under 5s' mortality<br />
rate by 20%; it is estimated<br />
to be 500‰.<br />
• Planned theoretical and practical<br />
training of traditional matrons<br />
by an experienced midwive and<br />
community health workers (prevention<br />
of the predominant diseases).<br />
• Recognition and protection of<br />
the Punans' rights through the<br />
Adat Punan organisation.<br />
Outlook:<br />
In addition to substitution<br />
work in the initial emergency<br />
phase in the first months, it<br />
is vital that we reorganise<br />
and support local health<br />
structures and healthcare<br />
staff as they re-start their<br />
medium-term activities.<br />
Alongside the physical<br />
reconstruction of buildings,<br />
MdM is involved in training<br />
and supporting medical staff<br />
in order to guarantee access<br />
to quality primary healthcare.<br />
Beneficiaries<br />
> directly: 800<br />
> indirectly: 9,000<br />
70/71<br />
Staff<br />
> local: 12<br />
> expatriate 1: 2 (based in Jakarta)<br />
+ 2 doctors (occasional missions)<br />
Co-ordinators<br />
> project: R. Garrigue<br />
> field: M.-L. Bry<br />
> HQ: V. Pardessus<br />
Source of funding<br />
> MdM<br />
Budget<br />
> 2005: 11,822 euros<br />
Beneficiaries<br />
> directly: 30,000<br />
Staff<br />
> local: 20<br />
> expatriate: 24<br />
Co-ordinators<br />
> project: P. Foldès<br />
> field: V. Cauche<br />
> HQ: Emergency desk<br />
then E. Martinon<br />
Sources of funding<br />
> MdM, ECHO, territorial local<br />
authorities<br />
Budget<br />
> 2005: 1,783,940 euros
Ivory Coast<br />
Mortality<br />
> infant: 117‰<br />
Life expectancy<br />
> at birth: 45.9<br />
HDI<br />
> 0.420; ranked 163/177<br />
GDP/inhabitant ($)<br />
> 816<br />
Beneficiaries<br />
>directly: 2,500 street children<br />
> indirectly: 25,000 children<br />
and young people in great<br />
difficulty<br />
Staff<br />
> local: 15 paid staff and<br />
6 volunteers<br />
Co-ordinators<br />
> project: J. Martin<br />
> field: K. Kouassi<br />
> HQ: C. Courtin<br />
Source of funding<br />
> MdM<br />
Budget<br />
> 2005: 81,422 euros<br />
Human Development Report 2005, UNDP<br />
The announcement of the appointment of Charles Konan Banny, hitherto the governor of<br />
the Central Bank of West African States, to the post of Prime Minister, and the maintenance<br />
of the ceasefire by a major international military arrangement have given reason to<br />
hope that the overall situation in the country will improve. But it remains divided in two: the<br />
north, under the control of the New Forces, and the south, controlled by the loyalist forces.<br />
The social and economic situation is improverishing the population. In Abidjan, since<br />
the departure of a significant number of Europeans, economic activities have collapsed,<br />
leading to disastrous unemployment and just as disastrous living conditions for under-age<br />
children living on the streets.<br />
Protecting street children<br />
Abidjan<br />
Activities: MdM has been working with minors since 1996.<br />
The current project has three objectives:<br />
• the protection and resocialisation of street children<br />
and minors in prison;<br />
• access to primary healthcare;<br />
• support for a local NGO: MESAD, Movement for<br />
Education, Health and Development.<br />
Its work involves<br />
• a process for resocialising children through street work,<br />
accommodation in a reception centre, psychosocial monitoring,<br />
support for professional integration and schooling, and<br />
re-establishing family contacts;<br />
• offering primary healthcare to children on the street and support<br />
for medical treatment at the Treichville health centre;<br />
• work amongst minors in Abidjan prison with the aim of improving<br />
their living conditions, providing physical, psychological<br />
and legal protection for minors deprived of freedom, facilitating<br />
their reintegration on leaving prison;<br />
• specific STI/HIV prevention activities.<br />
Progress bar at 31/12/2005<br />
Since July 2003<br />
Project ><br />
progress<br />
Outlook:<br />
With financial assistance from<br />
Médecins du Monde, the<br />
local NGO MESAD is continuing<br />
work developed by<br />
MdM between December<br />
1996 and June 2003.<br />
Since July 2003, the local<br />
NGO has been seeking funding<br />
to ensure it can provide<br />
the full programme. The<br />
country's instability does not<br />
encourage funders to fund<br />
such programmes.
Allowing access to healthcare<br />
Seguela<br />
Activities: This post-emergency programme is aimed at providing<br />
support for the Seguela regional hospital which is in<br />
a “rebel-held area”. The region is suffering from a breakdown in<br />
the supply of drugs, especially as most senior medical staff have<br />
left for the south. Thanks to supplies of drugs, small medical<br />
equipment and to expatriate surgical teams (surgeons and anaesthetists),<br />
the Regional Hospital has been able to start working<br />
again.<br />
Progress bar at 31/12/2005<br />
12/2002 05/2005<br />
Project > progress<br />
Access to surgical and obstetric care<br />
Touba<br />
Activities: This post-emergency programme is aimed at<br />
providing surgical support to Touba hospital in a “rebel-held<br />
area”, cut off from the rest of the country since the disturbances<br />
of September 2002. Treatment of trauma and obstetric<br />
emergencies does not exist and most qualified senior<br />
medical staff have left for the southern area.<br />
MdM's involvement in providing specific drugs and small medical<br />
equipment and in renovating the operating theatre and surgery<br />
department, should allow local staff still in the area to<br />
work in good conditions. The presence of an expatriate team<br />
made up of an anaesthetist, doctor, logistician and administrator<br />
has allowed the hospital to re-start a minimum of its activities<br />
interrupted during the conflict. Working with local and<br />
institutional staff, these activities should allow better care of<br />
pregnant women and the injured, in the hospital as well as in<br />
the supported health centres.<br />
Progress bar at 31/12/2005<br />
14/09/2005 31/12/2005<br />
Project > progress<br />
Outlook:<br />
A new project in another<br />
hospital is now being developed<br />
but will depend on how<br />
the crisis develops and on<br />
political stabilisation, vital<br />
conditions for activities restarting<br />
throughout the country,<br />
and especially for receiving<br />
supplies of drugs and<br />
medical staff returning to<br />
their posts.<br />
Outlook:<br />
As the minimum operating<br />
conditions required had not<br />
been met due to lack of collaboration<br />
between the head<br />
doctor and the nurses, the<br />
project was terminated as of<br />
31 December 2005.<br />
Beneficiaries<br />
> directly: 120,000<br />
> indirectly: 300,000<br />
Staff<br />
> local: 49<br />
> expatriate: 3<br />
Co-ordinators<br />
> project: A.-J. Pocheron<br />
> field: Luc Malingreau<br />
> HQ: C. Courtin<br />
Source of funding<br />
> ECHO<br />
Budget<br />
> 2005: 154,806 euros<br />
Beneficiaries<br />
> directly: 4,500<br />
> indirectly: 192,000<br />
Staff<br />
> local: 10<br />
> expatriate: 5<br />
Co-ordinators<br />
> project: A.-J. Pocheron<br />
> field: L. Malingreau<br />
> HQ: C. Courtin<br />
Source of funding<br />
> MdM's own funds<br />
Budget<br />
> 2005: 117,090 euros<br />
72/73
Kosovo<br />
Mortality<br />
Life expectancy<br />
HDI<br />
Actual GDP/inhabitant ($)<br />
> No specific data for Kosovo<br />
International delegation<br />
> MdM United States<br />
Beneficiaries<br />
> directly project 1:<br />
+/- 250,000 young people<br />
> > directly project 2:<br />
between 70 and 100 people/day<br />
> indirectly project 1: +/- 1 million<br />
under 24s living in Kosovo province<br />
Staff<br />
> local project 1: 8<br />
> local project 2: 2<br />
Co-ordinators<br />
> project: M. A. Chaud<br />
> mission projet 2: P. Dupin<br />
> field: G. Alliu<br />
> follow-up project 1: DR PACA<br />
> follow-up project 2: DR PACA<br />
Sources of funding<br />
> project 1: PACA local authorities,<br />
MdM United States<br />
> project 2: MdM<br />
Budget<br />
> 2005 project 1: 49,706 euros<br />
> 2005 project 2: 2,057 euros<br />
The negotiations on the final status of Kosovo, which remains a province of Serbia and<br />
Montenegro under international administration, are continually being postponed, whereas<br />
inter-ethnic tensions remain high. Serbs and Albanians still have diametrically opposing<br />
views on Kosovo's future status. The Serbs are unlikely to accept more than wide autonomy<br />
for the province, whereas the Albanians, who make up over 90% of the population, are<br />
demanding independence. Socially, unemployment has reached 60%, and 65% of the<br />
population live below the poverty line.<br />
Listening to young people<br />
Prishtina<br />
Activities:MdM's project is aimed at health prevention amongst<br />
young people aged between 13 and 24. It is run in partnership<br />
with Kosovo's Culture, Youth and Sports Ministry and a local<br />
NGO (Vita Kosova). Its aim is to set up a reception centre for<br />
young people which would be a place of welcoming, listening,<br />
information, consultation and orienta- tion. Direct (individual psychological<br />
support, integration in a treatment network, etc) and indirect<br />
assistance (training for youth organisations on the identified<br />
health topics, and ongoing training of the young people's listening<br />
point team) is given.<br />
Since 2004, the project has been sponsored by Salon-de-<br />
Provence's 'Espace Santé Jeunes'.<br />
Progress bar at 31/12/2005<br />
2003 2006<br />
Improving oral health<br />
Gllogovc<br />
Activities: MdM's project aims to improve oral health in this<br />
region through:<br />
• installing two complete dental surgeries at the Gllogovc health<br />
centre;<br />
• training local practitioners in new dental care techniques.<br />
The project ended in 2005 with an information activity in neighbouring<br />
schools on oral hygiene.<br />
Progress bar at 31/12/2005<br />
2004 2005<br />
Project ><br />
progress<br />
Project > progress<br />
Outlook:<br />
At the same time as supporting<br />
the ministry in its first<br />
year of financial commitment<br />
to the programme, MdM<br />
expects, on the one hand,<br />
to develop activities outside<br />
the centre and to promote<br />
the Dëgjo Rininë Centre and,<br />
on the other hand, to develop<br />
the local NGO Vita<br />
Kosova in its role as programme<br />
manager.<br />
Outlook:<br />
Equivalent work in the Serb<br />
enclave of Hocë e Madne.
Lebanon<br />
Shaken by the assassination in February 2005 of former Prime Minister Rafik Hariri, which<br />
led to the rushed withdrawal of Syrian troops, Lebanon remains an area of tensions. The<br />
country is a genuine crossroads; it houses hundreds of thousands of foreign workers and<br />
forms a transit place for people fleeing wars and dictatorial regimes in the Near East.<br />
Lebanon has not signed the Geneva Convention of 1951 and still refuses to be a reception<br />
country. Migrant workers, refugees and asylum seekers are strongly discriminated<br />
against and are often arbitrarily imprisoned; they suffer from extremely precarious living<br />
conditions.<br />
Access to care for imprisoned migrants<br />
Beirut<br />
Activities: At the beginning of 2005 MdM started work in<br />
Roumieh central prison in partnership with the Lebanese NGO,<br />
Ajem. The work involves the following activities:<br />
• welcoming new foreign inmates with welfare assistance, directing<br />
them towards the medical team and the welfare and legal<br />
care organisations (including Ajem);<br />
• medical triage in the wings;<br />
• medical consultations three times a week and monitoring of<br />
patients;<br />
• welfare and legal follow-up;<br />
• rehabilitation and supplying health equipment,<br />
distribution of blankets and hygiene products;<br />
• information sessions for prisoners, communicating IEC (information,<br />
education and communication) programmes/ sessions<br />
on scabies and hygiene.<br />
Progress bar at 31/12/2005<br />
10/01/2005 31/12/2008<br />
Project > progress<br />
Outlook:<br />
Continue the programme in<br />
2006: start activities focused<br />
on training and health education<br />
in other Lebanese prisons;<br />
set up information and<br />
awareness activities on<br />
imprisoned migrants' access<br />
to rights amongst the<br />
Lebanese authorities and<br />
the general public.<br />
Human Development Report 2005, UNDP<br />
Mortality<br />
> infant:27‰<br />
Life expectancy<br />
> at birth: 72<br />
HDI<br />
> 0.759; ranked 81/177<br />
74/75<br />
Actual GDP/inhabitant ($)<br />
> 4,224<br />
Beneficiaries<br />
> directly: at least 4,000 people<br />
(already in prison or recently entering<br />
prison) at Roumieh central prison.<br />
> indirectly: approx. 5,500 Lebanese<br />
prisoners in Roumieh prison, the<br />
medical and non medical prison staff<br />
at Roumieh, local teams, project<br />
partners<br />
Staff<br />
> local: 8<br />
> expatriate: 2<br />
Co-ordinators<br />
> project: B. Lambert<br />
> field: F. Mawazini puis B. Martin<br />
> HQ: S. Alary<br />
Sources of funding<br />
> French Foreign Ministry, UNHCR,<br />
MdM<br />
Budget<br />
> 2005: 170,763 euros
Liberia<br />
Mortality<br />
> infant: 152‰<br />
Life expectancy<br />
> at birth: 46.8<br />
HDI<br />
> not known<br />
Actual GDP/inhabitant ($)<br />
> 192<br />
Beneficiaries<br />
> directly: 124,678<br />
> indirectly: 200,506<br />
Staff<br />
> expatriate: 10<br />
Co-ordinators<br />
> project: P. Hirtz<br />
> field: S. Pont Turco<br />
> HQ: Emergency desk then project<br />
transferred to Africa desk: B.<br />
Contamin, A. Belaid<br />
Sources of funding<br />
> Echo, German and Dutch Foreign<br />
Ministries<br />
Budget<br />
> 2005: 1,065,691 euros<br />
Source: World Bank Report 2003<br />
Liberia is emerging from a fourteen year conflict which has cost 250,000 lives, caused the<br />
displacement of half the population, and completely devastated social and cultural life as<br />
well as the infrastructure and economy. The ceasefire agreement, signed in 2003 by the<br />
different factions, and the deployment of a civilian and military mission by the United<br />
Nations have engaged the country in an attempt at peace and reconstruction, consolidated<br />
by a national programme to demobilise and disarm the former fighters. The presidential<br />
elections held in October 2005 are a crucial step towards the political stabilisation of<br />
the country and, for the international community, are an important challenge to make this<br />
transition towards full and lasting autonomy successful.<br />
Primary, community<br />
and mental healthcare<br />
Gbarnga, Bong province<br />
Activities: In Bong county, MdM is training and supporting<br />
national healthcare staff from 9 health centres in the following<br />
activities:<br />
• consultations in primary and reproductive healthcare including<br />
STI prevention;<br />
• epidemiological surveillance (malaria, cholera, etc) and nutritional<br />
monitoring especially for under 5s;<br />
• vaccination services;<br />
• transferring emergencies towards referral hospitals.<br />
MdM is also setting up psychological and psychiatric support<br />
services for women and girls who have been the victims of<br />
sexual violence.<br />
Progress bar at 31/12/2005<br />
09/2003 poursuite du programme en 2006<br />
Project > progress<br />
Outlook:<br />
In 2006, MdM plans to open<br />
a 10th health centre,<br />
Jorwah, on the Guinea border<br />
which will offer the same<br />
primary healthcare services.<br />
MdM also wants to be more<br />
actively involved in addressing<br />
sexual violence against<br />
women<br />
(SGBV, sexual gender based<br />
violence) in Liberia.
Mali<br />
Mali is one of the transit countries for the migrant populations of Sub-Saharan origin<br />
heading towards Europe. Its immigration policy allows nationals from other African<br />
countries to enter the country without a visa. In addition, it is to Mali that the Algerian<br />
authorities return illegal migrants apprehended on their territory. Women are subject to<br />
the full force of the poor health conditions and the difficulty of accessing healthcare.<br />
Therefore, the high maternal mortality rate (580‰) can be explained by the consequences<br />
of vesico-vaginal type fistulas.<br />
Health watch amongst migrants<br />
Tinzaouatene, then Gao<br />
Activities: Started in September 2005, the pilot project aims<br />
to set up a programme aimed at improving the health and welfare<br />
conditions of the migrant populations in transit through Mali and<br />
to bear witness to rights violations by:<br />
• observing the living conditions and trajectories of the migrant<br />
populations in transit;<br />
• evaluating the conditions for migrant populations whereby they<br />
have access to healthcare in Tinzaouatene and Gao regions;<br />
• developing an information network and gathering testimonies of<br />
violations of which the migrant populations are victims.<br />
Progress bar at 31/12/2005<br />
09/2005 02/2006<br />
Surgery of exclusion<br />
Project > progress<br />
Mopti Region<br />
Activities: MdM is continuing its programme of prevention<br />
and treatment of vesico-vaginal fistulas. This has four aspects<br />
to it:<br />
• surgical treatment of women;<br />
• training local surgeons and the operating theatre team;<br />
• spreading prevention messages (on local radio, through<br />
theatre);<br />
• literacy sessions for patients who want it.<br />
Progress bar at 31/12/2005<br />
12/1999 06/2006<br />
Project > progress<br />
Outlook:<br />
End the pilot project after<br />
defining a suitable long-term<br />
programme.<br />
Outlook:<br />
Continue training surgeons and<br />
a gynaecologist in fistula surgery<br />
and set up a national project for<br />
treating vesico-vaginal fistulas<br />
integrating the work carried out<br />
by Mopti hospital.<br />
Support the growing autonomy<br />
of Mopti hospital until the new<br />
hospital is built in Sevare.<br />
Human Development Report 2005, UNDP<br />
Mortality<br />
> infant:122‰<br />
Life expectancy<br />
> at birth: 47.9<br />
HDI<br />
> 0.333; ranked 174/177<br />
Actual GDP/inhabitant ($)<br />
> 371<br />
International delegation<br />
> MdM Belgium<br />
Beneficiaries<br />
> directly project 1: not defined<br />
because pilot project<br />
> directly project 2: women victims<br />
of vesico-vaginal fistulas<br />
Staff<br />
> local project 1: 1<br />
> expatriate project 1: 1<br />
> local project 2: 7<br />
> expatriate project 2: 1<br />
Co-ordinators<br />
> project 1: D. Guerroudj<br />
> project 2: J.-M. Colas<br />
> field 1: A. Grousset<br />
> field 2: J.-M. Zino<br />
> HQ project 1: O. Mouzay<br />
> HQ project 2: O. Mouzay<br />
76/77<br />
Sources of funding<br />
> project 1: MdM<br />
> project 2: MdM, Norwegian church,<br />
AED<br />
Budget<br />
> 2005 project 1: 4,495 euros<br />
> 2005 project 2: 109,160 euros
Madagascar<br />
Mortality<br />
> infant: 78‰<br />
Life expectancy<br />
> at birth: 55.4<br />
HDI<br />
> 0,499; ranked 146/177<br />
Actual GDP/inhabitant ($)<br />
> 324<br />
Beneficiaries<br />
>directly project 1: local team from<br />
NGO Sisal (7 people)<br />
> directly project 2: at-risk groups<br />
(1,200 sex workers, mining prospectors,<br />
young people in or out of school and<br />
Salfa Centrre consultants<br />
> indirectly project 1: groups at risk<br />
of STIs/HIV/AIDS and the general<br />
population of Tulear<br />
> indirectly project 2: 25,000 people<br />
Staff<br />
> local project 1: Sisal team<br />
> local project 2: 6<br />
> expatriate project 1: 1<br />
> expatriate project 2: 1<br />
Co-ordinators<br />
> project 1: C. Ottenwaelder,<br />
C. Vichatzky<br />
> project 2: C. Vichatzky<br />
> field 1: X. Joubert<br />
> field 2: Ben Aboubacar<br />
> HQ project 1 and 2: O. Mouzay<br />
Sources of funding<br />
> project 1: MdM<br />
> project 2: MdM, AFD<br />
Budget<br />
> 2005 project 1: 9,429 euros<br />
> 2005 project 2: 92,644 euros<br />
Human Development Report 2005, UNDP<br />
Great poverty remains the lot of a large majority of Madagascans. Despite annual economic<br />
growth of 6% and debt cancellation in June 2005 by the G8, Madagascans<br />
continue to fight for their survival. Awareness of HIV is still insufficient, and the number<br />
of people affected continues to grow. The obvious insufficiency of medical and<br />
surgical care and difficulty accessing it are making an already alarming situation<br />
worse.<br />
STI/AIDS prevention and education<br />
Tulear<br />
Activities: The joint venture between Sisal and MdM involves<br />
technical support defined by the following activities:<br />
• evaluating and supporting human resources and monitoring<br />
the development of the Tulear centre. Training is also given;<br />
• supporting and mentoring Sisal managers (national co-ordinator,<br />
technical manager, administrative and financial manager);<br />
• providing group training and staff retraining;<br />
• providing support for Sisal's institutional capacity;<br />
• improving management skills<br />
Progress bar at 31/12/2005<br />
02/2004 02/2006<br />
Integrated project to fight against STIs/HIV/AIDS<br />
Ilakaka<br />
Activities: After a KAP survey and prior training of the Salfa<br />
(Madagascan NGO) team, the activities will be as follows:<br />
• IEC (Information, education, communication) and close<br />
work amongst at-risk populations;<br />
• prevention, screening and treatment of STIs;<br />
• voluntary, anonymous and free HIV testing and treatment of<br />
people living with HIV;<br />
• strengthening local capacity in the fight against STIs/HIV/AIDS.<br />
Progress bar at 31/12/2005<br />
12/2004 12/2006<br />
Project ><br />
progress<br />
Project > progress<br />
Outlook:<br />
The Sisal team in Tulear has<br />
done a good job in taking<br />
over the centre and in developing<br />
the planned programme.<br />
MdM will withdraw support at<br />
the beginning of 2006 and will<br />
thus allow Sisal to confirm its<br />
autonomy. However, MdM<br />
and Sisal will continue to work<br />
together as privileged partners<br />
in the fight against STIs/HIV in<br />
Madagascar.<br />
Outlook:<br />
MdM plans to provide technical<br />
support for 24 months,<br />
after which MdM should<br />
withdraw from the project
Support for health in prisons Beneficiaries<br />
Ambanja and Antsiranana<br />
> directly: 800 prisoners<br />
Activities: This programme is considered as a pilot project, as<br />
this is the first time MdM has got involved in prison work in<br />
Madagascar. The reference plan has six complementary aspects<br />
in order to act on the many factors behind poor prison conditions:<br />
• medical;<br />
• nutritional;<br />
• rehabilitation;<br />
• sanitation (in partnership with the Swiss NGO Medair, with whom<br />
MdM worked after the Gafilo cyclone);<br />
• welfare and legal;<br />
• co-ordination and continuation of the activities to ensure the<br />
effectiveness of the aforementioned aspects.<br />
Progress bar at 31/12/2005<br />
09/2005 08/2006<br />
Project > progress<br />
Outlook:<br />
Extend the pilot project to a<br />
regional programme, by initiating<br />
and developing this project<br />
in other prisons.<br />
Childhood Action, cardiopathy in children<br />
Antananarivo<br />
Activities: A team from Reunion made up of 2 heart surgeons,<br />
2 paediatric cardiologists and 1 anaesthetist and resuscitation<br />
expert carry out 2 visits each year to Soavinadriana<br />
hospital in Antananarivo. Each visit lasts a week. There are 3<br />
aspects to the team's activities:<br />
• consultations which in 2005 involved 454 patients, including<br />
191 new cases, 15 cases of closed-heart surgery and 74<br />
cases of open-heart surgery (medical evacuation).<br />
• surgery, where MdM's surgeons in conjunction with Professor<br />
Hubert Razafindramboa's local team carry out closed-heart<br />
operations. 20 operations were carried out in Antananarivo<br />
and 11 at the regional Félix Guyon Hospital in Saint-Denis,<br />
Reunion, for the open-heart operations;<br />
• skills transfer, which involves training a Madagascan heart<br />
surgeon in Reunion and mentoring of the local team during<br />
each visit.<br />
Progress bar at 31/12/2005<br />
1996<br />
Project ><br />
progress<br />
Outlook:<br />
MdM plans to continue its<br />
work in 2006 and is considering<br />
a possible consortium<br />
with other partners working in<br />
cardiopathy so that this project<br />
can continue.<br />
78/79<br />
Staff<br />
> expatriate: 1 national co-ordinator<br />
Co-ordinators<br />
> project: S. de Carheil<br />
> field: O. Bouron<br />
> HQ: O. Mouzay<br />
Sources of funding<br />
> MdM, French embassy<br />
Budget<br />
> 2005: 91,114 euros<br />
Beneficiaries<br />
> directly: 600<br />
> indirectly: families of children and<br />
Madagascan medical staff<br />
Staff<br />
> local: 4<br />
> expatriate: paediatric heart surgeons,<br />
paediatric cardiologists,<br />
anaesthetists and resuscitation<br />
experts, nurses (4 or 5 people for<br />
each medical-surgical visit)<br />
Co-ordinators<br />
> project: J.-F. Delambre<br />
> field: N. Ramamonjisoa<br />
> follow-up: DR océan Indien<br />
Sources of funding<br />
> La Réunion general council, MdM<br />
Indian Ocean donors<br />
Budget<br />
> 2005: 71,902 euros
Mexico<br />
Mortality<br />
> infant: 23‰<br />
Life expectancy<br />
> at birth: 75.1<br />
HDI<br />
> 0.814; ranked 53/177<br />
Actual GDP/inhabitant ($)<br />
> 6,121<br />
International delegations<br />
> MdM Spain, MdM Switzerland<br />
Beneficiaries<br />
> directly: indigenous population<br />
Staff<br />
> expatriate: 2<br />
Co-ordinators<br />
> project: T. Brigaud<br />
> field: C. Martin<br />
> HQ: M. Ethvignot<br />
Sources of funding<br />
> EU, MdM<br />
Budget<br />
> 2005: 236,005 euros<br />
Human Development Report 2005, UNDP<br />
Social inequalitiies persist in Mexico despite good economic health and the fact that<br />
this country is a real commercial power. In the south, Hurricanes Stan and Wilma hit<br />
the regions hard where the marginalised Indian populations already live in situations<br />
of extreme poverty. In the north, the linea, which many prospective illegal emigrants<br />
to the United States cross each day, remains a very precarious at-risk area.<br />
Improving the community health system<br />
Chiapas Region<br />
Activities: In Chiapas region, MdM's current programme<br />
(it has been working in Mexico since 1998) aims to improve<br />
the health of the Tzotzil population. With community support,<br />
MdM is working to train health promoters and to set up<br />
four micro-clinics to allow these populations to have access<br />
to healthcare.<br />
More than 500 promoters who are responsible for the health<br />
of their communities organise their work around three microclinics.<br />
Progress bar at 31/12/2005<br />
01/01/2003 31/06/2006<br />
Project ><br />
progress<br />
Outlook:<br />
Setting up a self-managed<br />
health system provides the<br />
promise of greater autonomy<br />
for the Indians, whereas<br />
genuine negotiations between<br />
the government and<br />
the Zapatista movement in<br />
the south of Chiapas would<br />
enable more lasting solutions<br />
for managing their health to<br />
be found.
Access to healthcare for the migrant population<br />
Tijuana, Mexicali<br />
Activities: MdM is implementing a project aimed at improving<br />
access to healthcare and respecting the right to health<br />
of migrant populations on Mexico's northern border in the<br />
towns of Tijuana and Mexicali.<br />
It has the following objectives:<br />
• facilitating healthcare for the migrant populations in Tijuana and<br />
Mexicali;<br />
• preventing the transmission of HIV/AIDS/STIs amongst the<br />
migrant population;<br />
• promoting and encouraging the respect of the right to health<br />
of the migrant populations on the northern border.<br />
Progress bar at 31/12/2005<br />
04/2005 03/2008<br />
Hurricane emergency<br />
Project > progress<br />
Chiapas (Escuintla, Mapastepec, Huixtla and Tapachula)<br />
Activities:Hurricane Stan hit southern Mexico on 4 October.<br />
The ensuing floods, rivers breaking their banks and landslides<br />
caused a lot of damage in Chiapas. After evaluating the<br />
affected areas between 7 and 13 October and making contact<br />
with the health authorities, the work focused on the town of<br />
Escuintla, where 84% of the population were affected by the<br />
hurricane.<br />
The activities have involved:<br />
• re-establishing access to healthcare for the affected<br />
populations of the Sierra Madre Mediana and Alta of Escuintla;<br />
• treatment of and surveillance of potential epidemics.<br />
Progress bar at 31/12/2005<br />
07/10/2005 15/12/2005<br />
Project ><br />
progress<br />
Outlook:<br />
The project will be continued<br />
under the same terms in<br />
2006.<br />
Outlook:<br />
The emergency medical treatment<br />
programme ended in<br />
December 2005.<br />
Beneficiaries<br />
> directly: migrants<br />
Staff<br />
> local: 1<br />
> expatriate: 1<br />
Co-ordinators<br />
> project: M.-D. Aguillon<br />
et F. Giraud<br />
> field: B. Ponçon<br />
> HQ: M. Ethvignot<br />
80/81<br />
Sources of funding<br />
> MdM, French Foreign Ministry<br />
Budget<br />
> 2005: 100,091 euros<br />
Beneficiaries<br />
> directly: 18,865 people<br />
Staff<br />
> local: 2<br />
> expatriate: 1<br />
Co-ordinators<br />
> project: T. Brigaud<br />
> field: C. Martin<br />
> HQ: F. Stea<br />
Sources of funding<br />
> Mexican Chamber of Commerce<br />
(Banamex); French Embassy,<br />
MdM<br />
Budget<br />
> 2005: 106,207 euros
Moldova<br />
Mortality<br />
> infant: 26‰<br />
Life expectancy<br />
> at birth: 67.7<br />
HDI<br />
> 0.671; ranked 115/177<br />
Actual GDP/inhabitant ($)<br />
> 463<br />
International delegation<br />
> MdM Greece<br />
Beneficiaries<br />
> directly: nearly 8,000 young people<br />
over two years, of whom around<br />
1,500 are from the most vulnerable<br />
sectors of the population, and the<br />
beneficiaries of the training (team<br />
from the ATIS centre in Balti - 8 people<br />
-, members of the victim identification<br />
network - approx. 60 people)<br />
> indirectly: parents of young people<br />
attending the centre and the whole<br />
of the Moldovan population potentially<br />
affected by trafficking.<br />
Staff<br />
> local: 10<br />
> expatriate: 1<br />
Co-ordinators<br />
> project: F. Parrot<br />
> field: L. Ilie<br />
> HQ: A. Landaes<br />
Source of funding<br />
> MdM<br />
Budget<br />
> 2005: 82,038 euros<br />
Human Development Report 2005, UNDP<br />
Today Moldova is one of the poorest countries in Europe. The very weak economic<br />
situation and increasing inflation are pushing Moldovans to emigrate en masse to<br />
more prosperous countries. Unfortunately, many of them have fallen into the hands of<br />
human traffickers who insidiously profit from the despair and lack of prospects of<br />
young Moldovans to feed their networks.<br />
Preventing trafficking<br />
and caring for the victims<br />
Balti Region, north Moldova<br />
Activities: There are two aspects to MdM's work:<br />
• increasing access to prevention services and to overall<br />
care for young people in general and young victims of<br />
trafficking or those belonging to at-risk groups, particularly in<br />
the context of a partnership with the ATIS Friend of Young<br />
People Centre, run by the TDV organisation;<br />
• help the Friend of Young People Centre to continue by<br />
being integrated into the national health system and strengthening<br />
collaboration with the regional and national networks<br />
fighting against human trafficking.<br />
Progress bar at 31/12/2005<br />
04/2005 12/2007<br />
Project > progress<br />
Outlook:<br />
Continue the activities.
Mongolia<br />
A young Asian democracy, Mongolia's economy is gradually taking off but a third of its<br />
population lives below the poverty line and corruption is endemic. In a country where life<br />
has remained focused on a traditional nomadic way of life, alcoholism has become a<br />
serious problem. Women and children are the first victims of alcohol-induced violence.<br />
Fighting against alcoholism<br />
and treating tuberculosis<br />
Ulan Bator<br />
Activities: MdM's project is focused on implementing a programme<br />
of alcoholism and tuberculosis prevention and<br />
treatment amongst people living in a district of yurts (Ulan<br />
Bator shanty towns), who are excluded from access to healthcare<br />
for administrative reasons.<br />
Mongolia suffers from a lack of co-ordination and diversity with<br />
respect to therapeutic models for alcoholism, as well as structural<br />
problems for treating tuberculosis. A local team, made up<br />
of a doctor, nurse and social worker, has been formed. In addition,<br />
a partnership has been signed with the Ulan Bator addic-<br />
tion centre.<br />
Progress bar at 31/12/2005<br />
10/2005 2006<br />
Project > progress<br />
Outlook:<br />
In January 2006 a fifteen<br />
day training seminar is planned,<br />
to be attended by three<br />
alcohol dependency experts.<br />
We have the following objectives<br />
for the coming year:<br />
• screening people living in<br />
the target yurt districts who<br />
are affected by alcoholism<br />
and tuberculosis and directing<br />
them towards suitable<br />
structures, with mobile MdM<br />
medical teams;<br />
• supporting target populations<br />
in irregular situations<br />
so that they recover their<br />
right to health (working together<br />
with organisations);<br />
• training and awareness<br />
programmes amongst health<br />
staff and target populations;<br />
• lobbying of health, police<br />
and political authorities with<br />
the creation of a co-ordination<br />
platform.<br />
Human Development Report 2005, UNDP<br />
Mortality<br />
> infant: 56‰<br />
Life expectancy<br />
> at birth: 64<br />
HDI<br />
> 0,679; ranked 114/177<br />
82/83<br />
Actual GDP/inhabitant ($)<br />
> 514<br />
Beneficiaries<br />
> directly: 1,500,000<br />
> indirectly: 1,500,000<br />
Staff<br />
> local: 3<br />
> expatriate: 2<br />
Co-ordinators<br />
> project: G. Lacaze and P. Guibé<br />
> field: O. Delclos (non-med.)<br />
and C. Durot (med.)<br />
>HQ: E. Martinon<br />
Sources of funding<br />
> MdM, currently requested (ADB,<br />
EU, JICA, etc.)<br />
Budget<br />
> 2005: 13,915 euros
Morocco<br />
Mortality<br />
> infant: 36‰<br />
Life expectancy<br />
> at birth: 69.7<br />
HDI<br />
> 0.631; ranked 124/177<br />
Actual GDP/inhabitant ($)<br />
> 1,452<br />
Beneficiaries<br />
> directly: around thirty participants<br />
in the training courses<br />
> indirectly: 29,000 victims of<br />
Moroccan jails<br />
Staff<br />
> expatriate: 2 psychiatrists, 1 doctor<br />
and 1 psychologist monitor the<br />
project and provide the training<br />
Co-ordinators<br />
> project: J. Beckouche<br />
> HQ: S. Alary<br />
Source of funding<br />
> MdM<br />
Budget<br />
> 2005: 7,889 euros<br />
Rapport sur le développement humain 2005, PNUD<br />
Moroccan society has been lastingly marked by the mass repression of the “Years of<br />
Lead”. The Equity and Reconciliation Committee (IER), set up on 1 January 2004 by the<br />
current monarch, Mohammed VI, has built up a large number of dossiers with a view to<br />
rehabilitating and compensating the victims of Hassan II's regime. Most of the people who<br />
were tortured and testified at that time have issued strong demands for medical treatment<br />
as well as legal and moral support.<br />
Supporting victims of torture<br />
Casablanca, Marrakesh<br />
Activities: At the request of organisations and the Reception<br />
and Orientation Centre for Victims of Torture (CAOVT), MdM's<br />
work involves organising two training sessions in psychological<br />
trauma for a multi-disciplinary team of doctors, psychologists,<br />
social workers and reception workers involved in various<br />
Moroccan organisations dealing with the physical and mental<br />
care of victims of torture. This training should allow the<br />
Moroccans to share practices and encourage the setting up<br />
of a network for caring for victims across the whole of Morocco.<br />
Progress bar at 31/12/2005<br />
01/01/2005 fin 2006<br />
Project > progress<br />
Outlook:<br />
The first training was given<br />
in June 2005. Two psychiatrists<br />
will evaluate this initial<br />
training amongst participants<br />
in March 2006. The second<br />
training will then take place<br />
during the second quarter of<br />
2006.
Nepal<br />
The coup of 1 February 2005 worsened an already very fragile military and political situation<br />
and most aid programmes were suspended because of the uncertainties over the<br />
country's future. Today Nepal is one of the 10 poorest countries in the world, and no effective<br />
development can be considered in such a political context of conflict. In addition,<br />
AIDS and tuberculosis are continuing to spread across the whole country.<br />
Fighting tuberculosis and HIV Mortality<br />
Western Regions<br />
Activities: MdM has been working in Nepal since 1995.<br />
The programme which began in 2002 aims to prevent and<br />
control the spread of tuberculosis and AIDS in four districts<br />
in western Nepal: Palpa, Syangja, Gulmi and Argha<br />
Kanchi.<br />
During 2005, the work was refocused on the fight against<br />
AIDS, and concentrated on the target populations only: intravenous<br />
drug users, migrants, prisoners, prostitutes and their<br />
clients.<br />
Awareness and information activities have been developed<br />
using health educators in the villages, voluntary counselling<br />
and testing centres (VCTs), prisons and hotels at the same<br />
time, in conjunction with our local partners, Naulo Gumti and<br />
Friends of Hope.<br />
Progress bar at 31/12/2005<br />
01/01/2002 28/02/2006<br />
Project > progress<br />
Outlook:<br />
In 2006, MdM expects to finalise<br />
its HIV prevention project<br />
and to explore the remote<br />
western areas with a view to<br />
running an emergency type<br />
project on access to healthcare<br />
for the people in the Maoist<br />
area, but also to develop a<br />
project amongst migrant<br />
populations.<br />
Human Development Report 2005, UNDP<br />
> infant: 61‰<br />
Life expectancy<br />
> at birth: 61.6<br />
HDI<br />
> 0.526; ranked 136/177<br />
84/85<br />
Actual GDP/inhabitant ($)<br />
> 237<br />
International delegations<br />
> MdM United States, MdM<br />
Switzerland<br />
Beneficiaries<br />
> directly: 1,150 and 50% of the<br />
prostitutes in Syangja district<br />
> indirectly: 1,200,000 (population<br />
of 4 districts)<br />
Staff<br />
> local:25<br />
> expatriate: 3<br />
Co-ordinators<br />
> project: P. Baguet and O. Lermet<br />
> field: M. Piasecki<br />
> HQ: E. Martinon<br />
Sources of funding<br />
> EU, ICCO, MdM<br />
Budget<br />
> 2005: 198,980 euros
Opération Sourire<br />
Countries of intervention<br />
in 2005<br />
Benin<br />
Cambodia<br />
Eritrea<br />
Madagascar<br />
Mali<br />
Mongolia<br />
Niger<br />
Pakistan<br />
Rwanda<br />
Co-ordinators<br />
> project: F. Foussadier;<br />
F. Lauwers<br />
> HQ: A. Segard<br />
Sources of funding<br />
> private funds, businesses,<br />
foundations<br />
Budget<br />
> 2005: 324,324 euros<br />
Opération Sourire's aim is to put a smile back on the faces of those who have been disfigured<br />
by war, illness and malnutrition and to enable people excluded because of their<br />
disability to have a social life again.<br />
Plastic surgery still does not exist in the health system of many countries because of a<br />
lack of qualified human resources, equipment and infrastructure. Due to the considerable<br />
demand for plastic surgery and the complete lack of treatment for patients, the doctors<br />
of Opération Sourire are working amongst this forgotten population.<br />
Activities and salient points in 2005<br />
Activities: 2005 was the year when the Opération Sourire<br />
projects' long term future was confirmed. These projects<br />
are more and more vital and becoming locally integrated. In<br />
particular, they reinforce the training given to local teams.<br />
Opération Sourire's work is thus gradually changing from<br />
replacing local staff to strengthening the skills of local healthcare<br />
teams.<br />
Outlook:<br />
Opération Sourire's projects<br />
are continuing, especially on<br />
the training side, to ensure<br />
that the local teams are integrating<br />
their new skills. In this<br />
context, Opération Sourire<br />
wants to take part in developing<br />
and setting up local<br />
centres, with increased capacity<br />
in terms of recruiting<br />
patients and post-operative<br />
monitoring. Recruiting local<br />
staff and strengthening<br />
management capacity should<br />
help achieve this objective.<br />
Projects to build plastic surgery<br />
centres with the involvement<br />
of Opération Sourire<br />
are being developed in<br />
Benin, Cambodia and Niger.
Pakistan<br />
The most violent earthquake in Central Asia since 1947 hit Pakistan on 8 October 2005. The<br />
number of victims exceeded 73,000 dead and 70,000 injured, including many children and<br />
young people. Nearly 70% of homes in Kashmir were destroyed, and help could only reach<br />
the area by air until roads were cleared and repaired.<br />
In this emergency situation, women continue to be deprived of their most basic human<br />
rights on a daily basis and are the victims of violence and killed, often for matters of honour.<br />
Emergency help for earthquake victims<br />
NWFP Province and Islamabad<br />
Activities: The day after the earthquake, the work was organised<br />
around three sites:<br />
• Mansehra (NWFP), where a surgical team came to support<br />
Pakistani teams to operate on earthquake victims;<br />
• Thakot and Balakot (NWFP), where permanent and mobile primary<br />
healthcare teams operated, thus providing an initial contact<br />
with emergency services for the population in these two areas.<br />
Once the immediate emergency had passed, Médecins du Monde<br />
got involved in helping homeless and displaced people through the<br />
winter by providing primary healthcare in Islamabad where a clinic<br />
(for general consultations, reproductive health, community health,<br />
etc.) was opened in camp H11, and in Mansehra, where a similar<br />
structure was set up in Jabba camp.<br />
Progress bar at 31/12/2005<br />
09/10/2005<br />
Project > progress<br />
Outlook:<br />
In 2006 MdM will seek to<br />
widen its work by getting<br />
involved in mobile consultations<br />
in the smallest camps<br />
which have sprung up in<br />
NWFP and in Islamabad. The<br />
need to support people as<br />
they return to their home areas<br />
will be assessed along with<br />
the need for longer term support<br />
for rebuilding and reactivating<br />
health services.<br />
Helping women victims of domestic violence<br />
Sargodha, Lahore, Faisalabad and Gujranwala<br />
Activities: A 9-month pilot project with the aim of providing<br />
medical, psychological and legal assistance to women<br />
victims of domestic violence was set up in the Dar-ul-Aman in<br />
Sargodha (Punjab). The activity was then gradually extended to<br />
three new refuges in Lahore, Faisalabad and Gujranwala. This programme<br />
stresses the involvement of civil society and government<br />
authorities, and on training the Dar-ul-Aman staff, a guarantee of<br />
the viability of such work.<br />
Progress bar at 31/12/2005<br />
2004 2008<br />
Project > progress<br />
Outlook:<br />
Continue the activities and<br />
extend to 8 Dar-ul-Aman in<br />
the Punjab. The project has<br />
7 aspects including medical<br />
assistance, psychological<br />
support, legal assistance<br />
and training for the staff of<br />
the Dar-ul-Aman and other<br />
Punjabi institutions, and<br />
government executives, etc.<br />
Human Development Report 2005, UNDP<br />
Mortality<br />
> infant: 81‰<br />
Life expectancy<br />
> at birth: 63<br />
HDI<br />
> 0.527; ranked: 173/177<br />
86/87<br />
Actual GDP/inhabitant ($)<br />
> 304<br />
International delegations<br />
> MdM Greece, MdM Cyprus<br />
This project is carried out in<br />
partnership with MdM Spain<br />
Beneficiaries<br />
> directly project 1: 50,000<br />
> directly project 2: 4,500 women<br />
and 360 children<br />
> indirectly project 2: 300,000<br />
Staff<br />
> local project 1: 20<br />
> local project 2: 10<br />
> expatriate project 1: 16<br />
> expatriate project 2: 2<br />
Co-ordinators<br />
> projects 1 and 2: B. Ten Kate<br />
> field 1: D. Defrade<br />
> field 2: M. Jactat / C. Buffet<br />
> HQ 1: desk Urgence<br />
> HQ 2: N. Bréchet<br />
Sources of funding<br />
> project 1: Dutch Foreign Ministry,<br />
Memisa Belgium, MdM<br />
> project 2: French Embassy in<br />
Khartoum<br />
Budget<br />
> 2005 project 1: 490,736 euros<br />
> 2005 project 2: 100,310 euros
Palestinian Territories<br />
Mortality<br />
> infant: 22‰<br />
Life expectancy<br />
> at birth: 72.5<br />
HDI<br />
> 0.729; ranked 102/177<br />
Actual GDP/inhabitant ($)<br />
> 1,026<br />
International delegations<br />
> MdM Cyprus, MdM Switzerland<br />
Beneficiaries<br />
> directly: 1,300 trainers, teachers,<br />
school children and hospital staff<br />
> indirectly: 1,400,000 people living<br />
in the Gaza strip<br />
Staff<br />
> local: 8<br />
> expatriate: 3 permanent<br />
and doctors for short periods<br />
Co-ordinators<br />
> project: R. Garrigue, M. Rajablat<br />
> field: V. Miollanay puis D. Trani<br />
> country: P. Villedieu<br />
> HQ: S. Alary<br />
Sources of funding<br />
> DAH, MdM<br />
Budget<br />
> 2005: 320,219 euros<br />
Rapport sur le développement humain 2005, PNUD<br />
The emergency continues in the Palestinian Territories despite the relative calm of 2005.<br />
Although the settlements have been dismantled and the Israeli army does not intend to<br />
penetrate inside the Gaza strip, it remains a hermetically sealed area, subject to considerable<br />
restrictions and air raids. In the West Bank, the Palestinian Authority, which is<br />
bogged down in the difficult task of administration post-Arafat, is struggling to find solutions<br />
for healthcare and the fight against poverty, amongst other things, bearing in mind<br />
the Israeli security pressure and the impact of the construction of the separation wall on<br />
the people's access to healthcare.<br />
Improving emergency treatment<br />
Gaza Strip<br />
Activities: There are three parts to the programme:<br />
• improving the civilian population's knowledge of first<br />
aid, and of how to treat emergencies before the emergency<br />
services arrive, in the Gaza strip between now and the<br />
end of 2006 (training trainers amongst 74 paramedics from<br />
the UNRWA health centres, 56 teachers, then training 1,200<br />
school children in the UNRWA refugee camps, integration of<br />
BLS in the UNRWA school curriculum from the start of the<br />
2005-2006 academic year;<br />
• a programme to train Emergency Medical Technician<br />
(emergency ambulance EMTs) trainers in the two<br />
Palestinian Red Crescent Society training institutions in Gaza<br />
and Ramallah, and setting up a new initial and ongoing training<br />
programme;<br />
• developing and setting up a reference “Plan for an<br />
influx of injured or sick patients” within the emergency<br />
department of Shiffa hospital (Gaza City).<br />
Progress bar at 31/12/2005<br />
01/01/2005 fin 2007<br />
Project > progress<br />
Outlook:<br />
MdM will continue all its activities<br />
in 2006.
Mental health<br />
Nablus district in the West Bank<br />
Activities: Nablus district is the most strictly sealed off district<br />
of the Palestinian Territories. MdM is determined to improve<br />
the treatment of mental health problems there through:<br />
• a campaign amongst the Palestinian people to remove the<br />
stigma of mental illness through booklets, posters, TV ads and<br />
radio programmes;<br />
• mental health training for medical and paramedical staff in<br />
the primary healthcare centres and for mental health professionals;<br />
• support for a “theatre in schools” activity, transferred to a<br />
local organisation;<br />
• mental health seminars;<br />
• activities in two literary cafés for men in Nablus town centre<br />
and Balata refugee camp;<br />
• setting up a mobile mental health consultation service in<br />
eight villages in Nablus district, also providing awareness and<br />
training sessions for primary healthcare staff in the dispensaries<br />
involved.<br />
Progress bar at 31/12/2005<br />
01/01/2005 fin 2007<br />
Project > progress<br />
Access to healthcare and the Wall<br />
West Bank<br />
Activities: Since May 2004, MdM has been developing<br />
activities aimed at providing medical support to the people<br />
affected by the Wall and bearing witness to its impact<br />
on health:<br />
• setting up an ambulance station in the Aizaria enclave, east<br />
of Jerusalem, in partnership with the Palestinian Red Crescent<br />
Society; training ambulance men;<br />
• improving ante- and post-natal monitoring for women with<br />
at-risk pregnancies; treatment of under 5s in 10 villages around<br />
Jenin and Bethlehem;<br />
• equipping a laboratory in Rantis village, in an enclave northeast<br />
of Ramallah.<br />
Progress bar at 31/12/2005<br />
01/04/2004 30/04/2005<br />
Project > progress<br />
Outlook:<br />
MdM is going to continue<br />
the activities it was involved<br />
in in 2005, start three listening<br />
points (reception centres<br />
with a therapeutic aim)<br />
and especially help to set up<br />
two medical and psychological<br />
community centres (one<br />
in Nablus and one in Jenin)<br />
in partnership with the<br />
Palestinian Health Ministry.<br />
Consultations will be taken<br />
over by the Palestinian Red<br />
Crescent Society.<br />
Outlook:<br />
The Wall programme ended<br />
in April 2005.<br />
Beneficiaries<br />
> directly: 3,000<br />
> indirectly: 3,000<br />
Staff<br />
> local:11<br />
> expatriate: 2<br />
88/89<br />
Co-ordinators<br />
> project: R. Garrigue, M. Rajablat<br />
> field: T. Groh, puis<br />
L. Robin, puis C. Thévenot<br />
> country: P. Villedieu<br />
> HQ: S. Alary<br />
Sources of funding<br />
> French Foreign Ministry, MdM<br />
Budget<br />
> 2005: 333,058 euros<br />
Beneficiaries<br />
> directly: 13,000 (mobile clinics),<br />
39,000 (Aizaria station)<br />
Staff<br />
> local: 3<br />
> expatriate: 2<br />
Co-ordinators<br />
> project: R. Garrigue, M. Rajablat<br />
> field: K. Peters et L. Weisgerber<br />
pour l’advocacy<br />
> country: P. Villedieu<br />
> HQ: S. Alary<br />
Sources of funding<br />
> MdM, French Consulate in<br />
Jerusalem<br />
Budget<br />
> 2005: 109,587 euros
Peru<br />
Mortality<br />
> infant: 26‰<br />
Life expectancy<br />
> at birth: 70<br />
HDI<br />
> 0.762; ranked 79/177<br />
Actual GDP/inhabitant ($)<br />
> 2,231<br />
Délégation internationale<br />
> MdM Espagne<br />
Beneficiaries<br />
> directly: 47,246,10<br />
to 19 year olds<br />
Staff<br />
> local: 5<br />
> expatriate: 1<br />
Co-ordinators<br />
> projects: M. Boscaméric,<br />
C. Batard<br />
> field: N. Gravier<br />
> HQ: Y. Le Corgne<br />
Sources of funding<br />
> Annenberg Foundation<br />
(United States), MdM<br />
Budget<br />
> 2005: 7,956 euros<br />
Human Development Report 2005, UNDP<br />
As the 2006 elections approach, Alejandro Toledo's government is desperately trying<br />
to appease the discontent and social movements, whose main demands in 2005 were<br />
for a salary increase, a review of agricultural policy and improved living conditions.<br />
However, unemployment and great poverty continue to cause deep disquiet in<br />
Peruvian society, especially in Lima, where more than a third of the population live on<br />
less than two dollars a day.<br />
Promoting sexual and reproductive health<br />
Lima<br />
Activities: The project aims to improve access to preventive<br />
and curative care with respect to sexual and<br />
reproductive health for 10 to 19 year olds. It works in three<br />
districts of the southern cone of Lima, around 9 existing health<br />
structures and through:<br />
• community awareness through trained promoters working<br />
within the districts to locate isolated young mothers and pregnant<br />
teenagers who do not have access to the health structures;<br />
a massive awareness campaign with more than two<br />
campaigns per district; support for local health structures<br />
through renovation and equipment, and healthcare staff training;<br />
work with schools;<br />
• identifying reception and meeting places exclusively for teenagers.<br />
Supplied by the town councils, these are listening and<br />
awareness centres which provide contact with local health professionals;<br />
• developing a local network of those interested in caring for<br />
teenage mothers: local government (town halls), basic welfare<br />
organisations, and public and private institutions of civil society.<br />
Progress bar at 31/12/2005<br />
01/10/2005 30/09/2008<br />
Project > progress<br />
Outlook:<br />
The following activities will be<br />
implemented:<br />
• a mass awareness campaign<br />
(such as a concert for<br />
young people);<br />
• two awareness campaigns<br />
per district (six in total);<br />
• training 45 peer teenagers;<br />
• opening nine centres for<br />
young people;<br />
• renovating and equipping<br />
nine health structures;<br />
• activating a network of key<br />
people.
Russia<br />
Despite a hardening of policy and its stated desire to strengthen control over civil society,<br />
Vladimir Putin's regime enjoys some popularity and this is because the Russian economy<br />
is prospering. However, the situation of the indigenous peoples is increasingly critical,<br />
and the arrival of thousands of migrants in these remote areas (thanks to the intensification<br />
of gas exploitation) has led to a demographic imbalance and an increase in ethnocultural<br />
stress. The lack of access to healthcare of these isolated indigenous peoples<br />
is alarming: some previously contained illnesses such as tuberculosis and diphtheria are<br />
reappearing, and their life expectancy is much lower than that of Russians.<br />
Helping isolated indigenous peoples<br />
Moscow<br />
Activities: As it is concerned with improving the primary health<br />
of the indigenous people without disturbing their way of life which<br />
is often based on nomadism, MdM has sought to encourage the<br />
training of indigenous nomadic health officers, to work in<br />
support of the existing structures (dispensaries and the Sanaviation<br />
programme sending doctors and emergency services to remote<br />
areas).<br />
MdM therefore organised a public health seminar with the aim<br />
of training Russian doctors to run and evaluate community health<br />
worker (CHW) programmes for these indigenous peoples.<br />
Using MdM's expertise and experience, based on running CHW<br />
programmes amongst Nenets nomads in the autonomous Yamal-<br />
Nenets district between 1994 and 2001, this training seminar was<br />
attended by 18 doctors from 6 regions.<br />
It was divided into three main parts:<br />
• presentation of features of CHW programmes;<br />
• complete revision of the content of the booklets developed for<br />
previous CHW programmes, with the addition of two sections on<br />
alcoholism and tuberculosis;<br />
• awareness of project management and programme evaluation<br />
by MdM's teaching team writing a practical guide including “recommendations”.<br />
Progress bar at 31/12/2005<br />
12/2005 2007<br />
Project > progress<br />
Outlook:<br />
The 6 participating regions<br />
must implement CHW programmes<br />
in 2006-2007, for<br />
which MdM will provide<br />
training for the CHWs and<br />
the booklet of training and<br />
work and will support the<br />
different stages as an<br />
expert reference.<br />
Human Development Report 2005, UNDP<br />
90/91<br />
Mortality<br />
> infant: 16‰ (40.9‰ amongst the<br />
indigenous Yamal peoples)<br />
Life expectancy<br />
> at birth: 65.3 (48 for the<br />
indigenous Yamal people)<br />
HDI<br />
> 0.795; ranked 62/177<br />
Actual GDP/inhabitant ($)<br />
> 3,018<br />
International delegation<br />
> MdM United States<br />
Beneficiaries<br />
> indirectly: 100,000<br />
Staff<br />
> local: 3<br />
> expatriate: 2<br />
Co-ordinators<br />
> project: F. et A. Desplanques<br />
> field: P. Baril<br />
> HQ: A. Landaes<br />
Source of funding<br />
> MdM<br />
Budget<br />
> 2005: 21.609 euros
El Salvador<br />
Mortality<br />
> infant: 32 ‰<br />
Life expectancy<br />
> at birth: 70.9<br />
HDI<br />
> 0.722; ranked 104/177<br />
Actual GDP/inhabitant ($)<br />
> 2,277<br />
International delegation<br />
> MdM Spain<br />
Beneficiaries<br />
> directly: 7,000<br />
> indirectly: 42,000<br />
Co-ordinators<br />
> project: J.-L. Pesle<br />
> suivi: DR Rhône-Alpes-Grenoble<br />
Source of funding<br />
> MdM<br />
Budget<br />
> 2005: 14,203 euros<br />
Human Development Report 2005, UNDP<br />
The damage caused by Hurricane Stan and the violence of the maras (organised bands<br />
whose income is mainly from drugs racketeering and trafficking) make it difficult to develop<br />
education systems, housing and access to healthcare, which are still insufficient,<br />
especially in the regions most affected by the civil war. MdM is concentrating its work on<br />
health assistance to the most vulnerable peoples of Morazán.<br />
A community health programme<br />
Morazán Region<br />
Activities: The project involves providing support to our<br />
local partner, Doctors for the Right to Health (MDS), to<br />
implement programmes concerning basic health services, environmental<br />
decontamination, food security, nutrition, childhoodrelated<br />
healthcare and training of promoters. The support involves:<br />
• management training for all MDS staff;<br />
• developing the organisation's communication system;<br />
• renewing IT equipment and software training;<br />
• disinfection, training and prevention in 20 groups of houses,<br />
as part of environmental decontamination campaigns;<br />
• digging a well and a septic tank for the staff living quarters,<br />
next to the El Tablon healthcare centre in Morazán.<br />
The project was disturbed in October 2005 by hurricane Stan<br />
which caused considerable damage and 72,000 victims in the<br />
country. Doctors for the Right to Health put in a lot of work<br />
during the emergency and was able to care for 572<br />
people.<br />
Progress bar at 31/12/2005<br />
10/2004 10/2007<br />
Project > progress<br />
Outlook:<br />
In 2006, the impact of the<br />
management and IT training<br />
of MDS staff will be evaluated<br />
to decide if any changes are<br />
needed. This training should<br />
mean the organisation is better<br />
run and organised.<br />
Developing the organisation's<br />
communication system will<br />
enhance the value of MDS's<br />
work and make it easier to<br />
find new financial backers.
Serbia<br />
The union of Serbia and Montenegro is politically unstable because of the uncertainties over<br />
the status of the neighbouring regions - Bosnia-Herzegovina and Montenegro - and of certain<br />
Serbian regions such as Voivodine and Kosovo. Following the conflicts and socio-economic<br />
upsets which shook this region in the 1990s and the clear absence of significant<br />
international cooperation, Serbia and Montenegro is also experiencing economic difficulties.<br />
The provision of healthcare has clearly deteriorated and the HIV epidemic is growing,<br />
especially amongst injectable drug users, although it is not possible to obtain clear information<br />
on the epidemiological level.<br />
Harm reduction<br />
Belgrade<br />
Activities: MdM's work amongst intravenous drug users has<br />
several aspects:<br />
• street work amongst drug users via a mobile unit; this<br />
aspect of the work involves exchange of sterile equipment and<br />
spreading prevention messages aimed at drug users, near where<br />
they live while respecting their way of life (street work by peers and<br />
professionals);<br />
• setting up a drop-in centre for intravenous drug users;<br />
• raising awareness about the health risks linked to drug use<br />
and prevention activities;<br />
• training those working with drug users.<br />
Progress bar at 31/12/2005<br />
10/2003 2009<br />
Project > progress<br />
Outlook:<br />
Support the local organisation<br />
VEZA as part of the<br />
transfer of the needle<br />
exchange programme which<br />
began in 2005. Set up a<br />
methadone programme.<br />
WHO Report 2005<br />
Mortality<br />
> infant: 14‰<br />
Life expectancy<br />
> at birth: 73<br />
HDI<br />
> not known<br />
92/93<br />
Actual GDP/inhabitant ($)<br />
> not known<br />
Beneficiaries<br />
> directly: 568<br />
> indirectly: 1,704<br />
Staff<br />
> local: 7<br />
> expatriate: 1<br />
Co-ordinators<br />
> project: P. Beauverie<br />
> field: C. Debeaulieu<br />
> HQ: A. Landaes<br />
Sources of funding<br />
> French Foreign Ministry, MdM<br />
Budget<br />
> 2005: 232,418 euros<br />
Veza support: 45,673 euros
Sri Lanka<br />
Mortality<br />
> infant: 13 ‰<br />
Life expectancy<br />
> at birth: 74<br />
HDI<br />
> 0.751; ranked 93/177<br />
Actual GDP/inhabitant ($)<br />
> 948<br />
Délégations internationales<br />
> MdM Spain, MdM Portugal,<br />
MdM Cyprus, MdM Greece,<br />
MdM USA, MdM Belgium,<br />
MdM Argentina<br />
Beneficiaries<br />
> directly project 1: 35,900<br />
> directly project 2: 80,000<br />
Staff<br />
> local project 1: 20<br />
> local project 2: 10<br />
> expatriate project 1: 7<br />
Co-ordinators<br />
> project 1: C. Giboin, A. Cavey<br />
> project 2: P. Foldès<br />
> field 1: S. Brignano<br />
> field 2: C. Giboin<br />
> HQ 1: Emergency desk<br />
then V. Pardessus<br />
> HQ 2: Emergency desk<br />
Source of funding<br />
> projects 1 and 2: MdM<br />
Budget<br />
> 2005 projects 1 and 2:<br />
631,944 euros<br />
Human Development Report 2005, UNDP<br />
Officially, a truce is in force between the government and the Liberation Tigers of Tamil<br />
Eelam (LTTE), but the peace process is still blocked and violence is increasing. The tsunami<br />
in 2004 weakened the country's economy and the population, already weak, suffered<br />
the full consequences of this. The Sri Lankan health system, however, is still considered<br />
a model for developing countries despite a fall in expenditure. But the health indicators<br />
do not take account of the area under LTTE control, which suffers from a serious lack<br />
of healthcare staff.<br />
Renovating health structures<br />
Mallavi, Tunukkai and Naadankandal - Mullaitivu district<br />
Activities: MdM is responsible for renovating and supporting<br />
health structures in the Manthal East and Tunukkai<br />
divisions (Mullaitivu district).<br />
The work in the Mallavi area is focused around 4 areas:<br />
• renovating and re-equipping Mallavi hospital (opening a new<br />
operating theatre and emergency department, reorganising the<br />
out-patients consultation service, pharmacy, maternity unit, etc.;<br />
• re-organising and training local medical staff;<br />
• supplying the hospital and two health centres with drugs and<br />
medical equipment;<br />
• raising the authorities' awareness of problems encountered by<br />
the hospital (funding, human and material resources).<br />
Progress bar at 31/12/2005<br />
15/01/2005 30/03/2006<br />
Project > progress<br />
Emergency aid to tsunami victims<br />
Kinnya Division - Trincomalee district<br />
Activities: Kinnya hospital, the referral centre for some 80,000<br />
people, was destroyed by the tsunami in December 2004. In conjunction<br />
with MdM Spain, the work has involved urgently re-establishing<br />
access to primary healthcare for the people of Kinnya living in a<br />
displacement camp, through mobile consultation services. More<br />
than 2,000 consultations were carried out in this way by our teams<br />
during the first weeks of the emergency amongst tsunami victims,<br />
while epidemiological monitoring was re-established.<br />
Progress bar at 31/12/2005<br />
28/12/2004 20/02/2005<br />
Project > progress<br />
Outlook:<br />
Several exploratory projects<br />
were carried out in the northern<br />
area and showed that health<br />
needs were covered. The work<br />
in Mallavi hospital will be<br />
suspended once the renovation<br />
work is complete. The work will<br />
be monitored from HQ (working<br />
with a Sri Lankan co-ordinator<br />
for any emergencies), as the<br />
desire is to consider a longer<br />
term project.<br />
Outlook:<br />
After the hospital had been<br />
rebuilt and the Sri Lankan<br />
authorities had re-established<br />
primary healthcare MdM<br />
was able to gradually withdraw<br />
in February 2005. The<br />
logistics and administrative<br />
base in Colombo was retained<br />
to support the teams in<br />
Mallavi, in northern Sri<br />
Lanka.
Sudan<br />
Following the Peace Agreements signed in January 2005 in southern Sudan, there have<br />
been population movements in the region. These are of people who had fled during the<br />
20 years of fighting in southern Sudan which ravaged these provinces and who are now<br />
returning to their home areas. The consequences of the war are disastrous socially as<br />
well as in terms of health and nutrition. The quality of healthcare is still deteriorating. In<br />
addition, although the social and political recomposition of southern Sudan is a fairly<br />
positive development, it is not happening without causing some local tensions between<br />
the different communities in the area.<br />
Emergency medical care<br />
Kalma, Dereij, Nyala - Southern Darfur<br />
Activities: MdM has set up a PHC centre in Kalma camp, equipped<br />
with a hospitalisation unit and delivery room, in conjunction<br />
with the health agencies already working there including ACF which<br />
is treating malnutrition. It includes 4 curative consultation posts,<br />
ante- and post-natal healthcare consultations, vaccination services,<br />
a medical analysis laboratory, quick testing for malaria and a<br />
pharmacy.<br />
Outside the camp, MdM is also involved in mobile camps in Dereij<br />
camp amongst groups of displaced people around Nyala.<br />
Progress bar at 31/12/2005<br />
14/07/2004 indéfini<br />
Progress bar at 31/12/2005<br />
25/11/2004 indéfini<br />
Project > progress<br />
Primary healthcare and surgery<br />
Malakal<br />
Activities: The project aims to improve the quality of care<br />
given by the surgery unit of Malakal general hospital and to<br />
guarantee access to it for more people, focused on 4 main areas:<br />
• renovating then equipping the surgery unit;<br />
• training staff involved in surgical treatment;<br />
• putting management systems for surgical consumables in place;<br />
• putting a data collection and transmission system in place.<br />
Project > progress<br />
Outlook:<br />
Continue community healthcare<br />
activities, occasional support<br />
work (water distribution, installation<br />
of diarrhoea treatment<br />
centres, nutritional screening,<br />
vaccination), logistical and<br />
human resources support and<br />
setting up an isolation camp in<br />
the event of a cholera epidemic.<br />
Outlook:<br />
Continue training started in<br />
November 2005 and<br />
renovation work started in<br />
September 2005.<br />
Human Development Report 2005, UNDP<br />
Mortality<br />
> infant: 63‰<br />
Life expectancy<br />
> at birth: 56.4<br />
HDI<br />
> 0.512; ranked 139/177<br />
94/95<br />
Actual GDP/inhabitant ($)<br />
> 412<br />
Délégations internationales<br />
> MdM Greece, MdM Canada<br />
Beneficiaries<br />
> directly project 1: 50,000<br />
> directly project 2: 50,000 (town)<br />
> indirectly project 1: 100,000<br />
> indirectly project 2: 150,000 (region)<br />
Staff<br />
> local project 1: 100<br />
> local project 2: 1<br />
> expatriate project 1: 17<br />
> expatriate project 2: 1 + surgical<br />
teams<br />
Co-ordinators<br />
> projects 1 and 2: L. Joseph, J. Larché<br />
(+ project 2: G. Isserlis)<br />
> field 1: M. Pomarel, N. Seris<br />
> field 2: F. Makpolo, N. Pilet<br />
> HQ project 1: desk Urgence,<br />
B. Contamin<br />
> HQ project 2: O. Mouzay, B. Contamin<br />
Sources of funding<br />
> project 1: DAH, German Foreign<br />
Ministry, DFID, ECHO<br />
> project 2: French Embassy, MdM<br />
Budget<br />
> 2005 project 1: 1,615,861 euros<br />
> 2005 project 2: 204,952 euros
Tanzania<br />
Mortality<br />
> infant: 104‰<br />
Life expectancy<br />
> at birth: 46<br />
HDI<br />
> 0.418; ranked 164/177<br />
Actual GDP/inhabitant ($)<br />
> 287<br />
International delegation<br />
> MdM Belgium<br />
Beneficiaries<br />
> directly project 1: 3,350<br />
> directly project 2: hospital staff and<br />
their families, HIV-positive pregnant<br />
women and their families, patients<br />
with an advanced HIV infection<br />
> indirectly project 1: 510,230<br />
> iindirectly project 2: educators,<br />
nurses<br />
Staff<br />
> local project 1: 10<br />
> local project 2: 10<br />
> expatriate project 1: 1<br />
> expatriate project 2: 2<br />
Co-ordinators<br />
> projects 1 and 2:<br />
P. Tattevin<br />
> general co-ord projects 1 and 2:<br />
S. Davies<br />
> HQ 1 and 2: C. Courtin<br />
Sources of funding<br />
> project 1: MARC foundation,<br />
AIDS Fund<br />
> project 2: Columbia University<br />
Budget<br />
> 2005 project 1: 181,047 euros<br />
> 2005 project 2: 179,878 euros<br />
Human Development Report 2005, UNDP<br />
This is the East African country with the highest growth (6.9% in 2005), but, like a<br />
certain number of African countries, poverty is not declining. The HIV prevalence<br />
rate is one factor responsible for this failure. Around 7% of the adult mainland population<br />
lives with HIV and antenatal consultations have shown prevalence rates between<br />
5% and 15% in certain regions, even if these rates have definitely fallen in the<br />
last ten years. The number of AIDS orphans now stands at nearly 2 million.<br />
Preventing mother-to-child transmission of HIV<br />
Bukoba<br />
Activities: The programme for preventing mother-to-foetus<br />
transmission of HIV has 3 aspects to it:<br />
• training hospital staff;<br />
• monitoring women during pregnancy: screening, prescribing<br />
AZT, information on transmission by breast-feeding;<br />
• monitoring women and their babies after delivery.<br />
Progress bar at 31/12/2005<br />
01/08/2002 30/06/2005<br />
Progress bar at 31/12/2005<br />
01/10/2004 2009<br />
Project > progress<br />
Access to effective antiretroviral<br />
combinations<br />
Bukoba<br />
Activities: The aim is to allow HIV-positive pregnant women and<br />
their families, patients with an advanced HIV infection, and hospital<br />
staff and their families access to antiretrovirals. To facilitate access<br />
to these treatments, MdM is using the HAART (Highly Active<br />
Antiretroviral Therapy) programme. This therapy programme is intended<br />
to reduce the incidence of transmission, especially from mother<br />
to child.<br />
Project > progress<br />
Outlook:<br />
Continue to transfer all activities<br />
to Bukoba regional<br />
hospital. Strengthen the<br />
assistance aimed at HIVpositive<br />
mothers so that they<br />
can continue to benefit from<br />
ARV treatments.<br />
Outlook:<br />
Continue all these<br />
activities in 2006.
Treating opportunistic infections<br />
Bukoba<br />
Activities: MdM is continuing its programme of HIV prevention<br />
and treatment of opportunistic infections by supporting<br />
Tadepa. Three aspects have been developed:<br />
• prevention (peer training, education by peers, access to<br />
condoms);<br />
• psychomedical (counselling, treating opportunistic diseases);<br />
• transfer of skills.<br />
Progress bar at 31/12/2005<br />
01/08/2004 30/04/2005<br />
Project > progress<br />
Outlook:<br />
Continue process of making<br />
the local NGO Tadepa autonomous<br />
and gradual withdrawal<br />
of MdM.<br />
Beneficiaries<br />
> directly: 500<br />
> indirectly: 510,430<br />
Staff<br />
> local: 20<br />
> expatriate: 1<br />
Co-ordinators<br />
> project: P. Tattevin<br />
> general co-ord: S. Davies<br />
> HQ: C. Courtin<br />
96/97<br />
Source of funding<br />
> MdM, French Foreign Ministry<br />
Budget<br />
> 2005: 53,317 euros
Turkey<br />
Mortality<br />
> infant: 33‰<br />
Life expectancy<br />
> at birth: 68.7<br />
HDI<br />
> 0.750; ranked 94/177<br />
Actual GDP/inhabitant ($)<br />
> 3,399<br />
Beneficiaries<br />
> directly project 1: pregnant women<br />
and infants<br />
> directly project 2: human rights<br />
defenders and prisoners who are<br />
victims of state violence<br />
> indirectly project 1: 4,000<br />
Staff<br />
> local project 1: 5 paid staff and<br />
occasional volunteer workers as it is<br />
officially illegal to give permanent<br />
assistance.<br />
> expatriate project 2: 6 on<br />
occasional projects<br />
Co-ordinators<br />
> project 1: G. de Castelnau<br />
> project 2: B. Granjon<br />
> follow-up projects 1 and 2:<br />
DR PACA<br />
Source of funding<br />
> projects 1 and 2: Bouches-du-<br />
Rhône department council<br />
Budget<br />
> 2005 project 1: 13,627 euros<br />
> 2005 project 2: 7,534 euros<br />
Human Development Report 2005, UNDP<br />
Le début des négociations concernant l’adhésion de la Turquie à l’Union européenne relance<br />
la question du respect des droits de l’homme dans un pays où les minorités, les détenus, les<br />
opposants politiques et les défenseurs des droits humains sont souvent victimes de mauvais<br />
traitements. Malgré un réel effort législatif et des engagements concernant le traitement judiciaire<br />
des actes de torture, la persistance de certaines pratiques demeure préoccupante.<br />
De surcroît, le regain d’agitation kurde fait craindre de nouvelles tensions à l’intérieur du pays.<br />
Caring for the most destitute<br />
Ayasma shanty town<br />
Activities: Medical and welfare care of the inhabitants, mainly<br />
displaced Kurds, of Ayasma district:<br />
• healthcare for women and children;<br />
• social and educational activities aimed at children, young<br />
people and women.<br />
In partnership with Solidarité et Liberté (a Marseilles-based<br />
organisation):<br />
• local partnership implementing a medical and welfare project<br />
combining healthcare, education and training (pre-school<br />
education, literacy);<br />
• human rights monitoring , especially the right to health.<br />
Progress bar at 31/12/2005<br />
2004 2006<br />
Progress bar at 31/12/2005<br />
2002 2006<br />
Project > progress<br />
Istanbul<br />
Activities: MdM provides medical and psychosocial<br />
assistance to human rights defenders fighting against Turkish<br />
repression, through:<br />
• supporting human rights defenders in three organisations (IHD,<br />
Goc'Der, Tuhad);<br />
• assistance in trials of human rights defenders;<br />
• testifying; a second assessment of patients whose state of<br />
health was judged compatible with their being reimprisoned by<br />
doctors close to the government was sent to the European<br />
Court of Human Rights, and led to suspension measures and<br />
sanctions against the original doctors.<br />
Project > progress<br />
Outlook:<br />
Monitor health, continue current<br />
activities and prepare to<br />
close the centre at the end of<br />
2006. Examine whether to<br />
transfer the project to another<br />
suburban area of Istanbul housing<br />
mainly displaced Kurds.<br />
Supporting the victims of political violence<br />
Outlook:<br />
Monitor how the situation<br />
develops and adapt MdM'S<br />
actions.
Uganda<br />
From the beginning of the devastation caused by the HIV epidemic, Uganda set up prevention<br />
programmes. However, even if the prevalence of HIV-positivite people seems to<br />
have fallen, more than two million Ugandans, according to estimates, are infected by the<br />
HIV virus, i.e. 10% of the population. It is true that many efforts have been made to reduce<br />
the epidemic but life expectancy (47 years) still shows the damage caused by this illness.<br />
Despite everything the country has maintained an astonishing growth rate of 7%<br />
per year, helped by a great deal of debt relief.<br />
Supporting the local NGO CIPA in its fight<br />
against HIV<br />
Kooki County, Rakai District<br />
Activities: A joint venture with local NGO CIPA has been<br />
set up to ensure prevention activities such as education activities,<br />
raising awareness of community leaders and women,<br />
and training sessions on STIs/AIDS will continue. It involves<br />
promoting behavioural changes and condom use in rural areas,<br />
improving treatment for AIDS patients and establishing a<br />
referral system for screening and treating people who<br />
are HIV positive.<br />
Progress bar at 31/12/2005<br />
04/2001 31/12/2005<br />
Project > progress<br />
Outlook:<br />
With financial support from<br />
MdM in 2005, the NGO<br />
CIPA should be operationally<br />
and technically autonomous<br />
by 2006.<br />
Human Development Report 2005, UNDP<br />
Mortality<br />
> infant: 81‰<br />
Life expectancy<br />
> at birth: 47.3<br />
HDI<br />
> 0.508; ranked 144/177<br />
Beneficiaries<br />
> indirectly: 172,000<br />
98/99 XX/99<br />
Actual GDP/inhabitant ($)<br />
> 249<br />
Staff<br />
> local: 4 (provision of 46 others to<br />
the local NGO)<br />
Co-ordinators<br />
> project: D. Sevelinge<br />
> field: C. Gulyetonda<br />
> HQ: O. Mouzay<br />
Source of funding<br />
> MdM<br />
Budget<br />
> 2005: 48,676 euros
Vietnam<br />
Mortality<br />
> infant: 19‰<br />
Life expectancy<br />
> at birth: 70.5<br />
HDI<br />
> 0.704; ranked 108/177<br />
Actual GDP/inhabitant ($)<br />
> 482<br />
International delegation<br />
> MdM Canada<br />
Beneficiaries<br />
> directly: 10,000<br />
> indirectly: 275,000<br />
Staff<br />
> local: 14<br />
> expatriate: 1<br />
Co-ordinators<br />
> project: F. Novel<br />
> field: A. Pinon<br />
> HQ: V. Pardessus<br />
Sources of funding<br />
> EU, AESN, MdM<br />
Budget<br />
> 2005: 283,424 euros<br />
Human Development Report 2005, UNDP<br />
The Vietnamese economy is growing rapidly, posting growth of 8%. However, 8%<br />
of the population, i.e. 1.4 million households, still live below the poverty line. In addition,<br />
263,000 people carry the HIV virus in a country where the use of injectable<br />
drugs and prostitution are common practices. Government policy on these issues<br />
is repressive which does not help work amongst these at-risk groups.<br />
Developing medical services<br />
Bac Kan and Thai Nguyen provinces<br />
Activities: The liberalisation of the 1980s deeply affected<br />
the Vietnamese primary healthcare system. Local health posts<br />
found that they had been deprived of their traditional public<br />
funding, and this had an effect on the quality of the service<br />
and the access to healthcare of vulnerable groups. In this<br />
context, promoting preventive health by village health workers<br />
amongst the most disadvantaged groups (women, children<br />
and ethnic minorities) is a priority.<br />
In 2005, this preventive health programme developed the following<br />
activities:<br />
• mother and child healthcare (health education, integrating<br />
the national programme at local level);<br />
• improving health staff's skills;<br />
• access to water and sanitation for homes in three local<br />
authorities (construction of water distribution networks, pit<br />
latrines, organisation and maintenance, education, etc.)<br />
• nutrition and prevention of childhood illnesses (community<br />
development through mothers' groups).<br />
• institutional development of the Hanoi Medical<br />
University (HMU).<br />
Progress bar at 31/12/2005<br />
01/11/2000 31/10/2005<br />
Project > progress<br />
Outlook:<br />
This project was completed in<br />
October 2005 and reached<br />
its objectives. The joint venture<br />
with Hanoi Medical<br />
University is continuing<br />
through a community-based<br />
access to healthcare programme<br />
for vulnerable<br />
groups (including drug users<br />
and prostitutes) in Tay Ho district<br />
in Hanoi.
Access to community-based healthcare<br />
Hanoi<br />
Activities: This access to community-based healthcare programme<br />
for vulnerable groups (including drug users and prostitutes<br />
living with HIV/AIDS), in Tay Ho and surrounding districts,<br />
is the result of a joint venture between Hanoi Medical University<br />
(HMU), the people's committee and Tay Ho district health services,<br />
the sub-department for Social Affairs for the Prevention<br />
of Social Ills (HSSEP) and MdM. At the request of HSSEP, HMU<br />
and MdM proposed offering care, treatment and assistance for<br />
people living with HIV/ AIDS at district level in the context of<br />
public health services and social action.<br />
At the end of 2005, the following activities had been set up:<br />
• a day care centre was opened as part of a district healthcare<br />
centre (HIV testing, primary health consultations, STIs,<br />
opportunistic infections, ARV treatment);<br />
• 2 mobile teams (prevention, needle exchange, condom distribution,<br />
treatment at home);<br />
• solidarity groups;<br />
• training for healthcare staff and social workers.<br />
Progress bar at 31/12/2005<br />
08/2005 08/2008<br />
Preventing and treating HIV<br />
Ho Chi Minh City<br />
Activities: This new three-year programme is based on<br />
the previous programme (PHC for the homeless including<br />
prostitutes and drug users) and the existing structure (day<br />
care centre and mobile teams) and is aimed at the same<br />
groups of people.<br />
During the first year of the project the focus was on:<br />
• treating all cases of STIs screened in the day care centre;<br />
• training local staff in HIV prevention and screening for HIV<br />
infection;<br />
• setting up an HIV screening centre within the day care centre.<br />
Baromètre au 31/12/2004<br />
20/12/2004 19/12/2007<br />
Project > progress<br />
Project > progress<br />
Outlook:<br />
Between now and the end of<br />
2006, 300 patients will be<br />
screened for HIV/AIDS, 50<br />
patients will receive antiretrovirals<br />
and 25,000 people will<br />
be contacted by the mobile<br />
teams and clubs.<br />
Outlook:<br />
Continue STI and HIV/AIDS<br />
screening, increase access to<br />
treatment for opportunistic<br />
infections and STIs. Continue<br />
training staff in HIV prevention,<br />
diagnosis and treatment of<br />
HIV-related illnesses and administering<br />
ARVs. Increase the<br />
number of patients on ARV (53<br />
patients on 31/12/05 150<br />
expected on 31/12/06).<br />
Beneficiaries<br />
> directly: 4,000<br />
> indirectly: 25.000<br />
Staff<br />
> local: 7<br />
> expatriate: 2<br />
Co-ordinators<br />
> project: K. Lacombe<br />
> field: A. Pinon<br />
> HQ: V. Pardessus<br />
Source of funding<br />
> Usaid (PACT)<br />
Budget<br />
> 2005: 15.496 euros<br />
Beneficiaries<br />
> directly: 6,500<br />
> indirectly: 266,000<br />
Staff<br />
> local: 6<br />
> expatriate: 3<br />
Co-ordinators<br />
> project: K. Lacombe<br />
> field: V. Trias<br />
> HQ: V. Pardessus<br />
Source of funding<br />
> Usaid (PACT)<br />
Budget<br />
> 2005: 526,990 euros<br />
100/101
Zimbabwe<br />
Mortality<br />
> infant: 78‰<br />
Life expectancy<br />
> at birth: 36.9<br />
HDI<br />
> 0.505; ranked 145/177<br />
Actual GDP/inhabitant ($)<br />
> 639<br />
Délégations internationales<br />
> MdM Spain and MdM Canada<br />
Beneficiaries<br />
> directly project 1: 350,000 inhabitants<br />
of Chipinge district<br />
> indirectly project 1: 30 community<br />
health workers in Chipinge<br />
Staff<br />
> local: 30<br />
> expatriate: 5<br />
Co-ordinators<br />
> project: C. Moncorgé<br />
> field: F. Azam<br />
> HQ: N. Bréchet<br />
Sources of funding<br />
> MdM, EU, HIVOS<br />
Budget<br />
> 2005: 486,932 euros<br />
Human Development Report 2005, UNDP<br />
The economic situation in this southern African country is disastrous. Living conditions<br />
are increasingly harsh and the impact of the HV/AIDS pandemic is devastating.<br />
26% of the population is HIV-positive. Since the explosion of the HIV/AIDS epidemic,<br />
life expectancy has fallen from 52 years in 1990 to 36 years in 2005. A third of the<br />
adult population is HIV-positive and each day around a hundred new born infants<br />
become HIV-positive.<br />
Out of a total population of 12 million inhabitants, there are around 800,000 orphan<br />
children. It is estimated that nearly 20% of these are HIV-positive. In addition, 90% of<br />
Zimbabweans affected by the virus and requiring antiretroviral treatment do not have<br />
access to it.<br />
Reducing the impact of HIV/AIDS<br />
Chipinge<br />
Activities: After a pilot phase of HIV/AIDS information and<br />
prevention which began in May 2004, MdM France, in partnership<br />
with MdM Canada, MdM Spain and FACT (a local<br />
NGO), is now developing a global approach for the whole of<br />
Chipinge district combining:<br />
• community information and awareness;<br />
• running information and screening centres;<br />
• running home assistance services for immobilised HIV-positive<br />
patients;<br />
• psychosocial and therapeutic support for orphans and vulnerable<br />
children;<br />
• support for the preventive and curative activities of 4 district<br />
hospitals and 44 dispensaries (preventing mother-to-child<br />
transmission, reducing the incidence of STIs, preventing and<br />
treating opportunistic illnesses, setting up and monitoring ARV<br />
treatments);<br />
• training staff and community health workers;<br />
• perational analysis of this model designed on a global scale,<br />
on a community basis, with a view to expanding and replicating<br />
it in other districts, provinces and countries.<br />
Progress bar at 31/12/2005<br />
05/2004 12/2007<br />
Project > progress<br />
Outlook:<br />
In 2006, our teams will work<br />
on consolidating our activities<br />
and setting up antiretrovirals<br />
in Chipinge hospital to bring<br />
the possibility of treatment<br />
closer to the communities.
Future projects<br />
> New projects 2006<br />
Month Country Town/Region Theme<br />
January Rwanda Kigali • Mental health work amongst genocide survivors<br />
Chad N'Djamena • Street children<br />
Daghestan Khassaviourt • Support for primary and secondary healthcare structures<br />
March Niger Keita • Improving the population's health, especially for under 5s, pregnant women<br />
and breast-feeding mothers<br />
EEritrea Afabet • Improving maternal health through obstetric surgery<br />
Nicaragua Puerto Cabezas • Domestic violence<br />
Nepal Dadeldhura • Access to healthcare programme<br />
April Bolivia Potosí and Sucre, • Access to diagnoses on environmental health<br />
Pilco Mayo river<br />
China Shanxi • Early, quality treatment of people living with HIV<br />
Afghanistan Kabul • Harm reduction programme<br />
Kosovo Rahovec • Dental project<br />
Romania Satu Mare • Preventing child abuse<br />
June Serbia Belgrade • Methadone project<br />
Guatemala Chimaltenango • Project denouncing lack of access to healthcare for women working in the maquillas (factories)<br />
September Algeria Algiers • Sexual violence<br />
> Exploratory projects 2006<br />
Month Country Town/Region Theme<br />
January Brazil Maranhao, Pernam- • Street children, rubbish tip sorters, people in Quilombos<br />
buco and Para states<br />
South Sudan Upper Nile • Access to healthcare for returnees<br />
(Koddok and Tonga)<br />
Morocco Rabat • Access to healthcare for migrants<br />
February Laos Xekhong and • Mother and child health<br />
Saravane provinces<br />
India Jaipur • Access to healthcare in the Jaipur shanty towns<br />
Senegal Podor, Gamadji Saré • Access to health care for scattered rural populations<br />
Nicaragua San Bartolo • Maternal health/cervical cancer screening<br />
Yemen - • Identifying a target population<br />
March Sri Lanka Mallavi • Support for surgical activities<br />
Russia - • Migrants<br />
Lebanon Bekaa and Tyre • Access to healthcare for elderly people in Palestinian refugee camps<br />
April Ecuador Tungurahua • Intercultural health project<br />
Kosovo South Serbia, Strepse • Access to healthcare for minorities in enclaves<br />
China Qinghai • Access to healthcare for Tibetan people<br />
May Afghanistan Kabul • Mental health<br />
• Primary healthcare amongst Kuchi nomads<br />
Burundi - • Access to healthcare<br />
Uganda Northern Uganda • Access to healthcare for IDPs (internally displaced persons)<br />
102/103
Action in France<br />
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Introduction to Mission France<br />
A few steps forward, many steps back<br />
Answers in the field of exclusion<br />
For the 19th year, Mission France has managed to<br />
considerably reduce the damage caused by legislators<br />
in the area of exclusion from healthcare. In<br />
2005, the neediest people continued to be stigmatised,<br />
those without papers have become the scapegoats<br />
for the government and the poorest are now<br />
perceived as profiteers or even fraudsters. The<br />
increase in the number of checks, the suspicion and<br />
arrests reinforce deep social decay shown by the<br />
continual rise in the number on income support and<br />
who are thrown out of rented accommodation.<br />
Faced with this deterioration of social relationships,<br />
Médecins du Monde's Mission France has<br />
responded in various ways.<br />
• Migrants in the Calais area are not asylum seekers<br />
but want to migrate to the United Kingdom.<br />
While waiting for the chance to cross the Channel,<br />
they are forced to take refuge in woods or makeshift<br />
shelters. When tracked down by the police,<br />
they are sometimes forced to leave duvets and<br />
clothes which they had found hard to obtain.<br />
A project involving healthcare and bearing witness<br />
is ongoing, a forum has been organised in Paris,<br />
and a strong call has been made to local health<br />
104/105<br />
authorities to provide the hospital at last with a<br />
PASS (permanent service offering access to<br />
healthcare).<br />
• In Guyana, the law is ignored, reinterpreted and<br />
not enforced. The shortage of medical staff is destroying<br />
the access to healthcare system. CMU (universal<br />
health insurance) and AME (state medical aid)<br />
are widely refused by professionals. MdM's Mission<br />
France has set up a healthcare centre and is focusing<br />
especially on pregnant teenagers.<br />
• In the housing crisis, the strictly unacceptable<br />
has become a daily occurrence. We meet families<br />
with children on the street, who remain there! Urban<br />
space has been reshaped so that it is no longer possible<br />
to lie down or take refuge there. Making the<br />
unacceptable visible was what the Paris<br />
Homelessness project did when it acquired tents for<br />
the homeless: people could no longer ignore what<br />
used to be just a shadow under a porch. We continue<br />
our efforts to seek a reaction from the authorities.<br />
• For sick homeless people, we have made a<br />
major contribution to making healthcare hostel beds<br />
more permanent. The working group led by the<br />
Social Work Directorate General has drawn up clear<br />
and ethical specifications. Definite progress.
Introduction aux missions France<br />
• State medical assistance will once again<br />
have been the government's focus in the middle<br />
of the summer… Decrees making access to<br />
healthcare for those without papers even more<br />
difficult were issued at the end of July. Hours of<br />
discussions between associations and the<br />
ministry were necessary before they agreed to<br />
write a circular limiting the damage.<br />
• The health insurance reform removes the<br />
possibility of healthcare centres run by associations<br />
referring patients for additional examinations.<br />
On MdM's initiative, a collective sent 10<br />
questions to the Health Ministry concerning the<br />
consequences of this reform on the neediest<br />
people. After seven months, we received an<br />
answer the substance of which was that people<br />
with problems should overcome them!<br />
• Médecins du Monde in Europe decided to<br />
bear witness to how difficult it is for those<br />
without papers to get access to healthcare, and<br />
to fight against the expulsions of seriously ill<br />
foreigners to countries where they will not<br />
receive care - to fight, therefore, against, a<br />
death sentence which albeit administrative is<br />
actually fatal! This is the purpose of the Access<br />
to Healthcare Monitoring Centre in Europe set<br />
up in 2005. It took some 900 letters, 50 meetings<br />
with MEPs and a cross-disciplinary investigation<br />
in 5 countries.<br />
• Drug users are surrounded by new doubleedged<br />
institutional measures. Although some<br />
advances have been made, RdR policies receive<br />
little funding and are burdened by a heavy<br />
administrative yoke. Most of MdM's RdR workers<br />
will be forced to set up autonomous associations<br />
to meet these new requirements, but<br />
are likely to find themselves in a federation<br />
intended to bear witness to the advances needed<br />
in risk reduction related to the use of<br />
psychoactive substances.<br />
Our projects continue to provide these skills in<br />
new and dynamic ways. In 2005, the biennial<br />
meetings of those involved in Mission France<br />
enriched the 212 participants and provided a<br />
forum to think about how to improve the quality<br />
of our practices, and about the challenges<br />
we need to take up in the area of prevention,<br />
treating mental illnesses as well as the suffering<br />
caused by living conditions and past trauma.<br />
Nathalie Simonnot,<br />
Mission France co-ordinator
The homeless and poorly housed<br />
Housing is a fundamental right; however, many people do not have access to it.<br />
Today in France there are approximately 100,000 homeless people and more than 3<br />
million are in sub-standard housing. The fires in dilapidated Paris hotels (nearly 50<br />
dead, most of them children) and the suburban riots have put the housing crisis back<br />
at the heart of public debate. Nearly 61% of patients seen by Mission France are<br />
homeless or live in sub-standard housing.<br />
> Housing, a fundamental right<br />
Since 1993<br />
Activities: Faced with the problems of people living in the Outlook:<br />
street who are too marginalised and weakened to make use Continue field work amongst<br />
of the public structures, MdM has developed mobile actions. the most needy people<br />
There are two objectives:<br />
(street work, welfare and<br />
• to inform people of their rights to access to healthcare, medical treatment, medical<br />
and refer and accompany them to public structures; consultations and nursing<br />
• to see those without sickness cover in healthcare cent- care in accommodation hosres<br />
until they regain their rights. Every year, MdM takes action, tels, work in partnership with<br />
in winter and in summer, requesting accommodation and long- health and accommodation<br />
term housing. From its experience on the ground, MdM is structures, involvement in<br />
continuing to bear witness to the harmful consequences the “cold weather plan”) and<br />
to health of the lack of housing as well as of poor hou- political action (bearing witsing.<br />
The discontinuity and unsuitability of accommodation ness, lobbying institutions to<br />
worsen the health of the neediest. Teams in France work throu- set up long-term accommoghout<br />
the year watching the situation in the context of patrols, dation structures suitable to<br />
medical consultations in accommodation centres and nursing the needs of the homeless).<br />
beds, etc. In 2005, DGAS (the Social Work Directorate General)<br />
asked MdM to take part in a thinktank and to draw up specifications<br />
formalising “healthcare hostel beds” and this led to<br />
a circular on how these beds should operate and be funded.<br />
In December 2005, the Paris homelessness project was heavily<br />
involved in distributing “igloo” tents to the homeless and<br />
to alerting the authorities to the urgent need to overhaul their<br />
accommodation provisions.<br />
Types of work<br />
> > Medical and welfare consultations, patrols: Le Havre,<br />
Marseilles, Metz, Nice, Paris, Strasbourg, Toulouse, Valenciennes.<br />
> > Medical consultations for the homeless in “healthcare hostel beds”:<br />
Bordeaux, Grenoble, Lyons, Strasbourg, Toulouse.<br />
> Ecoute santé (Health Listening post): Angoulême.<br />
> Consultations with other associations (Restos du cœur,<br />
Salvation Army, Abbé Pierre centres, Secours catholique, Aides,<br />
Point écoute santé jeunes…): Grenoble, Le Havre, Lyons, Metz,<br />
Nancy, Nantes, Reunion, Toulouse, Valenciennes.<br />
> Consultations in emergency accommodation centres: Lyons,<br />
Metz, Nice, Toulouse.<br />
> Welfare and health work in squats: Bordeaux, Paris.<br />
Number of projects<br />
> 16<br />
Number of volunteers<br />
> 182<br />
106/107<br />
Number of homeless in<br />
France<br />
> 86,500 people (source Insee, institute<br />
for economic and statistical<br />
information)<br />
Number of poorly housed<br />
> > 3.2 million (source Abbé Pierre<br />
Foundation)<br />
Most common conditions<br />
> dermatology problems, trauma, psychiatric<br />
problems, psychological suffering,<br />
ENT and respiratory infections<br />
Contacts with homeless<br />
> approx. 10,000<br />
> 17.8% of people seen in CASOs are<br />
homeless, and 43.4% live in insecure<br />
housing<br />
Characteristics<br />
of homeless seen in CASOs:<br />
> 26% are women<br />
> 60% are under 35<br />
> 8.6% are minors<br />
> 75% do not have the right to sickness<br />
cover<br />
Sources of funding<br />
> Local health authorities, town councils,<br />
department councils, etc.<br />
Main partners<br />
> Abbé Pierre Foundation, Secours<br />
catholique, Emmaüs, Red Cross,<br />
Restos du cœur, Samu social, DAL,<br />
local charities (Péniche, Amis de la<br />
rue, le Fournil, GAF, Enfants du<br />
monde, Droit de l'homme EMDH),<br />
etc.
Migrants<br />
All projects (healthcare<br />
centres, mobile projects)<br />
see immigrants in their<br />
programmes<br />
(in healthcare centres,<br />
30% are asylum seekers).<br />
Beneficiaries<br />
> 89% of patients seen for the first<br />
time are foreigners<br />
> 60% of them are illegal and 30%<br />
have applied for asylum<br />
Country of origin<br />
> Algeria, Romania, Morocco, Cameroon,<br />
Tunisia, etc. (Other nationalities turn up<br />
in different centres)<br />
Main conditions<br />
> osteo-articular, ENT, gastro-enterology,<br />
psychiatry, dermatology, gynaecology-obstetrics,<br />
psychological<br />
problems<br />
> 88% of foreigners seen have not<br />
acquired the right to health insurance<br />
when they are seen at a<br />
healthcare centre for the first time<br />
Number of projects<br />
> all programmes (centres, mobile<br />
actions and harm reduction programmes)<br />
Number of volunteers<br />
> nearly 2,000<br />
Sources of funding<br />
> Regional & local health authorities,<br />
department councils, regional councils,<br />
regional and national health<br />
insurance offices (CRAM, CPAM),<br />
etc.<br />
Partners<br />
> CASP, Cimade, Gisti, LDH, Anafé<br />
(National association helping foreigners<br />
at borders), CFDA (Committee for the<br />
right to asylum), Comede, involvement<br />
in ODSE (European monitoring centre<br />
for access to healthcare), local or regional<br />
association committees, etc.<br />
><br />
The 2003 law on immigration and the 2004 law on asylum have already made it harder<br />
to obtain a residence permit and refugee status, but the planned reform of the<br />
rules for foreigners entering and staying in the country and the right of asylum risks<br />
making a difficult situation even more difficult for prospective immigrants, asylum<br />
seekers and sick foreigners. The state medical aid reform of 2004 and July 2005<br />
makes it even harder for foreigners living irregularly in France to get access to healthcare.<br />
The health insurance reform which requires people to choose a regular doctor<br />
also penalises homeless people including migrants. More than 89% of patients in<br />
Médecin du Monde's healthcare centres are foreigners: they have more problems in<br />
getting sickness cover as they do not know their rights or how to acquire them.<br />
Facilitating access to healthcare<br />
Since 1986…<br />
Activities:<br />
• Healthcare centres: In 2005, the 21 healthcare centres<br />
saw 89% foreigners and carried out 45,783 medical consultations.<br />
The main obstacles to access to healthcare and rights<br />
quoted by people are lack of access to an address, financial<br />
difficulties, poor knowledge of rights and systems, administrative<br />
difficulties and the language barrier. MdM plays a bridging<br />
role and, where possible, refers people to the public health<br />
and welfare systems. Journeys into exile, often the source of<br />
major psychological and physical suffering, are taken into<br />
account, and psychological support work is being developed.<br />
The Paris and Marseilles CASOs have set up a specific<br />
HIV/hepatitis/STI prevention and screening programme.<br />
• CAFDA (Committee for asylum-seeking families)<br />
Project: MdM has set up reception, health and referral consultations<br />
for newly-arrived asylum-seeking famlies with a partner,<br />
CAFDA. In 2005, CAFDA received and housed more than<br />
5,000 people of 79 nationalities. 1,298 people (of 51 different<br />
nationalities) newly arrived at CAFDA were seen by the MdM<br />
team in 2005, i.e. 462 families.<br />
Types of work<br />
> All the projects provide consultations, dispense prevention messages<br />
and refer migrants to partners and public health systems.<br />
Testimonies on insecure living conditions linked to administartive status,<br />
the length of proceedings and housing difficulties are the basis<br />
for specific work to restrict the decline in migrants' rights.<br />
Outlook:<br />
MdM continues to work<br />
towards each person, whatever<br />
his administrative status,<br />
having immediate<br />
access to health insurance<br />
and being referred to existing<br />
health structures.<br />
Mission France is continuing<br />
to develop HIV, hepatitis and<br />
STI prevention and screening<br />
programmes, as well as<br />
programmes for treating<br />
migrants' psychological suffering.<br />
The European Access<br />
to Healthcare Monitoring<br />
Centre (started in 2004) lobbies<br />
European Union institutions<br />
and bears witness to<br />
the difficulties of getting<br />
access to healthcare for<br />
people living in insecure<br />
situations, on the basis of<br />
data collected on the ground<br />
(MdM works in 11 European<br />
Union countries).
Children<br />
Children are needier when faced with exclusion, poverty and illness. According to a<br />
CERC (Council for Employment, Income and Social Cohesion) report, 2 million children<br />
in France live below the poverty line and the number of isolated minors is estimated at<br />
40,000. In addition, an INSEE (the national institute for economic and statistical information)<br />
survey shows that 16,000 children are homeless. As well as paediatric monitoring<br />
in healthcare centres, Médecins du Monde has initiated projects to fight against<br />
lead poisoning, aimed at locating and protecting children from this. The Buddy project<br />
provides support to children separated from their families by hospitalisation.<br />
> Protecting isolated victims<br />
Buddy Project 1988 >… / Lead poisoning project 1993 >…<br />
Activities:<br />
• Hospital buddies: “an energy transfusion”. Buddies visit<br />
the child they support three times a week, including once<br />
during the weekend. The visits mean they can support isolated<br />
children while they are in hospital. They also help to break<br />
down loneliness, the children's needs are listened to and they<br />
are given the strength to fight on. The volunteer makes contact<br />
with the nursing team and helps maintain the relationship with<br />
the child's family in terms of respecting his or her identity and<br />
culture. Buddies are monitored by experienced co-ordinators,<br />
and always complement the nursing team. At the end of 2005,<br />
the project was introduced in Cayenne hospital.<br />
• Lead poisoning: lead poisoning affects the central nervous<br />
system. The consequences are irreversible and there is no<br />
treatment. Young girls who are poisoned pass the lead on to<br />
their babies twenty years later.<br />
MdM's work involves locating unhealthy housing so that families<br />
are warned and informed and affected children are protected.<br />
Child screening and protection activities are carried<br />
out in connection with state services, health workers, MCW,<br />
paediatricians, school doctors and local hygiene services.<br />
MdM is calling for a voluntarist policy to fight against child lead<br />
poisoning.<br />
Types of work<br />
> Lead poisoning project: seven towns in Hauts-de-Seine, Poitiers.<br />
Locating, screening, protecting children, involvement of institutions<br />
and medical staff.<br />
> Hospital buddies: Paris and the Paris area; Guyana.<br />
Personalised monitoring of hospitalised children away from their<br />
families.<br />
> Healthcare centres: paediatric consultations, referrals to MCW.<br />
> All healthcare centres see children.<br />
Outlook:<br />
• Buddies:<br />
Set up the project in the<br />
provinces in MdM's regional<br />
delegations in Marseilles and<br />
Lyons. Make a link with<br />
Saint-Denis hospital in<br />
Reunion. Develop training for<br />
volunteers and co-ordinators<br />
to improve the quality of listening<br />
and presence<br />
amongst the children in<br />
hospital.<br />
• Lead poisoning:<br />
Despite withdrawing at the<br />
end of 2004, Mission France<br />
in Bordeaux is staying in<br />
contact with the families<br />
monitored for four years.<br />
MdM's Suburbs project<br />
wants to consolidate its network<br />
so that the fight<br />
against child lead poisoning<br />
can continue without MdM,<br />
who will then be able to<br />
work in other towns around<br />
Paris. The Poitiers team is<br />
continuing its work.<br />
GUYANE<br />
108/109<br />
Beneficiaries<br />
> 1,693 children (under 15s) were<br />
seen in healthcare centres in 2005<br />
Main conditions<br />
> ENT, pneumology, lead poisoning,<br />
serious illnesses requiring long<br />
periods of hospitalisation<br />
Sources of funding<br />
> Local health authorities, CPAM<br />
(health insurance office),<br />
department councils, etc<br />
Buddies<br />
> number of children with buddies in<br />
2005: 111<br />
> number of volunteers:<br />
92 in Paris, 14 in Guyana<br />
> buddy partners:<br />
6 AP-HP (Paris) hospitals, 6 longstay<br />
centres in the Paris area,<br />
Cayenne hospital in Guyana<br />
Lead poisoning<br />
> number of children affected:<br />
85,000 poisoned, of which only<br />
5% screened (Inserm (national<br />
medical research institute) figures<br />
1999)<br />
> number of projects: 2<br />
> number of volunteers: 21<br />
> lead poisoning partners:<br />
Association of lead poisoningaffected<br />
families, Pact Arim, local<br />
health authorities, local hygiene<br />
services, MCW, doctors, hospitals,
Roma<br />
Main conditions<br />
> illnesses linked to living conditions,<br />
delay in accessing healthcare (in<br />
France and in their country of<br />
origin), and psychological trauma<br />
caused by repeated expulsions<br />
Epidemiological<br />
characteristics<br />
>Early neonatal mortality (0-1 month)<br />
nine times higher, infant mortality<br />
(0-1 year) five times<br />
higher, life expectancy 15 to 20<br />
years below that of the French<br />
population<br />
(Romeurope data, 1998)<br />
Number of projects<br />
> 4<br />
Number of beneficiaries<br />
> approx. 3,500 of whom more than<br />
2,000 in Ile-de-France (estimate)<br />
Number of volunteers<br />
> 76<br />
Sources of funding<br />
> Local health authorities,<br />
department councils, etc.<br />
Partenaires<br />
> Alpil, ASAV, ATD Fourth World,<br />
LDH, MRAP, Roma family support<br />
collectives, Romeurope, sector<br />
MCW, town councils, PASS (permanent<br />
access to healthcare service,<br />
etc.…<br />
><br />
The Roma have suffered racial discrimination and poverty in their countries of origin<br />
and are now living in deplorable conditions in France in shanty towns or squats.<br />
Repeated expulsions make them ever needier and make their lives even more insecure.<br />
Often forced into acting clandestinely, the Roma are often refused access to<br />
healthcare, and more generally, to their fundamental rights.<br />
Supporting expelled families<br />
1992, Suburbs Project: the 1st programme amongst migrant Roma<br />
Activities: MdM continues to visit places where the Roma<br />
live to help them get access to healthcare and their rights (universal<br />
health insurance and state medical aid). This health<br />
watch is aimed particularly at health education and promotion,<br />
schooling for children, help for access to drinking water<br />
and mother and child health. The mobile project amongst<br />
Roma in Lyon visited 17 places in 2005 and met nearly 1,000<br />
people, 56% of them women. The expulsion policy to which<br />
Roma are subject aggravates their already insecure living conditions<br />
even more. All their affairs are often destroyed, and<br />
contacts with healthcare structures and schools broken, etc.<br />
Their wandering forces them to settle in shanty towns, thus<br />
making it harder to access their fundamental rights and delaying<br />
or preventing the work of the medical and welfare teams working<br />
amongst them.<br />
Types of work<br />
> Health prevention and education, primary healthcare, help for children's<br />
schooling, access to drinking water, implementing sanitary<br />
measures, etc<br />
> Antenatal work: preventing terminations, monitoring pregnancies,<br />
information on contraception, child vaccinations, MCW support and<br />
in family planning centres.<br />
> Bearing witness to living conditions, repeated expulsions, obstacles<br />
to access to healthcare and rights.<br />
> Involvement of Roma family support committees, health workers,<br />
town councils and state services.<br />
Outlook:<br />
Continue local health work<br />
on the ground, with an<br />
emphasis on children and<br />
rights to health, and continue<br />
to develop mother and<br />
child health work. As part of<br />
the Romeurope collective,<br />
MdM will continue to work<br />
alongside other member<br />
associations against the<br />
discrimination and human<br />
rights violations of which the<br />
Roma are victims in France<br />
(expulsions from living places,<br />
police harassment,<br />
arrests, removals from the<br />
area, etc) and to improve<br />
access to fundamental rights<br />
for migrant Roma in France<br />
(right to health protection,<br />
housing, work and education).
Travellers<br />
Although the Besson law on travellers is not complied with, insofar as only 15% of<br />
towns with more than 5,000 inhabitants have fulfilled their obligations concerning<br />
sites for travellers, other plans do threaten them.<br />
In December 2005, a French MP managed to have an amendment to the national<br />
budget passed instituting a tax on caravans. This state tax (of several tens of euros<br />
per m2), which is not in any way a housing tax, does not give any welfare rights for<br />
housing. Associations defending travellers' rights are calling for this tax to be withdrawn<br />
as it is neither legitimate nor fair. They reaffirm the priority of having caravan<br />
housing recognised with all the welfare rights related to housing, and are asking to<br />
take part in the authorities laid down by the law, namely the National Consultative<br />
Committee, for all subjects concerning travellers, and Halde (the high authority in the<br />
fight against discrimination and for equality).<br />
><br />
Since 1997…<br />
Activities: MdM's mobile teams have two aims: to meet<br />
travellers whre they live and help them to have their rights recognised.<br />
In fact, there are very few sites for them, and where they exist,<br />
the living conditions are very insecure: no sewers, poor access<br />
to running water and electricity, the presence of rats, a lack<br />
of toilets. MdM is carrying out the following activities:<br />
• support, listening and referral activities;<br />
• activities aimed at facilitating access to healthcare,<br />
rights and schooling for children;<br />
• lobbying the public administrations to ask for sites to be<br />
created for travellers.<br />
Facilitating access to fundamental rights<br />
Types of work<br />
> Listening, psychological support, prevention and information messages.<br />
> Primary healthcare, help for schooling and access to housing,<br />
referral to other public welfare and health structures.<br />
> Lobbying town councils, health institutions and professionals to<br />
improve hygiene, living and health conditions; actions to recognise<br />
citizenship.<br />
> Involvement in department-level consultative committees for the<br />
plan to deal with travellers.<br />
Outlook:<br />
Continue activities to improve<br />
hygiene, living and health<br />
conditions for travellers, facilitating<br />
their access to public<br />
health and welfare structures<br />
and more generally to citizenship.<br />
The expert status<br />
acquired by the MdM<br />
Bordeaux team has allowed<br />
it, together with Gypsy associations<br />
and personalities<br />
working with the traveller<br />
community, to create a coordinating<br />
body whose aim<br />
is to contribute to putting in<br />
place suitable conditions for<br />
the traveller community.<br />
MdM's teams are involved<br />
with several authorities<br />
including the departmentlevel<br />
consultative committees<br />
for the plan to deal<br />
with travellers.<br />
Number of projects<br />
> 2<br />
Number of volunteers<br />
> 7<br />
110/111<br />
Number of beneficiaries<br />
> approx. 100 families<br />
Main conditions<br />
> depression, insomnia, cardiovascular<br />
diseases, addiction problems<br />
linked to living conditions<br />
and life style<br />
Social characteristics<br />
> isolation, lack of schooling,<br />
desocialisation<br />
Sources of funding<br />
> Regional health authorities and<br />
health insurance agencies<br />
Partners<br />
> Relais accueil gens du voyage,<br />
co-ordinating body for work<br />
amongst travellers, Centre social<br />
des Alliers, LDH, CCAS (local<br />
social work centres), schools,<br />
town councils, etc.
People working in prostitution<br />
Characteristics<br />
> people mainly from Eastern Europe,<br />
Sub-Saharn Africa and China, either<br />
holding tourist visas, applying for<br />
asylum or staying illegally, sometimes<br />
the victims of trafficking.<br />
Sex, age<br />
> mainly 20 to 40 year old women,<br />
transgendered people, men and<br />
sometimes minors<br />
Main conditions<br />
> gynaecology conditions, illnesses<br />
linked to street conditions, psychological<br />
illnesses linked to stress, isolation<br />
and ill-treatment, addictions<br />
Number of projects<br />
> 6 mobile teams/projects working<br />
amongst people involved in prostitution,<br />
in the street, often in close<br />
collaboration with CASOs and harm<br />
reduction programmes linked to<br />
drug use<br />
Number of beneficiaries<br />
> very hard to obtain data, probably<br />
around 1,000<br />
Number of volunteers<br />
> 117<br />
Partners<br />
> Cabiria, Amis du bus des femmes,<br />
Aides, local health authorities,<br />
Gasprom, Platfrom for the fight<br />
against human trafficking, anonymous<br />
screening centres (CDAG),<br />
health insurance office (CPAM), town<br />
councils, family planning centres,<br />
psychiatric emergency care, Samu<br />
social<br />
><br />
The internal security law which created the offence of passive soliciting and the massive<br />
police presence contribute to the repressive situation which restricts access to<br />
healthcare and to prevention material for people working in prostitution. These people<br />
are exposed to risks of sexually transmitted infections; they are sometimes drug<br />
addicts and in certain cases the victims of trafficking. They are in an extremely vulnerable<br />
situation, made worse by being criminalised.<br />
Support through prevention and information<br />
Since 1999 as a theme in its own right<br />
Activities: In a climate marked by a clear increase in violence<br />
against them, people working in prostitution find themselves<br />
in an extremely vulnerable situation with less access to<br />
associations and prevention material. Accommodation difficulties<br />
and slow access to rights are additional obstacles to<br />
getting healthcare. Médecins du Monde's work particularly<br />
involves mobile activities, health promotion and<br />
harm reduction concerning prostitution practices, with<br />
welfare, medical, administrative and legal support. The<br />
teams are keen to give information, adapted and translated if<br />
necessary, on risks linked to STIs, HIV, hepatitis and on rights.<br />
• In Le Havre, MdM has had to stop its work, as the police<br />
presence everywhere has led to the people working in prostitution<br />
disappearing completely from the streets.<br />
• In Poitiers, as part of the Abri collective, MdM started work<br />
amongst people working in prostitution in September 2005.<br />
• In Rennes, the exploratory project carried out in 2005 did<br />
not lead to setting up a specific programme.<br />
Types of work<br />
> All our programmes offer referrals to screening for HIV, VHB and<br />
VHC, distribute prevention material, listen, promote people's rights,<br />
inform and refer to public structures.<br />
> Metz: an itinerant structure set up with Aides.<br />
> Montpellier: as well as evening work in the city centre, a daytime<br />
weekly visit is organised on the main roads.<br />
> Nantes: physical accompaniment to hospitals and for any health<br />
care, for access to rights, to file complaints, and to courts for cases<br />
of soliciting. Help to register for literacy courses. Set up thematic<br />
health workshops.<br />
> Paris: information adapted and translated into Chinese, support<br />
and referral with interpreters.<br />
> Poitiers: patrols set up as part of a collective.<br />
> Rouen: a rota for bus visits set up, thanks to synchronisation with<br />
work of the Aides association and an infectious diseases screening<br />
project.<br />
Outlook:<br />
The projects want to work<br />
on and develop the testimony<br />
aspect, especially on the<br />
consequences of the internal<br />
security law on health and<br />
welfare for people working in<br />
prostitution.
HR & Needle Exchange<br />
The decree of 14 April 2005 legally recognises the harm reduction (RdR) policy. It has<br />
now been proved that needle exchange programmes are effective: they reduce needle<br />
and straw sharing, and therefore the risk of transmitting AIDS or hepatitis C. They<br />
also greatly reduce the risk of overdoses and allow drug users to be referred to health<br />
and welfare structures. This public health approach allows marginalised users to have<br />
access to welfare, healthcare, information, referral and support systems.<br />
Going to a marginalised population<br />
1996, granting of access prevention kit licence to Ministry of Health<br />
Activities: The distribution of sterile equipment, which Outlook:<br />
is fundamental to reducing the risks of taking drugs,<br />
means contact can be made with an often marginalised<br />
population who, without these programmes, would not<br />
have access to information and public treatment structures.<br />
Having made contact, the teams can pass on prevention<br />
messages, listen and refer drug users on medical, welfare<br />
or legal matters such as accommodation, rights, regularising<br />
legal situations, withdrawal, post-treatment care and substitution<br />
treatments. In Paris saliva tests to screen for hepatitis<br />
C are offered and, as well as allowing medical treatment if the<br />
result is positive, also mean that the team can talk to the person<br />
and give him more help. Other tools are used in this harm<br />
reduction process according to the context: inhalation straws<br />
for sniffers, crack pipe mouthpieces to avoid burns and VHC<br />
contamination, Sterifilt to filter non-injectable substances at<br />
the end of the needle. The field teams are continually involved<br />
in research and survey work on tools and prevention messages<br />
to improve their effectiveness. The street work often complements<br />
the work carried out in the mobile units.<br />
Types of work<br />
> 4 mobile structures: buses, vans and teams on foot amongst drug<br />
users in the street or in squats.<br />
> 1 permanent centre in Bordeaux, 1 permanent needle exchange<br />
centre in Paris and Marseille.<br />
> Sterile injection material made available in all CASOs<br />
> 236,808 needles given, 36% used needles returned.<br />
Encourage measures to<br />
make exchanges with users<br />
easier along the line of saliva<br />
tests for screening hepatitis<br />
C. The development of polyconsumption<br />
requires new<br />
tools to be created, especially<br />
linked to crack consumption.<br />
Since January 2006,<br />
needle exchange programmes<br />
have been recognised<br />
as medical and welfare institutions<br />
and are funded by<br />
health insurance as<br />
CAARUDs (Centres for supporting<br />
harm reduction for<br />
drug users) on condition that<br />
they carry out specific work<br />
(reception, referral, support,<br />
etc).<br />
As part of the move to becoming<br />
CAARUDs, the Paris,<br />
Bordeaux and Marseille programmes<br />
must leave MdM in<br />
2006 and become autonomous<br />
associations set up by<br />
the field teams supported by<br />
MdM.<br />
112/113<br />
Most common conditions<br />
> risks of infections linked to the<br />
intravenous use of drugs (VHC, VIH,<br />
VHB), abcesses, psychiatric co-morbidity,<br />
dental problems, psychological<br />
problems linked to exclusion<br />
> risks of marginalisation, discrimination<br />
and social harm<br />
Report from our programmes<br />
> clear development towards polyconsumption<br />
of injected and noninjected<br />
products. Persistence of<br />
strong prevalence of hepatitis C<br />
amongst injecting users<br />
Number of beneficiaries<br />
> factive file of nearly 2,600 IV<strong>DU</strong>s<br />
from 12,500 visits to mobile units<br />
and permanent centres. More than<br />
19,000 other contacts (for information,<br />
referrals and requests other<br />
than for material)<br />
Number of volunteers<br />
> 35 in multidisciplinary teams<br />
Sources of funding<br />
> mainly the state via local health<br />
authorities, local authorities, health<br />
insurance offices (CPAM), the<br />
National Fund for Health Prevention,<br />
Education and Information (FNPEIS),<br />
town councils, Ile de France regional<br />
health insurance office (CRAMIF)<br />
Partners<br />
> Department of Health, MILDT<br />
(Interdepartmental Committee for the<br />
fight against drugs and drug addiction),<br />
OFDT (French monitoring centre<br />
for Drugs and Drug Addiction) and<br />
all RdR structures in towns where we<br />
work.
Methadone Buses<br />
Drug users<br />
> approx. 200,000 injectors<br />
Main conditions<br />
> HIV, VHB, VHC contamination<br />
amongst injectors, psychiatric<br />
co-morbidity, psychological<br />
suffering linked to exclusion<br />
Number of projects<br />
> 2 methadone buses<br />
Number of beneficiaries<br />
> active file: 767 in 2 towns<br />
Number of contacts<br />
> an average of 100 contacts per<br />
day in Paris and 30 in Marseilles<br />
Number of volunteers<br />
> 23<br />
Sources of funding<br />
> CPAM (health insurance offices),<br />
local health authorities, Solidarité<br />
sida, Sidaction; MILDT<br />
(Interdepartmental committee on<br />
drugs and drug addiction), local<br />
and regional authorities<br />
Partners<br />
> ASUD, TIPI, Aides Provence,<br />
Sleep'in, HAS, emergency accommodation<br />
hostels, other drug addiction<br />
treatment centres (CSST) in<br />
Marseilles and Paris<br />
(especially Fernand-Vidal and<br />
Marmottan), hospitals, treatment and<br />
post-treatment institutions, etc.<br />
><br />
As methadone subsitution relieves withdrawal sensations, it reduces the risks linked<br />
to drug use, as well as helping the social and health reintegration of drug users, who<br />
are particularly vulnerable and often marginalised.<br />
Local work on a daily basis<br />
Since 1998<br />
Activities: The programmes are aimed at particularly marginalised<br />
users not covered by any other structure, and offer<br />
services at the level of need suited to the user's situation. A<br />
methadone dose is delivered daily to the patients on the programme.<br />
Patients are included from the day they request it,<br />
in the permanent centre after a medical interview. The programmes<br />
are aimed at treating opiate dependency by starting<br />
and continuing methadone substitution treatment.<br />
The programme includes monitoring the most problematic<br />
users; the aim is to refer patients to other structures. The buses<br />
act as bridges towards more permanent treatment systems.<br />
They are parked close to places where drugs are taken and<br />
provide a place where people can be seen and referred for<br />
medical, psychological and social care.<br />
Types of work<br />
> Mobile healthcare unit manned 7 days a week.<br />
> Local mobile teams.<br />
> Reception in a permanent centre.<br />
Outlook:<br />
In Paris, the team has been<br />
involved in a think-tank with<br />
the help of a philosopher on<br />
innovative therapeutic practices<br />
which should lead to a<br />
written paper in 2006. In<br />
Marseille, the team has formed<br />
an RdR platform which<br />
offers, in connection with the<br />
methadone bus's services,<br />
several types of work adapted<br />
to the people encountered<br />
in squats, nightlife<br />
venues, during street work,<br />
etc by offering suitable tools.<br />
These activities are run with<br />
operational partners (ASUD,<br />
TIPI, etc.).<br />
On the other hand, during<br />
2006, the 2 methadone<br />
buses (as well as the NEPs)<br />
are going to leave MdM. The<br />
association GAIA Paris will<br />
take over running the Paris<br />
CSST (drug addiction centre)<br />
and the association BUS<br />
31/32 will take over in<br />
Marseilles. These 2 associations<br />
have been set up<br />
especially for this purpose<br />
by the field teams and will<br />
continue to have strong links<br />
with MdM.
Raves<br />
Young people are taking more and more synthetic drugs. But the ban on raves forces<br />
participants into clandestine behaviour with all the related risks: poor security conditions,<br />
no medical support, nobody present from associations or institutions to provide<br />
prevention messages. The decree of 14 April 2005 banning testing for drugs is a<br />
real brake on our approach to these people. It was an essential tool for initiating<br />
discussions about prevention and for making users take responsibility for their<br />
drug-taking.<br />
Informing about risks<br />
Since 1997<br />
Activities: MdM's Raves project is involved in harm<br />
reduction work linked to the use of psychoactive substances.<br />
It has two main aspects:<br />
• health and prevention: offer places for medical care where<br />
people can be seen and listened to. The teams deal with minor<br />
cuts and bruises and emergencies. Prevention messages are<br />
given concerning the risks of taking drugs, cultural practices<br />
(tattoos, piercing, etc.), and STI, HIV and hepatitis transmission,<br />
etc;<br />
• analysis, on site using TLC (thin-layer chromatography)<br />
and testing (until April 2005, when testing was banned),<br />
and in a laboratory, of the components of the<br />
substances in circulation in order to adapt the prevention<br />
messages appropriately. Since 1999, MdM has been<br />
involved in the SINTES (National system for identifying toxins<br />
and substances) programme.<br />
In 2005, the Paris Raves project redirected its activities to<br />
squats. The team sets up RdR stands each Friday evening,<br />
visits around three squats each week and practices TLC analysis<br />
to identify the substances contained in the drugs taken.<br />
120 squats were visited and 36 RdR sessions were held in<br />
Paris (in all, more than 3,400 RdR contacts). The Marseilles<br />
RdR project also extended its activities into squats in 2005.<br />
Types of work<br />
> All the projects offer first aid, information and substance analysis in<br />
a harm reduction approach linked to drug use.<br />
> Work in places where young people gather such as free parties,<br />
teknivals, discotheques, clubs, squats, etc.<br />
> In 2005, 78 samples of synthetic drugs were collected, documented<br />
and analysed under the SINTES programme co-ordinated by<br />
OFDT (French monitoring centre for drugs and drug addiction).<br />
Outlook:<br />
Adapt the types of work the<br />
projects do to an increasingly<br />
difficult context where<br />
young people are dispersed<br />
and less and less accessible.<br />
Develop prevention<br />
tools and flyers, appropriate<br />
to the growing context of<br />
polyconsumption.<br />
Beneficiaries<br />
> approximately 40,000<br />
114/115<br />
Types of products<br />
> alcohol, ecstasy, cocaine, and<br />
other hallucinogens, amphetamines,<br />
heroin, anaesthetic substances<br />
(GHB, ketamine)<br />
Health problems<br />
encountered<br />
> headaches, vomiting, dizziness,<br />
psychological problems, anxiety<br />
attacks<br />
Most common risks<br />
> dehydration, bad trips,<br />
hyperthermia, hypoglycaemia<br />
Sex, age<br />
> mainly men, average age: 24<br />
Number of instances of<br />
treatment<br />
> 75 including 3 joint projects<br />
at teknivals<br />
Number of volunteers<br />
> 180<br />
Sources of funding<br />
> Ministry of Health, local health<br />
authorities, MILDT (interministerial<br />
committee on drugs and drug<br />
addiction), OFDT (French monitoring<br />
centre for drugs and drug<br />
addiction), local authorities<br />
Partners<br />
> Techno Plus, Aides, Orange<br />
Bleue, ASUD, TIPI, Act Up,<br />
Acothé, Nantes daytime reception<br />
centre, Espace indépendance,<br />
Sida paroles, Fratrie
Contacts (CASOs - Free Healthcare and Guidance Centres)<br />
> AIX-EN-PROVENCE<br />
Philippe ROQUEJEOFFRE Médecins<br />
du Monde Maison de la Solidarité<br />
Rue Philippe-Solari<br />
13100 Aix-en-Provence<br />
Tel.: 04 42 21 45 84<br />
Fax: 04 42 21 62 48<br />
medmondaix@wanadoo.fr<br />
> AJACCIO<br />
François PERNIN<br />
Médecins du Monde c/o Secours<br />
catholique<br />
6, bd Casanova<br />
20000 Ajaccio<br />
Tel.: 04 95 51 28 93<br />
Fax: 04 95 21 17 13<br />
All mail: F. Pernin<br />
La Gravona<br />
20000 Ajaccio<br />
Tel.: 04 95 29 90 75<br />
Fax: 04 95 29 94 24<br />
mdmcorse@wanadoo.fr<br />
> ANGERS<br />
Isabelle SALAUN, Frédéric VIE<br />
Médecins du Monde<br />
62, boulevard Saint-Michel<br />
49100 Angers<br />
Tel.: 02 41 43 65 66<br />
Fax: 02 41 43 01 49<br />
mdm.mdm-angers@wanadoo.fr<br />
> BESANÇON<br />
Violaine LLORCA<br />
Médecins du Monde<br />
Appartement 168003<br />
7, rue du Languedoc<br />
25000 Besançon<br />
Tel.: 03 81 51 26 47<br />
Fax: 03 81 52 70 28<br />
mdm.fc@wanadoo.fr<br />
> BORDEAUX<br />
Christophe ADAM Médecins<br />
du Monde<br />
2, rue Charlevoix-de-Villiers<br />
33000 Bordeaux<br />
Tel.: 05 56 79 13 82<br />
Fax: 05 56 52 77 69<br />
mfbordeaux@wanadoo.fr<br />
> GUYANA<br />
Sylvie CREGUT<br />
Médecins du Monde<br />
32, rue Vermont-Polycarpe<br />
97300 Cayenne<br />
Guyane<br />
Tel./Fax: 05 94 28 36 77<br />
mdmmfcayenne@wanadoo.fr<br />
> GRENOBLE<br />
Patrick BAGUET<br />
Médecins du Monde<br />
19, rue René-Thomas<br />
38000 Grenoble<br />
Tel.: 04 76 84 17 21<br />
Fax: 04 76 84 17 58<br />
mfgrenoble@free.fr<br />
> LA PLAINE-SAINT-DENIS<br />
Florence SUZAN<br />
Médecins du Monde<br />
8-10, rue des Blés<br />
93210 La Plaine-Saint-Denis<br />
Tel.: 01 55 93 19 29<br />
Fax: 01 55 93 19 30<br />
mdm.mission.banlieue@wanadoo.fr<br />
> LYONS<br />
Marc CUCHE, Karen FINSTERLE<br />
Médecins du Monde<br />
10, rue de Sévigné<br />
69003 Lyon<br />
Tel.: 04 78 89 99 99<br />
Fax: 04 78 71 75 72<br />
mflyon@free.fr<br />
> LE HAVRE<br />
Arlette SEIFFERT<br />
Médecins du Monde<br />
28, rue J.-B.-Eyriès<br />
76000 Le Havre<br />
Tel.: 02 35 21 68 66<br />
Fax: 02 35 22 67 33<br />
mdm.lehavre@wanadoo.fr<br />
> MARSEILLES<br />
Xavier CARRARD, Georgia COUFFIN<br />
et Florence LARMAT Médecins du<br />
Monde<br />
4, avenue Rostand<br />
13003 Marseille<br />
Tel.: 04 95 04 56 00<br />
Fax: 04 95 04 56 04<br />
mf.marseille@medecinsdumonde.net<br />
> MONTPELLIER<br />
Tony DA SILVA, Marie-Bernadette<br />
CADILHAC, Margarita GONZALEZ<br />
Médecins du Monde<br />
18, rue Henri-Dunant<br />
34090 Montpellier<br />
Tel.: 04 99 23 27 17<br />
mdmcaso34@wanadoo.fr<br />
> NANCY<br />
Jean-Marie GILGENKRANTZ<br />
Médecins du Monde<br />
5, rue de l'Armée-Patton<br />
54000 Nancy<br />
Tel.: 03 83 27 87 84<br />
Fax: 03 83 28 42 55<br />
medmond.nancy@free.fr<br />
> NANTES<br />
Philippe JARROUSSE,<br />
Jean Pierre CLAUZEL Médecins du<br />
Monde<br />
33, rue Fouré<br />
44000 Nantes<br />
Tel.: 02 40 47 36 99<br />
Fax: 02 51 82 38 09<br />
mdm.nantes@free.fr<br />
> NICE<br />
Bernard AUBIN<br />
Médecins du Monde<br />
34, rue Rossini<br />
06000 Nice<br />
Tel.: 04 93 16 59 60<br />
Fax: 04 93 16 59 61<br />
mdmnice@numericable.fr<br />
> PARIS<br />
Denis HERMAN, Marc LERICHE<br />
Médecins du Monde<br />
62 bis, avenue Parmentier<br />
75011 Paris<br />
Tel.: 01 43 14 81 81<br />
Fax: 01 47 00 75 53<br />
mfparis@medecinsdumonde.net<br />
> PAU<br />
Robert LAFOURCADE<br />
Médecins du Monde<br />
12 bis, place de la Monnaie<br />
64000 Pau<br />
Tel.: 05 59 83 74 28<br />
Fax: 05 59 27 22 32<br />
mdmpau@wanadoo.fr<br />
> ROUEN<br />
Agathe BONMARCHAND<br />
Médecins du Monde<br />
5, rue d'Elbeuf<br />
76100 Rouen<br />
Tel.: 02 35 72 56 66<br />
Fax: 02 35 73 05 64<br />
mdmrouen@wanadoo.fr<br />
> STRASBOURG<br />
Jean-Maurice SALEN<br />
Médecins du Monde<br />
24, rue du Maréchal-Foch<br />
67000 Strasbourg<br />
Tel.: 03 88 14 01 00/01<br />
Fax: 03 88 14 01 02<br />
mdmalsac@club-internet.fr<br />
> TOULOUSE<br />
Geneviève MOLINA Médecins du<br />
Monde<br />
5, boulevard de Bonrepos<br />
31000 Toulouse<br />
Tel.: 05 61 63 78 78<br />
Fax: 05 61 62 04 15<br />
mdmmidipy.delegation@laposte.net<br />
> VALENCIENNES<br />
Eliane LAMORISSE Médecins du<br />
Monde<br />
10-12, rue du Grand-Fossart<br />
59300 Valenciennes<br />
Tel.: 03 27 47 40 08<br />
Fax: 03 27 30 19 16<br />
mdmvalenciennes@free.fr
Contacts (mobile activities) - Community Medicine<br />
MOBILE PROJECTS<br />
STREET WORK<br />
> LYONS<br />
Françoise MICHAUD<br />
Médecins du Monde<br />
1, place du Griffon<br />
69001 Lyon<br />
Tel.: 04 78 29 59 14<br />
Fax: 04 78 29 55 91<br />
mflyon@free.fr<br />
> METZ<br />
René MOUTIER<br />
Médecins du Monde<br />
11, rue Saint-Pierre<br />
57000 Metz<br />
Tel.: 03 87 63 55 91<br />
Fax: 03 87 66 60 93<br />
medmond.metz@free.fr<br />
> POITIERS<br />
La Caravane<br />
Marie-Thérèse RAYMOND Médecins<br />
du Monde<br />
21, rue Boncenne<br />
86000 Poitiers<br />
Tel.: 05 49 01 77 77<br />
Fax: 05 49 60 28 93<br />
Back-up/Tel.: 05 49 38 45 10<br />
Fax: 05 49 38 45 11<br />
> SAINT-DENIS DE LA RÉUNION<br />
Médecins du Monde<br />
250 bis, rue Général-Rolland - bât. K<br />
SHLMR Bouvet - BP 964<br />
97479 Saint-Denis de la Réunion<br />
Cedex<br />
Tel.: 02 62 21 71 66<br />
Fax: 02 62 41 19 46<br />
medecinsdumonde.reunion<br />
@wanadoo.fr<br />
PROSTITUTION PREVENTION<br />
> LE HAVRE<br />
Arlette SEIFFERT<br />
Médecins du Monde<br />
28, rue J.-B.-Eyriès<br />
76000 Le Havre<br />
Tél. : 02 35 21 68 66<br />
Fax : 02 35 22 67 33<br />
mdm.lehavre@wanadoo.fr<br />
> METZ<br />
René MOUTIER, Frédérique CARRIE<br />
Médecins du Monde<br />
11, rue Saint-Pierre<br />
57000 Metz<br />
Tél. : 03 87 63 55 91<br />
Fax : 03 87 66 60 93<br />
medmond.metz@free.fr<br />
> MONTPELLIER<br />
Damien CHERET, Clélia VENTURINI<br />
Médecins du Monde<br />
18, rue Henri-Dunant<br />
34090 Montpellier<br />
Tél. : 04 99 23 27 17<br />
Fax : 04 99 23 27 18<br />
mdm_mtpl@club-internet.fr<br />
> NANTES<br />
Funambus<br />
Paul BOLO<br />
Médecins du Monde<br />
33, rue Fouré<br />
44000 Nantes<br />
Tél. : 02 40 47 36 99<br />
Fax : 02 51 82 38 09<br />
mdmfunambus@free.fr<br />
> PARIS<br />
Lotus Bus<br />
Chloé CATTELAIN, Marie DEBRUS<br />
Médecins du Monde<br />
62 bis, avenue Parmentier<br />
75011 Paris<br />
Tél. : 01 43 14 81 61<br />
Fax : 01 47 00 80 70<br />
lotusbus@medecinsdumonde.net<br />
> ROUEN<br />
Bus prévention<br />
Jean-Jacques PREY<br />
Médecins du Monde<br />
5, rue d’Elbeuf<br />
76100 Rouen<br />
Tél. : 02 35 72 56 66<br />
Fax : 02 35 73 05 64<br />
mdmrouen@wanadoo.fr<br />
TRAVELLERS' PROJECTS<br />
> STRASBOURG<br />
Catherine FRAPARD<br />
Médecins du Monde<br />
24, rue du Maréchal-Foch<br />
67000 Strasbourg<br />
Tél. : 03 88 14 01 01<br />
Fax : 03 88 14 01 02<br />
mdmalsac@club-internet.fr<br />
CHILDREN'S PROJECTS<br />
Child lead poisoning<br />
> LA PLAINE-SAINT-DENIS<br />
Claude CHAUDIERES<br />
Mission Banlieue<br />
Médecins du Monde<br />
8-10, rue des Blés<br />
93210 La Plaine-Saint-Denis<br />
Tél. : 01 55 93 19 29<br />
Fax : 01 55 93 19 30<br />
mdm.mission.saturnisme@wanadoo.fr<br />
Hospital buddies<br />
> PARIS<br />
Catherine PETERMAN<br />
c/o coordination Mission France<br />
Médecins du Monde<br />
62, rue Marcadet<br />
75018 Paris<br />
Tél. : 01 44 92 13 10<br />
Fax : 01 44 92 99 92<br />
parrainage@medecinsdumonde.net<br />
ROMA-GYPSY PROJECT<br />
> LA PLAINE-SAINT-DENIS<br />
Sylvie MONIN<br />
Médecins du Monde<br />
8-10, rue des Blés<br />
93210 La Plaine-Saint-Denis<br />
Tél. : 01 55 93 19 38<br />
Fax : 01 55 93 19 30<br />
mdm.mission.banlieue@wanadoo.fr<br />
POORLY HOUSED PROJECT<br />
Squats Project<br />
> BORDEAUX<br />
Liane and Guy MAYER<br />
Médecins du Monde<br />
2, rue Charlevoix-de-Villiers<br />
33000 Bordeaux<br />
Tél. : 05 56 79 13 82<br />
Fax : 05 56 52 77 69<br />
mfbordeaux@wanadoo.fr<br />
116/117<br />
> TOULOUSE<br />
Marie-Pierre BUTTIGIEG<br />
Médecins du Monde<br />
5, boulevard de Bonrepos<br />
31000 Toulouse<br />
Tél. : 05 61 63 78 78<br />
Fax : 05 61 62 04 15<br />
mdmmidipy.delegation@laposte.net<br />
Homelessness Project<br />
> MARSEILLE<br />
Denise CLÉMENT<br />
Médecins du Monde<br />
4, avenue Rostand<br />
13003 Marseille<br />
Tél. : 04 95 04 56 03<br />
Fax : 04 95 04 56 04<br />
mfmarseille@medecinsdumonde.net<br />
> PARIS<br />
Graciela ROBERT,<br />
Paul ZYLBERBERG<br />
Médecins du Monde<br />
62 bis, avenue Parmentier<br />
75011 Paris<br />
Tél. (en journée pour mess.) :<br />
01 44 92 14 98<br />
Tél. (de 21 h à 23 h) :<br />
01 43 14 81 74<br />
Fax : 01 43 14 81 51<br />
mdm@medecinsdumonde.net<br />
CAFDA Project<br />
> PARIS<br />
Fabrice GIRAUX, Marc LERICHE<br />
Médecins du Monde<br />
44, rue Planchat<br />
75020 Paris<br />
Tél./ Fax : 01 45 49 03 80<br />
mdmcafda2@yahoo.fr<br />
WELFARE<br />
SUPPORT PROJECT<br />
> BORDEAUX<br />
Arnaud WIEHN<br />
Médecins du Monde<br />
2, rue Charlevoix-de-Villiers<br />
33000 Bordeaux<br />
Tél. : 05 56 79 13 82<br />
Fax : 05 56 52 77 69<br />
mfbordeaux@wanadoo.fr
Contacts (Harm Reduction)<br />
NEEDLE EXCHANGE BUS<br />
> ANGOULÊME<br />
Valérie PATRIER<br />
Médecins du Monde<br />
22, allée du Champ-Brun<br />
16000 Angoulême<br />
Tél. : 05 45 65 11 82 (unit)<br />
Tél. : 05 45 65 07 47 (office)<br />
Fax : 05 45 61 18 85<br />
(unit and office)<br />
mdm-angouleme-rdr16@aliceadsl.fr<br />
HEALTH LISTENING BUS<br />
> ANGOULÊME<br />
Marie-Laure FERRARI<br />
Médecins du Monde<br />
22, allée du Champ-Brun<br />
16000 Angoulême<br />
Tél. : 05 45 65 11 82 (unit)<br />
Tél. : 05 45 65 07 47 (office)<br />
Fax : 05 45 61 18 85<br />
(unit and office)<br />
HARM RE<strong>DU</strong>CTION<br />
> MARSEILLE<br />
Béatrice STAMBUL<br />
Médecins du Monde<br />
4, avenue Rostand<br />
13003 Marseille<br />
Tél. : 04 95 04 56 06/08<br />
Fax : 04 95 04 56 07<br />
rdr.marseille@medecinsdumonde.net<br />
NEEDLE EXCHANGE BUS<br />
METHADONE BUS<br />
> PARIS<br />
Jean-Pierre LHOMME<br />
Médecins du Monde<br />
62 bis, avenue Parmentier<br />
75011 Paris<br />
Tél. : 01 43 14 81 61<br />
Fax : 01 47 00 80 70<br />
secrpes.parmentier<br />
@medecinsdumonde.net<br />
bus.methadone<br />
@medecinsdumonde.net<br />
NEEDLE EXCHANGE BUS<br />
> BORDEAUX<br />
Jean-Pierre DAULOUEDE,<br />
Guy MAYER<br />
Médecins du Monde<br />
2, rue des Etables<br />
33800 Bordeaux<br />
Tél. : 05 56 92 51 89<br />
Fax : 05 56 92 03 59<br />
rdr.mdm.bx@wanadoo.fr<br />
RAVES<br />
> BAYONNE<br />
Jean-Pierre DALOUEDE<br />
Médecins du Monde - Bizia<br />
(centre méthadone)<br />
Centre hospitalier Côte basque BP 8<br />
64106 Bayonne<br />
Tél. Bizia : 05 59 44 31 00<br />
Raves port. : 06 03 21 21 05<br />
Tél. Raves : 05 59 44 31 05<br />
Fax : 05 59 44 31 03<br />
mdm.bayonne@wanadoo.fr<br />
> NANTES<br />
Anne-Lise GUEGUEN<br />
Médecins du Monde<br />
33, rue Fouré<br />
44000 Nantes<br />
Tél. : 02 40 47 36 99<br />
Fax : 02 51 82 38 09<br />
mdm.nantes@free.fr<br />
> NICE<br />
Philippe de BOTTON<br />
Médecins du Monde<br />
34, rue Rossini<br />
06000 Nice<br />
Tél. : 06 08 27 20 94<br />
medecinsdumondenice@free.fr<br />
> PARIS<br />
Valère ROGISSART<br />
Médecins du Monde<br />
62 bis, avenue Parmentier<br />
75011 Paris<br />
Tél./ Fax : 01 43 14 81 69<br />
rave.paris@medecinsdumonde.net<br />
> TOULOUSE<br />
Olivier DROUAULT, Julien SANCHEZ<br />
Médecins du Monde<br />
5, boulevard de Bonrepos<br />
31000 Toulouse<br />
Tél. : 05 61 63 78 78<br />
Fax : 05 61 62 04 15<br />
mdmmidipy.raves@laposte.net<br />
XBT PROJECT<br />
National SINTES<br />
co-ordinating body<br />
> PARIS<br />
Stéphane LE VU<br />
Médecins du Monde<br />
62 bis, avenue Parmentier<br />
75011 Paris<br />
Tél./ Fax : 01 43 14 81 69<br />
xbt@medecinsdumonde.net<br />
s.levu@laposte.net
CÉDRIC HELSLY<br />
119/128<br />
><br />
MdM mobilisation
VALÉRIE <strong>DU</strong>PONT<br />
CATHERINE HENRIETTE<br />
MICHEL REDONDO<br />
CÉDRIC HELSLY<br />
JULIEN DE WECK<br />
LAHCÈNE ABIB<br />
VALÉRIE <strong>DU</strong>PONT<br />
mdm<br />
mdm
GÉRARD RONDEAU<br />
> January-February<br />
> Key events<br />
Tsunami: After this unprecedented humanitarian<br />
disaster, MdM got involved through its international<br />
network in providing emergency<br />
medical assistance to tsunami victims, reactivating<br />
healthcare systems in the stricken<br />
areas and dealing with risks of epidemics. At<br />
the same time, at head office, the doors were<br />
opened two Sundays in a row to welcome people<br />
affected by this drama and provide them with<br />
comfort and support.<br />
11 and 12 February: “Children and war, violence,<br />
trauma and rehabilitation” conference<br />
in the Senate. War is the main cause of infant<br />
mortality in the world. Wars almost always involve<br />
the whole population directly, so children are killed,<br />
wounded or displaced. They are witnesses of<br />
atrocious violence or forced to take part in it as<br />
soldiers, servants or sex slaves. The conference<br />
was organised together with Défenseur des<br />
enfants, Enfants réfugiés du monde and the Centre<br />
de recherches sur la paix, and was the opportunity<br />
to denounce the hindrances to child deve-<br />
JOËL ROBINE<br />
lopment and the attacks on their most fundamental<br />
rights, so that their suffering, needs<br />
and rights can at last be recognised. More than<br />
forty speakers (humanitarian workers, lawyers,<br />
sociologists, psychologists, etc.) took part in the<br />
conference talking to an audience of over 210<br />
people and trying to call on the public authorities<br />
to act by apleading for better protection for<br />
children in armed conflicts.<br />
14 and 15 February: campaign on the Wall<br />
and health in Palestine. . Two press conferences<br />
in Tel Aviv and Ramallah, in association<br />
with Physicians for Human Rights (an Israeli medical<br />
organisation) and the Palestinian Red Crescent<br />
Society, denounced the destructive effects of<br />
building the Separation Wall in the West<br />
Bank on Palestinians' access to healthcare<br />
and living conditions in the territories. The<br />
publication of the report, “The ultimate barrier:<br />
the Wall's impact on the Palestinian health system”,<br />
reaffirms MdM's fight to defend the civilian<br />
population's right to healthcare, right to<br />
VALÉRIE <strong>DU</strong>PONT<br />
120/121<br />
The tsunami struck South-East Asia on 26 December 2004. “Children and War” conference in the Senate. Mobilisation following the building of the wall in Palestine.<br />
physical and mental health, and freedom of movement,<br />
and for the Geneva Convention to be<br />
respected. At the same time, fourteen Israeli and<br />
Palestinian artists raised awareness amongst<br />
Israeli and Palestinian public opinion through their<br />
pictures of the security barrier and its consequences.<br />
The campaign was publicised locally<br />
by the Israeli magazine Ha'ir and the Palestinian<br />
paper Al Quds; the report was distributed to the<br />
authorities of Israel and the Palestinian Territories.<br />
> And also<br />
February: Publication of the book by Dr. Jacqueline<br />
Ferreira, “Caring for the poorly cared for -<br />
Ethnology of a free healthcare centre”, which<br />
carefully dissects the medical and social care given<br />
to patients by Médecins du Monde's teams.<br />
An exhibition of photos illustrating Roma<br />
living conditions in Romania had been touring<br />
France for a year and continued its tour in 2005.
SAMUEL BOLLENDORFF / L’OEIL PUBLIC<br />
> March<br />
Project amongst women prostitutes.<br />
> Key events<br />
15 March: open letter to the President of<br />
France on the harmful consequences of the<br />
internal security law on people involved in<br />
prostitution.<br />
The internal security law, which represses all,<br />
even passive, soliciting, puts a lot on pressure<br />
on people involved in prostitution, who must<br />
now hide to avoid police repression. These people,<br />
exposed to violence and risk of STIs, and<br />
suffering from an increasing feeling of insecurity,<br />
have in fact become even more vulnerable<br />
since this law was introduced, and the work of<br />
the Association has become very difficult as<br />
access to people involved in prostitution is now<br />
so restricted.<br />
DR<br />
Day of meetings on humanitarian surgery.<br />
20 March: MdM started lobbying MEPs to ask<br />
for an amendment to be added to the proposed<br />
European directive on procedures for deporting<br />
illegal migrants which will be passed in 2006.<br />
The text does not take into account the state<br />
of health of those to be deported, except to<br />
avoid their dying during the transport for their<br />
deportion. As MdM has noted the very poor<br />
health of a large number of migrants, we<br />
are calling for an amendment to be added<br />
banning the expulsion of seriously ill people<br />
and guaranteeing access to healthcare in<br />
the country, unless it can be proved that these<br />
people will have effective access to appropriate<br />
treatment and medical care in their countries of<br />
origin.<br />
> And also<br />
7 March: MdM was involved in a day of reflection<br />
on the human rights situation in the<br />
Kurdish South-East. The “Human Rights in<br />
Turkey: a growing reality?” conference was organised<br />
by the Group for Human Rights in Turkey<br />
with the support of FIDH (International Human<br />
Rights Federation).<br />
11 March: Médecins du Monde, Médecins<br />
Sans Frontières (MSF) and Aide Médicale<br />
Internationale (AMI) called on the French National<br />
Medical Association (CNOM) to act in the case<br />
of Dr Michele d'Auria, a doctor with the Abbé<br />
Pierre Foundation and a former expatriate volunteer<br />
of MdM, so that he can practise as a doctor<br />
in France. He had been accused in Italy of<br />
acts for which he has since<br />
19 March: MdM's surgery meetings.<br />
Surgeons on humanitarian missions are called<br />
to act quickly and to adapt to circumstances<br />
using the means available. This day of meetings<br />
was an opportunity to compare field experiences,<br />
exchange ideas and techniques and<br />
try together to find answers to all the questions<br />
which a surgeon on a project faces.
mdm<br />
Chechnya: MdM provides support to the victims<br />
of a continuous political and military crisis.<br />
Humanitaire Magazine No.12: “The Kurdish<br />
question and humanitarian workers.”<br />
5 April: “Perspectives - Chechnya, Northern<br />
Caucasus: the Kremlin's calculations in the<br />
region”. This meeting organised at MdM's<br />
head office was a time for discussions and<br />
reflection on the political and humanitarian<br />
future of Chechnya after the assassination of<br />
the Chechen President Maskhadov.<br />
19 April: organisation of a meeting to support<br />
Florence Aubenas and Hussein<br />
Hanoun, in conjunction with all the French<br />
international solidarity organisations. Those<br />
involved in international solidarity, who are independent<br />
witnesses and just as threatened in<br />
certain areas, could not do other than stand<br />
by the hostages and work for their liberation,<br />
which took place on 12 June.<br />
PASCAL DELOCHE<br />
Displaced people in Rwanda.<br />
28 April: «Tuez-les tous» (Kill them all), a<br />
documentary on the Rwandan genocide (made<br />
by R. Glucksman, D. Hazan and P. Mezerette).<br />
Screening and discussion on Rwanda organised<br />
by MdM at the Cinéma des Cinéastes.<br />
The quarterly magazine Humanitaire.<br />
122/123<br />
> April
DR<br />
> May-June<br />
MdM's new publicity campaign.<br />
> Key events<br />
19 May: launch of MdM's new campaign<br />
on behalf of forgotten crises. During a press<br />
conference, MdM launched its new campaign,<br />
which highlights what it is doing amongst populations<br />
who have been forgotten. Rather than<br />
seeking to make people feel guilty, it is encouraging<br />
collective awareness that we are all<br />
responsible for their being forgotten. The deliberately<br />
aged photo from Rwanda, which illustrates<br />
the theme, symbolises the deterioration<br />
of collective memory. The campaign won first<br />
prize in the press category in the awards for<br />
solidarity publicity.<br />
13 May: MdM's general assembly was the opportunity<br />
to re-launch our involvement in Darfur,<br />
because of the increased pressures on the displaced<br />
in Kalma camp. The Sudanese authorities<br />
are pushing displaced people to leave the camp<br />
against their will, by trying to “suffocate” them.<br />
Trade is hindered, and the freedom of movement<br />
of the displaced seriously curtailed.<br />
VALÉRIE <strong>DU</strong>PONT<br />
Teenager in Liberia.<br />
The people living in Kalma are gradually becoming<br />
completely dependent on international<br />
aid, especially for food, even though the humanitarian<br />
organisations having problems in getting<br />
supplies.<br />
At the same time, the area surrounding the<br />
camp where MdM is working is becoming very<br />
dangerous: roaming militias are involved in more<br />
and more violence, pillaging and rape. Insecurity<br />
reigns, the camp is less and less viable, and<br />
everything is being done to force the displaced<br />
to leave, exposing them to even greater dangers<br />
than in the “open-air prison” that is Kalma<br />
camp.<br />
> And also<br />
19 May: MdM's new Internet site was set<br />
up. The site at www.medecinsdumonde.org<br />
gives a new image, providing better information<br />
to the general public concerning MdM's<br />
projects. On the fringe of the national<br />
Humanitarian Action Exhibition, in partnership<br />
with Cinéma des Cinéastes, MdM organised<br />
an exhibition on the theme “Victims and/or<br />
killers? The child soldiers of Liberia”. Valérie<br />
Dupont exhibited her photos and François<br />
Margolin presented “Les petits soldats” (The<br />
Little Soldiers), a documentary which he made<br />
on the tragic situation of children enrolled in the<br />
Liberian army. Since January 2005, through its<br />
mental health programme, Médecins du Monde,<br />
has been involved in helping these child soldiers<br />
to rebuild their lives and reintegrate into<br />
society<br />
18 June: Lyon Migrants Day, meetings,<br />
exchanges and dialogue between the people<br />
of Lyons and the migrant population.<br />
23 June: MdM jointly signed the declaration<br />
calling on the G8 country leaders to quickly<br />
expand measures to eradicate poverty, give<br />
access to healthcare and education, and for<br />
sustainable development in developing countries.<br />
24-25 June: International day in support of victims<br />
of torture: MdM was involved in the conference<br />
organised by the Primo Levi Association,<br />
entitled “Wanderings and loneliness, the<br />
effects of torture and political violence”.<br />
Médecins du Monde has been involved in the<br />
Primo Levi Association's work for ten years. Its<br />
main aim is to offer care and support to victims<br />
of torture and political violence living in exile in<br />
France.
Key events<br />
Global action against poverty: as part of the<br />
“2005: no more excuses” platform, MdM was<br />
involved in “Action Mondiale contre la Pauvreté”<br />
(Global Action against Poverty). This international<br />
campaign aims to put pressure on Northern<br />
and Southern governments so that they take<br />
concrete and ambitious measures to reach the<br />
MDGs (Millennium Development Goals) adopted<br />
by the United Nations in 2000 to reduce extreme<br />
poverty. Throughout 2005, there was a campaign<br />
to call on political decision-makers with respect<br />
to the international agenda, especially on 1 July<br />
2005, World White Band Day, on the eve of<br />
the G8 conference. That day, people in over 100<br />
countries wore white bands and thereby answered<br />
yes to our call. Meetings were also organised<br />
throughout France.<br />
AME-CMU (State medical aid - universal<br />
health insurance): MdM got involved against<br />
the reforms restricting access to healthcare<br />
for people on low income and illegal foreigners<br />
and, at a joint press conference, denounced<br />
the aberration of the situation which involves<br />
requesting proof of identity and residence from<br />
those without papers in order to receive care,<br />
which leads to the most destitute being excluded<br />
from healthcare. Two decrees complicating<br />
access to AME still further were issued by the<br />
government on 28 July 2005: from now on,<br />
migrants with irregular status must provide proof<br />
they have lived in France for three months. This<br />
makes it almost impossible for these highly insecure<br />
and vulnerable people to get access to<br />
healthcare. An appeal to withdraw these decrees<br />
was made to the Council of State by MdM, Aides,<br />
LDH (Human Rights League), MRAP (Movement<br />
against Racism and for Friendship between<br />
Peoples) and GISTI (Immigrant Information and<br />
Support Group). Moreover, the Council of Europe's<br />
DR<br />
The campaign for White Band Day.<br />
Committee of Social Rights ruled against France<br />
in its decision of 3 November 2004 in which it<br />
recalled that those without papers and their children<br />
must receive effective medical assistance<br />
in accordance with the European Social Charter.<br />
> And also<br />
People's Health Assembly: Médecins du<br />
Monde took part in the 2nd People's Health<br />
Assembly which took place in Cuenca<br />
(Ecuador). The issues of access to health worldwide,<br />
and especially in poor countries, were<br />
presented and discussed in their diversity by<br />
health professionals and beneficiaries from the<br />
whole world (1,500 people from 82 countries):<br />
the right to health, HIV-AIDS, gender and women's<br />
health, environmental health, militarisation<br />
and territorial occupation, health system reforms,<br />
traditional medicine, etc.<br />
11 July: Françoise Jeanson and Bernard<br />
Granjon's opinion column in the Libération newspaper:<br />
“11 July 1995: a day of shame”, for<br />
the ten years since the Srebrenica massacre.<br />
mdm<br />
124/125<br />
Free healthcare and guidance centre (CASO).<br />
> July<br />
Humanitaire magazine, special edition No.<br />
2 “What health for migrants in Europe?”,<br />
which took up the proceedings of the Migrants<br />
Workshops held in December 2004 at MdM's<br />
head office, attended by Didier Fassin and Louis<br />
Mermaz.<br />
MdM has associated itself with the «Contrôlez<br />
les armes», the French section of the worldwide<br />
platform “Control Arms” campaign (launched<br />
by Amnesty International), which calls for<br />
an international treaty on the arms trade.<br />
Each year, over 500,000 people across the world<br />
are killed by bullets, and no effective control is<br />
exercised on the arms trade. It is estimated that<br />
80 to 90% of the small arms in circulation were<br />
originally traded legally.
August-September<br />
> Key events<br />
“Chill Août Tour” (Chill August Tour): organised<br />
by the Paris squats project, this tour started<br />
on 8 August 2005 and had several aims,<br />
including strengthening the existing set-up for<br />
MdM's different squats projects (Paris, Poitiers,<br />
Marseilles, etc) and starting squats projects in<br />
other towns, sharing and transferring harm reduction<br />
knowledge, organising workshops on drugs<br />
analysis and distribution of harm reduction material,<br />
and testimonies. The tour ended at the teknival<br />
organised between 25 and 29 August<br />
attended by 45,000 people.<br />
6 September: urgent appeal for real solutions<br />
to be provided for the problem of substandard<br />
housing.<br />
In the face of the inadequate housing policies<br />
proposed, MdM again called on the govern-<br />
> October<br />
> Key events<br />
17 October: on the International Day for the<br />
Eradication of Poverty, MdM's Mission<br />
France organised a testimony day. This event<br />
was firstly an opportunity to hear about the difficulties<br />
faced by the patients helped by MdM<br />
(extreme poverty, lack of access to housing and<br />
healthcare, etc) and the undeniable effects on<br />
their health. It was also an opportunity to argue<br />
for access to healthcare for everyone, hindered<br />
by restrictive changes to the law which prevent<br />
the most vulnerable people from receiving proper<br />
care. Today, the fundamental right that is<br />
the right of access to healthcare is flouted to<br />
the detriment of the weakest.<br />
ment to act, in an open letter to the Minister for<br />
the Interior, Nicolas Sarkozy.<br />
Reacting to further expulsions which threw<br />
already destitute families on to the streets, MdM<br />
again denounced the insecure living conditions<br />
of thousands of homeless people or those occupying<br />
unhealthy and insecure housing. MdM<br />
also linked up with the group “Pour un droit au<br />
logement opposable” (For a binding right to<br />
housing), so that people suffering from substandard<br />
housing can excercise their right to<br />
housing before the competent authorities.<br />
> And also<br />
Palestinian Territories: during the withdrawal<br />
from the Gaza strip, , Florence Traullé. a<br />
journalist on Nord Eclair, followed MdM's teams<br />
21 October: MdM denounced the withdrawal<br />
of the Global Fund, which had been<br />
working in Burma since April 2005. This coordinated<br />
multilateral funding device fighting<br />
against AIDS, tuberculosis and malaria was<br />
due to fund several programmes to the tune<br />
of 98 M$ over five years. However, for the first<br />
time, the Global Fund decided to withdraw<br />
from a country to which it had made commitments,<br />
justifying this reversal on the weight<br />
of constraints imposed by the military junta<br />
on humanitarian organisations. In actual fact,<br />
the Fund's managers seem to have yielded<br />
to pressure from one of its main funders, the<br />
United States, whose Congress had been cri-<br />
in Gaza for two weeks, reporting on their<br />
actions amongst the most destitute in daily<br />
accounts in a log published on MdM's website.<br />
15 August: alongside strong association involvement<br />
during 2005, F. Jeanson denounced<br />
the new reforms to the AME system which restrict<br />
access to healthcare for highly vulnerable<br />
people in an opinion column in L'Express<br />
magazine, “Save state medical aid”<br />
16 August: opinion column by F. Jeanson<br />
and D. Cannet in the La Croix newspaper:<br />
“Mothers weep for their children”, on the<br />
postponement of high-risk elections in<br />
Democratic Republic of Congo.<br />
26 August: opinion column by P. Micheletti<br />
“The end of the without frontiers”, in the<br />
Libération newspaper.<br />
ticising the funding funding provided by the<br />
Fund for several months. Meanwhile, MdM,<br />
which has been working for fifteen years in<br />
Burma, has noticed that its work (especially<br />
amongst prostitutes and drug addicts), together<br />
with that of other NGOs was having a<br />
significant impact on the HIV epidemic. By<br />
stopping all its funding, the Global Fund is<br />
preventing us from responding actively to an<br />
endemic disease which is ravaging this country,<br />
and is annihilating all local initiatives.<br />
7 October: the first stage of MdM's 25th anniversary,<br />
the exhibition of photos by Gérard<br />
Rondeau was presented in a national preview<br />
by the Provence-Alpes-Côte d'Azur
Key events<br />
126/127<br />
> October (cont'd) > Novembre<br />
region, in Marseilles. “Missions : Médecins<br />
[jusqu'au bout] du Monde”, (Missions :<br />
Doctors {to the ends} of the World) highlights<br />
the daily work of MdM's teams throughout<br />
the world. It provides a subjective view of<br />
MdM's work and history. G. Rondeau has followed<br />
teams of French doctors for many years<br />
from Niger to Russia, Iraqi Kurdistan to besieged<br />
Sarajevo, and from New York (where<br />
Doctors of the World USA is based) to Paris,<br />
and pays homage to them in this exhibition.<br />
A book containing these photographs has<br />
also been published.<br />
> And also<br />
MdM's teams which went to Pakistan after<br />
the earthquake which ravaged the north of the<br />
country shared their experience in a blog published<br />
on the Le Monde newspaper's website.<br />
After the first emergency phase, devoted to<br />
providing relief to the injured in the remote areas<br />
north of Islamabad, MdM extended its work by<br />
getting involved with the displaced gathered in<br />
makeshift camps.<br />
The book<br />
of photographs by<br />
Gérard Rondeau:<br />
“Missions: médecins<br />
[jusqu'au bout] du<br />
monde”.<br />
MdM celebrates its 25th birthday!<br />
MdM's 25th birthday was an opportunity for all<br />
the Association's staff and volunteers to look<br />
back over a quarter of a century of humanitarian<br />
experience and to renew everyone's commitment<br />
to damaged populations. Interventions<br />
in crises which receive little or no media attention<br />
make up a large part of MdM's activities.<br />
By placing its anniversary under the banner<br />
of the forgotten crises and commitment,<br />
MdM wishes to recall that humanitarian<br />
crises persist well after the media disappear<br />
and that our NGO's role is to bring them out of<br />
this often criminal oblivion. So, civilian involvement<br />
is essential so that these crises are dealt<br />
with on a political level in the long term.<br />
Through forums, open days, exhibitions and<br />
film screenings, the whole network was involved<br />
in bearing witness, and proposing and<br />
reflecting on new perspectives, without forgetting<br />
to pay homage to the field workers and<br />
their efforts.<br />
On 4 and 5 November, humanitarian workers,<br />
sociologists, academics and health professionals<br />
gathered at MdM's head office to<br />
exchange views on the direction and issues at<br />
stake for humanitarian action. Three forums<br />
were organised: “Humanitarian aid: views from<br />
elsewhere”, led by Didier Fassin, “Humanitarian<br />
action in disasters”, attended by Rony Brauman<br />
and Jean-François Mattéi, and “Prospects for<br />
the humanitarian action of tomorrow”, attended<br />
by Olivier Weber.<br />
5 November: launch of the first report from<br />
the Global Health Watch. Médecins du Monde<br />
organised the launch in France of Global Health<br />
Watch 2005-2006. This alternative report to<br />
that published each year by the WHO is the<br />
fruit of a vast international joint venture invol-<br />
CÉDRIC HELSLY<br />
MdM's 25th birthday party.<br />
ving over 120 public health experts, health workers<br />
and academics and over 70 NGOs and<br />
community groups. More than a report on health<br />
inequalities, it offers an assessment by civil<br />
society of the actions and policies of the<br />
main institutions which influence health<br />
worldwide. The report was supplemented by<br />
Global Action for Health, an advocacy document<br />
which proposes a timetable for actions<br />
that health associations can develop as of now.<br />
> And also<br />
25 November: Opération Sourire celebrated<br />
its 15th birthday in Phnom Penh. 200 people,<br />
including former patients and the first surgeons,<br />
gathered for this anniversary, recalling the importance<br />
of plastic surgery for children who can<br />
have a normal life again and regain the desire<br />
to smile.
CÉDRIC HELSLY<br />
> December<br />
Operation “Coup de Poing” (Punch) on 21 December in Paris.<br />
> Key events<br />
15 December: assessment of aid given to<br />
tsunami victims. At the request of the “Comité<br />
de la Charte” (Charter Committee), MdM reported<br />
on its post-tsunami activities in South-East<br />
Asia. After the relief work in the first weeks, MdM<br />
got involved in medium-term work, by helping<br />
to re-organise local health structures and<br />
supporting health staff in Indonesia and Sri<br />
Lanka. In all, MdM received over 9.75 million<br />
euros in the form of donations to help tsunami<br />
victims.<br />
21 December: for lack of a roof, a tent. Living<br />
on the street means being in danger of death.<br />
Reacting to the public authorities' lack of action<br />
concerning emergency accommo-dation, despite<br />
several homeless people having died of cold at<br />
the beginning of the winter, MdM took action by<br />
demanding concrete measures so that the homeless<br />
can have permanent accommodation and<br />
get off the street. MdM asked for a ban on putting<br />
anyone who has been offered accommodation<br />
back on the street. Since the morning of<br />
21 December when MdM launched Operation<br />
“Coup de Poing” (Punch), teams have been<br />
criss-crossing Paris offering tents to people<br />
living on the street. These tents are distress<br />
beacons and symbolise the roof which society<br />
should be capable of supplying to everyone. They<br />
are not solutions to the homelessness problem:<br />
on the contrary, they represent the current absence<br />
of a practical solution. This is why MdM called on<br />
members of parliament to act by sending the press<br />
file to each of them. On 31 December, MdM and<br />
Restos du Cœur jointly organised a patrol through<br />
Paris. Four buses criss-crossed the capital offering<br />
homeless people meals, presents as well as<br />
igloo tents.<br />
9 December: creation of the French group<br />
supporting the adoption of an additional<br />
optional protocol to the United Nations<br />
Covenant on Economic, Social and Cultural<br />
rights (1966) of which MdM is a part, so that<br />
these rights (including the right to health) can be<br />
the object of legal appeal, including at international<br />
level. The Group is calling for the imminent<br />
adoption of a text which will offer real guarantees<br />
to victims by including a non-derogable right of<br />
appeal to international law.<br />
> And also<br />
1 December: “The international community<br />
must keep its promises!” On World AIDS Day,<br />
MdM's international network again launched an<br />
appeal having noted the considerable gap between<br />
states' commitments on AIDS and the situation<br />
in the field, and the major impact of the<br />
shortage of doctors and nurses on the treatment<br />
of patients.<br />
9 December: international call for the right<br />
to health. MdM supported the initiative by Mary<br />
Robinson (the former United Nations High<br />
Commissioner for Human Rights) and Paul Hunt<br />
(the United Nation's Special Reporter on the<br />
Right to Health) who launched a call for the right<br />
to health, signed by over 30 former heads of<br />
state and government then open for NGOs to<br />
sign. In particular, the text asked for governments<br />
to act to promote access for everyone<br />
to healthcare, water and food, and<br />
to strengthen health systems and abolish<br />
user fees for basic healthcare.<br />
10 December: organisation of a photo exhibition<br />
at MdM's head office, entitled “Calais ou<br />
l'inhumanitaire au quotidian” (Calais or inhumanitarian<br />
action on a daily basis), along<br />
with a forum bearing witness to the situation of<br />
migrants in transit in Calais.<br />
13 December: Françoise Sivignon's opinion<br />
column denouncing the withdrawal of the Global<br />
Fund from Burma was published in the La Croix<br />
newspaper.<br />
Humanitaire Magazine No. 13:<br />
“Humanitarian action in disasters”.<br />
Forum on “Violence against women, here<br />
and over there”. On Human Rights Day on 10<br />
December, MdM organised a forum to denounce<br />
violence against women, illustrated especially by<br />
the Darfur crisis in Sudan, where rape is commonly<br />
used as a weapon.
The representation network<br />
129/142
Alsace<br />
Contact details<br />
> Regional delegation:<br />
24, rue du Maréchal Foch<br />
67000 Strasbourg<br />
Tél. : 03 88 14 01 00<br />
Fax : 03 88 14 01 02<br />
Mission France :<br />
03 88 14 01 01<br />
mdmalsac@club-internet.fr<br />
http://medecinsdumondealsace.org/<br />
Board Members<br />
> Regional Representative:<br />
Dr Maryvonne Le Gac<br />
> Secretary:<br />
Dr Paul-André Befort<br />
> Treasurer:<br />
Jean Litzler<br />
> Other Members:<br />
Aloyse Kriegel<br />
Catherine Frapard<br />
Dr Pierre Rosenstiel<br />
Dr Jean-Maurice Salen<br />
> Secretary of the delegation:<br />
Brigitte Fanteguzzi<br />
> Section Adoption :<br />
Colette Minard-Rosenstiel<br />
> Number of Members:<br />
71<br />
> Key events<br />
Publicity events<br />
and activities<br />
• Local Internet site: presentation of<br />
the delegation and its activities.<br />
• Information for students and<br />
secondary school pupils.<br />
• Concert by the Soroptimist<br />
Club-Service for a collection of<br />
hygiene products and blankets.<br />
• Screening of the film Caravan 55<br />
at the Odyssée cinema.<br />
• Presentation of Gérard Rondeau's<br />
book, 25 ans de Mission, at FNAC.<br />
• Concert by the Obernai choir with<br />
proceeds going to MdM.<br />
Partnerships<br />
• Group of psychiatrists and general<br />
practitioners on exclusion from health<br />
care and AME (state medical aid) and<br />
CMU (universal health insurance) restrictions.<br />
• Group of organisations working<br />
with people involved in prostitution.<br />
• 115 and its partners: Maraude<br />
Ville (Town Patrol), Restos du Cœur,<br />
etc.<br />
• Illkirch town.<br />
• Alerte group.<br />
Other activities<br />
• Adoption: 8 children arrived in<br />
Alsace; work with ASE (state<br />
childcare services) to give better<br />
information to couples seeking<br />
approval.<br />
• Setting up a trial exploratory<br />
project in Gamadji Saré, Senegal,<br />
started in the context of meetings<br />
with the town of Illkirch.<br />
> Aquitaine<br />
Contact details<br />
> Regional delegation:<br />
2, rue Charlevoix-de-Villers<br />
33300 Bordeaux<br />
Tél. : 05 56 79 13 82<br />
Fax : 05 56 52 77 69<br />
medecinsdumonde.bx<br />
@wanadoo.fr<br />
Board Members><br />
Regional Representative:<br />
Françoise Parrot<br />
> Secretary:<br />
Savine Baudet<br />
> Treasurer:<br />
Marc Denise<br />
> Other Members:<br />
Patrice Billecocq<br />
François Cougoul<br />
Jean-Pierre Daulouède<br />
Marie-Germaine Mazeran<br />
> Secretary of the delegation:<br />
Marie-Christine Chauveau<br />
> Number of Members:<br />
133<br />
> Pau branch:<br />
Contract:<br />
Robert Lafourcade<br />
Tel.: 05 59 83 74 28<br />
> Key events<br />
Publicity events<br />
and activities<br />
• Participation in the regional meetings<br />
of the Aquitaine regional council's<br />
decentralised co-operation and<br />
solidarity development body.<br />
• Local social forum with MdM<br />
stand.<br />
• Exhibition and sale of pictures with<br />
proceeds going to MdM.<br />
• Meeting with the Réseau Santé<br />
Solidarité (Health and Solidarity<br />
Network) and Secours Catholique on<br />
the topic of “the new poor in<br />
France”.<br />
• Global action “2005 no more<br />
excuses”: white band operation<br />
organised by MdM in Bordeaux with<br />
involvement of other organisations.<br />
• Organisation of Mission France's<br />
national days on 7, 8 and 9 October<br />
(around 220 participants).<br />
• International Day for the<br />
Eradication of Poverty.<br />
• Day to meet with all adopting<br />
families or in the process of adopting.<br />
• Lecture and debate on “Tsunami -<br />
Pakistan” with invitation to donors<br />
from Gironde: a hundred participants<br />
at Bordeaux 2 university.
Brittany<br />
Contact details<br />
> Regional delegation:<br />
19, rue Balzac<br />
56270 Ploemeur<br />
Tél. : 02 97 86 27 50<br />
kerduellic.hochet@wanadoo.fr<br />
Board Members<br />
> Regional Representative:<br />
Marie-Elizabeth Hochet<br />
> Secretary:<br />
Valérie Bergeron<br />
> Treasurer:<br />
Christophe Perron<br />
> Other Members:<br />
Xavier Guillery,<br />
Jean Godefroy<br />
> Number of Members:<br />
37<br />
> Key events<br />
Publicity events<br />
and activities<br />
• Presentation of MdM in information<br />
centres: Lorient, Vannes.<br />
• Work in partnership with other<br />
Breton associations to raise funds for<br />
South-East Asia after the tsunami.<br />
• Participation in association forums.<br />
• Involvement in the International Day<br />
for the Eradication of Poverty and<br />
signature of petitions.<br />
• Publicity work to set up a new<br />
press campaign: “We care for those<br />
whom the world is slowly forgetting.”<br />
Other activities<br />
• Adoption: three teams in Ille-et-<br />
Vilaine and Morbihan.<br />
• Harm reduction: work at four<br />
raves.<br />
• Setting up the Regional<br />
International Project in Mali.<br />
• Exploratory project in Romania.<br />
• Exploratory vulnerability project in<br />
Lorient and Vannes.<br />
> Corsica<br />
Contact details<br />
> Regional delegation:<br />
Résidence «La Gravona» bât. A<br />
Rue des Romarins<br />
20090 Ajaccio<br />
Tél. : 08 75 33 18 99<br />
Tél./Fax : 04 95 10 25 49<br />
mdmcorse@wanadoo.fr<br />
http://perso.wanadoo.fr/<br />
mdmcorse<br />
Board Members<br />
> Regional Representative:<br />
François Pernin<br />
> Secretary:<br />
Catherine Contois<br />
> Trésorière :<br />
Corinne Girardin<br />
> Other Members:<br />
Anne Galeani,<br />
Denise Giacomoni<br />
Michèle Iborra,<br />
Jean-Pierre Lucciani,<br />
Isabelle Serain,<br />
Myrtha de Tollenaere<br />
> Number of Members:<br />
30<br />
> Key events<br />
130/131<br />
Publicity events<br />
and activities<br />
• Participation in “Nurse” day.<br />
• Participation in associations' forum.<br />
• Participation, with testimony, in<br />
Regional International Project in<br />
Bulgaria, and fund raising at Young<br />
People's Market.<br />
Partnerships<br />
• With Ajaccio town council's CCAS<br />
(social work centre), MCH and<br />
Education Inspectorate in the<br />
context of the Regional International<br />
Project in Bulgaria.<br />
• Co-founder of an inter-association<br />
platform, setting up a winter night<br />
shelter with medical and<br />
psychological consultations. Plan for<br />
a permanent day centre is being<br />
developed.
Franche-Comté<br />
Contact details<br />
> Regional delegation:<br />
7, rue du Languedoc<br />
Appt 168 003<br />
25000 Besançon<br />
Tél. : 03 81 51 26 47<br />
Fax : 03 81 52 70 28<br />
mdm.fc@wanadoo.fr<br />
Board Members<br />
> Regional Representative:<br />
Jacques Guitard<br />
> Secretary:<br />
Violaine Llorca<br />
> Treasurer:<br />
Bernard Badey<br />
> Other Members:<br />
Philippe Boulhaut<br />
Marie-Claire Tisserand<br />
Jean-François Viel<br />
> Key events<br />
Publicity events<br />
and activities<br />
• Meeting with Franche-Comté<br />
Solidarité to assess the position of<br />
each participant in the association<br />
created for tsunami victims.<br />
• Participation in a regional press<br />
conference to defend a mother of<br />
Iranian origin, whose two children<br />
have been taken away from her.<br />
• Invitation by FR3 Franche-Comté to<br />
speak about MdM's 25 years.<br />
• Presence at MdM's 25th birthday<br />
celebrations in Paris and discussion<br />
on the possibility of setting up a<br />
Regional International Project in<br />
Franche-Comté.<br />
> Ile-de-France<br />
Contact details<br />
> Regional delegation:<br />
62 bis, avenue Parmentier<br />
75011 Paris<br />
Tél. : 01 43 14 81 99<br />
Fax : 01 48 06 68 54<br />
mdm.idf@medecinsdumonde.net<br />
Board Members<br />
> Regional Representative:<br />
Philippe Pluvinage<br />
> Secretary:<br />
Karen Segas<br />
> Treasurer:<br />
Claude Martine<br />
> Other Members:<br />
Maria Melchior<br />
Marie Debrus<br />
Catherine Peterman<br />
> Secrétaire<br />
de la Regional delegation:<br />
Anne Le Guelec<br />
> Number of Members:<br />
400<br />
> Key events<br />
Publicity events<br />
and activities<br />
• Work in high schools and training<br />
schools for nurses and other<br />
paramedic professions.<br />
• Stands at national events in Paris, in<br />
conjunction with the publicity<br />
department at head office, and at<br />
local events in Ile-de-France.<br />
• Involvement in the International Day<br />
for the Eradication of Poverty at Paris<br />
City Hall<br />
• Organisation of a forum on “Calais:<br />
inhumanitarian action on a daily<br />
basis.”<br />
• Participation in the forum “An equal<br />
right to health for foreign residents?”<br />
at the XIXth arrondissement town hall.<br />
Publications<br />
• Three issues of the Le Fil,<br />
newspaper each with 600 copies.<br />
Partnerships<br />
• MdM's Nord-Pas-de-Calais office<br />
for the Calais project.<br />
Other activities<br />
• Organising recruitment of new<br />
volunteers for projects in<br />
Ile-de-France.<br />
• Exploratory project in Moroccan<br />
access to healthcare for<br />
Sub-Saharan migrants in the context<br />
of a Regional International Project.
Languedoc-Roussillon<br />
Contact details<br />
> Regional delegation:<br />
18, rue Henri Dunant<br />
34090 Montpellier<br />
Tél. : 04 99 23 27 17<br />
Fax : 04 99 23 27 18<br />
mdmlr34@wanadoo.fr<br />
Board Members<br />
> Regional Representative:<br />
Mady Mercier<br />
> Secretary:<br />
Claude Aiguesvives<br />
> Treasurer:<br />
Françoise Jourdan<br />
> Other Members:<br />
Antonio Da Silva<br />
Delphine Peronne<br />
Mansoureh Yaghmaie-Astruc<br />
> Secretary<br />
of the delegation:<br />
Magali Ibanez<br />
> Number of Members:<br />
87<br />
> Key events<br />
Publicity events and activities<br />
• Participation in the International<br />
Day for the Eradication of Poverty in<br />
Montpellier.<br />
• Presentation of MdM and its<br />
projects in the nurse preparatory<br />
school at the Red Cross school in<br />
Grabels.<br />
• Participation in an evening<br />
organised by children's choir in<br />
Castries with proceeds going to<br />
tsunami victims.<br />
• Day of involvement in “2005, no<br />
more excuses” against poverty in<br />
Montpellier amongst drivers.<br />
• Stand at the associations' fair in<br />
Montpellier.<br />
Partnerships<br />
• Proposed partnership with the<br />
Dentistry School in Montpellier,<br />
amongst 5th and 6th year dentistry<br />
students.<br />
Other activities<br />
• Presentation of projects 'here and<br />
over there': training for going to<br />
projects abroad, recruitment of state<br />
nurses for international projects, job<br />
descriptions.<br />
> Lorraine<br />
Contact details<br />
> Regional delegation:<br />
5, rue de l’Armée Patton<br />
54000 Nancy<br />
Tél. : 03 83 27 87 84<br />
Fax : 03 83 28 42 55<br />
del.lorraine1@free.fr<br />
Board Members><br />
Regional Representative:<br />
Anne-Marie Worms<br />
> Secretary:<br />
Monique Ulrich<br />
> Treasurer:<br />
Anne-Marie Marchetto<br />
> Other Members:<br />
Lucien Gbetro<br />
Véronique Gorsic<br />
Marie-Pascale Verdenal<br />
Jean-Marie Gilgenkrantz<br />
> Lorraine Regional<br />
Projects:<br />
Nancy RM :<br />
Jean-Marie Gilgenkrantz<br />
Metz RM :<br />
René Moutier<br />
Mission Adoption RM :<br />
René Moutier<br />
> Key events<br />
132/133<br />
Publicity events and activities<br />
• Information evening for donors.<br />
• Participation in meetings on the<br />
following subjects:<br />
- Town Health Project in the Haut du<br />
Lièvre district of Nancy;<br />
- Student health: meetings with the<br />
university health service and social<br />
workers;<br />
- project to work with the Sonacotra<br />
hostels in partnership with the Nancy<br />
preventive medicine centre.<br />
• Meeting with the Strasbourg office<br />
on 9 December.<br />
• Television interview on M6 in<br />
October 2005.<br />
• Article in L'Est républicain<br />
(Est Magazine) on 12 December<br />
2005.<br />
Partnerships<br />
• University medicine (several<br />
meetings).<br />
• Nancy town council (reflection on<br />
the Town Health Workshop).<br />
• Sonacotra hostels, Nancy<br />
(prevention).<br />
• Nancy preventive medicine centre.<br />
Other activities<br />
• Plan for a Regional International<br />
Project in Burkina Faso: exploratory<br />
project in January 2005. The project,<br />
modified during the process, is still at<br />
the planning stage.
Midi-Pyrenees<br />
Contact details<br />
> Regional delegation:<br />
5, boulevard de Bonrepos<br />
31000 Toulouse<br />
Tél. : 05 61 63 78 78<br />
Fax : 05 61 62 04 15<br />
mdmmidipy.delegation<br />
@laposte.net<br />
Board Members<br />
> Regional Representative:<br />
Dr Florence Rigal<br />
> Secretary:<br />
Marie-Pierre Buttigieg<br />
> Treasurer:<br />
Luis Garcia<br />
> Other Members:<br />
Dr Pascale Estecahandy<br />
Monique Drevon<br />
Dr Frédéric Sananes<br />
> Project Co-ordinator:<br />
Tom Wingefeld<br />
> Secretary<br />
of the delegation:<br />
Isabelle Malet<br />
> Albi branch:<br />
Contact: Nicole Cany<br />
Tel.: 05 63 45 08 15<br />
> Key events<br />
Publicity events<br />
and activities<br />
• Various activities in secondary<br />
schools, nursing colleges, schools,<br />
etc; visit by nursing students to the<br />
office.<br />
• Organisation of a public meeting<br />
on the “Asia Emergency”.<br />
• Stands at the associations' day.<br />
• Organisation with Amnesty of a<br />
conference on violence against<br />
women.<br />
• Participation in a drama activity,<br />
forum in Mirail district for Women's<br />
Day.<br />
• Participation in a lunch-debate in<br />
a centre for the unemployed.<br />
• Participation in “2005, no more<br />
excuses” and the International Day<br />
for the Eradication of Poverty.<br />
• Internal meetings: Opération<br />
Sourire, working meeting on<br />
“improving CASO (free healthcare<br />
and guidance centre) practices”,<br />
meeting on articles of association,<br />
meeting on Pakistan.<br />
Editions et publications<br />
• Quarterly newspaper Lettre et<br />
débats.<br />
Exhibitions<br />
• Photo exhibition on Chad and<br />
Opération Sourire, Cambodia.<br />
Other activities<br />
• Various events with proceeds<br />
going to MdM: cross-country race<br />
(with Foulée pour la Vie, Solidarité<br />
en pays de Save), drama, concert,<br />
gala, tennis competition, auction,<br />
craft exhibition and sale, fashion<br />
parade, etc<br />
• Organisation of “6 hours for<br />
Chechnya” by Albi branch.<br />
• Adoption: someone on duty<br />
Mondays between 2 and 6 p.m.<br />
• Sorting drugs: 14 tonnes of<br />
unused drugs collected.
Nord-Pas-de-Calais<br />
Contact details<br />
> Regional delegation:<br />
10-12, rue du Grand Fossart<br />
59300 Valenciennes<br />
Tél. : 03 27 47 40 08<br />
Fax : 03 27 30 19 16<br />
mdmvalenciennes@free.fr<br />
Board Members><br />
> Regional Representative:<br />
Guy Dehaut<br />
> Project co-ordinator:<br />
Eliane Lamorisse<br />
> Secretary:<br />
Fabienne Ducatez<br />
> Treasurer:<br />
Christiane Ficheroulle<br />
> Other Members:<br />
Elisabeth Dusart<br />
Charles Lejeune<br />
Claudine Leleu<br />
> Number of Members:<br />
33<br />
> Key events<br />
Publicity events<br />
and activities<br />
• International Day for the<br />
Eradication of Poverty in partnership<br />
with local organisations.<br />
• Participation in area health<br />
programme in Valenciennes.<br />
• Presentations in nursing schools.<br />
• Participation in associations' forum<br />
for Valenciennes area.<br />
Partnerships<br />
• Emergency accommodation associations,<br />
CHRS (Accommoda-tion<br />
and Social Reintegration Centre), day<br />
centres: AJAR, APE, Midi-Partage,<br />
POSE, etc.<br />
• Rimbaud mobile team<br />
• PASS (healthcare access centres)<br />
(Espace Baudelaire).<br />
• Boutique Solidarité (drop-in<br />
centre).<br />
• SOS Bébé - assistance for families<br />
in financial difficulty.<br />
• Avenir et Coopération<br />
- humanitarian action logistics.<br />
Other activities<br />
• Assistance to Calais refugees<br />
(drugs, sleeping bags, medical<br />
consultations).<br />
• Collection of glasses reconditioned<br />
by an optician.<br />
• Collection and sorting of drugs (as<br />
part of Cyclamed) to run our centre.<br />
Surplus sent to Africa through Avenir<br />
et Coopération according to<br />
demand.<br />
> Normandy<br />
Contact details<br />
> Regional delegation:<br />
5, rue d’Elbeuf<br />
76100 Rouen<br />
Tél. : 02 35 72 56 66<br />
Fax : 02 35 73 05 64<br />
mdmrouen@wanadoo.fr<br />
Board Members<br />
> Regional Representative:<br />
Christian Cartier<br />
> Secretary:<br />
Agathe Bonmarchand<br />
> Treasurer:<br />
Michel Joly<br />
> Other Members:<br />
Arlette Seiffert<br />
Jean-Jacques Prey<br />
Mireille Vache-Picat<br />
> Secretary<br />
of the delegation:<br />
Claudie Hauduc<br />
> Antenne du Havre :<br />
Responsable : Arlette Seiffert<br />
Tél. : 02 35 21 68 66<br />
mdmlehavre@wanadoo.fr<br />
> Key events<br />
134/135<br />
Publicity events<br />
and activities<br />
• JRegional day Rouen-Le Havre on<br />
19 November 2005.<br />
New activity:<br />
• Setting up a Mediation-Health<br />
space in the Hauts de Rouen area of<br />
Rouen.
Indian Ocean<br />
Contact details<br />
> Regional delegation:<br />
250 bis, rue du Général Rolland<br />
Bât. K - SHLMR Bouvet<br />
BP 964<br />
97479 Saint-Denis Cedex<br />
Réunion<br />
Tél. : 02 62 21 71 66<br />
Fax : 02 62 41 19 46<br />
medecinsdumonde.reunion<br />
@wanadoo.fr<br />
Board Members<br />
> Regional Representative:<br />
Gilbert Potier<br />
> Secretary:<br />
Mireille Beaufils<br />
> Trésorière :<br />
Agnès Rovere<br />
> Other Members:<br />
Blandine Megroian<br />
Gilles Bourdiol<br />
Christophe Ottenwaelder<br />
(RM Tuléar)<br />
> Secrétaire<br />
de la Regional delegation:<br />
Claudie Pante<br />
> Autres membres actifs :<br />
Philippe de Chazournes<br />
Marie-Claude Castex<br />
Sophie Agbaglo<br />
Mélanie Maillot<br />
Pascale Lehoucq<br />
Frédéric Le Bot<br />
Jean-Luc Michel<br />
Dominique Rabouille<br />
Jean-François Delambre<br />
(RM Action Enfance)<br />
Philippe Jeu (Indonesia RP)<br />
Arnaud Bourde (Tsunami RP)<br />
Sylvie de Carheil (Prison RPs)<br />
Claudia Vichatzky<br />
(Ilakaka RP)<br />
> Number of Members:<br />
36<br />
> Key events<br />
Publicity events<br />
and activities<br />
• Mailing for Childhood Action: press<br />
releases, fundraising appeal.<br />
• Mission France: organisation of a<br />
Christmas meal for the homeless.<br />
Publications<br />
• Newspaper Mission n° 38.<br />
Training<br />
• Training for the post of administrator<br />
for the Antananarivo secretariat.<br />
• University diploma on “treating HIV<br />
infection and hepatitis B and C”<br />
obtained by Dr. C. Ralaivao, a paid<br />
member of staff of the Ilakaka project.<br />
Other activities<br />
• Mission France: medical and social<br />
consultations at the Boutique<br />
Solidarité (drop-in centre)<br />
(Abbé-Pierre Foundation)<br />
in Saint-Denis and Saint-Pierre.<br />
> PACA (Provence-Alpes-Côte d’Azur)<br />
Contact details<br />
> Regional delegation:<br />
4, avenue Rostand<br />
13003 Marseille<br />
Tél. : 04 95 04 59 60<br />
Fax : 04 95 04 59 61<br />
mdmpaca@medecinsdu<br />
monde.net<br />
Board Members<br />
> Regional Representative:<br />
Ariane Junca<br />
> General Secretary:<br />
Simone Varenne Blanc<br />
> Treasurer:<br />
Philippe Dupin<br />
> Other Members:<br />
Denise Clément<br />
Marie-Agnès Chaud<br />
Olivier Bernard<br />
Pierre-François Pernet<br />
> Project Co-ordinator:<br />
Isabelle Bouju Malaval<br />
> Accounts:<br />
Ghislaine Vincenti<br />
> Secretaries<br />
of the delegation<br />
Anne-Marie Combe<br />
Martine Semat<br />
Daniel Imbert<br />
> Number of Members:<br />
158<br />
> Key events<br />
Publicity events<br />
and activities<br />
• Organisation of monthly<br />
conferences on MdM's international<br />
and national work:<br />
- International projects: Colombia,<br />
Burkina Faso;<br />
- Tsunami emergency;<br />
- Health for all Africans, in Africa and<br />
in France;<br />
- The tsunami, one year on.<br />
• Lecture and discussion on peace<br />
for Israel-Palestine with Stéphane<br />
Hessel, a former French ambassador<br />
to the United Nations, Mr. François<br />
Roux, a lawyer practising in<br />
Montpellier, and Blandine<br />
Chelini-Pont, a historian.<br />
• Participation in a round-table on<br />
local radio: “The tsunami one year<br />
on”.<br />
• 25 years of Médecins du Monde:<br />
exhibition of photographs by Gérard<br />
Rondeau at the regional council,<br />
press conference, round table and<br />
running 5 “citizens' cafés” for two<br />
months based around national and<br />
international projects, for an<br />
audience of schoolchildren and<br />
students.
Pays de la Loire<br />
Contact details<br />
> Regional delegation:<br />
33, rue Fouré<br />
44000 Nantes<br />
Tél. : 02 40 47 36 99<br />
Fax : 02 51 82 38 09<br />
mdm.nantes@free.fr<br />
Board Members<br />
> Regional Representative:<br />
Paul Bolo<br />
> Secretary:<br />
Anne-Lise Guéguen<br />
> Trésorière :<br />
Nicole Neyrat<br />
> Other Members:<br />
Philippe Jarrousse<br />
Hélène Lepoivre<br />
Jean-Pierre Clauzel<br />
Marion Gassiot<br />
> Secretary<br />
of the delegation:<br />
Corinne Lepert<br />
> Number of Members:<br />
80<br />
> Key events<br />
Publicity events<br />
and activities<br />
• Talks in secondary schools,<br />
nursing schools and the nursing<br />
college of Nantes and Lorient.<br />
• Talk at the conference organised<br />
by the Paris ASTI (Solidarity with<br />
Immigrant Workers Association) on<br />
prostitution.<br />
• Participation in the National<br />
Congress of notaries in Nantes<br />
(stand).<br />
• Organisation of short courses for<br />
spring at Nantes University.<br />
• Presentation of MdM to the<br />
Institut de Formation de Santé<br />
dans l'Ouest (IFSO) (Western<br />
France Health Training Institute).<br />
• Open days at the Nantes office<br />
and mobile units on the<br />
International Day for the<br />
Eradication of Poverty.<br />
• Talk at a meeting of the Rennes<br />
co-ordinating body on prostitution.<br />
• Day of action as part of World<br />
AIDS Day.<br />
• Visit of the Prostitution project by<br />
two members of the Donors'<br />
Committee for two days.<br />
136/137<br />
Other activities<br />
• Involvement in many<br />
conferences, in France, on<br />
prostitution, trafficking and violence<br />
against women.
Poitou-Charentes<br />
Contact details<br />
> Regional delegation:<br />
22, allée du Champ Brun<br />
16000 Angoulême<br />
Tél. : 05 45 65 07 47<br />
Fax : 05 45 61 18 85<br />
desede@tiscali.fr<br />
Board Members<br />
> Regional Representative:<br />
Marie-Laure Ferrari<br />
> Secretary and Deputy<br />
Regional Representative:<br />
Daniel Reiss<br />
> Treasurer:<br />
Hubert Lacombe<br />
> Deputy Treasurer:<br />
Philippe Boulanger<br />
> International Project<br />
Co-ordinators + CCN<br />
(National Advisory<br />
Committee)<br />
Fabienne Drieu,<br />
Patrick Bouet<br />
(représentant au CCN)<br />
> Other Member:<br />
Myriam Massé<br />
> Secretary<br />
of the delegation:<br />
Paule de Sède<br />
> Angoulême branch<br />
(outside centre<br />
project):<br />
Contact: Marie-Laure Ferrari<br />
Tel.: 05 45 65 11 82<br />
Needle exchange programme<br />
co-ordinator: Valérie Patrier<br />
> Poitiers branch:<br />
Contact: Patrick Bouet<br />
Tel.: 05 49 01 77 77<br />
> Key events<br />
Publicity events<br />
and activities<br />
• ”Musiques métisses” (mixed-race<br />
music): with the bus present.<br />
• Partnership with the lycée<br />
Marguerite.<br />
• Performance of the play Ils<br />
s'aiment (They love each other), with<br />
proceeds going to MdM, in<br />
Angoulême supported by a radio<br />
programme with Radio Attitude.<br />
• Tea party on 31 December 2005<br />
for the most destitute.<br />
• Concert in Poitiers with proceeds<br />
going to MdM.<br />
• Radio programme with Radio<br />
Accord in Angoulême on the<br />
“Journée de la précarité” (Day of<br />
Poverty).<br />
• MdM stand in Poitiers during<br />
Solidarity Week.<br />
• Exhibition of drawings by child<br />
tsunami victims, in Poitiers.<br />
Partnerships<br />
In Angoulême:<br />
• Les gens du voyage (Travellers)<br />
association;<br />
• Omega (town council - CCAS<br />
(local social work centre));<br />
• PASS (Access to healthcare centre)<br />
Angoulême and EMAPASS (PASS +<br />
mobile addictions team) Ruffec.<br />
In Poitiers:<br />
• Restos du Cœur;<br />
• CRI;<br />
• Town Hospital Network.<br />
> Rhône-Alpes–Bourgogne<br />
Contact details<br />
> Regional delegation:<br />
1, place du Griffon<br />
69001 Lyon<br />
Tél. : 04 78 29 59 14<br />
Fax : 04 78 29 55 91<br />
lyonmdm@wanadoo.fr<br />
Board Members<br />
> Regional Representative:<br />
Michèle Roelens<br />
> Secretary:<br />
Isabelle Hermant<br />
> Treasurer:<br />
Pierre Micheletti<br />
> Other Members:<br />
André-Jean Pocheron<br />
Robert Allemand<br />
Félicie Monneret<br />
Edith Chabal<br />
> Secretary<br />
of the delegation:<br />
Clothilde Guillerm<br />
> Project Co-ordinator:<br />
Sophie Bret<br />
> Number of Members:<br />
environ 160<br />
> Antenne de Grenoble :<br />
Responsable : Jean-Pierre Vidal<br />
Tél. : 04 76 84 17 31<br />
mdm.grenoble@free.fr<br />
Coordinateur : Pierre Bourgey<br />
> Key events<br />
Publicity events<br />
and activities<br />
• In Grenoble, organisation and<br />
involvement in the International Day<br />
for the Eradication of Poverty.<br />
• In Lyon, organisation of a day of<br />
testimony on the health of migrants.<br />
• Testimonies and various talks<br />
concerning the problems of getting<br />
access to healthcare for highly<br />
vulnerable people.<br />
• Conferences on humanitarian<br />
action, emergency projects,<br />
development, the media and<br />
humanitarian work.<br />
• Meetings with primary and<br />
secondary pupils in Villeurbanne:<br />
testimonies of childhood in war, in<br />
partnership with the Maison du Livre,<br />
de l'Image et du Son (Book, Image<br />
and Sound Centre) in Villeurbanne.<br />
• In Grenoble, support for the<br />
national publicity campaign “We care<br />
for those whom the world is<br />
gradually forgetting” (more than 500<br />
display spaces offered).<br />
• Golf competitions, concerts,<br />
picture sales, partnerships with local<br />
businesses.<br />
Exhibitions<br />
• Touring photo exhibition on the<br />
Bolivia project: “The child workers of<br />
Potosí”.<br />
• Touring photo exhibition on the<br />
health of migrant people.<br />
• Touring photo exhibition on<br />
Afghanistan, Chechnya and “Street<br />
people in Grenoble”, South-East Asia,<br />
Indonesia - Tsunami: beyond death is<br />
life”.
Germany<br />
Contact details<br />
> Bureau international<br />
Aerzte der Welt<br />
Thalkirchner Str 81<br />
Kontorhaus 1<br />
81371 München<br />
Allemagne<br />
Tél. : 00 49 89 62 42 09 55<br />
Fax : 00 49 89 65 30 99 72<br />
info@aerztederwelt.org<br />
www.aerztederwelt.org<br />
Contacts :<br />
Dr Lecia Feszczak, Monika<br />
Kleck, Gertrud Wimmer<br />
Association under German<br />
law, constituted 19 March<br />
1999<br />
Board of directors<br />
> President:<br />
Pr Wilfried Schilli<br />
> Vice-President:<br />
Dr Pierre Rosenstiel<br />
> Treasurer:<br />
Rolf-Michael Schlegtendal<br />
> Other Members:<br />
Dr Klaus Wieners<br />
Dr Béatrice Stambul<br />
Dr François Scheffer<br />
Pr Albrecht Pfleiderer<br />
Pr Norbert Schwenzer<br />
Andreas Jungk<br />
> Key events<br />
Financial support for projects<br />
• Afghanistan: mother and child<br />
protection programme.<br />
• Angola: mother and child health<br />
programme in Huambo North<br />
province.<br />
• Ethiopia: prevention of mother-tochild<br />
HIV transmission programme<br />
in Mekele.<br />
• Pakistan: programmes<br />
supporting government refuges for<br />
women victims of domestic<br />
violence and emergency aid for<br />
earthquake victims.<br />
• Niger: Opération Sourire project.<br />
Human Resources support<br />
for projects<br />
• 10 German expatriate volunteers<br />
went out to international projects.<br />
Publicity events<br />
and activities<br />
• Celebration of 5 years of Aerzte<br />
der Welt in Germany and collection<br />
of two cheques from Sternstunden<br />
for Cambodia and Ethiopia.<br />
• “23 artists for Médecins du<br />
Monde” - sale of lithographs with<br />
proceeds going to MdM France,<br />
organised by the Oppenheim bank<br />
in Munich.<br />
• Three information letters made<br />
available on the internet and sent<br />
to donors, volunteers and partners.<br />
• Articles in national and regional<br />
newspapers on projects in<br />
Cambodia and Sri Lanka.<br />
• Sternstunden TV on Bavarian TV<br />
(short film on the project in<br />
Batticaloa in Sri Lanka).<br />
138/139<br />
Projects:<br />
• Two Opération Sourire projects in<br />
Cambodia (Kampong Cham and<br />
Phnom Penh).<br />
• Planning a local project in Munich<br />
(primary healthcare for people<br />
without medical insurance such as<br />
migrants and those without<br />
papers):<br />
- redefining the concept;<br />
- beginning to build up a network<br />
of volunteers;<br />
- co-operation with other partners<br />
in the field.<br />
• Three exploratory projects in<br />
Batticaloa in Sri Lanka:<br />
assessment of an idea to improve<br />
the local hospitals' surgical<br />
structures, through training<br />
orthopaedic surgeons to comply<br />
with hygiene standards and<br />
surgery techniques.<br />
> Acknowledgements: The German Foreign Ministry, the City of Munich, Johanniter, Freiburg University, Tübingen University, The Munich European Patent Office, Martin<br />
Medizintechnik, mibeg Verlag, Sueddeutsche Zeitung, Stethosglobe, Munich Eine-Welt-Zentrum, Munich Nord-Sued-Forum, Bayerischer Rundfunk, Sternstunden e.V., M-Net<br />
Munich, Sofa-lx-systems, Sonja Schultes & Hersberger, www.helpdirect.org, www.malinet.de, www.zdf.de/zdfde/inhalt (ZDF Spendenforum), Ansell Healthcare Europe, Ansell<br />
GmbH, Excognito Agentur für Public Realtions, Internationale Spedition Heinz Huber, O.D.C. Fruchthandels GmbH, Alter Hof, Gastronomie Firma Paul Hartmann AG, Euro<br />
RSCG LIFE Munich, Neumeister - Kunstauktionshaus München, Oppenheim jr. & Cie Bank. KGaA, Vermop - Professional Cleaning Systems, Vogtland Philharmonie Greiz<br />
Reichenbach, Tagesheimschule an der Hochstraße Munich
Japan<br />
Contact details<br />
> International Office:<br />
Médecins du Monde Japon<br />
PMC Building 6F<br />
1-23-5 Higashi-Azabu,<br />
Minato-ku, Tokyo 106, Japon<br />
Tél. : 00 81 3 35 85 64 36<br />
Fax : 00 81 3 35 85 11 34<br />
info@mdm.or.jp<br />
http://www.mdm.or.jp<br />
Contacts :<br />
Prune Helfter, Kehko<br />
Takayama, Nao Kuroyanagi,<br />
Tatsuya Kishi ( all staff)<br />
Association under Japanese<br />
law, constituted 10 October<br />
2000<br />
Board Members<br />
> Board of Directors<br />
President:<br />
Gaël Austin<br />
> Other Members:<br />
Yasuko Arai<br />
Dr Arnaud Bourde<br />
Dr Patrick David<br />
Dr François Foussadier<br />
Masako Harada<br />
Akitane Kiuchi<br />
Dr Norihiko Oura<br />
Dr Satoshi Yoza<br />
> Key events<br />
Financial support for projects<br />
• Bolivia: Health and child workers<br />
in Potosi project.<br />
• Cambodia: Opération Sourire<br />
project in Phnom Penh.<br />
• China: Chengdu project - AIDS<br />
prevention<br />
• Ethiopia: mother-to-child HIV<br />
transmission prevention<br />
programme.<br />
• Indonesia: emergency and posttsunami<br />
reconstruction<br />
programme.<br />
• Madagascar: Opération Sourire<br />
project in Antananarivo.<br />
• Pakistan: emergency<br />
programme.<br />
• DRC: programme supporting<br />
street children.<br />
• Sudan: emergency programme<br />
in Darfur province.<br />
• Sri Lanka: emergency and<br />
post-tsunami reconstruction<br />
programme.<br />
Human resources support<br />
for projects<br />
• 12 Japanese expatriate workers<br />
went out to international projects.<br />
Publicity events<br />
and activities<br />
• Organisation of photo exhibitions<br />
presenting MdM's HIV projects and<br />
emergency programmes in<br />
Indonesia and Pakistan in very<br />
busy places such as the corridors<br />
of the Tokyo underground.<br />
• Presentation of MdM's HIV<br />
projects on a stand at the<br />
international AIDS conference in<br />
Kobe.<br />
• Organisation of a charity dinner<br />
at the French embassy attended<br />
by over 200 people, with the<br />
voluntary involvement of renowned<br />
chefs and artists.<br />
• Publication of articles on<br />
Médecins du Monde and<br />
Opération Sourire in national and<br />
regional newspapers, and high<br />
circulation weeklies, and a short<br />
spot in a programme on the state<br />
radio station NHK.<br />
• Publication of a newsletter<br />
distributed to donors, volunteers<br />
and partners.<br />
> Acknowledgements: Air France, Air Tahiti Nui, Akebono Brake, Alsok, Aman Resorts, Asahi Pretec, Bristol Meyers Squibb Group, Chanel, Cn-Intervoice, French<br />
Chamber of Commerce and Industry in Japan, French Embassy in Japan, Felissimo Corporation, Ferris University, Flos, French Blue Meeting, French Food Culture Center, Ginza<br />
Gallery (Circle Club), Global Tank, Greeting life, Hyogo International Association, Impresario, JANIC, JICA, Members of the Agricultural Order of Merit in Japan, Å@Mitsui<br />
Sumitomo Insurance, Nippon Koa Insurance, NTT Data, Sanyu Network, Shibaura Institute of Technology, Shiseido, Sompo Japan Insurance, Sonia Rykiel, Tanabé Seiyaku, The<br />
TIE Corp. Tout le monde vœux, Yokohama French Film Festival.
The Netherlands<br />
Contact details<br />
> International Office:<br />
Dokters van de Wereld<br />
Rijswijkstraat 141 A<br />
1062 ES Amsterdam<br />
Pays-Bas<br />
Tél. : 00 31 20 465 2866<br />
Fax : 00 31 20 463 1775<br />
info@doktersvandewereld.org<br />
www.doktersvandewereld.org<br />
Contacts :<br />
Nadjehda Brouwer-<br />
Richardson, Reinier Spruit,<br />
Resy Arts, Anna Miranda<br />
Scholten, Arianne de Jong,<br />
Sacha Godschalk,<br />
Corinne Eisma ( all staff).<br />
Marian van Keuk, Gerd<br />
Beckers (co-ordinators)<br />
Association under Dutch law<br />
constituted 28 April 1997<br />
Board of directors<br />
> President:<br />
Dr Barbara ten Kate<br />
> Secretary:<br />
Dr Dirkjan Pot<br />
> Treasurer:<br />
Casper van Rijn<br />
> Other Members:<br />
Howard Teunisse<br />
Bernard Juan<br />
Françoise Sivignon<br />
> Key events<br />
Financial support for 10 programmes<br />
(through direct marketing) and the following<br />
projects, by project funders:<br />
• Burma: harm reduction for risks linked<br />
to drug addiction programme<br />
• Indonesia (West Papua):<br />
minorities' access to healthcare programme.<br />
• Tanzania: AZT programme.<br />
• Benin: AIDS programme.<br />
• DRC Goma: AIDS programme.<br />
• Madagascar: HIV/AIDS prevention<br />
programme.<br />
• Zimbabwe: financial support for<br />
FACT for HIV/AIDS prevention.<br />
• Indonesia (Papua Paniai): HIV/AIDS<br />
prevention programme in Primari.<br />
• Pakistan: emergency<br />
programmes.<br />
• Liberia: primary healthcare<br />
programme.<br />
Human resources support<br />
for projects<br />
• 10 Dutch expatriate volunteers went<br />
out to work on international projects.<br />
Publicity events<br />
and activities<br />
• Interviews with Dutch volunteers in<br />
the Dutch media (radio,<br />
newspapers and magazines).<br />
• Organisation of a press trip to<br />
Papua, Indonesia and publication of<br />
articles in four magazines.<br />
• Transparency Prize won for the<br />
publication of Dokters van de<br />
Wereld's 2004 annual report.<br />
• Three publications on Dokters van<br />
de Wereld's international<br />
activities, aimed at donors, sponsors<br />
and volunteers.<br />
National projects<br />
• Roma and Sinti: health<br />
programme for Roma and Sinti,<br />
especially women. Training and<br />
health education in Roma and Sinti<br />
communities in the Netherlands.<br />
Partnerships with LSRO (Dutch organisation<br />
for Roma and Sinti) and<br />
other organisations.<br />
• Undocumented migrants: pilot pro-<br />
140/141<br />
gramme to improve access to health<br />
care for those without papers in<br />
Amsterdam. Distribution of medical<br />
documents to those without papers<br />
(Medoc) and<br />
information campaign amongst those<br />
without papers and health professionals<br />
on access to<br />
healthcare.<br />
> Acknowledgements: Aids Fund, Cordaid, Dutch Ministry for Development Cooperation, ICCO, Oxfam Novib, NCDO, Nora Tol Virtual Publishing, Stichting Lions, STOP<br />
AIDS NOW, Zicht nieuwe media ontwerpers, Sandra van Noord - Bureau voor tekst en redactie, Ordina, Haute Finance, Paradiso, Tom van der Leij, Capi Lux Vak, and all our<br />
volunteers, trainees and thousands of private donors.
United Kingdom<br />
Contact details<br />
> International office:<br />
Médecins du Monde UK<br />
34th Floor<br />
One Canada Square<br />
Londres E14 5AA<br />
Royaume-Uni<br />
Tél. : 020 7516 9103<br />
Fax : 020 7516 9104<br />
info@medecinsdumonde.org.uk<br />
www.medecinsdumonde.org.uk<br />
Contacts :<br />
Karen McColl, Michelle<br />
Hawkins, Isabelle Raymond,<br />
Claire Loussouarn,<br />
Dorothy Muthuri,<br />
Elinor Middleton ( all staff). .<br />
Association under English law,<br />
constituted 13 January 1998<br />
Board Members<br />
> Board of directors:<br />
Dr David Barnes<br />
Dr Laurence Bioteau<br />
Janice Hughes<br />
Robert Lion<br />
Dr Sarah Pickworth<br />
Lord Rogers of Riverside<br />
Roo Rogers<br />
> Key events<br />
Financial support for projects<br />
• Cambodia: antiretroviral therapy<br />
programme in Phnom Penh.<br />
• Sudan Darfur: programme of<br />
medical aid to displaced people.<br />
• Sudan: surgery programme at<br />
Malakal.<br />
• Afghanistan: mother and child<br />
health programme in Kabul.<br />
• Tsunami: emergency programme.<br />
• Cuba: Café Salud programme in<br />
Havana.<br />
Human resources support<br />
for projects<br />
• 21 MdM UK expatriate volunteers<br />
went out to international projects.<br />
Publicity events and activities<br />
• Interviews with MdM UK<br />
volunteers in the British media and<br />
publication of articles on Médecins<br />
du Monde (newspapers,<br />
magazines, online, radio, TV).<br />
• Reception at the French<br />
Ambassador to the UK's residence<br />
to celebrate Médecins du Monde's<br />
25th birthday and raise awareness<br />
amongst the French community in<br />
London of the work of Médecins<br />
du Monde UK.<br />
• Launch of the web site<br />
www.medecinsdumonde.org.uk<br />
• Publication of News (twice), an<br />
information newsletter on MdM<br />
UK's activities, distributed to<br />
donors and volunteers.<br />
• Publicity: preparation of a press<br />
pack for the launch of a national<br />
project: “Project: London”, and<br />
organisation of a press conference<br />
in January 2006.<br />
Projects<br />
• Development of a national project<br />
to improve access to healthcare for<br />
vulnerable people groups in East<br />
London: registration with the<br />
Healthcare Commission (regulatory<br />
body), recruitment and training of a<br />
team of 33 volunteers, refurbishment<br />
of premises to create two<br />
medical rooms, creation of a<br />
network of local partners,<br />
fundraising to fund the project.<br />
• Participation in the European<br />
survey on access to healthcare for<br />
undocumented migrants in Europe.<br />
> Acknowledgements: Alliance Pharmacy, Department For International Development (DFID), the Elton John AIDS Foundation, Isle of Man Overseas Aid Committee,<br />
Canary Wharf Group, Clifford Chance, Chubb Insurance, Cubana, the French Embassy, the Frontline Club, Lonely Planet, MEDSIN, Nomad Travel Stores, Richard Rogers<br />
Settlement, SS Robin, the Sahara Trekkers, Sylvan Technical Services, Thames Wharf Charity, Tower Hamlets Primary Care Trust and all our volunteers and donors.
143/153<br />
The organisation
Médecins du Monde<br />
and its management<br />
Médecins du Monde's organisation is based on board members with experience overseas, volunteers in France, voluntary<br />
workers for international operations, and a permanent paid staff. The support of hundreds of thousands of<br />
donors ensures Médecins du Monde's financial independence. Thanks to this diversity, MdM operates permanently<br />
on the basis of debate, the views of civil society and the operational efficiency of its programmes for beneficiaries.<br />
As a result there is a strong and original organisational structure which is distinctive amongst large NGOs.<br />
>Decision-making<br />
authorities<br />
Once a year, MdM's members (1,562 in<br />
2005) meet in the General Assembly<br />
(GA), the highest decision-making body<br />
and the only one with the authority to<br />
amend the articles of association. The<br />
GA elects the twelve members of the<br />
Board of Management for three years,<br />
to which are added three substitutes.<br />
From amongst its members, the Board<br />
elects the President and the<br />
organisation's Officers for one year: the<br />
Vice-Presidents, Treasurer, Deputy<br />
Treasurer, General Secretary and Deputy<br />
General Secretary and a Representative.<br />
The Board, the organisation's executive<br />
body, meets monthly and takes any<br />
decisions concerning the organisation's<br />
management.<br />
To carry out its task properly the Board<br />
relies on:<br />
• an advisory structure of Association<br />
members;<br />
• a permanent operational structure;<br />
• joint decision-making bodies bringing<br />
together permanent staff and Association<br />
members;<br />
• the regional offices.<br />
>The advisory structure<br />
This includes the continental groups<br />
and thematic groups. Each of these<br />
groups, made up of volunteer members<br />
with overseas experience involved in<br />
projects, proposes or issues an opinion<br />
on the continent or theme for which it is<br />
responsible. Their role is vital in terms of<br />
analysing contexts, modes of<br />
intervention, and drawing on the<br />
experience of projects. The Association<br />
has five continental groups, eight<br />
thematic groups and a France group<br />
including the Mission France and Harm<br />
Reduction steering committees. The<br />
members of the advisory groups are<br />
elected according to the internal<br />
regulations.<br />
>The permanent<br />
operational structure<br />
This is led by two Directorates. The<br />
Humanitarian Aid Directorate includes<br />
the international operations<br />
department, the Mission France<br />
co-ordinating body, project logistics,<br />
the adoption department and the
communication department. The<br />
Management Directorate includes the<br />
human resources department, the<br />
development department, the finance<br />
and IT systems department and the<br />
legal department. Non-strategic<br />
operational decisions are made each<br />
week during a project meeting for<br />
project-related decisions and at a<br />
management meeting for other<br />
aspects. International programmes are<br />
managed by the programme's medical<br />
co-ordinator, who is responsible to the<br />
Head of Project who deals with aspects<br />
of policy or specific expertise and is in<br />
operational contact with the desk<br />
officer at head office or the project<br />
officer in some regional offices. Heads<br />
of Projects are proposed by the<br />
different internal bodies and ratified by<br />
the Board.<br />
>The joint decisionmaking<br />
bodies<br />
They include the Management<br />
Committee, which brings together the<br />
staff members involved in management<br />
each week and examines strategic<br />
decisions concerning projects, passe<br />
au crible les décisions bearing witness,<br />
political lobbying and publicity. Other<br />
joint decision-making bodies are the<br />
human resources group and the<br />
management group who meet each<br />
month to define human resources and<br />
management policies which are<br />
finalised and ratified by the Board.<br />
>The regional<br />
delegations<br />
In the regions, MdM has set up regional<br />
delegations. Elected every two<br />
years, the regional colleges represent<br />
the Association in the regions. The<br />
delegations carry out international or<br />
regional projects, within the overall<br />
framework defined by the Board. All the<br />
board members, Heads of Projects,<br />
group co-ordinators, regional and<br />
board representatives meet three times<br />
a year for a National Advisory Council<br />
meeting.<br />
144/145<br />
>The Donor Committee<br />
The Donor Committee is made up of a<br />
dozen co-opted members and it provides<br />
constructive criticism and consensual<br />
analysis on MdM''s projects, ratios<br />
or communication strategy. It is given<br />
funding to go and evaluate projects in<br />
France and abroad. Through its president,<br />
it can express its views to the<br />
Board and the general assembly.<br />
This specific set-up encourages debate<br />
at all levels. It allows MdM to be an active<br />
association which is both politically<br />
and financially independent. It encourages<br />
voluntary commitment by health<br />
workers in the service of the most<br />
destitute and vulnerable people, and has<br />
a constant concern for the quality and<br />
effectiveness of its international or local<br />
projects.
Department news<br />
All the head office departments support the programmes run by the organisation amongst the most vulnerable people in<br />
France and abroad. These departments must be run in a way which guarantees effective institutional, human, logistical, financial<br />
and budget support for projects, but also makes them answerable to our funders and donors. In 2005, work was developed<br />
in the humanitarian action, human resources and management areas.<br />
>Humanitarian action<br />
• The year was marked by emergency and<br />
reconstruction work as a result of the earthquakes<br />
in Asia and Pakistan. MdM demonstrated<br />
how reactive its emergency department is, as it<br />
was among the first teams to intervene on<br />
several sites. This was possible by the<br />
presence of long-term projects in Indonesia<br />
and Pakistan at the time of the disasters.<br />
• In this context, the humanitarian action<br />
directorate and the international operations<br />
department continued to develop international<br />
projects which increased in number and<br />
financial volume (higher volume of activity than<br />
the Association's in 2000, which means financial<br />
growth of over 30% compared to 2004).<br />
• The institutional development department<br />
increased and diversified programmes' financial<br />
resources through representation offices and<br />
actions in the field. These resources increased<br />
by 50% between 2004 and 2005.<br />
• The MdM Europe project expanded with the<br />
construction of the European Observatory and<br />
the launch of national projects in the United<br />
Kingdom and the Netherlands.<br />
>HR<br />
The response to the emergencies in Asia and<br />
Pakistan translated into a 50% rise in the<br />
number of expatriate volunteers sent on<br />
international projects in 2005. Moreover, the<br />
number of paid staff on the international<br />
projects increased significantly.<br />
>Management<br />
• The start of the year was marked by a large<br />
influx of gifts (due to the Asian tsunami). In<br />
addition, the plan to reduce appeals, tested in<br />
2004, yielded significant results as did the systematic<br />
offer to set up standing orders as a better<br />
way for donors to support MdM.<br />
• The policy of partnership with businesses was<br />
reinforced.<br />
• The setting up of a financial monitoring tool<br />
and a budget plan common to all MdM's<br />
projects was completed in 2005.<br />
• The international offices continued to<br />
develop in the United Kingdom and the<br />
Netherlands, and were reorganised in<br />
Japan and Germany. In addition, the<br />
relationship between MdM France and the<br />
international secretariat was strengthened<br />
during the year.<br />
>Management up to<br />
31/12/2005<br />
Humanitarian Action Directorate:<br />
Dr Michel Brugière<br />
Management and HR Directorate:<br />
François Dupré<br />
International Operations Department:<br />
Dr Gilles Raguin (until 1 August 2005)<br />
Mission France Co-ordinating Body:<br />
Nathalie Simonnot<br />
Finance and I.T. Systems Department:<br />
Catherine Duffau<br />
Administration and Legal Department:<br />
François Rubio<br />
Publicity and Development Department:<br />
Isabelle Finkelstein<br />
Adoption Dept :<br />
Dr Geneviève André-Trevennec
Médecins du Monde's<br />
International Network<br />
146/147<br />
Twelve delegations, nine in Europe (Belgium, Cyprus, France, Greece, Italy, Portugal, Spain, Sweden and<br />
Switzerland) and three in the Americas (Argentina, Canada and the United States) were members of Médecins du<br />
Monde's international network in 2005.<br />
The International Board (IB), whose task is to<br />
set the network's main policy directions, met<br />
twice in 2005. The presidents or vice-presidents<br />
of eleven of the network's twelve international<br />
delegations took part in the discussions.<br />
The International Executive Committee (IEC),<br />
which is responsible for drawing up an annual<br />
action plan based on the IB's policy directions,<br />
and for monitoring its operations, met five times<br />
in 2005.<br />
The International Secretariat (IS), led by a<br />
new director from January 2005, continued to<br />
ensure the network ran well and to co-ordinate<br />
the delegations' activities. The IS, made up of a<br />
team of five people, also worked on improving<br />
the network's organisation, especially by<br />
carrying out work on the operational co-ordination<br />
of emergency projects and on harmonising<br />
tools and security rules. In accordance with the<br />
decisions made in 2004 by the International<br />
Board, 2005 saw the launch of the process of<br />
evaluating the international delegations.<br />
This fair, standardised and planned process will<br />
provide the international network with an overall<br />
and exhaustive view of the offices and their<br />
activities by the end of 2006.<br />
The Presidents:<br />
Argentina: Dr Silvana Reinoso<br />
then Dr Alicia Luna<br />
Belgium: Dr Michel Degueldre<br />
Canada: Dr Réjean Thomas<br />
Cyprus: Dr Elias Papadopoulos<br />
France: Dr Françoise Jeanson<br />
Greece: Dr Socrates Mitsiadis<br />
then Dr Eleftheria Parthenopoulou<br />
Italy: Dr Faustino Boioli<br />
Portugal: Dr Mario de Sousa<br />
(temporarily Mrs Claudia Amaral)<br />
then Dr Rui Portugal<br />
Spain: Dr Teresa Gonzalez<br />
Sweden: Dr Anders Bjorkman<br />
Switzerland: Dr Nago Humbert<br />
United States: Dr Victoria L. Sharp<br />
>Operational<br />
co-ordination<br />
The international network worked together to<br />
provide aid to tsunami victims and then to<br />
victims of the earthquake which hit Pakistan. The<br />
co-ordination of operations implemented by the<br />
different international offices was provided in<br />
both cases by the International Secretariat.<br />
The joint pilot programme in Zimbabwe aimed at<br />
“reducing the impact of the HIV/AIDS epidemic<br />
on vulnerable orphans and children” in Chipinge<br />
district, implemented as a partnership between<br />
MdM Canada, MdM Spain and MdM France,<br />
entered its operational phase.<br />
>Priorities for 2005<br />
In accordance with the decisions made in 2004<br />
by the International Board, the themes of<br />
HIV/AIDS and migrants were the subject of<br />
considerable sharing and consultation across<br />
the network.
Sister organisations<br />
and local partners<br />
Médecins du Monde bases its work around local partners to provide links that will ensure the work will continue.<br />
If no partners exist, MdM supports the setting up of sister organisations, which are often formed on the initiative<br />
of, and based around, MdM's local team. They gradually become autonomous and are supported for one to two<br />
years on average. The structures thus created remain MdM's natural partners in the region.<br />
> In Europe<br />
• Bosnia-Herzegovina, Sarajevo<br />
<strong>DU</strong>GA (Drop-in and psychological<br />
support centre for children and young<br />
people). Set up in 1994, autonomous<br />
since 2002. info_duga@yahoo.com<br />
Activities: assistance to children, fight<br />
against AIDS.<br />
• Poland, Warsaw<br />
Nobody's Children Foundation<br />
Set up in 1990, autonomous since 2003.<br />
www.fdn.pl<br />
Activities: assistance to children.<br />
• Romania, Bucharest<br />
FICF (International Foundation for<br />
Children and Families). Set up in 1993,<br />
autonomous since 2003.<br />
Fax: + 40 21 311 19 15 / 23 05<br />
Activities: assistance to children.<br />
• Russia, Saint-Petersburg<br />
Humanitarian Action Foundation<br />
Set up in 1993, autonomous for its<br />
street children's work since 2003 and<br />
for harm reduction since 2005.<br />
www.humanitarianaction.org<br />
Activities: assistance to children, fight<br />
against AIDS, harm reduction.<br />
> In Africa<br />
• Mozambique, Maputo<br />
Meninos de Moçambique<br />
(Children of Mozambique)<br />
Set up in 2000, autonomous since 2001.<br />
Fax: + 258 30 41 16<br />
Activities: Assistance to children.<br />
• Madagascar, Tulear<br />
Sisal Association (Doctors for the<br />
Right to Health). Set up in 2002, autonomous<br />
since 2005.<br />
Activities: fight against AIDS, harm<br />
reduction.<br />
• Uganda, Kyotera<br />
CIPA (Community Initiative for the<br />
Prevention of HIV-AIDS/STIs).<br />
Set up in October 2003, autonomous<br />
since December 2005.<br />
cipacp@yahoo.com<br />
Activities: fight against AIDS.<br />
ORGANISATIONS REQUIRING<br />
SUPPORT FROM MDM<br />
> In Latin America<br />
• El Salvador<br />
MDS (Doctors for the Right to Health).<br />
Set up in 1998.<br />
www.mds.org.sv<br />
Activities: promoting the right to health.
In Africa<br />
• Tanzania, Bukoba<br />
Tadepa (Tanzania Development<br />
and Prevention of AIDS). Set up in<br />
2001.<br />
Activities: fight against AIDS.<br />
• Ivory Coast, Abidjan<br />
Mesad (Movement for Education,<br />
Health and Development).<br />
Set up in 2001.<br />
mesad_ci@yahoo.fr<br />
Activities: assistance to children, fight<br />
against AIDS.<br />
> In Europe<br />
• Bulgaria, Sofia<br />
Association Enfant et Espace (Child<br />
and Space Association).<br />
Set up in July 2005.<br />
Activities: assistance to children.<br />
def@bulinfo.net<br />
• Serbia, Belgrade<br />
VEZA. Set up in June 2005.<br />
vezango@gmail.com<br />
Activities: fight against AIDS, harm<br />
reduction.<br />
SOUTHERN<br />
PARTNER ASSOCIATIONS<br />
> In Africa<br />
• Guinea, Kindia<br />
KAD (Kindia Prisoner Assistance).<br />
Set up in 2000.<br />
Activities: assistance to prisoners<br />
• Rwanda, Kigali<br />
Ibuka (Remembrance and Justice)<br />
Set up in 1995.<br />
Activities: defending the rights of<br />
genocide victims.<br />
• DRC, Kinshasa<br />
AED (Assistance to disadvantaged<br />
children)<br />
Set up in 1966.<br />
Activities: assistance to young people.<br />
• Zimbabwe, Chipinge<br />
FACT (Family Aids Caring Trust).<br />
Set up in 1987.<br />
Activities: fight against AIDS.<br />
• Madagascar, Antananarivo, Ilakaka<br />
Salfa (Malagasy Lutheran Church)<br />
Set up in July 1987.<br />
Activities: primary healthcare.<br />
> In Latin America<br />
• Haiti, Port-au-Prince<br />
URAMEL (Medico-legal research<br />
and action unit).<br />
Set up in July 2002.<br />
www.uramel.net<br />
Activities: promoting justice in<br />
partnership with health professionals.<br />
> In the Middle East<br />
• Egypt, Cairo<br />
Hope Village<br />
148/149<br />
Set up in 1988.<br />
www.egyhopevillage.com<br />
Activities: assistance to children<br />
• Lebanon, Antelias<br />
Ajem (Justice and Mercy Association)<br />
Set up in January 1998.<br />
ajem@intracom.net.lb<br />
Activities: assistance to refugees, asylum<br />
seekers and imprisoned migrants.<br />
• Morocco, Casablanca<br />
Medical Association for the<br />
Rehabilitation of Victims of Torture.<br />
Set up in January 2001.<br />
caovt@menara.ma<br />
Activities: assistance to victims of torture.<br />
> In Europe<br />
• Moldova, Balti<br />
TDV (Youth for the Right to Live)<br />
btdv@mtc-bl.md<br />
Activities: assistance to children<br />
• Bulgaria, Sliven<br />
Fondation pour la Santé du Peuple<br />
Rrom (Roma Health Foundation). Set<br />
up in 1999. mngrf-sl@mbox.digsys.bg<br />
Activities: primary healthcare.<br />
> In Asia<br />
• Indonesia, Jakarta<br />
Yayasan Aulia. Set up in 1984.<br />
ypmaulia@cbn.net.id<br />
Activities: right to health and education<br />
and community organisation.
Médecins du Monde<br />
and civil society in France<br />
Leadership and<br />
co-ordination groups<br />
> SUD co-ordinating body - CCD<br />
> CNVA<br />
> FONJEP<br />
> Charter Committee<br />
> UNOGEP<br />
>Leadership and<br />
co-ordination groups<br />
SUD (Solidarity Emergency<br />
Development) Co-ordinating body.<br />
A co-ordinating body for French<br />
humanitarian and development NGOs<br />
which it represents in France and<br />
internationally. As a Board member,<br />
MdM represents the group in the CCD<br />
MdM<br />
Thematic platforms<br />
> Health and social<br />
• UNIOPSS - Alerte Group<br />
• CNLE<br />
• Foreigners' right to health monitoring centre<br />
• Platform for the fight against human trafficking<br />
• French co-ordinating body for the right to asylum<br />
• Romeurope<br />
• International Harm Reduction Association<br />
> Funding<br />
• AFTA<br />
> Human rights<br />
• CNCDH<br />
> International action<br />
• URD<br />
• Clong Volontariat<br />
(Development Co-operation<br />
Commission), a joint body informing<br />
NGOs of the public authorities'<br />
co-operation policy.<br />
CNVA (National<br />
Council of Associations)<br />
An independent authority attached to<br />
the Prime Minister's office, through<br />
which all French associations relate to<br />
Geographical platforms<br />
> Mixed commissions<br />
> Palestine platform (observer)<br />
the Prime Minister. MdM monitors<br />
issues related to humanitarian action.<br />
FONJEP (Youth and popular<br />
education co-operation fund)<br />
A jointly-managed association bringing<br />
together public administrations and associations.<br />
It helps associations by making<br />
it easier to do voluntary work. MdM<br />
monitors the issue of volunteers.
Comité de la Charte<br />
(Charter Committee)<br />
A committee bringing together<br />
associations that call on the public's<br />
generosity, in accordance with a<br />
charter and previously established<br />
recommendations.<br />
UNOGEP (National Union of<br />
Fundraising Organisations).<br />
>Thematic platforms<br />
Health and social<br />
• UNIOPSS (National Inter-federal<br />
Union of Private Health and Social<br />
Bodies).<br />
It works with institutions to have the<br />
health and social association sector<br />
recognised by European social policy.<br />
MdM belongs to the poverty and<br />
exclusion commission of the health<br />
and Europe groups. Link with the<br />
Alerte group.<br />
• CNLE (The National Council for<br />
Anti-Exclusion Policy).<br />
It checks that the government is<br />
enforcing all measures in the fight<br />
against exclusion.<br />
MdM has set up a group to monitor<br />
CMU (universal health insurance), and<br />
ask questions about the reception of<br />
asylum seekers and refugees.<br />
• ODSE (Foreigners' Right to Health<br />
Monitoring Centre)<br />
• Platform for the Fight against<br />
Human Trafficking.<br />
• French Co-ordinating body for the<br />
Right to Asylum.<br />
• Romeurope.<br />
• International Harm Reduction<br />
Association.<br />
Funding<br />
• AFTA (French Association for<br />
Association Treasurers).<br />
Human rights<br />
• CNCDH (National Advisory<br />
Committee on Human Rights). It<br />
formulates opinions and<br />
recommendations on human rights<br />
for the Prime Minister.<br />
International action<br />
• URD (Emergency Rehabilitation<br />
Development Group): group of relief work<br />
associations working through the<br />
humanitarian action quality process.<br />
• Volunteer NGO liaison committee<br />
(effective from 2004).<br />
150/151<br />
>Geographical<br />
platforms<br />
• Mixed commissions:<br />
Joint body of NGOs and public<br />
authorities. Exchanges on ways and<br />
means of working in a country.<br />
• The Palestine platform: Group of<br />
associations. MdM has observer<br />
status.
Médecins du Monde and<br />
international institutions<br />
NGOs that are active in the humanitarian area cannot ignore the international institutions, which are both important<br />
funders and front-line political authorities. Many decisions these days go beyond the national context and relate to<br />
European or global decisions. In order to fully understand this complex situation, Médecins du Monde is involved in<br />
different groups which facilitate access to the international decision-making authorities. At the same time, MdM is<br />
developing partnerships with other international organisations and has kept specific articles of association allowing<br />
it to intervene immediately.<br />
> European Union (EU)<br />
• The task of ECHO (the European<br />
Commission's Humanitarian Aid Office)<br />
is to provide assistance and relief to<br />
victims of natural disasters or conflicts<br />
outside the EU. ECHO has intervened<br />
in over 85 countries since 1982 and<br />
has an annual budget of over 500<br />
million euros.<br />
• EuropeAid (Co-operation Office) has<br />
the job of implementing the European<br />
Commission's external aid. The<br />
Commission is one of the main contributors<br />
of public aid for development.<br />
Over 150 countries, territories or organisations<br />
receive this aid which is<br />
managed by the Office.<br />
• MdM relates to EuropeAid through<br />
Concord (the European NGO<br />
Confederation for Relief and<br />
Development), which provides group<br />
lobbying of the European Union's institutions<br />
and takes part in developing<br />
common positions on European development<br />
policy and the major issues in<br />
North-South relations.<br />
• For several years, and especially in<br />
2005, MdM has been very active in<br />
Voice, an interface between associations<br />
and ECHO which brings together<br />
90 relief NGOs. MdM France is a member<br />
of the “Task Force” in charge of<br />
negotiating with ECHO in the name of<br />
the partner NGOs which are members<br />
of Voice. Thus, during the last few<br />
years, MdM has played a large part in<br />
the revision of ECHO's Framework<br />
Partnership Agreement (FPA) through<br />
the group set up by Voice to monitor<br />
the FPA.<br />
• MdM France and other member<br />
delegations of the international<br />
network regularly attend ECHO's intervention<br />
strategy planning meetings.<br />
> Council of Europe<br />
(COE)<br />
• The Council of Europe brings together<br />
46 European states. Set up in<br />
1949 to defend human rights, its particular<br />
focus since 1989 has been to<br />
help the Central and Eastern European<br />
(PECO) countries to implement and<br />
consolidate political reforms.
• MdM's international network has<br />
consultative status with the COE and<br />
is part of OING Service, a liaison<br />
group for NGOs with this status.<br />
> United Nations (UN)<br />
• The Economic and Social Council<br />
(ECOSOC) is the main organ of the UN<br />
co-ordinating the economic and social<br />
activities of the UN and its specialist<br />
bodies and institutions. MdM's international<br />
network has special consultative<br />
status which means that it can<br />
carry out lobbying activities, especially<br />
of the Human Rights Commission.<br />
It has observer status in this subsidiary<br />
organ of ECOSOC and is one of the<br />
few medical NGOs present in this<br />
public arena classifying human rights<br />
breaches. At the commission's annual<br />
meeting, MdM can intervene on each<br />
agenda item and submit texts.<br />
• MdM's international network has<br />
representation at the World Health<br />
Organisation (WHO) and the Office for<br />
the Co-ordination of Humanitarian<br />
Affairs (OCHA) in the High<br />
Commission for Refugees (HCR)<br />
This political representation is supplemented<br />
by an operational partnership<br />
agreement which MdM has<br />
with the HCR. There is an information<br />
exchange partnership between OCHA<br />
and MdM and keeps an operational<br />
eye on Reliefweb.<br />
• Some MdM projects are in contact<br />
with the United Nations Development<br />
Programme (UNDP) through operational<br />
collaboration and a policy, notably<br />
on the theme of children in conflicts.<br />
The same occurs with the United<br />
Nations Children's Fund (UNICEF) with<br />
which MdM works on several projects.<br />
• MdM is a member of the<br />
International Council of Voluntary<br />
Agencies (ICVA), a network of NGOs<br />
involved in human rights, which<br />
concentrates on humanitarian issues<br />
relating to refugees.<br />
ICVA brings together over 80 international<br />
NGOs. The Council relates to the UN<br />
authorities, especially as an interface<br />
with the HCR by tackling different themes<br />
such as the link between humanitarian<br />
workers and the military, or the protection<br />
of civilians in armed conflicts.<br />
152/153<br />
> World Bank (WB)<br />
The World Bank (WB) is one of the<br />
most important sources of aid for<br />
develop- ment, especially for the AIDS<br />
issue.<br />
It works in 100 client countries with the<br />
aim of assisting the poorest peoples<br />
and countries.
WE CARE FOR THOSE WHO THE WORLD IS GRA<strong>DU</strong>ALLY FORGETTING.<br />
Head office: 62 rue Marcadet 75018 Paris – Tel. +331 44 92 15 15 – Fax: +331 44 92 99 99 – www.medecinsdumonde.org – Publication manager: Dr. Françoise Jeanson – Chief editor: Giselda Gargano<br />
Editorial committee: Dr. Michel Brugière, Martine Mikolajczyk, Stéphanie Senet – Editorial staff: Raluca Gheorlan, Emmanuelle Harang, Germain Richard, Mame-Seynabou Sall<br />
Acknowledgements: to all participants to the 2005 edition – Design: Tel. 01 55 34 46 00 (ref. 2MDMRAP005) Copyright: any reproduction of this document is subject to a prior written request.