Activity Report 1994-2007
EMERGENCY
“All human beings are born free and equal in dignity and rights”. The acknowledgment of this principle “is the foundation of freedom, justice and peace in the world”. Universal Declaration of Human Rights Paris, 10th December, 1948, Article 1 and Preamble
EMERGENCY
Design: Zago LLC
Every year war and poverty destroy the lives of millions of people. In today’s conflicts, 90% of the victims are civilians.
EMERGENCY provides, high quality and free of charge medical and surgical assistance to victims of war, landmines and poverty. EMERGENCY promotes a culture of peace, solidarity and respect for human rights. EMERGENCY is an independent, nonprofit, neutral and nonpolitical humanitarian organization. It is dedicated to assisting the civilian victims of war, landmines and poverty. All EMERGENCY facilities are designed, built and run by specialized international personnel, who provide training for local staff. Surgery
Medicine
Rehabilitation
Surgery for victims of war
Internal Medicine
Physiotherapy
and land mines
Obstetrics and Gynaecology
Prosthesis production
Emergency and Trauma Surgery
Neonatology
Vocational training and
General Surgery
Paediatrics
cooperative workshops
Plastic and Reconstructive Surgery
Interventional cardiology
for physically disabled
Orthopaedic Surgery
First Aid
Assistance to widows and
Paediatric and Adult Cardiac Surgery Primary Health Care
orphans
Medical assistance for prisoners
Since 1994 2,750,000 patients have been treated free of charge in the surgical, medical and rehabilitation facilities run by EMERGENCY.
Afghanistan In 1999 EMERGENCY transformed a former police academy in the village of Anabah, in the Panjshir valley, into a Surgical Centre for war victims. Over the years, in order to meet the needs of the population, the admission criteria have been extended to all surgical emergencies, major traumas, paediatrics and internal medicine. In 2003 a Maternity Centre was established inside the hospital compound. A second Surgical Centre was established in Kabul in 2001. The EMERGENCY hospital is now the most important trauma centre in Afghanistan. The facility was upgraded in 2003 with a 6-bed ICU, and in August 2005 a CT-scan was installed. In September 2004 EMERGENCY opened a third hospital in Lashkar-gah, the capital of the Helmand province. The hospital, which is named after Tiziano Terzani, is the only structure that offers free, high quality medical assistance in an area ravaged by war. All hospitals are connected to First Aid Posts (FAPs) and Primary Health Centres (PHCs) located in heavily mined areas or in remote villages where there is no other medical facility. Each FAP is open 24/7, and an ambulance provides safe and fast transfer to hospital for urgent cases. Since 2001, EMERGENCY has been running a prison programme to provide medical assistance to inmates throughout the country.
China
Uzbekistan Tajikistan Turkmenistan Shebergan Anabah Kabul
Afghanistan Lashkar-gah Pakistan
Iran
EMERGENCY www.emergency.it
Anabah, the Panjshir valley
Surgical and Medical Centre Opened: December 1999 Activities: Surgery for war and landmine victims Emergency and Trauma Surgery Internal Medicine Paediatrics Facilities: Emergency Department, Outpatient Department, 2 Operating Theatres, Sterilization, Intensive Care Unit, Surgical-Medical Wards, Physiotherapy, Radiology, Laboratory and Blood Bank, Pharmacy, Teaching rooms, Playroom, Auxiliary facilities, Maintenance Department. Number of Beds: 70 Local staff: 197 Up to December 2007: Admissions: 14,627 Outpatient consultations: 61,204 Surgical operations: 10,387
Anabah, the Panjshir valley
Maternity Centre Opened: June 2003 Activities: Obstetrics and Gynaecology Neonatal Care Facilities: Emergency Department, Outpatient Department, Operating Theatre, Intensive Care Unit, Patient Wards, Nursery, Ultrasound, Delivery Room, Technical and Auxiliary facilities shared with the Surgical-Medical Centre. Number of Beds: 25 Local staff: 33 Up to December 2007: Admissions: 5,511 Outpatient consultations: 25,764 Surgical operations: 1,184 Births: 3,625
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Kabul
Surgical Centre for War Victims Opened: April 2001 Activities: Surgery for war and landmine victims Emergency and Trauma Surgery Facilities: Emergency Department, Outpatient Department, 2 Operating Theatres, Sterilization, Intensive Care Unit, Subintensive Care Unit, Surgical Wards, Physiotherapy, CT scan, Radiology, Laboratory and Blood Bank, Pharmacy, Teaching rooms, Playroom, Auxiliary facilities, Maintenance Department. Number of Beds: 95 Local staff: 226 Up to December 2007: Admissions: 15,695 Outpatient consultations: 46,837 Surgical operations: 18,253
Lashkar-gah
Surgical Centre for War Victims Opened: September 2004 Activities: Surgery for war and landmine victims Emergency and Trauma Surgery Facilities: Emergency Department, Outpatient Department, 2 Operating Theatres, Sterilization, Intensive Care Unit, Surgical Wards, Physiotherapy, Radiology, Laboratory and Blood Bank, Pharmacy, Teaching rooms, Playroom, Auxiliary facilities, Maintenance Department. Number of Beds: 70 Local staff: 184 Up to December 2007: Admissions: 5,688 Outpatient consultations: 37,547 Surgical operations: 6,066 EMERGENCY www.emergency.it
Afghanistan
First Aid Posts (FAP’s) and Primary Health Clinics Number: 29 Locations: Ahangaran, Anabah, Anjuman, Bagram, Bazarak, Changaram, Charikar, Dara, Darband, Dashty Rewat, Grishk, Gulbahar, Horaty, Kapisa, Khinch, Kohi-safi, Koklamy, Logar, Mirbachakot, Paryan, Rokha, Said Khil, Sangi Khan, Sayad and Shutul (where a mobile clinic is also operative). EMERGENCY also offers health care at the “Juvenile Rehabilitation Centre” and the “Tahi Mashkan” orphanage in Kabul. Local staff: 186 Up to December 2007: Patients transferred: 14,777 Outpatient consultations: 1,402,570
Prison Programmes Duab Prison: 694 patients examined and treated from 2001 to 2003 Shebergan Prison: 13,338 patients examined and treated from May 2002 to June 2004 Prisons in Kabul (Governmental Jail, Investigation Department, Pol-e-Charki): 130,998 patients examined and treated up to December 2007 Local staff: 24 Lashkar-gah Prison: 1,880 patients examined and treated from February 2006 to December 2007 Local staff: 2
Social Programme Carpet Factory April 2003 - April 2007 Location: Anabah, the Panjshir valley Teachers: 7 Weavers: 29
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Cambodia EMERGENCY’s Surgical Centre for war victims was established in Battambang in 1998, to provide free high quality surgical assistance and rehabilitation for victims of war and landmines. The Centre also provides plastic and reconstructive surgery for patients affected by polio, congenital malformations and burns. In 2005, following a memorandum of understanding signed with the Ministry of Health of Cambodia, the EMERGENCY hospital began to admit all trauma patients and other life-threatening surgical emergencies. After the closure of the department of traumatology at the provincial hospital, the EMERGENCY Surgical and Trauma Centre has become the referral facility for the entire province. In order to cope with the high number of landmine victims among the refugees returning from Thailand, a field programme in the northern Samlot region was established in 1999. EMERGENCY set up four First Aid Posts (FAPs) and a referral system to connect the remote and heavily mined Samlot district with the Surgical Centre in Battambang. A fifth FAP was opened in January 2000 in Tasanh, with a ward equipped for the treatment of malaria, endemic in this part of the country. Each FAP is open 24/7, and an ambulance provides transfer of urgent cases to the EMERGENCY hospital. In 2003, the management of 4 first aid posts was transferred to the local authorities, while EMERGENCY continues to support and supervise their activity. EMERGENCY is still present in the Samlot province with the FAP in O’Tatiak providing free primary health care.
Laos
Thailand
Battambang Samlot Cambodia Phnom Penh
Gulf of Thailand EMERGENCY www.emergency.it
Vietnam
Battambang
Surgical and Trauma Centre Opened: July 1998 Activities: Surgery for war and landmine victims Emergency and Trauma Surgery Orthopaedic, Plastic and Reconstructive Surgery Facilities: Emergency Department, Outpatient Department, 3 Operating Theatres, Sterilization, Intensive Care Unit, Surgical Wards, Physiotherapy, Radiology, Laboratory and Blood Bank, Pharmacy, Teaching rooms, Playroom, Auxiliary facilities, Maintenance Department. Number of Beds: 107 Local staff: 189 Up to December 2007: Admissions: 18,909 Outpatient consultations: 66,432 Surgical operations: 20,330
O’Tatiak
First Aid Post (FAP) Opened: 1999 Local staff: 4 Up to December 2007: Patients referred: 2,997 Outpatient consultations: 189,398* *This figure also includes consultations at the FAPs in O’Rotkroh, Chamlong Kouy, Tasanh e O’Chom before the facilities were transferred to the local authorities.
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Iraq EMERGENCY has been working in Iraq since March 1995, initially in the village of Choman on the Iraq/Iran border. The Sulaimaniya and Erbil Surgical Centres opened in 1996 and 1998, respectively, offering free high-quality surgical assistance to victims of land mines and war. Both centres were later equipped with specialized units for burns and spinal injury patients. Up to 2005, EMERGENCY treated over 330,000 people at the Centres in Erbil and Sulaimaniya and the network of first aid posts. In May, 2005, after 9 years of training the national staff, the Sulaimaniya and Erbil Surgical Centres and their network of First Aid Posts were transferred to the national health authorities. The Centres are now fully integrated into the national health system, offering free of charge highly qualified assistance to all patients. In 1998 EMERGENCY opened a Rehabilitation and Social Reintegration Centre in Sulaimaniya. The Centre provides lower and upper limb prosthetic services, physical rehabilitation and vocational training to physically disabled, and assists them in starting professional cooperative workshops. The Rehabilitation and Social Reintegration Centre is still managed by EMERGENCY.
Turkey
Choman
Erbil Sulaimaniya
Syria
Iran
Iraq Baghdad Jordan
Saudi Arabia
EMERGENCY www.emergency.it
Kuwait
Sulaimaniya
Rehabilitation Centre Opened: February 1998 Activities: Physical Rehabilitation Prostheses and orthoses production Facilities: Patient Wards, Physiotherapy, Indoor Swimming Pool, Orthopaedic and Prosthetic Workshops, Auxiliary facilities. Number of Beds: 41 Local staff: 92 Up to December 2007: Admissions: 4,425 Upper limb Prostheses: 642 Lower limb Prostheses: 4,223 Orthoses: 640
Sulaimaniya
Social Reintegration Programme Opened: 1998 Activities: Vocational training and development of small business cooperatives for the physically disabled Facilities: Classrooms, Vocational training workshops (professional sewing, leatherwork, woodwork, light carpentry, shoemaking), Auxiliary facilities. Trainees completing the programme: 561 Cooperatives set up: 186
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Sierra Leone In late 2000 EMERGENCY initiated a Surgical Programme to assist war victims. An abandoned medical clinic in the district of Goderich, on the outskirts of Freetown, was transformed and expanded into a Surgical Centre, by adding new buildings. This is where EMERGENCY provides treatment to war trauma, and orthopaedic patients. The admission criteria have now been expanded to include all life-threatening surgical emergencies. In spring 2002 a Paediatric Outpatient Department was opened in order to cope with the growing number of paediatric patients. In 2003 the government of Sierra Leone allocated a new area where EMERGENCY has built two new wards to expand its paediatric activities. Children admitted to the EMERGENCY Centre mainly suffer from severe malaria, acute anaemia and respiratory tract infections. Since 2005, there has been a programme to counter malnutrition at the Paediatric Centre the programme also involves mothers in hygiene and nutrition courses. In 2006, an oesophageal endoscopic dilatation programme was initiated to respond to the diffused phenomenon of burns as a result of the accidental ingestion of caustic soda, which is used by housewives to make soap. At present in Sierra Leone, the EMERGENCY Surgical and Paediatric Centres are the only facilities that offer free medical assistance and training in surgery and anaesthesia in a country still suffering the consequences of a long and destructive war.
Guinea
Sierra Leone Freetown Goderich
Atlantic Ocean Liberia EMERGENCY www.emergency.it
Goderich
Surgical Centre Opened: November 2001 Activities: Emergency and trauma surgery Orthopaedic and reconstructive surgery Facilities: Emergency Department, Outpatient Department, 2 Operating Theatres, Sterilization, Intensive Care Unit, Patient Wards, Physiotherapy, Radiology, Laboratory and Blood Bank, Pharmacy, Teaching rooms, Playroom, Auxiliary Facilities. Number of Beds: 99 Local staff: 256 Up to December 2007: Admissions: 13,423 Outpatient consultations: 114,782 Surgical operations: 10,784
Goderich
Paediatric Centre Opened: April 2002 Activities: Paediatrics Treatment of tropical and infectious diseases Facilities: Outpatient Department, Medical Ward, Technical and Auxiliary facilities shared with the Goderich Surgical Centre. Number of Beds: 16 Local staff: 8 Up to December 2007: Admissions: 4,917 Outpatient consultations: 72,396
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Sri Lanka Following an assessment carried out by a survey team a few days after the tsunami in December 2004, EMERGENCY supplied the Kalutara General Hospital with surgical instruments and medical consumables, enabling it to resume activities. In collaboration with a local organization, the Tamil Rehabilitation Organisation, EMERGENCY established an integrated programme to assist the coastal village of Punochchimunai, a Muslim minority community, in the eastern district of Batticaloa. The first phase of the programme called “Back to the sea” was completed at the end of July 2005, with the distribution of motor boats, canoes and fishing nets to the community’s fishermen. Local schoolchildren were supplied with school kits. EMERGENCY contributed to the reconstruction of 91 brick houses for families of the village who were made homeless by the tsunami. The renewed hostilities between the government and separatist Tamils in the Batticaloa area has held up work for many months, delaying the delivery of the houses.
Bay of Bengal
Punochchimunai Colombo
Kalutara
Sri Lanka Gulf of Mannar
EMERGENCY www.emergency.it
Sudan From spring 2004 to summer 2005, EMERGENCY provided assistance to the hospitals of Mellit and Al Fashir in North Darfur. Within the compound of the Al Fashir hospital, EMERGENCY built a surgical block composed of 2 operating theatres, a sterilisation room and a 20-bed ward. On the outskirts of Khartoum, where approximately 2 million Internally Displaced Persons (IDPs) live in camps in wretched conditions, EMERGENCY opened a Paediatric Centre. The Centre, situated in the Mayo camp, is the only medical facility free of charge in an area where 300,000 people live. In addition to an outpatient department, the Centre has a ward for day hospital and an ambulance to transfer the more serious cases to the city hospitals. Since April 2006, two community health promoters (CHP) have been visiting the young patients in their homes to ensure a proper follow up and to inform the families about basic hygiene rules. The Mayo Paediatric Centre also monitors women during pregnancy and runs a vaccination programme for children under 5. In April 2007, in Soba, a village along the banks of the Blue Nile, 20 kms from Khartoum, EMERGENCY opened the Salam Centre for Cardiac Surgery. The Salam Centre (“Salam” means peace in Arabic) is the first centre of excellence in cardiac surgery completely free of charge in Africa. It is a highly technological Centre, built using innovative techniques and also respects the environment. The Centre – managed by EMERGENCY, clinically and administratively – provides free specialist care to patients from Sudan and its bordering countries. As of 31st December 2007, patients from all over Sudan have been treated at the Centre, as well as patients from Eritrea, the Central African Republic, The Democratic Republic of Congo, Rwanda and Tanzania. Egypt Libya
Chad
Khartoum
SUDAN
Eritrea
Ethiopia
Central African Republic Democratic Republic of the Congo
Uganda Kenya
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Mayo, Khartoum
Paediatric Centre Opened: December 2005 Activities: Paediatrics Paediatric First Aid Facilities: Outpatient Clinics, Patient Ward, Laboratory, Auxiliary services. Number of Beds: 6 Local staff: 24 Up to 31 December 2007: Outpatient consultations: 39,275 Patients transferred: 547 Patients admitted for observation: 1,386
EMERGENCY www.emergency.it
Khartoum
The Salam Centre for Cardiac Surgery Opened: April 2007 Activities: Paediatric Cardiac Surgery Adult Cardiac Surgery Cardiology Facilities: 3 Operating Theatres, Intensive Care Unit, Subintensive Care Unit, Surgical Wards, Outpatient Departments, Catheterization Laboratory, Ultra Sound, Radiology, Laboratory and Blood Bank, Physiotherapy, Pharmacy, Technical and Auxiliary facilities, Repairs & Maintenance, Guesthouse for relatives of patients. Local staff: 308 Number of Beds: 63 Up to 31 December 2007: Admissions: 477 Outpatient consultations: 4,902 Cardiology examinations: 2,430 Open heart surgeries: 324 Diagnostic and interventional cardiology procedures: 147
Since May 2007, EMERGENCY commenced a regional health programme for paediatrics and cardiac surgery in Sudan and its bordering countries. EMERGENCY will establish Centres that will provide free paediatric care, and will also work in close collaboration with the Salam Centre, as cardiac screening and follow-up clinics. The first Paediatric Centre will be built in Bangui, in the Central African Republic.
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Italy Serious violations of human rights daily affect the lives of migrants coming to Italy. In April 2006 EMERGENCY opened an Outpatients clinic in Palermo to integrate the services provided by the National Health System and to improve access to treatment for migrants. The services provided in the clinic include: primary health care, paediatrics, dermatology, ophthalmology, ENT as well as social assistance. Many professionals regularly work pro bono to run the clinic: 15 dentists, 3 ophthalmologists, 15 general practitioners, 1 ENT specialist, 1 dermatologist, 1 paediatrician and 3 nurses. The clinic offers free health care to the migrants and to all those in need. Since its opening to 31st December 2007, 2,771 patients, coming from 62 different countries, have been treated at the Clinic. EMERGENCY also provides specialized medical services and training programmes in hygiene to prisoners in Rebibbia Prison - Nuovo complesso - in Rome.
Palermo
Programme for Migrants Outpatient Clinic Opened: April 2006 Activities: Primary Health Care Paediatrics Dermatology Dentistry Ophtalmology Ear Nose and Throat Specialist Facilities: Dental clinic, Optical clinic, 2 consultation rooms, Auxiliary facilities. Local staff: 6 Up to December 2007: Outpatient consultations: 11,889 EMERGENCY www.emergency.it
COMPLETED PROGRAMMES EMERGENCY builds and runs permanent facilities and trains national medical staff. The facilities are transferred to the local health authorities once they reach clinical and financial independence. 1994 - EMERGENCY renovated and reopened the surgical department of Kigali hospital in Rwanda. Over a period of four months, surgical assistance was provided for more than 600 victims of war and landmines. A maternity ward was also reopened, where over 2,500 patients received medical and surgical assistance. 1996/2005 - EMERGENCY built a Surgical Centre in Sulaimaniya, in northern Iraq, in order to provide assistance to the victims of war and landmines. The facility includes units for burns and spinal injury patients. In 2005 the Centre and the 22 First Aid Posts, connected to it, were transferred to the local health authorities. 1998/2005 - EMERGENCY built a Surgical Centre in Erbil, in northern Iraq, to provide assistance to the victims of war and landmines. The facility includes units for burns and spinal injury patients. In 2005 the Centre was transferred to the management of the local health authorities. 1999 - EMERGENCY supported the Jova Jovanovic Zmaj orphanage in Belgrade, Serbia. 1999/2003 - EMERGENCY established 5 First Aid Posts (FAPs) in the district of Samlot, in Cambodia, in order to provide assistance to the victims of landmines. In 2003 the FAPs of O’Rotkroh, Chamlong Kouy, Tasanh and O’Chom were transferred to the local health authorities. 2000 - EMERGENCY sent a surgical team to Eritrea in response to a request from the Italian Office for Cooperation and Development. During
the two-month mission the EMERGENCY team worked in the Mekane Hiwet Hospital in Asmara, treating victims of the war between Ethiopia and Eritrea. 2001 - EMERGENCY built a Prosthesis and Rehabilitation Centre in Diana, in northern Iraq. The Centre has been transferred to the management of the local health authorities. 2003/04 - EMERGENCY supplied drugs to the “Casa de la mujer”, a network of women’s centres to assist women suffering from cancer and diabetes, in Nicaragua. 2003 - EMERGENCY supplied Al-Kindi Hospital in Baghdad, Iraq, with generator fuel, medicines and medical consumables. Tons of medical supplies were also donated to the public hospital in Karbala, south of Baghdad. 2003 - EMERGENCY set up a Prosthesis and Rehabilitation Centre in Medea, Algeria. An existing clinic within the public hospital compound was renovated and equipped. EMERGENCY trained Algerian staff to provide specialized care for the physically disabled. The Centre, named Amal (“hope” in Arabic), was transferred to the local health authorities in 2004.
2003/04 - EMERGENCY sent a surgical team to work in the orthopaedic department of Jenin Public Hospital, Palestine. EMERGENCY also built a new orthopaedic ward, a new department of physiotherapy, a hospital kitchen and cafeteria. EMERGENCY was also responsible for training the Palestinian medical staff. 2004 - EMERGENCY supported the people of Falluja, Iraq, during the seige of the city which ended in May. Relief items, water and medical supplies were given to community leaders and to the local public hospital. 2004/05 - EMERGENCY rebuilt and equipped the Emergency Surgical Department of the university hospital of Al Fashir in North Darfur, Sudan. The structure includes a surgical block and a 20-bed ward. The Department was transferred to the Ministry of Health in August 2005. 2005 - EMERGENCY supplied Kalutara General Hospital, in Sri Lanka, with surgical instruments and medical supplies in order to boost clinical activities.
2003 - EMERGENCY built a Prosthesis and Rehabilitation Centre in Dohuk, northern Iraq. The Centre has been handed over to the management of the local health authorities. 2003 - EMERGENCY refurbished two Health Centres in Benguela Province, Angola, and equipped them with medicines and medical consumables. EMERGENCY ran the programme and trained Angolan medical staff untill February 2004.
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EMERGENCY’s Financial Resources EMERGENCY was founded in Italy in 1994 as a nonprofit organization to provide treatment and rehabilitation to the victims of wars and land mines. Since 1999 it has been officially recognized by the Italian Ministry of Foreign Affairs as a Non Governmental Organization (NGO). Since February 2005 EMERGENCY is present in the USA with groups of volunteers all around the Country. EMERGENCY is also active in the UK since December 2007.
EMERGENCY’s financial resources are primarily from donations by private citizens. From May 1994 to December 2006 (the most recently completed fiscal year) the total financial resources of EMERGENCY were 113,359,750 Euros. The average administrative overhead was 6.01% of total budget.
Financial resources managed by EMERGENCY to date:
Year
EURO
1994
435,977
2000
6,200,616
1995
317,828
2001
14,147,638
1996
1,582,883
2002
18,440,738
1997
2,754,334
2003
17,440,944
1998
2,157,363
2004
17,240,225
1999
3,979,566
2005
13,945,171
2006
14,716,032
2007
22,500,00 *
*Estimated balance
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DONATIONS Bank wire in favour of EMERGENCY: c/o Banca Popolare dell’Emilia Romagna IBAN IT 41 V 05387 01600 000000713558 c/o Banca Popolare di Milano IBAN IT 35 T 0558401600 000000067000 c/o Banca Etica, Filiale di Milano IBAN IT 02 X 05018 01600 000000130130 c/o Banca Monte dei Paschi di Siena IBAN IT 76 D 01030 01600 000007362036 Credit Card on-line (on Secure Server) at www.emergency.it (Euros)
For further information on how to support EMERGENCY please contact: progetti@emergency.it
EMERGENCY
via Meravigli 12/14 20123, Milan - ITALY tel +39 02 881881 fax +39 02 86316336
via dell’Arco del Monte 99/A 00186, Rome - ITALY tel +39 06 688151 fax +39 06 68815230
info@emergency.it www.emergency.it
roma@emergency.it www.emergency.it
EMERGENCY UK
info@emergencyuk.org www.emergencyuk.org
EMERGENCY USA
info@emergencyusa.org www.emergencyusa.org