Annual Report 2012 by Doctors of the World

DOCTORS OF THE WORLD

ANNUAL REPORT

2012

DOCTORS OF THE WORLD ANNUAL REPORT 2012

contents »

A word from our chair

2012 campaigns

Public and institutional funding

Emergency and long term programmes

Map

Sub-Saharan Africa

Latin America

Asia

Europe

North Africa and Middle East

108

110

112

DOCTORS OF THE WORLD ANNUAL REPORT 2012

A word from our Chair

ÂŠ Fabrice giraux / MdM

Humanitarian action

Âť Dr ThIErry BrIgAuD chAIR Of dOcTORS Of ThE wORLd fRANcE

Jordan

army set up a military hospital in a camp this summer, we restated our position In response to the Syrian crisis, syste- that blurring the lines between humanitarian and military action is dangerous. international humanitarian law and the In Syria, as soon as the security situation allowed, the MdM emergency team crossed the border to help set up a camp In partnership with organizations caring for 5,000 displaced people living under for Syrians at the Turkish border, we set canvas. And, whenever possible, when up a post-operative centre that can care groups of doctors are known to us we use for up to 100 wounded. them to get medical equipment, products and medicines in to the country. In Lebanon, in partnership with Amel, the local organization, in the Bekaa Valley, In the north of Mali, the capture of sevedoctors are caring for refugees. In Kha ral villages by insurgents and a coup in village, close to the Syrian border, we are Bamako at the beginning of the year has running medical sessions in a clinic, ena- forced MdM to rethink its strategy. We took the risk of continuing our long-term programmes alongside our emergency In Jordan, MdM teams are working in response. In practice, this means we are several refugee camps. When the French caring for Malian refugees crossing the

Burkina Faso border in the Djibo region and supporting Malian migrant organisations that look after displaced people. Our emergency teams also conducted an exploratory mission in the Mopti region.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

ther two areas worth highlighting. In addition, is our best weapon against the increasing 4,000 more beds were promised for asylum wave of abuse this community has suffered in seekers and 4,000 more beds for emergency accommodation. tion in what our teams see from one town to another, we have seen a blanket deterioration in roma living conditions.

We remain committed to constantly improving our work to ensure we are able to res- Internal Security Law was passed; 10 years of its damaging effects on the health of sex true to our principles and area of expertise. workers. This provides the perfect opportunity to call for the abolition of passive soliciting as A campaign to denounce a criminal offence and the decriminalisation health inequalities of prostitution. those involved in our work in France, delivered mains an issue. Leave to remain for foreigners a number of recommendations in the French with health problems was tightened up by the electoral year of 2012. This co-authored docu- law passed on 16 June 2011. MdM has calment spans a range of issues and campaigns led for the return to the previous 1998 law. We and has become a key point of reference. The await a political response. awareness-raising campaign, Vote Health!, took the advocacy messages across the health organisations, including MdM, are calcountry. ling for the merging of State Medical Aid and universal health Insurance. This still does not Since France’s political transition in June seem to be on the government’s agenda. 2012, there have been positive signs. In July, the 30 euro charge for State Medical Aid for vulnerable people compulsory for medical (AME in its French acronym) was abolished. students throughout their training is more perOn 11 December at the end of the Confe- tinent than ever and we will continue to call for rence against poverty and social exclusion such a change in syllabus. at which MdM was a key participant, the Prime Minister announced he was raising the Denouncing discrimination threshold of the universal health Insurance to against Roma groups Improvements to healthcare access centres (known as PASS in the French acronym), and more support to help people access their rights, notably to accommodation, are ano-

Facing more stigma than ever before, more and more families are forced to move repeatedly. We must continue to advocate at the highest level, so that this population, too often victims of discrimination, can see their health determinants improve and their voices heard, ensuring that they are fully involved in lobbying for their cause.

Denouncing inequality in access to care and rights with 21 healthcare and advice clinics in france and 65 outreach programmes, Our presence in squats, with sex workers, travellers and homeless people, is testament to MdM’s vitality. Once again this October, we presented the data gathered from our healthcare clinics in our observatory report on access to care for the most vulnerable. These significant figures confirm a deterioration of health indicators for patients seen in our centres. This worrying evidence points to a need for more advocacy, more political lobbying, more work to be done in our regional centres and brought to a national level.

This has included needs assessments, follow up, prevention activities, care, advice, setting up networks and local advocacy. The unwa- In November 2012, MdM reminded the Prime vering commitment of our staff and volunteers Minister of the need to make emergency

accommodation unconditional and available throughout the year, whilst underlining that emergency accommodation alone is not enough, without additional measures in place to meet the needs of the most vulnerable. In Calais, where we spoke out against police harassment, ‘prefabricated’ shelters, built by MdM with the agreement of the council, have improved the living conditions of the migrants. Our teams continue to guarantee access to care for the men and women in transit and speak out against the inhumane living conditions to which they are subjected. As for our harm reduction activities, in April 2012, MdM and gaia announced their plans to open up a drug consumption room in Paris, a space where advice about the risks associated with injection can be given in real life situations. A number of meetings with MPs and political decision makers allowed us to validate this decision, and it will roll out in 2013.

hospital continues with a joint commitment to closer collaboration between the Ile-de-France

volunteering time were recorded in 2012. Analysis of the data, collected with the support of Mission France’s management team, has enabled us to identify a new area of social vulnerability experienced by some parents.

Refreshing our way of working humanitarian action here and abroad

approach that we know well in France, alongside tools like our community health expertise, and taking the risk of supporting social change at an international level. On the ground, doing humanitarian action differently means questioning our way of working. Planning projects by giving greater space

as the follow up, and psychological care to better support children with their wellbeing and social integration, are now key to the programme.

Our key areas of advocacy

Women’s rights evolve, sometimes moving forwards (legalisation of abortions in uruguay 2012) and sometimes backwards, with international agreements that established proexamining the way we work in partnership gress for women 20 years ago being called is necessary, and moreover, it makes sense. in to question. There are encouraging signs; partnerships are in place on several projects. In the KPK Doctors of the World endorsed two key region of Pakistan, the organisation is impro- positioning documents on sexual and reproving access to care for people exposed to second on the importance of good quality borne from civil society. In spite of a worse- free care for pregnant women and children. ning security situation, a hospital has been In 2013, a reference framework will enable rebuilt and opened in Kenya, in partnership a quality assessment, already underway, on with the local organisation, WAhA. In the our programmes. Some programmes are onPuntland region of Somalia, MdM teams going (uruguay, Mexico, Côte d’Ivoire, Laos, are running 10 centres with the support of a haiti), others are just beginning (Chechnya, Peru) or are planned (Ethiopia, gaza). local organisation. a change in focus. To innovate, then, is to explore a model that does not only measure

In Palestine, especially in gaza where armed

Reducing the harm caused by drug use

again, the measures put in place by the teams As for our harm reduction projects abroad, on the ground in 2008, to use health centres in the outskirts following Operation Cast Lead, being handed over to local partners, while our programmes grow in East Africa. On meeworked this time too. ting Tanzanian politicians, I found that harm Finally, Operation Sourire’s strategic direc- reduction is an issue that resonates within tion, as outlined at the annual meeting in Decials know better than us the reality of the hIV our surgical interventions. The preparation, epidemic and want to support new avenues pre-op consultation and selection, as well of work to stem the disease. MdM’s partici-

DOCTORS OF THE WORLD ANNUAL REPORT 2012

pation at the Washington Aids conference Governance enabled us to work on key harm reduction In June 2012, the General Assembly with a advocacy messages, in particular on treatment for those suffering from hepatitis C. desire to continue the projects and direction initiated by Olivier Bernard.

The right to health for migrants Ten years after the closure of Sangatte, Doctors of the World’s regional foundations also continue to develop. Projects, human rights in France remains topical. run by those involved at the regional level, The network-wide European project gives have been formalised and a regional a structure and wider scope for lobbying policy framework has been put in place on the day-to-day reality for migrants to ensure a clear strategic direction. By here in Europe, where they are increasin- focusing on supporting existing projects gly excluded due to the economic crisis, affected by both xenophobia and isola- the regional delegations will continue to tion. We must also be active on this issue grow and gain greater legitimacy. outside European borders. At the heart of our organisation, our

International adoption: adapt and do not give up As the only french medical NGO with authorised adoption status (OAA), granted in 1988, Doctors of the World is a key player in international adoption. The organisation is working in 12 countries and is bound by the principles of the hague Convention. Motivated by the protection of vulnerable children and the defence of the rights of the child, Doctors of the World has made its priority complex adoptions of older children, siblings and children with serious medical conditions.

we work together. The autumn seminars were an opportunity to validate these policy choices, to enshrine social change in our projects’ terms of reference. The role of the Programme heads in our orgamust be embraced, and above all we must welcome new activists, who will be tomorrow’s leaders.

By daring to trust and daring to accept

Côte d’Ivoire

DOCTORS OF THE WORLD ANNUAL REPORT 2012

Campaigns 2012

Olympic games: The other side of the medal In July, athletes from around the world went to London in the hope of winning an Olympic medal. Doctors of the World used this opportunity to highlight the fact that from across the channel, every day, migrants try to reach the British capital in the hope of a better life. A few days before the opening ceremony, MdM screened a web-based documentary The Other Side of the Medal, revealing the determination of these ‘reluctant athletes’ faced with Watch the web-documentary: http://webdoc.medecinsdumonde.org/#/home

» © Dr/MdM

On the ground, the MdM road show went on a Tour de France to spread the word in 15 major cities. Several thousand voters were

The economic crisis… Imagine what it’s like for them

about the issues as part of this travelling exhibition and 30,000 of them slipped a Vote Health! ballot paper into the MdM urn. On the web, more than 100,000 people followed the campaign on the votezsante.org site. The organisation welcomes the abolition of the 30 euros charge for access to State Medical Aid (AME), a change that we had been calling © Benoît guenot for. however, MdM continues to advocate opportunity for MdM to alert the public and for the merger of AME and universal health politicians to this alarming situation. Coverage (CMu in its French acronym), and Among the patients seen by Doctors of the In the run up to the presidential and parlia- for the threshold for the CMu to be raised to World in 2011, a quarter presented late; mentary elections, we ran our Vote Health! the poverty line. The campaign was also an more than half of the pregnant women campaign. Images of a sick Marianne were opportunity to denounce repressive policies should have received ante-natal care ear- disseminated in the press, on posters and against migrants: policies that make people lier, and two-thirds of the children under busts displayed as part of an exhibition, to sick must be stopped. six years old were not up to date with their highlight that fact that health is a right gua- Check out the campaign at vaccinations. The 2012 elections were an ranteed by the state. http://votezsante.org

Made up of snapshots taken by its teams, on 10 December Doctors of the World launched a campaign that explores the question ‘We face economic crisis... Imagine what it is like for them.’ ‘Them’ being the excluded people MdM supports in France and around the world, and whose number is increasing with the crisis. First and foremost, a message of empathy for all those whose life is more

Vote health!

reminds us that, far from being obsolete, solidarity is one value which is needed more than ever. See the campaign at: http://tousmedecinsdumonde.org

DOCTORS OF THE WORLD ANNUAL REPORT 2012

2012

MDM FRANCE BUDGET €64.7

HUMAN RESOURCES*

IN FRANCE

INTERNATIONAL PROGRAMMES

147

3,642

20 healthcare and advice clinics 30,560 service users seen

5,626,354

BREAKDOWN

1,240

network members

Argentina Belgium Canada France germany greece Japan Netherlands Portugal Spain Sweden Switzerland united Kingdom united States

national employees

40 70 67 2,097

volunteers

305 200 105

headquarters employees actors supporting operations voluntary programme managers headquarters employees

* Figures as of 31 December 2012

26 10 17 5 9

of our programmes

Africa ................................ Latin America .................... Asia................................... Europe .............................. North Africa & Middle East .

in in in in in

15 countries 7 countries 12 countries 4 countries 8 countries

1 paediatric care centre in Mayotte

1,877

service users under 18 seen

67 programmes 46 countries

medical consultations

headquarters employees actors on our programmes in france

1,730,315

OF PROGRAMMES

1,212,088 medical consultations

expatriate employees

volunteers

84 13

medical consultations

actors on our international programmes

people targeted by our programmes

outreach programmes on access to healthcare and other rights

programmes with sex workers

harm reduction programmes

98 programmes in 30 towns

Asia

national programmes in 14 countries

MdM actors

Africa

165

international programmes in 65 countries

Asia

INTERNATIONAL NETWORK

Africa

NETWORK €113

OF INTERNATIONAL PROGRAMME EXPENDITURE

46% 15% 19% 4% 13% 3%

Africa Latin America Asia Europe North Africa and Middle East Miscellaneous projects (Opération Sourire, needs assessments, regionally-managed international programmes and cross-cutting projects)

DOCTORS OF THE WORLD ANNUAL REPORT 2012

Doctors of the World’s principles RIGOROUS MANAGEMENT AND FINANCIAL TRANSPARENCy MdM is approved by the Comité de la charte (the Charter Committee

MdM FRANCE INCOME ANd EXPENdITURE

transparency.

EXPENDITURE CONTROLS By EXTERNAL ORGANISATIONS MdM is subjected to control by the Cour des Comptes (French public Deloitte. Detailed audits are carried out by French, European and international institutional donors (such as EChO, the European Commission’s humanitarian agency) or the united Nations.

THE DONORS’ COMMITTEE MdM depends on an independent donors’ committee, which regularly analyses and examines our work.

FINANCIAL SCOPE some other organisations in the Doctors of the World network: MdM Belgium, MdM germany, MdM Japan, MdM Netherlands, MdM Spain, MdM Sweden, MdM united Kingdom, MdM united States.

Chad ©

www.medecinsdumonde.org

78.5% social programmes 15.3% fundraising costs 6.2% operating costs

INCOME 61% public generosity 31% public institutional grants 7% private grants and other private funds 1% other

DOCTORS OF THE WORLD ANNUAL REPORT 2012

Government and institutional

PROGRAMME AGREEMENTS BETWEEN AFD AND MDM The Council of Europe (COE) brings together 46 European states. MdM’s international network has consultative status and is part of OING Service, a liaison group for NgOs with this status.

UNITED NATIONS (UN)

institutions are essential

well as being important donors, these institutions

developing partnerships with some institutions,

to international decision-

EUROPEAN UNION (EU) For several years, MdM has been The two key European institutions particularly active in Brussels-based concerned with solidarity are the Euro- VOICE, the interface between NgOs and pean Commission’s humanitarian Aid Eu institutions (European Commission, Dg EChO, the European Parliament, development programmes (Dg DEVCo), Member States). VOICE brings together whose funding is provided by the mecha- 80 European NgOs, including the largest nisms of EuropeAid (AIDCo). senting the MdM network, is involved ECHO’s mandate is to provide aid and in various VOICE working groups (FPA emergency relief to populations affected Watch group, European budget monitoring, European Consensus on humanitathe Eu. EChO works in partnership with rian aid monitoring). around 180 organisations (European NgOs, the red Cross network and speMdM relates to EuropeAid via cialist uN Agencies). In 2011, EChO allo- CONCORD (European Confederation of cated nearly 1.2 billion euros to funding relief and Development NgOs) through the to humanitarian projects, with around half French NgO collective, Coordination SUD, going to NgOs. which lobbies Eu institutions and participates in the development of common posiDG DevCo is charged with imple- tions on European development policy and menting, via EuropeAid, the aid me- other major issues in North-South relations. chanisms of the European Commission, a major donor for international development.

(ECOSOC) is the main coordinating body for the economic and social activities of the uN and its specialist bodies and institutions. MdM’s international network has special consultative status which means that it can carry out lobbying activities, especially in relation to the human rights Commission. It has observer status in this subsidiary body of ECOSOC. has representation at the high Commission for refugees (uNhCr), the World health

THE GLOBAL FUND The global Fund against Aids, Tuberculosis and Malaria is an international multilateral donor created in 2002 and which gives grants to tackle hIV/Aids, TB and malaria. Since 2002, the global Fund has provided hIV treatment to 4.2 million people, 310 insected-treated bed nets to prevent malaria in 150 countries, to support large scale prevention, treatment and care programmes for these three diseases.

FRENCH DEVELOPMENT AGENCy (AFD) The French Development Agency (AFD in its French acronym) is one of the French governmental bodies involved in giving ment programmes.

the Coordination of humanitarian Affairs (OChA). tional Council of Voluntary Organisations (ICVA), a network of NgOs involved in human rights, which concentrates on humanitarian issues in relation to refugees. ICVA brings together more than 80 international NgOs.The Council relates to the uN authorities by tackling different themes, such as the relationship between humanitarian workers and the military, or the protection of civilians du-

As part of the general reform of public policy, AFD has been charged with a new responsibility since 2009: funding NgOs. This has led to the creation of the NgO Partnership Division, which steers the partnership with NgOs and monitors initiatives run by NgOs.

THE CRISIS CENTRE (CDC) The Foreign Affairs Ministry’s Crisis Centre manages French public funds for humanitarian emergencies (Fonds humanitaire d’urgence – Fuh).

Doctors of the World runs programmes working on mother and child health, family planning, tackling STIs, hIV and malaria, and is committed to structured development and strengthening its activities in relation to reproductive health and reducing risks associated with drug use and sexual practices. MdM has been working on harm reduction programmes since 1992, giving the organisation considerable expertise on this issue, both at home and abroad. Following the programme agreement on gender-related ment Agency (AFD in its French acronym) signed two new two-year programme agreements in 2010. One of these agreements relates to reproductive health while the other concerns harm reduction. In 2012, two new programme agreements were signed as part of this four-year partnership (2010-2014) with a total contribution from AFD of eight million euros. These agreements aim to strengthen the work on these issues within MdM, by developing cross-cutting approaches while providing a part of the funding for around 12 projects. Thanks to this support, MdM has been able to launch harm reduction projects in georgia, Kenya and Tanzania and reproductive health programmes in Mexico, guatemala and Laos. In line with international commitments on the harmonisation of aid and AFD’s strategic direction, harmonised sectoral approaches are a priority for strengthening health systems. For MdM, the co-operation with AFD on the cross-cutting programmes on reproductive health and harm reduction allows us to strengthen existing programmes and to raise MdM’s and institutional support that we need for our programmes.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

International programmes contents » »

Map of programmes

Sub-saharan Africa

Asia

» » » »

Harm reduction - Tanzania ©

DOCTORS OF THE WORLD ANNUAL REPORT 2012

Emergency and long-term programmes

Over and above the four areas of primary

- Departmental co-operation

reduction, migrantsâ&#x20AC;&#x2122; health and crises and nued to develop programmes encompas- supports Mujer y Salud and Iniciativas Sanitarias sing many areas

The emergency and rapid response unit (URR in its French acronym) - Increased co-operation within

the network -

Partnership at the heart of our work -

DOCTORS OF THE WORLD Russia

Romania Bulgaria Moldova

INTERNATIONAL PROGRAMMES

Turkey

Lebanon

Georgia

Afghanistan

Syria Palestine

Jordan

Nepal

Algeria Egypt Mexico

Burma

Mali Niger Chad

Haiti

Pakistan

India

Yemen

Guatemala Burkina Faso Guinea

Nicaragua

Liberia C么te d'Ivoire

Sri Lanka

Colombia

Somalia Kenya Rwanda Dem. Rep. of Congo Tanzania

Peru

Angola Zimbabwe

Uruguay

LONG-TERM PROGRAMME

EMERGENCY PROGRAMME

Madagascar

Indonesia

Laos

Philippines

ANNUAL REPORT 2012

DOCTORS OF THE WORLD ANNUAL REPORT 2012

programmes CHAd

Sub-Saharan

Liberia ©

DOCTORS OF THE WORLD ANNUAL REPORT 2012

“

My family gave me away in marriage when I was 11 years old. I fell pregnant at 13 and it was horrible. My baby died and I was very ill. One day, when listening to the radio, I learned that

mali

could be treated in Sominé Dolo de Mopti hospital. Doctors of the World and the hospital treated me. Now I am cured.”

1 1 1

Mali Niger Chad

Burkina Faso Guinea

Liberia 1

Côte d'Ivoire

Somalia

18 years old

Sahel Kenya Rwanda Dem. rep. of Congo

Tanzania

Angola

Zimbabwe

Madagascar

EMERGENCY PROGRAMME

LONG-TERM PROGRAMME

Detailed information sheets for the various programmes in sub-Saharan Africa are in the attached interactive CD

» ANgOLA » BurKINA FASO » ChAD » CôTE D’IVOIrE » DrC » guINEA

» KENyA » LIBErIA » MADAgASCAr » MALI » NIgEr » rWANDA

» SAhEL » SOMALIA » TANzANIA » zIMBABWE

DOCTORS OF THE WORLD ANNUAL REPORT 2012

SUB-SAHARAN AFRICA

Emphasis on sexual and reproductive health 300,000 women die every year during pregnancy or

MdM is striving to establish a continuum of care on its programmes. This includes informing women on the availability of healthcare services and on their rights regarding reproductive and sexual health. It also means offering quality care from the young girls’ adolescence right through to care for mothers, from family planning and ante-natal care to childbirth. This development requires a three-pronged approach.

Côte d’Ivoire

In Sahel, advocacy is bearing fruit with the example of the Djibo district in Burkina Faso, where local councils contribute to making deliveries and caesareans free of charge by topping up the state

support for referrals has become permanent, thanks to the commitment of local councils, who contribute to a common fund for referrals from Removing geographical barriers, which are their own budgets. In Cote d’Ivoire, the governoften an obstacle to access to healthcare. ment introduced free healthcare for women and In Chad, horse drawn carts have been given to remote villages, to enable women to reach the healthcare centre or hospital in case of obstetric so that free healthcare can be provided and that emergency but also to attend ante-natal clinics there is a continuity of care. or bring their children for medical consultations. In Liberia, maternity waiting homes have been Finally MdM highlights the importance of created so that women living in areas distant taking socio-cultural factors into account. from healthcare centres can stay for several In Niger, for example, the imams and all the comweeks until their pregnancy reaches full term and munity stakeholders are made aware of family then go to the clinic, where they can give birth planning, in order to break down a negative assisted by skilled health workers. image and allow women to access it with the

agreement of their families and the religious leaders. Also in Niger, at Illéla, a noteworthy MdM initiative has been the setting up of the ‘school for husbands’ that aims to reach women through their husbands. The men involved in the project, who are chosen by health workers and village leaders, are tasked with educating their peers in order to promote a change in behaviour amongst husbands.

and cultural barriers are obstacles to access to healthcare

In order to assure a high quality of healthcare, MdM restores and materially supports healthcare structures. In Kenya, for tion work and the creation of a maternity unit, Dadaab hospital was inaugurated. Furthermore, MdM trains personnel in Angola, Somalia, Chad and Mali, where surgical teams strengthen the skills of local surgeons in the

DOCTORS OF THE WORLD

» MALI Support and aid for victims

169

in the north, and by the

» zIMbAbWE

A programme integrated into the health system

Targeting pregnant women and children in particular, the action focused on three hospitals and 48 healthcare centres in Chipinge district of Manicaland province. In particular, MdM played an important role in making healthcare accessible to people who are hIV-positive. Thus, MdM led the decentralisation of screening services and the treatment of people who are hIV-positive (antiretroviral treatments and, in particular, prevention and treatment of opportunistic infections) and the prevention of mother to child transmission (PMTCT), from the provincial hospital to the district

ANNUAL REPORT 2012

hospital, right to health centres which are closest to the communities. Many community activities were used to provide information and raise public awareness. A wide network of community health workers was created to ensure that patients had follow-up visits at home and to establish a link with healthcare structures. Support groups have also emerged amongst patients with MdM’s backing. Following a handover period of over a year, the Ministry of health and the greater hope organisation took over.

the north by various jihadi

» ETHIOPIA The struggle against female genital mutilation

was provided to MdM Belgium’s emergency lation displacement towards neighbouring Already present in Kidal and Menaka, working on countries. On 16 January 2013, OChA esti- access to healthcare programmes, the Belgian

Burkina Faso, in refugee camps in Mentao and Damba, on the border with Mali. Three health centres were created to deliver primary healthcare but also to work on sexual and reproductive health, hIV prevention and malnutrition. Finally, 228,920 displaced people. to alleviate the problem of the indigenous per- at the end of 2012, in the Mopti and Tenenkou regions, an exploratory mission was undertaken Doctors of the World led two different actions. to assure the continuity of access to healthcare to support the health system from early 2013, in Firstly, medical, logistics and personnel support for the local population. Then MdM intervened in relation to primary healthcare and malnutrition.

» MAdAGASCAR After eight years of involvement in the Madagascan prison environment, at the end of December 2012, Doctors of the World withdrew from its programme for the humanisation of prison conditions, handing over to institutional and civil society partners. The objective being to

Humanising prison conditions

improve prisoners’ rights to health, MdM was directly involved in health issues such as the reno-

aim of obtaining a sustainable improvement in prison conditions with regard to overpopulation, hygiene and human rights. equipment, mentoring nurses, management of For eight years, MdM was involved in improving severe malnutrition and improvement of hygiene. living conditions of 24 prisons, thus affecting a In parallel, advocacy was conducted, with the third of all the country’s detainees.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

programmes MEXICO

Latin America

Haiti

â&#x20AC;&#x153;

HaiTi 61 years old

MdM has saved lives, not only by providing medical care, but also by raising awareness. People used to think of cholera as a mystical phenomenon, a curse. By way of vengeance, when the epidemic broke out in the town, over a dozen people were lynched. This phenomenon disappeared when MdM conducted awareness sessions within the community.â&#x20AC;?

Mexico

Haiti

Guatemala 1

Nicaragua

2 Colombia

Peru

LONG-TERM PROGRAMME

Uruguay

Detailed information sheets for the various programmes in Latin America are in the attached interactive CD

COLOMBIA guATEMALA hAITI MExICO

NICArAguA PEru uruguAy

DOCTORS OF THE WORLD ANNUAL REPORT 2012

LATIN AMERICA

» GUATEMALA / MEXICO Access to healthcare for women workers

Every year,

central American migrants

migrant women become domestic workers, but, usually in the absence of any contract of employment and being subjected to discrimination, they are unable to access healthcare. It is the same for sex workers, for whom there is no prevention or harm reduction activity. In Escuintla district in Guatemala, women

on health issues and informs them of their rights as workers. health promoters are recruited and trained to spread the word. Medical consultaconditions. tions are also organised in the workplace and can affect their health, they have limited access in MdM premises on Sundays. Finally, work is to healthcare. A survey carried out by MdM underway to co-ordinate efforts to enforce the teams showed that, despite having social secu- rights of women, particularly their right to access rity deductions on their wages, almost half of to health, in conjunction with the companies these workers were not registered with the social themselves and with public institutions. security system so could not access healthcare, particularly with regards to sexual and reproductive health. We estimate, for example, that over central American migrants (from guatemala, half of these women have no ante-natal care honduras, Nicaragua and El Salvador) who during pregnancy. Against this backdrop, MdM move on after a while or who stay in Chiapas, educates the women to have a positive outlook particularly in Tapachula and huixtla. Many

The Mexican health system’s response to these groups is barely adequate. MdM alerts women to health issues, notably through awareness campaigns on questions of sexual and reproductive health, violence and addiction, and on self-esteem. The organisation supports them to enable them to access health centres. A network of local stakeholders, whose aim is to support women’s rights has been strengthened. The project also relies on the involvement of the local authorities, the ministry of health and the local health bodies, as well as civil society working with partner NgOs.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» URUGUAy welcomes the

pregnancy, whist remaining vigilant over

Prevention and management of unwanted pregnancies Against a regional backdrop noted for its ductive rights, uruguay has distinguished itself this year by the passage of a law in favour of the partial decriminalisation of abortion. Despite this major step forward, there remain many obstacles and barriers. Since 2010, in partnership with Iniciativas Sanitarias (IS) and Mujer y Salud in uruguay, Doctors of the World has been running a programme intended to improve access to health services, with regard, in particular, to caring for -

gnancies. Thus, there has been awareness-raising for social organisations on the matter, and a coalition for ‘the right to decide’ has been established with the largest union in the country and sexual and reproductive health teams in three departments have been trained on the framework of the law on abortion. MdM will continue to support its partners to assist with the implementation of the law, to identify and analyse obstacles and barriers to sexual and reproductive health services, including, in the light of the new law, access to abortion services.

» HAITI

» COLOMbIA

Populations still affected

Opening a programme for women

From post-emergency to long-term actions 2012 was a pivotal year for Doctors of the World in Haiti, falling between the end of post-emergency intervention and ensuring the continuity of long-tem programmes. In Port au Prince, the remaining primary healthcare activities that were set up following the earthquake, have been handed over to the Minister of health. The last of the 10 clinics, built by MdM on the outskirts of the city, is now permanent and the authorities have appointed staff. In

» PERU

grand’Anse, the two cholera treatment centres were taken over by the health authorities during

Despite positive political progress including peace talks with the FARC, the population

on in a supporting role to deliver training and to assist with care in case of a peak in the epidemic. The long term primary healthcare and sexual and reproductive health programmes are continuing

and from the policy to eradicate cocaine, which deprives them of a source of income and contaminates their food crops. In Nariño, Meta and guaviare districts, MdM continues to provide access to healthcare for indigenous and mixed -

mission in Port au Prince will look into a new sexual and reproductive health project. © Lahcène Abib

cult for the government and other NgOs to reach. By organising mobile clinics, MdM dispenses primary healthcare and psychosocial care. In 2012, thanks to successful lobbying, the health authorities recruited nurses for two health centres in isolated areas and, increasingly, they accompany MdM teams who go out into the communities.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

programmes

Asia

LAOS

Burma

Russia

“

when I gave birth to my second baby: I received 1,000 rupees, my children had free vaccinations and received post-natal care. Now I work for JKSMS with Bhanwar (the programme’s social worker). I help other poor people. I take them to hospital to receive free treatment. ”

Afghanistan

Georgia

india Community health worker

Nepal

Burma

Laos

Philippines

India Pakistan

3 Sri Lanka

Indonesia

LONG-TERM PROGRAMME

Detailed information sheets for the various programmes in Asia are in the attached interactive CD ©

AFghANISTAN BurMA » gEOrgIA INDIA

INDONESIA LAOS NEPAL PAKISTAN

PhILIPPINES ruSSIA (grEAT NOrTh)

SrI LANKA

DOCTORS OF THE WORLD ANNUAL REPORT 2012

ASIA

reducing harm

without judging behaviour

which enabled the establishment of a dropin centre, of healthcare and of outreach activities, Doctors of the World is gradually handing over the baton to local stakeholders, with the intention of withdrawing from these activities in the course of 2013. People who use drugs have access to a range of services such as provision of injecting materials, screening for hIV and hepatitis, individual and group counselling, primary healthcare, management of addiction and social support. Furthermore, the resources and training centre established by MdM mean that since 2008, over 500 Afghan professionals (NgOs, community representatives, judicial and health agencies) have been trained in good practice for harm reduction.

Harm reduction - Afghanistan ÂŠ

In Georgia, the prevalence of hepatitis C is one of the highest in the world. Of an estimated 40,000 people who use intravenous drugs, titis C. As well as many harm reduction activities carried out in the healthcare and advice centre managed by the georgian organisation New Vecsis was conducted in 2012 and will help reinforce advocacy on access to treatment for hepatitis C.

as Georgia. It is one of the countries in the world most affected by the hepatitis C epidemic. MdM conducted a preliminary exploratory mission at the end of 2012, to identify a new project whose aim would also be to strengthen advocacy for access to screening and treatment - of hepatitis C. cription of antiretrovirals to people who use drugs - In Burma, MdM is working with people who titution treatment. At the beginning of 2013, the use drugs in four clinics in the Kachin area Afghan government announced an expansion of access to substitution treatment to 850 patients. gon. Medical, psychological, social and judicial

care is provided by a team of health professionals and peer educators. At the end of 2012, 1,320 people were on antiretrovirals and 300 people who use drugs were on methadone. In total around 20,000 people

In Georgia, of an estimated

40,000 people who use drugs, 70 to 90% have contracted hepatitis C

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» LAOS / NEPAL

reducing maternal mortality In both Nepal and Laos, women have very little access to sexual and reproductive healthcare

90,000

both to improve provision

consultations were carried out in Pakistan by MdM teams

to minimise any barriers preventing access to © Dr/MdM

» bURMA / PAKISTAN © Stéphane Lehr

Secondly, MdM is focusing on women’s health

In Laos, MdM subscribes to the national pois working on the provision of healthcare licy of free healthcare by distributing healthby renovating and equipping healthcare solutions. In Nepal, by being involved in micro- cheques, which provide pregnant women with centres, training personnel and commufree access to ante-natal and post-natal consulnity stakeholders. Thus, in Laos, 10 com- independence through improved management tations, professional medical-assisted labour, munity midwives and 144 village-based health of household budgets, forward planning for treatment for pregnancy-related complications promoters have been trained on maternal health expenditure and access to emergency and transport to enable them to reach healthhealth issues. obstetric funds. care centres.

» INdIA

Programme handover -

Access to healthcare for displaced people

they have limited access to

consultations, as well as ante-natal consultations, nutritional rehabilitation, vaccination sessions etc. In 2012, 90,000 consultations were carried out by MdM teams.

On the Afghan border, at the outer limits of the tribal areas of north Pakistan, MdM the KIA and the Burmese government resis working in isolated areas where displaced people have found refuge with family members throughout 2012 caused the displacement of or relatives. The organisation’s strategy is to fol- over 100,000 people, who found themselves in makeshift camps. MdM does not have access working in an environment of unstable security. to these camps so supports two local organisaA lengthy process of information provision and tions who run health centres in six camps close gaining acceptance is needed with leaders and to the Chinese border. MdM provides medicommunities before any medical activity can cines, equipment, renovates the centres, trains commence. Mobile clinics are set up to support the staff and oversees the emergency referral of health facilities and offer primary healthcare patients to hospitals.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

programmes bULGARIA

Europe

Chechnya

Russia

“

Bulgaria Coordinator

Very often roma living in Nadezhda suffer discrimination at the hands of the emergency services of the Sliven regional hospital. When they call the emergency number 112 and ask for an ambulance, the phone operator claims that there isn’t one available to come to Nadezhda. In reality, ambulances do not go to this area or only after several calls. Sometimes the ambulance arrives with a police escort.”

Romania

Moldova

Bulgaria

LONG-TERM PROGRAMME

Detailed information sheets for the various programmes in Europe are in the attached interactive CD © Gaëlle Girbes

BuLgArIA MOLDOVA

rOMANIA ruSSIA (SAMArA AND ChEChNyA)

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» CHECHNyA

» ROMANIA

IN EUROPE

Focus on mother and child health

Building a project together

» MOLdOvA Handover of the project

despite attempts at reconstruction, the chechen health system -

complex phenomenon surrounded by

Between 2008 and 2010, the reconstruction or refurbishment of health facilities was a Chechen government priority. Nevertheless, access to healthcare is not guaranteed because

In 2003, in the Balti region of northern Moldova, prostitution networks and MdM launched a programme to combat this forced labour... phenomenon and to support victims. In 2012, MdM handed over to local professionals, focusing on two major aspects of the problem: prevention and support for victims. This support is MdM has assisted over 300 victims and their families with two mobile teams, each comprising medical, psychological, judicial and social. a social worker and a psychologist, who went Throughout the programme, by means of training out to meet families and identify victims. Over and support for a national reference system (NrS), 10,000 people have taken part in awareness sesWhen the victims return after having escaped or MdM has improved the ability of local professio- sions run by MdM, their partners and Moldovan negotiated their release, they often suffer serious nals to identify, record and support victims. Fol- volunteers. emotional distress, rejection by their families and lowing a national workshop on NrS, a guide for MdM has served as a bridge between the exisdare not lodge a complaint and make themselves was published and 4,000 copies were distributed ting system and the victims, as well as supporknown. They do not know their rights and so do to all social workers in Moldova. Victims’ access ting and energising the policy introduced by the not turn to institutions or aid organisations. to multi-disciplinary support was also improved. government through its support for NrS.

Moldova is one of the poorest countries in Europe and the one most affected by human Poverty, corruption, domestic violence and unemployment are all factors contributing to the departure of many Moldovans for other countries. An estimated quarter of the population works abroad, of whom at least 60,000 end up exploited in networks dealing in prostitution, for-

» bULGARIA Improve the health of roma

Firstly, the training of gynaecologists and midwives, to international standards, in ante-natal and post-natal care, as well as formalising and communicating protocols for care. Then, the establishment of a mobile team of gynaecologists used by personnel who do not always have all in primary healthcare centres. Finally, strengthethe necessary skills and are understaffed in all ning the knowledge and skills of women and their specialist areas. As for medicines, they are avai- in-laws in matters of sexual and reproductive lable in grozny but not in rural areas. Against this health. In 2013, MdM hopes to further develop background, MdM set up in the Vedeno region the role of community midwives as mediators for with the objective of improving mother and child the health education of their fellow citizens. health. The focus is on three particular issues.

In Sliven, MdM is working with Roma people of Nadezhda, the poorest people in the country and victims of discrimination. Since 2009, health education sessions have been organised to raise awareness in the communities, of various issues such as hygiene, family planning, ante-natal and post-natal care. At the end of 2012, the municipality provided premises for this activity. Once the premises have been renovated, in 2013, they will serve as a hygiene unit so that pregnant women and young mothers can go for a shower and have a place where they can get personalised advice.

district

DOCTORS OF THE WORLD ANNUAL REPORT 2012

programmes yEMEN

Syrian crisis

“

I used to work in Dar al-Shifa hospital, which was bombed a week ago. government forces use ambulances to attack Turkey

Syria

bodies were returned to their families seven days later.”

Lebanon (Syrian crisis) Palestine Jordan (Syrian crisis)

Egypt Algeria

Yemen

EMERGENCY PROGRAMME

LONG-TERM PROGRAMME

Detailed information sheets for the various programmes in North Africa and the Middle East are in the attached interactive CD

ALgErIA EgyPT PALESTINE

SyrIA (JOrDAN, LEBANON)

TurKEy yEMEN

DOCTORS OF THE WORLD ANNUAL REPORT 2012

NORTH AFRICA AND THE MIDDLE EAST

Providing care in Syria and on the

borders, bearing witness to suffering

In order to assist refugees at the borders, MdM is also operating in Lebanon, supporting its longtime partner, Amel, at El Ein in Bekaa region and at Kha in a health centre run by a priest. MdM

Syrian border ÂŠ

to Jordan. Therefore from the outset, MdM supported the Jordanian authorities in the transit camps, treating the injured and referring the in Bekaa region via the organisation Salam. most serious cases and women on the point of giving birth to nearby hospitals. In order to In June, the union of Syrian Medical Aid Organisations (known by the acronym uOSSM) camps were created in and around the town of requested support with training and supervision ramtha. During the summer, MdM renovated a for a post-operative and rehabilitation centre that building donated by the municipality, to open it it opened on the northern border of Syria. So as a health centre in ramtha. Over 100 consul- a rehabilitation specialist, two physiotherapists tations per day take place there. In addition to and a nurse went to the centre, taking with them primary healthcare, psychiatrists, psychologists equipment and medicines. and social workers provide psychological support. Many refugees are traumatised by what they have seen and lived through, both before on the ground witnessed medical staff and during their escape. being abducted, tortured, killed and hospitals bombed... In July, MdM launched an At the same time, MdM opened a primary heal- appeal to alert the general public and governthcare centre in zaatari camp, where two doc- ments to the intolerable situation of health tors carry out over 200 consultations a day, as professionals in Syria. Thus, the second line of well as one in King Abdullah Park camp, suppor- action has been to support Syrian organisations ting the Jordanian ministry of health. inside the country. Working with uOSSM and

other Syrian medical partners, MdM transports medicines and surgical equipment. And lastly, primary healthcare and surgical kits as well as vehicles, are positioned in Jordan and Lebanon, poised to respond rapidly if the borders are opened. As time goes on the needs have become more and more acute in northern Syria. In September, MdM arrived at Qah camp, which is inhabited by centre was opened and water treatment, distribution of blankets and tarpaulins for the winter were put in place. By the end of December, the camp had 4,300 inhabitants. In response to requests by pregnant women, MdM set up a rest centre, where women could go after giving birth. In 2013, it will become a mother and child healthcare centre, providing ante-natal and post-natal care. In 2013 activities will be stepped up in Lebais ongoing. After two years, there is no slowing down in population movements and access to

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» ALGERIA / TURKEy

» PALESTINE

Access to healthcare and to rights for migrants

Training to manage emergencies

are conducted both in france and abroad with an approach tailored to each the emphasis is on raising awareness, health education and on rights, whereas healthcare centre which treats

In Algeria, MdM raises the awareness of migrants and their right to health. A network has been established of healthcare providers, working in a mediating role in various health facilities to advise and provide treatment to migrants. In fact, even if free access to healthcare is tech-

nically guaranteed, for sub-Saharan migrants, especially undocumented migrants, the reality is very different, because they face hostility from health workers, denial of treatment, or are reported to the police who then arrest them. MdM and its Algerian partners are working to raise awareness of the need for migrants to access healthcare and, where necessary, accompany them to healthcare facilities. health mediators are chosen from amongst the migrants to promote health education and make referrals. With its partners and migrant support organisations, MdM aims to create a network around the issue of access to healthcare for migrants, to improve quality of care and to add weight to its advocacy activity. In Turkey, MdM supports a medico-social centre in the Kumkapi area of Istanbul, which is managed by its partner TOhAV. This centre is open to anyone who is excluded from public health facilities, most of whom are undocumented migrants, asylum seekers and refugees. Those working in this centre provide primary healthcare and support and guidance for patients so that they are referred to appropriate hospitals, accompanying them when needed. It is also a place for rest, for listening, for information and education. Patient testimonials, as well as expertise provided by the team, on conditions of access to healthcare for poor migrants in Turkish health

services, were collected during the year. This work feeds into lobbying of local and international authorities for the improvement of medical treatment of poor migrants in Turkey. 3,000 consultations were carried out in 2012 and the project will continue in 2013.

Present in the Gaza strip since 2002, and having witnessed how hospital emergency services are overwhelmed, particularly in times of crisis, MdM has helped improve emergency care, in health centres and at community level. To this end, volunteers from the Palestinian community have been trained in

rooms have been set up—with equipment During this period, 2,200 consultations and and staff training—in health centres, allowing patients to be treated and, where appropriate, be completed here, without the need for transto be referred on. fer to a hospital. made an important contribution to the treatment of the injured during Israel’s last military action on the gaza strip in November 2012.

» yEMEN

Closure of the project in Saada

DOCTORS OF THE WORLD ANNUAL REPORT 2012

Programmes in france contents »

Map

Programmes in France

Roma

Prostitution

» » » » » » » »

Migrants project, on the Channel coast ©

Dunkirk

“

ToulouSe

We go on outreach patrols all year round, but from March onwards we’re the only ones. homeless people prefer the cold to the heat, because they can combat cold with blankets, but can’t do anything against the heat. In summer, we give them water and soup because some don’t eat when the soup kitchens are closed.”

Colombes

La Plaine-Saint-Denis

Volunteer

HEALTHCARE AND ADVICE CLINIC

Saint-Eloy-les-Mines

OUTREACH PROJECTS

SEX WORKERS BUDDYING CHILDREN IN HOSPITAL HARM REDUCTION

PAEDIATRIC CLINICS

DOCTORS OF THE WORLD ANNUAL REPORT 2012

Programmes in france A progressive chipping away at certain social protection measures, accentuated by the current global economic crisis and policies which, at best, do not meet the needs is resulting in growing social and geographical 2012, it seems to have become increasingly

french nationals and

On a daily basis Doctors of the World France teams witness the damaging effects of the chipping away at social protection measures on people’s health and the challenges that this presents for public health. In fact, Doctors of the World’s 21 healthcare and Advice Clinics (CASO in the French acronym) are far from empty. Quite the contrary; for the last few years there has been more and more work.

Doctors of the World is watching carefully to make sure that commitments made during the last election campaign are upheld

cult to access healthcare. As a result, according to the doctors in our clinics, more than a third of service users delay seeking healthcare even though four in ten consultations require long-term treatment (for at least six months) and more than

one in 10 service users present with a potentially serious condition (e.g., hypertension, diabetes, asthma, epilepsy, cancer or psychosis).1 given the constant increase in the portion of fees not covered by health insurance (e.g., franchises médicales,2 removal of certain medicines from the list of reimbursed drugs, increase in hospital in-patient costs) it is increasingly important for the most vulnerable to be able to access top-up insurance. In 2012, migrants represented the vast majority of service users seen in Doctors of the World clinics. This population continues to face oppressive policies, aimed at dissuading those without residency permits from staying in France, which put them in danger and further stigmatise some groups. Migrants in transit on the Channel coastline, undocumented migrants in Mayotte or sex workers, another marginalised group, are subject to a lot of pressure. This climate sees their living conditions deteriorate and further distances them from the health system (often leading to gaps in treatment and/or people giving up on seeking healthcare). At the same time, these problems hinder efforts on prevention, harm reduction and to help these groups access access healthcare and other rights. In the context of political change, voluntary sector organisations saw some positive changes in

1. Doctors of the World (2012). Observatory on access to healthcare — report of Mission France 2011.

2. Deductions from the amount reimbursed for certain medications and procedures.

since 2004. Our service users face particularly the poverty line and most experience serious housing problems (nearly half live in insecure accommodation and a quarter are staying in public or voluntary sector accommodation facilities or are homeless). For many reasons (e.g., poor awareness of their rights, administrative complexity, language bar-

2012, suggesting a different approach towards deprivation and a political will to reintroduce dialogue and consultation. The charge for access to State Medical Aid was removed, along with some temporary measures for romanian and Bulgarian citizens. Doctors of the World remains concerned, however, about the pressures put on the roma minority last summer and the obstacles which continue to hinder this group from improving their living conditions. Doctors of the World continues to watch carefully to ensure commitments are being upheld. Particularly strong measures are needed to respond to the economic crisis and its consequences for the most vulnerable groups. In addition, the right

of seriously ill foreigners to obtain a visa must be respected, the offence of passive soliciting must be repealed urgently and effective responses, such as authorisation for the opening of drug consumption rooms, are needed to tackle the hepatitis C epidemic among people who use intravenous drugs. The national conference on tackling poverty and year plan that will contribute to an improvement measures to facilitate access to care, such as to see, however, concrete steps towards the merger of the State Medical Aid scheme with

the universal health Coverage scheme and a clear policy on helping people towards longterm housing solutions. As a health and social organisation, Doctors of the World will follow the implementation of measures which are announced, and will highlight the importance of continuing the consultation with public and voluntary sector organisations which was carried out throughout this conference. Public health principles and respect of fundamental rights must form the fundamental basis for public policies to enable the best possible access to healthcare for all.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

Observatory on access to healthcare » PROGRAMMES IN FRANCE

Migrants

(vulnerable migrants and asylum seekers) » PROGRAMMES IN FRANCE

By the side of vulnerable migrants »

Bearing witness to obstacles to healthcare for vulnerable and/or excluded groups

» ACTIVITIES

saw » 88% of migrants did not have effective access

a total of

30,560 44,888

» ACTIVITIES

» 3,855

MOST COMMON NATIONALITIES

Défenseur des droits1 denounced police harassement of migrants) to Mayotte (where access to healthcare is not in place for foreign minors).

COMMON REASONS FOR MEDICAL CONSULTATIONS

» OUTLOOK

report presents a review of the clinics’ activities and our service users. It is developed on the basis of

consultations

and problems with access to healthcare, preventive services and other rights.

The Observatory on Access to healthcare supports all the programmes in France to develop data collec-

consultations

» 18,000 social consultations

» OUTLOOK

is 33

collection tools and consolidate the data collected.

years

NUMBER OF PROGRAMMES

» 12.3%

NUMBER OF VOLUNTEERS

» 94.1%

in shelters etc.

We are continuing to develop prevention and screening programmes (rapid diagnostic tests for hIV, hepatitis and tuberculosis) in our programmes. The abolition on 1 January 2013 of the offence of solidarity is a positive sign for organisations working for migrants’ rights. At a time when the economic crisis is revealing hostile behaviour towards migrants, and when access to healthcare for vulnerable and poor migrants is under threat, as evidenced by the backward steps in relation to visas for seriously ill foreigners, MdM continues to work, with our partners, to bear witness to the conditions these group live in and to lobby for effective access to healthcare.

PARTNERS

» 96.3%

FUNDING

1. Opinion 2011-113 of 12 November 2012

FUNDING

DOCTORS OF THE WORLD ANNUAL REPORT 2012

roma

» PROGRAMMES IN FRANCE

Working with roma to improve health BENEFICIARIES

NUMBER OF VOLUNTEERS

» 148

» ACTIVITIES

NUMBER OF PROGRAMMES

»9

FUNDING

accompaniment to mother and child health protection services and family planning. PARTNERS

PROGRAMME LOCATIONS

In 2012, MdM and other organisations continued and completed an action-research project on health mediation which was launched in 2011 with the aim of facilitating access for women and young children to health services and to improve how services welcome them in four locations: Lille (Areas), Fréjus (Sichem), Nantes (MdM) and Val-d’Oise (Asav). The results of this experiment demonstrate the relevance of health mediation as a tool and recommend that the profession of health mediator be recognised as a health profession in order to improve access to healthcare for these groups. By recognising the pertinence of health mediation to address social inequalities,

» OUTLOOK MdM continues to work closely with other organisations to lobby the authorities to improve the living conditions on settlements where roma are living. We are also working hard to ensure that there are no more advance evictions without suitable long-term alternatives.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

harm reduction » PROGRAMMES IN FRANCE

reducing the risks of drug use TyPES OF DRUGS

HEALTH PROBLEMS

» ACTIVITIES

context: BENEFICIARIES

(ErLI); NUMBER OF VOLUNTEERS

» 121

FUNDING

» OUTLOOK

PARTNERS

» Aides Espace Indépendance Sida Paroles, La Case

reduction tool.

LOCATION OF PROGRAMMES

DOCTORS OF THE WORLD ANNUAL REPORT 2012

Sex workers » PROGRAMMES IN FRANCE

Providing support and facilitating access to healthcare for sex workers

BENEFICIAR IES

» ACTIVITIES

NUMBER OF VOLUNTEERS

» 117

COMMON CONDITIONS

health workshops, in order to provide prevention materials, to provide information on the risks of sexually transmitted infections, hIV and hepatitis and to offer a listening service.

FUNDING

PARTNERS

» d’urgence

LOCATION OF PROGRAMMES

Droits

» OUTLOOK With the aim of raising awareness and offering better access to hIV screening, the teams are considering the possible use of rapid testing kits. In addtion, MdM would like to develop its activities with peer educators, who have a been able to reach. In December 2011, then presidential candidate François hollande promised to abolish the offence of soliciting. This proposal will be debated in the Senate at the end of March 2013, in the absence of a plan for a more general law on prostitution. MdM will be watching carefully.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

health and housing » PROGRAMMES IN FRANCE

NUMBER OF PROGRAMMES

» 19

NUMBER OF VOLUNTEERS

» 363

Taking the health impact of poor housing into account » ACTIVITIES

MOST COMMON HEALTH PROBLEMS

teams, EMPP).

CONTACTS WITH HOMELESS AND POORLy HOUSED PEOPLE

» »

Through its work, MdM is able to speak out about the harmful consequences of homelessness or poor housing on health.

» OUTLOOK MdM will continue this work in 2013 and will follow the implementation and progress in measures announced in the .

FUNDING

KEy PARTNERS

La Péniche, les Amis de la rue, le Fournil, le GAF, Enfants du Monde Droits de l’Homme

LOCATION OF PROGRAMMES

DOCTORS OF THE WORLD ANNUAL REPORT 2012

Prevention project

Buddying

hIV-hepatitis-STIs-Tuberculosis

children in hospitals

» PROGRAMMES IN FRANCE

Tackling hIV, STIs, hepatitis and tuberculosis

Supporting sick and isolated children

BENEFICIARIES

NUMBER OF CHILDREN BUDDIED IN 2012

HEALTH PROBLEMS

» ACTIVITIES

NUMBER OF VOLUNTEERS

views and group sessions.

» 94 » »

To help children to deal with the solitude and suffering more easily, the buddying must be set up as quickly as possible. Buddying involves three types of activity:

testing services and local laboratories. Offering rapid hIV and hepatitis C testing.

PARTNERS IN ILE-DE-FRANCE

the abrupt separation from parents; support activities;

FUNDING

» 166 » »

with health and social services on the other hand. Institut Curie PILOT PROJECT LOCATIONS

» »

In 2012, MdM launched some new initiatives: Following the example of the clinics in Cayenne, Nice and Strasbourg, the healthcare and Advice Clinics in Bordeaux and Nantes introduced rapid hIV testing.

CENTRES IN THE PARISIAN REGION

» Centre des Côtes

To be able to do this, our volunteers visit the children three times a week, including once at the weekend, and sometimes organise outings if the child is well enough. Sometimes volunteers accompany children to their homes.

» OUTLOOK for drug users in the premises of the harm reduction facilities run by the organisation Bizia.

» OUTLOOK

and to develop access to screening in appropriate and innovative ways.

IN FRENCH GUIANA

FUNDING

DOCTORS OF THE WORLD ANNUAL REPORT 2012

Regional delegations Given a legitimate mandate by the Board the local level, the regional bodies responded by lobbying the authorities while carrying on

their area, to mobilise members, strengthen partnerships, develop strategy and continue

Clinic - Toulouse ÂŠ

DOCTORS OF THE WORLD ANNUAL REPORT 2012

Mobilising our members in the regions 2012 was a busy year politically, and several campaigns were carried out: one for the general public, around the presidential and parliamentary elections; and an internal campaign for the regional elections in early 2013. Between March and June, the Vote Health roadshow visited 14 towns. This presented the opportunity to speak about our local programmes, while also raising awareness of MdM’s recommendations for long-term health policy. Our teams engaged with professionals and decision-makers, but also with the general public whether through direct contact on the streets, by organising conferences and debates or by writing letters asking for meetings with candidates. In this way, the regional delegations managed to get clear position statements from local politicians on some of Doctors of the World’s advocacy themes. These campaigns were an opportunity to get media coverage. We also organised a number of press conferences, for example, to highlight roma evictions, for the International Day for the Eradication of Poverty, or to air criticisms of the Internal Security Law…

Our advocacy work goes much further than these events. In relation to violence against women, the exhibition, Women, the Aftermath of Violence, was shown in Le havre and Toulouse.

Motivating and supporting volunteers

the regional delegations, and, as such, is increasingly being systematically encouraged

lation in Mulhouse; a study on the deployment of MdM teams in rural Aquitaine; establishment of a mediation, prevention and health education programme among vulnerable groups in the Bruche valley; an investigation on the avoidance of incarceration for homeless people with psychosis in Marseille; studying the possibility of opening a programme in Avignon in the Vaucluse; a needs assessment in the detention area in Nice). These assessments, which are linked to the organisation’s advocacy for better access to healthcare for the most vulnerable, enable us to monitor health needs.

debate was held in Lille. On poverty and deprivation, a conference was organised in Ajaccio. In relation to housing, a conference was held in nally, the Nantes team lobbied for the recognition of health mediator as a health profession. In the run up to the 2013 regional elections within Doctors of the World, the regional bodies organised the succession: encouraging new members to join (thereby increasing the number of people None of these initiatives will lead anywhere unless eligible to vote), identifying possible candidates we work closely with a network of partners. That is and supporting them through the process. why the regional representatives organised informal meetings with voluntary and public sector parInnovation and partnerships tners. In some regions this resulted in closer links - on skills (with training centres and universities on gations has resulted in some innovative initia- communication, training and evaluation) and on tives. These include surveys (on the revalence operational questions. In Marseille, for example, a of diabetes, hypertension and obesity in deprived partnership was developed with Nouvelle Aube, a groups in Strasbourg, on Local health Insurance self-help organisation working with young people in squats. In rouen, Soins pour tous, which works study on the health needs of the roma popu- with homeless people became a partner.

sought to step up their work. Most of the regionally-managed international projects (MIr in the French acronym) have successfully been handed over to local partners, as in Algeria and India. In other cases, these programmes provided support or a new impetus to local partners—as in guinea, with the coordinator’s visit to France, or in romania with the development of a new project working with vulnerable groups and roma. New programmes have started in Sri Lanka (an outreach programme on access to healthcare in the north) and in Tunisia (with an extension of the gourbi programme and a needs assessment in Kasserine region). The European dimension has also inspired regional delegations that want to work across borders. For example, Aquitaine is working with Doctors of the World Spain on harm reduction. Similarly, the Nord-Pas-de-Calais region and Doctors of the World Belgium working on migration journeys. Another example is the building of bridges with Eastern European countries where many of our service users come from. Although still in the planning, these initiatives should take shape throughout 2013.

Our regional delegations have shown that they can motivate their volunteers. Beyond providing healthcare, volunteers are called upon to raise awareness among young people (in schools, training centres, and in medical, nursing and social work schools), to bear witness by taking part in communication events (exhibitions, conferences etc.), to feed into our policy decisions (by participating in national seminars on particular topics, regional away days, team meetings etc.), to

port and integrate them into their own regional activities. The healthcare and Advice Clinic in Besançon has now joined the Alsace regional delegation (December 2012). The rhône-Alps delegation now has programmes in the Auvergne (adoption, university diploma and a rural health programme). In addition, the delegations increasingly share skills and encourage joint meetings and training sessions in the regions (always combined with a tour of the premises and a presentation on projects). In the East of the country, for example, Nancy and Strasbourg are putting together an inter-university diploma on health and deprivation. The adoption teams from Metz, Nancy and Strasbourg met with the adoption team at Nancy university hospital.

and to welcome new volunteers into the team. This degree of involvement and activism should be recognised and supported. The involvement of volunteers is a priority for regional delegations, and, as such, is increasingly being systematically encouraged. recruitment Regional development of new volunteers (organisation of open days or Most regional delegations presented a regional plan to the decision-making bodies within our but is not the only one. It also means welcoming organisation. With a unifying aim, these plans new volunteers and supporting them throughout prioritise innovation, better support for volunteers their involvement with the organisation. This can within MdM and strengthening advocacy. be achieved through the development of a dele- To realise these plans, we tried setting up joint regation welcome pack, regular information and gional committees with three delegations (Aqui- taine, Normandy, rhone-Alps). These committes nars and workshops, encouraging membership and allocate resources. Following the positive of the organisation and so on. Paying attention in this way helps ensure the quality results of this trial, each delegation is invited to of our work and the relevance of our position sta- conduct the same exercise which is somewhat tements. A new generation of activists is gradually cumbersome but which ensures a shared vision joining, and sometimes shaking up, our teams. of regional strategies. And regional delegations need to nurture this type portance of regional delegations, who have a key role to play in MdM. As the link between headPooling resources quarters and the work on the ground, they have To help some programmes to be less isolated, becomemore autonomous in implementing their nearby delegations have agreed to provide sup- plans and a healthy involvement of volunteers.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

Directory of regional delegations » Alsace / Franche-Comté

» Lorraine

» Loire 44000 NANTES

alsace@medecinsdumonde.net

Aquitaine

lorraine@medecinsdumonde.net

pays-de-la-loire@medecinsdumonde.net

» Midi-Pyrenees

» Poitou-Charentes

31000 TOULOUSE aquitaine@medecinsdumonde.net

Corse

midi-pyrénees@medecinsdumonde.net

poitou-charentes@medecinsdumonde.net

» Normandy

» Rhone-Alps / Auvergne /Burgundy

76000 ROUEN corse@medecinsdumonde.net

normandie@medecinsdumonde.net

» Île-de-France

» Indian ocean

rhone-alpes@medecinsdumonde.net

75011 PARIS ile-de-france@medecinsdumonde.net

» Languedoc-Roussillon

ocean-indien@medecinsdumonde.net

» PACA

languedoc-roussillon@medecinsdumonde.net mdmpaca@medecinsdumonde.net

Find the detailed sheet for each regional delegation in the interactive CD attached to this report

Outreach Bus - Lyon ©

DOCTORS OF THE WORLD ANNUAL REPORT 2012

International The international network is made up of 14 organisations: Argentina, Belgium, Canada, France, Germany, Greece, Japan, Netherlands, Spain, Portugal, Sweden, Switzerland, United Kingdom and United States.

for the most vulnerable. With a common charter, name and logo, the 14 organisations aim to offer care and engage in advocacy, mobilising healthcare professionals in their respective countries. The international network management team (its French acronym is DrI) is resIn 2012, the combined MdM international ponsible for its coordination and development, with guidance from the two largest organisations in the network, MdM in 65 countries and 165 national pro- France and MdM Spain. The team supgrammes in 14 countries. The internatio- ports the development of network memnal network members seek to re-establish, bers according to their needs and means. or often simply to enable, access to care In addition, the 10 European members

are now united in their lobbying activities ponsible for health policy at a European union level. The network is working more closely than ever before on joint communications in their respective countries, taking advantage in particular of the growing use of social media.

» dri@medecinsdumonde.net + 33 1 44 92 14 80

» INTERNATIONAL NETWORK MEMBERS » Doctors of the World Argentina Chair: Mr gonzalo Basile www.mdm.org.ar

» Doctors of the World Belgium Chair: Prof. Michel Degueldre www.medecinsdumonde.be

» Doctors of the World Canada Chair: Dr Nicolas Bergeron www.medecinsdumonde.ca

» Doctors of the World Germany Chair: Prof. Jochen zenker www.aerztederwelt.org Outreach teams working with homeless - Greece ©

» Doctors of the World Greece Chair: Dr Nikitas Kanakis www.mdmgreece.gr

» Doctors of the World Japan Chair: Mr gaël Austin www.mdm.or.jp

» Doctors of the World Netherlands Chair: Dr remco Van de Pas www.doktersvandewereld.org

» Doctors of the World Portugal Chair: Dr Abílio Antunes www.medicosdomundo.pt

» Doctors of the World France

» Doctors of the World Spain

Chair: Dr Thierry Brigaud www.medecinsdumonde.org

Chair: Dr Alvaro gonzalez www.medicosdelmundo.org

» Doctors of the World Sweden Chair: Mme Kristina Meseret Andersson www.lakareivarlden.org

» Doctors of the World Switzerland Chair: Professor Nago humbert www.medecinsdumonde.ch

» Doctors of the World UK Chair : Ms Janice hughes www.doctorsoftheworld.org.uk

» Doctors of the World US Chair: Ms Abby Stoddard www.doctorsoftheworld.org

Find the detailed information sheet for each member of the international network in the attached CD.

DOCTORS OF THE WORLD

Sweden

ANNUAL REPORT 2012

Russia Germany Netherlands Belgium Bulgaria Romania Moldova

United Kingdom Canada France

ACROSS THE INTERNATIONAL NETWORK

Turkey

Spai n United States of America

Mongolia

Switzerland Georgia

Japan

Portugal Greece Tunisia

Lebanon

Syria

Afghanistan

Palestine Jordan Nepal

Algeria Mexico

Haiti El Salvador

Mali Niger Mauritania Chad Senegal Burkina Faso Guinea-Bissau Guinea Sierra Leone Côte d’Ivoire French Guiana (Fr) Liberia Benin

Bangladesh

Egypt

Burma

Dominican Republic

Honduras

Guatemala Nicaragua

Colombia

Pakistan

Laos

Philippines

Cambodia Somalia Sri Lanka

Ethiopia Togo

Uganda Kenya

São Tomé & Principe

Ecuador

India

Yemen

Rwanda

Indonesia

Dem. Rep. of Congo Tanzania

Peru

Mozambique Mayotte (Fr.)

Angola

Madagascar

Bolivia

Reunion (Fr.)

Paraguay

Uruguay Argentina

INTERNATIONAL PROGRAMMES

NATIONAL PROGRAMMES

Zimbabwe

Timor Leste

DOCTORS OF THE WORLD ANNUAL REPORT 2012

Overview of programmes run by international network members Social and economic crisis in Europe

members were busy

emergency responses

and we welcome a new

and networks that were previously offering them basic protection. Austerity mea- NgOs and healthcare workers offer care and sures taken to combat the situation impacted on support, but the responsibility to ensure that the both social protection schemes and healthcare most vulnerable people are protected is that of services. Meanwhile, an increase in unemploy- the respective governments; some of which are ment and poverty across Europe has given rise simply no longer providing this support. Patients to more hate speech, stigmatising migrants. An suffering multiple deprivation should be receiving increase in xenophobic incidents has been seen more support in these times of xenophobia and in greece and other European countries. An economic crisis, not less. increase in migration within Europe is another Our 2012 report on access to care in Europe growing phenomenon which is a consequence of poverty. Those Eu citizens living in poverty were unable to access care without paying full with no social protection, who have medical needs, are treated in the same way as undocumented migrants from outside the Eu. stories of violence at our clinics had lived in a At the same time, those who already suffered multiple deprivation before the crisis, such as undocumented migrants, asylum seekers, people suffered violence at the hands of police or the who use drugs, sex workers, Eu citizens living in poverty, and the homeless, have seen a reduction in, or the removal of, the social safety nets bad or very bad state of health.

the reasons given for migration by service users, which counters the idea that the welfare state is a major pull factor for migrants. Patients seen on a daily basis by MdM programmesâ&#x20AC;&#x201D;be they locals or migrants, children or older people, pregnant women or those suffering from chronic conditionsâ&#x20AC;&#x201D;continue to be in a worse state of health than the general population. Several network members have seen a drastic reduction in institutional or private grants. This has meant we need to seek more diverse sources of income in order to continue offering To show solidarity with our greek colleagues, the annual international network meeting was held in Athens in May 2012. It was a great opportunity to share the work of these colleagues, who have been overwhelmed with need since the beginning of the crisis in greece, and to brief both international and greek journalists. We also spoke at the university of Athensâ&#x20AC;&#x2122;s medical school.

up and running in no time. Just a few weeks after the arrival of the new Director, the team launched ricane Sandy, which hit the American coast at the end of 2012. Clinics were set up in rockaways, near to JFK airport. This area housed people who were vulnerable even before the hurricane hit, so this will be a long-term project and the team will remain in place in 2013. The launch of Doctors of the World uS is an important step for our international network. Along-

Moreover, network-wide communication on the largest crises (through websites, conferences, and press releases) mean that both human and For example, in 2012, several international members supported our work in Syria by seeking institutional and private funding in their respective international, and as such, have the necessary means to deliver care programmes in complex environments.

in the Americas. For more information: www.doctorsoftheworld.org

Pooling resources on emergency missions

66 programmes in 25 countries; 34 programmes in 13 countries; 24 programmes in 13 countries;

In 2012, we continued our efforts to pool resources on our emergency missions. Security risks in some places (e.g., the Sahel, Syria), as well grammes in nine countries; as the cost of intervention in some of the most (outside the European union): remote areas, has meant that collaboration across The launch of Doctors of the World in the international network has been indispensable. the United States regular workshops are held to ensure a coor- For more information on the work of the interDuring 2012, Doctors of the World opened a new dinated approach to security measures. These national network: www.mdm-international.org workers on high-risk programmes. Experienced with institutions and partners in the uS, bring in security staff outline network-wide protocols that new skills and set up projects. With a great team are then adapted according to the situation of and an active Board, Doctors of the World was the country in question.

World HealTH day

92 DOCTORS OF THE WORLD ANNUAL REPORT 2012

Syrian Crisis

Fight against HIV/Aids

deprivaTion

DOCTORS OF THE WORLD

HAITI, TWO yEARS ON 12 January Twenty-four months after the earthquake that devastated haiti, Doctors of the World published a multimedia experience on the internet entitled nished portrait, created by artist rémi Courgeon. Since the earthquake struck on 12 January 2010, the country has been undergoing a process of reconstruction. MdM continues to provide primary care, sexual and reproductive health education and support for women who are victims of vioExperience the web-documentary here: www.medecinsdumonde.org/haiti-2-ans-apres

MAyOTTE 29 March tors of the World in Mayotte suffer from acute malnutrition. This statistic comes from a study of 422 children coming to the Koungou pediatric clinic, which was opened in 2009.

WORLD HEALTH DAy 7 April In February, MdM launched its Vote Health! campaign, sending a roadshow across the country to meet the public and politicians. On World health Day activists stormed the Place du Palais royal dressed up as sick Mariannes (the symbol of the French nation), to pass on the Vote Health! message. At the same time, a cyber-protest brought together 5,500 internet users at the Place de la Bastille: their avatars paraded across the site votezsante.org, brandishing placards sharing our messages. more information on our proposals at: MdM sur www.votezsante.org

and where a repressive immigration policy impedes access to care for children. During the human rights commissioner’s visit in November, MdM called for measures to be put in place to ensure effective access to care for all children in Mayotte.

EMERGENCy ACCOMMODATION 28 March MdM’s survey conducted amongst people who called the emer-

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Quarter 1

ANNUAL REPORT 2012

HEPATITIS 22 May SOS Hépatitis and MdM organise a protest day against hepatitis B and C. Both organisations offer rapid testing for hIV and hepatitis at the Plaine-Saint-Denis MdM healthcare centre. In France, some 500,000 people carry the hepatitis virus. But while rapid testing is available for hIV,

it is not for hepatitis. MdM calls for permission to carry out both tests to ensure that those affected receive treatment earlier and avoid risky complications. See the video here: www.medecinsdumonde.org/Presse/Communiques-depresse/France/22-mai-Journee-sauvagede-lutte-contre-les-hepatites-virales

EUROPEAN FINANCIAL CRISIS 24 May The Presidents and Directors of the 14 international network organisations meet in Athens 24-25 May to denounce the austerity measures that adversely affect

European healthcare systems. Against the backdrop of the crisis, MdM calls for equal access to care for everyone in the European union. It also calls for an end to the expulsion of seriously ill migrants if care is not available in their country of origin.

NIGER April

is just one of the shocking statistics published in MdM’s annual emergency accommodation survey, conducted this winter. The organisation criticises the ‘thermometer-guided’ management of emergency accommodation and recommends setting up accommodation that is open all year round, adapted for those who need it. Download the report at: www.medecinsdumonde.org/Presse/Communiques-de-presse/ France/Fin-du-plan-grand-froid

people suffer from food insecurity. In Niger, Doctors of the World stepped up its malnutrition prevention programmes in the local health centre in Tahoua and made sure that pregnant women and cal and nutritional care. © Dr/MdM

DOCTORS OF THE WORLD ANNUAL REPORT 2012

October/ November/ december

OLyMPIC GAMES 5 July In the run up to the Olympic games opening ceremony in London, MdM aired a web-documentary entitled 2012: The Other Side of the Medal to highlight the tough living conditions and lack of access to care experienced by migrants in the Nord-Pas-de-Calais. Made up of © Sandra Calligaro interviews, it shares the determination of Watch the web-documentary: these ‘reluctant athletes’ who try every http://webdoc.medecinsdumonde.org/#/ day to reach London. home SyRIA 31 July In Syria and the refugee camps in neighbouring Jordan and Lebanon, 18 months into the brutal conflict, fundamental human rights are being breached daily: women and children injured or killed, doctors tortured, hospitals targeted, and deliberate blocking of medical aid access

HIV 22 to 27 July Fight HIV and hepatitis, not drug users! This was the message brought by Doctors of the World to the 19th International Aids Conference held in Washington. With recognised expertise in the area of prevention, MdM calls for the use of a proven community-based response. MdM also highlighted the importance of people living with hIV, and for more harm reduction programmes in Africa.

INTERNATIONAL DAy FOR THE ERADICATION OF POVERTy 17 October Against the backdrop of the International Day for the Eradication of Poverty, Doctors of the World publishes its annual observatory on access to healthcare in France report. This yearly benchmark underlines the deterioration of access to

care in the past 12 months. MdM calls on the government to put special measures in place to protect the poorest. Download the report here:

to areas under attack. Faced with this dramatic situation, Doctors of the World speaks out and launches an MALI appeal to remind all parties that internatio- 11 September nal laws exist and must be respected.

FIGHT AGAINST HIV 1 December

http://appelsyrie.medecinsdumonde.org

On World Aids Day, MdM publishes a web-documentary entitled Nothing Will Be Done Without Us. ‘us’ refers to the peer workers who share prevention messages within their own communities (sex workers, people who use drugs etc.) This community-based, medical and social approach to harm reduction is now internationally recognised as the most effective method of preventing transmission.

In the north of the country, the violence centuated by the coup on 22 March, has resulted in close to 400,000 displaced people. At the border with Burkina Faso, Doctors of the World opened health centres in two Malian refugee camps, holding around 15,000 people. In spite of political tensions, MdM continues its medical activities and scales up its response to the food crisis in the Sahel.

Quarter 4

Quarter 3

July/ August/ September

medecinsdumonde.org

HUMAN RIGHTS 10 December Twenty-one months since the Syrian revolution began, the violence against civilians continues with the death toll reaching over 40,000, and more than one million displaced people (according to the uN). Working in the refugee camps in Jordan and Lebanon, and since October in Qah camp in the north-west of Syria, MdM provides care and medical equipment to thousands of Syrians displaced

VIOLENCE 17 December On the International Day to End Violence Against Sex Workers, MdM publishes the results of the survey carried out on the Lotus Bus (a project that supports Chinese migrant sex workers). The reperienced at least one form of violence. MdM calls for the repeal of the passive

soliciting law and rejects all future plans for criminalisation of clients that could further increase the vulnerability of sex workers and lead to an even greater infringement of their rights. read the results of the survey: www.medecinsdumonde.org/ Presse/Prostitution-et-violences

rights Day, the appeal launched in July is more relevant than ever. Find the press pack here: http://www.medecinsdumonde.org/ Presse/Dossiers-de-presse/A-l-International/Soigner-en-Syrie-et-aux-frontierestemoigner-des-souffrances

DOCTORS OF THE WORLD ANNUAL REPORT 2012

Cross-cutting projects enables teams on the ground to improve

Côte d’Ivoire ©

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DOCTORS OF THE WORLD ANNUAL REPORT 2012

» Sexual and

reproductive health promotion of the right to health and universal access

to services A rights-based approach to public health Doctors of the World has developed 20 projects that address the theme of sexual and reproductive health. Each project responds to the Chad, improving access to maternal healthcare, prevention of, and care for, unwanted pregnancies in uruguay, etc. Moreover, MdM aims to improve access to healthcare for local communities as well as the quality of care provided. This involves facilitating the relationship between the community and healthcare services and increasing awareness regarding access to sexual and reproductive healthcare. Within this overarching theme, MdM is also able to identify and care for victims of gender-based violence and work on its key aim of supporting the teams on the ground to implement their projects. Two key areas of work Over and above a purely health perspective, MdM is focusing its lobbying activities on two key priorities: healthcare systems that are functional and accessible to all, MdM advocates the adoption of public policy establishing free access to pri-

Lobbying activities have started in several areas, notably Niger, Burkina Faso and Côte d’Ivoire. Finally, general advocacy on universal health coverage was ongoing throughout 2012 and will continue in 2013, culminating in the adoption of this principle as one of our key post-2015 development objectives.

countries with highly restrictive abortion laws. A call for Access to Safe and Legal Abortion was developed by MdM and its partners. It links was held in uruguay and a second in Mexico City to exchange ideas and share advocacy strategies.

FUNDING

Chad ©

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» harm reduction

focused on supporting stigmatised populations

A medical and political approach based on public health and human rights Since 1989, Doctors of the World has been working on harm reduction programmes in France and abroad. In collaboration with people who use drugs, sex workers, and men who have sex with men, MdM is implementing projects to reduce the risks related to the use of psychoactive substances and risky sexual practices, by providing a holistic response encompassing medical, psychosocial and community care.

Two key areas of work It now offers a range of training courses for various workers in the sector (institutions, local NgOs and health professionals...) and the needle exchange component, which has seen positive results, has been extended.

new infections are amongst intravenous drug users. Access to affordable treatments is crucial. In this area, MdM’s advocacy focuses on three strategies: mobilising civil society workers, supporting the production of generic medicines and proposing an appropriate treatment model. In April, a French coalition was formed to tackle the theme of access to hepatitis treatment (ANrS, Aides, Sidaction, Act up, MSF, ChV, etc.). Then, an international coalition (hepCoalition, www.hepcoalition.org), made up of a range of self help groups and NgOs, was created at the international conference on Aids in Washington in July 2012. This aims to coordinate actions targeting the

Afghanistan ©

FUNDING

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DOCTORS OF THE WORLD ANNUAL REPORT 2012

Adoption » Socio-cultural determinants and access to care (DSC-AS project)

ledge base of each community. Taking this into account, the working group, supported by the AFD for three years (2008-2011),

Vulnerable children, our priority -

CO-ORDINATION

(Working with Communities and Socio-cultural Determinants of Access to Care), and delivered programme support by setting up qualitative studies. Also, to enable exchange and information gathering, the group now has a mini-site, linked to the main MdM website: dsc.medecinsdumonde.org.

» MEMBERS OF THE ADOPTION COMMITTEE REPRESENTING THE BOARD

La Défaite de la pensée,

geopolitical analysis and security

FUNDING

BUDGET

COUNTRIES

» ORGANISATION AND HUMAN RESOURCES

MdM holds an adoption licence in 85 French departments. The pro-

exchange information on volatile or particularly risky environments. In May 2012, Doctors of the World became a Member of the EISF Steering Committee.

MdM has accompanied the transfer of 3,934 adopted children since 1990. In 2012, 96 children arrived in France and were adopted by 84 families.

MdM keeps track of the adopted children and their families for at least two years, as and when necessary.

STAFF

In 2012, Doctors of the World continued to strengthen its operational capacity for analysis and risk reduction in order to ensure the safety of its national and international teams on the ground, and is establishing these activities for the long term. Security assessment missions were carried out in the yemen, Afghanistan, Pakistan and the Democratic republic of Congo. MdM is also a member of the

» ACTIVITIES

becoming rarer and the humanitarian space has been reduced. The principle of not shooting at ambulances, far from being resto endemic crime in areas of growing poverty under unstable regimes.

of origin. The team prepares candidates for these complex adoptions and monitors the situation closely after the adoption, to reduce the risk of failure.

challenging; as a result, the team have called on experts to carry out ongoing staff training. as an Approved Adoption Agency, we communicate with regional councils at regular meetings or at special meetings in cases of complex adoptions. The team also contributes to themed working groups, at the request of government departments and works in partnership with international structures (the Swiss Foundation of the International Social Service, for example), or experts from other host countries such as Canada or Belgium, in order to study and anticipate problems and be an ‘engine’ for constructive change.

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Opération Sourire Operation Sourire

give back a smile and help social reintegration CO-ORDINATION

» »

» ACTIVITIES This programme is inspired by the principle of solidarity with the most disadvantaged people: those suffering from

FUNDING

their communities.

BUDGET

COUNTRIES

(Cambodia, Madagascar, Mongolia and Chad), caring for 361 patients mainly suffering from cleft palates and scarring from burns. MdM germany, Japan and the Netherlands implemented their own missions in Cambodia, Bangladesh, Burundi, Burma, Sierra Leone and guinea-Bissau.

carried out by MdM Netherlands, which conducted nearly 500 operations in 2012. These missions are particularly coordination before, during and after the mission.

» OUTLOOK In 2013, the Operation Sourire teams plan to carry out 29 missions, including four exploratory missions. MdM France plans to carry out 14 missions and to continue to support the development of new missions by other network members.

Madagascar ©

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DOCTORS OF THE WORLD ANNUAL REPORT 2012

The Board of Directors At the General Assembly on 2 June 2012, Doctors of the World members elected the Board:

» Chairman

» Deputy treasurer

Dr Thierry Brigaud

Dr Luc Jarrige

Prevention doctor

hospital doctor

» Vice-chairs Dr Françoise Sivignon radiologist

Other board members : » Patrick

David

Anaesthetist, intensive care doctor

Dr Frédéric Jacquet Public health inspector

Doctors of the World management at 31 December 2012

» General Director: Pierre Salignon » International Operations Director : Dr Gilbert Potier » French Programmes Director : Dr Jean-François Corty » Finance and Information Systems Director : Thierry Barthélemy » Human Resources Director : Anne-Claire Deneuvy » Administration and Legal Director : François Rubio » Communication and Development Director : Juliette Chevalier until June, Luc Evrard since November

» Adoption Director : Dr Geneviève André-Trévennec » General Secretary of the International Network: Jean Saslawsky

» Claire

Boulanger

Substitute board members : » Margarita

gonzalez

Nurse » Olivier

Maguet

Consultant » Philippe

de Botton

Endocrinologist

Consultant

» General secretary Dr Patrick Beauverie hospital pharmacist

» Deputy general secretary Maria Melchior Epidemiologist

» Olivier

» gérard

Christophe Adam general Practitioner

Pascal

Surgeon » Andrea

Nurse

» Treasurer

Bernard

Paediatrician, hospital doctor

Brezovsek

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DOCTORS OF THE WORLD ANNUAL REPORT 2012

OUR PRIVATE PARTNERS

Foundations and businesses American Express Japan, Fellissimo Japan, Annenberg Foundation, Drosos Foundation, Ichiyoshi Shoken Japan, McCall MacBain Fondation, Mitsui Japan, Open Society Foundation, renovabis Foundation, Stern Stunden Foundation, Fubon Cultural & Educational Foundation, Norwegian Church Aid, Air France, BVA, Association of Cake Designers in France, Air France Foundation, Association Ouest France Solidarité, French Aviation Club, Bärchen, Bred, CIC, rhône-Alpes Islamic Council - Lyon mosque, Crédit agricole, Crédit mutuel, Crédit coopératif, Agnès B Foundation, L’Occitane Foundation, L’Oréal Foundation, Optic 2000 Foundation, roi Baudouin Foundation, PPr foundation for dignity and women’s rights, PSA Peugeot Citroën Foundation, Veolia

INSTITUTIONAL PARTNERS Multilateral organisations European union (Dg Echo, Dg DevCO/ EuropeAid), united Nations agencies (uNDP, uNFPA, uNhCr, unicef, OChA,

dage, Éguilles, Auray, Leers, Nevers, rungis, Talange, Blanquefort, Annemasse.

Bilateral organisations

For our regionally-managed international projects District councils: Bouches-du-rhône, Alpesde-haute-Provence, gironde, Charente-Maritime, Vosges, Doubs, reunion, Midi-Pyrénées, Paca; regional councils: Provence-AlpesCôte d’Azur and rhône-Alpes; présidence des régions, guadeloupe prefecture.

assistance (AAH – urgence development assistance: Department for International Development (DFID), Spanish -

development assistance (DDC), Danish Agence francaise de développement (AFD), Centre de crise du ministère des Affaires étrangères et européennes (CDC), French embassies (via SCAC and FSD).

dation, GCE Fidélisation, Imerys Ceramics France, l’Acoustics SA, Ivoire, Les Éditions Maréchal, Maximiles, Mobilorama, Scooter

uNAIDS, uNODC, WFP, WhO), global Fund, World Bank, 3 Diseases Fund (3DF).

uSAID via the NgO PSI, Canadian International Development Agency (CIDA), ment assistance (JICA). Safer de l’Île-de-France, reunion District Council, Val-d’Oise District Council, Alsace regional Council, PACA regional Council, Nord-Pas-de-Calais regional Council, Aurillac Basin Council and greater Angoulême Council. -

For our programmes in France Agence nationale de recherche sur le Sida (ANrS), regional health agencies (ArS), Caisse nationale d’assurance maladie (CNAM), family allowance funds (CAF), regional health insurance funds(CMr), local health insurance

free anonymous screening centres (CDAg), district councils, regional councils, town councils, Agence nationale pour la cohésion sociale et l’égalité des chances (ACSE), Ministry of health (DgS), Ministry of Social Cohesion (DgCS), Institut national de la santé et de la recherche médicale (INSErM), healarmy, Direction de l’action sociale, de l’enfance et de la santé (DASES), Mission

interministérielle de lutte contre la drogue et la toxicomanie (MILDT), Département Santé et Société (DSS), regional health insurance fund unions (urCAM), hospitals, guiana social security fund (CgSS), Mutualité sociale agricole (MSA), Observatoire français des drogues et des toxicomanies (OFDT). OUR PARTNER ASSO CIATIO NS

Aides, ALC Nice, Amnesty International, Anef, Association de communication et d’action pour l’accès aux traitements, Association des régions de France, Association française de réduction des risques, Association des familles victimes du saturnisme, Association d’autosupport et de réduction des risques des usagers de drogues, Association des gens du voyage, Santé sans frontières, Association des inadaptés des PO, Association des médecins du Pays de Retz, Association Cercle central, Association Gérer son stress, Association médicale Pascal, Association Partage et Fraternité, Association Régul 31, Association Rencontre avec des hommes remarquables, Association Une foulée pour la vie, Association Le Foyer, Association Setton, Association Sanatatea, Association Sida paroles, Association Gaïa Paris, ATD Quart-Monde, Avenir et Coopération, Banque humanitaire, Bus 31/32, Pays de la Loire

planning centre, Coordination française pour le droit d’asile (CFDA), Collective of associations united for a new housing policy, Alsace Collective of organisations working with sex workers, Collectif interassociatif sur la santé (CISS), romeurope collective, Migrants outre-mer (MOM) collective, Alerte collective, Collectif de Soutien aux Victimes de Bam, Comité des amis d’Emmaüs, Communauté mariste, Congrégation des sœurs augustines, Cordaid, the red Cross, CSF, Coordination française pour le droit d’asile, Coordination nationale des réseaux (CNr), Cyclamed, Droit au logement, D’une rive à l’autre, DhL Liens, Emmaüs, Entraide majolane, rimbaud mobile team, Fédération des associations pour la promotion et l’insertion par le logement (FAPIL), Fédération internationale des ligues des droits de l’homme (FIDh), Fédération nationale des associations d’accueil et de réinsertion sociale (FNArS), Foyer Sonacotra, Foyer Saint-Benoît, gisti, harm reduction International (hrI), Ordre de Malte, La Case, Les Amis du bus des femmes, Les Mondes solidaires, Les Restos du cœur, Le Stade rennais FC, Brittany football league (and the Brittany clubs), Ligue des droits de l’homme, Max havelaar, Novib, Observatoire du droit à la santé des étrangers (ODSE), Observatoire international des prisons (OIP), Pact, Pas-

serelle la Santé sans frontières, Pharmacie Humanitaire Internationale (PhI), Plateforme contre la traite des êtres humains, Secours Catholique, Sidaction, Sid’espoir, Solidarité Sida, SOS Drogue international (SOS DI), SOS Femmes, rasko, Techno Plus, uNIOPSS, Veille sociale, Vialtis, Tourism for Development (TFD), AS Kiwanis Club, Addocuiation, Les Jardins du livre, Association école de Karaté traditionnel, Saint-Nazaire Atlantique rotary Club, Association Notre-Dame des Aides. AND ALL OUR OTHER PARTNERS WHO HAVE SUPPORTED OUR WORK AT HOME AND ABROAD DURING 2012, PARTICULARLy THOSE WHO HAVE SUPPORTED US WITH A LEGACy OR LIFE INSURANCE POLICy AND OUR OTHER INDIVIDUAL DONORS.

111

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DOCTORS OF THE WORLD ANNUAL REPORT 2012

from 0 to 1, created by the uN Development Program to evaluate the level of human development of

Glossary A

AACID: Agencia Andaluza de Cooperacion Internacional para el Desarrollo ACF: Action Contre la Faim (Action against hunger) AFD: Agence française de développement (French Development Agency) AFR: Association française pour la réduction des risques (French harm reduction Association) AIDS: AME: Aide médicale de l’État (State Medical Aid) AME: Association malienne des expulsés (Malian Association for Deportees) ANRS: Agence nationale de recherche sur le sida et les hépatites virales (French National AIDS and Viral hepatitis research Agency) ARACEM: Association des refoulés d’Afrique centrale au Mali (Association for Central African Deportees in Mali) ARCAT: Association pour la recherche et la communication pour l’accès aux traitements (Association for research and Communication on Access to Treatment) AP-HP: Assistance publique-Hôpitaux de Paris (Paris hospitals social services) ARS: Agence régionale de santé (regional health Agency) ARV: Antiretrovirals ASE: Aide sociale à l’enfance (Child social services)

CAARUD: Centre d’accueil et d’accompagnement à la réduction des risques pour les usagers de drogues (harm reduction centre for drug users) CASO: Centre d’accueil, de soins et d’orientation (healthcare and Advice Clinic) CCN: Conseil consultatif national au Congo (Congo National Consultative Council) CDAG: Centre de dépistage anonyme et gratuit (Free and anonymous screening centre) CEDCF: Community Development and Environment Conservation Forum CENHOSOA: Soavinandriana hospital CFDA: Coordination française pour le droit d’asile (French Co-ordinating body on the right to Asylum) CHP: Community health Partnership CHV: Collectif Hépatites virales (Viral hepatitis Coalition)

ICRC: International Committee of the red Cross CIMADE: Comité inter-mouvement auprès des évacués - service œcuménique d’entraide (Ecumenical Mutual Aid Service) CISS: Collectif interassociatif sur la Santé (Voluntary Sector health Coalition) CLE: Collectif interassociatif de lutte contre l’exclusion (Voluntary Sector Coalition against Exclusion) CMF: Centre for Micro Finance CMU: Couverture maladie universelle (universal health Insurance) COCA: Consultations d’orientation et de conseils en adoption (Adoption advice and orientation sessions) COE: Council of Europe COMEDE: Comité médical pour les exilés (Medical Committee for Exiles) CONCORD: Confédération européenne des ONG d’urgence et de développement (European Federation of Emergency and Development NgOs) COPIL: Comité de pilotage (Steering Committee) CORDAID: Catholic Organisation for relief and Development Aid COREVIH : Comité de coordination de lutte contre l’infection due au VIH (Co-ordination Committee for Action Against hIV) CPAM: Caisse primaire d’assurance maladie (Local CREN(I): Centre de récupération et d’éducation nutritionnelle (infantile) ((Infant) Nutritional recovery and Education Centre) CRIPS: Centres régionaux d’information et de prévention du sida (regional Centre for Prevention and Information on Aids) CSAPA: Centre de soins, d’accompagnement et de prévention en addictologie (Addiction Care, Support and Prevention Centre)

DDVLAT: Dispositif départemental de vaccination et de lutte anti-tuberculeuse (District Action Plan for Vaccination and Tackling Tuberculosis) DEEE: Déchets d’équipements électriques et électroniques (Electronic and Electric Equipment Waste) DEV-CO: International Development Aid Programme DFID: Department for International Development

key criteria: life expectancy, educational level and standard of living.) HRI: harm reduction International

I DIU: Diplôme interuniversitaire (Joint university Degree) DPO: Division du partenariat avec les ONG (NgO Partnership Division) DREES: Direction de la recherche, des études, de l’évaluation et des statistiques (Department for research, Evaluation and Statistics) DRR: Disaster risk reduction

ECHO (Dg EChO: Directorate-general EChO, DIPEChO: Disaster Preparedness EChO) ECOSOC: united Nations Economic and Social Council EISF: European Interagency Security Forum EMPP: Équipe Mobile Psychiatrie Précarité (Psychiatry Outreach Team) ERLI: Éducation aux risques liés à l’injection (Education on risks associated with injection) ESC: École supérieure de commerce (Business School) EU: European union

FARC: Colombian Armed revolutionary Forces FAS: Foetal alcohol syndrome FED: Fonds européen de développement (European Development Fund) FGM: Female genital mutilation FIFDH: droits humains (International human rights Film Festival and Forum) FPA Watch Group: Framework Partnership Agreement FUH: Fond humanitaire d’urgence (humanitarian Emergency Fund)

GISTI: Groupe d’information et de soutien des immigrés (Immigrant support and information group) GIZ: Deutsche Gesellschaft für Internationale Zusammenarbeit

HDI : human Development Index (statistical index,

ICVA : International Council of Voluntary Agencies IFRASS: Institut de formation, recherche, animation sanitaire et sociale (health and Social Training and research Institute) IFSI: (Nurse Training Institute) INSEE: Institut national de la statistique et des études économiques (National Economic Statistics Institute) INSERM: Institut national de la santé et de la recherche médicale (National health and Medical research Institute) INTERREG: European Cross-Border Co-operation IREPS: Instance régionale d’éducation et de promotion de la santé (regional health Education and Promotion Authority) IRTS: Institut régional du travail social (regional Social Work Institute) IS: Iniciativas Sanitarias ISDP : Integrated Services for Displaced People ISPED: Institut de santé publique, d’épidémiologie et de développement (Public health, Epidemiology and Development Institute) IUT: Institut universitaire de technologie (university Technology Institute) IVDU: Intravenous drug users

JKSMS: Jan Kala Sahitya Manch Sanstha

KAD: Kindianaise d’assistance aux détenus (Kindianese Support for Detainees) KIA: Kachin independence army KPK: Khyber Pakhtunkhwa province in Pakistan

LDH: Ligue des droits de l’homme (human rights League) LSD: Lysergic acid diethylamide LSI: Loi pour la sécurité intérieure (Internal Security Law)

MCWAK: Maternity and Child Welfare Association

Khampur MDGs: Millenium Development goals MdM: Médecins du Monde (Doctors of the World) MILDT: Mission interministérielle de lutte contre la drogue et la toxicomanie (Interministerial programme against drugs and addiction) MIR: Mission internationale régionale (regionally managed international programme) MNLA: Mouvement national de libération de l’Azawad (National Azawad Liberation Movement) MSF: Médecins sans frontières (Doctors without Borders) MSPP: Ministère de la Santé publique et de la Population (Ministry of Public health and Population) MySU: Mujer y Salud (women and health)

Treatment in Africa SCAC: Service de coopération et d’action culturelle (Aid and cultural support department) SCD: Socio-cultural determinants SEDEC: Social and Economic Development Centre SIAO: Service intégré d’accueil et d’orientation (Integrated reception and Advice Service) SOLIPAM: Solidarité Paris maman SRH: Sexual and reproductive health STRASS: union of sex work STI: Sexually transmitted infection SUD: Solidarité Urgence Développement (Solidarity Emergency Development)

NGO: Non-governmental organisation NSR : National System of referral

TLC : Thin layer chromatography TOHAV: Foundation for Society and Legal Studies in Turkey TROD: rapid diagnostic tests and advice

OAA : OCHA: ODSE : Observatoire du droit à la santé des étrangers (Observatory on right to health for Migrants) INGO: International non-governmental organisation

PACA : Provence-Alpes-Côte d’Azur PASS: Permanence d’accès aux soins de santé PPR : Fondation Pinault-Printemps-Redoute (PinaultPrintemps-redoute Foundation) PRAH: Programme médico-social en soins spécialisés (Specialist healthcare and medico-social programme) PRAPS: Programme régional d’accès à la prévention et aux soins (regional Programme for Access to Prevention and healthcare) PTMCT: Prevention of Mother to Child Transmission

UN: united Nations UNDP: united Nations Development Programme UNFPA: united Nations Population Fund UNHCR: united Nations high Commissioner for refugees UNICEF: united Nations Fund for Children UNIPA: Unidad Indígena del Pueblo Awá UNOPS: UOSSM: Union des organisations de santé et de soins médicales (union of health and medical care organisations) URR: Emergency and rapid response

VHAI: Voluntary health Association of India HVC: hepatitis C virus HIV: VOICE: Coalition of European NgOs

DRC: Democratic republic of Congo RdR: harm reduction REEJER: Réseau des éducateurs des enfants et jeunes de la rue (Network of street children educators)

S2AP: Service d’analyse, d’appui et de plaidoyer (Analysis, Support and Advocacy Department) SAI: Service adoption international SAPTA: Support for Addictions Prevention and

WHO: World health Organization WAHA: Women and health Alliance WFP: World Food Programme

XBT: Drug analysis

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ThANKS wITh ThE 2012 EdITION

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

Angola -

Improvement in health and the right to health

ALL

young people »

» ACTIVITIES 0.51 UNDP 2012

» »

PERSONNEL

» »

CO-ORDINATORS © Agnès Varraine Leca

» © Virginie de galzain

MdM France and MdM Spain are working on a joint project in Kwanza-Norte province, aiming to reduce maternal and infant mortality, which is the highest in Southern Africa. The programme’s objective is to improve existing health facilities through extensive training of health professionals in management, referral and data collection. It

POPULATION

OF THE

» » FUNDING

BUDGET

Médecins du Monde (Doctors of the World)

51.1 yRS 148

and women.

» RESULTS 346 people trained in sexual and reproductive health: 148 nurses, 150 student nurses in training, 12 teachers, 11 municipal trainers and 25 statisticians. 563 people (women and young people) made aware of their rights regarding sexual and reproductive health.

» OUTLOOK Activities will continue in 2013. Increased mobilisation of community stakeholders (young people, traditional midwives, ‘leaders’) will involve the people in management and decision-making in matters of health.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

Access to dental healthcare

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

Treating child malnutrition

» diébougou, a region in the south west

» diébougou and dissin, south-west region

» ACTIVITIES 0.34

55.9 yRS 183

UNDP 2012

POPULATION

» »

PERSONNEL

Since the end of 2011, the dental health service has been fully integrated into the activities of PrAh (medicosocial programme for specialist care including ophthalmology, physiotherapy, mental health and dentistry). The number of visitors to the dental practice and peripheral services is continuously increasing and a new dental chair was installed in March. During the summer, the two nurses responsible for the surgery completed a training course in a specialist denture laboratory in Nice and then at the surgery. Consequently, the manufacture of dentures is now fully operational. Alongside this, twice a month, a mobile clinic brings dental treatment to people living in remote villages. Since the reduction in the cost of extractions in mobile clinics at the end of 2009 (1,500

» ACTIVITIES 0.34 UNDP 2012

» »

CO-ORDINATORS

» »

Finally, an information campaign to raise awareness amongst the general public of the question of access to dental healthcare took place in November in collaboration with the puppet company Les Grandes Personnes de Boromo.

» RESULTS

FUNDING

PERSONNEL

association

CO-ORDINATORS

BUDGET

Fondation l’Occitane

» OUTLOOK the guidance of PrAh. The package has been up and running for three years in partnership with dental equipment maintenance professionals.

BUDGET

Technical feasibility studies have been completed in the course of the year, premises and the women’s groups vest time in 2012.

The project will proceed with technical and marketing training for the women in the association, with a start in

Fondation l’Occitane

» RESULTS

» OUTLOOK

FUNDING

women’s groups, local farmers, small shops).

missions missions

In Diébougou, following on from a programme of access to nutritional healthcare, run in partnership with the Centre for recuperation and nutrition education (CrEN) and the CMA (a therapeutic CrEN), MdM is supporting

POPULATION

55.9 yRS 183

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

Treating child malnutrition

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

Access to primary health-

» djibo district, Soum province

» ACTIVITIES 0.34 UNDP 2012

POPULATION

» »

55.9 yRS 183

supplies medicines for the treatment of associated conditions and has a buffer stock of nutritional inputs and routine treatments to alleviate occasional failures in the system. Support is given to the district team to manage

PERSONNEL

CO-ORDINATORS

» » »

FUNDING

» ECHO

BUDGET

» ACTIVITIES

The project was launched in August with renovation work and upgrading the medical and technical equipment which enabled an intensive nutritional rehabilitation centre to be opened on the site of Djibo hospital. Personnel

0.34 UNDP 2012

POPULATION

» »

PERSONNEL

» RESULTS On average, 59 severely malnourished children admitted to hospital for treatment every month.

» »

CO-ORDINATORS

» OUTLOOK

» » »

The project will continue in 2013, to ensure that the service is fully integrated into Djibo hospital and to guarantee good quality care for severely malnourished children. Children living in refugee camps in Soum province will

FUNDING

55.9 yRS 183

MdM’s project aims to ensure that basic, good quality healthcare is available in the refugee camps of Mentao and Damba. It has supplied a health centre in each of the camps, supplying essential medicines, delivering preventive and curative care (malaria, reproductive healthcare, treatment for STIs and hIV/Aids, support for cases of malnutrition). The system of free referrals to the Djibo medical centre, with its surgical unit, has been organised for the most complex cases. A system for epidemiological monitoring was set up in the camps and their surroundings. Two vaccination campaigns against polio and measles were carried out by the management team of the Djibo health district, with logistical support from MdM. This provided protection for 2,000 children.

» RESULTS 208 referrals or medical evacuations were carried out.

strengthened. BUDGET

» OUTLOOK The situation in Mali is still far from stable and the outlook for the return of communities remains a distant one, so the programme continues for 2013. Particular attention will be paid to epidemiological monitoring in the camps.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

Chad Reducing maternal and neonatal mortality, and

Supporting the health authorities to provide

healthcare

» ACTIVITIES 0.34 UNDP 2012

POPULATION

» »

49.9 yRS 184

MdM is working in 15 health centres and in the maternity department of the hospital in Mao, Kanem’s regional capital. Through continued supervision and training, MdM enhances the skills of the health workers in support of mother and child healthcare. Training is also given to traditional midwives and awareness-raising sessions are organised in the communities on sexual and reproductive health and on vaccination. A pilot referral project has been established, to allow pregnant women from isolated villages to reach a health centre for the monitoring of

PERSONNEL

» »

These surgical procedures are carried out with the co-operation of Chadian doctors who have also received training. Psychosocial support is also given to the women both before and after surgery.

CO-ORDINATORS

» » »

FUNDING

BUDGET

» RESULTS 239 traditional birth attendants trained. 521 awareness-raising sessions reaching 21,529 villagers. Eight carts in use for referrals.

» ACTIVITIES 0.43

By way of continuity, 2013 will be an opportunity to strengthen the partnership between MdM and the health authorities, providing technical support to regional delegations in the organisation of health activities in their districts and supporting them in the development of an annual operational plan.

MdM is supporting 45 healthcare centres in three districts to uphold the policy of free healthcare (for pregnant

UNDP 2012

the way from unicef and MdM to deliver them to the centres. Technical and organisational support is provided by MdM’s professional teams, to district management teams and to healthcare personnel in the centres. Finally, lobbying of the health authorities has taken place, to support the implementation of this policy and to disseminate information to all communities involved.

POPULATION

» »

PERSONNEL

» »

» RESULTS

CO-ORDINATORS

» » »

FUNDING

» OUTLOOK

56 yRS 168

BUDGET

98,590 paediatric consultations.

» OUTLOOK In 2013, MdM will continue its support in the districts for the introduction of targeted free healthcare as well as its lobbying work. Furthermore, in Abidjan and San Pédro, a needs assessment in harm reduction for vulnerable populations (men having sex with men, women working in the sex industry, people who use drugs) is also planned.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

Integrated programme

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

Promoting health the streets

» ACTIVITIES 0.30

48.7 yRS 186

» ACTIVITIES

Launched in 2003 to demonstrate that treatment for people living with hIV was possible, even against a backdrop

0.30

UNDP 2012

Congolese civil society. In order to prepare for this outcome, we have, from the outset, promoted a shared management model, involving the health authorities, groups of people living with hIV and civil society.

POPULATION

» »

PERSONNEL

» »

CO-ORDINATORS

» »

houngba

» FUNDING

BUDGET

It can be broken down into three themes: – the promotion of a high quality medical provision; – support for civil society and organisations of people living with hIV, in their work towards prevention and assistance for people who are infected with the virus; universal access to treatment and to improve the coordination and control of policies pursued in the country.

POPULATION

» »

PERSONNEL

» »

48.7 yRS 186

activities to its main partners. The Congolese rEEJEr, AED and CCN organisations are the main players and guarantors of the implementation and continuity of activities. Drop-in centres, such as the one in Bomoyi Bwa Sika which is managed by AED, provide access to healthcare for children (treatment and prevention), a safe place to spend the day and/or the night and various care services (psychosocial support, self-esteem activities etc). Every day, mobile teams trawl the streets of Kinshasa, to meet children and strengthen the link between the centres, the monitoring teams and those on the streets. Over and above the access to services, the involvement of the girls at different levels of the project allows us to work with them and for them, to develop responses that

CO-ORDINATORS

» »

» RESULTS

» RESULTS 5,990 patients seen, of which 1,829 are on antiretroviral treatment (ArV). 6,324 new patients screened.

» OUTLOOK In 2013, our main focus will be the transfer of activity to local stakeholders, which will be regulated by shared governance between health authorities, civil society and patient organisations. Finally, this local presence will feed

FUNDING

184 girls started to use contraceptives.

» OUTLOOK BUDGET

The major challenge for 2013 will be to consolidate the transfer of activities. That will allow Doctors of the World to further develop its work with the girls in terms of coaching and support on reducing the risk that they face (hIV, early pregnancy, sexual violence, STIs) and how to deal with these risks.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

communitybased mental health gender-related violence

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

Improving prison conditions

» ACTIVITIES 48.7 yRS 186

CO-ORDINATORS

MdM’s activities are built around three themes: – enhancing the skills of a network of psychosocial counsellors, seen as the real gateway to multi-disciplinary care (medical, psychosocial, judicial and economic) for victims of sexual violence; – support for setting up community projects aiming, on the one hand, to strengthen the integration of mental health issues in relation to sexual violence, and on the other, to develop the expertise of civil society partner organisations; – support for the structuring of a resource centre for those involved in the struggle against sexual violence, which will be jointly run by Congolese civil society and state institutions. This centre, a real community resource for civil society, is currently in the process of being transferred to these organisations.

» RESULTS

4,549 victims of sexual violence have been seen by counsellors. 10 civil society organisations supported.

0.30 UNDP 2012

POPULATION

» »

PERSONNEL

» » »

FUNDING

0.36

» OUTLOOK

BUDGET

Mental health is increasingly central to the programme in goma. In 2013, building on the strengths of the counsellors will continue by working in a network. The prime objective is to work with our partners in the communities to enhance, and better target, our community-based actions and improve opportunities for community care.

The objective of the partnership between MdM and the association Kindian Assistance to Detainees (KAD) is to improve prison conditions in Kindia’s central prison with regard to the environment (hygiene and sanitation, refurbishment, rehabilitation and maintenance of the facility), to health (medical consultations, supplying the pharmacy, dietary support for the undernourished) and to re-integration (teaching, literacy training, income-generating

UNDP 2012

PERSONNEL

» RESULTS

CO-ORDINATORS

» »

FUNDING

» Fondation Mérieux Grand Chalon BUDGET

» »

» ACTIVITIES 54.5 yRS 178

Access to healthcare for prisoners guaranteed, four nurses in training, literacy training for prisoners and occupational reintegration. No new cases of malnutrition recorded.

» OUTLOOK lets for bricks fabricated) and the development of a countrywide KAD network to ensure a sustainable imprint of its actions on the local landscape. Moreover, it is important to develop new income-generating activities (several avenues are under discussion) so that KAD can gradually become autonomous.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

Improving access to mother and child

0.52

» dadaab district

The project, launched in September 2011, has provided support for the Dadaab district hospital, a referral facility for refugee and local populations. MdM has underpinned the construction and improvement of the Dadaab hospital whilst its partner organisation Women and health Alliance International (WAhA) has taken on responsibility for medical activity including personnel training. The newly improved hospital includes a delivery suite, two operating theatres, a maternity suite, an emergency room, a pharmacy, an admissions department and an outpatient consultation room; MdM provided the medical equipment for these departments. The bed capacity has doubled (currently 53 beds).

POPULATION

» »

PERSONNEL

» »

» RESULTS

CO-ORDINATORS

» » »

16,192 medical consultations. 189 vaginal deliveries. 90 caesarean deliveries.

FUNDING

» OUTLOOK BUDGET

» Nairobi

» ACTIVITIES

57.7 yRS 145

UNDP 2012

» Fondation Beaudoin

ANNUAL REPORT 2012

harm reduction amongst people who use drugs

drought

DOCTORS OF THE WORLD

» AFRICA

The project will come to an end in February 2013. MdM is currently working on a strategy to identify potential activities to be developed. The danger and extreme instability of the zone give rise to complications regarding the establishment of a new project.

» ACTIVITIES 0.52 UNDP 2012

57.7 yRS 145

In this preliminary phase, MdM is consulting people who use drugs and Kenyan NgOs to identify the precise nature of their needs and priority areas for intervention. MdM is sharing its experience of harm reduction, gained

PERSONNEL

CO-ORDINATORS

» » »

FUNDING

BUDGET

» OUTLOOK MdM will launch the project by setting up a mobile unit. here, MdM and Sapta will provide prevention materials and will lead awareness-raising sessions on harm reduction. MdM will supplement its work either by opening a

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

Reducing poverty and improving access to healthcare

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

Paediatric cardiac surgery -

» Bong county

» Antananarivo

» ACTIVITIES 0.39 UNDP 2012

POPULATION

» »

PERSONNEL

» »

CO-ORDINATORS

» » »

FUNDING

57.3 yRS 174

MdM and its partners are supporting 16 healthcare centres, including a hospital which is considered the reference hospital for obstetric and neonatal emergencies in Bong county. This support comprises the provision of a minimum standard of care in areas of sexual and reproductive health, maternal and neonatal health as well as mental health and primary healthcare. In line with national policy, access to healthcare is free of charge. Community health initiatives have also been established in the surrounding villages. A home for pregnant women, which was built as a pilot, is now operational. It means that women approaching full-term, or women in need of monitoring during their pregnancy, can be close to a healthcare centre. A second home is under construction. The 69-bed hospital, primarily deals with women with antenatal or postnatal complications, deliveries and neonatal care. Two theatres mean that surgical operations can be performed. MdM provides both structural and operational support. In terms of skills transfer, MdM is responsible for training hospital staff, nurses, midwives and local healthcare personnel.

» RESULTS 552 caesareans performed by surgeons, 1,923 deliveries carried out in hospital, 4,440 children under one year old have had a full set of vaccinations.

BUDGET

» OUTLOOK in Bong, MdM will gradually hand over all its activity to the healthcare facilities and health authorities by the end of 2013. The challenge for 2013 is to implement the exit strategy and to identify possible future projects in Liberia.

» ACTIVITIES 0.48 UNDP 2012

POPULATION

PERSONNEL

» »

CO-ORDINATORS

» » »

FUNDING

BUDGET

66.9 yRS 151

pices of this project, which was launched in 1996. MdM is involved throughout, from initial screening to follow-up treatment of children who have had operations. Every year, the paediatric-cardiac team from MdM Indian Ocean (made up of cardiologists, cardiac surgeons and intensive care anaesthetists) comes to Madagascar for two weeks. Closed heart operations are performed in collaboration with the Madagascan surgical team from a hospital in the capital city (CENhOSOA). The ultimate objective is to create a team that is able to carry out these operations without outside help. For this reason, surgeons, cardiologists and anaesthetists are trained in reunion. however, children who need open heart surgery are treated in reunion and in France with the help of several partners: la Ribambelle, la Chaîne de l’espoir, Rencontres africaines and Mécénat Chirurgie cardiaque.

» RESULTS 614 consultations, 38 children have had open-heart surgery and 22 closed-heart surgery. One intensive care anaesthetist and one anaesthetics nurse trained.

» OUTLOOK Four people from the intensive care department of the partner hospital will be trained in order to complete a team (surgery, cardiology and intensive care anaesthetics) which is capable of carrying out closed-heart operations. A cardiac surgery unit and a recovery room will be built by the Bohras community. MdM will be involved in equipping this unit.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

Emergency response

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

Giovanna »

» ACTIVITIES 0.48 UNDP 2012

POPULATION

» »

PERSONNEL

» »

CO-ORDINATORS

» » »

66.9 yRS 151

hurricane giovanna arrived from the east of the island during the night of 13th-14th February 2012 then went right across Madagascar as far as the west coast. right from the outset, MdM was involved, evaluating what was needed. MdM set up free treatment for sick people in affected communities in seven healthcare centres in the Vatomandry district on the west coast. This ran until mid-June 2012. MdM also repaired the district hospital buildings that were partly destroyed by the hurricane.

» RESULTS The seven healthcare centres in affected communities have medicines to provide free treatment for people hit by the hurricane.

» OUTLOOK In 2013, MdM will remain vigilant and will prepare so that it is able to respond to any new emergencies, whether

» ACTIVITIES 0.48 UNDP 2012

POPULATION

» »

PERSONNEL

» »

CO-ORDINATORS

» » »

66.9 yRS 151

In partnership with other stakeholders in the prison environment, including the ICrC, MdM is pressing the Ministry of Justice to humanise prison conditions in Madagascar. With the aim of making tangible improvements medicines and equipment, buddying for nurses, management of severe malnutrition and improvement in hygiene regimes. In addition, MdM is lobbying for a sustained improvement in prison conditions with regard, in particular, to prison overcrowding, hygiene and human rights. Furthermore, MdM is supporting local organisations with the implementation of micro-projects to assist with the re-integration of prisoners. By capitalising on the work carried out in Madagascar’s prisons since 2005, MdM has developed many tools, such as training modules, which have become points of reference at the national level.

» RESULTS

FUNDING

» ECHO

In 2012, MdM was involved with 5,600 inmates and trained 615 members of staff in 24 prisons.

BUDGET

» OUTLOOK

MdM withdrew from this programme at the end of December 2012 in favour of institutional partners and civil society, who have taken on a part of the operation with the intention of pursuing the activity in the best possible conditions.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

Reducing health

comprehensive

natural disasters

with obstetric

» ACTIVITIES 0.48 UNDP 2012

POPULATION

» »

PERSONNEL

» »

CO-ORDINATORS

66.9 yRS 151

The project is entering its third phase, to strengthen and transfer assets and operations to Madagascan stakeholders. This transfer comprises: support for the health system (monitoring health in the communities and epidemiological surveillance), support for victims of natural disasters (training rescue workers, training an emergency medical team, developing a contingency plan) and maintaining the momentum at community level for disaster related harm reduction. Training for trainers is being carried out to ensure the sustainability of these activities. A joint multi-dimensional project (health, water and sanitation, food safety) with MdM, Care and Medair is underway in Vangaindrano, in the south-east of the island. MdM is providing support on health aspects of disaster risk reduction to improve the quality of care for victims of these disasters. An emergency team has been formed and equipped with the necessary equipment and a network of rescue workers is in place.

» ACTIVITIES 0.34 UNDP 2012

POPULATION

» »

PERSONNEL

CO-ORDINATORS

» » »

FUNDING

19 unit heads trained by the red Cross to support rescue workers. 12 members of the risk management committees become trainers.

BUDGET

» OUTLOOK

» »

In 2013, MdM will continue its policy of developing capacity and transfer of skills to local stakeholders, with a view to closing the programme at the end of the year. The project that was begun in Vangaindrano will be consolidated. The capitalising on experience and lobbying of the authorities, donors and partners will also continue.

51.9 yRS 182

There are three elements to MdM’s activities: surgical treatment for women, as well as continued training of surgeons at Mopti hospital, psychological counselling for the women and awareness raising and prevention work in the communities. The major political crisis that shook Mali in 2012 and the worsening security situation have made access to the sing sessions and promotion of deliveries in health centres, which are usually carried out in the whole Mopti area,

» RESULTS

» »

BUDGET

has been carried out, with a view to supporting advocacy in favour of free provision of this treatment.

» RESULTS 93 patients have had operations. 865 psychological assessments have been completed. 24 discussion groups. 199 villages have had an awareness-raising session.

» OUTLOOK MdM will withdraw from this project which was launched 20 years ago. Surgeons at the hospital are trained and a local NgO will be given assistance to take over the psychosocial activities.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

Improving access to health-

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

Strengthening malnutrition and

populations »

» Illéla district in Tahoua region

» ACTIVITIES 0.34 UNDP 2012

POPULATION

» »

PERSONNEL

» »

CO-ORDINATORS

51.9 yRS 182

MdM is training all those involved from four partner organisations, to ensure the provision of a reception and listening service and medical guidance for migrants. MdM is helping to set up a referral network of professionals, whose expertise in support for migrants is strengthened. This transfer of skills comes with raising awareness and providing information on migration in general and on the traumatic consequences of a forced return, to help combat the discrimination that is often suffered by migrants. In Bamako, a system of referral to two healthcare centres has been established to ensure the best possible care for sick migrants. Data are collected to better understand the health problems that occur along the migration route and feed into advocacy on access to healthcare for migrants.

» RESULTS

» »

604 migrants and 281 displaced people seen by partner organisations.

FUNDING

91 people receive psychological counselling.

BUDGET

» OUTLOOK

» »

Access to healthcare for migrants is a priority issue for MdM. In 2013, links between migrant projects in France and abroad (Algeria, Turkey) will be strengthened, with the aim of conducting common lobbying activities. We will also support our local partners with their lobbying activity.

» ACTIVITIES 0.30 UNDP 2012

51.1 yRS 186

MdM has stepped up its activities in the 22 integrated health centres and in the Intensive Nutritional recovery Centre (CrENI) by providing extra health workers, by training new health workers as well as ensuring that there is an improvement in management of stocks of nutritional supplements and contraceptives. The NgO has carried

POPULATION

» »

PERSONNEL

» »

CO-ORDINATORS

ving its prevention activities. With the help of local networks, including local NgOs, religious leaders and matrons, awareness-raising activity and health education have been carried out using various methods, in order to prevent pregnancies that are too closely spaced and poor nutritional practices.

» » »

» RESULTS

FUNDING

» OUTLOOK

BUDGET

MdM is continuing its work in 2013, further strengthening its supervisory role in all health training in the district. Work with community leaders will be improved by taking into account the results of the research. Three local NgOs will be involved and supported so that they can gradually take over the activity.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

Rwanda Psychological

Improving access to primary healthcare

genocide survivors

» ACTIVITIES 0.43 UNDP 2012

POPULATION

» »

PERSONNEL

» »

55.7 yRS 167

The psychological and social reintegration of survivors suffering trauma associated with the genocide is at the heart of the Ibuka project and MdM’s work. Support for these people is based on group therapy, which allows them to overcome their traumas and build up a support network. Furthermore, Ibuka professionals are given skills training which in turn allows them support and supervise other partner participants. Since 2011, the system set up by MdM has been passed on by Ibuka professionals to other mental health practitioners, through group training, supervision and capitalising on experience.

» ACTIVITIES NIgER

» RESULTS

0.30

51.1 yRS 186

0.34

51.9 yRS 182

0.34

55.9 yRS 186

geographic perspective, and an improvement in the quality and organisation of the services. Furthermore, MdM is promoting new health policies in favour of removing user fees. Particular efforts have been made with regard to the questions of referrals and medical evacuations, by setting up community contribution systems, with the support of the local authorities, which allow a long-term arrangement to be a possibility.

» RESULTS

UNDP 2012

CO-ORDINATORS

» » »

FUNDING

BUDGET

48 practitioners, including 10 psychologists training as supervisors.

» OUTLOOK In 2013, MdM is working to ensure the sustainability of the project by passing on the methodology, by empowering Ibuka professionals and working towards recognition for the system by mental health authorities at a national level and by other national and international stakeholders.

POPULATION

With regard to the adoption of new policies on access to healthcare by the health authorities, progress has been

PERSONNEL

» OUTLOOK

» » » »

CO-ORDINATORS

» » »

FUNDING

BUDGET

All activity remains at the mercy of the constantly degrading security situation, which has led MdM to take certain measures aimed at reducing risk, without actually compromising the implementation of plans to date. In Mali, in reproductive health activities and on referrals / evacuations, two areas that have shown positive results since the start of the project.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

Somalia - Puntland Providing good quality mother and child health services

harm reduction amongst drug users

» Bosaso, Puntland

» ACTIVITIES

51.5 yRS UNDP 2012

and medical supplies. MdM also trains medical staff and offers activities for health education. It carries out important collection and analysis of medical data; a records system has been established, especially for obstetric and gynaecological emergencies in the maternity department of the Isnino centre. Alongside this, as part of the nutrition framework, MdM delivers education sessions in the health centres on nutritional health and distributes food rations to women giving birth, to those who are breastfeeding and to children under two years old. A system for recording severe acute malnutrition, a screening mechanism and a system of registration for vulnerable and/or displaced people have been established.

POPULATION

» »

PERSONNEL

» »

CO-ORDINATORS

» » »

» RESULTS

FUNDING

and WFP

BUDGET

Five health centres have been renovated and equipped. 26,562 patients have had medical consultations of which:

0.48 UNDP 2012

POPULATION

» »

PERSONNEL

» »

CO-ORDINATORS

» » »

FUNDING

58.9 yRS 152

After two years the programme is well accepted and there is a genuine co-operation between the public institutions, medical facilities and civil society. The drop-in centre, which is open six days a week, offers information on prevention, screening for infectious diseases, new syringes, psychosocial activities and referrals to healthcare facilities. MdM continues to go out to the most at-risk users with a mobile unit to offer them prevention materials and to invite them to come to the drop-in centre. The training and resources centre has begun to train medical personnel from partner health facilities, such as the NgOs who are involved. Many other stakeholders in Tanzania and neighbouring countries have been made aware of the issues, including parliamentarians and members of governments. groups of drug users have also formed cooperatives and launched income-generating activities. Some users have also chosen to take action to educate their peers, the general public and policy makers. Their voices are starting to be heard.

» RESULTS

- 3,600 pregnant women.

» OUTLOOK This project began in July 2011 and will end in December 2013. Consideration of the strategy to be developed from 2014 is underway.

BUDGET

25,000 syringes and 14,000 condoms per month have been distributed.

» OUTLOOK MdM will support the introduction of methadone in the project area and the development of harm reduction activities throughout Dar es-Salaam. The project will also provide training for Kenyans involved in harm reduction.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» AFRICA

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» LATIN AMERICA

Colombia -

Access to and mother and child health

rural and indigenous populations isolated by the

» ACTIVITIES 52.7 yRS

MdM is helping to make pregnancy safer, looking out for and responding to epidemics including caring for people affected by hIV in Chipinge district. This activity is particularly aimed at pregnant women and children. MdM is also lending support to three hospitals and 48 health facilities in the district. MdM is continuing the handover of activities started in 2011 to the Ministry of health and also to the greater hope Trust. Along with its partners, MdM is concentrating its efforts on training nursing staff and village health workers, in minimal risk maternity, care for people with hIV, monitoring epidemics and is organising many community awareness sessions on these issues. MdM also supports and trains ‘grandmothers of the heart’ who look after hIV orphans. Days dedicated to children, to increase the number of children who are screened and treated for hIV, are organised with the health centres. Finally, vehicles and equipment were given to partner organisations, prior to the departure of MdM in June 2012, to facilitate the continuation of activities.

UNDP 2012

POPULATION

» »

PERSONNEL

» »

CO-ORDINATORS

» » »

Simona Zompi

» RESULTS

FUNDING

BUDGET

Almost 3,400 women gave birth in supported health facilities 169 hIV positive children given ArV treatment. 1,300 people informed on minimal risk matenity and/or hIV/Aids.

A needs assessment of women who are victims of violence was conducted in harare, but did not lead to a project, owing to the fact that others were working on this issue. MdM remains watchful of the political and health situation in the country and is ready to intervene in case of an acute crisis, particularly in the capital.

» ACTIVITIES Working in partnership with the public health services MdM deploys outreach activities which offer medical and 0.72 UNDP 2012

73.9 yRS 91

more, the programme aims to increase the active involvement of communities and their leaders through training

POPULATION

» »

PERSONNEL

» »

CO-ORDINATORS

» RESULTS 32 mobiles health clinics established, of which 16 are with the cooperation of the health authorities.

» OUTLOOK

MdM plans to withdraw from zones where the security situation is improving and where the health authorities are

» »

to strengthen and sustain its activities in the municipalities of southern Meta and in the remote areas of guaviare.

FUNDING

» OUTLOOK

BUDGET

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» LATIN AMERICA

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» LATIN AMERICA

Colombia -

Access to rural and indigenous populations isolated by the

» Nariño department

Sexual and reproductive in export industries

» Escuintla department

» ACTIVITIES 0.72 UNDP 2012

POPULATION

» »

PERSONNEL

» »

73.9 yRS 91

In close cooperation with the healthcare centre managed by the indigenous organisation unipa, MdM deploys mobile clinics, within the Awas indigenous territories. The medical teams dispense medical and psychological treatment, focusing on the monitoring of pregnant women and children, vaccinations, nutritional monitoring, family planning, the diagnosis of malaria and tuberculosis and on mental health. MdM’s work also includes prevention activities, training and promotion of healthcare among community leaders and indigenous health promotion practitioners.

» RESULTS

» ACTIVITIES 0.58 UNDP 2012

POPULATION

» »

PERSONNEL

» »

24 mobile clinics established in collaboration with the indigenous organisation unipa.

CO-ORDINATORS

» OUTLOOK

» »

In 2013, MdM will continue to support unipa in its lobbying for a healthcare system which is culturally appropriate to the Awa people.

FUNDING

CO-ORDINATORS

BUDGET

71.4 yRS 133

MdM organises medical and sexual and reproductive health consultations in export companies and farms. A medical service, open to workers, is also provided every Sunday in MdM premises. health promoters are recruited from amongst the workers and trained to deliver information on health, workers’ rights and human rights. Alongside this, visits are organised jointly to the companies with the various administrative bodies and guatemalan health services, which help to raise awareness of the health of women workers and to coordinate the actions of public institutions towards an improvement in respect for their rights, including access to healthcare

» RESULTS

healthcare (Srh). 64 women were trained and their skills in Srh were developed.

plants (known as maquilas).

FUNDING

BUDGET

» OUTLOOK In 2013, MdM will focus on consolidating its activities with key partners in the project and on lobbying in favour of the sexual and reproductive rights of women. In August 2013, the results of a study carried out by MdM on the rights to sexual and reproductive health of women working in the clothing and agrifood industries will be presented at a conference.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» LATIN AMERICA

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» LATIN AMERICA

Haiti

Supporting the treatment

Supporting primary health care and -

mortality »

» ACTIVITIES 62.4 yRS 161

MdM provides support for the district’s epidemiological monitoring service to facilitate a rapid response and to reduce the risk of spread when an outbreak of cholera occurs. The programme also guarantees a better response to emergencies, as part of the protocol implemented by the health management services in grand’Anse. It ensures that activities are coordinated with water and sanitation authorities. MdM teams support the Ministry of health’s operations in cases of emergency or peaks in the epidemic, with a mobile team working throughout the department. In cooperation with the state authorities, MdM provides care for sick people, thanks to a pool of nurses who are mobilised in case of emergency. Finally, the programme’s teams provide medicines, equipment, train health personnel in epidemic management and organise awareness-raising sessions in the general population.

» »

» RESULTS

0.46 UNDP 2012

POPULATION

» »

PERSONNEL

» »

CO-ORDINATORS

26 outlying cholera treatment centres supported. FUNDING

41,363 people made aware of cholera prevention methods. »

0.46

» OUTLOOK With cholera becoming endemic, MdM will gradually withdraw and will no longer be involved directly with caring for the decreasing number of cholera patients. Despite this, MdM continues to support the local authorities so that they are better equipped to deal with emergency epidemic situations.

MdM is working in partnership with the district health authorities, to provide many activities that will make quality

UNDP 2012

POPULATION

» »

PERSONNEL

» »

CO-ORDINATORS

healthcare and to reproductive healthcare. The programme also has a nutritional arm, which supports a nutritional stabilisation unit at Jérémie hospital. MdM’s activities impact on all levels of the continuum of care: - at a community level, extensive work is carried out with networks whose role is to raise awareness in the communities, to assist with providing health education and to provide a link with mainstream services; - at an institutional level, support for health structures is achieved through the partial or total removal of user fees and through personnel support to ensure that treatment is available and that training is ongoing etc.; - at state level, advocacy is conducted with the health department and also at national level, to ensure that the

» » FUNDING

BUDGET

» ACTIVITIES 62.4 yRS 161

» RESULTS 49,024 general consultations.

BUDGET

» OUTLOOK In 2013, MdM will continue its work promoting access to, and quality of, healthcare for pregnant women and support and lobby the local and national authorities.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» LATIN AMERICA

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» LATIN AMERICA

Haiti th

Improving access to healthcare

Sexual and reproductive

» Port-au-Prince

» Tapachula, huixtla

» ACTIVITIES 0.46 UNDP 2012

POPULATION

» »

PERSONNEL

» »

62.4 yRS 161

tière-Ti Kajou requested assistance from MdM. Initially, this assistance took the form of a temporary health centre, then, wishing to ensure the sustainability of the project, MdM built a healthcare facility in agreement with the Ministry of health, which enabled access to French Development Agency funds. The healthcare facility, completed in April 2012, was handed over to the health authorities the following 5 May and subsequently has featured on the Ministry of health’s health map. Throughout 2012, MdM facilitated the supply of medicines, covered part of the wages and provided staff training. This support came to an end on 31 December 2012, with the health

CO-ORDINATORS

» » »

» ACTIVITIES 0.78 UNDP 2012

POPULATION

» »

77.1 yRS 61

The project provides migrant women (working in the sex industry and domestic employees) with all the necessary information and support regarding sexual and reproductive health and enables them to go to existing health centres, as well as combating the discrimination and violence that is directed against them. Awareness campaigns are organised among these women on the subjects of sexual and reproductive health, violence, addiction and self-esteem. This project reinforces a network which is working to support the rights of women. It also pro-

PERSONNEL

» »

The project also relies on the participation of the local authorities (Chiapas Ministry of health, local health authorities) and civil society through several NgO partners.

CO-ORDINATORS

» RESULTS 2,643 sexual and reproductive health consultations.

FUNDING

» RESULTS

» »

4,000 migrant women attended awareness sessions. Seven sexual and reproductive health training workshops organised with 293 participants. 600 women directed to healthcare centres. 45,342 condoms and lubricants distributed.

FUNDING

BUDGET

migrant women in chiapas

» OUTLOOK

BUDGET

assist the health authorities with the transition to a more permanent facility. From 2013, MdM is planning a new project in Port-au-Prince, around sexual and reproductive health, focusing on the issue of post-abortion complications and supporting local players.

» OUTLOOK In 2013, MdM will continue its activities and will also be involved with a project run by the local Centre de droits de l’Homme Fray Matias de Cordoba organisation, which aims to defend and promote the right to decent working conditions for migrant domestic employees.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» LATIN AMERICA

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» LATIN AMERICA

Nicaragua Improving sexual and reproductive health

Reducing maternal mortality caused by unwanted pregnancies » Puerto cabezas, North Atlantic autonomous region

» ACTIVITIES 0.60 UNDP 2012

74.3 yRS 129

» ACTIVITIES

MdM is running an awareness campaign on the subject of sexual and reproductive health amongst women,

0.74 UNDP 2012

In conjunction with the Ministry of Education, a sex education project has been developed with teachers. Education sessions on the prevention of violence are organised for the men in various areas of the town. In order to improve the standard of care, MdM supplies the healthcare units with equipment and medicines.

PERSONNEL

» »

» RESULTS

CO-ORDINATORS

and 15 nurses have been trained. As a result of the training, the level of knowledge on sexual and reproductive

» »

» OUTLOOK

FUNDING

The project will come to an end in May 2013. Thanks to the day-to-day work by partner organisations on the project, the sexual and reproductive health activities introduced by MdM will continue.

POPULATION

» »

PERSONNEL

» Junta de Andalucia BUDGET

» » »

74.2 yRS 77

Since September 2012 a team has been on hand to coordinate the opening of the project and to deal with the relevant local administration formalities. The team has also made contact with local partners and the Ministry of health. The aim of the project is to guarantee access to contraception and to immediate treatment in case of obstetric complications so that the rate of maternal illness and mortality is reduced. The project also aims to

» OUTLOOK The project should begin at the beginning of 2013 when all the necessary permits have been obtained.

BUDGET

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» LATIN AMERICA

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» ASIA

Afghanistan Reducing harm abortions and promoting sexual and reproductive rights 0.79 UNDP 2012

PERSONNEL

» »

CO-ORDINATORS

» » »

77.2 yRS 51

» ACTIVITIES

Camilla giugliani

» RESULTS One regional workshop, four awareness days, two training sessions for health professionals organised, one

FUNDING

BUDGET

» At national level and in the Artigas, Paysandu and cerro Largo districts

The project is structured around two central themes: - in uruguay, support for two civil society organisations engaged in promoting and defending sexual and reproductive rights: on the one hand, Iniciativas Sanitarias (IS), an organisation of health professionals, and on the other hand, Mujer y Salud en Uruguay (Mysu), a feminist organisation. Our partnership is working simultaneously on the implementation of the law in defence of sexual and reproductive rights, in three areas of the country (Artigas, Paysandu and Cerro Largo) and on an advocacy campaign in favour of the legalisation of abortion; - at regional level, by implementing three regional workshops, MdM is trying to foster dynamic exchanges between partner and associated organisations around the theme of access to safe and legal abortion.

» OUTLOOK A second phase of the project, lasting two years, will begin in August 2013. It will focus on the analysis of obstacles and barriers to sexual and reproductive health facilities, including access to abortion services following the introduction of the new law. Indeed, certain aspects of the new law, partially decriminalising abortion, and the contrasting reality of its implementation, suggest that many challenges lie ahead for uruguay.

harm reduction amongst people who use drugs » ACTIVITIES 0.37 UNDP 2012

POPULATION

» »

PERSONNEL

» »

49.1 yRS 175

ring a range of complementary services including: provision of syringes, screening for hIV and hepatitis, individual and group counselling, primary health care, treatment for addiction and social support. Furthermore, this activity opiate substitution treatment (methadone) available only in the MdM centre since February 2010. In parallel with these various services, since 2008, MdM has provided training for over 500 Afghan professionals (NgOs, community representatives, judicial and health authorities) in good practice for harm reduction. The

CO-ORDINATORS

» » »

» RESULTS

FUNDING

59 intravenous drug users have had access to methadone. 900 drug users have used MdM services. 106,000 syringes have been distributed.

BUDGET

» OUTLOOK

substitution treatment to 850 intravenous drug users throughout the country (350 in Kabul, of which 200 through the MdM project). In this context, MdM will complete the transfer of activities to a national partner and withdraw from the project during 2013.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» ASIA

Strengthening community health systems

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» ASIA

Primary health-

» Payapon township

» ACTIVITIES 0.50

65.7 yRS 149

UNDP 2012

POPULATION

» »

auxiliary midwives. health committees are mobilised and supervised by MdM teams to implement prevention activities and health education sessions with the villagers. A fund, managed by the village health committees, has been set up in the 25 most remote villages, so that the most isolated populations can reach the hospitals in case of obstetric emergencies and illness in children under

PERSONNEL

» RESULTS

CO-ORDINATORS

» » »

» ACTIVITIES 0.50 UNDP 2012

POPULATION

» »

PERSONNEL

» »

20,000 consultations completed. 130 active community health workers. -

» »

CO-ORDINATORS

» » »

169 patient referrals, thanks to village funds. FUNDING

BUDGET

populations in

» OUTLOOK On 1 May 2012, the project was handed over to MdM Netherlands, which will continue the activities, strengthening the mother and child component and the public health system.

FUNDING

BUDGET

65.7 yRS 149

MdM is working with local partners to support several healthcare centres which have been established in six camps for internal refugees along the border with China. The support comprises provision of medicines and medical equipment, renovation of health centres and covering the costs of medicines and/or transport to hospitals in the area for emergency cases.

» RESULTS 13,000 medical consultations completed, 3, 900 mosquito nets distributed. 10 emergency kits containing essential medication. 24 medical emergencies referred.

» OUTLOOK In 2013, MdM hopes to continue this work in partnership with two local NgOs. The programme will expand to include training health personnel who work in the centres and the organisation of mobile clinics.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» ASIA

Prevention and STIs and

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» ASIA

harm reduction amongst people who use intravenous drugs

» ACTIVITIES 0.50 UNDP 2012

POPULATION

» »

PERSONNEL

» »

CO-ORDINATORS

» » »

65.7 yRS 149

MdM is providing medical, psychological, social and judicial support to people who use drugs through four clinics, one in rangoon and three in Kachin. They draw upon a team of health professionals and peer educators from the communities. The medical support includes provision of antiretrovirals for hIV-positive patients who need them and issuing methadone to people who use drugs. The teams also go out into the streets to meet the most vulnerable populations and offer them prevention materials. MdM has succeeded in forging strong links, not only with community and civil society organisations, but also with the health authorities and is now recognised as a major player in harm reduction in Burma.

» RESULTS 1,320 people on antiretrovirals. 300 drug users on methadone.

» Tbilisi

» ACTIVITIES 0.75 UNDP 2012

POPULATION

» »

PERSONNEL

» »

CO-ORDINATORS

73.9 yRS 72

MdM is supporting New Vector, its local partner, with the management of a drop-in centre which offers users a wide range of harm reduction services: sterile equipment, prevention, screening, medical and psychological consultations, as well as dental care. The teams also do outreach work to provide sterile equipment and to spread the word on prevention. As part of its cooperation with the georgian harm reduction network, MdM also organises training and is lobbying for the decriminalisation of harm reduction practices and for better access to diagnosis and treatment of hepatitis C.

» RESULTS

» »

1,040 dental consultations carried out. FUNDING

BUDGET

» OUTLOOK In 2013, MdM will continue to contribute to advances in methadone substitution and to support the involvement of local community players in prevention activities. MdM is involved with a national process aimed at supporting the Ministry of health to increase availability of antiretroviral treatment.

FUNDING

» OUTLOOK

BUDGET

In 2013, MdM will focus on integrating drug dependent women into the programme. The establishment of a mobile clinic will enable us to reach users who either dare not or are unable to go to the drop-in centre. The study

hepatitis C.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» ASIA

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» ASIA

India

Improving access to care

Access to primary healthcare

and children

» Jaipur, Rajasthan

» ACTIVITIES 0.55

65.8 yRS 136

» ACTIVITIES

MdM Midi-Pyrenees, in collaboration with its Indian partner JKSMS, has completed the training of 40 commu-

0.55

UNDP 2012

JKSMS’s social workers, are now run by community health workers. The programme team is still present in the slums, almost on a daily basis, and has extended the activities to include the most disadvantaged people living in the streets. They use interactive theatre as well as traditional support mechanisms and group or individual discussions to raise awareness and, therefore, improve access to healthcare for the population. Alongside this, the team continued to build upon links with nearby healthcare facilities, especially the Anganwadi centres and to lobby the Jaipur health authorities to secure the sustainability of the activities.

POPULATION

» »

PERSONNEL

» »

CO-ORDINATORS

» RESULTS

» »

POPULATION

» »

PERSONNEL

CO-ORDINATORS

» » »

65.8 yRS 136

MdM and Voluntary health Association of India (VhAI) are working with the Orissa state government to develop a programme of access to primary healthcare in six public healthcare units. The objective is to contribute to an improvement in the rural population’s health and to re-establish and promote the provision of healthcare. The main activities can be broken down as follows: the training of medical personnel, health education sessions in the communities—mainly on sexual and reproductive health—and medical consultations. MdM is also involved with the renovation of the main clinic and lobbying at district and state level to raise awareness among the public authorities of the living conditions of tribal and marginalised populations. Beyond the implementation of a joint project, the strengthening of the partnership is a key element of MdM’s activities in India.

» RESULTS 1,800 children attended health education sessions at school and 620 adolescents took part in a health campaign

FUNDING

» FUNDING

Une foulée pour la vie

BUDGET

» OUTLOOK So that its activities can be fully handed over to the communities and civil society, MdM will continue to support JKSMS, its Indian partner, in an effort to persuade the Jaipur authorities to take on all or part of the programme.

BUDGET

» OUTLOOK In 2013 the programme’s activities around access to primary healthcare will be strengthened and sustained and the partnership with VhAI will be further developed, through the organisation of a seminar on sharing lessons learned for advocacy.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» ASIA

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» ASIA

Laos Improving access to sexual and reproductive health

Pilot programme motherhood » western Papua

» ACTIVITIES 0.63 UNDP 2012

69.8 yRS 121

» ACTIVITIES

As planned, MdM withdrew at the end of May 2012 handing over to Kinaonak, the local community organisation, whose peer educators were trained by MdM. In April, a workshop brought together partners and the authorities

0.54

» »

PERSONNEL

of sexual and reproductive health and the prevention of STIs and hIV/Aids. This workshop also provided the opportunity to showcase the Kinaonak organisation and to conduct lobbying on issues that have been important throughout the years of the programme: access to healthcare for the population, requesting the creation of an

» » »

» OUTLOOK

» »

A support and monitoring visit is planned for summer 2013. Primarily, this will allow us to take stock of achievements and of challenges faced by Kinaonak. Additional training will be provided, depending on the needs.

FUNDING

BUDGET

MdM is working in the southern province of Champassak, in Soukhouma and Mounlapamok districts. The pro-

old. MdM has renovated health centres, provided the necessary medical equipment and trained midwives (in pregnancy, delivery, neonatal care, spacing of births) and volunteers in the villages to promote maternal healthcare. MdM and Lao red Cross have together set up a system of health cheques, which enable pregnant women to access free healthcare. The cheques are distributed by village volunteers and cover ante-natal and post-natal consultations, delivery (with a caesarean if necessary) and complications linked to pregnancy. They also cover the cost of non-medical facilities such as transport to a medical centre to give birth, an allocation for meals and transport to a specialist centre in case of obstetric complications.

» »

» RESULTS

FUNDING

10 community midwives and 144 promoters of maternal and child health trained in the villages. 558 women gave birth free of charge in a medical centre.

BUDGET

» OUTLOOK

» »

PERSONNEL

» »

CO-ORDINATORS CO-ORDINATORS

67.8 yRS 138

UNDP 2012

POPULATION POPULATION

» »

In October 2012, a second phase was launched. This includes two other district hospitals and provides support for emergency obstetric care and for the establishment of a programme in the healthcare centres to prevent the transmission of hIV/Aids from mother to child. MdM Japan will also continue to develop the activities it started at

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» ASIA

Improve access

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» ASIA

assistance sexual and reproductive health services

» ACTIVITIES 0.46 UNDP 2012

POPULATION

» »

PERSONNEL

» »

CO-ORDINATORS

» » »

69.1 yRS 157

munities in the Sindhupalchok district. The objective is to increase use of sexual and reproductive health public services and to reduce factors contributing to maternal and neonatal mortality. Doctors of the World’s project intends both to ensure that good quality health services are available at community level (renovation and equipping of health facilities, training of health personnel, referrals) and to support women by improving their ability to nance activities, and in education sessions on prevention, management of pregnancy, childbirth and post-natal pendence through better management of the family budget, anticipation of expenditure on health and access to emergency obstetric funding. chok district and CMF provides technical support. MdM has also forged close links with Planet Finance, which

» »

0.52 UNDP 2012

POPULATION

» »

PERSONNEL

» »

CO-ORDINATORS

» » »

FUNDING

BUDGET

» ACTIVITIES

» RESULTS » OUTLOOK In 2013, MdM will continue to work with the health authorities in remote communities of Sindhupalchok district, to ensure that the healthcare services continue to be available. MdM will pay close attention to the continued provision of competent healthcare personnel for the duration of the project to every clinic—even in the most remote.

BUDGET

65.7 yRS 146

is aggravated by a health system that has been bled dry and cannot meet the demands of a growing population. alarming in this province. Since 2009, MdM has been working in various districts of KPK to provide access to primary healthcare for the most vulnerable and, in particular, for women and children. MdM’s mobile medical teams support the district health facilities to provide general medical consultations, sexual and reproductive healthcare consultations, to improve immunisation coverage, to identify children suffering from malnutrition and deliver health education sessions. MdM provides training for health personnel, supplies medicines and readyto-use therapeutic foods and is responsible for referring patients to other healthcare facilities when necessary.

» RESULTS 90,000 consultations carried out in all the health facilities.

» OUTLOOK In 2013, MdM will reduce its activity in some healthcare facilities and redeploy its mobile medical teams to the Peshawar and Tank districts, where the humanitarian and health issues are particularly acute owing to the concentration of displaced people.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» ASIA

ANNUAL REPORT 2012

Supporting the organisation provide emergency obstetric care

DOCTORS OF THE WORLD

» ASIA

by domestic violence

» Punjab Province

» ACTIVITIES

0.52

65.7 yRS 146

UNDP 2012

POPULATION

» »

CO-ORDINATORS

» » »

FUNDING

» Ouest France Solidarités BUDGET

provide emergency obstetric care. The health centres have an outpatient department, equipped with an ultrasound machine, and an ambulance for referral of high-risk pregnancies. The recruitment of female community health workers, allows women to be informed about basic healthcare, family planning as well as prevention, hygiene and health education.

» RESULTS 4,900 mother and child consultations. 200 assisted deliveries in health centres.

» ACTIVITIES 0.52 UNDP 2012

POPULATION

» »

PERSONNEL

» »

CO-ORDINATORS

65.7 yRS 146

Since 2004, MdM has been working with the Department of Social Affairs of Punjab to improve the care of women and their children who, as a result of violence, have decided to leave the family home and take refuge in one of the province’s 34 Dar ul-Amans. Around mid-2011, MdM began the transfer of the project to the Punjab authorities and now concentrates its activities on enhancing the skills of those working in the Dar ul-Amans and of the Department of Social Affairs to ensure the sustainability of multidisciplinary services and compliance with minimal standards, as well as the development of management tools. MdM coordinates the Mumkin platform, which links 19 Pakistani organisations involved in the defence of rights violence, which was voted on by the Punjab Senate at the end of 2011.

» OUTLOOK The partnership launched in 2010 between MdM and MCWAK came to an end in late 2012.

» » FUNDING

» RESULTS with women in the Dar ul-Amans.

» OUTLOOK BUDGET

and will continue the project until the end of 2014, with a view to further improving the long term protection of women who are victims of abuse and violence, even in the Dar ul-Amans, through the introduction of systematic mechanisms for prevention, detection and care for victims of violence.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» ASIA

Preventing environ-

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» ASIA

community health Partnership NGO

among vulnerable populations »

» ACTIVITIES 0.65 UNDP 2012

PERSONNEL

CO-ORDINATORS

» »

69 yRS 114

analyse more precisely the high-risk practices employed by the recyclers and possible alternatives to bring about a change in these practices. The next stage will be to educate MdM community workers on different types of rubbish that are handled by the recyclers and to train them in new good recycling practice to reduce the health and environmental risks.

» OUTLOOK

FUNDING

» Fondation Veolia BUDGET

change in practices, to support the communities (especially in their ability to respond to their problems) and to promote access to appropriate and quality care.

» ACTIVITIES 0.79 UNDP 2012

POPULATION

CO-ORDINATORS

» » »

69.1 yRS 55

Community health Partnership (ChP) is an organisation that trains health mediators from the indigenous communities of the great North. In addition, it is working to educate and train professionals in foetal alcohol syndrome and in suicide prevention amongst young people. Activities are conducted in partnership with MdM, the Nenetsk yasavey organisation and the Lithuanian youth Psychological Aid Centre, which specialises in the issue of suicide in young people.

» RESULTS 23 head teachers trained in suicide prevention amongst young people. 13 alcohol specialists and 19 students of psychology and education trained in foetal alcohol syndrome.

FUNDING

BUDGET

» OUTLOOK ChP will continue its work in 2013. Experiences will be shared at a seminar planned for autumn 2013. MdM will continue to support ChP to become more autonomous.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» ASIA

Access to

vulnerable populations returning home

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» EUROPE

Roma community

» Nadezhda ghetto, Sliven community

» ACTIVITIES 0.72 UNDP 2012

POPULATION

PERSONNEL

75.1 yRS 92

Commission. Establishment of mobile clinics from September 2012, in partnership with Valvuthayam Sedec Mannar, to provide access to healthcare for populations in the process of re-integration in Mannar district. Feasibility study underway on a women’s project (physical, psychological and social health). In coordination with Mannar hospital, mobile clinics in 19 villages in the Madhu and West Mathai districts (20,000 people) which were

» » »

Raggioli

FUNDING

BUDGET

» ACTIVITIES 0.78

73.6 yRS 57

UNDP 2012

POPULATION

» »

PERSONNEL

CO-ORDINATORS

» RESULTS 2,300 consultations took place.

Sexual and reproductive health

» »

CO-ORDINATORS

» OUTLOOK

» » »

Develop psychosocial care for widows and/or women who are head of the family. Develop a partnership with an independent, local NgO which works with widows and/or the most vulnerable women who are head of the family.

FUNDING

for pregnant women and their babies to provide them with access to showers and personal advice.

» RESULTS 132 awareness-raising group sessions attended by 232 participants.

Fondation Renovabis

BUDGET

The team is made up of a midwife and health mediators from the roma communities in the area. Their principal activity consists of raising awareness and instructing the population of Nadezhda in sexual and reproductive health, and hygiene. This raising of awareness is achieved both on an individual basis during daily tours of the area and meeting the inhabitants, and collectively by way of practical activities four times a week in awarenessraising session for groups of men and women of childbearing age. Once a week the team runs sessions directed

» OUTLOOK health education activities will continue throughout 2013. In addition, pregnant women, young mothers and their newborn babies will be able to access a hygiene point.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» EUROPE

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» EUROPE

Romania -

and assistance

Protecting children and supporting the organisation cOPII

» Balti

» ACTIVITIES 0.66

69.6 yRS 113

» ACTIVITIES

MdM carries out activities in three areas:

0.79

UNDP 2012

- meetings to train professionals in the social sector, medical personnel and psychologists; POPULATION

PARTENAIRE

» »

» COPII association

74.2 yRS 56

After the closure of the programme in 2010, MdM carried on with its professional exchanges in 2012 to support the romanian organisation COPII, building together their goals of helping people living in situations of great vulnerability. MdM carried out an analysis of the four municipalities situated close to the town of Satu Mare and held a working seminar on the direction of the project. At the same time, MdM linked up COPII with the rainbow network, made up of MdM’s ‘sister’ organisations in Poland, Bosnia, russia and Bulgaria.

CO-ORDINATORS PERSONNEL

» »

» RESULTS

» »

850 professionals were trained.

CO-ORDINATORS

» » »

FUNDING

BUDGET

FUNDING

» OUTLOOK The programme ended in November 2012 following a planned withdrawal. An exploratory mission on the topic of alcohol was carried out with the aim of opening a new programme during 2013.

BUDGET

» OUTLOOK A two year project (2013-14) has been put forward to MdM, looking at aiding COPII in promoting better access to healthcare and rights for vulnerable people (including women and children through a maternity network) living in the four municipalities of the Judet (‘district’) of Satu Mare. Funding is currently being sought.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» EUROPE

syndrome

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» EUROPE

Improving the access to, » Tolyatti, Samara region

» ACTIVITIES 0.79 UNDP 2012

69.1 yRS 55

In 2012, MdM carried out a contact mission in Tolyatti. The association set up a project to prevent foetal alcohol syndrome (FAS) along with the NgOs Project April and Open Alternative, targeting those women who are parti-

mothers and children

» ACTIVITIES

PERSONNEL

» »

CO-ORDINATORS

» » »

FUNDING

BUDGET

general information on FAS and its prevention, training gynaecologists, and thirdly to train doctors specialising in addiction medicine, psychologists and social workers.

0.79 UNDP 2012

» RESULTS

POPULATION

Six gynaecologists trained in prevention of FAS 26 professionals (psychologists, doctors and social workers) were trained in motivational interviewing and brief intervention.

PERSONNEL

» OUTLOOK

» » »

CO-ORDINATORS

» » »

69.1 yRS 55

The goal of the programme’s activities is to reintegrate ante- and post-natal healthcare into primary healthcare centres in Vedeno district by: - training professionals (midwives and gynaecologists) in international standards of ante- and post-natal care; - developing and publicising protocols for care through professionals in the sector; - setting up a mobile outreach team of gynaecologists in the primary healthcare centres; - strengthening the knowledge and skills of women and their in-laws on matters of sexual and reproductive health. In 2012, the programme was essentially dedicated to setting up partnerships with local health authorities and to beginning the training activities and setting up the mobile team.

» RESULTS

In 2013, MdM will expand the training and develop protocols for professionals on the prevention of the risks FUNDING

cancer.

BUDGET

» OUTLOOK

» »

and mothers in-law.

» NORTH AFRICA AND MIDDLE EAST

DOCTORS OF THE WORLD ANNUAL REPORT 2012

Promoting access to rights and to

migrants

» NORTH AFRICA AND MIDDLE EAST

» constantine

» ACTIVITIES

73.4 yRS 93

0.71

UNDP 2012

POPULATION

» »

PERSONNEL

» »

CO-ORDINATORS

» » »

» RESULTS

FUNDING

» »

Five organisations engaged in the care of people living with STIs/hIV/Aids within the migrant populations. 250 healthcare actors were made aware of the health and legal needs of migrants.

POPULATION

PERSONNEL

Cirta Oxygène CO-ORDINATORS

» »

€

» OUTLOOK

Since 2008, Doctors of the World rhone-Alps has been supporting and accompanying the work of the organisation Cirta Oxygène in Constantine. Initially, this related to diagnosis and treatment of asthma in one area of the town (El gamas). This was followed by support for their programme of health education in matters of chronic diseases. The programme consists of promoting health education for patients suffering from chronic diseases by developing activities and non-medicinal practices (therapeutic education for patients), and promoting these practices to the authorities and health professionals in the country. With the aim of a gradual withdrawal by MdM, a link has been established with the organisation Education Santé Isère, through training in grenoble, then in Constantine, of Cirta Oxygène’s members and partners.

» RESULTS

FUNDING

Individual medical consultations, dietary workshops, training in self-management for around a hundred people.

BUDGET

» OUTLOOK

» »

BUDGET

73.4 yRS 93

UNDP 2012

needs of migrants in relation to health or legal issues. Finally, MdM trains people working on migrant-related issues, as well as peer educators. In parallel, MdM has set up a network of carers able to play a mediating role within healthcare facilities, welcoming and looking after the medical needs of migrants. The task of mapping the places where migrants have established themselves in Algiers, as well as a survey of healthcare facilities able to receive these migrants, was completed. Lastly, a network of organisations working with migrants was set up. Around a hundred people attended a conference to discuss rights and access to healthcare for migrants.

ANNUAL REPORT 2012

healthcare education concerning chronic diseases

» wilaya Algiers

0.71

DOCTORS OF THE WORLD

€

In 2013, with the technical support of Education Santé Isère training programme will look at improving the knowledge and practices of healthcare professionals in matters of

With a view to the sustainability of the achievements of the current project, MdM will strengthen the network of within the areas of sexual and reproductive health of the migrant population. Bridges will be built between migrant projects in France and international projects (Mali, Turkey) to facilitate joint advocacy work.

Cirta Oxygène to develop a health education approach and to set up of a network of voluntary and public sector actors in Constantine. This will be the last part of the programme and will see the end of the partnership between MdM and Cirta Oxygène.

» NORTH AFRICA AND MIDDLE EAST

Supporting access to

DOCTORS OF THE WORLD ANNUAL REPORT 2012

street children in cairo

» NORTH AFRICA AND MIDDLE EAST

» Gaza Strip

» ACTIVITIES 0.66 UNDP 2012

POPULATION

» »

PERSONNEL

» »

CO-ORDINATORS

» » »

For the last phase of the project, the particular focus has been on strengthening the advocacy activities and on involving key people, both at the Ministry of health level and within civil society. This is to ensure the continuity of the project through the health network that has been established. The project enabled the development of a manual of good practice on health, to support the efforts of social workers from the different NgOs working with street children. stage: capacity building for the groups of trainers who will carry to pass on know-how to organisations, as well as a collective initiative looking at dealing with prevention of hIV/Aids in street children.

» RESULTS 22 social workers are able to use the health manuals for children living on the streets.

FUNDING

» Fondation Drosos

» OUTLOOK

BUDGET

In 2013, Doctors of the World France will begin a new project improving mental health services in primary healthcare centres and on a community level in greater Cairo, in partnership with the Ministry of health and seven local organisations. It is aimed at the most vulnerable people like women affected by violence, children in a vulnerable position or people living with hIV or hepatitis C.

€

ANNUAL REPORT 2012

Emergency response and training civilians

» Greater cairo

73.5 yRS 112

DOCTORS OF THE WORLD

» ACTIVITIES 0.67 UNDP 2012

73 yRS 110

MdM trains and supports healthcare personnel in the treatment of patients in emergency rooms set up in 11 healthcare centres. The number of emergency consultations continues to grow since the creation of these emergency rooms, thus relieving the emergency services in hospitals. In other areas, community volunteers (men and

POPULATION

» »

PERSONNEL

» »

By establishing village committees and lobbying the Ministry of health, MdM aims to improve emergency response and coordination of health actors.

» RESULTS

CO-ORDINATORS

18 emergency service personnel trained and supported by MdM.

» » Vinhas FUNDING

BUDGET

€

» OUTLOOK MdM hopes to continue its support of emergency personnel in the Central zone, but is also seeking to develop a programme promoting reproductive health in partnership with civil society and the Ministry of health.

» NORTH AFRICA AND MIDDLE EAST

DOCTORS OF THE WORLD ANNUAL REPORT 2012

0.67 UNDP 2012

POPULATION

» »

PERSONNEL

73 yRS 110

ANNUAL REPORT 2012

Syrian crisis »

» ACTIVITIES

To improve the psycho-social services in nine villages, MdM trains professionals in mental health community centres, social workers and teachers in 12 primary schools. A reference system and technical support for trained personnel is now in place. MdM also raises awareness in the community so that people suffering from psychological problems will be less stigmatised. the medical personnel in 10 healthcare centres, was organised. MdM also helped establish community emergency committees to manage crises and has equipped them to be able to respond.

» »

0.65

76 yRS 116

UNDP 2012

POPULATION

» » » » »

CO-ORDINATORS

MdM team.

» »

» RESULTS

Primary healthcare activities: in Jordan at ramtha (King Abdullah Park camp and the healthcare centre in the town of ramtha) and in zaatari refugee camp; in Lebanon in the valley of Bekaa, in the health centres of our partners, and in the north of Syria, in Qah camp for displaced people. Mental healthcare activities: in Jordan at Amman, ramtha and Mafraq, by training Syrian psychologists. Preparation for emergency: prepositioning of medical and surgical material on the borders (Jordan, Lebanon and

PERSONNEL

CO-ORDINATORS

DOCTORS OF THE WORLD

Aid to populations

healthcare and emergency the most vulnerable communities

» NORTH AFRICA AND MIDDLE EAST

Supporting the network of Syrian doctors by sending material and medical supplies, as well as providing logistical support. Post-operative care and rehabilitation for Syrian refugees on the Turkish-Syrian border.

» RESULTS

43,098 consultations carried out.

Vinhas FUNDING

health problems. FUNDING

BUDGET

» OUTLOOK

Centre de crise

€

» OUTLOOK Following a needs assessment carried out in 2012, MdM hopes to extends its support for access to mental healthcare to the whole of Nablus governorate, in partnership with MdM Switzerland and the Palestinian Counselling Centre. MdM will stay mobilised to respond to crisis situations in case of attack or violence in the villages.

BUDGET

€

a second phase of the project will start in March 2013. MdM will carry on its current activities and will support additional health centres on the borders, as well as in the north of Syria.

» NORTH AFRICA AND MIDDLE EAST

DOCTORS OF THE WORLD ANNUAL REPORT 2012

Access to healthcare and to rights

» NORTH AFRICA AND MIDDLE EAST

DOCTORS OF THE WORLD ANNUAL REPORT 2012

Primary populations

Istanbul » Istanbul

» ACTIVITIES 0.72

74.2 yRS 90

UNDP 2012

MdM provides medical and social aid to undocumented migrant populations living in the Kumkapi neighbou-

» missions CO-ORDINATORS

» »

FUNDING

POPULATION

» »

PERSONNEL

65.9 yRS UNDP 2012

both the local and European levels. MdM carried out an important study on access to healthcare conditions for migrants and gathered case studies on migrants’ experiences in Kumkapi and on migration routes. MdM and Tohav are involved in encouraging the interest of Turkish civil society and promoting human rights, which includes the right to health, for migrant populations. Communication sessions were organised to spread this advocacy work not only in Turkey but also in the countries of the Eu. At the same time a seminar took place in March in Paris on the health consequences of migration routes, and a presentation was made to the Council of Europe in October.

» RESULTS

» »

CO-ORDINATORS

» » »

€

Vinhas » »

professionals were carried out over the course of the year, focusing on psychological suffering, and enabling more than 60 individual interviews to take place and gathering eye-witness accounts on their way of life. With MdM’s support, Tohav received a European grant for the care of asylum seekers and refugees living in Istanbul.

» OUTLOOK Medical and social aid will continue in 2013 with a new Turkish partner. MdM will use advocacy work as a tool for change both on an operational level (modifying current legislation in Turkey, promoting the respect for rights) as well as on the political agenda. We must put forward objective arguments on the consequences of European policies on immigration and asylum that condemn migrants to a life of deprivation and discrimination.

» RESULTS 34,448 consultations carried out by the mobile clinics.

BUDGET BUDGET

In three districts of Saada governorate, MdM’s activities look at re-establishing access to healthcare for the population. The organisation provides assistance to six health centres (supplying medicines, light renovation work, epidemiological surveillance) and has set up four mobile clinics that provide direct care: primary healthcare

PERSONNEL

FUNDING

» ACTIVITIES

€

28 healthcare professionals trained.

» OUTLOOK Taking account of the worsening security situation across the whole country, MdM hopes to redirect its activities in yemen towards those regions where primary healthcare is most lacking, incorporating a community-based approach to tackling severe malnutrition in children.

» NORTH AFRICA AND MIDDLE EAST

DOCTORS OF THE WORLD ANNUAL REPORT 2012

Access to

» REGIONAL DELEGATIONS

Besançon, Strasbourg

crisis TEAM

» Sanaa, Shu’ub and Al-Thawrah 65.9 yRS UNDP 2012

POPULATION

» »

PERSONNEL

CO-ORDINATORS

» » »

Vinhas FUNDING

BUDGET

€

» ACTIVITIES Over three months, between March and May 2012, in four healthcare centres in the capital, MdM provided medicines and medical equipment, trained national personnel and supervised and evaluated compliance with hygiene and care protocols. This action allowed the population to have access to primary healthcare consultations, antenatal check-ups and family planning consultations, as well as vaccinations against measles for children.

» RESULTS 466 family planning consultations.

» » »

» PROGRAMMES - healthcare and Advice Clinic in Strasbourg - homelessness project in Strasbourg - roma project in Strasbourg - Adoption programme in Strasbourg

» RESULTS 2012 Health promotion - Introduction of rapid diagnostic tests for hIV in the Strasbourg healthcare and Advice Clinic - Presentation of results of the evaluation of the prevalence of diabetes, hypertension and obesity in vulnerable groups in Strasbourg Regional activities - Launch of a needs assessment on the health needs of the roma population in Mulhouse - Establishment of a mediation, prevention and health education programme for vulnerable groups in the Bruche valley - Co-operation projects between the adoption programmes in the grand Est region: joint training day with the three teams (Metz, Nancy, Strasbourg) and the adoption advice service in Nancy hospital - Connecting the Besancon health and Advice Clinic to the Alsace regional delegation in December Communication, advocacy and lobbying - representing MdM at the Council of Europe - Organisation of a round table at the Council of Europe Social Exclusion and Health: the right to health for all. - Organisation, as a member of Strasbourg International Solidarity group, of various events linked to the political changes in the southern Mediterranean - Two preparatory days for adoptive parents-to-be adopt a child

DOCTORS OF THE WORLD ANNUAL REPORT 2012

- Participation in the 10th voluntary sector fair in Strasbourg on 22 - 23 September - Participation in the humanitarian and charity fair in haguenau on 14 October - Organisation of a breakfast meeting with voluntary sector and public sector partners in Strasbourg on 22 November - Inauguration of the delegation library

» REGIONAL DELEGATIONS

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» REGIONAL DELEGATIONS

Corsica Bordeaux, Bayonne, Pau TEAM

» » »

» PROGRAMMES - healthcare and Advice Clinics in Bordeaux and Pau - roma programme in Bordeaux - rave project in Bayonne - Adoption programme in Bordeaux

» RE SULTS 2012 Programmes - reorganisation of the Bordeaux healthcare and Advice Clinic - Introduction of rapid hIV tests in the healthcare and Advice Clinic in Bordeaux and the Bayonne programme country (introduction of thin-layer chromatography, development of an outreach team, operating from partners’ premises) - Study on the possibility of an MdM intervention in the rural context - review of joint programme (cross-cutting) themes (mental health, accompaniment, prevention) Communication and events - Participation in the International human rights Film Festival in gironde - Mobilisation for the MdM Vote health campaign: street exhibition and dialogue with the general public from 12 to 15 April - Two debate evenings at the utopia cinema on Roma: Pariahs in Europe on 12 and 19 April - Participation in the voluntary sector forum Humanitarian Tour de France on 25 October - Participation in the Health, Vulnerablility day, in partnership with ISPED on 28 November roma evictions - Coordination of the university diploma Health, Deprivation,

Solidarity at Bordeaux-2 university - Ongoing teaching on humanitarian medicine and health and deprivation in the third cycle of the general medicine curriculum - raising awareness of medical and social professionals in MdM’s values (internships for student nurses, optional module for medical students, interns in general medicine, students etc.) Mobilising members - Training modules for volunteers on Analysis of practices and Dealing with violence - Ongoing review committees on reception and care - hosting the national treasurers meeting on 5 September - Organisation of an Open Day on 25 November to help recruit new volunteers - Introduction of an induction process for new volunteers Outlook - Election of a new regional Board - Strengthening the skills of the MdM team (including members) through training - Implementation of monitoring/evaluation of the regional plan

Ajaccio

TEAM

» »

» PROGRAMMES - healthcare and Advice Clinic in Ajaccio - homelessness project in Ajaccio - Coordination of the Coalition against Exclusion

» RESULTS 2012 Programmes - Developing plans to combine the Delegation and Clinic premises - MdM volunteer sessions at the winter night shelter growing deprivation and strengthen proposals for partnership working Partnership projects - Involvement in the development of the regional programme for access to healthcare for the most disadvantaged and participation in the permanent conference to monitor actions mittee - Participation in the Stomato project for disadvantaged groups - Involvement in the development of reception areas for travellers - Participation in the Getting off the streets project - Joint development (with the regional health agency and the town hall) of a local mental health committee Communication - Bearing witness, through the media and a radio programme, on exclusion and deprivation - Organisation of a conference in Ajaccio on We are facing deprivation, with the authors of the book Paroles de précaires, François Pernin (MdM) and Jérôme Camilly

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» REGIONAL DELEGATIONS

Paris, Saint-denis TEAM

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» PROGRAMMES - healthcare and Advice Clinic in Paris and Saint-Denis - homelessness project in Paris - Lotus Bus programme in Paris - Drug analysis programme in Paris - ErLI programme in Paris and Colombes - roma programme in Saint-Denis - health and housing programme in Saint-Denis - Buddying programme across Île-de-France - rave project across Île-de-France

» RESULTS 2012 Programmes - Self-evaluation of the homelessness programme in Paris - Carrying out a survey on Ile-de-France Local health Insu-

Mobilising members and volunteers - Organisation of a monthly meeting to welcome and integrate volunteers - Organisation of bi-monthly training sessions for Ile-deFrance volunteers from January to December

- Participation in the regional health conference and the rences - Participation in the PrAPS steering committee and in the working group on PASS and PrAPS - representation at the 11th arrondissement town hall and in some COREVIH Est committees (women, migrants, precarity and addiction) - Participation in the Paris PASS coalition - Participation in the Ile-de-France PASS steering committees (Pitié-Salepétrière hospital in Paris, Delafontaine hospital in Saint-Denis, Avicenne hospital in Bobigny) - Joint organisation of a conference with the PASS coalition on 26 January

DOCTORS OF THE WORLD ANNUAL REPORT 2012

- Organisation of a debate on Undocumented mothers and babies on 21 June - Joint organisation of the national PASS conference in November - Participation in the Perinatal precarity working group in the Solipam network - Participation in the working group on tuberculosis in partnership with Seine-Saint-Denis district council Communication and awareness-raising - Co-ordination of the health, Deprivation and Solidarity university diploma in rené-Descartes - Paris-V university - Presentations in the nursing training institute, social work schools and at CrIPS and in bodies organising civic service - Participation in Solidarity Days organised by the towncouncil in the 11th arrondissement - Press conference on 16 October for the publication of the report from MdM’s Observatory on Access to healthcare in France - During the presidential election campaign, meeting with candidate François hollande in Aubervilliers; and in the run up to the parliamentary elections meetings with Cécile - Mobilisation for MdM’s Vote Health! campaign: exhibition in the street and dialogue with the general public - Participation in a round table discussion at the town hall in the 18th arrondissement town hall in the run up to the parliamentary elections in the presence of Daniel Vaillant

» REGIONAL DELEGATIONS

» PROGRAMMES

TEAM

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- healthcare and Advice Clinic in Montpellier - roma project in Montpellier - homelessness programme in Montpellier - health promotion project with street sex workers in Montpellier - harm reduction programme in festivals and raves in Languedoc-roussillon - Adoption programme in Montpellier

» 2012 RESULTS Mobilising members and volunteers - Creation of a welcome booklet for volunteers - Organisation of days on Getting to know MdM, on where the delegation is going - Presentation of the regional plan to the national consultative committee

- Participation in the creation of the Siao hérault action plan - Involvement of MdM in the regional health agency and Siao committees Communication and awareness-raising - Coordination of the second university diploma Health, Deprivation and Welfare with Montpellier medical school and IrEPS - Involvement on the university diploma Public health practices in developing countries - MdM presentations on our knowledge and work on caring for vulnerable groups at home and abroad in schools, nurse training institutes and medical schools - Mobilisation for MdM’s Vote Health! campaign: exhibition and engagement with general public, media debate in Montpellier - Participation in the notaires’ conference in Montpellier

DOCTORS OF THE WORLD ANNUAL REPORT 2012

- Participation in the Antigone des associations event in Montpellier in September

» REGIONAL DELEGATIONS

» PROGRAMMES - healthcare and Advice Clinic in Nancy - Outreach projects in Nancy and Metz (medico-social consultation in a shelter) - Adoption in Nancy and Metz TEAM

» » »

» 2012 RESULTS Communication and awareness-raising - Mobilisation for MdM’s Vote Health! campaign: outdoor exhibition and engagement with general public in Nancy and Metz and organisation of a policy round table on Access to Healthcare for All. Insurance, denial of care... What solutions? - Participation in World AIDS Day, 1 December in Metz - Close collaboration with the Alsace delegation on introduction of an inter-university diploma in Nancy and Strasbourg on health and deprivation

- Participation in the steering committee of the PASS in Nancy - Contacting parliamentary candidates, in partnership with shared proposals - Advocacy for opening of a dental PASS in Nancy with the Espace lionnois and the dental department of the university

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» REGIONAL DELEGATIONS

Toulouse

TEAM

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» PROGRAMMES - healthcare and Advice Clinic in Toulouse - homelessness programme in Toulouse - harm reduction programme in Toulouse - health support project for vulnerable migrant families from Eastern Europe in the Toulouse area - Welcome project in shelters in Toulouse - hIV, STI and hepatitis prevention programme in Toulouse - Adoption programme in Toulouse - Mother and child health project (regionally-managed) in 11 shantytowns in Jaipur, India

» 2012 RESULTS Representation and voluntary sector action - Participation in the roma Solidarity collective - Work on the theme of health and housing as part of the joint voluntary sector collective. Communication and awareness raising - Events (Foulée pour la vie, Solidarité en pays de Save) organised in aid of MdM - Organisation of the photo exhibition Women, the aftermath of violence accompanied by a performance Dix moi de chair, dix moi de chiffon - Exhibition Women in the eye of the storm (hIV/Burkina Faso) at the ABC cinema; part of the Women, in the aftermath of violence exhibition in the Diversités space (Toulouse City hall) for the international day against violence against women; exhibition on India in the restaurant, Le gascon - Participation in a roundtable discussion on hIV with unicef; in a conference on Nomad and citizen at Toulouse mediatheque - Displaying a stand at Toulouse Business School, in the restaurant Folles saisons and at the voluntary sector day (Seysses). Participation in a careers forum in the pharmacy school

DOCTORS OF THE WORLD ANNUAL REPORT 2012

- Organisation of a jumble sale Nulle part en Europe, Qui a tué Chea Vichea ? and Génération perdue - Mobilisation for MdM’s Vote Health! campaign: outdoor March and organisation of a debate with local politicians - Presentations on humanitarian health in nurse training institutes, pharmacy school, high schools, welcoming interns - Presentation of MdM’s adoption work to four distric councils, organisation of a training day for people applying to adopt Mobilising members and volunteers - Working meetings on bearing witness with the healthcare and Advice Clinic volunteers, two half-day visits to partners’ premises - Information and training meetings for volunteers on various themes Humanitarian action, Ethics, Alcohol - hosting the national Operation Sourire meeting International programme - Withdrawal from the mother and child health programme in 11 shantytowns in Jaipur at the end of 2012; evaluation, advocacy, learning lessons from the programme in 2013 and continuation of the partnership with JKSMS in the form of technical and moral support.

» REGIONAL DELEGATIONS

Le havre, Rouen TEAM

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» PROGRAMMES - healthcare and Advice Clinic in rouen - Travellers project in rouen - Sex workers project in rouen - homelessness project in rouen - Psychological support consultations for asylum seekers and their children in Le havre - Winter programme in Le havre - Project treating traumatism linked to FgM in Le havre - Adoption programme in Le havre

» 2012 RESULTS Programmes - Extension of the healthcare and Advice Clinic with premises provided by rouen council to facilitate access to people with disabilities or reduced mobility - Acquisition of an outreach unit for MdM’s work in rouen, funded by the regional health agency, Matmut, the district and town councils - Organisation of an open day at the healthcare and Advice Clinic in rouen and recruitment of new volunteers - Consideration of a needs assessment among sex workers in Le havre - Closer collaboration with the healthcare Access for All association, which works with homeless people Communication and awareness-raising - Lectures in schools, universities, medical and social care centres and training centres in Le havre - hosting the photographic exhibition Women, in the aftermath of violence at Caucriauville mediatheque from 3 to 14 January and a conference on 5 January with Mariam Traoré - Mobilisation for MdM’s Vote Health! campaign: outdoor exhibtion, engagement with the general public and orga-

DOCTORS OF THE WORLD ANNUAL REPORT 2012

nisation of a political round-table on access to healthcare for vulnerable groups - Participation in World Aids Day (in collaboration with the CODAh health department) Mobilising members and volunteers - Obtaining authorisation from the regional health agency to offer rapid testing - Participation in the Board of the Le havre hIV network - Meeting with a delegation visiting from Burkina Faso organised by the district council

» REGIONAL DELEGATIONS

Saint-denis, Saint-Pierre,

TEAM

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» PROGRAMMES - homelessness programme in Saint-Denis and in SaintPierre in reunion - healthcare and Advice Clinic in Mayotte - Disaster risk reduction programme in Madagascar - Programme supporting prisoners in Madagascar - Long-term paediatric surgery programme in Madagascar - Long-term paediatric cardiac surgery programme in Madagascar - Emergency programme (Indian Ocean)

» 2012 RESULTS Communication - Workshop on programmes in reunion with volunteers and organisation of a press conference - National workshop in Madagascar Programmes - Infant cardiac surgery in Madagascar and reunion: training one Malagasy doctor and one Malagasy nurse in surgery and cardiac recovery; welcoming trainees in reunion and host families - Final year of the prisons project in Madagascar (access to healthcare, tackling severe malnutrition, hygiene, health rehabilitation, promoting prisoners’ rights): gradual withdrawal from all areas with complete withdrawal planned and gradual handover to civil society - Post-cyclone (Binghiza) needs assessment in Atsimo-Atsinanana region

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» REGIONAL DELEGATIONS

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» REGIONAL DELEGATIONS

DOCTORS OF THE WORLD ANNUAL REPORT 2012

PACA Aix-enProvence, Nice TEAM

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» PROGRAMMES - healthcare and Advice Clinics in Aix-en-Provence, Nice, and Marseille - gourbi project with undocumented seasonal farm workers in Berre-l’Étang - roma programme in Marseille - homelessness programme in Marseille and Nice - Mediterranean harm reduction project - Adoption programme in Marseille and in Nice - Burkina Faso regionally-managed project – Diébougou: access to dental and nutritional care - romania regionally-managed project – Satu Mare supporting COPII, a local organisation which works with children - Turkey regionally-managed project: migrants project in Istanbul

» 2012 RESULTS Support for new projects or strengthening existing programmes by innovating and resisting attacks on fundamental human rights: - Needs assessment on avoiding imprisonment for homeless people with psychosis in Marseille - Development of a partnership with Nouvelle Aube, selfhelp organisation working in squats and with young people in trouble - Study/preliminary contact on the possibility of launching a programme in Avignon in the Vaucluse - Launch of the Berre-gardhimaou project: extension of the gourbi programme to Tunisia - Development of a new project in romania, targeting vulnerable groups and roma - Evaluation in Kasserine region in Tunisia - Launch of an outreach programme on healthcare access in the north of Sri Lanka, following an exploratory mission conducted in July 2012 - Needs assessment in the detention area at Nice

Communication - Partnership with Aix-Marseille university on internal communication for the production of regional media tools in 2013 - Mobilisation for MdM’s Vote Health! campaign: outdoor exhibition and engagement with the general public in Marseille (21-22 March) and Nice (14-15 March)

Angers, Nantes TEAM

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» PROGRAMMES - healthcare and Advice Clinics in Angers and Nantes - Programme for people charging for sexual services in Nantes - Needs assessment in hostess bars in Nantes - Outreach programme (medical and social consultations in a shelter) in Nantes - Pilot programme on health mediation with roma women and children in Nantes - Mother and child health programme with roma migrants in Nantes - Adoption programme in Nantes

» 2012 RESULTS Communications and awareness-raising - Participation in Angers migrants’ coalition: lobbying the Prefet on the arrangements for migrants’ reception in Maine-et-Loire - Participation in ASAV’s national pilot programme on health mediation - Mobilisation against abusive practices by the Prefecture, and meeting with Prefet, as part of the Committee monitoring the right to remain for ill foreigners Communication, advocacy and awareness-raising 1/ Fighting against policies which make people ill and disseminating our ethical approach: - Organisation of an awareness-raising day for the general public in Nantes on the anniversary of the Internal Security by to vote for our two proposals (removal of article 50 on passive soliciting from the Internal Security Law, cancelling the plan for the law on penalisation of clients) Amours propres among Europe Écologie Les Verts festival in Nantes with a presentation by Estelle robin-you,

- Participation in prostitution hearings - Participation in a debate evening on the theme of undocumented migrants - Speeches to municipal police agents on the living condistudent nurses, to volunteers at a day centre, to staff at from associations on deprivation, roma health and migrants - Co-construction of a four-day professional training module on roma migrants 2/ Advocacy for access to healthcare for the most vulnerable in France - Mobilisation for MdM’s Vote Health! campaign: outdoor exhibition and engagement with the general public in Angers and Nantes; press conferences; lobbying candidates for the parliamentary and presidential elections on access to healthcare for all, meetings with about 10 candidates in Loire-Atlantique and Maine-et-Loire - Joint organisation of a seminar with Nantes university hospital and the Loire-Atlantique Santé Migrants Association From a land of exile to a host land, a traumatic reality for asylum seekers and refugees, as part of our advocacy for the implementation of cross-cultural healthcare in Nantes university hospital - Organisation of a press conference on problems with access to healthcare in Loire and organising a photographic exhibition for the launch of the Observatory report - Presentations to the conference on the health mediation trial at the Ministry of health, advocacy for the recognition of mediator as a profession

» REGIONAL DELEGATIONS

Angers, Nantes

3/ housing - Temporary health monitoring in a squat Nantes Mobilising members and volunteers - Organising a stand at the volunteering forum and meeting in Beaulieu - Development of a regional plan for 2013-2018 by around 20 people involved in the regional delegation

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» REGIONAL DELEGATIONS

Angoulême, Poitiers TEAM

» » »

» PROGRAMMES - Winter patrols in Angoulême - Travellers’ programme in Angoulême - Outreach programme (mobile medical consultations) in Angoulême - Street outreach programme in Angoulême and Poitiers - Sex workers programme in Poitiers - Mother and child migrants project in Poitiers - Migrant families project in Poitiers

» 2012 RESULTS Communication and awareness raising - Participation in events for the International Day for the nisation of a conference and debate - Participation in the Festival Musiques Métisses, in Angoulême, by setting up of the bus and the exhibition as part of MdM’s Vote Health! campaign - Setting up an MdM stand during the Ogres de Barback concert in rouillac - Participation in the voluntary sector day - Participation in the celebration for the 30th anniversary of the Le Toit du monde association Mobilising members and volunteers - Preparatory meetings to advocate on the healthcare ac- Presentation of the members’ regionalisation plan - Organisation of the MdM summer school in Angoulême Representation and voluntary sector action - Participation in local health workshops, coordination meetings with emergency health and social partners - Participation in the monitoring committee for ill foreigners in Angoulême - Facilitating the monitoring committee for ill foreigners in Poitiers

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» REGIONAL DELEGATIONS

clermontferrand, Lyon, Grenoble, Saint-étienne TEAM

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» PROGRAMMES - healthcare and Advice Clinics in grenoble and Lyon - homelessness programmes in grenoble and Lyon - Squat and shanty town outreach in Lyon - rural programme in Les Combrailles - Adoption programmes in Clermont-Ferrand, grenoble, Lyon and Saint-Étienne - regionally-managed international programme in Algeria - regionally-managed international programme in guinea - regionally-managed international programme in Palestine

» 2012 RESULTS Voluntary sector cooperation and partnerships - Participation in several press conferences and collective events in grenoble, organised by the Alerte Isère collective, in relation to housing. - Observing the practices of the Prefecture towards asylum seekers in grenoble Lyon Programme news - Improved reception in the Lyon healthcare and Advice Clinic - Evaluation of the Bus and Maruade programmes - Development of street patrols in Lyon and the implementation of prevention activities - reduction in adoption applications and in the number of children adopted in the region - Visit by Cellou Baldé, MdM’s partner in guinea: discussions with the medical service in Varennes-le-grand prison - Supporting our partner in Algeria and delaying the planned health education training until 2013

DOCTORS OF THE WORLD ANNUAL REPORT 2012

- Linking the Auvergne programmes to the rhone-Alps Burgundy delegation (adoption and rural programme) Communication and awareness raising - Joint organisation with the uNESCO Chair of the Catholic university on 19 and 20 October in Lyon - Meeting Respecting fundamental rights in a state of law: the question of housing vulnerable groups in France, in partnership with the Abbé Pierre foundation and the Institut Lyonnais des droits de l’homme on 26 January in Lyon - Mobilisation for MdM’s Vote Health! campaign: outdoor and cafe-debate in March - Photo exhibition by reza at Lyon Opera as part of the events for international solidarity from 9 to 30 October - Presentations in undergraduate and professional training: continuation of the university diploma Santé, solidarité, précarité in grenoble, in partnership with grenoble medical faculty and the City council; participation in the humanitarian medicine module at Lyon-Est medical school; presentation for the Access to healthcare module for the SAMDArrA inter-university diploma in health, Society and Migration (Le Vinatier university hospital), Lyon and Saint-Etienne medical schools - Participation in the humanitarian Tour de France (Bioforce) at grenoble and Annemasse - Joint organisation of communication meetings and international solidarity events in October in Lyon: Journalists and humanitarian workers: exchange of practices - Training offered by COMEDE on migrants’ rights for MdM social workers in Lyon

» REGIONAL DELEGATIONS

clermontferrand, Lyon, Grenoble, Saint-étienne

Mobilising members and volunteers - regional day : MdM: a place of political engagement - Introducing volunteer recruitment sessions in grenoble - Seminar on mental health in MdM in Lyon: Caring for mental health: are therapy and policies counterproductive?

DOCTORS OF THE WORLD ANNUAL REPORT 2012

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CONTACT DETAILS

» Médicos del Mundo Argentina

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ACKNOWLEDGEMENTS

» NATIONAL PROJECTS

ANNUAL REPORT 2012

ving in rural areas and to combat gender-related violence

MdM Argentina has two strategic priorities in Latin America. Caring for marginalised people in urban areas: - Primary care programme with a focus on mental health and addiction for those (adults and children) living on the streets of Buenos Aires and rosario. - Migration and health programme promoting intercultural health in Buenos Aires and Córdoba amongst migrants from Bolivia, Peru, Paraguay and the Dominican republic. - Childhood and public health programme with a focus on primary health and promotion of the rights of children and adolescents and raising awareness on drug use in the city and the province of Buenos Aires. - Environmental health programme: education and promotion of environmental health and community epidemiological surveillance in the basin of the Matanza-riachuelo river in the city and province of Buenos Aires. - right to health and hIV/Aids prevention programme for prisoners incarcerated in the federal prison system and across Buenos Aires province. Supporting the rural population, who are mainly indigenous: - Comprehensive health promotion strategy and community-based epidemic prevention activities to tackle chagas disease and the dengue fever epidemic. - Strengthening intercultural primary healthcare activities amongst indigenous women.

Fondation Navarrese Viole OTC Aecid República Dominicana

DOCTORS OF THE WORLD

» INTERNATIONAL PROJECTS MdM Argentina international projects are concentrated in the Caribbean and South America. In Peru, in the provinces of Chincha and Pisco, MdM Argentina works on the promotion of health for women li-

» INTERNATIONAL NETWORK

» COMMUNICATION AND EVENTS MdM Argentina once again attended the National Social Forum on health and the Environment in Argentina. The organisation championed the national debate entitled

Madre de Dios in the Peruvian Amazon. In Paraguay, following the coup d ‘état and after helping victims of the aftermath of the Curuguaty massacre, MdM Argentina rolled out a primary health care strategy, promoting traditional medicine and interculturality in the indigenous rural communities of the Canindeyú region. In Haiti, in the rural communities of Leogane, Petite rivière, Mirebalais and Lascahobas, MdM Argentina pursues its public health programmes and the reinforcement of the local primary care network and community health and the development of harm reduction programmes to improve community responses to emergencies. In Bolivia, MdM Argentina continues to support and to exchange ideas through the right to health platform in Bolivia and to train community leaders with Alames-Bolivia. In Dominican Republic, MdM Argentina has a project to combat cholera and gender-based violence in rural communities and border provinces of Elias Pina, Independencia and Bahoruco. A project proposal is underway for the comprehensive management of emergency response plans in Enriquillo region.

and social security in Argentina and organised the session as part of the National Congress. MdM Argentina also organised the second conference on Interculturality and the State’s agenda: a dialogue between indigenous people, people of African descent and migrants from the Southern Cone under the patronage of the Pan-American health Organization, the Ministry of Culture and Inadi. It promoted, organised and participated in the debate and presentation of research results at the Latin American Congress of Social Medicine and Collective health in Montevideo (uruguay). It was invited by the Ministry of health and the Institute of Advanced Studies in Public health to participate in the debates on regional Integration of Mercosur, unasur, Celac, and health systems in Venezuela. MdM Argentina was also invited as a speaker to the Health and International cooperation seminar organised by PAhO, the National School of Public health and the Cuban Ministry of health within the framework of the International Convention of Public health in havana. Congress of health Sciences held by the Autonomous university of Santo Domingo and the Seminary of Social medicine, speaking on Health systems reforms and wellbeing in Latin America. It also participated as coordinator of the International health Committee of the Civil Society Advisory Council at the Mercosur Social Summit in Argentina and Brazil. Finally, it organised a campaign to mark 10 years of its health programme on the streets with a special day in December 2012 and the presentation of its annual report.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» INTERNATIONAL NETWORK

» NATIONAL PROJECTS

CONTACT DETAILS

» Médecins du Monde Belgium

Brussels - Frontline (Para-) medical teams working night and day in homeless accommodation (SAMu Social), squats, occupations, on the street, winter shelters carried out +/- 6,000 consultations, with an emphasis on continuity: screening, vaccination, prevention, referral to external agencies or the healthcare and Advice Clinic. Many cases of tuberculosis and an increase in chronic diseases were found. - healthcare and Advice Clinic (2nd line): +/- 5,800 free social, medical and psychological consultations by appointment were given. The emphasis was on referral to medical centres and other sociomedical professionals. growing number of cases where reintegration into mainstream services is denied. - Specialist consultations: when we are unable to get a patient back into mainstream services, MdM guides them to a network of volunteer specialists for a range of treatments including dentistry (partnership with Dentists of the World): +/-500 consultations. - With her: advice, support and care; gynaecological consultations, family planning and paediatrics for extremely isolated women and children. here there was a marked increase in the medical aspect of the project: about 300 contacts. A survey on the health of roma women was also carried out.

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Antwerp - (Para) medical teams offering night and day care in homeless shelters: +/- 1,500 consultations. - healthcare and Advice Clinic: Consultations that are free and by appointment: +/- 3,200 social, medical and psychological consultations. There is also an advocacy network for access to care for pregnant women and follow-up for diabetics without access to care.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

La Louvière - Opening of a medical consultation section within the public-sector advice clinic: +/- 100 consultations.

» INTERNATIONAL PROJECTS Mali refocusing of our long-term project towards emergen+/- 4,000 consultations per week, 150,000 medical procedures, and delivery of 120 tonnes of medical equipment, medicines and nutritional assistance. -Support for 26 health facilities (two CSrEF, 18 CSCOM and six PSA) in the regions of gao and Kidal.

» INTERNATIONAL NETWORK

ACKNOWLEDGEMENTS

Région bruxelloise

Ethiopia - refurbishment of Filtu maternity ward and community health.

» KEy EVENTS 2012 restructuring of the national projects into an integrated system (1st, 2nd, 3rdline). Notable improvement of the medical quality of the programmes. Development of a strong membership base within MdM Belgium; volunteers are also involved in the association. Strengthening of

Quantum leap in the DrC programmes. -response to cholera and measles epidemics. -Screening and management of malnutrition. Democratic Republic of Congo - Support for 45 health centres and three hospitals in West Kasai: training, supervision, equipment and products, renovation, incentives etc. -Support for victims of violence by Congolese people returned by the Angolan security forces. South of west Kasai. -response to measles outbreaks. Haiti -Assisting Nippes Department in the management of cholera outbreaks. -Training of gynaecologists. -Closure of the support project in the Petit-goâve maternity ward. Tunisia -Promoting a participative approach to encourage synergies between maternity units and collective strategic planning in order to improve the birthing process. gafsa region.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» INTERNATIONAL NETWORK

DOCTORS OF THE WORLD ANNUAL REPORT 2012

Canada » NATIONAL PROJECTS

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» Médecins du Monde Canada

Canada

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EMPLOyEES

Set up in 1999, has two key components: community healthcare which aims to improve the health conditions of people who are destitute, homeless, marginalised and excluded from healthcare, and psychological support for those working with excluded people. Montreal Project also aims to improve the collaboration between the network of community organisations and public health institutions. Three district nurses supported by a dozen volunteer doctors, in partnership with outreach workers and stakeholders in several community organisations, administer care, share prevention and health promotion activities, and refer to the public network of health and social services for marginalised people. In 2011-2012, almost 1,000 patients were reached; 4,000 treatments were given by nurses, more than 200 medical consultations and 1,000 psychological support visits conducted in nearly 50 Montreal community organisations. In operation since September 2011, the clinic set up to enjoys the support and collaboration of many doctors and other professional volunteers. They welcome and treat migrants without medical coverage and refer them to specialists if neces-

services; nearly 150 were able to see a doctor and nearly 600 treatments were given by nurses.

» INTERNATIONAL PROJECTS Haiti - Since April 2012: strengthening of the health system to

ACKNOWLEDGEMENTS

L’Œuvre Léger Développement et ressources humaines Canada

Port-au-Prince district. A plan for the elimination of cholera from the island of hispaniola over 10 years (2012-2022) provides for a two-year emergency phase during which cholera will remain a major public health problem which must be addressed. At the same time, local capacity

» INTERNATIONAL NETWORK

Canada must also be strengthened. under the eradication plan, the project is to support and reinforce the Delmas municentres and community oral rehydration posts in the CitéSoleil municipality for prevention and support of cholera. The plan also includes the setting up of a community early warning system and rapid response, with the deployment of emergency medical teams in the event of cholera outbreaks, particularly related to natural disasters. -Support for the Delmas/Cité-Soleil municipal health ofof 19 community oral rehydration posts in eight districts of Cité-Soleil and a cholera treatment unit in Chapi health centre. Nearly 10,000 people have been treated for cholera symptoms and more than 2,500 people suffering from severe dehydratation transferred to cholera treatment centres to receive appropriate care. -Access expanded to family planning and maternal health care in the Cité-Soleil municipality in the Port-au-Prince referred to the Fontaine health Centre. 1,219 awareness sessions on family planning, the importance of monitoring cases of high-risk pregnancies were referred, mainly to

3,660 women who were followed up as part of the project gave birth in hospital. Finally, 65 hIV-positive women in the prevention of transmission from mother to child programme (PMTCT) adopted contraception after childbirth. Colombia Financial partnership with MdM France for the primary health care project for rural people affected by the Copartment of Meta (Colombia).

» COMMUNICATIONS AND EVENTS In 2011/12, Doctors of the World Canada relaunched its youth wing. The annual gala was held in May 2012, with hundreds of participants and brought in over $50,000 for the projects. More than 15,000 individual donors contributed to our international and national projects.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» INTERNATIONAL NETWORK

2012 saw a number of changes at the heart of the organisation. Internally, the arrival of new people, together with a partially renewed Board of Directors, allowed us

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» Aerzte der Welt e.V / Doctors of the World Germany

one hand, to reinforce the institutional development of the organisation, and on the other hand, to democratise its way of working. This work enabled us to develop our activities both delivering care and engaging in advocacy.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

- Togo: 2012 saw the launch of a new project in Togo, in collaboration with the National School of Midwifery in Lomé. MdM germany supports this institution as well as young women from rural areas who undertake to practise their profession in their region of origin. - Papua New Guinea: An all-new project for MdM

» NATIONAL PROJECTS

out an infant vaccination campaign, in particular in rural areas. Preparation and consultation with local stakeholders took place in 2012.

BOARD

- open.med clinic in Munich: the trends of previous years continued in 2012 with 1,425 consultations carried

» COMMUNICATION AND EVENTS

CONTACT

2012 saw issues highlighted by the MdM network exteneastern European countries. Despite the legal obligation for everyone to purchase health insurance, in practice a growing number of people, including women and children, have no access to the care that they need. - MedMobil mobile unit in Stuttgart: The work with vulnerable people continues, with more than 1,200 consultations conducted for 250 patients in 2012. The integration of this project, offering care and advice, into the public system is under discussion with various partners, including the City of Stuttgart.

EMPLOyEES

» INTERNATIONAL PROJECTS - Cambodia: Operation Sourire reconstructive surgery programme activities continued with three missions carried out in 2012. Thanks to the support of Siemens, we were able to develop the ‘skills transfer element’ with a new component for the training of local medical staff in the use of ultrasound devices. - Myanmar (Burma): MdM germany’s project in Burma is designed to restore sight to people who are totally or partially blind. Ophthalmology specialists operate for successful mission, the team was unfortunately unable to return to rakhine state in the autumn of 2012 due to unrest.

and Syrian crises received wide press and television coits consequences particularly in Spain, greece and Portugal were also widely reported in germany. The campaign Gesundheit ist kein Luxus (Health is not a luxury) was the key campaign, and focused on the consequences of the crisis in Europe and on the health predicaments of vulnerable people. The exhibition accompanying the campaign attracted more than 5,000 visitors and many internet users participated in our cyber-event (www.gesundheitkeinluxus.org).

» INTERNATIONAL NETWORK

ACKNOWLEDGEMENTS

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» INTERNATIONAL NETWORK

CONTACT DETAILS

» Doctors of the World Greece

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1st 2nd

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DOCTORS OF THE WORLD ANNUAL REPORT 2012

» NATIONAL PROJECTS - Five clinics open to all:

Patras (2012). Teams of volunteer doctors, nurses, social workers and psychologists provide care primary healthcare and medicines, as well as psychological support to those who are excluded from the public health system. - A home for asylum seekers: the principal objective is to facilitate the inclusion and integration of asylum seekers into greek society, providing them with shelter, food, counselling and medical care. - Mobile medical units: MdM has set up seven mobile units to provide primary health care to people with limited access to health services.

elderly people living in poverty. The programme provides health care and drugs, immunisation coverage, home visits and food aid packages.

» INTERNATIONAL PROJECTS Uganda Support for medical centres in the villages of Monte and gulu. Tanzania Project for early detection and treatment of diabetes in rural Ifakara.

» COMMUNICATION AND EVENTS

-December 14, 2012, MdM greece organised an opencourses in dental hygiene, as well as paediatric examina- air event that included building a Christmas tree made tions and vaccines for children. The unit works in remote from bottles of uhT milk, as part of the ongoing nutrition campaign. areas, in particular in isolated villages and islands. -Campaign entitled «Piggy bank of dignity: small change can make a difference”. The piggy banks were placed in the elderly. - department stores, theatres and schools that organised tical and psychological support, as well as essential their own campaigns for fundraising in support of our vaccines, to the roma people living in camps in Athens, work. Thessaloniki and Chania. display during a week of commercial events in Thessalothe unit offers psychological support, primary health care, niki, the biggest of its kind in greece. It was awarded a testing for Aids and hepatitis B and C to drug users, du- prize for the stand! ring weekly consultations. The programme provides new -During the Christmas holidays, MdM greece organised an SMS campaign in support of its programmes. syringes to drug users and disposes of used syringes. in Patras and Igoumenitsa, improving access to primary health care and identifying vulnerable people (including asylum seekers) in need of international protection. The unit provides medical, psychological and legal support. and psychosocial support to homeless people in the centre of Athens and the port of Piraeus. Message of life: health and food aid programme for

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- MdM greece organised several press conferences and participated in several events and festivals. MdM, for example, gave a press conference on the theme Athens, a city in humanitarian crisis, 2012-2013. Interviews with MdM greece were broadcast by the international media (press, television, radio), mostly European.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

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» Doctors of the World Japan

» NATIONAL PROJECTS - Project Tokyo Project addressing the needs of homeless people from Ikebukuro, Tokyo, who suffer from disease or have special needs. It helps these very vulnerable people to lead a more stable and safer life, and has helped a number of them to become more self-reliant and no longer to have

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DOCTORS OF THE WORLD ANNUAL REPORT 2012

The MdM Japan team is responsible for planning and implementing a paediatric project to complement MdM France’s work. This project will target 15,000 children sak province.

» COMMUNICATION AND EVENTS Advocacy MdM Japan focused its advocacy on local issues. In 2012, the Tokyo project team joined the commission of the national survey of homeless people organised by the Ministry of health, Labour and Social Affairs. This allowed

- Post-emergency project for the north east of Japan MdM teams have set up three projects in areas affected by the earthquake, the tsunami and the nuclear accident that took place in 2011. Two of these projects provide mental health care and support the efforts of local partners to create new services in these sectors. More than Communication 150 consultations were given by MdM doctors, nurses - Japanese Council of Advertising campaign: and physiotherapists, to residents, health professionals MdM Japan was selected by the Japanese Council of and overworked social workers. The third project has Advertising for a public relations campaign in 2013-2014 renovated health facilities devastated by the tsunami. Nofree advertising space in four major media channels: TV, tably, it provided two municipal hospitals with scanners. radio, newspapers and magazines, a donation equivalent » INTERNATIONAL PROJECTS to hundreds of millions of yen. - Opération Sourire - goodwill Ambassador: The MdM Japan team had two missions in Bangladesh, In June 2012, one of the most famous Japanese presenone in Cambodia and an exploratory mission to Myan- ters, Christel Takigawa, became the MdM Japan goodmar. As planned, the mission in Cambodia was closed will Ambassador. her support will increase the visibility of our work in Japanese society. launched: a training programme in a medical faculty and the expansion of our operations in another city. MdM Japan also sent an exploratory mission to Myanmar, where new activities will be implemented in 2013. - Paediatric project in Laos a long term project in Laos, where MdM France has been running a mother and child health project since 2010.

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» FINANCIAL SUPPORT TO MDM FRANCE PROGRAMMES -haiti: earthquake emergency -Nepal: maternal and child health -Sahel: primary health care -Niger: maternal care -Syria: emergency -DrC: primary health care -Niger: primary health care -horn of Africa: emergency -Somalia: maternal care -Liberia: maternal care -Angola: maternal and child health -Madagascar: cardiac surgery

» HUMAN RESOURCES SUPPORT TO MDM FRANCE PROJECTS Operation Sourire Madagascar: 2 volunteers

DOCTORS OF THE WORLD ANNUAL REPORT 2012

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DOCTORS OF THE WORLD ANNUAL REPORT 2012

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DOCTORS OF THE WORLD ANNUAL REPORT 2012

Portugal CONTACT DETAILS

» Dokters van de Wereld

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on 28 April 1997

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ACKNOWLEDGEMENTS

» Innovatiefonds Zorgverzekeraars Commissie PIN Stichting RC Maagdenhuis NutsOhra Foundation Stichting Janivo Kerk in Actie Remonstranten Hulp na Onderzoek écht@goed doen

» NATIONAL PROJECTS Undocumented migrants programme: Improving access to health care for undocumented migrants in Amsterdam and the hague. Awareness-raising, mediation and prevention activities for undocumented migrants. registration of undocumented migrants with general practitioners. -1,290 consultations were conducted face-to-face or over the phone to provide mediation or information on the Dutch healthcare system and on the right to health. -In 158 cases, problems were encountered in access to healthcare. MdM Netherlands intervened with the health

-Publication of articles on undocumented migrants in the press. -Creation of a website aimed at raising public awareness of migrants (dagvandemigrant.nl). -Visibility in the media on Operation Sourire, including a free advertising campaign. -As part of the ‘Blue Monday’ world record of people smiling for Operation Sourire. -Launch of the new MdM Netherlands website. -Increase of activities online and on social networks (Facebook, web, youTube). -Two fundraising campaigns for Operation Sourire: the Dam-tot-damloop race and a half-marathon.

access to care. With the help of MdM Netherlands, 124 patients who needed to consult a doctor were able to » FINANCIAL SUPPORT TO MDM FRANCE PROGRAMMES register in the local area. -Awareness: MdM Netherlands organised a meeting of -Liberia: maternal and child health experts on healthcare and undocumented migrants in -Niger: nutritional programme the Netherlands. The team participated in MdM’s Euro- -guatemala: improvement of health care for women working in factories -Syria: refugee camps » INTERNATIONAL PROJECTS -horn of Africa: nutritional programme MdM Netherlands continues its international projects -Colombia: primary healthcare in Indonesia and Myanmar. In Indonesia, the project -West Papua (Indonesia): improvement of sexual health focuses on the improvement of healthcare for mothers, and birth control newborns and children. In Myanmar, we focus on mother and child healthcare and on the improvement of access to primary healthcare.

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» Medicos do Mundo (MdM)

1300-125 Lisbon

Saber é Poder Project (from March 2011 to February 2014) reduces the rate of teenage pregnancies by strengthening the implementation of family planning and by facilitating access for adolescents from all the São Tomé e Príncipe districts.

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Project Terceira (C)idade (from 2002 until June 2014) reduces the factors that affect the autonomy and independence of older people in situations of isolation or social vulnerability.

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HUMAN RESOURCES

MdM Netherlands received a lot of coverage in a wide range of media.

» INTERNATIONAL PROJECTS

Saúde Móvel Project (from January 2010 to December 2012) contributed to a reduction of the number of people living with hIV/Aids and improved knowledge about hIV/ Aids among people living on the streets of Lisbon. Bolina Project (from January 2010 to December 2012) promoted social inclusion of vulnerable children and youth living in the District of Quinta da Serra (Prior Velho).

jects in partnership with university hospitals and Interplast holland as part of Operation Sourire. In total, 495 patients were operated on by MdM Netherlands in Bangladesh, guinea-Bissau and Sierra Leone.

» COMMUNICATION AND EVENTS

» NATIONAL PROJECTS

ghout 2012

Viver Positivo Project (from January 2011 until April 2013) improves the quality of life for people living with hIV/Aids in São Tomé e Príncipe. Piasheb Project 31, 2012) contributes to achieving the MDgs relating to access to water and sanitation. Also contributes to achieving the objectives of the country’s strategic plan

Estilus Project (from July 2010 to June 2014) contributes to activities that reduce risk behaviours in the to the reduction of the rate of infant mortality. school environment. youth enrolled in school EB 2/3 of Canelas, Vila nova de gaia. Additionally, the educational -enhancing access to safe drinking water; community involved in this project will also be indirect -improving access to basic sanitation; -promoting universal access to basic education; -reducing the rate of infant mortality due to infectious PT Project Prevenção para Todos (from March 12 to diseases transmitted by faecal-oral route, particularly April 2013) reduces inequalities in access to medical care, cholera and diarrhoea. in particular primary healthcare for isolated people over » COMMUNICATION AND EVENTS 65 who live in rural areas. Third edition of the solidarity race Mais Project Mentes animadas, Idades somadas The Corrida Solidária project aims to increase awareness (from September 2012 to March 2013) contributes to on humanitarian issues related to education and developstrengthening intergenerational and multi-ethnic social ment amongst young people and the educational comintegration for people who live in the municipal housing munity. complexes rua João Nascimento Costa e rua Carlos Botel-ho/Coopératives rua João Nascimento Costa e Carlos Botelho. 123,000 participants.

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Portugal -The 3rd edition: between February and December 2012, we followed up with 450 schools, crèches, non-for-pro-

Institutional fundraising campaign Launch of the institutional fundraising campaign - one of the strategic pillars of Opération SOS – with Silvia Alberto, presenter on rTP, as our Ambassador. The campaign carries the slogan And if I didn’t have access to medical care? and aims to raise funds for MdM.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

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ANNUAL REPORT 2012

Spain » NATIONAL PROJECTS

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» Médicos del Mundo España

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Campaign disseminated on -TV -radio -Press -Mupis/roll up -Cinemas -Online

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Doctors of the World Spain develops projects focused on The teams consist of more than 400 people of different the social determinants of health, which prevent the full realisation of rights. These projects are aimed at people who are sex workers, In relation to humanitarian action: migrants (including prevention of female genital mutilation), -Crisis in the Sahel: MdM participates in the strengthening drug users and homeless people. of public health systems and communities in Mali, Burkina Faso, Mauritania and Senegal. Since the approval of the royal Decree 16/2012, undo- -Sierra Leone cholera epidemic: MdM Spain set up an cumented migrants no longer have access to free public emergency team in Kabala in partnership with local healthcare (only care for minors, ante- and post-natal care health authorities. and emergencies are still covered). This is why MdM Spain -Sahrawi refugee camps: international staff were evacua- ted temporarily on advice from the Spanish government selves outside the healthcare system and bears witness following a serious alert of risk of attack on foreign targets. and engages in advocacy for the repeal of this law.

» COMMUNICATION AND EVENTS

MdM Spain launched: - An internet petition with Amnesty International and red Acoge asking automonous communities not to adopt measures that reduce access to health and to maintain access to care for all. -The campaign Derecho a curar (right to Care) with the Spanish Society of Family and Community Medicine is sexual exploitation. aimed at encouraging professionals in the public health » INTERNATIONAL PROJECTS system to assert their code of ethics when dealing with International projects are divided between Africa, Latin the exclusion of undocumented migrants from care. WitAmerica, the Caribbean and the Middle East. MdM Spain hin this framework, a document entitled Semá¬foro de is present in 19 countries, with a total of 55 projects, la exclusión sanitaria en España was published. The connecting the team with more than three million people document sets out the response of regional autonomous who exercise rights and responsibilities. communities in dealing with undocumented migrants and access to health, and included examples of cases of vioMdM is working in a network with more than 100 national lation of rights. organisations, with a focus on the following themes: -Campaign Contágiate por el virus de la salud, (Get infec-Access to public health services; ted by the health virus); http://www.elvirusdelasalud.org, -Sexual and reproductive health; an initiative that seeks to mobilise organisations and the -gender-related violence; general public to defend the universal right to health. It -health policy incorporating vulnerable people and taking focuses on maternal mortality and the fact that childbirth gender into account. rolled out nationally in 2012, These aim to encourage children and adolescents to participate in the defence of the right to health and to raise awareness amongst medico-social healthcare professionals about the situation

» INTERNATIONAL NETWORK

DOCTORS OF THE WORLD ANNUAL REPORT 2012

» INTERNATIONAL NETWORK

DOCTORS OF THE WORLD ANNUAL REPORT 2012

Spain ACKNOWLEDGEMENTS

Agència Catalana de Cooperació al Desenvolupament Agència Internacional de Cooperació Internacional del Govern de Illes Balears Axencia Asturiana de Cooperación

Bancaja Cabildo de Gran Canaria Cajamar Diputaciones Provinciales de Albacete Huesca, Málaga, Sevilla y Zaragoza ; Diputación foral de Bizkaia Fondo Local Navarro, Fondo Universidad de CastillaLa Mancha, Fundación Castellano-Manchega de Cooperación, Gobierno de Aragón, Gobierno de Navarra, Junta de Castilla y León, Junta de Comunidades de Castilla-La Mancha

is the primary cause of death amongst young women in the world. -The Action for global health network developed two main activities in Spain: the presentation of the report ¿Resultados o simple retorica? on European health aid and the organisation of the international seminar Working towards the world we want: social protection in health for all, which took place on October 25, 2012 in Madrid. Events - Luis Valtueña International Photography Award: Olmo Calvo won the 16th edition for his portfolio of photos entitled Víctimas de los desahucios, which focused on the stories of people who had been evicted for non-payment of mortgages.

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» Läkare i världen Sverige

Medical clinic in Stockholm In 2012, MdM Sweden continued and developed its activities for undocumented migrants at the clinic that was established in 1995. The clinic is open one evening a week and delivers emergency care without appointment. The Centre treated 405 people during the year and recorded a total of 582 medical consultations thanks to the commitment of more than 100 volunteers, including nurses, physiotherapists, and other professionals. A psychiatrist and several psychologists also provide assistance to migrants every other week. Cooperation with lawyers and other specialists on asylum rights and immigration laws continues and legal advice is offered every week. An hIV testing service is offered every month by Noaks Ark, hIV prevention specialists. All these services are free.

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tion with an account which starts with Xunta de Galicia

A new agreement was signed with a Stockholm clinic belonging to the State-funded health system. MdM consultations now take place in the premises of this clinic.

ACKNOWLEDGEMENTS

» COMMUNICATION AND EVENTS Tribunal 12, a cultural event, took place on May 12, 2012. It helped to raise awareness of the human rights violamigrants and asylum seekers in Europe. MdM Sweden was involved in this event in many ways. Skärholmsloppet is a local annual event dedicated to the kilometre race through a south Stockholm suburb. MdM Sweden volunteers were responsible for treating the injured runners. A number of volunteers wearing the MdM logo also participated in this race.

was awarded to MdM Sweden’s clinic for undocumented migrants by Stockholm County Council. The County Council is responsible for all medical care funded by public funds and public transport in Stockholm County. Several outreach meetings were held this year as part of a two-year project on sexual and reproductive rights, which is now complete. This project reached hundreds of health professionals.

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ANNUAL REPORT 2012

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» INTERNATIONAL PROJECTS

Health and Migration Network To promote access to care for vulnerable groups living in Neuchâtel, the Network offers nursing consultations, psychosocial counselling, follow-up and referral to healthcare clinics or to a network of private doctors.

Haiti MdM continues its projects supporting haitians by strengthening access to primary healthcare and managing acute malnutrition in the goave region. In 2012, MdM prolonged its efforts to hand over a number of curative and preventive care activities provided by clinics in the area to the health authorities. renovation and reconstruction of clinics affected by the earthquake are still ongoing. MdM took over the management of Petit-goâve

In 2012, MdM began a new strategy to strengthen awareness-raising activities aimed at the migrant community and to set up an agreement with the authorities and Neuchâtel hospital in order to hand over the management of the project to public institutions within two years.

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Permanence Santé In Lausanne, in partnership with the Fleur de Pavé charity, MdM manages activities to promote health, reduce risks and share information around the conditions of access to care for street sex workers. In 2012, in order to better meet the needs of women, MdM strengthened the collaboration with its partner and relations with the medical network. Also, a new project was set up to facilitate access to screening for sexually transmitted infections. Acknowledging the responsibilities of public health institutions, the Department of Public health in Vaud has 2013 and 2014 and to take over the activities in 2014. Accueil Santé Asile MdM evaluated the feasibility of a new project, Accueil Santé Asile, in centres for asylum seekers in Neuchâtel. MdM intends to strengthen access to care and prevention/health promotion services in the centres for asylum seekers in Neuchâtel for a period of two years (20132014), before handing over the management of these activities to the relevant public institutions. The project has three main activities: 1) access to care; 2) health information/education activities; 3) epidemiological monitoring.

with severe malnutrition plus medical complications. After the passage of hurricanes Isaac and Sandy, MdM set -

» INTERNATIONAL NETWORK

Benin MdM had supported the opening in 2010 of the sickle cell anaemia treatment centre in zou and Collines districts. It was fully handed over to local health authorities in the course of 2012. Awareness-raising activities continue and the work has been documented. MdM laid the foundations for a second phase in the establishment of a second public service of medical care for Borgou and Alibori districts. Cameroon In response to a request from the Neuchatel-based organisation rEA Cameroon, MdM extended its project planning work. A second exploratory mission helped to lay the foundations for a project aimed at improving support for maternal and child health in Koupa Kagnam Commune, in Foumban district.

laid the foundations of a new community health project in partnership with the Swiss NgO Enfants du Monde. This project aims to improve the health of mothers, newborns and children.

» COMMUNICATION AND EVENTS

Palestine 2012 has seen the implementation of the second phase of the mental health project in halhul, strengthening the capacity of a strong multidisciplinary team now recognised by patients for their experience. MdM has put an emphasis on how to relate theory to practice, training, supervision and implementation of new therapeutic and community activities for patients.

In 2012: a new website, a conference held at Club 44 in La Chaux-de-Fonds focusing on people who are excluded from the health Insurance Act (LaMal), a stand at the geneva Fete de la Musique, and the organisation of a Doctors of the World festival. In addition to these annual events, throughout 2012 MdM worked on a new communications strategy and organised a programme of campaigns for 2013, when MdM Switzerland will celebrate its 20-year anniversary.

DOCTORS OF THE WORLD ANNUAL REPORT 2012

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» Doctors of the World UK

Project: London aims to improve access to care for the most vulnerable people. The clinic is open three days

London E14 5AA

nurses and volunteer staff provide information, advice and practical assistance. MdM uK also works with clinics specialising in sexual health and with other local partners as part of awareness-raising activities. In 2012: -Project: London had the support of 101 active volunteers and 183 volunteer interpreters. cludes awareness-raising activities. - 55 sessions were provided, training health professionals and community agencies, reaching over 1,500 people. -A close follow-up scheme was introduced for the most vulnerable users so that they are able to access specialised services, where appropriate. -reports were submitted to British parliamentary committees and human rights bodies.

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1998

» INTERNATIONAL PROJECT

ACKNOWLEDGEMENTS -

MdM uK supports the MdM France programme in Mali, with a focus on women and children’s health.

ANNUAL REPORT 2012

Nearly £10,000 (approximately €11,500) raised. Virgin Active Triathlon: an increasingly popular event which, during the Olympic year, raised nearly £5,000. The Santa run: in greenwich Park, our great team of 82 runners ran 5 km or 10 km and raised more than £10,000.

» FINANCIAL SUPPORT FOR MDM FRANCE PROGRAMMES Syria: Emergency project (uK Department for International Development), which contributes to the reduction of the impact of the Syrian crisis on the mental and physical health of the Syrian population. The number of people

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» Doctors of the World-USA, Inc.

Treat, Connect, and Restore Following hurricane Sandy, which devastated the east coast of the united States last October, MdM uSA programme. The objective of the project is to provide primary health care to marginalised people living in the rockaways region in New york. The targeted populations are those that do not have access to healthcare because of hurricane Sandy and/or poverty, in particular undocumented migrants.

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with the vast majority of people taking refuge in Lebanon or Jordan. MdM works in both countries and provides primary healthcare to vulnerable people in the overcrowded camps, as well as in its clinics, where its doctors see more than 150 patients a day.

» COMMUNICATION AND EVENTS Communication 2012 highlights include: -Paper published in Open Democracy on the theme Why do migrant mothers die in childbirth? -Interview by the BBC World Service on Mali. -report on the BBC Outlook programme on Doctors of the World. -British Medical Journal coverage on World health Day. Events The royal Parks half marathon: one of the most scenic races in the world follows a route through the royal parks.

» INTERNATIONAL PROJECTS MdM uSA currently has no ongoing international projects. A collaboration with MdM France on a project to reduce the risks for injecting drug users in Vietnam is planned.

EMPLOyEES

» COMMUNICATION AND EVENTS -Launch of Doctors of World uSA in June 2012 at the Doubles Club at the Sherry Netherland hotel in New york. -Dr. ron Waldman, Member of the Board, attended a ceremony organised by the Association des Maliens de Washington, who gave a $12,000 donation to help the regions of Kidal and gao in northern Mali.

VOLUNTEERS

ACKNOWLEDGEMENTS

Jeune Chambre de Commerce Franco-britannique

DOCTORS OF THE WORLD

L’Association des Maliens de Washington

DOCTORS OF THE WORLD ANNUAL REPORT 2012