DOCTORS OF THE WORLD - HUMANITARIAN NGO - ANNUAL REPORT ACTIVITIES IN 2010 by Médecins du Monde

2010

DOCTORS OF THE WORLD ANNUAL REPORT

CONTENTS // 03

Our work

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// 10

2010: key figures

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// 12

International programmes

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Scope of programmes

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Africa

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Latin America

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Asia

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Eastern Europe

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Near and Middle East

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// 64

International network

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// 78

Cross-cutting projects

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// 88

Programmes in France

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// 108 Action and advocacy

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// 121 Regional delegations

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// 139 Our organisation

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// 150 Glossary

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// 154 Acknowledgements

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DOCTORS OF THE WORLD ANNUAL REPORT 2010

OUR WORK PIERRE BOURDIEU

“Society is only bearable because I can be outraged.”

Haiti, emergency programme ÂŠ LahcĂ¨ne Abib

DOCTORS OF THE WORLD ANNUAL REPORT 2010

OUR WORK In the context of a worsening social and economic environment, MdMâ&#x20AC;&#x2122;s programmes in France, in Europe and worldwide came under pressure in 2010. It was a year tainted by a rapid rise in poverty and health inequalities for the most vulnerable.

ÂŠ David Delaporte

DOCTORS OF THE WORLD INTERNATIONAL PROGRAMMES : FOUR PRIORITY THEMES

8&92:OLIVIER BERNARD ?HIJ8KILM(AN(KA<MAHJ(AN(M7I(OAHPK(NHQL<I

The international work of Doctors of the World focuses on four key themes: !"#$%!&'()#*(!+%','-(',./)0()#*(+,1+"*/!&%2,(3,)0&3-(3)+4(+,*/!&%"#()#*(&3,( 563&()6)%#'&(789-()#*(4%6+)#&(3,)0&3:

detailed knowledge of the Afghan border area and long-established partnerships in the region allowed us to carry out targeted responses to help the victims, again with the support of very autonomous and responsive local teams. We chose to focus ;(<"#$%!&'()#*(!+%','=(,4,+6,#!>(+,'- on the areas we know well, allowing us to 1"#',(%#(7)%&%()#*(?)@%'&)# respond to medical needs by rolling out A#( BC( D)#/)+>( CEBE-( )( *,2)'&)&%#6( mobile units and by supporting existing ,)+&3F/)@,( *,'&+">,*( 7)%&%- leaving heath facilities. the capital Port-au-Prince badly affected. MdM had already been working in While our presence in some countries is Haiti for over 20 years, and our teams not always comfortable, the vital imporresponded immediately and continued tance of our work in areas affected by to work throughout the year, delivering 3"#)+3'& -#$& 32+*%*& (-*& 4%%#& 2%-5627%$& medical and social care in the most de- this year. In Afghanistan, Pakistan, prived areas of the capital and surroun- Iraq, Sudan, the Palestinian Territories, ding areas. Yemen, Somalia, DRC and Colombia we continue to support people living in A#,(>,)+("#-(&3,('"!%)0-(1"0%&%!)0()#*( the areas of the world which are most 3,)0&3( '%&/)&%"#( +,4)%#'( "G( 6+,)&( in need. This often means operating in !"#!,+#:(The outcome of the elections complex environments that can only be is uncertain and a cholera epidemic has managed by setting up innovative proaffected the whole island. In the past few jects, such as our harm reduction promonths the local and international staff gramme in Kabul. have faced many challenges and have saved many lives, but the future of the Security concerns constitute a major many victims remains precarious. "1,+)&%#6( !"#'&+)%#& that we cannot ignore. The kidnapping of internatioDuring the summer of 2010, MdM res- nal and national staff in Afghanistan !"#$%$& '"& '(%& )""$*& +#& ,-.+*'-#/& 012& and in the Sahel region highlights the

importance of maintaining the independence of both our choices and our -3'+"#*&+#&'(%&6%;$/ The confusion between security and '&+)&,6%!( *,!%'%"#'( "#( &3,( "#,( 3)#*-( )#*( 3/4)#%&)+%)#( )%*( "#( &3,( "&3,+-( !"#&%#/,'(&"(6+"R: While we remain open to dialogue with governments and the United Nations, it is more important than ever to reassert our independence from political, economic and military agendas.

beginning to slow downâ&#x20AC;&#x201D;care for HIV positive people in DRC, where treatment has been interrupted due to lack of funds, is of particular concern.

>("&(-=%&*%H&>+'(&7%#@&+#&*14IJ-(-2-#& Africa or elsewhere, is one of the areas we would like to continue to develop in the future.

HIV and pregnancy-related mortality account for almost half of the deaths in women between 15 and 49 years old ABC0<&B"7%#&-#$&C%-;'(<&DEEF@/&G(-'& is why we continue to prioritise pregnant women and children. In this area, the lessons learnt over the past few years in Liberia and the Sahel region are worth highlighting. Our work towards improving these health systems, by training healthcare professionals and helping break $">#&6#-#3+-;&4-22+%2*&'"&3-2%<&2%!2%*%#'& real added value in our interventions that can be replicated elsewhere. Both the G8 and G20 summits will be held in France in 2011. This will create an opportunity to emphasise the fact that health must not become a luxury, especially for women and children.

;(S%6+)#&'()#*(3,)0&3 Readmission agreements, Frontex, Dublin IIâ&#x20AC;&#x201D;so many names, decrees, and "563+-;& ?1+$-#3%& 41'& -;;& >+'(& '(%& *-7%& aim, namely to exert pressure on southern countries to control their migration )">*<&-#$&'"&!1*(&'(%&+**1%&"5&7+?2-'+"#& management outside Europe.

8#( J/*)#-( our work supporting people living in the isolated Jebel Marra region "5&9-2512<&=+3'+7*&"5&'(%&3"#)+3'&4%'>%%#& government and rebel forces, has been hampered for the past few months. At the time of publication, the authorities have ordered our teams out of Darfur, thus driving out one of the few teams of humanitarian workers and witnesses present and active on the ground, who have been caring for tens of thousands of displaced people seeking refuge from '(%&6?('+#?/ ;(7)+4(+,*/!&%"#()#*(&3,(563&()6)%#'&( 789 ;(J,./)0()#*(+,1+"*/!&%2,(3,)0&3 Having started a programme with drug More generally, over and above cri- users in Kabul, MdM is continuing its sis interventions, there have been real harm reduction activities. In Tanzania, advances in the past few years across for example, we have set up a project to the health spectrum. These include the support sex workers and people who are global increase in the numbers of people drug dependent. Although our approach receiving antiretroviral drugs (more than 2%)%3'*&-&*'2-'%?+3&3("+3%&5"2&'(%&"2?-#+6=%&7+;;+"#@<&'(%&62*'&%#3"12-?+#?&6?12%*& sation, it is also an extension of what we on reduction of maternal mortality in se- have been doing in Europe. veral areas of the world and the support of the international community for initia- This response to people and issues that '+=%*&'"&2%7"=%&6#-#3+-;&4-22+%2*&'"&3-2%/& are misunderstood or ignored (such as However, it should be acknowledged HIV levels amongst marginalised groups, that these innovative developments are like drug users, sex workers or men

Our programmes working in the home countries of many of these migrants (Afghanistan and across sub-Saharan K52+3-#&+#&!-2'+31;-2@<&41'&-;*"&-;"#?&'(%& migratory routes (e.g. Turkey, Algeria -#$&'(%&J-(%;@<&?+=%&1*&-&?;"4-;&!%2*!%3tive on the human, medical and social dynamics in play. Assisting these people during the course of their migration, we aim not only to provide care, but also to document the negative impact on health of the immigration policies adopted by the 27 European Union countries. ;(K,2,0"1%#6(4"+,(,F/)0(1)+&#,+'3%1'( Our thirtieth Anniversary was the opportunity to highlight work with our local partners. In June, interesting and productive debates held in Paris led to a number of commitments. A useful initiative was set up in Pakistan in August following the )""$*&'(-'&*'213.&'(%&3"1#'2L/&M#&-$$+'+"#& to the programmes led by our teams, we also decided to support MCWAK, a former partner, to enable them to set up a 7"'(%2&-#$&3(+;$&!2"N%3'&>+'(+#&'(%&)""$& zone.

HUMA

Undocumented mi!"#$%&'(#)*'+,(-)./%,*&' accessing healthcare in most European Union countries. This is due mainly to legal barriers and the complexity of the system, but also the fear of being reported or arrested. The Huma network has launched a European declaration, reminding healthcare professionals of their ethical obligation to care for all without discrimination. The declaration will be presented to policy makers in 2011. LIBERIA

2010 was pivotal to our Liberian programme. In Bong County since 2003, we have worked with a number of partners to strengthen the capacity of the local health authorities and support 16 health centres in the east of the county. These health centres include a new hospital, CB Dunbar Health Complex, built by the Ministry of Health and Doctors of the 01"/+''#$+'1(-),#//2' opened by the Liberian president last December. This hospital is intended to become the key point of referral for obstetrics and neonatal care in the region.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

GUATEMALA

31"'%4*'5#&%'-6*'2*#"&7' Doctors of the World has supported women working in clothing and food factories in Guatemala. Between 2006 and 2009, MdM carried out a number of surveys to document working practices and record any violations of rights. The survey revealed that only 50% of the workers bene-%*+'("18'#$2'&1),#/' protection at all. AME

France’s 2011 budget, which introduces substantial restrictions on State Medical Aid (AME in its French acronym)1, was adopted on 30 December 2010. It failed to take into account the joint report issued by the Social Services and Finance departments. This report concluded that the increase in AME costs was not related %1'9*$*-),#"2'("#.+' and recommended that neither the fee to access the AME nor the need for prior agreement in advance of hospital treatment should be introduced.

1 : A number of groups are against '(%*%&3(-#?%*/&G"&6#$&"1'&7"2%<& please visit: www.odse.eu.org

Q(T#,RU(R"+0*(%'(/#*"/V&,*0>(!"4%#6( %#(&"(V,%#6(at Europe’s southern borders. We have had to revisit our preconceptions of the Arab world, where, from Tripoli to Bahrain, from Tunisia to Cairo, people hope for democracy, freedom and a better life. MdM has worked in this region for many years and our chosen policy of favouring a partnership approach has borne fruit. Supporting key civil society workers in Egypt, for example, means we are in a good position to understand the population’s emerging needs. By working with African and Arab organisations that care for migrants on the Libyan border, we give humanitarian aid and demonstrate international solidarity in action.

need to remain independent from the most in need. We have to face facts—to French government’s operations in this bring into question social welfare support for the most vulnerable today, is to quespart of the world. tion the very basis of our social security system. Faced with the emergence of ;(8#&,+#)&%"#)0()*"1&%"# MdM continues to be a major player an ever-expanding commercial health in the sphere of international adoption, market, which attracts investors across enjoying respect and recognition in the '(%& 4"-2$<& 52"7& '(%& 6%;$& "5& 7%$+3+#%& sector. By prioritising complex adoptions to medical or home care, the Universal (older children, siblings, sick or disabled Health Insurance and State Medical Aid 3(+;$2%#@<&'(%&"2?-#+*-'+"#&7-H+7+*%*&'(%& schemes are the last traces of a disapvalue of its medical expertise and conti- pearing policy, which was once based nues to consider the service a major part on collective strength and management. of its child protection mandate. ;( H,4)%#( $,.%V0,( )#*( )*2"!)&,( G"+( !3)#6,( The situation faced by migrants in Calais and Dunkirk continues to be worrying. Every day our volunteer teams offer ;(7,)0&3()#*(&3,(,#2%+"#4,#& healthcare and work to ensure that our In 2010, more than half the world’s 4%#%63+-2+%*P&51#$-7%#'-;&2+?('*&-2%&2%*population was living in urban areas. pected. The growing population, coupled with increasing industrialisation, brings with it 8#( S)>"&&,, a French department in new problems: global warming, industrial disasters and the management of medical ;(N%63&%#6()6)%#'&(3,)0&3(%#,F/)0%&%,'( the Indian Ocean, our teams cared for >-*'%&4%3"7%*&$+5631;'/&G(%&+#32%-*%&+#& 8'( 4,*%!%#,( V,!"4%#6( )( 0/./+>( 1+"- around 3,000 children in 2010. Over and natural disasters led to us setting up risk */!&-( 1)+&%!/0)+0>( G"+( &3,( 1""+,'&W( above healthcare, we also continued our reduction programmes, notably in Mada- O$OP*& (%-;'(& "4*%2=-'"2L& 6#$+#?*& "#& work to guarantee that their human rights gascar, where our teams are working with access to healthcare in France, show were upheld. Social security department local communities on their preparation there has been a marked increase in the court proceedings upheld our request for, and response to, cyclones. This is an number of consultations in our centres '(-'&'(%2%&4%&$+2%3'&-56;+-'+"#&"5&-&7+#"2& area of expertise we hope to develop in "=%2& '(%& !-*'& '>"& L%-2*& A1!& QRS@<& -#& '"&-&*"3+-;&*%312+'L&"563%/&U213+-;;L<&'(%& the future. increase in patients presenting late for court found that France was in breach '2%-'7%#'&A1!&TES@&-#$&-&TES&+#32%-*%& of the International Convention on the Having contributed to the improvement of in consultations for children. The need to Rights of the Child. working conditions at the uranium mines combat these worrying developments in Gabon and Niger and set up a health make our work in France more important The implementation of almost entirely remonitoring system there, MdM has cho- than ever. pressive policies to deal with *+/6(/',+'( sen to withdraw from this region. The %#(N+)#!, hampers an effective response decision was prompted by worsening We must continue to offer care and bear to the 3,1)&%&%'( <( ,1%*,4%!( which afsecurity conditions in the Sahel and our >+'#%**&'"&'(%&$+5631;'+%*&5-3%$&4L&'("*%& fects this population. The development

“HERE” IN FRANCE AND IN EUROPE

of our health education programme, focused on the risks related to drug injection, will continue and we should be able '"&*(-2%&'(%&62*'&2%*1;'*&"5&'(+*&!+;"'&!2"ject in France in 2011. Having introduced rapid HIV testing in French Guiana, the teams will introduce similar services in mainland France. ;(<"#*,4#%#6(&3,(%41)!&("#(3,)0&3("G( ',!/+%&>(1"0%!%,' In France, the continuation in 2010 of a regressive policy in terms of access to care for the most vulnerable and excluded has led to an unprecedented level of stigmatisation of the poorest in our society. The speech given by the French President in the summer in Grenoble, which made a commitment to use all measures necessary to ensure “complete security” to address the problems in our society, and the recent Parliamentary vote for the gradual dismantling of State Medical Aid are alarming indications of the government’s approach to the most vulnerable in our society. MdM continues its condemnation of the use of medical professionals for security purposes. In 2010, we published a guide to medical ethics in the face of security policies, as we had already done in 2007 in relation to our position on DNA testing. In 2010 we also participated in the Delinquents Solidaires collective, called for signatures from healthcare professionals for a European Declaration on Non-discriminatory Access to Healthcare and, more recently, protested against the contradictory choice made by the Health Minister to

approve rapid testing for HIV at the same time as dismantling State Medical Aid and compromising access to treatment for the most vulnerable. ;(P"VV>%#6()&()(I/+"1,)#(0,2,0 Doctors of the World cares for vulnerable people in 11 European countries. This Europe-wide presence and expertise give us a special responsibility. Over and above our work on the ground, we have prioritised setting up a European Observatory to monitor and document disparities in access to care at the very heart of the European Union. This project is made possible by the collaboration of our teams at a European network level, all of whom are working with those most in need in their own communities. ;( H,&)%#( )( *>#)4%!( 2"0/#&,,+( '&+/!&/+,( R3%0'&( !"#'"0%*)&%#6( "/+( 1+%2)&,( G/#*%#6( 2010 was a year of rapid growth for MdM, both in the number of projects and "12&6#-#3+-;&3"77+'7%#'*/&G(+*&?2">'(& was led by an extra 10 million euros being committed to international projects over two years. Whilst this growth is an indication of our organisation’s vitality and ability to respond to the needs we see on the ground, we should take care that it does not impinge on our independence. Increasing our private funding in the years to come is still a priority. Doctors of the World is a medical organisation with more than 2,000 volunteers in France and 1,200 members who believe that, in addition to providing care and

advocacy, there is still room for activism in our society. This approach is one that engages members of society at the heart of an organisation that is acutely aware of, and concerned about, the emergence of new levels of poverty and exclusion from care for the most marginalised. O%&3(1+"X,!&'(%#(YZ(!"/#&+%,'(%#()**%&%"#(&"(N+)#!,-("/+(2"0/#&,,+'(+,4)%#( G)%&3G/0( &"( &3,%+( %#%&%)0( 10,*6,=( to care and bear witness. Throughout the 30 years of our operations we have been able to build strong ties around the world with partners in civil society. In an unstable world, responding to disparities that are always worsening, it is more important than ever to maintain these local links that allow us to understand and respond better to the needs of the people with whom we work.

PAPUA

Isolated and marginalised, the community faces a worrying health situation: life expectancy is just 50 years, HIV infection rates are much higher than the national average and the maternal mortality rate is higher than in the rest of Indonesia. Doctors of the World has worked in the Puncak Jaya region for twelve years and today is one of the few international NGOs to work alongside, and with, these communities, while respecting their values and cultural practices.

Migrants programme, Dunkirk ÂŠ Benoit GuĂŠnot

2010: KEY FIGURES INTERNATIONAL NETWORK

HUMAN RESOURCES*

185

293

171 14

international programmes in 64 countries national projects in 14 countries network members

Argentina Belgium Canada France Germany Greece Italy Japan Netherlands Portugal Spain Sweden Switzerland United Kingdom

MDM FRANCE RESOURCES

employees

BREAKDOWN

179 47 13 54 257 136 352 1,690

HQ employees 6%;$&%7!;"L%%* employees in regional delegations employees in programmes in France expatriate departures %H!-'2+-'%*&+#&'(%&6%;$VV 6%;$&=+*+'*&5"2 needs assessments and technical support local staff on programmes

* Staff numbers are expressed as Full-Time Equivalents (FTE). ::';.89*"'1('*<5#%",#%*&',$'%4*'-*/+'1$'=>'?*)*89*"'@A>A'B61/.$%**"&'#$+'*85/12**&CD

EXPENDITURE 78.7% social programmes 15.8% fundraising 5.5% overheads

INCOME 61% public generosity 34% institutional grants 4% private grants and other private funds 1% other sources

DOCTORS OF THE WORLD ANNUAL REPORT 2010

service users attending 21 Healthcare and Advice Clinics

people who could access services provided by MdM

18,471 103

dental consultations social consultations programmes in 30 towns

!"#$%"%%$&4%#%63+-2+%* !%"!;%&>("&(-=%&4%#%6'%$&52"7&"#% or more services provided by MdM

1,356,681medical consultations '"$%(&people on antiretrovirals 68 programmes 43 countries

Latin America

3,919

medical consultations

Africa

38,606

Near and Middle East Various projects

5,008,100 target population

Africa............................... in 16 countries Latin America................... in 7 countries K*+-&-#$:3%#'2-;&K*+-////////&+#&&9 countries Eastern Europe................ in 4 countries Near and Middle East....... in 7 countries North Africa & Middle East

volunteers

27 15 13 4 9

Eastern Europe

2,000 28,160

GEOGRAPHICAL BREAKDOWN OF PROGRAMMES

Asia and Central Asia

INTERNATIONAL PROGRAMMES

Eastern Europe

Latin America

Africa

IN FRANCE

Asia and Central Asia

MDM INTERNATIONAL NETWORK BUDGET €114 M

GEOGRAPHICAL BREAKDOWN OF INTERNATIONAL PROGRAMMES EXPENDITURE

41% 26% 17% 2% 9% 5%

Africa Latin America K*+-&-#$:U%#'2-;&K*+Eastern Europe North Africa and Middle East Various projects (Adoption, Opération Sourire, needs assessments, regionally managed international !2"?2-77%*&-#$&32"**I31''+#?&!2"N%3'*@

INTERNATIONAL PROGRAMMES

DOCTORS OF THE WORLD ANNUAL REPORT 2010

CONTENTS // 14 S)1

> CLICK HERE

16 Africa

> CLICK HERE

28 Latin America

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38 Asia

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48 Eastern Europe

> CLICK HERE

56 Near and Middle East

> CLICK HERE

14 MAP OF INTERNATIONAL PROGRAMMES

Algeria Mexico

Mali Niger Chad

Haiti Guatemala

Burkina Faso Guinea

Nicaragua

Liberia Colombia

Sahel

Peru

EMERGENCY AND LONG-TERM PROGRAMME

LONG-TERM PROGRAMME

EMERGENCY PROGRAMME

Uruguay

Russia

Serbia Romania Bulgaria Moldova

Turkey

Afghanistan Iraq

Lebanon

Syria Palestinian Territories Nepal Egypt

Burma Vietnam Pakistan

India

Yemen

Sudan Ethiopia

Somalia Rwanda Dem. rep. of Congo Tanzania

Angola

Madagascar

Zimbabwe

Indonesia

Laos

L8[IH

8#(&3,(#"+&3(,)'&("G(L%6,+-(%#(&3,(M)3"/)(+,6%"#-(MdM is supporting the health system of Keita district, putting in place measures in the healthcare centres, to deal with malnutrition.

Niger ÂŠ Martin Courcier

DOCTORS OF THE WORLD ANNUAL REPORT 2010

PROGRAMMES IN AFRICA

Madagascar © Bruno Fert

18 PROGRAMMES IN AFRICA

Tanzania © Olivier Dubuquoy

DOCTORS OF THE WORLD ANNUAL REPORT 2010

TANZANIA Ewasta 37 years old

“I came to the hospital in Murgwanza for '(%&62*'&'+7%&+#&DEEW/&K'&'(-'&'+7%<&M&>%+?(%$& 37 kg, and did not feel at all well. I was given antiretroviral therapy and now I weigh 50kg, which is a good sign. I come once a month to collect my medication and have a thorough check-up. In the future, I hope to teach my children about ways to prevent AIDS.”

20 AFRICA Algeria

Mali

2 1

1 2

Niger Chad

Burkina Faso Guinea

Sudan

Liberia

Ethiopia Somalia Sahel Rwanda Dem. Rep of Congo

Tanzania

Angola

Zimbabwe Madagascar

EMERGENCY AND LONG TERM PROGRAMME

LONG TERM PROGRAMME

DOCTORS OF THE WORLD ANNUAL REPORT 2010

CD Detailed information sheets on the various programmes implemented in Africa can be found on this interactive CD. Use the links below. // ALGERIA

> CLICK HERE

// NIGER

> CLICK HERE

// ANGOLA

> CLICK HERE

// RWANDA

> CLICK HERE

// BURKINA FASO

> CLICK HERE

// SAHEL

> CLICK HERE

// CHAD

> CLICK HERE

// SOMALIA

> CLICK HERE

// DRC

> CLICK HERE

// SUDAN

> CLICK HERE

// ETHIOPIA

> CLICK HERE

// TANZANIA

> CLICK HERE

// GUINEA

> CLICK HERE

// ZIMBABWE

> CLICK HERE

// LIBERIA

> CLICK HERE

// MADAGASCAR

> CLICK HERE

// MALI

> CLICK HERE

Liberia ÂŠ Georges Gobet/AFP

DOCTORS OF THE WORLD ANNUAL REPORT 2010

SIGNIFICANT EVENTS IN AFRICA

LIBERIA

RECONSTRUCTION OF THE HEALTH SYSTEM SINCE OPENING IN 2003 THE MAIN AIM OF MDM’S PROGRAMME IN THE BONG REGION HAS BEEN TO RE-ESTABLISH ACCESS TO HEALTHCARE FOR THE POPULATION, WHICH HAS BEEN VICTIM OF A BLOODY ARMED CONFLICT. SINCE 2006 AND THE FORMING OF ELLEN JOHNSON-SIRLEAF’S GOVERNMENT, THE PROGRAMME HAS MOVED TOWARDS SUPPORTING THE RECONSTRUCTION OF THE HEALTH SYSTEM BY ASSISTING THE EFFORTS OF THE MINISTRY OF HEALTH.

Doctors of the World is involved at a national 0,2,0(%#(&3,(*,2,0"14,#&("G(2)+%"/'(3,)0&3(1"0%!%,'-()#*('/11"+&'(&3,(\"#6(!"/#&>()/&3"+%&%,'(%#(&3,%+(,GG,!&%2,(%410,4,#&)&%"#(%#(0"!)0( 3,)0&3( G)!%0%&%,':( In this way, MdM has been able to encourage the integration of a complete package of healthcare—in particular with relation to the screening and treatment of HIV/AIDS as well as taking care of mental health—in facilities closest to the patients. Whilst developing an insti'1'+"#-;&-!!2"-3(<&O$O&2%'-+#*&-&*+?#+63-#'&3"7munity base so that it can strengthen the links between the population, the healthcare centres and their personnel, thereby ensuring continuity of care. Faced with the challenges brought about by the shortage of human resources in healthcare, MdM supports a school for nurses and midwives by awarding scholarships to students who commit to staying in rural areas.

Delivery room in the new CB Dunbar hospital

A BRAND NEW MOTHER AND CHILD HOSPITAL WAS OPENED IN DECEMBER IN BONG COUNTY

Owing to the country’s extremely high maternal mortality rate, sexual and reproductive health has, since 2007, become one of the project’s priorities. The rebuilt CD Dunbar hospital was opened in December 2010 in the presence of Ellen Johnson-Sirleaf, the president of Liberia. This means there is now a comprehensive range of treatments, delivered by a specialist gynaecological-obstetric and neo-natal unit. This unit will also become a national training centre for obstetrics and gynaecology.

TANZANIA

Harm reduction: a public health issue

THE OPENING OF THE FIRST HARM REDUCTION PROGRAMME IN AFRICA FOLLOWING ITS PROGRAMMES AMONG THE GENERAL POPULATION, MDM IS NOW TURNING TO HIGH RISK GROUPS O3%0,( S*S( 3)'( V,,#( 1+,',#&( %#( QG+%!)( G"+( BE( >,)+'-( and in Tanzania in particular, with projects to tackle HIV/AIDS among the general population (access to treatment and antiretrovi2-;*&%'3@<&'(+*&+*&'(%&62*'&'+7%&'(-'&+'&(-*&;-1#3(%$& a programme aimed at high risk groups like drug users, sex workers and sexual minorities. It opened its doors in November 2010 in Dar es Salaam, Tanzaniaâ&#x20AC;&#x2122;s main port. It should, in

20 supported health facilities to treat malnourished children

'+7%<&32%-'%&'(%&62*'&#%%$;%&%H3(-#?%&3%#'2%&+#& sub-Saharan Africa. For the moment, areas where intervention is reX1+2%$&(-=%&4%%#&+$%#'+6%$<&-*&>%;;&-*&'(%&.%L& players involved in this issue, like, for example, an association of ex-drug users. The staff have been recruited and a workshop was held in November with all the stakeholders, organisations, police, national and local public authorities, to

ÂŠ Olivier Dubuquoy

raise awareness of this public health issue, but also to understand and evaluate what is nee$%$&"#&'(%&?2"1#$/&B"2.&>+'(&$+2%3'&4%#%63+-ries begins in 2011.

CHAD

FROM MOTHERS TO CHILDREN M3,("VX,!&%2,("G(&3,(4)&,+#)0(3,)0&3(1+"X,!&-( 0)/#!3,*(%#(&3,(])#,4(+,6%"#(%#(CEE^- is to allow detection and treatment of pregnancyrelated complications and, in particular, obstetric 6*'1;-*/&M#&DEQE<&>(%#&-#&+#32%-*%&+#&3-*%*&"5& 3(+;$&7-;#1'2+'+"#&>-*&"4*%2=%$&+#&'(%&6%;$<&O$O& decided to expand the programme to take on responsibility for the medical care of children under

6=%&L%-2*&";$/&G(%&+#'%#'+"#&+*&'"&'2%-'&7-;#1'2+'+"#& and associated illnesses, such as malaria. In parallel, following a cholera outbreak of epidemic proportions in certain provinces in Chad, the association has contributed in Kanem region by assisting the authorities in prevention and treatment.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

NIGER

NUTRITIONAL EMERGENCY N"00"R%#6(G)%0,*(3)+2,'&'(%#(CEE^-()(#/&+%&%"#)0(!+%'%'(3)*(&)@,#(3"0*(%#(L%6,+(V>(&3,(,#*( "G(&3,(>,)+: In response to this crisis, in 2010 MdM launched an emergency programme in the agricultural region of Tahoua.

healthcare personnel in treatment protocols, supported the system for supplying nutritional products, or provided them directly in order to plug any gaps, and supervised the work at individual health centre level.

The aim was to support the healthcare centres and hospitals in three districts in their treatment of malnourished children. Working closely with the health authorities, MdM organised the active screening of malnourished children, trained

In this way, the children have had access to dry therapeutic foods in 47 healthcare centres. Children suffering from associated illnesses have been able to be treated in each of the three district hospitals supported by MdM.

SOUTH-SUDAN THE BEGINNINGS OF A NEW PROGRAMME MdM remains very watchful of the humanitarian situation in South Sudan. With this in mind, in 2010, two exploratory missions were sent to look into the feasibility of a project in Juba, the capital of South Sudan. A long term programme could see the light of day in the future but the activities will depend entirely on the local political context.

19,645 children cared for over the year

In the Tahoua region, the number of cases of acute malnutrition tripled in one year ÂŠ Martin Courcier

26 Programme au Niger

ÂŠ Bruno Fert

Presentation of MdMâ&#x20AC;&#x2122;s activities concerning disaster risk reduction

MADAGASCAR

PREVENTION OF NATURAL DISASTERS \,!)/',(S)*)6)'!)+(%'(+,6/0)+0>(,.1"',*(&"( #)&/+)0( *%')'&,+'( )#*-( %#( 1)+&%!/0)+-( &"( 3/++%!)#,'-(S*S(*,!%*,*(&"(%#&+"*/!,(1+,2,#&%2,( )!&%"#(&"()&&,41&(&"(0%4%&(&3,(,GG,!&': Drawing on experience gained over the past 15 years of establishing emergency missions, the organisation has launched a new preventative education project in the communities to raise awareness of the health

and socio-economic consequences of these disasters. On the ground, we have supervised the training of rescue workers, provided support for the infrastructure, helped with the establishment of shelters, provided assistance with the creation of local and regional disaster response committees A%;-4"2-'+#?& 3"#'+#?%#3L& !;-#*@& -#$& (-=%& 3"#'2+buted to the improvement in collection of data

NEW PROJECT TO RAISE COMMUNITY AWARENESS OF THE HEALTH AND SOCIO-ECONOMIC EFFECTS OF DISASTERS

"#& %!+$%7+3*& -#$& 7-;#1'2+'+"#/& G(%& 62*'& !2"N%3'<& which was launched in the Maroantsetra region, concluded in 2010 with a capitalisation exercise. This was immediately duplicated in autumn 2010 in the Sava region.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

MIGRANTS

IMPROVED ACCESS TO HEALTHCARE IN MALI AND ALGERIA S*S( 3)'( !"#&%#/,*( %&'( R"+@( 3,01%#6( 4%6+)#&'(&"(6)%#()!!,''(&"(3,)0&3!)+,-(1)+&%!/0)+0>(%#(&R"(QG+%!)#(!"/#&+%,'=(S)0%()#*(Q06,+%):( In Bamako, the organisation has helped several local partners, as part of a mental health programme. Principal amongst these are the Malian K**"3+-'+"#&5"2&9%!"2'%%*&AKOY@&-#$<&*+#3%&DEQE<& the Association of Central African Deportees in Mali, which takes care of all transit migrants in the Malian capital, regardless of their status or nationality. The training of the local organisations’ personnel and the creation of a network of professionals in Bamako are the two pillars which underpin the project. In the course of the year, '+7%;L&6#-#3+-;&*1!!"2'&(-*&-;*"&4%%#&!2"=+$%$& to these local organisations, notably when huge >-=%*&"5&7+?2-#'*&-22+=%$&4L&3(-2'%2&)+?('*&52"7& Libya.

in September 2010. She began by building contacts with local partners then, with them, set up the new project. To facilitate access to healthcare for migrants in Algiers, the work of local healthcare professionals must be supported in order to reduce the discrimination which migrants are often subject to.

SUPPORTING LOCAL PROFESSIONALS WORKING TO REDUCE THE DISCRIMINATION SUFFERED BY MIGRANTS

8#( Q06,+%)-( )( #,R( 1+"6+)44,( 1+"2%*%#6( )!cess to healthcare was established in the last quarter following the arrival of a co-ordinator

1,061 migrants interviewed by our local Malian partners Access to healthcare for migrants is a priority for the organisation

<APAS\8Q

J%#!,(CEEZ(S*S(3)'(V,,#(R"+@%#6( %#(&3,(S,&)()+,)()#*(&3,(+,6%"#("G( &3,(S,*%"(Q&+)&"(+%2,+ to promote access to healthcare for the most vulnerable rural populations.

Colombia ÂŠ Michel Redondo

DOCTORS OF THE WORLD ANNUAL REPORT 2010

PROGRAMMES IN LATIN AMERICA

Nicaragua © Lâm Duc Hiên

ZE PROGRAMMES IN LATIN AMERICA

Haiti © Lahcène Abib

DOCTORS OF THE WORLD ANNUAL REPORT 2010

HAITI Eddy Person in charge of a camp for displaced people

“None of the people have work, they have no

money, no home and they feel abandoned. The camps are horribly overcrowded, the stagnant water lying around attracts mosquitoes. People want to leave but they have nowhere to go. They don’t know how long they will be there so they have started to set up small businesses. Little by little the tents are replaced by more solid wooden and sheet metal structures.”

ZC LATIN AMERICA

Mexico

Haiti

Guatemala

Nicaragua

3 Colombia

Peru

EMERGENCY PROGRAMME

EMERGENCY AND LONG TERM PROGRAMME LONG TERM PROGRAMME Uruguay

DOCTORS OF THE WORLD ANNUAL REPORT 2010

CD Detailed information sheets on the various programmes implemented in Latin America can be found on this interactive CD. Use the links below. // COLOMBIA

> CLICK HERE

// GUATEMALA

> CLICK HERE

// HAITI

> CLICK HERE

// MEXICO

> CLICK HERE

// NICARAGUA

> CLICK HERE

// PERU

> CLICK HERE

// URUGUAY

> CLICK HERE

Haiti © Sophie Brändström

DOCTORS OF THE WORLD ANNUAL REPORT 2010

SIGNIFICANT EVENTS IN LATIN AMERICA After the earthquake, the cholera epidemic

HAITI: A CONTINUALLY EVOLVING EMERGENCY PROGRAMME MDM MOBILISED ALL ITS EFFORTS INTO PROVIDING A HEALTHCARE RESPONSE APPROPRIATE TO THE HAITIAN SITUATION FOLLOWING THE EARTHQUAKE WHICH SHOOK THE COUNTRY ON 12 JANUARY 2010, LEAVING 250,000 DEAD, 300,000 INJURED AND 1.3 MILLION PEOPLE HOMELESS.

EVEN THOUGH CHOLERA HAD DISAPPEARED YEARS AGO, HAITI WAS HIT BY AN EPIDEMIC IN MID-OCTOBER.

M3,+,( R,+,( G"/+( @,>( 13)','( "G( &3,( ,4,+6,#!>(4%''%"#(%#(7)%&%(*/+%#6(CEBE: From 14 January, just two days after the earthquake, MdM responded to the extreme emergency by ;-1#3(+#?&*12?+3-;&"!%2-'+"#*&-#$&7"4+;%&62*'&-+$& clinics in various parts of Port-au-Prince.

From July onwards, MdM undertook to centralise activities so that, with the co-operation of the Ministry of Health, they could be integrated with the national health system. Unfortunately, this work could not be completed because of the cholera epidemic which broke out in October.

Z%'>%%#&O-23(&-#$&[1;L<&QE&6H%$&3;+#+3*&>%2%&*%'& up, mainly in the areas of Port-au-Prince, where people who had become homeless as a result of the earthquake had gathered. In the Grand’Anse department, which saw 120,000 people come from Port-au-Prince, the project has been strengthened by the establishment of government healthcare facilities, by provision of completely free healthcare and by improvement in the management of malnutrition. Over 9,000 consultations a week were carried out to treat mainly respiratory infections, diarrhoea, skin disorders, cases of malaria and sexually transmitted infections.

At that point, we activated the fourth phase of the programme with an emergency response to the epidemic which has claimed 4,000 lives since mid03'"4%2/&M#&9%3%74%2&DEQE<&O$OP*&6?('&-?-+#*'& cholera comprised four key actions: recruitment of 90 staff in Port-au-Prince to implement prevention actions at the community level, provision of support for those with moderate or severe dehydration +#&(%-;'(&3%#'2%*&A3(";%2-&'2%-'7%#'&1#+'*@&7-+#;L& +#&\2-#$PK#*%&AT<EEE&3-*%*@<&!2"=+*+"#&"5&-741lances to transfer serious cases and admission to cholera treatment centres in Port-au-Prince and Grand’Anse, where there were very few NGOs.

Z_ NEW PROGRAMMES HAVE BEEN LAUNCHED IN MEXICO, GUATEMALA AND URUGUAY TO IMPROVE THE SEXUAL AND REPRODUCTIVE HEALTH OF WOMEN

Reproductive health in Guatemala

FOCUS ON SEXUAL AND REPRODUCTIVE HEALTH THE LATIN AMERICAN PROGRAMMES WHICH FOUGHT AGAINST GENDER-RELATED VIOLENCE CAME TO AN END IN 2010 TO MAKE WAY FOR A NEW CROSS-CUTTING PROJECT: IMPROVING ACCESS TO SEXUAL AND REPRODUCTIVE HEALTHCARE.

S*SU'(1+"6+)44,'(%#([/)&,4)0)(`1+"&,!&%#6( &3,(+%63&'("G(&,.&%0,(R"+@,+'(%#(maquilas) and in L%!)+)6/)( `',./)0( )#*( *"4,'&%!( 2%"0,#!,a( 4)>( 3)2,( !"4,( &"( )#( ,#*-( V/&( &3,( R"+@( 0%2,'( "#:( The activities have been handed over to local partners who were involved in the projects. Furthermore, a symposium, organised on 11 October 2010 at the French National Library in Paris, enabled us to evaluate %H+*'+#?& 2%*!"#*%*& +#& '(%& 6?('& -?-+#*'& ?%#$%2I related violence. In 2010, the organisation launched several projects to promote access to sexual and reproductive healthcare for women. An initial programme was set up in Mexico aimed at migrant women working in prostitution or as domestic workers. In Guatemala, women working in export industries in Escuintla and Suchitepéquez are helped to obtain access to healthcare. In Uruguay,

the programme, set up as a result of a needs assessment in 2009, has launched three main -3'+=+'+%*& -*& !;-##%$/& G(%& 62*'& +*& +#=";=%$& >+'(& supporting two local organisations which specialise in issues related to abortion, in order to enable them to expand their work over a larger geographical area. The second strand is advocacy work with a view to decriminalising abortion. The third activity aims to share information on the practices related to abortions with organisations in other countries, where projects on sexual and reproductive health exist or will be developed (Mexico, Guatemala, Nicaragua -#$&,%21@/ Finally, MdM completed a needs assessment in Nicaragua, in the rural areas of Puerto Cabezas, with a view to launching a new project in 2011, to support improved access to sexual and reproductive healthcare.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

GUATEMALA

Emergency programme following the hurricane

HURRICANE EMERGENCY 7/++%!)#,( Q6)&3)( 3%&( <,#&+)0( Q4,+%!)( "#( C^( S)>( CEBE-( !)/'%#6( &"++,#&%)0( +)%#( %#( &3,( ,#&%+,(+,6%"#(and leaving 250 people missing in Guatemala. MdM set up an emergency programme to facilitate access to medical treatment and to prevent illnesses linked to the disaster. This meant we were able to carry out medical consultations, to distribute medicines, raincoats and boots and to support the local workers’ organisation Madre Tierra.

Programme en Colombie

1,049 people were treated in eight communities in Suchitepéquez department © MdM

COLOMBIA

IN THE MIDST OF ARMED CONFLICT M3,( 1+"6+)44,( "G( )!!,''( &"( 3,)0&3!)+,( G"+(&3,(1,"10,('/GG,+%#6(&3,()+4,*(!"#$%!&( %#( L)+%b"( +,6%"#( V,6)#( %&'( )!&%2%&%,'-( )'( 10)##,*-(%#(CEBE:( An indigenous co-operative is supported in its health work for these vulnerable communities.

Access to healthcare for rural, indigenous populations of Meta and Arato

The programme of access to healthcare in the Meta area has been extended to follow '(%&3"#)+3'&-*&+'&7"=%*&"#&-#$&'"&!2"=+$%&-#& appropriate health response.

NEPAL

8#(L,1)0-(R3,+,(4)&,+#)0()#*( neonatal mortality rates are )4"#6'&(&3,(3%63,'&(%#(&3,(R"+0*MdM has introduced an innovative programme, which links reproductive health with microcredit.

Nepal ÂŠ Benoit GuĂŠnot

DOCTORS OF THE WORLD ANNUAL REPORT 2010

PROGRAMMES IN ASIA

Burma © Sophie Brändström

40 PROGRAMMES EN ASIE

Pakistan © Katrijn Van Giel

DOCTORS OF THE WORLD ANNUAL REPORT 2010

PAKISTAN Afsar Khan 65 years old

“M'P*&'(%&62*'&'+7%&M&(-=%&*%%#&'(%&7"#*""#&3-1*%& so much damage—half of my village was affected. G(%&)""$*&*'-2'%$&-'&]&"P3;"3.&+#&'(%&7"2#+#?& on 28 July and we left our house immediately, taking with us only the clothing we were wearing. We were unable to take anything else. We realised straight away that it was dangerous because the water was already waist-high.”

42 ASIA

Russia

Afghanistan

Nepal

Burma

Laos India

Vietnam

Pakistan

Indonesia

EMERGENCY AND LONG TERM PROGRAMME LONG TERM PROGRAMME

DOCTORS OF THE WORLD ANNUAL REPORT 2010

CD Detailed information sheets on the various programmes implemented in Asia can be found on this interactive CD. Use the links below. // AFGHANISTAN

> CLICK HERE

// BURMA

> CLICK HERE

// INDIA

> CLICK HERE

// INDONESIA

> CLICK HERE

// LAOS

> CLICK HERE

// NEPAL

> CLICK HERE

// PAKISTAN

> CLICK HERE

// RUSSIAN FEDERATION

> CLICK HERE

// VIETNAM

> CLICK HERE

Pakistan ÂŠ Katrijn Van Giel

DOCTORS OF THE WORLD ANNUAL REPORT 2010

KEY EVENTS IN ASIA

PAKISTAN

EMERGENCY: FLOODS AND DISPLACED PEOPLE AN EMERGENCY PROGRAMME WAS LAUNCHED BY MDM IN SUMMER 2010 IN RESPONSE TO THE FLOODS WHICH HIT PAKISTAN BETWEEN AUGUST AND OCTOBER.

M3,(,4,+6,#!>(1+"6+)44,(R)'(,'&)V0%'3,*( %#(L"R'3,+)()#*(<3)+')**)(*%'&+%!&'(`R3,+,( Bd-EEE(4,*%!)0(!"#'/0&)&%"#'(R,+,(*,0%2,+,*a( )'(R,00()'(%#(]"3)&(*%'&+%!&-(R3,+,(*%)++3",)( &+,)&4,#&(!,#&+,'(R,+,(',&(/1(%#(&3,(*%'&+%!&( 3"'1%&)0()#*(%#(P%)F/)&(S,4"+%)0(7"'1%&)0:(

particularly in dealing with obstetric emergencies free of charge. It is worth mentioning that MdM had already been present in the Khyber,-.('1#.>-&!2"=+#3%&A^,^@<&*+#3%&'(%&7-**+=%& military counter-insurgency intervention, which occurred in 2009 and which resulted in the displacement of almost three million people.

C-=+#?& *%%#& '(%& )""$*& *%2+"1*;L& -55%3'& "'(%2& regions, such as the Punjab, MdM supported MdM set up mobile clinics in Swabi, Buner and the work of the local MCWAK organisation with Kohat districts. The programme was extended its post-emergency maternal health activities, to Hangu in December 2010.

AFGHANISTAN

LAUNCH OF THE FIRST METHADONE SUBSTITUTION PROGRAMME M3,(4)%#(,0,4,#&'("G(&3,(3)+4(+,*/!&%"#(1+"- prescriptions were issued from March onwards, 6+)44,-(0)/#!3,*(%#(])V/0(%#(CEE_-()+,(1+,- which was a very positive development for users. 2,#&%"#-()!!,''(&"(!)+,()#*(&+,)&4,#&()#*(&3,( M#&'"'-;<&RE&!-'+%#'*&4%#%6'%$&'(2"1?("1'&'(%&L%-2/&& &+)%#%#6("G(0"!)0(L[A':( Furthermore on 1 December, World Aids Day, M#& '(%& 62*'& X1-2'%2& "5& DEQE<& -5'%2& ;%#?'(L& >"2.& an awareness day was organised in the Ministry >+'(&'(%&-1'("2+'+%*<&O$O&>-*&6#-;;L&!%27+''%$& of Health by drug users themselves, supported '"&+7!"2'&7%'(-$"#%&+#'"&K5?(-#+*'-#/&G(%&62*'& by MdM.

ÂŠ Sandra Calligaro

Harm reduction amongst drug users

LAOS

A NEW REPRODUCTIVE HEALTHCARE PROJECT

ÂŠ Marie-Pierre Buttigieg

Mother and child healthcare in Orissa province

S*SU'(R"+@(%#(P)"'(V,6)#(%#(Q/6/'&(CEBE( %#( &R"( *%'&+%!&'( "G( <3)41)'')@( 1+"2%#!,:( This new project will aim to improve the availability of reproductive healthcare, in particular by supporting around 10 health centres and by training personnel. The activities have not yet begun, owing to delays with registration, but the go-ahead has been given. Information has been gathered in order to supplement the work of the needs assessment.

INDIA CO-OPERATION WITH THE LOCAL VHAI NETWORK Q#(,.10"+)&"+>(1+"X,!&(R)'(0)/#!3,*(%#(S)>-( order to provide the best possible response to %#(A+%'')(1+"2%#!,-(%#(&3,(,)'&("G(8#*%)-("#( emergencies linked to natural disasters in India &3,('3"+,'("G(&3,(\)>("G(\,#6)0-(with the aim or in other countries. of bringing primary healthcare to the people of this very cut-off region. As a result of this work, we wanted to carry out several projects in cooperation with VHAI, the local NGO network. of pregnant women in Orissa Amongst these were helping to set-up a project province gave birth with in Kalahandi, information sharing, the organisamedical assistance in 2010, '+"#&"5&3"#5%2%#3%*&-#$&>"2.*("!*&-#$&6#-;;L<& compared with 20% in 2007 capacity building and sharing of expertise in

A PILOT PROGRAMME FOR SAFE MOTHERHOOD

50%

ÂŠ MdM

Tackling maternal mortality in rural areas

DOCTORS OF THE WORLD ANNUAL REPORT 2010

24H/24 most of the emergency obstetric services are available round the clock '(-#.*&'"&'(%+2&6#-#3+#?& through a microcredit system

RUSSIAN FEDERATION © Stéphane Lehr

To improve access to, and the quality of, maternity care in Sindhupalchowk district

NEPAL

THE FIRST ASSESSMENT HEALTHCARE STAFF HAVE BEEN TRAINED IN OBSTETRIC CARE AND INFECTION PREVENTION 8#(&3,(4%**0,("G(&3,(0)'&(*,!)*,-()!!"+*%#6(&"( &3,(O"+0*(7,)0&3(A+6)#%')&%"#-(4)&,+#)0(4"+&)0%&>(%#(L,1)0(+,)!3,*(eYE(G"+(,2,+>(BEE-EEE( V%+&3':( This was one of the reasons for MdM launching a combined reproductive healthcare -#$& 7+32"6#-#3%& !2"?2-77%& +#& DEER<& +#& J+#$hupalchowk district. We set up this project in cooperation with the Ministry of Health and between June 2008 and December 2010 58 healthcare

staff were trained in obstetric care and infection prevention. MdM provided support for the district hospital, for two primary healthcare centres and for eight health posts. Moreover, 4,143 women have had access to reproductive health awareness-raising and 1,348 pregnant women received delivery .+'*/&_+#-;;L<&`<aW]&("1*%(";$*&(-=%&4%#%6'%$&52"7& '(%&7+32"6#-#3%&!2"N%3'/&G(%&!2"N%3'&>+;;&#">&4%& extended to a neighbouring district.

THE END OF THE MIGRANT PROGRAMME The programme providing access to healthcare for migrants was launched in Moscow in April 2008 and came to an end in April 2010. Its primary achievement was to create a network of professionals, including 50 doctors, who are aware of the needs of migrants. Moreover, in 2010, MdM carried out a needs assessment in the Russian Federation, with the aim of developing a new programme to reduce the risks associated with alcohol consumption. This is an issue that we have already been working on in Mongolia.

\gP[QH8Q

8#(J0%2,#-(%#(L)*,f3*)(*%'&+%!&- the Roma population lives in deplorable sanitary conditions. In 2010, priority was given to maternal and child healthcare.

Bulgaria ÂŠ GaĂŤlle Girbes

DOCTORS OF THE WORLD ANNUAL REPORT 2010

PROGRAMMES IN EASTERN EUROPE

Moldova © Lizzie Sadin

50 PROGRAMMES IN EASTERN EUROPE

Serbia © Benoit Guénot

DOCTORS OF THE WORLD ANNUAL REPORT 2010

SERBIA Andgela 32 years old, heroin user

“I went to Savski Venac (a health centre *1!!"2'%$&4L&O$O@<&>(%2%&'(%&*'-55&'"".&3-2%& of me straight away. Right from the start I had support meetings. Quite the opposite to the hospitals where they give you methadone then throw you out! I come every day because I really feel that they listen to me.”

52 EUROPE

Moldova Romania

Serbia

Bulgaria

LONG TERM PROGRAMME

DOCTORS OF THE WORLD ANNUAL REPORT 2010

CD Detailed information sheets on the various programmes implemented in Eastern Europe can be found on this interactive CD. Use the links below. // BULGARIA

> CLICK HERE

// MOLDOVA

> CLICK HERE

// ROMANIA

> CLICK HERE

// SERBIA

> CLICK HERE

54 KEY EVENTS IN EASTERN EUROPE

A REPORT COMPLETED IN OCTOBER IDENTIFIES THE KEY ELEMENTS OF A SUCCESSFUL PARTNERSHIP

THIRTY YEARS OF PARTNERSHIPS IN EASTERN EUROPE ÂŠ Lizzie Sadin

AN IMPORTANT ANALYSIS WAS CARRIED OUT BETWEEN MAY AND SEPTEMBER 2010, AIMED AT REACHING A BETTER UNDERSTANDING OF THE RELATIONSHIPS THAT HAVE BEEN MAINTAINED BETWEEN MDM AND THIRTEEN OF ITS LOCAL PARTNERS BASED IN EASTERN EUROPE.

8#( ZE( >,)+'( "G( )!&%2%&>( %#( I)'&,+#( I/+"1,-( S*S( 3)'-( 5+'&( )#*( G"+,4"'&-( *,2,0"1,*( 1+"6+)44,'( G"+( &3,( 1+"&,!&%"#( "G( !3%0*+,#:( M3,( 1+"6+)44,'( %#( ?"0)#*( `!3%0*+,#( R3"( )+,(2%!&%4'("G()V/',a("+(%#(\"'#%)(`!3%0*+,#( R%&3(*%')V%0%&%,'a()+,(&R"(,.)410,':(MdM then adapted to meet the changing needs by turning its attention, for example, to high risk groups in J%24+-<&"2&'"&=+3'+7*&"5&'2-563.+#?&+#&O";$"=-/&K'& the heart of the success of each of these projects were the partnerships which were established with many local organisations. For this reason, an evaluation of these numerous collaborative projects in 2010 tried to gain a better understanding of the scope of the partnerships.

Partner in Moldova

According to the report, based on the results of questionnaires sent to 13 organisations, it may*+7!;L&4%&6#-#3+-;&*1!!"2'&41'&3-#&-;*"&4%&'%3(nical assistance, in the form of an exchange of expertise, or could be the shared management of a project. The report concludes by identifying the key elements of a successful partnership: '(%& 3;"*%& +#=";=%7%#'& "5& %-3(& !-2'#%2& +#& $%6ning the project, agreement on the objectives of the project, joint development of a strategy for implementation, agreement on the distribution of roles, activities and resources, complemen'-2L& *.+;;*<& ?""$& 3"I"!%2-'+"#<& -& !2%I$%6#%$ '+7%'-4;%&5"2&'(%&!-2'#%2*(+!&-#$<&6#-;;L<&?""$& inter-personal relationships and transparency!

DOCTORS OF THE WORLD ANNUAL REPORT 2010

GEORGIA

NEW HARM HIKg<M8AL ?HADI<M 8#( CEBE( &3,( &,)4( R"+@%#6( "#( &3,( 3)+4( +,*/!&%"#( 1+"6+)44,( %#( MV%0%'%( V,6)#( &"( 4)@,( 1+,1)+)&%"#'( G"+( &3,( 0)/#!3( "G( )!&%2%&%,':( In the Georgian capital, there are around 27,000 people using intravenous drugs, who are at high risk of HIV/AIDS infection. In fact, of the 2,700 people in the country, who are infected with HIV/AIDS, 57% are intravenous drug users. MdM’s objective was to support the local NGO, New Vector, with the aim of opening a reception centre and organising *!%3+63&'2-+#+#?&-2"1#$&(-27&2%$13'+"#/&012& objective is also to undertake advocacy work at a national level, with a view to the decriminalisation of drug use and provision of social and medical support for users.

SERBIA

EASIER ACCESS TO METHADONE Whilst access to methadone in Serbia was 1+,2%"/'0>("#0>()2)%0)V0,(G+"4(3"'1%&)0(1'>!3%)&+%!(/#%&'-(*+/6(/',+'()+,(#"R()V0,(&"()!!,''('/V'&%&/&%"#(&+,)&4,#&(%#(3,)0&3(!,#&+,':

THE MDM TEAM HAS WORKED CLOSELY WITH THE STAFF OF A PRIMARY HEALTHCARE CENTRE TO INTRODUCE AN INNOVATIVE AND RESPECTFUL APPROACH TO WORKING WITH DRUG USERS.

Methadone centre in Belgrade

This innovation is a result of in-depth work which culminated in October 2009. Since then the centre, located in a primary healthcare centre in Belgrade, has delivered methadone substitution treatment to 120 patients. In 2010, MdM also provided technical support to a centre in Obrenovac—one of six new Serbian centres offering substitution treatment

120 !-'+%#'*&4%#%6'%$& from appropriate follow-up during their substitution therapy

and funded by the Global Fund to Fight Aids, Tuberculosis and Malaria. The debate is underway at a national level, with a new law on substitution treatment and drafting of a document on the medical treatment and re-socialisation of drug users:(

?QPIJM8L8QL(MIHH8MAH8IJ

J%#!,(B^^d-(S*S(3)'(V,,#(R"+@%#6( "#()(R%*,(2)+%,&>("G(1+"X,!&'(in the Palestinian Territories including mental health programmes, reproductive health awareness, emergency care and primary healthcare.

Gaza ÂŠ Giovanni Marrozzini

DOCTORS OF THE WORLD ANNUAL REPORT 2010

PROGRAMMES IN THE NEAR AND MIDDLE EAST

Lebanon © Viviane Joakim

58 PROGRAMMES IN THE LIQH(QLK(S8KKPI(IQJM

Yemen © MdM

DOCTORS OF THE WORLD ANNUAL REPORT 2010

YEMEN Ahmed Inhabitant of Bani Kayes

“The state does nothing for those of us who live a long way from the policymakers. We are left to ourselves, to poverty, to all the diseases to which we fall victim. It’s shameful!”

60 NEAR AND MIDDLE EAST Turkey

Iraq Syria Lebanon Palestinian Territories

Egypt

Yemen

LONG TERM PROGRAMME

DOCTORS OF THE WORLD ANNUAL REPORT 2010

CD Detailed information sheets on the various programmes implemented in the Near and Middle East can be found on this interactive CD. Use the links below. // EGYPT

> CLICK HERE

// IRAQ

> CLICK HERE

// LEBANON

> CLICK HERE

// SYRIA

> CLICK HERE

// PALESTINIAN TERRITORIES

> CLICK HERE

// TURKEY

> CLICK HERE

// YEMEN

> CLICK HERE

62 KEY EVENTS 8L(M7I(LIQH(QLK(S8KKPI(IQJM

MdM supports eight primary healthcare centres

YEMEN

EMERGENCY IN SAADA REGION ÂŠ MdM

AN EMERGENCY PROGRAMME WAS SET UP AT THE START OF 2010 IN RESPONSE TO THE CONFLICT IN SAADA GOVERNORATE, WHERE HOUTHI REBELS ARE FIGHTING THE YEMENI GOVERNMENT, AND WHERE THERE WAS A MAJOR MILITARY INTERVENTION IN NOVEMBER 2009.

M"( 1/&( &3,( '%&/)&%"#( %#( !"#&,.&-( '%#!,( CEEY( &3,+,(3)2,(V,,#($)+,h/1'("#()(+,6/0)+(V)'%'( %#(&3%'(+,6%"#-(*,'1%&,(&3,('%6#%#6("G()(!,)',5+,()6+,,4,#&(%#(N,V+/)+>(CEBE()#*()(',&&0,4,#&(R3%!3(R)'(5#)0%',*(%#(Q/6/'&:( MdM responded to this humanitarian emergency by setting up programmes around two main areas. Initially, mobile clinics were organised in neighbouring Hajjah governorate so that both displaced people and host communities could have access to healthcare. Then health centres were supported to ensure their sustainability.

33,776 CONSULTATIONS PROVIDED BY MOBILE TEAMS IN 12 LOCATIONS IN SAADA GOVERNORATE WHICH WERE WORST AFFECTED BY THE CONFLICT

In Saada, mobile clinics were also established to provide primary healthcare. This classic emergency project was further developed with the -$$+'+"#&"5&*!%3+63&-3'+=+'+%*&+#&'(%&-2%-*&"5&7-ternal and reproductive health and the treatment of severely malnourished children.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

LEBANON

COMPLETION OF THE MENTAL HEALTH PROJECT M3,( 4,#&)0( 3,)0&3( 1+"6+)44,-( 0)/#!3,*( V>( S*S(%#(CEEc-(%#(&3,(?)0,'&%#%)#(+,G/6,,(!)41'( "G(L)3+(,0h\)+,*()#*(\)**)R%-(%#(&3,(#"+&3("G( P,V)#"#-(R)'(R"/#*(/1()&(&3,(,#*("G(CEBE:( After three years of activity, MdM reported positive results based on data collected on the spot. G(%&62*'&2%*1;'*&*(">&'(-'&'(%&-$1;'&!"!1;-'+"#& in the camps had access to mental healthcare, thanks to the team made up of one psychiatrist, two psychologists, two nurses and two social workers. A second positive outcome was that local expertise had been reinforced by the training provided for medical staff and social workers. A third result was raised awareness of problems associated with mental health among the general

population, thanks to awareness campaigns 3"#$13'%$&+#&'(%&6%;$/&b"'-4;%&-7"#?*'&'(%*%& was World Mental Health day, which is held every year on 10 October, and included discussion sessions and a poster campaign. Finally and most importantly, mental healthcare has been integrated into primary healthcare by the United Nations Relief and Work Agency for Pales'+#%&-#$&'(%&O+$$;%&Y-*'&AcbdBK@/&G(+*&%#*12%*& the sustainability of actions implemented in the course of the past three years.

Sustainable action integrating mental healthcare into the primary healthcare system

TURKEY MIGRANTS M3,( 1+"6+)44,( G"+( 4%6+)#&'( %#( &3,( ]/41)@%( F/)+&,+( "G( 8'&)#V/0( +,)00>( '&)+&,*( %#( CEBE:( A partnership with the Turkish Tohav organisation led to the opening of a centre for migrants in January. In September, the centre saw an average of eight people a day, mostly seeking treatment for skin conditions, pharyngitis, bronchitis and gastroenteritis. Under the management of MdM’s Provence-Alpes-Cote d’Azur regional delegation, this project meets two main objectives: to provide socio-medical support for migrants, and to gather evidence on their situation for use in developing a medical, social and legal case to use in lobbying EU member states.

5,200 psychological and psychiatric consultations, and home visits © Viviane Joakim

INTERNATIONAL NETWORK

DOCTORS OF THE WORLD ANNUAL REPORT 2010

CONTENTS // 66 CEBE=()(!3)00,#6%#6()#*(%#&,#',(>,)+

> CLICK HERE

// 68( ?+"6+)44,(S)1

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// 70( A2,+2%,R("G(1+"6+)44,'

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72 Haiti emergency: the MdM network in action

> CLICK HERE

74 Working with Roma people across Europe

> CLICK HERE

76 AIDS: a network priority

> CLICK HERE

MDM INTERNATIONAL NETWORK 2010: A CHALLENGING AND INTENSE YEAR The global network is made up of 14 organisations in Argentina, Belgium, Canada, France, Germany, Greece, Italy, Japan, Netherlands, Portugal, Spain, Sweden, Switzerland and the United Kingdom. Each one of these organisations is independently governed, managed by a board of directors, responsible under national legislation. G(%&M#'%2#-'+"#-;&b%'>"2.&C%-$&0563%&A9dM&+#&+'*& _2%#3(&-32"#L7@&+*&3(-2?%$&>+'(&3"I"2$+#-'+#?& and developing the MdM network with guidance from MdM France and MdM Spain, the largest organisations in the network.

M#'%2#-'+"#-;&b%'>"2.&C%-$&0563% dri@medecinsdumonde.net + 33 1 44 92 14 80 www.mdm-international.org

G(%&62*'&(-;5&"5&DEQE&>-*&%H'2%7%;L&41*L/&G(%2%& were multiple challengesâ&#x20AC;&#x201D;from the earthquake +#& C-+'+& '"& )""$*& +#& ,-.+*'-#e41'& -;*"& '(%& world economic crisis making the poor poorer. G(%& !"";+#?& "5& (17-#<& 6#-#3+-;& -#$& ;"?+*'+3*& resources from across the network enabled us to perform our work better. Raising funds is a challenge in these times of economic crisis. MdM decided to extend its international search for funding by opening an "563%&+#&b%>&f"2.&+#&DEQQ/ In 2010 the network implemented 356 programmes in 78 countries: 185 international programmes in 64 countries and 171 national programmes in 14 countries.

Based in Paris and Madrid, a team of six people supports the development of network members according to their needs and means. DRI visited teams throughout 2010 and organised mee- G(%&#%'>"2.P*&5"31*&-32"**&-;;&6=%&3"#'+#%#'*& tings to enable technical and policy exchanges, is to restore, or quite simply to facilitate, access to support common initiatives and to facilitate to care for the most vulnerable people. co-ordination, consultation and communication within the network.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL NETWORK MEMBERS » Doctors of the World Argentina http://www.mdm.org.ar » Doctors of the World Belgium http://www.medecinsdumonde.be » Doctors of the World Canada http://www.medecinsdumonde.ca » Doctors of the World France http://www.medecinsdumonde.org » Doctors of the World Germany http://www.aerztederwelt.org » Doctors of the World Greece http://www.mdmgreece.gr » Doctors of the World Italy www.medicidelmondo.it » Doctors of the World Japan http://www.mdm.or.jp » Doctors of the World Netherlands http://www.doktersvandewereld.org » Médecins du Monde Portugal http://www.medicosdomundo.pt » Doctors of the World Spain http://www.medicosdelmundo.org » Doctors of the World Sweden http://www.lakareivarlden.org » Doctors of the World Switzerland http://www.medecinsdumonde.ch » Doctors of the World UK http://www.doctorsoftheworld.org.uk

N"+(4"+,(%#G"+4)&%"#()V"/&(&3,( international network’s 1+"6+)44,'-(10,)',(/',( &3,(0%#@'()V"2,:(

Mali © MdM Belgium

68 INTERNATIONAL NETWORK PROGRAMMES

United Kingdom Canada

"3ance Italy Spain Portugal

Algeria Mexico

Mali Niger Mauritania Chad Senegal Burkina!"aso G-01$2!,issau Guinea Sierra!4eone

Dominican Republic Haiti

Salvador

Honduras

Guatemala

Curaçao

Nicaragua

"3$178'9uia12!("3) Colombia

Sao!Tomé!and!Princ

Ecuador

Peru

Bolivia Chile Paraguay

Uruguay Argentina

INTERNATIONAL PROGRAMM56!

NATIONAL PROGRAMMES

Liberia Benin

Sweden Russia

Germany Netherlands

Belgium

e y

Serbia !!!!,-lgaria !!!!!!(omania !!!!!!!!!.*/dova Switzerland Kyrgyzstan

Turkey

Japan Greece

Iraq Lebanon

Syria Palestinian Territories

Afghanistan

Nepal Bangladesh

Egypt

Pakistan

Burma

Vietnam India

Yemen

Laos Cambodia

Sudan Ethiopia Uganda Somalia

cipe

Rwanda

Indonesia

#$%&'($)&'*+!Congo Tanzania Mozambique Mayotte!:"r.)

Angola

Madagascar RĂŠunion!:"r.)

Zimbabwe

Ti%*3!4este

OVERVIEW OF PROGRAMMES RUN BY INTERNATIONAL NETWORK MEMBERS A SHARED GOAL: ACCESS TO HEALTHCARE FOR THE MOST VULNERABLE

Many of the national projects, carried out in 11 countries in Europe and in Canada, Japan and Argentina—as with the organisations’ international projects—work to improve access to care for people excluded from the health system for economic, social, legal or religious reasons, or because of their ethnicity. In 2010, the MdM network as a whole implemented !"#$"%&&'()%*"#(()+,') continents, with a total of 356 programmes in 78 countries: 185 international programmes in 64 countries and 171 national projects in 14 countries.

CROSSING-CUTTING PROGRAMMES Women and children The health of women and children is at the heart of our work. The programme to improve sexual and reproductive health of women living in the Matagalpa region in Nicaragua, set up by MdM Canada, projects set up by MdM Spain in several countries in Central America (Salvador, Honduras, \1-'%7-;-@<& -*& >%;;& -*& '(%& !2"?2-77%*& >"2king with street children led by MdM Belgium in Z-7-."&AO-;+@<&-#$&4L&O$O&_2-#3%&+#&^+#*(-*-<& count amongst the most striking examples of the network-wide commitment to support women and children.

INTERNATIONAL PROGRAMMES QG+%!)-( the continent whose countries have some of the worst health indicators in the world, remains top of the list in terms of the international network’s projects. The HIV prevention and care programme set up by MdM Portugal in Namaacha district in Mozambique, primary health and reproductive healthcare programmes led by MdM Spain in Mauritania, the programme to support the Sahraoui Health Ministry’s central pharmacy implemented by MdM Greece, or programmes to fight against sickle-cell anaemia in Benin set up by MdM Switzerland, are several examples of the diversity of our work in Africa. The safety of the teams remains an 7)+4(+,*/!&%"# important challenge in Darfur, Somalia and the Other projects focus on ‘high risk groups’ such Sahel region. as women working in prostitution, people who use drugs and migrants. Examples of this work Latin America is, after Africa, the continent which include harm reduction work in Kachin, Burma, hosts the second largest number of our proand access to healthcare for migrants and asy- grammes. In addition to the many health projects lum seekers in prisons in Lebanon, both set up carried out with local groups, the earthquake that by MdM France. struck Haiti on 12 January mobilised the network’s

DOCTORS OF THE WORLD ANNUAL REPORT 2010

resources. Eight network members sent teams to international conventions protecting children use. MdM practises a low-threshold approach the country. S*S(3)'(V,,#(%#(7)%&%(G"+(CB(>,)+'( and pregnant women, but also basic rights like with this group, offering clean needles and other drug paraphenalia, as well as accurate informaaccess to healthcare for all. )#*(R%00('&)>(G"+(4)#>(4"+,:( tion on the products used and ways to reduce In Asia, the Middle East and Oceania, where Other projects are carried out amongst the risks associated with drug use. '(%&+#'%2#-'+"#-;&#%'>"2.&+*&-;*"&!2%*%#'&A-&65'(& 3"4,0,''( 1,"10,-( whose health can deterio"5&"12&!2"N%3'*&-2%&3-22+%$&"1'&+#&'(%*%&-2%-*@<& rate rapidly. Mobile teams are at work in the OTHER PROJECTS MdM concentrates on crisis intervention (as in majority of the countries to reach those living on A range of other programmes is rolled out by the the occupied Palestinian Territories, where MdM the street, with some specialised interventions, different MdM teams (e.g. prevention of genital France, MdM Switzerland and MdM Spain are *13(&-*&7%#'-;&(%-;'(&+#&O-2*%+;;%&A_2-#3%@&-#$& mutilation, child lead poisoning, support for the >"2.+#?&"#&7%#'-;&(%-;'(&-#$&%7%2?%#3L&3-2%@& G".L"&A[-!-#@/ elderly, medical and social support in deprived or post-crisis (like the programme improving -2%-*i@/& access to care for mothers and children led by S,4V,+'("G(&3,(H"4)(1"1/0)&%"# suffer from O$O&,"2'1?-;&+#&G+7"2&g%*'%@/& discrimination in their country of origin as well Working together, MdM teams are engaged in as in the countries they move to. This is why advocacy in their own countries and internatioFinally, HIV/AIDS severely affects South East MdM teams in France, Greece, Netherlands and nally. We call for better access to healthcare for Asia, and major projects working with high risk Portugal visit the families where they live (often all and for prevention and treatment for HIV/AIDS, groups are being run by MdM France in Burma, +#& 1#(L?+%#+3& %#=+2"#7%#'*@& '"& 5-3+;+'-'%& '(%+2& hepatitis and tuberculosis. We are also working Afghanistan, Vietnam and Papua. access to vaccination and healthcare, focusing towards the reduction of health inequalities and the right to real access to healthcare for everyone on pregnant women and children. NATIONAL PROGRAMMES irrespective of immigration status. In the international network countries (Argentina, S)0,()#*(G,4)0,(',.(R"+@,+'-(often migrants, Belgium, Canada, France, Germany, Greece, face multiple risks (e.g. violence from custoItaly, Japan, Netherlands, Portugal, Spain, Swe- mers, police harassment, exploitation and infec$%#<& J>+'h%2;-#$& -#$& '(%& c#+'%$& ^+#?$"7@<& QRQ& '+"1*&$+*%-*%*&'(2"1?(&1#*-5%&*%H&>+'(&3;+%#'*@/& programmes are run by predominantly volunteer In addition to these dangers, they suffer from teams, working to support people who would not stigmatisation. MdM performs outreach on the be able to access care without help. streets and runs mobile units, but also visits venues like clubs and massage parlours in order In the majority of countries, undocumented to to help to reduce the risks inherent in this 4%6+)#&' are the people who live in the grea- line of work (Canada, Spain, France, Portugal, test state of precariousness, with very restric- c#+'%$&^+#?$"7<&J>+'h%2;-#$@/ FOR MORE INFORMATION ON THE ted, or often non-existent, rights. Therefore in PROGRAMMES RUN BY -;;&'(%&3"1#'2+%*&>(%2%&>%&(-=%&#%'>"2.&"563%*& ?,"10,(R3"(/',(*+/6'&=%2L&"5'%#&6#$&+'&(-2$&'"& MDM INTERNATIONAL NETWORK A%H3%!'&+#&[-!-#@<&>%&(-=%&*%'&1!&!2"?2-77%*& protect their health, as they are forced into the MEMBERS: HTTP://WWW.MDMworking with this population, seeking to uphold shadows because of the criminalisation of drug INTERNATIONAL.ORG

HAITI EMERGENCY: THE INTERNATIONAL NETWORK IN ACTION » INTERNATIONAL NETWORK

On 12 January 2010, an earthquake measuring 7.3 magnitude -%..'/'0)1%2.23)4'%,2/$) more than 250,000 people dead, approximately 300,000 wounded and 1.3 million people homeless. MdM teams, who were already present in the area, leapt into action and were in Port-auPrince by 14 January.

MdM carried out several hundred surgical operations, distributed essential drugs and transported logistics and medical equipment. This work was facilitated by the international network’s installation of a logistic base in Santo Domingo. Medical consultations, nursing care and hospital transfers were arranged in six areas of Port-au-Prince. In Petit Goâve, MdM supported pharmacies, maternity units and paediatric hospital services.

and shantytowns. In Cité-Soleil, the largest slum in Port-au-Prince, four mobile clinics covered 16 settlements and districts. In 10 months, (from mid[-#1-2L&'"&'(%&4%?+##+#?&"5&9%3%74%2@<&O$O&3-2ried out more than 580,000 medical consultations, including 800 surgical interventions. Equivalent to 9,250 medical consultations per week.

Filling the gaps in access to healthcare 0=%2;"-$%$& ("*!+'-;*& -#$& 6#-#3+-;;L& +#-33%*sible private clinics meant that before the earthquake half the population did not have access to care. The presence of medical NGOs had made it possible for tens of thousands of Haitians to see an improvement in access to care.

After the earthquake, the cholera epidemic _2"7&'(%&%-2;L&$-L*&"5&'(%&"1'42%-.&ADW&03'"4%2@<& MdM mobilised its staff and logistics in Port-auPrince, Petit Goâve, Grand Goâve, Nippes and Grand’Anse. MdM set up a cholera treatment 3%#'2%& +#& [j2j7+%& -#$& O"2"#& A\2-#$PK#*%@<& Grand Goâve, Petit Goâve and Port-au-Prince.

By the end of January, nine clinics were set up in Port-au-Prince in the makeshift settlements

Cholera treatment units were set up mainly as extensions of our existing clinics in the affected

To address the needs of the Haitian population, the MdM team was expanded from 85 people M#& -$$+'+"#<& QDE<EEE& !%"!;%& )%%+#?& '(%& 3-!+'-;& before the earthquake to 291, then to 1,268 sought refuge in Grand’Anse, an area not affected AFaS& C-+'+-#@& '"& 2%*!"#$& '"& '(%& 3(";%2-& "1'by the earthquake. To respond to the increased 42%-./& G(%& M#'%2#-'+"#-;& b%'>"2.& C%-$& 0563%& need, MdM widened its community health pro- has been in charge of co-ordinating the teams gramme. Thanks to this initiative, 11 health centres since July 2010, through a general co-ordinator could offer free care to the whole population. and an assistant on the ground.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

areas and the camps. Patients were treated in isolation; our teams cared for the mild cases and referred more serious cases to the cholera treatment centres. The teams also moved around the island raising awareness amongst the population about the disease. By the end of December 2010, MdM had treated 9,430 people. After the emergency: access to healthcare for all Haiti needs to set up a sustainable national health service. At the moment, there are fewer problems in accessing care thanks to the humanitarian groups on the ground, but there is a risk that the problems will return if a social healthcare system is not set up soon. Doctors of the World conducted some research +#& '(%& 6%;$& 52"7& DEEW& '"& DEEF& +#& \2-#$PK#*%<& and witnessed the positive impact of the elimination of user fees for pregnant women and 3(+;$2%#&1#$%2&6=%/ Since the earthquake, this system has been extended to include the homeless and those who have been displaced. Doctors of the World, working with the Haitian Ministry of Health and Haitian organisations, calls for this free access to care, at the very least for the most vulne2-4;%&!%"!;%<&'"&4%&6#-#3%$&+#&'(%&;"#?&'%27&4L& international donors.

Haiti ÂŠ LahcĂ¨ne Abib

WORKING WITH THE ROMA POPULATION IN EUROPE » INTERNATIONAL NETWORK

Doctors of the World remains concerned by the health situation of Roma people in Europe. The health indicators are testament to their poor living conditions—early death, pregnant women not receiving medical follow up, children who have not been vaccinated. These indicators are still rarely addressed, even today. There is another common complaint: the discrimination suffered by the Roma people, both in their own countries and in the countries where they settle.

In 2005, the European Union declared a Decade of Roma Inclusion for countries to work together to improve Roma integration.

But Doctors of the World works, above all, to facilitate access to mainstream health services. This is done by working with health professionals to improve the care they offer to this It had been believed that Romania and Bul- group, offering treatment with respect, recogaria’s entry into the European Union would gnising mental health issues, accompanying improve the treatment of the Roma migrants service users along the course of treatment coming from these two countries. However, -#$&6?('+#?&-?-+#*'&$+*32+7+#-'+"#/ the CE/2004/38 Directive, enforced prior to the entry of these countries to the EU, restricted Obtaining equal rights freedom of movement in Europe to Europeans Doctors of the World lobbies to obtain access >+'(& *1563+%#'& 6#-#3+-;& 2%*"123%*& -#$& (%-;'(- to school without discrimination (not special care cover. As a consequence, many Roma d"7-& 3;-**%*@<& '"& 3-#3%;& '(%& _2%#3(& d"7-& have lost their ‘leave to remain’ status and all identity card, to provide clean areas for camps that goes with it, including their right to receive with access to drinking water and rubbish colsocial welfare. lection, to remove the Roma’s ‘stateless’ status in the Netherlands (a status also transferred The programmes '"&#%>4"2#*@<&'"&%#*12%&'(%&;->&+*&2%*!%3'%$& The MdM network has been working with by municipalities and for European directives d"7-&!%"!;%&*+#3%&QFFD<&62*'&+#&_2-#3%&'(%#& banning large scale expulsions of European in Greece, the Netherlands, Bulgaria, Portugal, citizens to be upheld. Italy, Germany and the United Kingdom. Roma and Europe Most of these programmes focus on children and The Romeurope collective, created by Doctors of pregnant women: vaccinations, pregnancy care the World following a European project between -#$&(%-;'(&%$13-'+"#&A-#-'"7L<&+#5-#'&3-2%&%'3i@/ 1997 and 2000, is a strong lobbying force at

DOCTORS OF THE WORLD ANNUAL REPORT 2010

the European level. It has set up several meetings with MEPs at the European Commission. Meetings with associations in Romania (Romani Criss@&-#$&+#&C1#?-2L&AYddU@<&-#$&-;*"& with groups active in other European countries, will improve the international network’s ability to work together to obtain, for example, better access to preventive activities and to healthcare without discrimination. Roma Programmes \/06)+%)= at the heart of the Roma city of Sliven, the team works with the population to increase their knowledge of the human body and health. Ongoing work with public health services aims to ensure effective access to care. N+)#!,=( teams around Paris, Strasbourg, Nantes, Lyon, Marseille, Aix-en-Provence and Bordeaux visit Roma areas (mainly camps and *X1-'*@&'"&*32%%#&5"2&+;;#%**%*<&'"&"2?-#+*%&-3cess to mainstream healthcare services and to try to improve living conditions. [+,,!,= in camps around Athens and Thessalonika, the teams organise vaccination campaigns

for children, and lobby the Ministry of Health about the problems Greek and overseas Roma have in accessing care and the unhygienic living conditions they face. Netherlands: support for families who are ‘without nationality or stateless’ enabled us to highlight this previously unrecognised problem. A report on these forgotten families was published in partnership with a number of other organisations. ?"+&/6)0= in an area where African families and Roma were re-housed, nurse consultations -2%& '(%& 62*'& *'%!& '"& %#?-?%& '(%& !"!1;-'+"#& +#& prevention activities and care. 8#( 8&)0>- MdM carried out an anthropological study amongst Roma children. S*S( [,+4)#>( and( S*S( g#%&,*( ]%#6*"4 support Roma people as part of their work in Healthcare and Advice Clinics.

AIDS: A NETWORK PRIORITY Âť INTERNATIONAL NETWORK

5"#$"%&&'().#)+$6.) HIV, sexually transmitted infections, hepatitis and tuberculosis have been key areas of work since the beginning of the networkâ&#x20AC;&#x2122;s development.

M3,',( 1+"6+)44,'( )+,( #"R( !)++%,*( "/&( %#( Doctors of the World works by building the capaZd(*%GG,+,#&(!"/#&+%,'()#*(R"+@(%#(*%GG,+,#&( 3+'L&"5&;"3-;&"2?-#+*-'+"#*&'"&6?('&KM9J&-#$&4L& ways: setting up regular forums with local health authorities. However, we also work with international k& G(2"1?(& ?%#%2-;& !2"?2-77%*& >(+3(& +#3;1$%& groups like the Global Fund and UNAIDS. prevention activities, access to testing and treat7%#'&A+#3;1$+#?&("7%I4-*%$&3-2%@<&!-2'+31;-2;L&+#& When Doctors of the World sets up a project rural areas. to care for HIV-positive people in a developing country, as is the case in Tanzania, the organisak&G(2"1?(&*!%3+-;+*%$&!2%=%#'+"#&!2"?2-77%*& tion also lobbies on behalf of all people who are like prevention of mother-to-child transmis- at risk (e.g. gay men, sex workers, drug users, sion, harm reduction programmes working with 7+?2-#'*@&'"&4%&?+=%#&-33%**&'"&3-2%/& people who use drugs and sex workers and psychosocial support and treatment (including -#'+2%'2"=+2-;*@&5"2&$21?&1*%2*&-#$&*%H&>"2.%2*/ _2"7& Z%#?1%;-& AK#?";-@& '"& U+'jIJ";%+;& AC-+'+@<& '(2"1?(&C-#"+&-#$&C"&U(+&O+#(&U+'L&Al+%'#-7@<& Doctors of the World teams work to improve access to care for incredibly vulnerable people, suffering from discrimination and remote from the healthcare system, by integrating HIV prevention and care, as early as possible, into primary care provision.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

Vietnam © Xavier Gary

CROSS-CUTTING PROJECTS

DOCTORS OF THE WORLD ANNUAL REPORT 2010

CONTENTS // 80 Q#)0>'%'-(&,!3#%!)0('/11"+&()#*()*2"!)!>(/#%&(

> CLICK HERE

81 Promotion of sexual and reproductive health

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81 Harm reduction amongst stigmatised groups

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82 Quality of medicines

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82 Tackling gender-based violence

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83 The HUMA network

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84 Action for Global Health

> CLICK HERE

85 Access to healthcare and socio-cultural determinants

> CLICK HERE

// 86( Q*"1&%"#

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// 87 OpĂŠration Sourire

> CLICK HERE

ANALYSIS, TECHNICAL SUPPORT AND ADVOCACY UNIT At the heart of the International Operations Department is the unit known as S2AP which carries out programme analysis, and provides technical support and advocacy, ensuring that the projects undertaken are as relevant as possible and that quality standards are high. Advocacy reinforces the impact of our work in the +'40)%/0)'/6%/*'().6') #"$%/2(%.2#/7()2/-8'/*') amongst policymakers.

The work of the S2AP is carried out in collabora- The S2AP brings together technical advition with all those involved in our programmesâ&#x20AC;&#x201D; !"#!$%#&'$($)*'+"#$&%$,-%%"#").$/"0,!1 managers, desk officers from headquarters, Medical: 3"I"2$+#-'"2*&-#$&'%-7*&+#&'(%&6%;$/ E'&*<.#/'#$+'"*5"1+.)%,6*'4*#/%4I In 2010, S2AP also produced guides on mana- E'JKLM4#"8'"*+.)%,1$I ging sensitive personal data, gender-related E'54#"8#)*.%,)#/'5"1+.)%&I violence and health education, along with a cata- E'+#%#')1//*)%,1$I logue of project management tools. These do- E'*6#/.#%,1$7'(1//1F'.5'#$+')#5,%#/,&#%,1$D cuments were shared with other workers in the Expertise: humanitarian sector. E'4.8#$'",!4%&'#$+',$%*"$#%,1$#/'4.8#$,%#",#$' law; E'&."6*,//#$)*'1('!*151/,%,)#/')1$%*<%'#$+'&*The key areas of work for this department curity risks; E'!*$+*"G9#&*+'6,1/*$)*I are as follows: E'#$#/2&,&'1('%4*')1$%*<%',$'F4,)4'5"1!"#88*& E'#))*&&'%1'4*#/%4)#"*'#$+'&1),1G)./%."#/'+*terminants. are implemented; E'6#/,+#%,1$'1('%4*')1$%*$%'#$+'8*%41+1/1!,)#/ and technical consistency of programmes; Advocacy: E'%*)4$,)#/'*<5*"%,&*'1$')"1&&G).%%,$!'5"1H*)%&I E'-$#$),#/'#))*&&,9,/,%2'1(')#"*I E'%"#,$,$!'&.551"%I E'4.8#$'"*&1.")*&'(1"'4*#/%4I E'&.551"%'(1"'+#%#')1//*)%,1$'#$+'+1).8*$%,$!' E'4*#/%4'-$#$),$!'#$+'%4*'N?O&I lessons learned; E'#+61)#)2'(1"'#))*&&'%1')#"*',$')1$P,)%'#"*#&I E' 8*%41+1/1!,)#/' &.551"%' (1"' #+61)#)2' E'/1992,$!'(1"'#))*&&'%1')#"*'(1"'.$+1).8*$%*+' migrants and asylum seekers in Europe. strategies.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

8#(CEBE-(&R"(1+%"+%&>()+,)'= MdM strengthened its work in the areas of sexual and reproductive health and harm reduction (working with people who use drugs and sex workers). This was achieved by rolling out two programmes, set to run for two years, which included a number of projects focused on these themes.

» PROMOTION OF SEXUAL AND REPRODUCTIVE HEALTH (SRH)

CO-ORDINATION

» Headquarters: M. Lussier » Board member with responsibility for the project: C. Giboin FUNDING

» French Development Agency

Sexual and reproductive health touches many areas of women’s health— maternal and child health, family planning, prevention of sexually transmitted infections and HIV/AIDS. Several MdM projects work in these areas and the organisation is keen to do more. In this area, a two-year programme focused on promotion of sexual and reproductive health was launched in 2010. Its main objective is to increase the use of sexual and reproductive health services in the areas where MdM is present. This programme encompasses 12 countries worldwide.

» HARM REDUCTION AMONGST STIGMATISED GROUPS MdM has worked with high-risk groups, including drug users and sex workers, for many years. The activities and lifestyle of these individuals makes them more vulnerable, and as a consequence, prone to stigmatisation. M#&2%*!"#*%&'"&'(%&$+5631;'+%*&'(-'&!%"!;%&+#&'(%*%&?2"1!*&5-3%<&O$O&4%?-#&*"I3-;;%$&m(-27&2%$13'+"#P& programmes in 1992. These projects offer a holistic response: medical, psycho-social and community-based support. They aim to reduce the risks associated with drug taking and to promote safe sex practices. Our experience in this area has led to an ambition to strengthen these projects and increase MdM’s presence in the international arena. Thus, in 2010 a two-year international harm reduction programme began. Its main aim is to reduce HIV and hepatitis infections amongst drug users and sex workers as well as working on issues to do with stigmatisation and criminalisation. This programme encompasses six projects across the world.

COUNTRIES

» Since April 2010, this programme has covered nine countries operationally: the Sahel region (Burkina Faso, Mali, Niger), Ethiopia, Liberia, Laos, Haiti, Guatemala, Mexico BUDGET

» 2.7 million euros for 2010-2012

CO-ORDINATION

» Headquarters: M. Lussier » Board member in charge of the project O. Maguet FUNDING

» French Development Agency COUNTRIES

» Since April 2010 this programme has been operational in three countries: Tanzania, Georgia, Democratic Republic of Congo (Kinshasa) BUDGET

» 1.3 million euros for 2010-2012

» QUALITY OF MEDICINES

CO-ORDINATION

» Headquarters: V. Solbès

The work that began last year continued with new audits in Kenya and Yemen to ensure secure supplies and to follow-up on the recommendations which emerged from the pharmaceutical audits in Haiti, Colombia, DRC, Palestinian Territories and the Netherlands. The work includes improvements in storage conditions, training teams in stock management, with more pharmacists being *85/12*+'1$'%4*'-*/+7'#$+',$'*8*"!*$)2')1$%*<%&',$'5#"%,)./#"D In 2011, MdM will join a pilot project entitled QUAMED. Quality Medicine for All, co-ordinated by the K#'>%2!&M#*'+'1'%&"5&G2"!+3-;&O%$+3+#%<&+*&-#&"!%2-'+"#-;&-#$&*3+%#'+63&!2"N%3'&41+;'&"#&'(%&$%=%;"!ment of a North-South network. It aims to improve universal access to quality medicines through the involvement of operational and academic professionals. Joining the network, and pooling our resources with other network members, should allow us to expand our activities to evaluate and audit the quality of medicines and thus improve the quality of pharmaceutical supplies in the countries where we work.

» TACKLING GENDER-BASED VIOLENCE

Fighting against gender-based violence is one of MdM’s top priorities. For several years the organisation has rolled out projects across continents, working to prevent and respond to violence against women. Over and above the care we provide, the projects cover medical, social and legal issues in order to achieve real social change wherever possible.

CO-ORDINATION

» Headquarters: J. Branchat and C. Duplessy in 2010, A. Desmarest in 2011 Board member in charge of the project: J. Larché FUNDING

» French Development Agency, French Ministry of European and Foreign Affairs BUDGET

In 2010, MdM organised two events: a photography exhibition at Paris City Hall entitled Women, the aftermath of violence by photographer Lâm Duc Hiên, and an international conference focusing on gender-based violence at the French National Library in Paris. Several other forums and tools were also set up. Namely, creation of a thematic space on gender4-*%$&=+";%#3%&"#&'(%&+#'2-#%'&-#$&"2?-#+*-'+"#&"5&-&2%?+"#-;&>"2.*("!&+#&K!2+;&+#&^+#*(-*-&A9dU@& to exchange best practice to prevent and respond to gender-based violence. Finally, several tools outlining the methodology to improve holistic care for victims of gender-based violence were produced this year: a guide Prevention and response to gender-based violence; an

» €5,300,000 (over 36 months)

DOCTORS OF THE WORLD ANNUAL REPORT 2010

!"#$%&'$('"#)'*)+, guide outlining the management and protection of sensitive data entitled; a paper entitled -)./+'/,01%/%2'&34415"6/%%)&&'"1'/'7),$%/+'%)5"$*%/")n&-#$&-&42+%6#?&!-!%2&"#&Genderbased Violence. The international programme on violence against women came to and end in October 2010. Nonetheless, the cross-cutting approach to integrating this topic into all of MdM’s programmes continues.

» THE HUMA NETWORK

Created in 2008, the HUMA network is a European advocacy project which calls for access to effective and equitable care for asylum seekers and undocumented migrants in the European Union. In 2010, the network comprised 16 members (of whom 10 are part of the MdM network). Its lobbying actions are 9#&*+'1$'-*/+'*<5*",*$)*'#$+'"*&*#")4'F1"Q')1$+.)%*+'92'%4*'JRNS'$*%F1"Q' and by MdM.

CO-ORDINATION

» (7,)*F/)+&,+': J. Poirson, A. Soler, V. Lepage (France), B. Blondel (Brussels), S. Collantes (Madrid) \")+*(4,4V,+(%#(!3)+6,("G(&3,(1+"X,!&: M. Teule (MdM France), H. Bertevas (MdM Spain), M. Degueldre (MdM Belgium) FUNDING

» DG Sanco (European Commission), European programme for Integration and Immigration (EPIM) BUDGET

In 2010, the network was consolidated, welcoming three new members. Its focus was on advocacy activities and two workshops were organised to support the common advocacy messages of the network members and their national strategies. Several symposiums and events were also arranged to raise awareness amongst policy makers and the general public about access to healthcare for undocumented migrants and asylum seekers. Twelve countries launched a European Declaration calling for health professionals to support access to healthcare for all—this announcement was widely supported by health professionals and medical organisations. The recommendations on universal access to care for children and pregnant women were drawn up before the EU Council’s conclusions "#&'-3.;+#?&(%-;'(&+#%X1-;+'+%*&-#$&-;*"&4%5"2%&'(%&9%3;-2-'+"#&"5&'(%&Z%;?+-#&,2%*+$%#3L&"#&'(%&6?('& against child poverty. A public hearing was organised at the European Parliament in December. Increasing the network’s expertise was another focal point: at the start of 2010, an in-depth analy*+*&"5&;%?-;&52-7%>"2.*&-#$&-&6%;$&*'1$L<&3-22+%$&"1'&+#&3";;-4"2-'+"#&>+'(&!-2'#%2*&+#&'(%&3"1#'2+%*& concerned, enabled us to write up a report on access to care for undocumented migrants and asylum *%%.%2*&+#&5"12&3"1#'2+%*&AUL!21*<&O-;'-<&,";-#$<&d"7-#+-@/& The HUMA project will end in March 2011. Before then, several lobbying activities will be organised—a new report will be published and the European Declaration will be presented to national and European policy makers. A summary of HUMA’s activities and achievements will be provided.

» €1,153,770 (amended in 2010) for 20082011 COUNTRIES AND PARTNERS

» 16 EU countries: Belgium (MdM), Cyprus (Kisa), Czech Republic (MKC), France (MdM), Germany (MdM), Greece (MdM), Italy (MdM), Malta (Skop), Netherlands (MdM), Poland (SIP), Portugal (MdM), Romania (Arca), Slovenia (Slovenska Philantropija), Spain (MdM), Sweden (MdM), United Kingdom (MdM) FOR MORE INFORMATION PLEASE VISIT:

» www.huma-network.org

» ACTION FOR GLOBAL HEALTH Created in October 2006, Action for Global Health is a European advocacy network working on health and development. MdM France and MdM Spain are members. Its aim is to encourage national and EU policy makers to play an active part in reaching the Millennium Development Goals (MDGs) for health by 2015. T4*'$*%F1"Q'#,8&'%1',85"16*'4*#/%4'-$#$),$!'#$+'%1'&%"*$!%4*$'4*#/%4'&2&%*8&' in developing countries, but also to promote equal access to care though user fee exemption policies for essential care. In April 2010, Action for Global Health’s fourth annual report set out three priority areas for action in "2$%2&'"&2%-3(&'(%&O9\*&5"2&(%-;'(&+#&6=%&L%-2*/&,14;+*(%$&+#&6=%&;-#?1-?%*<&+'&+*&-#&-$="3-3L&'"";& used to lobby European and national authorities. In September, a conference was organised at the French Senate featuring a documentary about the South African singer Yvonne Chaka Chaka and The Motherland Tour: A journey of African Women. This 6;7&*%#$*&"1'&-&!"*+'+=%&7%**-?%&-4"1'&K52+3-&-#$&(+?(;+?('*&+#+'+-'+=%*&'(-'&-2%&3122%#';L&>"2.+#?&>%;;/ From March to September 2010, MdM worked with Oxfam France and Action for Global Health on a campaign to highlight the importance of reducing maternal mortality. More than 10,000 signatures were collected on an online petition which was presented to President Sarkozy at the United Nations O9\&3"#5%2%#3%/&G"&6#$&"1'&7"2%&-4"1'&'(%&3-7!-+?#&Non assistance à mère en danger (F ailing to (%;!&=1;#%2-4;%&7"'(%2*@&*%%o&>>>/*-#'%!"12'"1'%*/"2? In 2011, the network will continue to campaign for the health MDGs and recognition of the right to health. At a European level, two roundtable discussions on aid effectiveness were held in Brussels. In France, the main focus will be on the themes discussed at the G8 and G20: aid effectiveness, -33"1#'-4+;+'L&A$%;+=%2+#?&"#&!;%$?%*@&-#$&;"44L+#?&5"2&+##"=-'+=%&6#-#3%&7%3(-#+*7*&*13(&-*&-& 6#-#3+-;&'2-#*-3'+"#&'-H/&

CO-ORDINATION

» (7,)*F/)+&,+': V. Gagnet \")+*(4,4V,+(+,'1"#'%V0,(G"+(&3,(1+"ject: C. Giboin FUNDING

» Action Aid International, recipient of a donation from the Bill and Melinda Gates Foundation BUDGET

» €113,263 for 2010 (09/2009-08/2010) COUNTRIES

» France, Germany, Italy, Spain and UK. A team is also based in Brussels to work with European institutions TO FIND OUT MORE VISIT

» http://www.actionforglobalhealth.eu

DOCTORS OF THE WORLD ANNUAL REPORT 2010

» ACCESS TO HEALTHCARE AND SOCIO-CULTURAL DETERMINANTS Frontline staff, whether in France or abroad, are confronted by complex .$+*"&%#$+,$!' #$+' 9*4#6,1."' ("18' %4*' 9*$*-),#",*&' 1(' %4*,"' F1"QD' T4*' F#2' people feel about health and access to care comes from a mix of norms, values, *<5*",*$)*7'Q$1F/*+!*'#$+'5"#)%,)*&D'T4,&'5"1!"#88*'*$#9/*&'-*/+'5"1(*&&,1nals to gain a better understanding of socio-cultural determinants and, in turn, to ,85"16*'%4*'"*/*6#$)*'#$+'*(-),*$)2'1('5"1!"#88*'+*/,6*"2D' In 2010, a workshop took place in Kathmandu on the theme of Working with Communities. It brought together MdM staff and community members from 11 different countries. Two guides on violence -?-+#*'&>"7%#&-#$&(%-;'(&%$13-'+"#&>%2%&>2+''%#<&-#$&6;7*<&3-*%&*'1$+%*&-#$&-2'+3;%*&>%2%&!2"$13%$& to raise awareness amongst current and future humanitarian workers about the effects of sociocultural determinants. M#&DEQQ<&*'2%#?'(%#%$&4L&;%-2#+#?&52"7&!"";%$&%H!%2+%#3%*&-#$&'%-7*&2%'12#+#?&52"7&'(%&6%;$<&'(%& project intends to continue its awareness-raising activities by organising another workshop to share information and holding debate evenings. To capitalise on the information gathered the team will produce two more practical guides and expand the existing blog into a mini-site which will be attached to MdM’s main website.

CO-ORDINATION

» (7,)*F/)+&,+'= M. Bouchon; S. Gumucio; J.-F. Corty 9"0/#&,,+(4,4V,+'= M.L. DeneffeDobrzynski; M.A. Vincent; D. Maraval FUNDING

» French Development Agency, MdM BUDGET

» U>AA7AAAVBAWM@AAXGAXM@AAYC' €188,640 (09/2009-08/2010) U@>>7=ZAVBAYM@A>AGAXM@A>>C TO FIND OUT MORE VISIT

» www.mdm-scd.org

ADOPTION Doctors of the World is the only medical, humanitarian organisation in France to have integrated an international adoption programme into its founding statutes and to have set up an international adoption agency. The status of Approved Adoption Agency (AAA) was granted in 1988. Our objective as an AAA is consistent with our overall mission to stand up for those who are 81&%'6./$*"#9/*7'$#8*/2')4,/+"*$'B1(%*$'%4*'-"&%'%1'&.((*"',$')",&*&'1"')1$P,)%C'#$+'%1'+*(*$+'%4*,"'(.$+#8*$%#/'",!4%&['%1'4#6*'#' family, access to healthcare and an education.

Putting )4,/+"*$'-"&%

8#(CEBE-(S*SU'()*"1&%"#(1+"6+)44,(+,4)%#,*(&3,(0)+6,'&(%#(N+)#!,()#*(&3,("#0>("#,(%#&,6+)&,*(%#&"()(4,*%!)0(L[A:(G(%&!2+"2+'L&+*&'"&6#$&5-7+;+%*&5"2&3(+;$2%#&>("&3"1;$&#"'&4%&-$"!'%$&+#& their own country. MdM accompanies and prepares the candidates for complex adoptions: adoption of multiple siblings, children over seven years old and adoption of children with medical conditions.

CO-ORDINATION

» ACTIVITIES

FUNDING

MdM supported the adoption of more than 3,700 children between 1990 and 2010. In 2010, 203 children arrived in France and were adopted by 186 families. Half of the adoptions were complex: k&TD&3(+;$2%#&AQa/WS@&>%2%&-$"!'%$&>+'(&*+4;+#?*<&!2+7-2+;L&52"7&U";"74+-<&Z2-h+;<&C-+'+&-#$&d1**+-n k&QT&3(+;$2%#&AW/`S@&>%2%&";$%2&'(-#&*%=%#<&-#$<&"5&'(%*%<&*%=%#&>%2%&-$"!'%$&>+'(&*+4;+#?*n k&Da&3(+;$2%#&AQD/TS@<&7-+#;L&52"7&U(+#-&-#$&l+%'#-7<&(-$&7%$+3-;&3"#$+'+"#*/& MdM supports the children and their families for two years, as and when needed. In 2010, MdM carried out 750 home visits.

» ORGANISATION AND HUMAN RESOURCES MdM is authorised for adoption in 82 French departments and, in addition to the work at headquar'%2*<&(-*&Qa&-$"!'+"#&(14*&+#&+'*&2%?+"#-;&"563%*/

» Headquarters: [:(Q#*+,h M+,2,##,!(`1),*%)&+%!%)#a Board members with responsibility for the project: A:(\,+#)+*(`1),*%)&+%!%)#aP:(D)++%6, » Adopting families, for the main part » Ministry of Foreign Affairs (SAI) » MdM and private donors BUDGET

» €410,000 (in 2010, provisional) COUNTRIES

» Albania, Brazil, Bulgaria, China, Columbia, Ivory Coast, Haiti, Madagascar, Philippines, Ukraine, Vietnam » Non-operational country from April 2010: Russia STAFF

G(%&-$"!'+"#&!2"?2-77%&4%#%6'*&52"7&-&(+?(;L&X1-;+6%$&=";1#'%%2&>"2.5"23%o&Q]S&-2%&$"3'"2*<& 33% psychologists, 16% paramedics, 11% social workers, 8% teachers or teaching assistants and Q`S&-2%&52"7&"'(%2&!2"5%**+"#*&A+#3;1$+#?&;%?-;&!2"5%**+"#-;*@/

» OUTLOOK The focus will continue to be on complex adoptions. The mission is also continuing its risk preven'+"#&-!!2"-3(<&+#&!-2'+31;-2&'(2"1?(&-$"!'+=%&5-7+;L&!2%!-2-'+"#&-#$&6#-#3+-;&'2-#*!-2%#3L/

» CBd(1,"10,- of whom 98% are volunteers, working for the adoption team, at headquarters and at 15 regional 1(-)*&

DOCTORS OF THE WORLD ANNUAL REPORT 2010

OPÉRATION SOURIRE <+,)&,*(%#(B^c^-(Opération Sourire(%'()(10)'&%!('/+6,+>(1+"6+)44,(&3)&(+,)!3,'("/&(&"(&3,(1""+,'&()#*(4"'&(%#(#,,*:(Carried out in close co-operation with our partners in Asia and Africa, our teams work on specific reparatory surgical needs ranging from the face, to limbs, or the whole body.

Give back a smile to those +,&-!."*+ by illness or malnutrition

» ACTIVITIES

2010 was a year of international growth. UK and Dutch teams joined Opération Sourire alongside teams from France, Japan and Germany.

CO-ORDINATION

» Head of Programme: N:(N"/'')*%,+ » Headquarters: P:(80%i FUNDING

The key activities per mission are : k&J12?+3-;&+#'%2=%#'+"#*&+#&!-2'#%2*(+!&>+'(&'(%&("*'&("*!+'-;n k&G2-+#+#?&5"2&;"3-;&*'-55<&$"#%&'(2"1?(&m*(-$">+#?P&-#$&'%3(#+3-;&'2-+#+#?&"#&'(%&*12?+3-;&'%3(#+X1%*& used. During 2010, MdM France teams operated on patients suffering from cleft lips or scarring from burns. Thirteen missions were organised in seven countries: Cambodia, Chad, Madagascar, Mali, Mongolia, Niger and Rwanda. In addition, MdM France supported other members of the MdM international network with their missions in Bangladesh and Cambodia, with both medical logistics and staff.

» OUTLOOK

In preparation for the resumption of activities in Pakistan, a feasibility study was conducted this year in Islamabad. There is considerable need for care for victims of acid attacks. To respond to this need, MdM plans to organise regular trips from next year.

» PUA+,)0(N"/#*)&%"# BUDGET

» €415,256 COUNTRIES:

» Cambodia, Chad, Madagascar, Mali, Mongolia, Niger, Rwanda

PROGRAMMES IN FRANCE

DOCTORS OF THE WORLD ANNUAL REPORT 2010

CONTENTS // 94 (?+"6+)44,'(%#(N+)#!, 99 Observatory on Access to Healthcare

> CLICK HERE

100 Migrants

> CLICK HERE

102 Roma

> CLICK HERE

103 Health and housing

> CLICK HERE

104 Harm reduction

> CLICK HERE

105 Sex workers

> CLICK HERE

106 Prevention Project

> CLICK HERE

107 Buddying children in hospital

> CLICK HERE

Dunkirk

FRANCE

Colombes

HEALTHCARE AND ADVICE CLINIC

OUTREACH PROJECT

SEX WORKER PROGRAMME

BUDDYING CHILDREN IN HOSPITAL

HARM REDUCTION PROGRAMME

PAEDIATRIC HEALTH CENTRE

Saint-Denis

La Plaine-Saint-Denis

DOCTORS OF THE WORLD ANNUAL REPORT 2010

Homelessness programme in Nice ÂŠ Virginie de Galzain

^C PROGRAMMES IN FRANCE

Migrants’ living area in Dunkirk © Benoit Guénot

DOCTORS OF THE WORLD ANNUAL REPORT 2010

DUNKIRK Mathieu Quinette Doctors of the World programme co-ordinator in Dunkirk

“Here it is a permanent emergency situation. We are dealing with people who are struggling with day to day survival. The repressive policies of the government since the closure of the Sangatte centre and the dismantling of ‘the jungle’ in September 2009 have consequences for health. We are mainly treating conditions directly linked to the dreadful living conditions: )+7*L&*(%;'%2*<&!2"4;%7*&>+'(&-33%**&'"&>-'%2& and hygiene, no waste disposal and so on.”

PROGRAMMES IN FRANCE 2010 was a disastrous year for access to healthcare in France, representing one step further in the stigmatisation and rejection of the most vulnerable.

S%6+)&%"#( 1"0%!>( #"R( )%4'( &"( *%'!"/+)6,( 2/0#,+)V0,(6+"/1'-(H"4)()#*(/#*"!/4,#&,*( 4%6+)#&'( G+"4( '&)>%#6( %#( N+)#!,j,2,#( %G( %&( 4,)#'(1/&&%#6(0%2,'(%#(*)#6,+("+(G/+&3,+('&%64)&%'%#6(!,+&)%#(6+"/1':(And all to the considerable detriment of public health and fundamental human rights.

goods take place, or by destroying basic equipment distributed by voluntary groups to provide some protection from storms and cold.

N/+&3,+4"+,-( &"( G/+&3,+( +,'&+%!&( )!!,''( &"( 3,)0&3!)+,( G"+( &3,',( 1"1/0)&%"#'( &3,( '&)&,( 4,*%!)0( )%*( `QSI( %#( %&'( N+,#!3( )!+"#>4a( R)'(&3+,)&,#,*(V>(&3,(CEBB(5#)#!,(V%00:(The In 2010, the large-scale expulsion of Roma recent increase in the costs of the AME—wronfamilies continued and were highlighted after gly attributed by the majority of MPs and the the President’s speech in July. The Roma ?"=%2#7%#'& '"& -41*%& 4L& 4%#%63+-2+%*e>-*& population’s fears were exacerbated by used as a pretext to pass changes which render repeated intimidations and irregular deporta- the system almost unworkable. Namely, an inition procedures. These large-scale expulsions tial fee of 30 euros, a requirement for agreement resulted in breaks in treatment for patients with +#&-$=-#3%&52"7&'(%&(%-;'(&+#*12-#3%&"563%*&5"2& chronic conditions such as tuberculosis, as any costly hospital care and a reduction in the well as interruptions to child measles vaccina- range of care on offer. tion campaigns at a time when the epidemic Recent data from MdM’s observatories in France has resurfaced in France and in Europe. and Europe, however, have shown that more J%4%0)+0>-(&3,(3)++)''4,#&()#*(*,1"+&)&%"#("G( '(-#&F]S&"5&!-'+%#'*&AFES&5"2%+?#&#-'+"#-;*@&;+=%& 4%6+)#&'(G+"4("/&'%*,(&3,(Igj1)+&%!/0)+0>(%#( below the poverty line and are struggling to surS)>"&&,( AQF<EEE& %H!1;*+"#*@& 41'& -;*"& +#& U-;-+*& vive, rather than worrying about cosmetic surgery -#$&91#.+2.e+#'%#*+6%$/&M#&'(+*&-2%-&"5&'(%&#"2- and in-vitro fertilisation as some have suggested. thern coast, the police forces are prepared to disrupt the work of humanitarian and social orga- M"(4)@,(4)&&,+'(R"+',-(cEk("G(1)&%,#&'(*"( nisations by arresting service users near premises #"&(3)2,(&3,(3,)0&3(!"2,+(&3)&(&3,>()+,(0,6)00>( where consultations and distribution of essential ,#&%&0,*(&": There are delays in seeking access to

DOCTORS OF THE WORLD ANNUAL REPORT 2010

healthcare in 22% of cases because of essentially administrative reasons (such as the complexity of '(%& !2"3%$12%*@& "2& 5"2& *-5%'L& 3"#3%2#*& A5%-2& "5& ?"+#?&"1'@/ Although the same critics like to argue that there +*&-&7-**+=%&)">&"5&7+?2-#'*&>("&!;-#&'"&7-.%& excessive use of the French healthcare system, the data show that in the vast majority of cases migration takes place for economic reasons. Medical reasons only apply in a very small minority of casesâ&#x20AC;&#x201D;less than 10% of people with chronic conditions such as HIV or hepatitis knew that they were infected when they arrived in Europe. The very day that the law was published, a joint report of the General Inspectorates on Finance and on Social Affairs backed up the case being made by MdM and the voluntary sector collectives who have mobilised against these decisions, highlighting once again how absurd these changes are. M3,( +%63&( &"( V,( 6+)#&,*( )( 2%')( G"+( 4,*%!)0( reasons is also threatened by the law on %44%6+)&%"#-(%#&,6+)&%"#()#*(#)&%"#)0%&>-()#*( &3,(*,V)&,(%'("#6"%#6(%#(CEBB:

MdM will continue to work with vulnerable popu4%.2#/()2/)9"%/*'):;<)=624')+$6.2/$)>#").6')"'(!'*.) of the essentials of public health and against the essentials of security. %#(N+)#!,:(At the beginning of 2010, these tests were still not permitted although some countries in Europe were using them and MdM was already 8#(+,'1"#',(&"(&3,(3,1)&%&%'(<()#*(789(,1%*,- using them in international programmes. 4%!'-(S*S(3)'(!"#&%#/,*(&"(%##"2)&,- and to turn policy into operational reality, particularly in MdM participated in various working groups to relation to harm reduction. A project for intrave- promote the use of these tests. To support this nous drug users has been started. This health advocacy work, the organisation decided to education project, aimed at limiting the risks start using the tests in French Guiana (a French associated with injection (transmission of hepati- $%!-2'7%#'&>+'(&(+?(&CMl&!2%=-;%#3%@&52"7&'(%& '+*&U<&CMl<&*%!'+3-%7+-@<&1*%*&-#&+#$+=+$1-;&'(%"- end of 2009. retical and practical approach developed during a pre-determined number of sessions where the Finally, favourable legislation was published on 17 user uses the product which he or she normally November 2010, more than a year after the High uses. Working with Gaia Paris and Sida Paroles, Authority on Health had recommended that rapid the objective is to demonstrate the relevance of diagnostic texts could be used beyond certain this approach for public health. A joint evaluation emergency situations or in a research context. with AIDES is underway, in partnership with the In 2011, therefore, we will extend the use of this French medical research institute (INSERM in its _2%#3(&-32"#L7@&-#$&>+'(&6#-#3+-;&*1!!"2'&52"7& the National Agency for Research on AIDS and l+2-;&C%!-'+'+*&AKbdJ&+#&+'*&_2%#3(&-32"#L7@/&

France who would otherwise be sent to their country of origin.

MdM is still working with other voluntary and public sector organisations to preserve these arrangements for access to healthcare, whose disappearance would effectively mean Q#"&3,+( %##"2)&%2,( )+,)( "G( R"+@-( "#( &3,( death for many seriously ill patients living in G+%#6,'("G(&3,(0)R-(%'(&3,(/',("G(+)1%*(789(&,'&'(

health cover, because they are undocumented migrants, should be registered by Mayotte social *%312+'L&"563%/&G(+*&$%3+*+"#&+*&(+*'"2+3&4%3-1*%<& 5"2& "#%& '(+#?<& '(+*& +*& '(%& 62*'& '+7%& -& 3(+;$& (-*& been registered in his or her own right for social security and also because France’s violation of the International Convention on the Rights of the Q0"#6'%*,(&3,(1+"X,!&'("#(&3,(6+"/#*-(%#(CEE^( Child has been recognised. S*S(0)/#!3,*()(0,6)0(!3)00,#6,(%#(S)>"&&, to enable access to healthcare for children of O"+@%#6(R%&3(3"4,0,''(1,"10,("#(&3,(6+"/#*-( undocumented migrants or unaccompanied S*S(3)'(!"#&%#/,*(&"('1,)@("/&()V"/&(&3,( minors not being cared for by social services 0)!@( "G( ,4,+6,#!>( )!!"44"*)&%"#( and suiand without access to social security—State table long-term housing as well as about the Medical Aid does not cover this region. MdM needs and situation of this group, many of whom -*.%$&'(%&O-L"''%&*"3+-;&*%312+'L&"563%&'"&!2"- are seriously ill. In addition, our teams continue vide social security cover for several children we to work with other voluntary sector organisations were looking after. Where these requests were to provide medical and social support in squats, refused we decided to help the families to take where a diverse population of artists, undoculegal action to realise their right to health, and mented migrants and students live. In this context, thus to access social security. The case was public health problems—such as those linked to heard by Mamoudzou social security tribunal in $21?&1*%&"2&$+5631;'+%*&>+'(&-33%**&'"&(%-;'(3-2%& in general—continue to be neglected. March 2010. tool in our programmes in mainland France in order to facilitate diagnosis. In addition, MdM is still very involved in prevention of, and screening for, sexually transmitted infections and tuberculosis. We are studying other rapid diagnostic tests, particularly for hepatitis and tuberculosis.

In a judgement on 17 December 2010, the court declared that some of the arrangements in place in Mayotte contravene the International U"#=%#'+"#& "#& '(%& d+?('*& "5& '(%& U(+;$& AMUdU@& and, as a result, a child whose parents have no

<+%','()+,(!/++,#&0>(,+/1&%#6(!0"',(&"("/+("R#( V"+*,+'( )#*( I/+"1,( ',,4'( &"( R"++>( 4"+,( )V"/&(&3,()++%2)0("G(/#*"!/4,#&,*(4%6+)#&'( '(-#&!2"7"'+#?&'(%+2&2+?('&'"&)%%&-#$&>%;3"7+#?& people who have been subjected to extreme

violence. At the same time, the French authorities are introducing a system of migration management which is based on stigmatisation while destroying the existing arrangements for access to healthcare. MdM will continue to work with these groups in France and to defend a sense of solidarity in our approach to healthcare and to call for the fundamentals of public health to come before security concerns.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

Roma camp near Paris © Steven Wassenaar

Healthcare and Advice Clinic in Lyon ÂŠ Elisabeth Rull

DOCTORS OF THE WORLD ANNUAL REPORT 2010

OBSERVATORY ON ACCESS TO HEALTHCARE » PROGRAMMES IN FRANCE

Doctors of the World’s Observatory on Access to Healthcare in France was created in 2000 following new legislation which came into force in 1999 and 2000 (the anti-exclusion law, establishment of heal.6*%"')%**'(()#>+*'(3)2/."#08*.2#/)#>)?/2,'"(%4)1'%4.6)@/(8"%/*'3)"'/'=%4)#>)A.%.')B'02*%4)C20D).#).'(.2>E) to the reality or otherwise of better access to healthcare and to highlight potential gaps for people on the margins of these arrangements. This is an essential tool to help us understand the populations seen by Doctors of the World teams and enables us to see the links between their living conditions, rights and health problems. It also enables us to identify discriminatory practices and to see where the arrangements are not working well—as well as to highlight positive experiences. BEARING WITNESS TO BARRIERS TO HEALTHCARE FOR VULNERABLE GROUPS The Observatory helps us to develop understanding of vulnerable groups, which are often %H3;1$%$&52"7&"563+-;&!14;+3&(%-;'(&*'-'+*'+3*/&G(%& $-'-&+#3;1$%&-&*+?#+63-#'&#174%2&"5&("7%;%**& people and undocumented migrants. It enables us to develop, and make the case for, proposals from the perspective of our work on the ground. Doctors of the World can then lobby or inform political decision-makers and health professionals to improve access to prevention and to care for vulnerable groups. It also enables the teams working on the ground to have access to indicators with a view to enabling them to monitor and assess how their work changes over time.

An annual report is published each year to mark the International Day for the Eradication of Poverty. This report is based on: k&7%$+3-;&-#$&*"3+-;&$-'-&3";;%3'%$&+#&'(%&DQ&C%-;thcare and Advice Clinics in an electronic format; k& $-'-& 3";;%3'%$& 4L& -& ?2">+#?& #174%2& "5& outreach projects; k&'%*'+7"#+%*&52"7&*%2=+3%&1*%2*n k& "4*%2=-'+"#*& 52"7& '("*%& +#=";=%$& +#& '(%& !2"gramme on the current arrangements for access to healthcare and the problems which exist; k&!2"?2-77%&-3'+=+'L&2%!"2'*n k&7"#+'"2+#?&"5&;%?+*;-'+=%&-#$&2%?1;-'"2L&$%=%lopments relating to access to healthcare; k&3"7!-2+*"#*&>+'(&"'(%2&*'1$+%*&-#$&2%!"2'*&+#& relation to health and deprivation.

21 Healthcare and Advice Clinics saw a total of

28,160 service users, including 20,225 new service users in the course of 59,316 appointments.

They carried out

42,525

medical consultations, including dental care, equivalent to:

» 38,606 medical

consultations for 21,234 service users

» 3,919

dental consultations for 1,742 service users

» 18,471

social consultations

100

MIGRANTS

(VULNERABLE MIGRANTS AND ASYLUM » PROGRAMMES IN FRANCE

( P,6%'0)&%"#("#(%44%6+)&%"#(3)'(0,*(&"(G/+&3,+(*,&,+%"+)&%"#(%#(&3,('%&/)&%"#("G(G"+,%6#(#)&%"#)0'(%#(N+)#!,:(M3%'(3)'( %#!0/*,*(+,4"2)0("G(&3,(+%63&(&"(+,6/0)+%')&%"#()G&,+(BE(>,)+'-(%#!+,)'%#6(#/4V,+'("G(*,1"+&)&%"#'-(1)+&%!/0)+0>(G"+(&3,( H"4)(1"1/0)&%"#:(8#()**%&%"#-(&3,(+,!,#&(+,G"+4("G(J&)&,(S,*%!)0(Q%*(`QSI(%#(%&'(N+,#!3()!+"#>4a-(%#(1)+&%!/0)+(R%&3(&3,( %#&+"*/!&%"#("G()#(%#%&%)0(!3)+6,("G(ZE(,/+"'- %'(!+,)&%#6(#,R(V)++%,+'(&"(3,)0&3!)+,:(Q&(&3,(')4,(&%4,()'(&3,',(+,'&+%!&%"#'-(( R3%!3(R%00(!"4,(%#&"(,GG,!&(%#(CEBB-(4)%#&,#)#!,("G(&3,(+%63&(&"()(2%')(G"+(4,*%!)0(+,)'"#'(G"+(',+%"/'0>(%00(G"+,%6#,+'(%#(

Supporting vulnerable migrants

» ACTIVITIES In 2010, MdM helped vulnerable migrants visiting our Healthcare and Advice Clinics to access their rights: k 92% of new patients are foreign nationals; k 33% of these are seeking, or have sought, asylum (including pending applications, applications >(+3(&(-=%&#"'&4%%#&*147+''%$&-#$&2%51*%$&3;-+7*@n k 85% of migrants did not have effective access to health coverage when they came to the clinic 5"2&'(%&62*'&'+7%/&05&'(%*%<&FES&*("1;$<&'(%"2%'+3-;;L<&4%#%6'&52"7&-33%**&'"&J'-'%&O%$+3-;&K+$<& although this is not the case in practice. Spotlight on two programmes: North coast k& M#& DEQE<& +#& 2%*!"#*%& '"& '(%& ;-3.& "5& -#L& *(%;'%2& -#$& (%-;'(& %X1+!7%#'<& O$OP*& !2"?2-77%& redoubled its efforts on sanitation by building showers, latrines and setting up a drinking water '-#.&A>(+3(&>-*&+77%$+-'%;L&'-.%#&->-L&4L&'(%&!"2'&-1'("2+'+%*@/&G"&2%*!"#$&'"&'(%&$+*7-#'ling of the shelters and destruction of migrants’ belongings, the team worked with other local organisations to organise regular distribution of essential equipment (duvets, materials to rebuild *(%;'%2*&%'3/@/ The teams regularly witness attacks on the rights of people passing through the region and a real lack of access to healthcare. Because of their poor living conditions (lack of water, heat and (L?+%#%&5-3+;+'+%*<&-*&>%;;&-*&"=%232">$+#?@&'(%&7+?2-#'*&-2%&7"2%&=1;#%2-4;%&'"&*.+#&!2"4;%7*/& These represent the most common condition diagnosed—on average 50% of consultations in under 18s and 25% of consultations in adults. In 14% of consultations, scabies was diagnosed. Mayotte In 2010, the team carried out nearly 3,000 medical consultations with children (60% of whom >%2%&1#$%2&5"12&L%-2*&";$@/&G(%2%&(-$&4%%#&$%;-L*&+#&*%%.+#?&(%-;'(3-2%&+#&#%-2;L&`ES&"5&'(%*%& cases. The two most common conditions recorded are linked to their poor living conditions:

MOST COMMON NATIONALITIES

» Romanian, Algerian, Moroccan, Cameroonian and Tunisian COMMON REASONS FOR MEDICAL CONSULTATIONS

» Acute respiratory infections, uncomplicated hypertension, dermatological problems, noninsulin dependent diabetes, depression, acute bronchitis, anxiety, back problems…

DOCTORS OF THE WORLD ANNUAL REPORT 2010

SEEKERS) N+)#!,(%'(%#!+,)'%#60>(/#*,+(&3+,)&:(8#(,GG,!&-(&3,(!"#!,1&("G(T+,)0()!!,''U(!"/0*(V,(+,10)!,*(V>( &3,(#"&%"#("G(T)2)%0)V%0%&>("G(&+,)&4,#&U(%#(&3,(!"/#&+>("G("+%6%#:(8#(+,'1"#',(&"(&3,',()&&)!@'-(&3,( 2"0/#&)+>(',!&"+(!"#&%#/,'(&"(563&(G"+(&3,(+%63&'("G(4%6+)#&':(Q00(&3,(K"!&"+'("G(&3,(O"+0*(1+"6+)44,'(%#(N+)#!,(1+"2%*,(!)+,()#*()*2%!,(&"(4%6+)#&(',+2%!,(/',+':

46% had respiratory problems and 30% skin problems. The two main obstacles to healthcare cited were poor awareness of the ‘bons rosesP&A!+#.&5"27*@&>(+3(&?1-2-#'%%&-33%**&'"&3-2%&5"2& 3(+;$2%#&AR]S@&-#$&4%+#?&'""&-52-+$&'"&?"&"1'&4%3-1*%&"5&5%-2&"5&-22%*'&AWaS@/&G(%2%&-2%&-;*"& problems for the mobile clinics that the MdM team organises. The year ended with a small victory, which will enable, we hope, all those under 18 to register $+2%3';L&>+'(&'(%&*"3+-;&*%312+'L&"563%/&_"2&*%=%2-;&7"#'(*<&O$O&(-*&4%%#&6?('+#?&5"2&'(%&2+?('& to register a severely disabled child. A decision from Mamoudzou social security tribunal on 17 December 2010 judged that the current situation did not comply with the International Convention on the Rights of the Child.

» OUTLOOK MdM continues to campaign for everyone to have healthcare coverage and to be able to access appropriate health services, irrespective of their immigration status. Prevention and screening A2-!+$&'%*'+#?&5"2&CMl<&(%!-'+'+*<&'14%231;"*+*@&!2"?2-77%*&-2%&4%+#?&$%=%;"!%$&+#&'(%&3;+#+3*&-#$& as part of outreach activities. At this time, when access to State Medical Aid is no longer free and where the right to a visa on medical grounds for seriously ill foreigners living in France is under threat, MdM continues to work with other organisations to defend the rights of migrants and will continue to call on elected politicians. We will also monitor the situation so that we can bear witness to any impact that these measures have on health.

» RANGE OF SERVICES ;(S,*%!)0()#*('"!%)0(!"#'/0tations and referral to health )#*('"!%)0(',+2%!,': ;(P"VV>%#6(G"+(&3,(%410,4,#&)&%"#("G()11+"1+%)&,(3,)0&3( services: healthcare access

"G5!,'(`?QJJa-(#/+'%#6(V,*'( %#('3,0&,+'(,&!: ;(7,)0&3(1+"4"&%"#("/&+,)!3( )!&%2%&%,': ;(<"00,!&%#6(4,*%!)0()#*('"!%)0(*)&)-()'(R,00()'(1,+'"#)0(

!)',('&/*%,'(!"#!,+#%#6(&3%'( 1"1/0)&%"#U'(0%2%#6(!"#*%&%"#'( )#*(1+"V0,4'(R%&3()!!,''(&"( 3,)0&3!)+,-( 1+,2,#&%2,( ',+2%!,'()#*("&3,+(+%63&':

NUMBER OF PROGRAMMES » Q00(1+"6+)44,' VOLUNTEERS » C-EEE FUNDING

» Regional public health agencies, district and regional councils, town councils… PARTNERS

» CASP, CIMADE, GISTI, LDH, Anafé, CFDA, COMEDE, participation in the ODSE (Observatory on migrants’ right to health), the MOM collective, local and regional voluntary sector co-ordination bodies

102

ROMA » PROGRAMMES IN FRANCE

2010 was a very hard year, with a toughening of the government’s stance towards the Roma. This population has been subject to even more fear and pressure. MdM teams working with Roma groups jumped into action to highlight the health consequences of the new measures to evict Roma. MdM continues to issue reminders that these measures are particularly damaging because they push people further away from health services and voluntary sector support, they lead to gaps in treatment and make it impossible to introduce effective measures to prevent epidemics.

Working with Roma to improve health » BANLIEUE/SAINTDENIS, BORDEAUX, GRENOBLE, LYON, MARSEILLE, MONTPELLIER, NANTES, NANCY, STRASBOURG, TOULOUSE

» OUTLOOK

BENEFICIARIES

In partnership with other organisations, MdM is continuing to lobby the public authorities for a better standard of living for the Roma population.

NUMBER OF VOLUNTEERS

MdM, in partnership with Romeurope and four other organisations working in places where Roma ?2"1!*&;+=%&AJ-+#'I9%#+*<&b"2$I,-*I$%IU-;-+*&-#$&_2jN1*@<&(-*&*%'&1!&-&(%-;'(&7%$+-'+"#&!2"N%3'&>+'(& the aim of facilitating access to healthcare for women and young children and improving the service '(%L&2%3%+=%/&G(%&!+;"'&!(-*%&AQ]&7"#'(*@&"5&'(+*&(%-;'(&7%$+-'+"#&!2"N%3'&>+;;&4%&3-22+%$&"1'&-7"#?& around 100 people living in Nantes and will be managed by the MdM Nantes Roma programme team.

» RANGE OF SERVICES ;(S,*%!)0(G"00"Rh/1=(1+%4)+>( &%"#'( %#( ',&&0,4,#&'( `,:6:( 3,)0&3!)+,()#*(3,01%#6(1,"10,( +,G/',(!"00,!&%"#-()!!,''(&"( access mainstream health ser- R)&,+a()#*(&"(5#*()11+"1+%)&,( 2%!,': 3"/'%#6: ;( N)!%0%&)&%#6( '!3""0%#6( G"+( ;(S)&,+#%&>(!)+,=(?+,2,#&%"#( !3%0*+,#=( +)%'%#6( )R)+,#,''-( "G()V"+&%"#'-()#&,h#)&)0(4"#%)*4%#'&+)&%2,(1+"!,*/+,'()#*( &"+%#6-(%#G"+4)&%"#("#(!"#&+)2)!!%#)&%"#': !,1&%"#-(!3%0*(%44/#%')&%"#-( ;(J)#%&)&%"#=(0"VV>%#6(!"/#!%0' )!!"41)#%4,#&( &"( 4"&3,+( G"+(%41+"2,*(3>6%,#,(!"#*%- )#*( !3%0*( 3,)0&3( 1+"&,!&%"#(

',+2%!,'()#*(G)4%0>(10)##%#6: ;(\,)+%#6(R%&#,''(&"(&3,(0%2%#6( !"#*%&%"#'-( +,1,)&,*( ,.1/0sions and other obstacles hin*,+%#6()!!,''(&"(3,)0&3!)+,( )#*("&3,+(+%63&': ;(S"V%0%')&%"#("G('/11"+&(!"44%&&,,'(G"+(H"4)(G)4%0%,'-("&3,+( 3,)0&3()!&"+'-(&"R#(!"/#!%0'( )#*(1/V0%!(',+2%!,':

» L,)+0>(Z-EEE(V,#,5!%)+%,' » BYZ NUMBER OF PROGRAMMES

» 10 FUNDING

» Regional public health agencies, district councils, regional councils, town councils… PARTNERS

» Romeurope, support committees, shelters, mother and child health protection services, Comité d’aide médicale…

DOCTORS OF THE WORLD ANNUAL REPORT 2010

HEALTH AND HOUSING » PROGRAMMES IN FRANCE

Although there have been significant advances in relation to the right to housing—a fundamental right—with the adoption of the DALO law in 2007 (realising the legally binding right to housing), three years after the law came into force there are still more than 3.5 million people who are homeless or poorly housed.1 There are also another five million people who are in extremely insecure accommodation and a shortage of 900,000 homes—and all this in a country where the right to housing is written into law. The vast majority of patients seen by MdM are homeless or living in insecure accommodation.

Taking the health impact of poor housing into account » ANGOULÊME, AJACCIO, BORDEAUX, BANLIEUE IN AND AROUND PARIS, CALAIS/DUNKIRK, CAYENNE, GRENOBLE, LE HAVRE, LYON, MARSEILLE, METZ, MONTPELLIER, NANCY, NANTES, NICE, PARIS, POITIERS, RÉUNION (ST-DENIS), STRASBOURG, TOULOUSE, VALENCIENNES

1- Source: The state of poor housing in France, 2011 report by the Abbé-Pierre Foundation. 2- Sources: INSEE, population 3%#*1*&Ad,@&DEEWn&9dYYJ<& 2008 survey of social establishments 2008; administrative sources.

» ACTIVITIES The objectives of our work with homeless people are: k&'"&+$%#'+5L&=1;#%2-4;%&!%"!;%&>("&#%%$&'"&4%&-33"7!-#+%$&'"&7-+#*'2%-7&(%-;'(&-#$&>%;5-2%& services and relevant voluntary sector services; k&'"&"2?-#+*%&7%$+3-;<&*"3+-;&-#$&!2%=%#'+"#&*%2=+3%*n k&'"&+#5"27&!%"!;%&"5&'(%+2&2+?('*&-#$&-33"7!-#L&'(%7&+5&#%3%**-2Ln k&'"&*%%&!%"!;%&>("&$"&#"'&(-=%&-33%**&'"&(%-;'(3-2%&+#&O$O&3;+#+3*<&1#'+;&'(%L&3-#&2%-;+*%&'(%+2 right to health coverage. Our objectives in relation to housing and health are: k&'"&!2%=%#'&3(+;$&;%-$&!"+*"#+#?n k&'"&*'1$L&'(%&+7!-3'&"5&!""2&("1*+#?&"#&+#(-4+'-#'*P&(%-;'(n k&'"&41+;$&-&#%'>"2.&"5&2%;%=-#'&"2?-#+*-'+"#*&-#$&+#$+=+$1-;*/

MOST COMMON HEALTH PROBLEMS

» Back problems, gum and teeth problems, gastric problems, viral hepatitis, respiratory infection, asthma, parasites/ candidosis, skin infections, anxiety-stress, somatic problems, depressive syndrome, hypertension, diabetes… NUMBER OF PROGRAMMES

» CZ NUMBER OF VOLUNTEERS

» C^E HOMELESS IN FRANCE

» BZZ-EEE2 CONTACTS WITH HOMELESS PEOPLE

» S"+,(&3)#(CC-EEE

Based on our work, MdM France bears witness to the damaging health consequences of homelessness and poor housing. We also provide social support through our outreach teams on patrol and our visits to squats, medical consultations in night shelters etc.

» OUTLOOK k&G"&3"#'+#1%&"12&(%-;'(3-2%<&!2%=%#'+"#&-#$&-33"7!-#+7%#'&-3'+=+'+%*/ k&G"&3"#'+#1%&"12&;"44L+#?&5"2&!14;+3&+#*'+'1'+"#*&'"&7%%'&'(%&(%-;'(&#%%$*&"5&("7%;%**&!%"!;%&-#$ to develop public sector outreach activities (‘nursing bed’ facilities in shelters, mental health ou'2%-3(&%'3/@ k&G"&512'(%2&*'1$L&'(%&+7!-3'&"5&!""2&("1*+#?&"#&'(%&(%-;'(&"5&"331!-#'*/ k&G"&3"#'+#1%&'"&!2"7"'%&-33%**&'"&*1+'-4;%&-33"77"$-'+"#&-#$&("1*+#?/

» Cck of service users attending our clinics are homeless or in shelters. Of these, 15% are under 18 and 80% do not have effective access to healthcare; » Yck live in insecure accommodation (of these, 67% are being put up temporarily by family or friends) FUNDING

» ARS, Île-de-France Regional Council, district councils, regional councils, town councils… PARTNERS

» Abbé Pierre Foundation, Secours catholique, Emmaüs, Red Cross, Restos du coeur, Samu social, DAL, local organisations (La Péniche, les Amis de la rue, le Fournil, GAF, Enfants du monde Droits de l’homme…), Mother and Child Protection Services

104

HARM REDUCTION » PROGRAMMES IN FRANCE

In June 2010, an INSERM report on harm reduction among drug users stated that harm reduction has played an ,851"%#$%'"1/*',$'"*+.),$!'%4*',$),+*$)*'1('JKL7'9.%'%4#%'*6,+*$)*')1$)*"$,$!'4*5#%,%,&'\',$(*)%,1$'F#&',$&.(-),*$%7'%4.&' highlighting the limitations of this strategy. To tackle the hepatitis C epidemic in drug users, MdM set up a project focused on educating users on the risks associated with injection (ERLI) in July 2010. This action-research project, in partnership with AIDES and INSERM in Marseille and supported by the national HIV and hepatitis research agency, will enable us to evaluate this new harm reduction tool.

Reducing the risks of drug use

» 6 RAVE PROGRAMMES BAYONNE, MEDITERRANEAN (BASED IN MARSEILLE AND NICE), MONTPELLIER, NANTES, PARIS (WITHDRAWAL FROM THE PARIS RAVE PROGRAMME AT THE END OF 2010, HANDOVER TO USER GROUPS) AND TOULOUSE; 2 NEEDLE EXCHANGE PROGRAMMES (LYON AND ANGOULÊME, WHO HANDED OVER TO AIDES AT THE ];?'^3''@A>ACI'>V_`TM DRUG ANALYSIS PROJECT; 1 PROGRAMME OF EDUCATION ON RISKS ASSOCIATED WITH INJECTION (ERLI)

» ACTIVITIES Since 1997 MdM has been running prevention and harm reduction activities at techno festivals. A changing context has led us to develop our work: k&+#&52%%&!-2'+%*&-#$&+#&32"**I4"2$%2&3;14*n k&+#&*X1-'*<&$12+#?&!-2'+%*&41'&-;*"<&7"2%&+7!"2'-#';L<&"#&-#&%=%2L$-L&4-*+*/&G(%&,-2+*&d-=%&!2"N%3' has redirected some of its activities towards squats; k&+#&'%3(#+=-;*<&>(%2%&"12&>"2.&+#3;1$%*&5"12&3"7!"#%#'*o – welcome (prevention table, provision of prevention materials such as injection kits, roll-your*'2->i@n – prevention interviews; p&2%-**12-#3%&A*1!%2=+*%$&3(+;;"1'&h"#%*<&!;-3%&5"2&3-2+#?&5"2&-#$&$+-?#"*+#?&3";;-!*%*@n – drug analysis with thin layer chromatography, the only method which is legal. In 2010, 204 *-7!;%*&A-;;&$21?*&3"74+#%$@&>%2%&3";;%3'%$&-#$&-#-;L*%$&4L&'(%&qZG&!2"N%3'/& The Rave programme teams went out 113 times, including one technival, and the Angouleme needle exchange programme carried out 177 outings.

» OUTLOOK k&K$-!'+#?&"12&>"2.+#?&7%'("$*&'"&'(%&#%%$*&"5&"12&'-2?%'&?2"1!*/ k&U"#*";+$-'+#?&'(%&YdgM&!2"?2-77%/ k&_"2&*X1-'*o&%#*12+#?&'(%&;"#?&'%27&*1*'-+#-4+;+'L&"5&'(%&3122%#'&-22-#?%7%#'*<&!-2'+31;-2;L&+#&'%27* of medico-psycho-social sessions. k&_"2&2-=%*r!-2'+%*o&3"#'+#1%&'(%&3122%#'&-22-#?%7%#'*&+#&!-2'#%2*(+!&>+'(&1*%2*&?2"1!*&>+'(&-&=+%>& to handover to mainstream services, particularly the CAARUDs. k&,2"7"'+#?&'(+#&;-L%2&3(2"7-'"?2-!(L&-#$&'(%&2%3"?#+'+"#&"5&$21?&-#-;L*+*&-*&-&(-27&2%$13'+"#&'"";/

HEALTH PROBLEMS

» Hepatitis C, HIV, psychiatric breakdowns, anxiety crises, dependency, various somatic problems MOST COMMON RISKS

» Hepatitis C transmission, HIV, psychiatric breakdowns, dehydration, hyperthermia/ hypothermia, hypoglycemia BENEFICIAIRES

» L,)+0>(CC-EEE(/',+(!"#&)!&'( at raves/festivals and nearly 1,000 user contacts on the needle exchange programme. NUMBER OF VOLUNTEERS

» BZc FUNDING

» Ministry of Health, regional public health agencies, regional councils, INTERREG (Europe)… PARTNERS

» Techno Plus, AIDES, L’Orange bleue, Asud, le Tipi, Act Up, l’Acothé, Espace Indépendance, Sida Paroles, Liberté association, Bizia, Gaïa, La Fratrie, ANPREF, AFR…

1- ERLI: education on risks associated with injection.

SEX WORKERS

DOCTORS OF THE WORLD ANNUAL REPORT 2010

» PROGRAMMES IN FRANCE

In June 2010 the National AIDS Council confirmed that contradictions between health policy and other policies, in particular security and immigration policy, hinder work on prevention, harm reduction and access to healthcare. Access to healthcare and to other rights for sex workers is increasingly restricted, despite the fact that they are particularly exposed to sexually transmitted infections. Victims of violence and abusive arrests, sex workers, particularly since the Internal Security Law1 made passive soliciting a crime, often have to hide. This makes them less visible, more vulnerable and further distances them from health and social services—and making the work of support organisations more difficult.

Providing support and facilitating access to healthcare for sex workers » MONTPELLIER, NANTES, PARIS, POITIERS, ROUEN

1- LSI: Law n°2003-239 of 18 March 2003 on internal security.

» ACTIVITIES Since 1999, MdM has been supporting sex workers through prevention activities and information. In practice, this includes the following activities: k&"2?-#+*-'+"#&"5&#+?('&-#$&$-L&"1'2%-3(&*%**+"#*&+#&!;-3%*&>(%2%&!2"*'+'1'+"#&'-.%*&!;-3%<&+#&"2$%2& to provide prevention materials and to offer a listening service; k&$%=%;"!7%#'&"5&7"2%&+#$+=+$1-;+*%$&*1!!"2'&A3"#*1;'-'+"#*<&*32%%#+#?<&;+*'%#+#?i@&$12+#?&3;+#+3& sessions and in health workshops; k&!(L*+3-;&-33"7!-#+7%#'&'"&7-+#*'2%-7&(%-;'(&*%2=+3%*<&-#$&5-3+;+'-'+#?&3"771#+3-'+"#&5"2&'("*%& who do not speak French; k&-$-!'+#?&-#$&'2-#*;-'+#?&(%-;'(&!2"7"'+"#&+#5"27-'+"#&2%;-'+#?&'"&JGM*<&CMl&-#$&+#$+=+$1-;&2+?('*/

» OUTLOOK The Internal Security Law1 has resulted in a shift in the places where prostitution takes place. Today, the teams know that they will not be able to reach all sex workers. In Nantes, an ‘indoor project’ has been offering information and advice to sex workers operating in private places, particularly aimed at bar hostesses, since 2007. M#&"2$%2&'"&2-+*%&->-2%#%**&-#$&'"&+7!2"=%&-33%**&'"&CMl&'%*'+#?<&'(%&'%-7*&>+;;&$%=%;"!&*!%3+63& outside screening activities, in partnership with the CDAG service and some other organisations. The possible use of rapid HIV testing in voluntary sector services will also enable us to be closer to target populations and to increase early uptake of screening.

BENEFICIARIES

» Q+"/#*(B-BEE NUMBER OF VOLUNTEERS

» 102 COMMON CONDITIONS

» Gynaecological problems, illnesses linked to conditions on the streets, psychological problems linked to stress, isolation or abuse, drug dependency… FUNDING

» Regional public health agencies, district councils, regional councils, town councils, Ensemble contre le sida Sidaction, Paris Observatory on Gender Equality, European Commission. PARTNERS

» AIDES, Arcat, CDAG, CIMADE, Friends of the Women’s Bus, Droits d’urgence, Red Cross.

106

PREVENTION PROJECT

HIV-HEPATITIS-STI-TUBERCULOSIS » PROGRAMMES IN FRANCE

MdM teams see people who live in deprivation and migrants, who come from regions with higher prevalence of HIV, hepatitis and tuberculosis. In France, migrants represent 47% of new HIV cases, and the number of tuberculosis cases in people born overseas is eight and a half times higher than that of people born in France. The prevalence of hepatitis B and hepatitis C is three times higher in the vulnerable people who are covered by the CMU (Universal Health Insurance).

Tackling HIV, hepatitis and tuberculosis

» CLINICS LYON, MARSEILLE, ROUEN, TOULOUSE, PARIS, SAINT-DENIS, PAU, NICE, CAYENNE » PROSTITUTION PROGRAMMES LOTUS BUS PARIS, FUNAMBUS NANTES » HOMELESSNESS PROGRAMMES: METZ, LYON » PROGRAMMES WITH PEOPLE WHO USE DRUGS EDUCATION ON RISKS ASSOCIATED WITH INJECTION PROGRAMME (ERLI), PARIS AND COLOMBES

» ACTIVITIES

BENEFICIARIES

k&J'2%#?'(%#+#?&!2%=%#'+"#&-#$&+7!2"=+#?&-33%**&'"&'%*'+#?&-#$&'2%-'7%#'&5"2&*%2=+3%&1*%2*&>%&*%%& in our Healthcare and Advice Clinics, as well as through our outreach work among sex workers, homeless people and those who use drugs. k& M#'%#*+5L+#?& !2%=%#'+"#& %55"2'*o& !2"=+$+#?& !2%=%#'+"#& 7-'%2+-;*& A)L%2*<& 3"#$"7*& %'3/@<& +#$+=+$1-;& interviews and group sessions. k&M7!2"=+#?&-33%**&'"&*32%%#+#?o&%#3"12-?+#?&*%2=+3%&1*%2*&'"&?"&5"2&'%*'+#?<&!-2'#%2*(+!*&>+'(&52%%< anonymous testing services and local laboratories. k&_-3+;+'-'+#?&-33%**&'"&(%-;'(3-2%o&!-2'#%2*(+!&>+'(&7-+#*'2%-7&(%-;'(&*%2=+3%*<&!(L*+3-;;L&-33"7panying service users. k&U";;%3'+#?&'%*'+7"#+%*&"5&3-*%&*'1$+%*&+#&2%;-'+"#&'"&'(%*%&$+*%-*%*/

» OUTLOOK We would like to continue these efforts in relation to prevention, access to testing and healthcare 5"2&'(%*%&=1;#%2-4;%&?2"1!*<&-#$&'"&%H'%#$&'(%7&'"&-;;&!2"?2-77%*&-32"**&_2-#3%/&O"2%&*!%3+6cally, we would like to: consolidate our partnerships with anonymous, free screening centres; do further work on screening for tuberculosis; and continue our efforts to introduce rapid testing in _2-#3%&A-*&>%&(-=%&$"#%&+#&U-L%##%@&>+'(&'(%&-+7&"5&!2"7"'+#?&-33%**&'"&-!!2"!2+-'%&-#$&+##"vative screening for the groups which currently have low take-up.

»&RANGE OF SERVICES

;(L%#,(1%0"&(7,)0&3!)+,()#*(Q*- 1+"'&%&/&%"#-(%#G"+4-(+,G,+()#*( 2%!,(<0%#%!'(!)++>("/&(1+,2,#- 13>'%!)00>()!!"41)#>(1,"10,( &%"#()!&%2%&%,'("#()(*)%0>(V)'%'-( &"()!!,''(3,)0&3!)+,-(1+,2,#R%&3( )!!,''( &"( 1+"G,''%"#)0( &%"#()#*("&3,+(+%63&': %#&,+1+,&%#6: ;(MR"(3"4,0,''("/&+,)!3(&,)4'( ;(MR"(',.(R"+@,+("/&+,)!3(1+"- 6"( "/&( %#&"( &3,( '&+,,&'( )#*( 6+)44,'-( G"!/'%#6( "#( +,*/- *,0%2,+(1+,2,#&%"#(4,'')6,'( !%#6(&3,(+%'@'()''"!%)&,*(R%&3( %#(,4,+6,#!>('3,0&,+'("+(%#(&3,(

1+,4%','("G("&3,+("+6)#%')&%"#': ;(A#,(1+"X,!&(R%&3(*+/6(/',+'( `IHP8(1+"6+)44,a(*,0%2,+'(%#*%2%*/)0(,*/!)&%"#)0(',''%"#'-( V"&3(&3,"+,&%!)0()#*(1+)!&%!)0-( R3%0,(&3,(/',+(/','(&3,(1+"*/!&( %#(&3,(R)>('l3,(#"+4)00>(*",':

» The 23,185 service users attending the pilot programmes HEALTH PROBLEMS

» HIV/AIDS, hepatitis B and C, sexually transmitted infections, tuberculosis FUNDING

» Ministry of Health, Doctors of the World’s own funds

DOCTORS OF THE WORLD

BUDDYING CHILDREN IN HOSPITALS

ANNUAL REPORT 2010

» PROGRAMMES IN FRANCE

Many children, often from disadvantaged backgrounds, from France and elsewhere in the world, are admitted to hospitals in and around Paris for conditions that cannot be treated closer to home. Not all of these children can be accompanied by their parents. The Buddying Programme volunteers aim to ease the difficulties caused by this separation. The importance of the volunteers’ presence is recognised. The buddying programme has also been operational in French Guiana since it began.

Supporting sick and isolated children

» PARIS AND THE PARISIAN REGION, FRENCH GUIANA

» ACTIVITIES Since 1988, the buddying programme has supported nearly 2,000 isolated children while they were in hospital, including around 300 in French Guiana. M"(3,01(!3%0*+,#(&"(*,)0(R%&3(&3,('"0%&/*,()#*('/GG,+%#6(V,&&,+- the buddying must be set up as quickly as possible, as an ‘emergency programme.’ Three visits a week are essential to establish a structured relationship with the child, which will, in turn, help him or her to overcome hospitalisation. ?+,2,#&%"#j'(%&!2"?2-77%&-+7*&'"&7+#+7+*%&!*L3(";"?+3-;&!2"4;%7*&3-1*%$&4L&1#6;;%$&%7"'+"nal needs and the abrupt separation from parents. J/11"+&jthe children are supported throughout their hospital stay, sometimes moving from one 5-3+;+'L&'"&-#"'(%2<&(%;!+#?&'(%7&'"&6#$&'(%&2%*"123%*&>+'(+#&'(%7*%;=%*&'"&3"!%&>+'(&'(%+2&+;;#%**/ M3,(1+"6+)44,U'(2"0/#&,,+'()0'"(3,01(&"(4)%#&)%#(0%#@'-(and sometimes to help restore damaged relationships, with parents. Sadly, in 15% of cases, the volunteers accompany the child to the end of his or her life. The complementary support provided by volunteers and by healthcare *'-55&2%+#5"23%&"#%&-#"'(%2&-'&*13(&$+5631;'&'+7%*/

» OUTLOOK Carrying out a review on ‘relay buddies’ when parents are present; provision of IT equipment for 3(+;$2%#&'"&5-3+;+'-'%&3"771#+3-'+"#&>+'(&'(%+2&5-7+;+%*&Al+=%#$+&*1!!"2'@n&2%*%-23(&"#&#%>&("*!+'-; partners.

» RANGE OF SERVICES ;(M3+,,(2%'%&'()(R,,@(&"(!3%0*+,#-( %#!0/*%#6( "#,( R,,@,#*( 2%'%&:(M3,('!3,*/0,()#*(0,#6&3( "G(2%'%&'(*,1,#*'("#(&3,(!3%0*U'( )6,()#*(4,*%!)0(!"#*%&%"#: ;(?"&,#&%)0("/&%#6'(R3,#(&3,( !3%0*(%'(R,00(,#"/63:

;(Q!!"41)#>%#6(!3%0*+,#(R3,# &3,>(+,&/+#(3"4,-(%G(+,F/,'&,*( V>(&3,(4,*%!)0(&,)4: Volunteer recruitment and training is carried out by Doc&"+'("G(&3,(O"+0*:(9"0/#&,,+

( G"00"Rh/1( %'( !)++%,*( "/&( V>( 2"0/#&,,+(!"h"+*%#)&"+': K%'!/''%"#(6+"/1'()+,("+6)#%',*(%#()00(&3,(10)!,'(R3,+,( 2"0/#&,,+'(R"+@(`R%&3('/11"+&( from the Fondation de Francea:

NUMBER OF CHILDREN BUDDIED IN 2010

» 180 » In the Parisian region: BZd » In French Guiana: 45 NUMBER OF VOLUNTEERS

» 108 » In the Parisian region: 91 » In French Guiana: Be COUNTRY OF ORIGIN

» France (French Guiana, Réunion, Mayotte, Antilles), Africa, North Africa PARTNERS

» In Île-de-France: Paris hospitals: Necker Sick Children’s Hospital, Armand-Trousseau Hospitals, Robert-Debré Hospital, SaintLouis Hospital, Édouard-Rist medical and educational clinic. Centres in the Parisian region: Centre des Côtes - Les Logesen-Josas, Margency Children’s Hospital, the French Red Cross, Bullion paediatric and rehabilitation hospital, PaulParquet Foundation-Neuillysur-Seine, Montreuil medical centre for young children » In French Guiana: Andrée-Rosemon hospital, Cayenne

108

ACTION AND ADVOCACY

DOCTORS OF THE WORLD ANNUAL REPORT 2010

CONTENTS 110

January- February

> CLICK HERE

111

March

> CLICK HERE

112

April

> CLICK HERE

113

May

> CLICK HERE

114

June

> CLICK HERE

115

July

> CLICK HERE

116

August – September

> CLICK HERE

118

October

> CLICK HERE

119

November

> CLICK HERE

120

December

> CLICK HERE

109

110

JANUARY

FEBRUARY

Haiti emergency

Dunkirk, programme with migrants

Sudan

KEY EVENTS

AND ALSO…

KEY EVENTS

2$34$567869:

2$33$567869:

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Q( *,2)'&)&%#6( ,)+&3F/)@,( 3%&'( 7)%&%-( leaving 250,000 dead, 300,000 injured and making 1.3 million homeless. Doctors of the World immediately sends an emergency team of doctors, surgeons, nurses, ;"?+*'+3*& %H!%2'+*%/& G(%& '%-7& ?-=%& 62*'& aid and performed operations and also assessed needs that were not being met. Mobile clinics also gave consultations in Port-au-Prince and Cité-Soleil.

J/11"+&(G"+(QG63)#'(%#(?)+%'=()(6+"/1( "G(L[A'(`%#!0/*%#6(S*Sa(!)00'(G"+()( 0"#6h&,+4( 3"/'%#6( '"0/&%"#:( In response to the cold snap that hit Paris, MdM and other organisations set up temporary accommodation to house Afghan refugees in Paris. Following the closure of the Sangatte centre and the ‘jungle’ in Calais, there are around 150 people who are excluded from any support.

N"00"R%#6( 3,)2>( 563&%#6( %#( &3,( D,V,0( S)++)( +,6%"#-( which led to more than 100,000 people being displaced, MdM has been forced to scale back its activities in Darfur. Access to care is endangered by large-scale looting in the healthcare centres. MdM calls for the key players in '(%&3"#)+3'&'"&2%*!%3'&-#$&!2"'%3'&'(%&$+*placed population. Working in the region since 2008, MdM has set up programmes to improve access to primary care.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

MARCH

Yemen

Photographic exhibition

Maquila in Guatemala

AND ALSO…

KEY EVENTS

2$;$<=>9869:

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2$C$@69DE

J%#!,( CEE^-( &3,( #"+&3( "G( m,4,#( 3)'( R%&#,'',*()(+,h%6#%&%"#("G(&3,(!"#$%!& between the Houthi rebels and the ?"=%2#7%#'/&G(+*&*+H'(&2"1#$&"5&3"#)+3'<& much more serious than it was previously, has heavily damaged the healthcare system: health centres and schools have been deliberately targeted.

I.3%V%&%"#l?)+%' The exhibition entitled Exil, Exit? uncovers the reality faced by undocumented migrants, thanks to case studies and photos taken by Olivier Jobard. They document the living conditions, the journey and health status of some of the most excluded and discriminated against people in Europe.

A#(8#&,+#)&%"#)0(O"4,#U'(K)>- MdM highlights the violence suffered by women working in textile and agribusiness factories in Guatemala. MdM calls for the factories, and the French companies they work with, to respect workers’ rights. MdM teams have been working since 2005 with workers in 16 factories in Chimaltenango and Sacatepéquez regions.

Those healthcare professionals who 3"1;$&(-=%&)%$&'(%&3"#)+3'/&O$O&*%'&1!& two programmes to care for 250,000 displaced people. Mobile units were sent to the outskirts of Saada and Hajjah to offer medical consultations to displaced people. MdM is also supporting clinics in the villages.

?/V0%!)&%"#("G(&3,(7/4)#%&)+%)#( Review: Should humanitarianism be de-westernised?

111

112

APRIL

Microcredit and reproductive health programme, Nepal

Photographic exhibition

Mayotte

KEY EVENTS

AND ALSO…

2$I$6F9GH$$

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2$3 APRIL

M"( 4)+@( O"+0*( 7,)0&3( K)>-( Doctors of the World showcases its microcredit and reproductive health project in Nepal. This project perfectly illustrates the Failing to help vulnerable mothers campaign launched by Oxfam, Doctors of the World and Action for Global Health. The campaign runs from March to September 2010 in the run up to the New York MDG Summit, and calls for French policymakers to uphold the commitments they signed up to with respect to access to care for mothers and children.

I.3%V%&%"#l?)+%' The exhibition Women, the aftermath of violence. A sound and photography exhibition that forms part of MdM’s efforts to combat violence against women and '"&6#$&!"**+4;%&*";1'+"#*/&G(%&!("'"?2-pher Lâm Duc Hiên collected audio and video recordings of seven women, who had been affected by violence, whom he had met through MdM’s programmes. Following the exhibition, in co-production with Chêne publishers, MdM published a diary to support the women. The diary contains photos of the women -#$&2%)%3'+"#*&"#&'(%+2&!;+?('&4L&*%=%#& well known female personalities.

K"!&"+'( "G( &3,( O"+0*( 3%630%63&'( &3,( *+)4)&%!( '%&/)&%"#( %#( S)>"&&,-( )G&,+( the authorities were called in for ques&%"#%#6(V>(&3,(7QPKI(`7%63(Q/&3"+%&>( Q6)%#'&( K%'!+%4%#)&%"#( )#*( ?+"4"&%#6(IF/)0%&>a:&G(%&CKg9Y&3"#627*&'(%& discrimination and serious infringements to the right to health, which had been taken up by MdM and other groups working in Mayotte for many years. Almost a third of the population has no medical cover and no access to care except in emergencies. In order to improve access to care for the least well off, and in particular children, MdM opened a centre for paediatric care in Koungou shantytown in December 2009.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

MAY

Niger

Palestinian Territories

Opération Sourire programme in Mongolia

AND ALSO…

KEY EVENTS 2$4J$@6:

2$K3$@6:

8#(+,'1"#',(&"(G""*(%#',!/+%&>(%#(&3,( J)3,0( +,6%"#-( Doctors of the World launches two programmes to fight malnutrition. In Niger, MdM launches a programme of prevention and health3-2%&5"2&3(+;$2%#&1#$%2&6=%/&M#&U(-$<&'(%& organisation sets up an access to care programme in 20 clinics in the Mao district, in the north-west of the country.

Doctors of the World condemns the 0%2%#6(!"#*%&%"#'(%#(&3,([)f)(J&+%1(and calls for the immediate lifting of the blockade. Numerous medical treatments are unavailable in the Gaza strip due to the blockade and the resulting shortages. It also affects medical professionals who -2%&1#-4;%&'"&4%#%6'&52"7&X1-;+'L&'2-+#+#?& within or outside the Gaza Strip.

20 years of Opération Sourire Founded in 1990, Opération Sourire celebrates its twentieth year. This mission gives back a smile to those who (-=%& 4%%#& $+*6?12%$& 4L& +;;#%**& "2& 7-;nutrition, enabling those previously excluded by their disability to reintegrate into society. Since its creation, more than 7,000 patients have been treated thanks to 25 programmes in eight countries (Bangladesh, Benin, Cambodia, Chad, O-$-?-*3-2<&O-;+<&O"#?";+-&-#$&b+?%2@/

113

114

JUNE

Advertising campaign

Round table discussion

Harm reduction programme in Marseille

KEY EVENTS

AND ALSO…

2$KBTH ANNIVERSARY

2$L$587=

2$4;$587=

N"+( %&'( ZEth( )##%2,+')+>-( S*S( /#2,%0,*( %&'( #,R( 1/V0%!%&>( !)41)%6#( We are all Doctors of the World: Created by Saatchi & Saatchi, the campaign comprises four posters and two videos shown on the internet, television and in the cinema. The campaign focuses on donors and features four major priorities: CMl&!2%=%#'+"#<&6?('+#?&=+";%#3%&-?-+#*'& women, helping migrants and emergency response. In partnership with Dailymotion and Capa, a video competi'+"#&>-*&-;*"&(%;$&-#$&6=%&>+##%2*&>%2%& selected in September.

A0%2%,+( \,+#)+*( %'( +,h,0,!&,*( G"+( )( ',!"#*( &,+4( )'( 1+,'%*,#&( )&( S*SU'( [,#,+)0(Q'',4V0>: Head of the Paediatric Department of the Aubagne Hospitial AZ"13(%*I$1Id(s#%@<& '(%& `Q& L%-2& ";$& doctor joined Doctors of the World in 2000 as medical co-ordinator in Kosovo and then Guinea.

M3,( L)&%"#)0( 8#'&%&/&,( "G( 7,)0&3( )#*( S,*%!)0(H,',)+!3(`8LJIHSa(1+,',#&'( )( 1)1,+( "#( 3)+4( +,*/!&%"#( )4"#6'&( *+/6(/',+':(There is a particular focus on the upsurge in hepatitis C cases in this population. Doctors of the World calls for the immediate publication of the report and a rapid roll-out of its recommendations.

K"!&"+'( "G( &3,( O"+0*( "+6)#%','( )( round table entitled Humanitarians and partners: a new order? where our partners were given the chance to talk about '(%+2& !2"N%3'*<& $+5631;'+%*& -#$& ("!%*& 5"2& the future.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

JULY

Roma camp, Marseille

London to Paris bike ride

Humanitairian Review

KEY EVENTS

AND ALSO…

2$KB$58H:

2$<9?@$43$A?$4;$58H:$4B3B

L%!"0)'(J)+@"f>U'('1,,!3(%#([+,#"V0,( G/+&3,+( '&%64)&%','( H"4)( 1,"10,: Roma people in France are being repeatedly evicted, interrupting medical follow up and hindering the work of organisations that support them. The result is limited vaccinations, lack of care during pregnancy or for long-term conditions— Roma people are paying for this policy with their health. MdM has been working with this population for 17 years.

5th London to Paris +%*,: Publication of the HumaAfter three days of hard work covering nitarian Review: The 318 km, the participants arrived in Paris. future of humanitarianism. The event, organised by MdM UK and MdM France, has several aims: to raise funds, to spread the word about MdM’s work and to bring together like-minded people who want a sporting challenge at the same time as promoting the cause. In 2010, they raised 70,000 euros.

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AUGUST

SEPTEM

Displaced people in Pakistan

Programme in Papua

Destruction of the jungle

KEY EVENTS

2$33$68O8MA$$

2$N$68O8MA

2$44$M=FA=@>=9

M"++,#&%)0( +)%#( 3%&'( ?)@%'&)#-( V+%#6%#6($""*'()!+"''(&3,(!"/#&+>: MdM comes to the aid of thousands of victims, re-establishing access to drinking water and food in KPK district. The organisation also sets up mobile clinics—offering medical consultations, prevention, treatment and vaccinations—in Nowshera and Charsadda districts. MdM has been in the KPK zone for a year giving aid to the population displaced as a conseX1%#3%&"5&'(%&3"#)+3'&4%'>%%#&'(%&G-;+ban and the Pakistani army.

A#( 8#*%6,#"/'( ?,"10,U'( K)>-( MdM publishes a report into access to care for the forgotten people of Indonesia, the Papuans. Touched by major epidemics like HIV, the Papuan people suffer from a cruel lack of access to healthcare. MdM criticises the Indonesian healthcare system that is not adapted to local realities, and rolls out an awareness campaign integrating Papuan traditions.

A#( CC( J,1&,4V,+( CEE^-( &3,( <)0)%'( TX/#60,U( R)'( *%'4)#&0,*:( A year on, Doctors of the World, along with a group of other organisations, takes stock of the situation. The number of migrants has decreased due to a repressive policy which blocks access to care for undocumented people. There has been ongoing harassment by the police, systematic destruction of shelters, and even of material belonging to NGOs (on 30 July the water tank set up by MdM in Dunkirk >-*&$%*'2"L%$@/

DOCTORS OF THE WORLD ANNUAL REPORT 2010

BER

For access to healthcare without discrimination

Flash mob for the Failing to help vulnerable mothers campaign

DVD, CD-Rom

AND ALSO… 2$3;$M=FA=@>=9

2$3C$M=FA=@>=9

P)/#!3( "G( )( I/+"1,)#( *,!0)+)&%"#( towards non-discriminatory access &"(3,)0&3!)+,:(In an environment where access to care, particularly for undocumented migrants, is deteriorating, Doctors of the World and the European network, HUMA, calls on healthcare professionals, organisations and healthcare organisations to sign a European Declaration for Non-discriminatory Access to Healthcare.

N+"4( CE( &"( CC( J,1&,4V,+( &3,( S%00,##%/4( K,2,0"14,#&( [")0'( J/44%&( %'( 3,0*(%#(L,R(m"+@:(The team behind the campaign entitled Failing to help vulnerable mothers& "2?-#+*%*& -& )-*(& 7"4& '"& highlight to the French President, Nicolas Sarkozy, the problem of maternal mortality around the world. This event, organised on 18 September at the Trocadéro, marked the end of the campaign. More than 10,500 people signed the petition that was presented to the French president before he left for New York.

S*S( !+,)&,'( )#( ,*/!)&%"#)0( &""0( G"!/',*("#(!%&%f,#'3%1: We care for those people that the world is gradually forgetting was produced for teachers working with primary school pupils. The curriculum enables the students to learn about solidarity, fundamental rights and the right to health. It includes a CD-Rom, a DVD and ready-to-use workshops.

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OCTOBER

International Day for the Eradication of Poverty

Conference on gender-related violence

Humanitarian Review

KEY EVENTS

AND ALSO…

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2$33$?DA?>=9

A#( &3,( )##/)0( 8#&,+#)&%"#)0( K)>( G"+( &3,( I+)*%!)&%"#( "G( ?"2,+&>-( K"!&"+'( "G( &3,( O"+0*( 1/V0%'3,'( &3,( +,1"+&( "G( %&'(AV',+2)&"+>("#(Q!!,''(&"(7,)0&3!)+,: This worrying assessment, based on the data gathered in our clinics in France, condemns the deterioration in health status of our patients, which can be explained in part by security and immigration policies that further target vulnerable people. Between 2007 and 2009, MdM recorded a two-fold increase in delays in seeking healthcare, an increase of 17% in the number of consultations provided and a 30% rise in consultations for children.

<"#G,+,#!,( )&( &3,( N+,#!3( L)&%"#)0( P%V+)+>: Doctors of the World organises a symposium entitled After the evidence, ways to *.#"' .)(,)589/&),' 0$1+)(%). It brought together a number of professionals to discuss gender-based violence, giving them the opportunity to exchange their %H!%2+%#3%*&-#$&6#$&*";1'+"#*/&K&1#+=%2sal problem spanning many different scenarios, the phenomenon is an undeniable human rights violation and a real public health concern.

Publication of the Humanitarian Review: Partnership: towards co-operation without compromise.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

NOVEMBER

Haiti, cholera emergency

Webdoc Life in a Bag

KEY EVENTS 2$4$7?P=@>=9

2$4L$7?P=@>=9

N)!,*( R%&3( &3,( 6+"R%#6( !3"0,+)( ,1%*,4%!( &3)&( 3%&( 7)%&%-( K"!&"+'( "G( &3,( O"+0*( '&,11,*( /1( %&'( 1+"6+)44,'starting up prevention activities, setting up cholera treatment units and cholera treatment centres. Whilst the work of humanitarian organisations such as Doctors of the World remains essential and necessary, it must not replace the central role of the Haitian state and international donors. Accordingly, MdM calls for the promised reconstruction to be carried out. Because if this does not happen, Haiti is at risk of a second earthquake, this time economic, social and political.

Webdoc entitled Life in a Bag( 1+"*/!,*( V>( &3,( <)1)( Q6,#!>( G"+( Doctors of the World’s thirtieth anni2,+')+>:( This webdoc follows the lives of four people who have been helped by MdM in France, through the objects found in their bag. Diane Grimonet, photographer, Solveig Anspach, Director, and Karima Hamzaoui, journalist, took part in this project.

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DECEMBER

Rapid testing

Healthcare and Advice Clinic

Humanitarian Review

KEY EVENTS

AND ALSO…

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A#( O"+0*( Q8KJ( K)>-( MdM sets up rapid testing in its Saint-Denis clinic. The Health Ministry had published, some days before, new rules permitting the use of rapid testing. This test enables the !-'+%#'&'"&6#$&"1'&'(%+2&*'-'1*&+#&TE&7+nutes from a simple drop of blood from -&6#?%2/&G(+*&3(-#?%&+#&'(%&21;%*&*("1;$& mean that the most vulnerable people, particularly undocumented migrants, can access testing more easily.

8#( CEBE-( &3,( 6"2,+#4,#&( 2"&,*( &"( %#&+"*/!,( )( ZE( ,/+"( ,#&+>( !3)+6,( &"( )!!,''(&3,(J&)&,(S,*%!)0(Q%*('!3,4,: State Medical Aid is the medical cover granted to undocumented migrants living on under 634 euros per month and who can prove they have been in the country for over three months. This new measure, which is due to come in to force in March 2011, is a real backwards step in access to care for undocumented migrants. It may have extremely detrimental effects for undocumented migrants and public health.

Publication of the Humanitarian Review: Haïti, leaving aid dependence behind?

DOCTORS OF THE WORLD ANNUAL REPORT 2010

REGIONAL DELEGATIONS CONTENTS H,6%"#)0(*,0,6)&%"#'

> CLICK HERE

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Alsace

> CLICK HERE

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Aquitaine

> CLICK HERE

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Corsica

> CLICK HERE

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Franche-Comté

> CLICK HERE

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Île-de-France

> CLICK HERE

128

Languedoc-Roussillon

> CLICK HERE

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Lorraine

> CLICK HERE

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Midi-Pyrénées

> CLICK HERE

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Nord-Pas-de-Calais

> CLICK HERE

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Normandy

> CLICK HERE

134

Indian Ocean

> CLICK HERE

135

Provence-Alpes-Côte d’Azur

> CLICK HERE

136

Loire

> CLICK HERE

137

Poitou-Charentes

> CLICK HERE

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Rhône-Alpes-Burgundy

> CLICK HERE

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REGIONAL DELEGATIONS In 2010, the responsibilities of the 15 regional delegations of Doctors of the World were extended. With responsibility for directing and carrying out MdMâ&#x20AC;&#x2122;s work in their geographical areas, these delegations ensure that our strategy meets local needs.

Q6)%#'&( )( V)!@*+"1( "G( 3,)0&3( )#*( '"!%)0( !3)#6,'(`&3,(7"'1%&)0h?)&%,#&'h7,)0&3hM,++%&"+%,'(0)R-(,'&)V0%'34,#&("G(+,6%"#)0(3,)0&3( )6,#!%,'(,&!:a(&3,(+,6%"#)0(*,0,6)&%"#'(3)2,( 3)*( &"( )*)1&( %#( "+*,+( &"( )'',''( &3,( !3)00,#6,'()#*(G/&/+,(1+%"+%&%,': That is why the regional boards drafted a project to enable them to develop their political stance and activities.

Health Conferences and is involved in various groups, including, among others, the Roma collective and the health and poverty network. The regional delegations have been able to raise awareness among future health professionals and the general public through presentations in schools, participation in medical, paramedic and GP training and involvement in the Health and Deprivation university diploma.

The delegations organised volunteer training and carried out communication activities through fesDoctors of the World is keen to reinforce this tivals, events and exhibitions, such as Exil, Exit. regional perspective and aims, therefore, to The regional branches rolled out national cam- support domestic programmes, to develop parpaigns on themes such as healthcare access tnerships with local institutions (particularly for "563%*<& (%-;'(& -#$& ("1*+#?& "2& 7%#'-;& (%-;'(/& 2%?+"#-;;LI7-#-?%$&+#'%2#-'+"#-;&!2"N%3'*@&-#$& They also jumped into action to defend access to maintain links with our members and donors to healthcare for vulnerable groups, by orga- *"&'(-'&>%&3-#&3"#'+#1%&5"2&6?('&5"2&-33%**&'"& nising petitions and by getting in touch with healthcare for all. politicians. As an important player in regional affairs, Doctors of the World is represented in the Regional

DOCTORS OF THE WORLD

QPJQ<I

ANNUAL REPORT 2010

» REGIONAL DELEGATIONS

CONTACT

» 24, rue du Maréchal-Foch 67000 Strasbourg Tel: 03 88 14 01 00 Fax: 03 88 14 01 02 alsace@medecinsdu monde.net REGIONAL BOARD

» Representative: Q#*+i(<0)2,+& » Secretary: S)+%,hP/!,(Q+V"6)'& » Treasurer: J"13%,(?> » Other board members: <3)#&)0(\%'!3"GG-(N,+#)#*( D,30-(H"'%#,(P,&&,-(9%#!,#&( Schneider » Delegation secretary: m)'4%#)(N,+!3%"/ » Number of members: eZ » Number of volunteers: BZE PROGRAMMES

» Adoption programme in Strasbourg » Outreach programmes (Roma project - homelessness programme) in Strasbourg » Healthcare and Advice Clinic in Strasbourg

» ACTIVITIES

» PUBLICITY EVENTS AND ACTIVITIES

k&G(%&C%-;'(3-2%&-#$&K$=+3%&U;+#+3&+*&+#32%-*+#?;L&5"31*+#?& on individual support to help people access their rights and mainstream health services. This includes physically accompanying people, where necessary. k&M#=";=%7%#'&+#&'(%&K;*-3%&d%?+"#-;&U"#5%2%#3%&"#&C%-;'(& and Independence, the prevention commission, the users’ commission and the poverty platform. k&M#=";=%7%#'&+#&'(%&*'%%2+#?&3"77+''%%&5"2&'(%&9+*'2+3'&J"cial Cohesion Division’s winter plan. k& M#=";=%7%#'& +#& '(%& Health and Deprivation university diploma in partnership with Strasbourg University, teaching the optional course modules on humanitarian medicine and migration and health. k&M#=";=%7%#'&+#&'(%&*'%%2+#?&3"77+''%%&5"2&'(%&(%-;'(3-2%& -33%**&"563%*&-'&J'2-*4"12?&-#$&Y*3-;%&J-+#'Il+#3%#'&("*pitals. k& M#=";=%7%#'& +#& '(%& N"+#'& ,2%5%3'12%IUMOK9YIO$OIUKSAS working group on the study of people ordered to leave France. k&O%74%2*(+!&"5&'(%&4"-2$*&"5&Alsace Migration Santé and of Humanis.

k&02?-#+*-'+"#&"5&-#&"!%#&$-L&+#&b"=%74%2&DEQE/ k&,-2'+3+!-'+"#&+#&-&3"#5%2%#3%&"#&DE&03'"4%2&DEQE&-'&'(%& Council of Europe on the subject of Unaccompanied minors: what protection in Europe? k&,2%*%#'-'+"#*&"#&The different faces of humanitarian medicine and Roma health issues during the 17th emergency meeting organised by the emergency services in November 2010.

» PARTNERSHIPS k&M#=";=%7%#'&+#&'(%&>"2.&"5&'(%&d"7-&-#$&G2-=%;;%2*&9+=+*+"#& of the Council of Europe. k&O%74%2&"5&'(%&*'%%2+#?&3"77+''%%&-#$&3"I3(-+2+#?&"5&'(%& mental health group. k&02?-#+*-'+"#&"5&*%7+#-2*&+#&!-2'#%2*(+!&>+'(&'(%&7%$+3-;& faculty, the European Centre for Teaching and Research on Ethics and the Political Studies Institute. k& G(%& -$"!'+"#& !2"?2-77%& (-*& $%=%;"!%$& 2%;-'+"#*(+!*& with four general councils and the organisation Enfance et Familles d’adoption.

124

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» REGIONAL DELEGATIONS

CONTACT

» 2 rue Charlevoix-de-Villers 33300 Bordeaux Tel: 05 56 79 13 82 Fax: 05 56 52 77 69 aquitaine@medecins dumonde.net PAU BRANCH

» 12 rue des Alliés 64000 Pau Tel: 05 59 83 74 28 caso.pau@medecins dumonde.net BAYONNE BRANCH

» Centre hospitalier de la CôteBasque - BP 8 64109 BAYONNE Cedex Tel: 05 59 44 31 05 raves.bayonne@medecins dumonde.net PROGRAMMES

» Adoption project in Bordeaux » Rave project in Bayonne » Squat and ill migrants programme in Bordeaux » Roma project in Bordeaux » Healthcare and Advice Clinics in Bordeaux and Pau REGIONAL BOARD

» Representative: N+)#n"%'(<"/6"/0 » Secretary: 9i+"#%F/,(P)&"/+ » Treasurer: Q0)%#(\"+6#, » Other board members: Q+@)%&f(Q6/,++,&.,h<"0%#)-( N)V%,##,(N)2)+,0h[)++%6/,'-( S)+!(S%6#"##)&-( Arnaud Wiehn » Delegation secretary: S)+%,h<3+%'&%#,(<3)/2,)/ » Number of members: BB^ » Number of volunteers: 150

» ACTIVITIES k&d%!2%*%#'-'+"#&"#&'(%&KX1+'-+#%&2%?+"#-;&(%-;'(&-#$&+#dependence conference and the Gironde regional health agency conference. k&,-2'+3+!-'+"#&+#&ONG Conseil’s training for fundraisers. k&g-1#3(&"5&'(%&1#+=%2*+'L&$+!;"7-&"#&Health, Deprivation and Solidarity at Bordeaux-2 University. k&0#?"+#?&'%-3(+#?&"#&(17-#+'-2+-#&7%$+3+#%&-#$&(%-;'(& and deprivation in the third cycle of the general medicine curriculum. k&,2%*%#'-'+"#*&"#&(17-#+'-2+-#&7%$+3+#%&-'&Z"2$%-1H&-#$& Agen universities. k&B%;3"7+#?&'2-+#%%*<&+#3;1$+#?&*'1$%#'&#12*%*&-#$&$"3tors, as well as IUT, IRTS and University students. k&G>"&!2%!-2-'"2L&7%%'+#?*&"#&!-2%#'+#?&-#$&-&!+3#+3&'"& bring together current and future adoptive families.

» INTERNATIONAL PROGRAMME k&G(%&2%?+"#-;;LI7-#-?%$&+#'%2#-'+"#-;&!2"?2-77%&+#&b+3-ragua ended in September 2010, but the work will continue. All of the district medical and paramedical staff have been trained to screen for pre-cancerous lesions in the cervix.

» PUBLICITY EVENTS AND ACTIVITIES k&K#&"!%#&$-L&'"&(%;!&2%321+'&#%>&=";1#'%%2*/ k&,-2'+3+!-'+"#&+#&Gironde International Human Rights Film Festival. k&K2'&%H(+4+'+"#&-#$&*-;%&5"2&C-+'+/ k&9+*31**+"#&-'&*32%%#+#?&"5&G"#L&\-';+5P*&6;7&Liberté, with debate on the question What place for Roma migrants in European cities? in partnership with Bordeaux city council and other organisations. k&9+*31**+"#&%=%#+#?&"#&What place for Roma migrants in our urban areas? in collaboration with the Roma collective in the greater Bordeaux area. k&9"3'"2*&"5&'(%&B"2;$&*'-#$&-'&'(%&#-'+"#-;&#"'-2L&3"#5%2%#3%& in Bordeaux. k&G%;%=+*+"#&2%!"2'*&5"2&'(%&M#'%2#-'+"#-;&9-L&5"2&'(%&Y2-$+3-'+"#&

"5&,"=%2'L&"#&d"7-&A_2-#3%&D@<&-'&Z"2$%-1H&C%-;'(3-2%&-#$& K$=+3%&U;+#+3&"#&-33%**&'"&(%-;'(3-2%&5"2&3(+;$2%#&AG_Q@&-#$&6=%& 2%!"2'*&"5&*%=%#&7+#1'%*&%-3(&Ad"7-&-#$&'(%&3;+#+3@&42"-$3-*'& as part of the Magazine de la santé, on France 5.

» PARTNERSHIP

Partnership agreement with Unis-Cité.

DOCTORS OF THE WORLD

<AHJ8<Q

ANNUAL REPORT 2010

» REGIONAL DELEGATIONS

CONTACT

» Résidence Monte-Cinto 22, rue du Dr-Dell-Pellegrino 20090 Ajaccio T*/['AaVYbV>AV@bVaY corse@medecinsdumonde.net PROGRAMMES

» Healthcare and Advice Clinic in Ajaccio » Homelessness project in Ajaccio REGIONAL BOARD

» Representative: position vacant » Secretary: position vacant » Treasurer: Jean-Pierre Luciani » Other board members: <)&3,+%#,(<"#&"%'-(N+)#n"%'( ?,+#%#-(N+)#n"%'(o/%0%!3%#%-( 8')V,00,(J,+)%# » Number of members: 26 » Number of volunteers: 25

» ACTIVITIES

Healthcare and Advice Clinic Free clinic on Fridays for the most vulnerable groups with a volunteer team of health professionals, receptionists, social workers and psychologists, to help people access healthcare and to accompany service users in the process of accessing their rights. Outreach consultations in partnership with the Federation of Secular and Continuous Education Associations (FALEP in its French acronym). MdM provides doctors and nurses for the medical compo#%#'&"5&'(%&>"2.<&>(+;%&_KgY,&'-.%*&3-2%&"5&'(%&6#-#3+-;&-#$& social activities. P&0*).(#R$ !"S.&#$ S&T&#,-)(.-)U$ +&,R$ /UV.-)U$ "WS0*sion (CLE in its French acronym) k&O$O&+*&+#=";=%$&+#&'(%&UgY/ k& O$O& =";1#'%%2& *%**+"#*& +#& -& #+?('& *(%;'%2& "!%#& $12+#?& the winter. k&K#&-#-;L*+*&"5&+**1%*&2%;-'+#?&'"&?2">+#?&$%!2+=-'+"#&-#$&+#& preparation for implementing projects with potential partners A-&;"#?I'%27&#+?('&*(%;'%2@/

» PARTNERSHIPS k&U"#*1;'-'+"#*&-'&'(%&3;+#+3&$%!%#$&"#&-&>+$%&#%'>"2.&"5& partners: pharmacists, dentists, insurers, nurses and hospitals. k&K?2%%7%#'&'"&2%5%2&!%"!;%&>+'(&!*L3(+-'2+3&!2"4;%7*&'"&-& !*L3(+-'2+3&"1'2%-3(&!2"N%3'&5"2&!%"!;%&+#&$+5631;'L/ k&9+*31**+"#&-#$&%H3(-#?%&>+'(&;"3-;&=";1#'-2L&*%3'"2&!-2tners. k& \2-#'*& 52"7& '(%& 2%?+"#-;& !14;+3& (%-;'(& ?2"1!<& '(%& ;"3-;& (%-;'(&+#*12-#3%&"563%<&KN-33+"&U+'L&U"1#3+;&-#$&U"2*+3-#& local government.

» PUBLICITY EVENTS AND ACTIVITIES k&M#=";=%7%#'&+#&-$="3-3L&%=%#'*&+#&2%;-'+"#&'"&;"3-;&+#*'+tutions. k&C%-=L&+#=";=%7%#'&+#&'(%&!"=%2'L&*%3'"2/ k&,2%*%#'-'+"#&"5&'(%&$%;%?-'+"#P*&-3'+=+'+%*&-#$&!2"?2-77%*& on the local radio Alta Frequenza, which gives broadcast time to voluntary sector organisations.

126

NHQL<7Ih<ASMr » REGIONAL DELEGATIONS

CONTACT

» ACTIVITIES

» (e-(+/,(*/(P)#6/,*"!-( CdEEE(\,')#n"# M,0=(EZpcBpdBpC_pYe !)'":V,')#!"#q4,*,!%#' */4"#*,:#,&

Medical consultations at the Healthcare and Advice Clinics -#$&2%5%22-;*&'"&Z%*-#t"#&(%-;'(3-2%&-33%**&"563%/

REGIONAL BOARD

Publicity in local print media on MdM consultations in Besançon.

» Representative: D)!F/,'([/%&)+* » Secretary: 9%"0)%#,(P0"+!) » Treasurer: \,+#)+*(\)*,> » Other board members: r2,0>#,(P)6#%,# » Number of members: 15 » Number of volunteers: 10

» PUBLICITY EVENTS AND ACTIVITIES

» PARTNERSHIPS k& \%#%2-;& 3"1#3+;<& Z%*-#t"#& '">#& 3"1#3+;<& (%-;'(3-2%& -33%**&"563%&A,-**@/

DOCTORS OF THE WORLD ANNUAL REPORT 2010

sPIhKIhNHQL<I » REGIONAL DELEGATIONS

CONTACT

» 62, bis av. Parmentier 75011 Paris Tel: 01 48 06 63 95 Fax: 01 48 06 68 54 ile-de-france@medecins dumonde.net SAINT-DENIS BRANCH

» 8-10, rue des blés 93210 La Plaine-Saint-Denis Tel: 01 55 95 19 32 caso-saint-denis@medecins dumonde.net PROGRAMMES:

» Lotus Bus programme in Paris » Homeless programme in Paris » CAFDA programme in Paris » XBT programme in Paris » ERLI projects in Paris and Colombes » Roma programme in SaintDenis » Child lead poisoning programme in Saint-Denis » Buddying programme in Îlede-France » Rave and Squat programme in Île-de-France » Healthcare and Advice Clinics in Paris and Saint-Denis REGIONAL BOARD

» Representative: Jeanine Rochefort » Secretary: Denis Pedowska » Treasurer: Q0,.)#*+,(?,>+, » Other board members: J"5)(Q"/%!%-(8')V,00,(<3)V%#h[%V,+&-(D,)#([/,++%#%-( [i+)+*(?)'!)0 » Delegation secretary: P%',&&,(]"f%@%0) » Number of members: ZdZ » Number of volunteers: 400

» ACTIVITIES

» PARTNERSHIPS

k&g-1#3(&"5&'(%&!2"?2-77%&"#&%$13-'+"#&"5&'(%&2+*.*&-**"3+-'%$&>+'(&+#N%3'+"#&AYdgM@/ k&M7!;%7%#'-'+"#&"5&-&2%*%-23(I-3'+"#&!2"N%3'&"#&'(%&;+#.*& between poor housing and health problems. k& G(%& 7%#'-;& (%-;'(& >"2.+#?& ?2"1!& 3-22+%$& "1'& -& #%%$*& assessment on vulnerable groups affected by psychiatric problems. k&M#'%2#-;&%=-;1-'+"#&"5&'(%&d"7-&!2"?2-77%/ k&Y*'-4;+*(7%#'&"5&7"#'(;L&+#$13'+"#&7%%'+#?*&5"2&=";1#'%%2*/ k&,-2'+3+!-'+"#&+#&'(%&M;%I$%I_2-#3%&2%?+"#-;&(%-;'(&-#$&+#$%pendence conference and similar bodies in the region. k&d%!2%*%#'-'+"#&-'&'(%&QQth arrondissement town hall and in some COREVIH working groups (women, migrants, depri=-'+"#&-#$&-$$+3'+"#@/ k&M#=";=%7%#'&+#&'(%&,-2+*&(%-;'(3-2%&-33%**&"563%&A,KJJ@& collective and member of the steering committee for the national PASS conference in 2011. k&M7!;%7%#'-'+"#&"5&'(%&Health, Deprivation and Solidarity university diploma in René-Descartes - Paris-V University. k&,2%*%#'-'+"#*&+#&'(%&#12*+#?&'2-+#+#?&+#*'+'1'%<&*"3+-;&>"2.%2& schools and at CRIPS. k&G2-+#+#?&(%-;'(&7%$+-'"2*&Ad"7%12"!%I9\J&!2"N%3'@/ k&_-="12-4;%&2%!"2'&52"7&'(%&Comité de la charte.

k& G2-+#+#?& L"1#?& !%"!;%& 1#$%2'-.+#?& 3+=+3& *%2=+3%<& -'& '(%& request of Unis-Cité. k&02?-#+*-'+"#&"5&-&'2-+#+#?&-#$&+#5"27-'+"#&*%**+"#<&5-3+;+'-ted by COMEDE and CIMADE and at the request of COREVIH, on the rights of migrants living with HIV. k&Emmaüs, Samu social, Aurore, and the Red Cross for the university diploma. k&,-2+*&,KJJ&3";;%3'+=%<&QQth arrondissement council, COREVIH East.

» PUBLICITY EVENTS AND ACTIVITIES

k&M#=";=%7%#'&+#&O$OP*&Women, the aftermath of violence exhibition at the Hotel de Ville in Paris. k&,2%*%#'-'+"#&"#&(%-;'(&+#%X1-;+'+%*&'"&,-2+*&3+'L&3"1#3+;/ k&M#=";=%7%#'&+#&'(%&J";+$-2+'L&9-L*&"2?-#+*%$&4L&'(%&QQth arondissement council. k&,2%**&3"#5%2%#3%&+#&03'"4%2&5"2&!14;+3-'+"#&"5&'(%&2%!"2'&"5& MdM’s Observatory on Access to Healthcare. k&d%!2%*%#'-'+"#*&'"&'(%&M;%I$%I_2-#3%&2%?+"#-;&3"1#3+;&"#& Roma issues.

128

PQL[gIKA<hHAgJJ8PPAL » REGIONAL DELEGATIONS

CONTACT

» 18, rue Henri-Dunant 34090 Montpellier Tel: 04 99 23 27 17 Fax: 04 99 23 27 18 languedoc-roussillon@ medecinsdumonde.net PROGRAMMES

» Adoption programme in Montpellier » Prostitution programme in Montpellier » Healthcare and Advice Clinic in Montpellier » Dental project in Montpellier » Outreach work (mobile teams – Roma) in Montpellier » Rave project, in partnership with the Mediterranean harm reduction programme REGIONAL BOARD

» Representative: S)*>(S,+!%,+ » Secretary: ?)'!)0(Q#*+i » Treasurer: N+)#n"%',(D"/+*)# » Other board members: [/>(<+"'-(\+%6%&&,(K,( \0)#!3)+*-([%00,'(N"/!)/*-( <>+%0(D)/4, » Delegation secretary: S)6)0%(8V)#,f » Number of members: ^C » Number of volunteers: 115

» ACTIVITIES k&O$O&(-*&4%%#&+#=";=%$&+#&%*'-4;+*(+#?&'(%&d"7-&3";;%3'+=%/ k&G(%&$%;%?-'+"#&(-*&-;*"&-3'+=%;L&*1!!"2'%$&'(%&Health and Vulnerability Network. k&g-1#3(&"5&'(%&1#+=%2*+'L&$+!;"7-&"#&Health and Deprivation, >+'(&'(%&-22+=-;&"5&'(%&62*'&DE&*'1$%#'*/ k&Y*'-4;+*(7%#'&"5&-#&-$="3-3L&?2"1!&"#&J'-'%&O%$+3-;&K+$/ k&U2%-'+"#&"5&-&>"2.+#?&?2"1!&'"&+$%#'+5L&-&;"3-;&!2"N%3'/ k& J12=%L& "#& =+";%#3%& -?-+#*'& >"7%#& +#& '(%& %#=+2"#7%#'& around prostitution. k&Three training sessions on raves (on drug analysis, and on 2%-**12-#3%&5"2&1*%2*@&-#$&-#&%H3(-#?%&"5&!2-3'+3%*/

» PARTNERSHIPS

Medical faculty, District Department on Social Cohesion, regional conferences on health and independence, the Health and Deprivation collective, the Roma collective, MEP, AIDES and a harm reduction organisation.

» PUBLICITY EVENTS AND ACTIVITIES k&,-2'+3+!-'+"#&+#&'>"&2-$+"&!2"?2-77%*&AM#'%2#-'+"#-;&9-L& 5"2&'(%&Y2-$+3-'+"#&"5&,"=%2'L@/ k&g"3-;&Gl&!2"?2-77%&AM#'%2#-'+"#-;&9-L&5"2&'(%&Y2-$+3-'+"#& "5&,"=%2'L@/ k&,("'"&%H(+4+'+"#&"#&d"7-&5"2&Maison Tiers-Monde fortnight in Montpellier. k&,2%**&3"#5%2%#3%&-'&'(%&O$O&$%;%?-'+"#&AQR&03'"4%2@/ k&,2%*%#'-'+"#*&+#&7+$$;%&*3("";*&-#$&*%3"#$-2L&*3("";*<& nurse training institutes and the regional social work institute on Health and Deprivation.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

PAHHQ8LI » REGIONAL DELEGATIONS

CONTACT

» 5, rue de l’Armée-Patton 54000 Nancy Tel: 03 83 27 87 84 lorraine@medecins dumonde.net » Metz Branch 7 rue Clérisseau 57000 Metz Tel: 03 87 66 60 93 hc.metz@medecins dumonde.net PROGRAMMES

» Adoption programmes in Nancy and Metz » Outreach programme in Metz » Healthcare and Advice Clinic in Nancy » Outreach project in Nancy REGIONAL BOARD

» Representative: Q##,hS)+%,(O"+4' » Secretary: [i+)+*(7i0)' » Treasurer: S)+!(K)2%* » Other board members: Q##,hS)+%,(S)+!3,&&"-( N)V%,##,(J"44)!)0-( S)+%,h?)'!)0,(9,+*,#)0 » Delegation secretary: Aurore Romain » Number of members: 55 » Number of volunteers: 66

» ACTIVITIES k&M7!;%7%#'+#?&'(%&!;-#&$%=%;"!%$&>+'(&'">#&3"1#3+;*&-#$& the police department to house around 100 people from the Laneuveville Roma camp. k&,;-#*&5"2&-#&K$=+3%&-#$&\1+$-#3%&!2"N%3'&+#&K$"7-&*(%;'%2& in Essey-lès-Nancy. k&J%''+#?&1!&>"2.+#?&?2"1!*&5"2&'(%&2%?+"#-;+*-'+"#&!2"N%3'& AO%'h&-#$&b-#3L@/ k&A psychiatric needs assessment for a very vulnerable po!1;-'+"#&A+#&3"I"!%2-'+"#&>+'(&-&'2-+#%%&!*L3(";"?+*'@/ k&MdM once again became involved in the inter-university $+!;"7-&"#&%'(+3*&AC%#2+I,"+#3-2j&c#+=%2*+'L<&b-#3L@/ k&Analysis on the potential implementation of the university diploma on Health and Deprivation, in collaboration with Strasbourg University.

» INTERNATIONAL PROGRAMME Withdrawal from the regionally-managed international programme in Burkina Faso supporting mother and child health in Gnagna province after completion of the three year project. The activities included helping the population become more autonomous, building capacity amongst health pro5%**+"#-;*&2%)%3'+#?&#-'+"#-;&!";+3L&!2+"2+'+%*&-#$&+#=";=%7%#'& of management teams from the district.

» PUBLICITY EVENTS AND ACTIVITIES k& _1#$2-+*+#?& '(2"1?(& %=%#'*& *13(& -*& >-;.*<& ?";5& '"12#-ments. k&_+5'(&+**1%&"5&'(%&#%>*;%''%2&En passant par la Lorraine. k&,2%**&1!$-'%&5"2&'(%&M#'%2#-'+"#-;&9-L&5"2&'(%&Y2-$+3-'+"#& of Poverty on 17 October. k&02?-#+*-'+"#&"5&-&2"1#$&'-4;%&$+*31**+"#&Is there a future for humanitarian aid? k&l-2+"1*&+#5"27-'+"#&*%**+"#*&"#&O$O&+#&*3("";*&-#$&'2-+ning establishments. k&U"#5%2%#3%&"#&d"7-&+**1%*&$12+#?&g"22-+#%&7%$+3-;&>%%./

» PARTNERSHIPS

k&Annual participation in the Marché du Monde Solidaire. k& Involvement in the regional health and independence conference and the prevention working group of Lorraine Regional Health Agency. k& Establishing relationships with many organisations in Nancy and identifying areas for collaboration (social moni'"2+#?@/ k&Participation in the Roma network (voluntary sector and !14;+3&*%3'"2&!-2'#%2*@/

BZE

S8K8h?mHILIIJ » REGIONAL DELEGATIONS

CONTACT

» 5, boulevard de Bonrepos 31000 Toulouse Tel: 05 61 63 78 78 Fax: 05 61 62 04 15 midi-pyrénées@medecins du monde.net ALBI BRANCH

» Tel: 05 63 45 08 15 PROGRAMMES

» Adoption programme in Toulouse » Homeless programme in Toulouse » Harm reduction programme in Toulouse » Healthcare and Advice Clinic in Toulouse » Project in shelters in Toulouse » HIV, STI and hepatitis prevention project in Toulouse » Child lead poisoning project in Toulouse » Chechen project in Albi REGIONAL BOARD

» Representative: K+(7i0t#,(\"##,& » Secretary: K+(S)>)(P)1"+&,h9,+6#,' » Treasurer: K+(N0"+,#!,(H%6)0 » Other board members: N+)#n"%',(Q+!,0%#-([,#,2%t2,( [,#t2,-(<0)%+,(["+%'',-( J,+6,(P)!)# » Delegation secretary: 8')V,00,(S)0,& » Number of members: 84 » Number of volunteers: 180

» ACTIVITIES k&Y*'-4;+*(7%#'&"5&-&d"7-&J";+$-2+'L&3";;%3'+=%/ k&d%?1;-2&=+*+'*&'"&-&3-7!&"5&d"7-#+-#*&-#$&N"+#'&>"2.&>+'(& the Mother and Child Protection service and Haute-Ga2"##%&=-33+#-'+"#&-#$&'14%231;"*+*&*%2=+3%&A99lgKG@/ k& B"2.+#?& 7%%'+#?*& "#& -$="3-3L& "#& '(%& C%-;'(3-2%& -#$& Advice Clinic volunteers; information and training meetings for volunteers on various themes (raves, gaza, psychiatry -#$&=1;#%2-4+;+'L@n&7%%'+#?&'"&2%!"2'&4-3.&"#&"=%2*%-*&7+**+"#*&&A9%7"32-'+3&d%!14;+3&"5&U"#?"<&C-+'+@/ k&B"2.&"#&'(%&'(%7%&"5&(%-;'(&-#$&("1*+#?&-*&!-2'&"5&'(%& joint voluntary sector collective. k&J%''+#?&1!&7%%'+#?*&'"&!2%!-2%&!"'%#'+-;&-$"!'+=%&!-2%#'*& A62*'&2"1#$&"#&m'(%&7%%'+#?P&-#$&*%3"#$&2"1#$&"#&m-4-#$"#7%#'P@/

» INTERNATIONAL PROGRAMME

Programme on mother and child health in 10 shantytowns in Jaipur, India. Withdrawal from the programme is planned in 2011.

» PUBLICITY EVENTS AND ACTIVITIES k&02?-#+*-'+"#&"5&9"3'"2*&"5&'(%&B"2;$&*177%2&*3("";&DEQE/ k&M#=";=%7%#'&+#&'(%&:;*%#/,)&&A-$=%2'+*+#?&3"7!%'+'+"#@&-'& Toulouse Business School. k&U2"**&%=%#'*&AFoulée pour la vie, Solidarité en pays de Save@&+#&-+$&"5&O$O/ k&,("'"?2-!(+3&%H(+4+'+"#&"#&M#$+-&-'&d"?1%'&L"1'(&3%#'2%<& Arvel travel agency in Lyon, at MdM’s Rhône-Alpes delegation, at the Grenier du Roy in Villemur-sur-Tarn, at Portet-sur-Garonne social work centre, in Munich, at the Le 5 ?-;;%2L&+#&d-4-*'%#*&A*%=%2-;&?2"1!&=+*+'*&4L&3(+;$2%#@&-#$&+#& Albi general council premises. k&J1!!"2'&5"2&Un étai pour le Vietnam for an evening against malaria at Utopia cinema. k& ,2%*%#'-'+"#& "#& (17-#+'-2+-#& (%-;'(& +#& #12*%& '2-+#+#?& +#*'+'1'+"#*& AK13(<& G"1;"1*%& d%$& U2"**@& -#$& -'& M_dKJn

welcoming nurse training institute students (Rodez, Ran?1%+;<&G"1;"1*%&d%$&U2"**<&,-7+%2*@n&'-.+#?&!-2'&+#&-&2"1#$& table discussion at Rodez nurse training institute.

» PARTNERSHIPS

k&M#*'+'1'+"#-;&6#-#3+-;&!-2'#%2*(+!*o&C-1'%I\-2"##%&9+*'2+3'& Council, Toulouse City Council, Midi-Pyrenees Regional Health Agency, Midi-Pyrenees Regional Council. k&,-2'#%2*(+!&>+'(&Y2-*7%&-#$&\j2-2$IO-23(-#'&("*!+'-;&'"& organise a seminar.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

India © Marie-Pierre Buttigieg

BZC

LAHKh?QJhKIh<QPQ8J » REGIONAL DELEGATIONS

CONTACT

» 10-12, rue du Grand-Fossart 59300 Valenciennes Tel: 03 27 47 40 08 Fax: 03 27 30 19 16 caso.valenciennes medecinsdumonde.net CALAIS BRANCH

» Centre de santé Place de l’Europe 59760 Grande-Synthe T*/['AZVbAV=WVWWVA= migrants.ndpc@medecins dumonde.net PROGRAMMES

» Coastal migrants programme » Healthcare and Advice Clinic in Valenciennes REGIONAL BOARD

» Representative: [/>(K,3)/& » Secretary: N)V%,##,(K/!)&,fh7/4V,+& » Treasurer: S)+%,h<3+%'&%#,(\"/+0)+* » Other board members: r0%)#,(P)4"+%'',-(<0)/*%#,( P,0,/-(D,)#hP/!(S,+0, » Number of members: Zc » Number of volunteers: 60

» ACTIVITIES k&Launch of a logistical component as part of the coastal migrants programme: essential supplies, shelter, access to water, makeshift showers, waste management and latrines. k&Follow-up and support for migrants when the Téteghem and Loon-Plage settlements were destroyed. k& Distribution of essential equipment (tarpaulins, sleeping 4-?*<&>-'%2!2""5&3;"'(+#?<&'"+;%'2L&.+'*&%'3/@&-2"1#$&91#.+2.& before winter. k&Awareness-raising training for Dunkirk hospital staff. k&Member of the steering committee of Dunkirk healthcare -33%**&"563%&A,KJJ@/ k&Establishment of medical consultations and vaccination campaigns in the Roma camps in Lens. k&Joint organisation of the university diploma on Health and Deprivation in Lille medical faculty.

» PUBLICITY EVENTS AND ACTIVITIES

k&Request to the Prefet to apply the mainstream regime and the principle of non-conditionality as outlined in the guidelines on winter arrangements. k&M#=";=%7%#'&+#&'(%&-#'+I!"=%2'L&3";;%3'+=%/

» PARTNERSHIPS k&U2%-'+"#&"5&-&N"+#'&=";1#'-2L&*%3'"2&?2"1!&"#&7+?2-#'*&+#& Dunkirk. k& ,-2'#%2*(+!& >+'(& '(%& 7"4+;%& d+74-1$& '%-7& +#& l-;%#ciennes.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

LAHSQLKm » REGIONAL DELEGATIONS

CONTACT

» 5, rue d’Elbeuf 76100 Rouen Tel: 02 35 72 56 66 normandie@medecins dumonde.net LE HAVRE BRANCH

» 28, rue Jean-Baptiste-Eyriès 76600 Le Havre Tel: 02 35 21 68 66 hc.lehavre@medecins dumonde.net PROGRAMMES

» Adoption programme in Le Havre » Prostitution programme in Rouen » Travellers programme in Rouen » Big Freeze project in Le Havre » Outreach project (consultations) in Le Havre » \*"%,-)#%*&'(1"'#&2/.8'&**kers project in Le Havre » Tackling violence against women project in Le Havre » Healthcare and Advice Clinic in Rouen REGIONAL BOARD

» Representative: <3+%'&%)#(<)+&%,+ » Secretary: 9)0i+%,(7)#"/&hJ!,&V"# » Treasurer: H"V,+&(7)!F/,& » Other board members: S/+%,0(<"/+)#&-(Hi4%( ?%!)+*-(D,)#hD)!F/,'(?+,>-( Arlette Seiffert » Delegation secretary: J"13%,(\i#i6%' » Number of members: 51 » Number of volunteers: 61

» ACTIVITIES

k& The Healthcare and Advice Clinic in Le Havre stopped offering medical consultations and referred people to the (%-;'(3-2%&-33%**&"563%/ k&Involvement in Le Havre Big Freeze plan. k&Member of the steering committee on the establishment of a health and reception point at Elbeuf-Louviers-Val-deReuil hospital. k&Involvement in working meetings organised by Carrefour des solidarités on: the district plan on reception, accommodation and integration; the integrated welcome and guidance service; establishment of a steering committee. k&Contributing to the working group on health and culture to promote access to health in Saint-Étienne-du-Rouvray. k&Involvement of the travellers’ mission in the commemoration of the deportation and internment of Tziganes (1939QF`D@&$12+#?&'(%&*%3"#$&>"2;$&>-2/

» PUBLICITY EVENTS AND ACTIVITIES k&,2%*%#'-'+"#*&"#&(17-#+'-2+-#&-#$&?;"4-;&(%-;'(&+**1%*&+#& g%&C-=2%&+#*'+'1'+"#*&AMcG<&'2-+#+#?&"2?-#+*-'+"#*<&*3("";*&%'3/@/ k&,2%*%#'-'+"#&'"&9+%!!%&#12*%&'2-+#+#?&+#*'+'1'+"#&*'1$%#'*& on health and travellers. k& ,2%*%#'-'+"#& "#& O$OP*& >"2.& +#& d"1%#& =";1#'-2L& *%3'"2& forum. k& M#=";=%7%#'& +#& '(%& O-3-$-7& u& U"& %=%#'<& $%$+3-'%$& '"& homeless people. k&,-2'+3+!-'+"#&+#&B"2;$&KM9J&9-L&>+'(&'(%&"2?-#+*-'+"#<&g-& Boussole. k&G(%&$%;%?-'+"#&"2?-#+*%$&-&2%?+"#-;&$-L&"#&_2%#3(&;->&-#$& humanitarian affairs. k&_2-#3%&a&2%!"2'&"#&'2-=%;;%2*/

» PARTNERSHIPS k&,-2'#%2*(+!&>+'(&'(%&g%&C-=2%&$%#'-;&3-2%&-33%**&"563%<& with the provision of specialist volunteers. k&Partnership with the Médico Lions Club for the supply and preparation of spectacles. k& AIDES, La Boussole, the psychiatric outreach team for vulnerable people, relais accueil gens du voyage, Atelier Santé Ville, the free and anonymous testing centre. k&d"1%#&C%-;'(&M#*12-#3%&0563%/ k&O"4+;%&C%-;'(3-2%&K33%**&c#+'&Ac7-*@/ k&Regional health agency, the district council, family planning services, the Committee for social action and prevention.

BZY

8LK8QL(A<IQL » REGIONAL DELEGATIONS

CONTACT

» 250 bis, rue du Gal-Rolland Bât. K - SHLMR Bouvet BP 964 97479 Saint-Denis Cedex Tel: 02 62 21 71 66 Fax: 02 62 41 19 46 ocean.indien@medecinsdu monde.net MAYOTTE BRANCH

» N° 2 Lotissement Sim Kwale 97600 Mamoudzou Tel: 08 69 60 72 89 centredesoins.mayotte@ medecinsdumonde.net MADAGASCAR BRANCH

» Lot II Y 34 A Bis Ampasanimalo (route de l’Université) 101 Antananarivo - BP 3633 PROGRAMMES:

» Homeless programme » Mayotte programme » Prisons programme in Madagascar » Disaster risk reduction programme in Madagascar » Emergency programmes » Long-term paediatric surgery programme » Long-term child cardiac surgery programme REGIONAL BOARD

» Representative: Pascale Luciani » Secretary: H)>4"#*,([+"'', » Treasurer: D")!3%4(S)#!,)/ » Other board members: K"4%#%F/,(<">,f-(P/@,( 7)+1,+-(<3+%'&"13,( A&&,#R),0*,+-(I44)#/,00,( Rachou » Delegation secretary: D"3)#,(Q0)4i0"/ » Number of members: Zc » Number of volunteers: 50

» ACTIVITIES k&Needs assessment to evaluate the needs of people working in prostitution in southern Reunion. k&Development of Mission France programmes in southern d%1#+"#&AJ-+#'I,+%22%@o&7%$+3-;&3"#*1;'-'+"#*&5"2&=1;#%2-4;%& groups. k&Opening of a paediatric health centre in a deprived area of ^"1#?"1&AO-L"''%@/ k&MdM campaign in Mayotte for registration of children at '(%&*"3+-;&*%312+'L&"563%/

» INTERNATIONAL PROGRAMMES k&Disaster risk reduction programme in Madagascar: launch of a project in Sambava and working to capitalise on the results of this programme. k&J12?%2L&!2"?2-77%*&A3-2$+-3&-#$&=-*31;-2@&+#&O-$-?-*car: the regionally-managed international cardiac surgery !2"?2-77%& 2%3%+=%$& 6#-#3+-;& *1!!"2'& 52"7& O"#-3"& -#$<& since then, has been managed by headquarters. Training and capacity building activities took place with two paediatric vascular surgery programmes and two child cardiac surgery programmes as part of Opération Sourire. k&Support programmes in prisons in Madagascar (access to healthcare, tackling severe malnutrition, hygiene, refur4+*(+#?&*-#+'-2L&5-3+;+'+%*<&!2"7"'+#?&!2+*"#%2*P&2+?('*@/&O$O& has withdrawn from some of the prisons and plans to withdraw from the remaining prisons within 18 months. k&M#$+-#&03%-#&#-'12-;&$+*-*'%2&A3L3;"#%*@&!2"?2-77%o&'(%2%& were no emergency programmes in 2010.

» PUBLICITY EVENTS AND ACTIVITIES

;(Mailing on MdM’s 30th anniversary in Réunion. ;(O%$+-&3-7!-+?#&'"&6#$&("*'&5-7+;+%*/ ;(Organisation of a concert for the victims of the January 2010 earthquake in Haiti. ;(Delegation open day. ;(Taking action against anti-Roma discrimination (with the (17-#&2+?('*&;%-?1%&-#$&1#+"#*@/

» PARTNERSHIPS

;( Felix-Guyon Regional Hospital for the care of children involved in the paediatric surgery programme. ;(The Red Cross for Mission France outreach patrols. ;( Saint-Denis Council and north and south Abbé-Pierre shops: lending premises for homeless person clinics. ;(Reunisaf: voluntary sector collective for the Belles de nuit sex worker programme in southern Réunion. ;(Regional health agency; regional strategic health plan. ;(District council and Réunion prefecture.

DOCTORS OF THE WORLD

?Q<Q(`?+"2,#!,hQ01,'h<u&,(*UQf/+a

ANNUAL REPORT 2010

» REGIONAL DELEGATIONS

CONTACT

» 4, avenue Rostand 13003 Marseille Tel: 04 95 04 59 60 Fax: 04 95 04 59 61 paca@medecins dumonde.net NICE BRANCH

» 34, rue Rossini 06000 Nice Tel: 04 93 16 59 60 mf.nice@medecins dumonde.net AIX-EN-PROVENCE BRANCH

» Pôle humanitaire 7, rue Diouloufet 13100 Aix-en-Provence Tel: 04 42 21 45 84 caso.aix@medecinsdu monde.net

» ACTIVITIES

» PUBLICITY EVENTS AND ACTIVITIES

k& G(%& C%-;'(3-2%& -#$& K$=+3%& U;+#+3& +#& b+3%& (-*& 3%-*%$& to carry out applications for renewal of State Medical Aid 4%3-1*%&>"2.&>+'(&;"3-;&(%-;'(&+#*12-#3%&"563%P*&>"2.&(-*& improved the quality of the service and information. k& d%$+2%3'+#?& '(%& O%$+'%22-#%-#& (-27& 2%$13'+"#& !2"N%3'& towards the regional development of thin layer chromatography and users’ self help in the urban setting. k&G%27+#-'+"#&"5&9"3'"2*&"5&'(%&B"2;$P*&+#=";=%7%#'&+#&'(%& psychiatric outreach project with Marseille hospitals. k&J'1$L+#?&'(%&!"**+4+;+'+%*&5"2&-&J'2%%'IC"*!+'-;I,2+*"#&!2"N%3'/ k&M#&-&("*'+;%&3"#'%H'<&'(%&d"7-&!2"?2-77%&(-$&'"&'-.%& emergency action to help this population and speak out about their situation to the European Commission.

k&O"4+;+*-'+"#&5"2&'(%&1#$"317%#'%$&7+?2-#'*&7-23(%*&+#& Provence, Vitrolles, Aix-en-Provence, Marseille, MouansSartoux and Nice, with around 30 consultations per evening. k&,("'"?2-!(+3&%H(+4+'+"#&"#&Les dents de Berre… tant qu’il y aura des tomates, one year after the Gourbi in Berre was destroyed on 31 July and 1 August. k&,-2'+3+!-'+"#&+#&B"2;$&d%51?%%&9-L&+#&b+3%&+#&[1#%/ k&U"#3%2'&4L&91"&O+*3%;;-#%"1*&+#&-+$&"5&9"3'"2*&"5&'(%& World in Nice in December.

PROGRAMMES

» Adoption programmes in Marseille and in Nice » Healthcare and Advice Clinics in Aix-en-Provence, Marseille and Nice » Gourbi programme in Berrel’Étang » Roma programme in Marseille » Psychiatric outreach programme in Marseille » Homeless programmes in Marseille and Nice » Mediterranean harm reduction programme

» INTERNATIONAL PROGRAMMES

k&8#(\/+@%#)(N)'"= the oral health and nutrition components of the project were combined. The delegation began to pre!-2%&5"2&>+'($2->-;&+#&DEQQ&-#$&>"2.%$&"#&'(%&6#-#3+-;&=+-bility of the projects. k&7)%&%= personal involvement of health professionals in the district Pont humanitaire et médical 13. k&Turkey: launch of operations to provide medical care and social support for migrants in Istanbul.

REGIONAL BOARD

» Representative: ?3%0%11,(*,(\"&&"# » Secretary: S)+%,hN+)#!,(L,6+,0 » Treasurer: ?%,++,hN+)#n"%'(?,+#,& » Other board members: Si0"*%,(?%!)+*-(S%!3,0( [0)''-(Di+u4,(?)'%#,&&%-( <3+%'&"13,(H"/. »''c"1H*)%'1(-)*"[' 8')V,00,(S)0)2)0 » Accounts: [3%'0)%#,(9%#!,#&% » Delegation secretaries: Q##,hS)+%,(<"4V,-( K)#%,0(84V,+&-(S)+&%#,(J,4)& » Number of members: BZC » Number of volunteers: 220

» PARTNERSHIPS k&_+#-#3+-;&*1!!"2'&52"7&'(%&033+'-#%&5"1#$-'+"#&'"&32%-'%& -&O+*";-&)"12&7-#15-3'12+#?&1#+'&+#&Z12.+#-&_-*"&'"&!2%=%#'& chronic child malnutrition. k&G(%&2%?+"#-;&3"1#3+;&->-2$%$&-&*!%3+63&O-2*%+;;%&%=+3'+"#*& emergency grant to strengthen the Roma outreach activities.

BZ_

PA8HI

» REGIONAL DELEGATIONS

CONTACT

» 33, rue Fouré 44000 Nantes Tel: 02 40 47 36 99 Fax: 02 51 82 38 09 pays-de-la-loire@medecins dumonde.net ANGERS BRANCH

» 62, boulevard Saint-Michel 49100 Angers Tel: 02 41 43 65 66 caso.angers@medecins dumonde.net PROGRAMMES

» Adoption programme in Nantes » Prostitution programme in Nantes » Healthcare and Advice Clinics in Nantes and Angers » Romanian Roma project in Nantes » Anti-poverty project in Nantes » Rave/festival project in Nantes REGIONAL BOARD

» Representative: ?3%0%11,(D)++"/'', » Secretary: K"4%#%F/,(S)+&%# » Treasurer: Q##,hP%',([/i6/,# » Other board members: D,)#hm2,'(H"!3,+-(N)V%,##,( K)#%,0-(<)&3,+%#,(\"/0%#6/%,f-(S%!3)v0(\,'#)+* » Delegation secretary: <"+%##,(P,1,+& » Number of members: e_ » Number of volunteers: ^E

» ACTIVITIES

?+"6+)44,(R"+@%#6(R%&3(',.(R"+@,+'(%#(L)#&,' k&Qualitative survey on rights issues and violence encountered during sex work. k& Five joint outings with the free anonymous screening centre, the tuberculosis centre and AIDES. k&Team training (HIV, hepatitis, harm reduction, counselling -#$&%7!">%27%#'@/ k&Thematic events during day-time sessions. k&Publication, as part of a European project, of a guide to good practice for people working with sex workers opera'+#?&+#&!2+=-'%&!2%7+*%*&-#$&"5&-&;%-)%'&5"2&*%H&>"2.%2*&+#& six languages. ?+"X,!&(R%&3(H"4)(4%6+)#&' k&Internal evaluation of the programme. k&Helping to build a research-action project on health mediation with the Romeurope collective, the Ministry of Health and the National Prevention and Health Education Institute (INPES +#&+'*&_2%#3(&-32"#L7@&>+'(&2%321+'7%#'&"5&-&(%-;'(&7%$+-'"2& who speaks Romanian in December 2010. k&Joint outreach work with the tuberculosis centre and the vaccination centre. 7,)0&3!)+,()#*(Q*2%!,(<0%#%! k&Survey to assess the needs for cross-cultural consultations in Loire-Atlantique. k&Development of a service to accompany people in the process of applying for visas on medical grounds.

» PARTNERSHIPS

PASS, CIMADE, ASAMLA, the Joint Prevention and J32%%#+#?&U%#'2%&AUgKG<&U9K\<&=-33+#-'+"#&3%#'2%@<&Restos du cœur, Nantes Romeurope collective, REVIH, the Banque humanitaire et alimentaire, UGOMPS.

» PUBLICITY EVENTS AND ACTIVITIES

k&Presentation of the Haiti programme to Nantes healthcare assistant school. k&Inauguration of the new mobile outreach unit. k&,2%*%#'-'+"#&'"&b-#'%*&#12*%&'2-+#+#?&+#*'+'1'%&"#&'(%&(%-;'(& and vulnerability of Roma migrants. k&Participation in the 4th global forum on human rights with the exhibition Exil, Exit? and organisation of a round table discussion on Minority rights, what kind of citizenship for the Roma population? in partnership with the Maison des citoyens du monde and the Human Rights League with the support of the Permanent International Secretariat on Human Rights. k&Organisation of an evening debate to discuss “How can we improve joint working with the Roma?” with the townhospital network.

DOCTORS OF THE WORLD

?A8MAgh<7QHILMIJ

ANNUAL REPORT 2010

» REGIONAL DELEGATIONS

CONTACT

» 22, allée du Champ-Brun 16000 Angoulême Tel: 05 45 65 07 47 Fax: 05 45 61 18 85 poitou-charentes@medecins dumonde.net POITIERS BRANCH

» 12, rue des Carmélites 86000 Poitiers Tel: 05 49 01 77 77 hc.poitiers@medecins dumonde.net PROGRAMMES

» Traveller programme in Angoulême » Street work programme in Angoulême » Utiss mother and child programme in Poitiers » Prostitution programme in Poitiers » Listening health bus project in Angoulême » Winter patrols in Angoulême » Consultations project in Angoulême » Caravan project (psychiatric outreach sessions) in Poitiers » Monitoring committee for ill foreigners in Poitiers REGIONAL BOARD

» Representative: S)+%,hP)/+,(N,++)+% » Secretary: S)+%,00,(K,0)6, » Treasurer: S>+%)4(S)'', » Other board members: ?)&+%!@(\"/,&-(D"',&&,( <)%00,&"#-(K)#%,00,(K,2,*,!-( S)6)0%(<)&3)0%G)/0& » Delegation secretary: ?)/0,(*,(Jt*, » Number of members: dZ » Number of volunteers: 55

» ACTIVITIES k&B%%.;L&$+*31**+"#&*%**+"#*&>+'(&'(%&#+?('&'%-7&"5&"12&!-2tner Afus 16. k&g"44L+#?&>"2.&>+'(&'(%&K;%2'&U"77+''%%&"#&M;;&_"2%+?#%2*/ k&,2%*%#'-'+"#*&"#&(17-#+'-2+-#&-3'+"#&-#$&9"3'"2*&"5&'(%& World’s work to Thouars and Poitiers nurse training institutes. k&,2%*%#'-'+"#&"#&7+?2-#'&3(+;$2%#&+#&[%-#IO"1;+#&7+$$;%& school in Poitiers. k&,2%*%#'-'+"#&"#&$%!2+=-'+"#&'"&K;+j#"2I$PKX1+'-+#%&*%3"#dary school students in Poitiers.

» PARTNERSHIP

k&Partnership with Jean-Rostand secondary school to produce the annual report and to organise a 20th anniversary event for Mission France in Angoulême. k&Partnership with Erasmus to raise funds for Pakistan. k&Donors: Mutuelle Santé Agricole AOJK@<&d%?+"#-;&C%-;'(& Agency, Charente and Vienne district councils, Angoulême, Saint-Yrieix, L’Isle-d’Espagnac and Jarnac town councils, ,"+'+%2*&*"3+-;&>"2.&3%#'2%&AUUKJ@/

» PUBLICITY EVENTS AND ACTIVITIES Angoulême k&Commemoration of the 20th anniversary of Mission France in Angoulême. k&Concert by the group Notes d’espoir in Chasseneuil in aid of MdM Angoulême. k&Radio interview on Radio Attitude for the International Day for the Eradication of Poverty. k&Stand in Angoulême centre with the voluntary sector collective 17 octobre.

Poitiers k&Feedback to the team on the participation of the Poitiers branch’s head of programme in the China-Europa Forum in Cheng-Du and Hong Kong on Tackling poverty and exclusion. k& Inauguration of new premises (12, Rue des Carmélites, ,"+'+%2*@/ k&Participation in the Voluntary Sector Day. k&Participation in the Le monde en fête day.

BZc

H7wLIhQP?IJh\gH[gLKm » REGIONAL DELEGATIONS

CONTACT

» 13, rue Sainte-Catherine 69001 Lyon Tel: 04 78 29 59 14 Fax: 04 26 84 78 08 rhone-alpes@medecins dumonde.net GRENOBLE BRANCH

» 19, rue René-Thomas 38000 Grenoble Tel: 04 76 84 17 31 mf.grenoble@medecins dumonde.net SAINT-ÉTIENNE BRANCH

» 5, rue Edgar-Degas 42100 Saint-Étienne Tel: 04 77 38 57 18 paule.jamen@medecins dumonde.net marie-claude.jacquemond @medecinsdumonde.net PROGRAMMES:

» Adoption programmes in Lyon, Grenoble and SaintÉtienne » Outreach programmes (Squat and shantytown project – Outreach Bus) in Lyon » Outreach patrols in Grenoble » Healthcare and Advice Clinics in Lyon and Grenoble REGIONAL BOARD

» Representative: ?%,++,(S%!3,0,&&% » Secretary: Robert Allemand » Treasurer: S%!3t0,(H",0,#' » Other board members: S)+!(\0)#!3,+-( \,+#)+*(P"#6%#-( M3i+t',(L)#*)6"V)0"/-( Q#*+ihD,)#(?"!3,+"# » c"1H*)%'1(-)*"&[ ?)"0)(\)+%0-(Q/+i0%,(L,2,/ » Delegation secretary: <0"&3%0*,([/%00,+4 » Number of members: 155 » Number of volunteers: 260

» ACTIVITIES

k& Mobilisation in Lyon and Grenoble against the government’s programme of evicting Roma. k&Participation in the undocumented migrants’ march. k&Regional information day on Ethical questions arising from the emergency response in Haiti. k&Acquisition and refurbishment of a new bus. k&Internal evaluation of the squat programme. k&Establishment of an action plan on advocacy on health and housing. k&Internal discussions on improving and refocusing the Lyon Healthcare and Advice Clinic. k&Research-action projects on child lead poisoning among the Roma population. k&Carrying out a regional survey to improve understanding of the barriers which prevent people becoming members of MdM. k&Strengthening our involvement in education and training on humanitarian action, health, vulnerability (medical school, nurse training institute, university courses in the humanita2+-#&6%;$@/

» PARTNERSHIPS

k& Operational and political co-ordination with voluntary sector collectives, as part of the Roma, housing and harm reduction programmes. k& Setting up a partnership with the organisation Ruptures, with a view to progressive handover of the harm reduction work currently carried out on the bus. k&Involvement in the eastern regional health and independence 3"#5%2%#3%&A\2%#"4;%@/ k&Production of the internal newsletter with the humanitarian masters students of Lyon-2 University. k&Organisation of events to raise money for the Haiti emer-

gency (Lyon national orchestra concert, rugby match with g"1&d1?4L<&b+#.-*+&3"#3%2'@/

» INTERNATIONAL PROGRAMMES

k&Health in prisons in Guinea: ongoing partnership with Kindianese Aid for Detainees in Kindia to improve detention conditions. k&Health education in relation to chronic diseases in Algeria: two training courses on health education organised by Éducation Santé-Isère, including one with Cirta Oxygène in Algeria.

» PUBLICITY EVENTS AND ACTIVITIES

k&Press conference for the 17 October. k&Organisation of a conference jointly with Grenoble political studies institute on Challenges for humanitarian work in Afghanistan. k&Cross-country ski race, La Foulée Blanche, in Autrans (Ver3"2*@/ k&Cinema screenings and discussions in and around Lyon during the <1+=)(*+7&&5%*'+=-;&A+#'%2#-'+"#-;&*";+$-2+'L&>%%.@/

DOCTORS OF THE WORLD ANNUAL REPORT 2010

OUR ORGANISATION CONTENTS S*S()#*(%&'(4)#)6,4,#&

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Department news

> CLICK HERE

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Partner organisations

> CLICK HERE

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Public and institutional Funding

> CLICK HERE

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Civil society in France

> CLICK HERE

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Board of directors

> CLICK HERE

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KA<MAHJ(AN( M7I(OAHPK AND ITS MANAGEMENT Doctors of the World is M3)#@'( &"( &3%'( *%2,+'%&>( "G( 1,"10,( decisions concerning the organisation’s 0'!'/0'/.)#/)F8%42+'0) %#2"02,*-( S*S( )0R)>'( "1,+)&,'( "#( management. &'&G'"()=2.6)+'40) &3,( V)'%'( "G( *,V)&,-( the views of civil *"3+%'L<&-#$&'(%&"!%2-'+"#-;&%563+%#3L&"5& To carry out its tasks properly the Board experience, volunteers in +'*& !2"?2-77%*& 5"2& 4%#%63+-2+%*/& K*& -& relies on: France, expatriate voluntary result, MdM has an original organisatio- k&-#&-$=+*"2L&*'213'12%&"5&O$O&7%74%2*n workers for international nal structure which is strong and distinc- k&-&!%27-#%#'&"!%2-'+"#-;&*'213'12%n k& N"+#'& $%3+*+"#I7-.+#?& 4"$+%*& 42+#?+#?& operations and a permanent tive among large NGOs. together the staff and MdM members; paid staff. The support of k&'(%&2%?+"#-;&$%;%?-'+"#*/ DECISION-MAKING IN MDM hundreds of thousands of A#!,()(>,)+-(S*S(4,4V,+'(`B-Bcd(%#( donors ensures Doctors 2010) come together at the General As- THE ADVISORY STRUCTURE #>).6')H#"407()+/%/*2%4) *%74;L&A\K@<&'(%&(+?(%*'&$%3+*+"#I7-.+#?& M3%'( %#!0/*,'( &3,( !"#&%#,#&)0( 6+"/1'( independence. body and the only one with the authority )#*( &3,4)&%!( 6+"/1': Each of these to modify the organisation’s statutes. The groups, made up of volunteer members GA elects 12 members of the Board of with project experience or involved in proDirectors, and three substitute members. jects, advises on the continent or theme for which it is responsible. The role is vital From among its members, the in terms of analysing contexts, working Board elects the President and methods and drawing on the experience the organisation’s Bureau for one "5& !2"N%3'*/& O$O& (-*& 6=%& 3"#'+#%#'-;& year: the vice-Presidents, the groups, four thematic groups and a Treasurer, the Deputy Treasurer, France group, which combines the MisGeneral Secretary, Deputy General sion France steering committee and the Secretary and a Representative. The Harm Reduction committee. The memBoard, the organisation’s executive bers of the advisory groups are elected in body, meets monthly and takes any line with the internal regulations.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

THE PERMANENT OPERATIONAL STRUCTURE

gations carry out international or regional projects, within the overall framework M3%'( %'( 0,*( V>( &R"( K%+,!&"+)&,': The $%6#%$&4L&'(%&Z"-2$/&K;;&"5&'(%&2%?+"#-;& Humanitarian Aid Directorate includes members, the Heads of Programme, the the International Operations Division, the group co-ordinators, the regional repreMission France Division, the Adoption sentatives and the board members meet Department and the Communication three times a year for a National Advisory Department. The Management Direc- Council meeting. torate includes the Human Resources Division, the Development Division, the THE DONORS’ COMMITTEE Finance and IT Division and the Legal K"#"+'( )+,( +,1+,',#&,*( V>( &3,( K"Division. Non-strategic operational deci- #"+'U( <"44%&&,,: The Committee is sions are made each week by the Inter- made up of 12 co-opted members and national Operations Division during a it provides constructive criticism and ‘project meeting’ for programme-related consensual analysis of MdM’s projects, decisions and at a ‘management mee- 6#-#3%&"2&3"771#+3-'+"#&*'2-'%?L/&M'&+*& ting’ for other aspects. given funding to go and evaluate projects

in France and abroad. Through its Chair, it can express its views to the Board and to the General Assembly. G(+*&*!%3+63&*%'I1!&%#3"12-?%*&$%4-'%& at all levels. It allows MdM to be an active organisation which is both politically and 6#-#3+-;;L& +#$%!%#$%#'/& M'& %#3"12-?%*& voluntary commitment by health workers in the service of the most destitute and vulnerable people, and has a constant concern for the quality and effectiveness of its international and local projects.

THE JOINT DECISION-MAKING BODIES M3,',( %#!0/*,( &3,( I.,!/&%2,( <"44%&&,,-( R3%!3( V+%#6'( &"6,&3,+( &3,( '&)GG( )#*( 2"0/#&,,+'( %#2"02,*( %#( 4)#)6,4,#&- each week and examines strategic decisions concerning projects and takes a close look at decisions about bearing witness, political lobbying and publicity. Other joint decision-making bodies include the human resources group, which 7%%'*&7"#'(;L&'"&$%6#%&(17-#&2%*"123%*& and management policies which are then 6#-;+*%$&-#$&2-'+6%$&4L&'(%&Z"-2$/

REGIONAL DELEGATIONS Q!+"''(N+)#!,-(K"!&"+'("G(&3,(O"+0* 3)'(',&(/1(+,6%"#)0(*,0,6)&%"#': Elected every three years, the regional boards represent MdM in the regions. The dele-

DOCTORS OF THE WORLD MANAGEMENT ON 31DECEMBER 2010 » [,#,+)0(K%+,!&"+-(7/4)#%&)+%)#(Q!&%"#=(Pierre Salignon » [,#,+)0(K%+,!&"+-(S)#)6,4,#&=(François Dupré » K%+,!&"+("G(8#&,+#)&%"#)0(A1,+)&%"#'= Dr Carole Dromer until September, then Dr Gilbert Potier » K%+,!&"+("G(N+,#!3(?+"6+)44,'= Dr Jean-François Corty » K%+,!&"+("G(N%#)#!,()#*(8M= Thierry Barthelemy » K%+,!&"+("G(7/4)#(H,'"/+!,'= Thomas Durieux until August, then Anne-Claire Deneuvy » K%+,!&"+("G(Q*4%#%'&+)&%"#()#*(P,6)0=(François Rubio » K%+,!&"+("G(<"44/#%!)&%"#()#*(K,2,0"14,#&=(Juliette Chevalier » K%+,!&"+("G(Q*"1&%"#=(Dr Geneviève André-Trévennec » [,#,+)0(J,!+,&)+>("G(&3,(8#&,+#)&%"#)0(L,&R"+@=(Benjamin Nguyen until June, then Jean Saslawsky

142

DEPARTMENT NEWS MANAGEMENT

-&'"";&'"&>+;;&+7!2"=%&'(%&+#'%?2-'+"#&"5&6#-#3+-;&+#formation between the international programmes M3,(*%')'&,+(%#(7)%&%()&(&3,(V,6%##%#6("G(&3,( and headquarters. Use of this new tool will begin >,)+( )GG,!&,*( &3,( V/*6,&( )11+"2,*( )&( &3,( in 2011. ,#*("G(CEE^:(The scale of the disaster and the fact that our donors responded generously In 2010, MdM redoubled its efforts to diversify 7%-#'& -& *+?#+63-#'& +#32%-*%<& +#& '(%& 2%?+"#& "5& the organisation’s private donors—through 20%, in the organisation’s income and expen- the marketing department—and the funding sources—through the institutional funding dediture in 2010. partment. This is an important factor to assure The policy of maintaining a mix of funds—which the organisation’s independence. includes regular donations through direct debit and periodic appeals for donations in a more In addition, a strengthening of the manageemotive way using mailshots—has enabled us ment controls and the development of internal to consolidate our fundraising over the remain- checks are two important objectives for MdM. $%2&"5&'(%&6#-#3+-;&L%-2&-#$&(-*&#"'&-55%3'%$& G(%*%& "4N%3'+=%*& >%2%& 2%3"#627%$& +#& DEQE& the other programmes (i.e. apart from those in -#$&%55"2'*&'"&-3(+%=%&'(%7&>+;;&4%&+#'%#*+6%$& in coming years. C-+'+@/ As a result of invitations to tender issued in late 2009, we have changed the agency we use for both fundraising and legacies. The Finance and IT Division worked hard to understand the needs and organisational issues in 2%;-'+"#&'"&'(%&)">&"5&+#5"27-'+"#&4%'>%%#&(%-$X1-2'%2*&-#$&'(%&6%;$/&G(+*&;%$&'"&'(%&!14;+3-'+"#&"5&

HUMANITARIAN ACTION

grammes within the organisation, particularly within headquarters, the Board approved the creation of a Mission France Division from the existing Mission France Co-ordination Unit. The Mission France Division is supporting the process of regionalisation that has been policy for several years now, and the essential positioning of the organisation in relation to the recently created regional health agencies. International Q'(%#("&3,+(>,)+'-(&3,(8#&,+#)&%"#)0(A1,+)&%"#'( K%2%'%"#(3)'(',,#()(#/4V,+("G(*,1)+&/+,'()#*( '"4,()++%2)0': There is a willingness to enable (%-$X1-2'%2*&%7!;"L%%*&'"&2%'12#&'"&'(%&6%;$&-#$<& 3"#=%2*%;L<&'"&2%321+'&6%;$&!%2*"##%;&5"2&N"4*&-'& headquarters or in the regional delegations. Notable events of the year: k&G(%&$%!-2'12%&"5&'(%&\%#%2-;&9+2%3'"2&5"2&C1manitarian Action, after a 20-year career in MdM, and the arrival of his successor after a long recruitment process.

France M3,(1+"X,!&'(%#(N+)#!,(!"#'&%&/&,("#,("G(&3,( 4)%#( "1,+)&%"#)0( ,0,4,#&'( "G( S*SU'( R"+@: k&G(%&-22+=-;&"5&'(2%%&7%$+3-;&-$=+*"2*&+#&'(%&M#'%2In order to improve the positioning of these pro- national Operations Division, following a Board

DOCTORS OF THE WORLD ANNUAL REPORT 2010

decision to reinforce the medical skills integrated into project teams. k&K&7-**+=%&2%*!"#*%&'"&'(%&C-+'+&%7%2?%#3L<&+#& '%27*&"5&(17-#&2%*"123%*<&6#-#3%<&"!%2-'+"#-;& deployment and communication. k& K& *L74";+3& !2"?2-77%& +#& ,-.+*'-#& '"& $%monstrate our willingness to develop targeted !2"?2-77%*& >(+3(& 7%%'& +$%#'+6%$& #%%$*& 41'& are not particularly large in scale. At the same time, the Emergency Desk responded to emergencies in Sudan, Somalia and Latin America by supporting local partner organisations. k&G(%2%&>%2%&"#?"+#?&*%312+'L&+**1%*<&!-2'+31;-2;L& with the recurrent problems in the Jebel Marra region in Darfur and in Somalia, and also a deterioration in working conditions for our teams on '(%&?2"1#$&+#&'(%&J-(%;&2%?+"#&-#$&"'(%2&3"#)+3'& areas, such as Yemen. These problems led us to renew the post of Security Advisor, whose role is to provide daily advice on security risks for teams.

HUMAN RESOURCES M3,( @,>( ,2,#&'( G"+( &3,( 7/4)#( H,'"/+!,'( K%2%'%"#(*/+%#6(&3,(>,)+(R,+,= k&K&7-**+=%&2%*!"#*%&'"&'(%&C-+'+&%-2'(X1-.%&-#$& cholera epidemic to set up, and monitor, large MdM teams, including as many national as international staff. k&\2">+#?&+#=";=%7%#'&"5&#-'+"#-;&7-#-?%7%#'& personnel and institutional partners in MdM training programmes, leading to an increase in the number of sessions in English. k& U2%-'+"#& "5& -& #%>& !"*'& $%$+3-'%$& '"& ?1+$+#?& and improving the recruitment process, and the introduction of a new IT tool which will facilitate the monitoring of MdM volunteer and employee career paths.

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PARTNER ORGANISATIONS Doctors of the World bases its work around local partners to provide links that will ensure the work we set up will continue. If no partners exist, MdM supports the creation of orga nisations, often formed on the initiative of, and based around, MdM’s local team. The partners gradually become autonomous and are supported for, on average, one to two years. The structures created in this way remain MdM’s natural partners in the region.

INDEPENDENT ORGANISATIONS INITIATED BY MDM » In Europe

» In Africa

k Bosnia-Herzegovina, Sarajevo Duga (Reception and Psychological Sup!"2'&U%#'2%&5"2&U(+;$2%#&-#$&K$";%*3%#'*@/ Created in 1994, autonomous since 2002. info_duga@yahoo.com Activities: supporting children, preventing HIV/AIDS. k&Russian Federation, St-Petersburg Humanitarian Action, Created in 2001, autonomous since 2003. >>>/(-5I*!4/"2?n&"563%v(-5I*!4/"2? Activities: HIV prevention, supporting street children, harm reduction, access to healthcare and support programme for migrant workers. 2$9*!!-()$<","#(.-&)X Great North, Siberia Chukotka. Doverie&AU"#6$%#3%&J"3+%'L&U(1."'.-P*& J"3+%'L&J"42+%'L&O"=%7%#'@<&32%-'%$&+#& 2001. doverie@anadyr.ru 2$F&0(),X Warsaw Nobody’s Children Foundation, created in 1990, autonomous since 2003. www.fdn.pl Activities: supporting children. 2$9&'()-(X Bucharest FICF (International Foundation for Children -#$&_-7+;+%*@/&U2%-'%$&+#&QFFT<&-1'"#"mous since 2003. Fax : + 40 21 311 19 15 / 23 05 Activities: supporting children. 2$>*0U(#-(X&J"6Child and Space Association, created in July 2005. Activities: supporting children.

2$@&Y('+-Z*"X Maputo Meninos de Moçambique (Children of O"h-74+X1%@<&32%-'%$&+#&DEEE<&-1'"#"mous since 2001. Fax: +258 30 41 16 Activities: supporting children. 2$@(,(U(!S(#X Tulear Association Sisal (Doctors for the Right to C%-;'(@<&32%-'%$&+#&DEED<&-1'"#"7"1*& since 2005. 2$8U(),(X Kyotera CIPA (Community Initiative for the Pre=%#'+"#&"5&CMlrKM9JrJGM*@/&02?-#+*-'+"#& created in October 2003, autonomous since December 2005. cipacp@yahoo.com K3'+=+'+%*o&6?('+#?&CMlrKM9J/ 2$A()Y()-(X$Bukoba Tadepa (Tanzania Development and Pre=%#'+"#&"5&K+$*@<&32%-'%$&+#&DEEQ/ K3'+=+'+%*o&6?('+#?&CMlrKM9J/ 2$D[."$,\G]&-#"X Abidjan MESAD (Movement for Education, Health -#$&9%=%;"!7%#'@/&02?-#+*-'+"#&32%-'%$& in 2001. mesad_ci@yahoo.fr Activities: supporting children, tackling HIV/AIDS.

» In Latin America Salvador MDS&A9"3'"2*&5"2&'(%&d+?('&'"&C%-;'(@/& Association created in 1998. www.mds.org.sv Activities: promoting the right to health.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

ORGANISATIONS INITIATED BY MDM AND REQUIRING SUPPORT FROM MDM » In Europe 2$Serbia, Belgrade Veza, created in June 2005. vezango@gmail.com Activities: tackling AIDS, harm reduction.

MDM’S PARTNER ORGANISATIONS » In Africa 2$Angola, Lobito Omunga Activities: advocating for the recognition of street children’s rights, working with young people to improve their skills and help them become independent. 2$Burkina Faso, Gnagna ICODEV (Community Initiatives for Deve;"!7%#'@/&U2%-'%$&+#&DEEa/ Activities: health, literacy, land management, rural routes. 2$Guinea, Kindia KAD&A^+#$+-#%*%&K**+*'-#3%&'"&,2+*"#%2*@/ Created in 2000. Activities: supporting prisoners. 2$@(,(U(!S(# Madagascan Red Cross, created in 1963. Activities: disaster preparedness, rescue and fundamental services in communities, hygiene and cleanliness campaigns. Aumônerie catholique des prisons (the U-'(";+3&,12*%&+#&,2+*"#*@&32%-'%$&+#&'(%& 1980s. Activities: supporting prisoners (social, 5""$<&7%$+3-;&-#$&;%?-;&-+$@/ k&Mali, Bamako AME (O-;+-#&K**"3+-'+"#&5"2&9%!"2'%%*@/& Created in 1996. Activities: legal and social support to people deported and returned, advocating for their rights.

ARACEM (Association for Central African $%!"2'%%*&+#&O-;+@<&32%-'%$&+#&DEEW/ Activities: supporting Central and West African deportees. 2$Rwanda, Kigali IBUKA&AO%7"2L&-#$&[1*'+3%@/&U2%-'%$&+#& 1995. Activities: defending the rights of victims of genocide. 2$DRC, Kinshasa AED&AK+$&'"&9+*-$=-#'-?%$&U(+;$2%#@<& created in 1966. Activities: supporting adolescents. 2$Senegal, Podor ASRADEC (Senegalese association for research and support for community deve;"!7%#'@<&32%-'%$&+#&QF]Q/ www.asradec.org Activities: health, income-generating activities, environment and sanitation, literacy. 2$A()Y()-(X Tayohag, created in 2002. Activities: awareness-raising activities amongst young people and the community to prevent drug use, professional training. Poverty Fighters, created in 1999. Activities: socio-professional reintegration of drug users, prevention HIV in young people, supporting AIDS orphans. 2$Zimbabwe, Chipinge FACT&A_-7+;L&K+$*&U-2+#?&G21*'@<&32%-'%$& in 1987. Activities: tackling HIV/AIDS.

» In Latin America 2$Guatemala, Chimaltenango AMES, (Asociación de Mujeres en Solidaridad@<&32%-'%$&+#&QFFW. Activities: access to healthcare for low income groups and Maquila&A5-3'"2L@&>"2kers’ rights. 2$Haiti, Port-au-Prince URAMEL (Medico-Legal Research and K3'+"#&c#+'@/&02?-#+*-'+"#&32%-'%$&+#&[1;L& 2002. www.uramel.net Activities: promoting justice, in partnership with health professionals.

2$Nicaragua, Puerto Cabezas Nidia White&AB"7%#P*&-**"3+-'+"#@<& created in 1990. lakisha81@hotmail.com Activities: defending the rights of women as part of the law on autonomy.

» In the Middle East 2$Algeria, Algiers Cirta Oxygène, created in 2007. Activities: prevention, health education. 2$Egypt, Cairo El Ma’wa Foundation; Nour el Hayat; Caritas Cairo; Egyptian Association for Societal Consolidation; Ana el Masry. Activities: social support for street children. 2$G#(Z, Kirkuk FUAD (United Foundation for Relief and K4+$+#?&9%=%;"!7%#'@<&32%-'%$&+#&DEET/ http://fuad-iraq.org/eng Activities: health and gender programme with vulnerable groups, civil society. 2$G#(Z, Erbil PAO&A,14;+3&K+$&02?-#+h-'+"#@<&32%-'%$&+#& 2003. http://pao-org.com Activities: civil society intervention, health, human rights. 2$Lebanon, Beirut AJEM&A[1*'+3%&-#$&O%23L&K**"3+-'+"#@<& created in January 1998. ajem@intracom.net.lb Activities: supporting refugees, asylum seekers and detained migrants. 2$Syria, Alep SARC&AJL2+-#&K2-4&d%$&U2%*3%#'@ Activities: health centres.

» In Europe 2$Kosovo, Pristina Vita Kosova, created in 2006. Activities: health, human rights, civil society, gender. 2$Moldova, Balti TDV (Tinerii Pentru Dreptul la Viata@ btdv@mtc-bl.md Activities: supporting children. Sotis&A_-7+;L&U2+*+*&U%#'2%@<&32%-'%$&+#& 2009.

ognatiuc@mail.ru Activities: shelter for women affected by violence and provision of psycho-social rehabilitation service. Atis Created in 2005. linaosoianu@yahoo.com Activities: medical, psychological and youth health consultations. Centre Nufarul Alb, Fdleeti, Glinjeni village, created in 2009. Activities: shelter and psycho-social consultations. Social Assistance Section AJKJ@ Activities: supporting victims of human '2-563.+#?/ 2$Romania, Satu Mare Copii, created in 2001. Activities: promoting the rights of children.

» In Asia 2$India, Jaipur JKSMS, (Jan Kala Sahitya Manch Santha@<& created in 1983. www.jksms.org Activities: working with vulnerable groups in shantytowns: education, awareness-raising, reintegration, training, advocacy. 2$Papua, Mulia Primari, created in 1999. primaripapua@yahoo.co.id Activities: preventing HIV/AIDS and primary healthcare. 2$F(^-!.()X Punjab MCWAK (Maternity & Child Welfare Asso3+-'+"#&^(-#!12@<&32%-'%$&+#&QFFR/ Activities: reproductive health and economic development projects with women and communities.

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PUBLIC AND INSTITUTIONAL FUNDING Links with international institutions are essential for NGOs working in the humanitarian +'40I)C()='44)%()G'2/$)2&!#"tant donors, these institutions are important policy makers. Doctors of the World is involved in different groups which facilitate access to the international decision-making authorities. At the same time, MdM is developing partnerships with other international organisations.

EUROPEAN UNION (EU) The two key European institutions concerned with solidarity are the European Commissionâ&#x20AC;&#x2122;s Humanitarian Aid 0563%&A9\&YUC0@&-#$&'(%&U"77+**+"#P*& %H'%2#-;& -+$& !2"?2-77%& AY12"!%K+$@& which runs international development !2"?2-77%*&A9\&9YlU"@/ MdM supports the principles enshrined in the 2007 European consensus on humanitarian aid and ensures the promotion and the application of these principles wherever we work on the ground.

nearly 1.1 billion euros to humanitarian projects, with around half going to NGOs. k&I/+"1,Q%* is charged with implementing the European Commissionâ&#x20AC;&#x2122;s external aid mechanisms through DG DEVCo. The EU is one of main institutional donors for development assistance. k&_"2&*%=%2-;&L%-2*<&S*S(3)'(V,,#(1)+&%!/0)+0>( )!&%2,( %#( 9A8<I( in Brussels, the interface between NGOs and EU institutions (European Commission, DG ECHO, the European Parliament, Member J'-'%*@/&l0MUY&42+#?*&'"?%'(%2&]E&Y12"pean NGOs, and the largest and most +#)1%#'+-;& +*& O$O& _2-#3%<& 2%!2%*%#'+#?& the MdM network, and involved in nearly all VOICE working groups (FPA Watch Group, humanitarian reform, civilian and 7+;+'-2L&2%;-'+"#*(+!*@/

k(M3,(4)#*)&,("G(I<7A is to provide aid and emergency relief to populations -55%3'%$&4L&#-'12-;&$+*-*'%2*&"2&3"#)+3'& outside the EU. ECHO works in partnership with around 200 organisations (European NGOs, the Red Cross network and specialist UN Agencies, particularly cbCUd& -#$& B_,@/& M#& DEQE<-& 2%3"2$I MdM relates to EuropeAid via CONCORD breaking year with the emergencies in (European Confederation of Relief and Haiti and Pakistan, ECHO allocated 9%=%;"!7%#'&b\0*@&'(2"1?(&'(%&_2%#3(&

DOCTORS OF THE WORLD ANNUAL REPORT 2010

NGO collective, Coordination SUD, which humanitarian issues. ICVA brings tolobbies EU institutions and participates in gether more than 80 international NGOs. the development of common positions on The Council relates to the UN authorities European development policy and other by tackling different themes such as the relationship between humanitarian wormajor issues in North-South relations. kers and the military, or the protection of ;(M3,(<"/#!%0("G(I/+"1, brings together 3+=+;+-#*&$12+#?&-27%$&3"#)+3'*/ 46 European states. MdM’s international network has consultative status with the THE GLOBAL FUND COE and is part of OING Service, a liaison The Global Fund against AIDS, Tuberculosis and Malaria is an international group for NGOs with this status. multi-lateral donor created in 2002 and UNITED NATIONS (UN) which gives grants to tackle HIV/AIDS, ;( M3,( I!"#"4%!( )#*( J"!%)0( <"/#!%0( TB and malaria. The Global Fund plans AY3"*"3@&+*&'(%&7-+#&3"I"2$+#-'+#?&4"$L& to distribute 11.7 billion dollars in the for the economic and social activities of DEQQIDEQT& 6#-#3+-;& !%2+"$& '"& *1!!"2'& the UN and its specialist bodies and insti- large-scale prevention, treatment and tutions. MdM’s international network has care programmes for the three diseases. special consultative status which means that it can carry out lobbying activities, FRENCH DEVELOPMENT especially in relation to the Human Rights AGENCY Commission. It has observer status in The French Development Agency (AFD +#& +'*& _2%#3(& -32"#L7@& +*& "#%& "5& '(%& this subsidiary body of ECOSOC. French governmental bodies involved in ;( S*SU'( %#&,+#)&%"#)0( #,&R"+@ has ?+=+#?& "563+-;& $%=%;"!7%#'& -**+*'-#3%& representation at the High Commission 5"2&!""2&3"1#'2+%*/&M'*&-+7&+*&'"&6#-#3%& 5"2&d%51?%%*&AcbCUd@<&'(%&B"2;$&C%-;'(& development programmes. 02?-#+h-'+"#& ABC0@& -#$& '(%& cb& 0563%& for the Co-ordination of Humanitarian As part of the general reform of public !";+3L&Ad\,,@<&K_9&(-*&4%%#&3(-2?%$& K55-+2*&A0UCK@/ with a new responsibility since 2009: k&S*S(%'()(4,4V,+("G(&3,(8#&,+#)&%"- funding NGOs. This has led to the crea#)0(<"/#!%0("G(9"0/#&)+>(A+6)#%')&%"#' tion of the NGO Partnership Division, AMUlK@<& -& #%'>"2.& "5& b\0*& +#=";=%$& +#& which steers the partnership with NGOs human rights, which concentrates on and monitors initiatives run by NGOs.

PROGRAMME AGREEMENTS BETWEEN AFD AND MDM 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 cross-cutting strengthening of its activities in relation to reproductive health and reducing health risks. 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 =+";%#3%&ADEERrDEQE@<&O$O&-#$&'(%&_2%#3(&9%=%;"!7%#'& K?%#3L& AK_9& +#& +'*& _2%#3(& -32"#L7@& *+?#%$& '>"& #%>& programme agreements in 2010, with funding of four million euros from AFD. One relates to reproductive health, while the other concerns harm reduction. These agreements aim to strengthen the work on these issues within MdM, by developing cross-cutting approaches while providing a part of the funding for around 12 projects. Thanks to this support, MdM was able to launch the harm reduction projects in Georgia and Tanzania and the reproductive health programmes in Mexico, Guatemala and Laos. In line with international commitments on the harmonisation of aid and AFD’s strategic direction, harmonised sectoral approaches are a priority for strengthening health systems. For MdM, the co-operation with AFD on the cross-cutting programmes on reproductive health and harm reduction allows us to strengthen existing programmes and also brings 6#-#3+-;&-#$&+#*'+'1'+"#-;&*1!!"2'&5"2&"12&!2"?2-77%*/

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CIVIL SOCIETY IN FRANCE CO-ORDINATION GROUPS Co-ordination SUD(`J"0%*)+%&>(I4,+6,#!> K,2,0"14,#&(<"h"+*%#)&%#6(V"*>aa A co-ordinating body for French humanitarian and development NGOs which it represents in France and internationally. As a Board Member, MdM represents the group in the Development Co-operation Commission, a joint body informing NGOs on public institutions’ development policies. <L9Q(`L)&%"#)0(<"/#!%0("G(9"0/#&)+>(A+6)#%sations) An independent authority attached to the Prime O+#+*'%2P*& "563%<& '(2"1?(& >(+3(& -;;& '(%& _2%#3(& organisations relate to the Prime Minister. MdM monitors issues relating to humanitarian activities. NALDI?( `m"/&3( )#*( 1"1/0)+( ,*/!)&%"#( !"h "1,+)&%"#(G/#*a A jointly-managed organisation bringing together public authorities and voluntary organisations to facilitate voluntary work and fund volunteers’ social charges. MdM monitors volunteering issues. <3)+&,+(!"44%&&,, A committee bringing together organisations that fundraise from the general public, in accordance with the Charter and recommendations.

L)&%"#)0(g#%"#("G(N/#*+)%'%#6(A+6)#%')&%"#'( `France Générositéa:

N+,#!3(<"h"+*%#)&%#6(\"*>("#(&3,(H%63&(&" Q'>0/4:

8<9Q(`8#&,+#)&%"#)0(<"/#!%0("G(9"0/#&)+>(Q6,#!%,'a:

H"4,/+"1,: 8#&,+#)&%"#)0(7)+4(H,*/!&%"#(Q''"!%)&%"#:

QNMQ(`N+,#!3(Q''"!%)&%"#("G(9"0/#&)+>(A+6)#%')&%"#(M+,)'/+,+'a:

THEMATIC PLATFORMS Health and Welfare gL8A?JJ( `L)&%"#)0( 8#&,+hG,*,+)0( g#%"#( "G( ?+%2)&,(7,)0&3()#*(O,0G)+,(A+6)#%')&%"#'a: Works with institutions promoting the recognition of the voluntary sector in health and welfare in European social policy. MdM belongs to the poverty and exclusion commission of the health and Europe groups. Link with the Alerte group. <LPI(`L)&%"#)0(<"/#!%0(Q6)%#'&(I.!0/'%"#a: It checks that the government is enforcing all 7%-*12%*&+#&'(%&6?('&-?-+#*'&%H3;1*+"#/&O$O& has set up a group to monitor the CMU (univer*-;& (%-;'(& +#*12-#3%@<& +#=%*'+?-'+#?& +**1%*& 2%;-ting to asylum seekers and refugees. AKJI( `AV',+2)&"+>( "#( S%6+)#&'U( H%63&( &"( 7,)0&3a: ?0)&G"+4( G"+( &3,( N%63&( Q6)%#'&( 7/4)#( M+)G5!@%#6:

Human rights <L<K7(`L)&%"#)0(Q*2%'"+>(<"44%&&,,("# 7/4)#(H%63&'a: It delivers opinions and recommendations on human rights to the Prime Minister. ?+%4"(P,2%-(?)+%' Holistic care for asylum seeking victims of torture. International Action gHK( `I4,+6,#!>( H,3)V%0%&)&%"#( K,2,0"14,#&( [+"/1a= group of relief organisations working on quality assurance in humanitarian activities. 9"0/#&,,+%#6( L[A( 0%)%'"#( !"44%&&,, (effec'+=%&52"7&DEE`@/

GEOGRAPHICAL PLATFORMS S%.,*(!"44%''%"#'= Joint body of NGOs and public authorities. Exchanges on working methods in a country. ?)0,'&%#,(10)&G"+4= Group of voluntary organisations. MdM has observer status.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

BOARD OF DIRECTORS The General Assembly elects 12 members of the Board for three years, along with three substitute board members. The Board in turn elects the President and the Bureau: the vice-presidents, the treasurer, the deputy treasurer, the general secretary and the deputy general secretary. As the executive body of the organisation, the Board meets every month and takes decisions on the management of the organisation.

At the General Assembly on 5 June 2010, Doctors of the World members elected the Board :

2$?.V"#$+&(#,$'"'+"#!1$ » Dr Christophe Adam General practitioner, Bordeaux

» Claire Boulanger-Lambert

» President: Dr Olivier Bernard Paediatrician, hospital doctor, Marseille

» 9%!,h1+,'%*,#&'=( Dr Thierry Brigaud Prevention doctor, Valenciennes

Dr Patrick David Anaesthetist, intensive care doctor, Reims

» [,#,+)0(',!+,&)+>= Dr Frédéric Jacquet Public health inspector, Montpellier

» K,1/&>(6,#,+)0(',!+,&)+>= Dr Patrick Beauverie Hospital pharmacist, Fontenay-sous-Bois

» Treasurer: Catherine Giboin

Manager, Le Mans

» Dr Xavier Carrard General practitioner, Marseille

» Dr Armelle Desplanques-Leperre Doctor, healthcare quality and safety, Haute Autorité de santé, Saint-Denis

» Dr Fabrice Giraux General practitioner, Paris

2$M*+!.-.*."$>&(#,$@"'+"#!1 » Olivier Maguet Consultant in social work and health, Ymonville

» Dr Brigitte Maître, Doctor, Mâcon

» Dr Jérôme Larché Medical intensive care doctor, Narbonne

Public health consultant, London

» K,1/&>(&+,)'/+,+= Dr Luc Jarrige, Hospital intensive care doctor, Moulins

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GLOSSARY A Q<N= Action Contre la Faim&AK3'+"#&-?-+#*'&C1#?%2@ QNK= Agence française de développement (French 9%=%;"!7%#'&K?%#3L@ QG[7(= Action for Global Health QNH= Association française pour la réduction des risques A_2%#3(&C-27&d%$13'+"#&K**"3+-'+"#@ QNMQ= Association française des trésoriers et responsables d’associations (French Association of Treasu2%2*&-#$&O-#-?%2*&"5&l";1#'-2L&02?-#+*-'+"#*@ QNgJ(B_= Fédération des acteurs de l’urgence sociale de la Charente (Charente Federation of Social Y7%2?%#3L&K3'"2*@ Q8KJ=(K3X1+2%$&M771#%&9%63+%#3L&JL#$2"7% Q8KIJ= Association de lutte contre le VIH-sida et les hépatites&AK**"3+-'+"#&_+?('+#?&KM9J&-#$&C%!-'+'+*@ QDIS: Association of Justice and Mercy QSI= Aide médicale de l’État&AJ'-'%&O%$+3-;&K+$@ QSI= Association malienne des expulsés (Malian K**"3+-'+"#&5"2&9%!"2'%%*@ QSIJ= Association des Mujeres en Solidaridad AB"7%#P*&J";+$-2+'L&K**"3+-'+"#@ ALQNI= Association nationale d’assistance aux frontières pour les étrangers (National Association to C%;!&_"2%+?#%2*&-'&'(%&Z"2$%2*@ QL?HIN= Association nationale prévention réduction des risques en espace festif (National Association for C-27&d%$13'+"#&-'&_%*'+=-;*@ ANRS: Agence nationale de recherche sur le sida et les hépatites virales (National AIDS and Viral Hepatitis d%*%-23(&K?%#3L@ QHQ<IS= Association des refoulés d’Afrique centrale au Mali (Association for Central African Depor'%%*&+#&O-;+@ QH<QM= Association pour la recherche et la communication pour l’accès aux traitements (Association for Research and Communication on Access to G2%-'7%#'@ QH9= Antiretrovirals QJQSPQ= Association santé migrants Loire-Atlantique

Ag"+2%IK';-#'+3&O+?2-#'&C%-;'(&K**"3+-'+"#@ QJHQKI<= Association sénégalaise de recherche AJ%#%?-;%*%&d%*%-23(&K**"3+-'+"#@ ASUD: Auto-Support des usagers de drogues (Drug 1*%2*P&*%;5&(%;!@

B \<[= Calmette and Guérin vaccine

C <QQHgK= Centre d’accueil et d’accompagnement à la réduction des risques pour les usagers de drogues AC-27&2%$13'+"#&3%#'2%&5"2&$21?&1*%2*@ <Q?J= Comité d’action et de promotions sociales AU"77+''%%&"5&*"3+-;&!2"7"'+"#&-#$&-3'+"#@ <QJ?: Centre d’action sociale protestant (Protestant J"3+-;&K3'+"#&U%#'2%@ <<QJ= Centre communal d’action sociale (Local J"3+-;&J%2=+3%*&U%#'2%@ <<K= Commission coopération développement A9%=%;"!7%#'&U"I"!%2-'+"#&U"77+**+"#@ <<S?= Centre communautaire médico-psychologique AO%$+3"I!*L3(";"?+3-;&3"771#+'L&3%#'2%@ <<L= Convention collective nationale (Joint national -?2%%7%#'@ <KQ[= Centre de dépistage anonyme et gratuit (Free -#$&-#"#L7"1*&*32%%#+#?&3%#'2%@ <K<= Center for Disease Control <NKQ= Coordination française pour le droit d’asile A_2%#3(&U"I"2$+#-'+#?&4"$L&"#&'(%&d+?('&'"&K*L;17@ <[JJ= Caisse générale de sécurité sociale (Social J%312+'L&_1#$@ <7?= Community Health Partnership <8KQ= Canadian International Development Agency <8SQKI= Comité inter-mouvement auprès des évacués-service œcuménique d’entraide (Ecumenical

O1'1-;&K+$&J%2=+3%@ <PI= Collectif interassociatif de lutte contre les exclusions&Al";1#'-2L&*%3'+"#&3";;%3'+=%&-?-+#*'&%H3;1*+"#@ <SQ= Commonwealth Medical Association <Sg= Couverture maladie universelle (Universal C%-;'(&M#*12-#3%@ <Sgh<= Couverture maladie universelle complémentaire AU"7!;%7%#'-2L&c#+=%2*-;&C%-;'(&M#*12-#3%@ <L<K7= Commission nationale consultative des droits de l’homme (National Consultative Commis*+"#&"#&C17-#&d+?('*@ <LPI= Conseil national des politiques de lutte contre la pauvreté et l’exclusion sociale (National Council on ,"=%2'L&-#$&J"3+-;&YH3;1*+"#@ <LJ= Conseil national du sida (National AIDS U"1#3+;@ <L9Q= Conseil national de la vie associative (National U"1#3+;&"5&l";1#'-2L&02?-#+*-'+"#*@ <AI= Council of Europe <ASIKI= Comité médical pour les exilés (Medical U"77+''%%&5"2&YH+;%*@ <"1%0= Steering Committee <AHI= Cooperation For Rehabilitation <AHI987= Comité de coordination de lutte contre l’infection due au VIH (Co-ordination Committee for K3'+"#&K?-+#*'&CMl@ <?QS= Caisse primaire d’assurance maladie (Local C%-;'(&M#*12-#3%&0563%@ <HIL= Centre de récupération et d’éducation nutritionnelle&Ab1'2+'+"#-;&d%3"=%2L&-#$&Y$13-'+"#&U%#'2%@ <H8?J= Centres régionaux d’information et de prévention du sida (Regional Centre for Prevention and M#5"27-'+"#&"#&KM9J@ <HIL8= Centre de récupération et d’éducation nutritionnelle intensive (Intensive Nutritional Recovery and Y$13-'+"#&U%#'2%@ <HILQJ= Centre de récupération et d’éducation nutritionnelle ambulatoire sévère (Walk-In Centre for d%3"=%2L&-#$&Y$13-'+"#&5"2&J%=%2%&O-#1'2+'+"#@ <HJQ= Conférences régionales de la santé et de l’autonomie (Regional Conferences on Health and M#$%!%#$%#3%@

DOCTORS OF THE WORLD ANNUAL REPORT 2010

<M<= Cholera treatment centre <JJS= Caisse de sécurité sociale de Mayotte (MaL"''%&J"3+-;&J%312+'L&0563%@

D KK<J= Direction départementale de la cohésion sociale&A9+*'2+3'&9%!-2'7%#'&"5&J"3+-;&U"(%*+"#@ KK9PQM= Dispositif départemental de vaccination et de lutte anti-tuberculeuse (District Action Plan for l-33+#-'+"#&-#$&G-3.;+#?&G14%231;"*+*@& K[K= Direction générale de la coopération au développement belge (Belgian Development Assistance 9%!-2'7%#'@ K8<= Drop-in Center K<?= Direction for Child Protection DPO: Division du partenariat avec les ONG (NGO ,-2'#%2*(+!&9+=+*+"#@ DRASS: Direction régionale des affaires sanitaires et sociales (Regional Health and Social Affairs Depart7%#'@ KH<= Democratic Republic of Congo DREES: Direction de la recherche, des études, de l’évaluation et des statistiques (Department for d%*%-23(<&Y=-;1-'+"#&-#$&J'-'+*'+3*@ DRR: Disaster risk reduction DUA: Dar ul-Aman Kg[Q= Children and young people’s psychological support centre

E I<7A=&Y12"!%-#&U"77+**+"#&C17-#+'-2+-#&0563% I<AJA<= UN Economic and Social Council ENSP: École nationale de la santé publique (National ,14;+3&C%-;'(&J3("";@ I?8S= European Programme for Integration and

Immigration Erasme: Centre régional de formation aux métiers du social (Regional Centre for Social Work Training and ,2"5%**+"#*@ IHQJSgJ= European Region Action Scheme for the Mobility of University Students IHP8= Éducation aux risques liés à l’injection (Educa'+"#&"#&2+*.*&-**"3+-'%$&>+'(&+#N%3'+"#@ IHH<= European Roma Rights Center IJ<= École supérieure de commerce (Business J3("";@ EU: European Union

H 7QPKI=(Haute Autorité de lutte contre les discriminations et pour l’égalité (High Level Body Fighting K?-+#*'&9+*32+7+#-'+"#&-#$&,2"7"'+#?&YX1-;+'L@ 7QJ= Haute Autorité de santé AC%-;'(&K1'("2+'L@ 7K8= Human Development Index 789=&C17-#&M771#"$%63+%#3L&l+21* 7S<= Hamad Medical Corporation 7?JM= Loi hôpital, patients, santé et territoire (Pa'+%#'<&C"*!+'-;*<&C%-;'(&-#$&G%22+'"2L&g->@ 7J\<= Hong Kong and Shanghai Banking Corporation 7gSQ= Health for Undocumented Migrants and Asylum seekers

NQ<M=(Family Aids Caring Trust NQPI?= Fédération des associations laïques et de l’éducation permanente (Federation of Secular 0#?"+#?&Y$13-'+"#&K**"3+-'+"#*@ NQA(= Food and Agriculture Organization NQH<= Armed Revolutionary Forces in Colombia NLQHJ= Fédération nationale des associations d’accueil et de réinsertion sociale (National Federation of J"3+-;&d%+#'%?2-'+"#&-#$&d%3%!'+"#&K**"3+-'+"#*@ NALDI?= Fonds de coopération de la jeunesse et de l’éducation populaire (Youth and Popular Education U"I"!%2-'+"#&_1#$@ NMI= Full-time equivalent

G [QN=(Groupe Amitié Fraternité [8JM8= Groupe d’information et de soutien des immigrés&AM77+?2-#'&*1!!"2'&-#$&+#5"27-'+"#&?2"1!@ [HJ?=(Groupement régional de santé publique Ad%?+"#-;&,14;+3&C%-;'(&\2"1!@

151

152

8\g]Q= Memory and Justice 8<AKI9= Community Initiatives for Development 8<H<= International Committee of the Red Cross 8<9Q= International Council of Voluntary Agencies 8I<= Information, education, communication 8I?= Institut d’études politiques (Political Studies M#*'+'1'%@ 8NHQJ= Institut de formation et de recherche en action sociale (Social Work Training and Research M#*'+'1'%@ 8NJ8= >(&"$"3"',)';157/"$1(')('&1$(&'$(*57$)5&'(Nurse G2-+#+#?&M#*'+'1'%@ 8[JJ= Istituto Guatemalteco de Securidad Sociale A\1-'%7-;-#&J"3+-;&J%312+'L&M#*'+'1'%@& 8SM= Institut de médecine tropicale (Tropical Medi3+#%&M#*'+'1'%@ 8L?IJ= Institut national de prévention et d’éducation pour la santé (National Institute for Prevention and C%-;'(&Y$13-'+"#@ 8LJII= Institut national de la statistique et des études économiques (National Institute for Economic J'1$+%*&-#$&J'-'+*'+3*@ 8LJIHS= Institut national de la santé et de la recherche médicale (National Institute for Health and O%$+3-;&d%*%-23(@ 8LMIHHI[= European Cross-Border Co-operation 8HMJ= Institut régional du travail social (Regional J"3+-;&B"2.&M#*'+'1'%@ 8gM= Institut universitaire de technologie (University G%3(#";"?L&M#*'+'1'%@ 89Kg= Intravenous drug users

KAD: Kindianaise d’assistance aux détenus (Kin$+-#%*%&J1!!"2'&5"2&9%'-+#%%*@ KPK: Kyber Pakhtunkhwa (Province in North West ,-.+*'-#@

J D]JSJ= Jan Kala Sahitya Manch Sanstha

L PK7= Ligue des droits de l’homme (Human Rights g%-?1%@ PJ8= Loi pour la sécurité intérieure (Internal Security g->@ PA??J8= Loi d’orientation et de programmation pour la sécurité intérieure (Law on Direction and Planning 5"2&M#'%2#-;&J%312+'L@

M SQI= Ministère des Affaires Etrangères (Ministry of _"2%+?#&K55-+2*@ S<7=(Mother and Child Health S<OQ]= Maternity and Child Welfare Association Khampur SK['=(Millenium Development Goals S*S= Médecins du Monde A9"3'"2*&"5&'(%&B"2;$@ SKJ= Médecins pour le droit à la santé (Doctors for '(%&d+?('&'"&C%-;'(@ SI?=(Mutuelle étudiante PACA, Languedoc Roussillon, Corse (PACA, Languedoc Rousillon and Cor*+3-&J'1$%#'&M#*12-#3%@ S8PKM= Mission interministérielle de lutte contre les drogues et la toxicomanie (Inter-Ministerial Task _"23%&"#&921?*&-#$&K$$+3'+"#*@ SANQ=&O+#+*'2L&"5&_"2%+?#&K55-+2*&A[-!-#@

S?[= Global Media Agency SJQ= Mutuelle santé agricole (Agricultural Health M#*12-#3%@

N L<=&b"'&3;-**+6%$ L[A= Non-governmental organisation

O A<7Q=&cb&0563%&5"2&C17-#+'-2+-#&K55-+2* ODSE: Observatoire du droit à la santé des étrangers A04*%2=-'"2L&"#&d+?('&'"&C%-;'(&5"2&O+?2-#'*@ ANKM= Observatoire français des drogues et des toxicomanies (French Observatory on Drugs and 921?&9%!%#$%#3%@ OS: Opération Sourire AM<(QI<8K(= ?*%$(/'@)%($%/',)'+/':.)(%$/'!A4/B1+/' de Cooperacion Internacional y Desarrollo (Technical 0563%&"5&'(%&J!-#+*(&M#'%2#-'+"#-;&9%=%;"!7%#'& ,2"?2-77%@

P ?Q<Q= Provence-Alpes-Côte d’Azur PAO: Public Aid Organisation PASS: Permanence d’accès aux soins de santé AC%-;'(3-2%&K33%**&0563%@ ?KQ78= C+/($*%/"$1(',)'+=1;;5)',=/%%3)$+',=#D9)5.)ment et d’insertion (Plan for Provision of Accommo$-'+"#&-#$&M#'%?2-'+"#@ ?78= Pharmacie humanitaire internationale (Internatio#-;&C17-#+'-2+-#&,(-27-3L@ ?JN= Pharmaciens sans frontières (Pharmacists Wit-

DOCTORS OF THE WORLD ANNUAL REPORT 2010

("1'&Z"2$%2*@ ?MS<M=(Prevention of mother-to-child transmission

R HIgL8JQN=(Prevention of foetal alcohol syndrome network HI987=(Town-Hospital Network

S JQH<= Syrian Arab Red Crescent SAS: Social Assistance Section S2AP: Service d’analyse, d’appui et de plaidoyer AK#-;L*+*<&J1!!"2'&-#$&K$="3-3L&9%!-2'7%#'@ J8QA= Service intégré d’accueil et d’orientation (Inte?2-'%$&d%3%!'+"#&-#$&K$=+3%&J%2=+3%@ JH7=(Sexual and reproductive health JM8=(Sexually transmitted infections SUD: Solidarité urgence développement (Solidarity 5"2&Y7%2?%#3+%*&-#$&9%=%;"!7%#'@

3-;&,*L3("IJ"3+-;IO%$+3-;&c#+'@ gSQ??= Unité mobile d’action psychiatrique pour les personnes précarisées (Mobile psychiatric outreach 1#+'&5"2&=1;#%2-4;%&!%"!;%@ UN: United Nations gLQ8KJ= United Nations Programme on HIV/AIDS UNASUR: Union Sudamericana de Naciones (Union "5&J"1'(&K7%2+3-#&b-'+"#*@ UNDP: United Nations Development Programme gLN?Q= United Nations Population Fund gL7<H= United Nations High Commissioner for Refugees Unicef: UN Fund for Children gL8A?JJ= Union nationale interfédérale des œuvres et des organismes privés sanitaires et sociaux (National Inter-federal Union of Private and Social 02?-#+*-'+"#*@ gLAK<=&c#+'%$&b-'+"#*&0563%&"#&921?*&-#$&U2+7% gHQSIP= Unité de recherche et d’action médico-légale&AO%$+3"I;%?-;&d%*%-23(&-#$&K3'+"#&c#+'@ gH<QS= Union régionale des caisses d’assurance maladie&Ad%?+"#-;&c#+"#&"5&C%-;'(&M#*12-#3%&0563%*@ URD: Groupe urgence réhabilitation développement AY7%2?%#3L&d%(-4+;+'-'+"#&9%=%;"!7%#'&\2"1!@ UNRWA: United Nations Relief and Works Agency USA: United States of America gJN= Unidad de Salud de la Familia del Paraguay A,-2-?1-L&_-7+;L&C%-;'(&c#+'@&

TADEPA: Tanzania Development and Prevention of Aids M\= Tuberculosis MK9=(Young People for the Right to Live M8<QK= Tokyo International Conference on African Development

g[AS?J= Unité de gynécologie-obstétrique médico-psycho-sociale (Obstetric and Gynaecologi-

O\8= Wallonie-Bruxelles International O7A= World Health Organization

ON?: World Food Programme

X x\M=(Drug analysis

9<<M=(l";1#'-2L&U"#6$%#'+-;&U"1#*%;;+#?&-#$&G%*ting 9A8<I= Collective of European NGOs

153

154

OUR THANKS TO: OUR PRIVATE PARTNERS N"/#*)&%"#'()#*(V/'%#,'','= Norwegian Church Aid, Air France, Association Ouest France Solidarité, Aviation Club de France, Bärchen, Bred, CIC, Crédit mutuel, Crédit coopératif, Annenberg Foundation, Gates Foundation, Clinton Foundation, Drosos Foundation, Fondation de France, L’Occitane Foundation, L’Oréal Foundation, Marcel Lepoutre Foundation, Maria Stroot Foundation, McCall MacBain Foundation, Optic 2000 Foundation, Roi Baudoin Foundation, Renovabis Foundation, Sternstunden Foundation, Fubon Cultural & Educational Foundation, PPR Foundation for Women’s Dignity and Rights, Imerys Ceramics France, l’Acoustics SA, Ivoire, Les Éditions Maréchal, L’Oréal SA, Matmut Assurances, Mr and Mrs Peters, Oh Éditions, Orepa Prévoyance, Réunion Rotary Club, </(1*':0)("$&' France, Société générale, Solidarpresse, Vinci, Vivendi INSTITUTIONAL PARTNERS S/0&%h0)&,+)0("+6)#%')&%"#'= European Union: DG ECHO,DG EuropeAid; United Nations agencies (UNDP, UNFPA, UNHCR, UNICEF, OCHA, UNAIDS, UNODC, WFP, WHO, CHF, Yd_@<&\;"4-;&51#$&-?-+#*'&KM9J<&'14%231;"*+*&-#$& 7-;-2+-<&B"2;$&Z-#.<&T&9+*%-*%*&_1#$&AT9_@/ \%0)&,+)0("+6)#%')&%"#'= k&M#&Y12"!%o&\%27-#&"563+-;&$%=%;"!7%#'&-**+*'-#3%& AKKCI12?%#3%@<&c^&"563+-;&$%=%;"!7%#'&-**+*'-#3%o& 9%!-2'7%#'&5"2&M#'%2#-'+"#-;&9%=%;"!7%#'&A9_M9@<&J!-#+*(&"563+-;&$%=%;"!7%#'&-**+*'-#3%&(AECID, Junta de Andalucia@<&O"#-3"&"563+-;&$%=%;"!7%#'&-**+*'-#3%&A9UM@<& 91'3(&"563+-;&$%=%;"!7%#'&-**+*'-#3%&AO_J&-#$&'(2"1?(&'(%& b\0*&U"2$-+$&-#$&b"=+4@<&b"2>%?+-#&"563+-;&$%=%;"!7%#'& -**+*'-#3%<&J>+**&"563+-;&$%=%;"!7%#'&-**+*'-#3%o&Direction du Développement et de la Coopération Suisse&A99U@/ k&In France: Agence française de développement&AK_9@<& Centre de crise du ministère des Affaires étrangères français AU9U@<&_2%#3(&%74-**+%*&A=+-&JUKU&-#$&_J9@<&Organisation internationale de la francophonie&A0M_@/ k&Others: American development assistance: USAID via Pact, PSI, Columbia University. Canadian International 9%=%;"!7%#'&K?%#3L&AUM9K@<&[-!-#%*%&"563+-;&$%=%;"!7%#'& -**+*'-#3%&A[MUK@/ N+,#!3(0"!)0()/&3"+%&%,'=(Rhône-Alpes region, Safer de l’Île-de-France, Réunion 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. Town councils: Paris, Grenoble, Rhinau, Le Cannet, Rehon, Dreux, Fontenay-sous-Bois, Montpellier, Guillestre, Haironville, Joigny, Rouen, Senches, Tournus, Dreux, Montpezat de Quercy, Saint-Aubin, Saint-Étienne… N"+("/+(+,6%"#)00>h4)#)6,*(%#&,+#)&%"#)0(1+"X,!&'= k&District councils: Bouches-du-Rhône, Alpes-de-HauteProvence, Gironde, Charente-Maritime, Vosges, Doubs, La Réunion, Midi-Pyrénées, PACA. k&Regional councils: Provence-Alpes-Côte d’Azur and Rhône-Alpes; présidence des régions, Guadeloupe prefecture. ?+"6+)44,'(%#(N+)#!,= Groupes régionaux de santé publique A\dJ,@<&Agences régionales de santé AKdJ@<&Caisse nationale d’assurance maladie&AUbKO@<&5-7+;L&-;;">-#3%&51#$*&AUK_@<&2%?+"#-;& (%-;'(&+#*12-#3%&51#$*&AUOd@<&;"3-;&(%-;'(&+#*12-#3%&"563%*& AU,KO@<&2%?+"#-;&(%-;'(&+#*12-#3%&"563%*&AU2-7@<&;"3-;& *"3+-;&*%2=+3%*&AUUKJ@<&52%%&-#"#L7"1*&'%*'+#?&3%#'2%*& AU9K\@<&$+*'2+3'&3"1#3+;*<&2%?+"#-;&3"1#3+;*<&'">#&3"1#3+;*<& Agence nationale pour la cohésion sociale et l’égalité des chances AKUJY@<&direction générale de la Santé&A9\J@<&direction générale de l’Action sociale&A9\KJ@<&2%?+"#-;&(%-;'(& -#$&*"3+-;&-55-+2*&$%!-2'7%#'*&A92-**&-#$&9$-**@<&!2%5%3'12%*<&(%-;'(3-2%&-33%**&"563%*&A,-**@<&'(%&'%22+'"2+-;&-27L<& direction de l’Action sociale, de l’Enfance et de la Santé A9-*%*@<&Mission interministérielle de lutte contre la drogue et la toxicomanie&AOMg9G@<&département Santé et Société A9JJ@<&2%?+"#-;&(%-;'(&+#*12-#3%&51#$&1#+"#*&Ac23-7@<&("*!+'-;*<&\1+-#-&*"3+-;&*%312+'L&51#$&AU\JJ@<&Mutualité sociale agricole AOJK@<&Observatoire français des drogues et des toxicomanies&A0_9G@/ OUR PARTNER ASSOCIATIONS AIDES, ALC Nice, Amnesty International, ANEF, Association de communication et d’action pour l’accès aux traitements, Association des régions de France, AFR, 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, Cercle central, 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, E)("5)',)'4+/($*%/"$1(',)&'C/2&',)'+/'-1$5), Coordination française pour le droit d’asile (CFDA), Collectif Alsace d’associations intervenant auprès des personnes se prostituant, collectif interassociatif sur la santé (CISS), collectif Romeurope, collectif Migrants outre-mer (MOM), collectif Alerte, Collectif de soutien aux victimes de Bam, Comité des amis d’Emmaüs, Communauté mariste, Congrégation des sœurs augustines, Cordaid, the Red Cross, CSF, Coordination française pour le droit d’asile, Coordination nationale des réseaux&AUbd@<&UL3;-7%$<&Droit au logement, D’une rive à l’autre, DHL Liens, Emmaüs, Entraide majolane, Équipe mobile Rimbaud, Fédération des associations pour la promotion et l’insertion par le logement (Fapil), FIDH, Fédération nationale des associations d’accueil et de réinsertion sociale (Fnars), foyer Sonacotra, foyer StBenoît, Gisti, International Harm Reduction Association AMCdK@<&L’ordre de Malte, La Case, les Amis du bus des femmes, Les Mondes solidaires, les Restos du cœur, le Stade rennais FC, Ligue de Bretagne de football (and '(%&Z2+'-##L&5""'4-;;&3;14*@<&Ligue des droits de l’homme, Max Havelaar, Novib, Observatoire du droit à la santé des étrangers&A09JY@<&Observatoire international des prisons A0M,@<&,-3'<&Passerelle la Santé sans frontières, Pharmacie humanitaire internationale&A,CM@< 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,&G"12+*7&5"2&9%=%;"!7%#'&AG_9@<&AS Kiwanis Club, Addocuiation, Les Jardins du livre, Association école de karaté traditionnel, Rotary Club SaintNazaire Atlantique, Association Notre-Dame des Aides AND ALL OUR OTHER PARTNERS WHO HAVE SUPPORTED OUR WORK AT HOME AND ABROAD DURING 2010, PARTICULARLY THOSE WHO HAVE SUPPORTED US WITH A LEGACY OR LIFE INSURANCE POLICY AND OUR OTHER INDIVIDUAL DONORS.

EDITOR-IN-CHIEF AP898IH(\IHLQHK CO-ORDINATION 7rPyLI(9QPPJ( EDITORIAL COMMITTEE DgP8IMMI(<7I9QP8IH( [8JIPKQ([QH[QLA( 8JQ\IPPI(\8A7hDA7LJAL( ]QJ8Q(\AL]AOJ]Q

EDITORS SQH[Qgx(Kg[AgDAL( [8JIPKQ([QH[QLA JMr?7QL8I(JILIM( 7rPyLI(9QPPJ

GRAPHIC DESIGN PUr<PQ8HIgH

EDITORIAL SECRETARY M7rHyJI(\ILA8M

PRODUCTION OF THE CD FILES 8JQ\IPPI(SQHM8DQhA<7AQ

MAPS DgP8IL(\AgJQ<( 98L<ILM([8Q9IPP8(

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PICTURE EDITOR QgHAHI(9AIM

TRANSLATION ]QHIL(S<<APP( IP8LAH(S8KKPIMAL [8PP(<A<]8L QL[IP8LI(KQ98IJ THANKS MA(I9IHmALI(O7A( 7IP?IK(O8M7(M78J( CEBE(IK8M8AL

This report is printed on FSC certified paper made up of 50% new fibres and 50% recycled fibres.

Zimbabwe © Lahcène Abib / Haiti © Lahcène Abib

Doctors of the World France 62 rue Marcadet 75 018 Paris www.medecinsdumonde.org

Tel. +33 1 44 92 15 15 Fax. +33 1 44 92 99 99

ALGERIA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

\"+*,+(!0"'/+,'(%#(#"+&3,+#(Q06,+%)(3)2,(,GG,!&%2,0>(V0"!@,*(&3"/')#*'("G('/VhJ)3)+)#(4%6+)#&': Only around a hundred were able to obtain refugee status. The vast majority of migrants live outwith the law and in very precarious condi%,1$&D'T4*,"'#))*&&'%1'4*#/%4)#"*',&'5#"%,)./#"/2'+,(-)./%'#$+'),6,/'&1),*%2'&%".!!/*&'%1'+*#/'F,%4'%4*'&,%.#%,1$D

LONG TERM LIFE EXPECTANCY 72.9 YRS HDI 0.677; RANK 84/169 Source: UNDP 2010

POPULATION

» Target: 5,000 PERSONNEL

» International: 2 CO-ORDINATORS

» Programme: J"13%,(Q00)+>-( ?3%0%11,([)V+%i » Field: <)4%00,(P,(?+%#!, » Headquarters: 8')V,00,(\+/)#* FUNDING

» S*S

Facilitating access to healthcare for migrants

» Alger R%0)>)-(&"R#'(%#(&3,('"/&3()#*("#(&3,(!")'&

» ACTIVITIES The programme aims to improve access to healthcare and to other rights for migrants in Algiers by bringing together various local players. There programme has four components: creation of a network of health service mediators, helping organisations to support migrants, developing community-based health education activities and launching a process of capitalising on this experience and transnational lobbying activities.

ALGERIA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

J/VX,!&(&"('&+/!&/+)0(+,G"+4'(&3)&(&,#*(&"R)+*'(1+"6+,''%2,(1+%2)&%')&%"#-(the Algerian public health sector is in crisis. S&'#'"*&./%7'#))*&&'%1'4*#/%4)#"*',&'9*)18,$!',$)"*#&,$!/2'+,(-)./%7'#$+'.$#((1"+#9/*7'(1"'%4*'515./#%,1$D'T4*'(1//1FG.5'1(' treatment for chronic conditions is deteriorating and health education, prevention and accompaniment activites are very poorly developed.

LIFE EXPECTANCY 72.9 YRS HDI 0.677; RANK 84/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['340 » Target: 30,000

LONG TERM

» <"#'&)#&%#,

Health education

» ACTIVITIES MdM is supporting Association Cirta Oxygène (ACO) with the implementation of a primary and community health promotion programme. This programme involves promoting health education for patients affected by chronic diseases, by developing community-based activities and practices that do not depend on medication. The programme also aims to demonstrate the value of these practices to the country’s health authorities and other stakeholders.

PERSONNEL

» National: 1 » International: 0 CO-ORDINATORS

» Programme: Robert Allemand » Monitoring: Q#6i0%F/,(9i+i-( H3u#,hQ01,'(H,6%"#)0( K,0,6)&%"# FUNDING

» 8't+,(K%'&+%!&(<"/#!%0-([+,#"V0,(<%&>(<"/#!%0-(S*S BUDGET

» 2010: €14,935

» RESULTS T`E&+#$+=+$1-;*&(-=%&!-2'+3+!-'%$&+#&KU0P*&=-2+"1*&-3'+=+'+%*&A6=%&(%-;'(L&%-'+#?&>"2.*("!*<&'>"& thematic focus groups, individual interviews, one training session on controlling blood sugar levles, three awareness-raising campaigns, six meetings with public sector doctors and one semi#-2&"#&(%-;'(&%$13-'+"#@/

» OUTLOOK From 2011, ACO would like to develop its activities with a younger target group. The organisation has submitted an application to the multi-party joint programme. In addition, the organisation is looking for funds to be able to become autonomous.

ANGOLA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

J%#!,(&3,(,#*("G(&3,(R)+(%#(CEEC-(Q#6"0)(3)'(V,,#(+,V/%0*%#6(%&',0G-(R%&3(3,01(G+"4(%&'("%0(+,2,#/,':(However, the situation remains very insecure for the most disadvantaged and the gap between the rich and the poor is growing. Although the budget allocated to health is increasing, the majority of the population is still excluded from healthcare. The most vulnerable are the poor urban populations, particularly street children, as well as the rural populations.

LIFE EXPECTANCY 48.1 YRS HDI 0.403; RANK 146/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['150

LONG TERM

» Lobito, \,#6/,0)(1+"2%#!,

Supporting care for street children

» ACTIVITIES Between 2005 and 2008, MdM worked in Angola to improve the living conditions of street children in Lobito, in partnership with civil society and the government, by improving access to healthcare and to hygienic conditions, helping with socio-economic reintegration and strengthening the child protection system.

CO-ORDINATORS

» Programme: P/!(D)++%6/, » Headquarters: J&i13)#%,(K,+"f%,+ FUNDING

» g\J(N"/#*)&%"# BUDGET

» 2010: €17,491

In view of the results obtained, and to ensure that the activities undertaken will be sustainable, MdM decided that the project was ready for handover to the Angolan organisation OMUNGA in 2009. OMUNGA works on children’s rights and is very involved in advocacy activities. Until March DEQE<&0Ocb\K&2%3%+=%$&6#-#3+-;&-#$&'%3(#+3-;&*1!!"2'&52"7&O$O&'"&(%;!&*'2%#?'(%#&+'*&3-!-city so that the handover could take place in the best possible conditions.

» RESULTS Since 2009, 150 children and adolescents living on the streets have been supported in a health centre, around 20 have received training.

» OUTLOOK In 2011, MdM France and MdM Spain are going to open a joint project in Kwanza Norte province. This project aims to improve the right to health for women and young people by strengthening the health system in relation to sexual and reproductive health and by mobilising civil society and the community.

BURKINA FASO

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

O%&3("#,("G(&3,(1""+,'&(3,)0&3(+,!"+*'(%#(O,'&(QG+%!)-(economic growth which has not impacted on living conditions #$+'#'/#)Q'1('51/,%,)#/'F,//'%1',85"16*'%4*'4*#/%4'&2&%*87'#))*&&'%1'4*#/%4)#"*'"*8#,$&'6*"2'+,(-)./%'(1"'81&%'`."Q,$#9f&'g' abh'1('F418'/,6*'9*/1F'%4*'516*"%2'/,$*D'\4,/+"*$'.$+*"'-6*'#$+'5"*!$#$%'F18*$'#"*'81&%'#((*)%*+D'N+N',&'F1"Q,$!'%1' prevent and to provide care for children affected by malnutrition.

LIFE EXPECTANCY 53.7 YRS HDI 0.305; RANK 161/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['22,000 » T#"!*%[')4,/+"*$'.$+*"'-6* PERSONNEL

» National: 5 » International: 0

LONG TERM

» K%iV"/6"/-(J"/&3hO,'&(+,6%"#

Caring for children affected by malnutrition

The programme focuses on strengthening and consolidating care and prevention activities in relation to malnutrition in children monitored and/or accommodated in a Nutritional Recovery and Education Centre.

» ACTIVITIES

G(2%%& >%%.;L& #12*%& 3-2%& *%**+"#*& +#& '(%& !2"=+#3+-;& ("*!+'-;& AUOK@& '-.%& !;-3%<& %#-4;+#?& 4%''%2& medical and nutritional monitoring for all the children. This also enables us to consolidate the par'#%2*(+!&>+'(&'(%&b1'2+'+"#-;&d%3"=%2L&-#$&Y$13-'+"#&U%#'2%&AbdYU@&+#&'(%&UOK/

CO-ORDINATORS

» Programme: ?3%0%11,(*,(\"&&"# » Monitoring: ?Q<Q(H,6%"#)0( K,0,6)&%"#-(8')V,00,(S)0)2)0

K& 6=%I4%$& bdYU& '2%-'7%#'& 5-3+;+'L& (-*& 4%%#& *%'& 1!& +#*+$%& '(%& !2"=+#3+-;& ("*!+'-;& '"& 3-2%& 5"2& malnourished children. Training was provided for the whole NREC team in May 2010 on the pro$13'+"#&"5&O+*";-&)"12&-#$&"#&(L?+%#%&!2-3'+3%*/

FUNDING

» Q01,'hS)+%&%4,'(K%'&+%!&( <"/#!%0-(1+%2)&,(*"#)&%"#'-(N+,#!3(,4V)''>(%#( A/)6)*"/6"/-(PUA!!%&)#,( N"/#*)&%"#-(S*S BUDGET

» RESULTS 46 children affected by acute or chronic malnutrition have received medical care in the NREC. 318 3(+;$2%#&(-=%&4%%#&7"#+'"2%$&-*&"1'!-'+%#'*&>+'(&#1'2+'+"#&-$=+3%&-#$&$+*'2+41'+"#&"5&)"12/&QT]& children have been screened and treated in villages.

» 2010: €44,500

» OUTLOOK In 2011, MdM will consolidate its activities by strengthening the partnership with the district hospital, by promoting systematic referral of severely malnourished children to the NREC. A Misola )"12&7-#15-3'12+#?&1#+'&>+;;&-;*"&4%&*%'&1!&+#&"2$%2&'"&!2%=%#'&3(2"#+3&7-;#1'2+'+"#&-#$&'"&?%#%2-'%& income which will help sustain the NREC activities in the long term. Finally, the programme will fund the provision of medical and recovery equipment in the NREC.

BURKINA FASO

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

POPULATION

» `*$*-),#"2['10,000 » Target: 180,000 inhabitants of the province PERSONNEL

» National: 2 » International: 0

Access to oral healthcare

» K%iV"/6"/

» ACTIVITIES The dental surgery&A"!%#&6=%&$-L*&-&>%%.@&3"#'+#1%*&+'*&>"2.&>+'(&-#&+#32%-*%&+#&'(%&#174%2&"5& 3"#*1;'-'+"#*&ARQD@&3"7!-2%$&'"&!2%=+"1*&L%-2*&A-2"1#$&Wa&!-'+%#'*&!%2&7"#'(<&-#$&"5&'(%*%&]ES& -2%&#%>&!-'+%#'*@/&G(%&7"4+;%&3;+#+3&(-*&3"#'+#1%$&+'*&>"2.&A"#%&"1'+#?&!%2&>%%.@&"=%2&'(%&L%-2& >+'(&(%-=L&-''%#$-#3%&Aa`W&!-'+%#'*<&#%-2;L&-;;&"5&'(%7&#%>@&-#$&-&#%'&+#32%-*%&+#&'(%&!%23%#'-?%& "5&%H'2-3'+"#*&4%3-1*%&"5&-&2%$13'+"#&+#&3"*'*&ARES&+#&DEQE<&3"7!-2%$&'"&TaS&+#&DEEF@/

» RESULTS 712 consultations, with an extraction performed in 50% of these cases.

CO-ORDINATORS

» Programme: N)##>(\,#'"/'')# » Field: K%,/*"##i(7%,# » Monitoring: ?Q<Q(H,6%"#)0( K,0,6)&%"#-(8')V,00,(S)0)2)0 FUNDING

» S*S-(N+,#!3(,4V)''>(%#( A/)6)*"/6"/ BUDGET

» 2010: €44,500

» OUTLOOK In 2011, MdM will develop new activities: reducing the costs of extractions and the introduction "5&-&*%2=+3%&'"&!2"$13%&-#$&6'&5-;*%&'%%'(&>+'(&-&=+%>&'"&'(%&6#-#3+-;&*1*'-+#-4+;+'L&"5&'(%&!2"N%3'&& after MdM’s withdrawal at the end of 2011. K& #%>& *%2=+3%& "5& '(%& $%#'-;& 3(-+2& A3(%3.+#?& '(-'& +'& +*& >"2.+#?& !2"!%2;L@& +*& *3(%$1;%$& 5"2& O-23(& 2011. In June, the nurse will be trained in dentistry and will strengthen the PRAH team.

CHAD

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

M3,+,(3)2,(V,,#('"4,('%6#%5!)#&(%41+"2,4,#&'(`%41+"2%#6(+,0)&%"#'(R%&3(J/*)#-(,#*("G(4%0%&)+>(3"'&%0%&%,'(%#(&3,(,)'&( "G( &3,( !"/#&+>a( )#*( <3)*( V,6)#( CEBE( %#( +,0)&%2,( 1"0%&%!)0( '&)V%0%&>:( 7"R,2,+-( &3,( 3,)0&3( '%&/)&%"#( +,4)%#'( R"++>%#6:( <3)*(%'("#,("G(&3,(+)+,(!"/#&+%,'(R3,+,(4)&,+#)0(4"+&)0%&>(%'(!"#&%#/%#6(&"(%#!+,)',:(CEBE(R)'()0'"(4)+@,*(V>()(G""*( !+%'%'(%#(&3,(J)3,0(+,6%"#. LONG TERM LIFE EXPECTANCY 49.2 YRS HDI 0.295; RANK 163/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['68 196 » Target: 113,851 PERSONNEL

» National: 39 » International: 6 CO-ORDINATORS

» Programme: Éric Peterman » Field: \)'%0,(I4)(IV,*, » Headquarters: \,+&+)#*(\+iF/,2%00, FUNDING

» g#%!,G-(gLN?Q-(JR%''(1/V0%!( G/#*'-(K[hI<7A-(S*S BUDGET

» 2010: €930,028

Improving access to healthcare for women and children

» Kanem

» ACTIVITIES In partnership with the local authorities, MdM supports 10 health facilities and the regional ("*!+'-;<&1#$%2&'(%&-1*!+3%*&"5&'(%&#-'+"#-;&7"'(%2&-#$&3(+;$&(%-;'(&!";+3L/&M#&'(%&6%;$<&O$O&!2"=+$%*&*12?+3-;&-#$&!*L3("I*"3+-;&3-2%&'"&>"7%#&*155%2+#?&52"7&6*'1;-*&-#$&*1!!"2'*&'(%&7-'%2#+'L& unit and operating theatre to be able to carry out emergency caesarians. MdM provides the health facilities with support for maternal and neonatal care (antenatal consultations, caring for compli3-'%$&$%;+=%2+%*<&*%#$+#?&$-#?%2"1*&$%;+=%2+%*&'"&("*!+'-;&4L&-741;-#3%@/&G(%&!2"N%3'&-;*"&2-+*%*& awareness among villagers about issues around mother and child health and trains traditional birth attendants. In response to the food crisis which affected the Sahel area in 2010, MdM also supported '2%-'7%#'&5"2&3"#$+'+"#*&;+#.%$&'"&-31'%&7-;#1'2+'+"#&5"2&3(+;$2%#&1#$%2&6=%&+#&DE&(%-;'(&5-3+;+'+%*& between May and October.

» RESULTS WE&>"7%#&*155%2+#?&52"7&6*'1;-*&>%2%&"!%2-'%$&"#&+#&DEQE&-#$&QQ<aEa&!%"!;%&2%3%+=%$&+#5"27-'+"#&"#&7-'%2#-;&-#$&#%"#-'-;&(%-;'(&"2&"#&6*'1;-*/

» OUTLOOK MdM will reinforce its support for the health facilities in the region by expanding to another 15 3%#'2%*&-#$&%H!-#$&-33%**&'"&!2+7-2L&(%-;'(3-2%&5"2&3(+;$2%#&1#$%2&6=%/&K'&'(%&("*!+'-;<&O$O& continues to concentrate on training national surgical teams to provide quality care to patients.

DRC

DOCTORS OF THE WORLD ANNUAL REPORT 2010

DEMOCRATIC REPUBLIC OF CONGO

INTERNATIONAL PROGRAMMES » AFRICA

K)4)6,*(V>()(0"#6(!%2%0(R)+- DRC has experienced real setbacks since 1970 and remains one of the poorest countries in the world. The gradual return to peace is bringing stability, but things are not yet back on track. As we go into 2011, an election year, it seems that we must continue to wait. MdM is working on two health policy areas—in relation to sexual violence and access to healthcare for vulnerable groups—in partnership with civil society and the health authorities. LONG TERM LIFE EXPECTANCY HDI 0.239; RANK

48 YRS 168/169

Source: UNDP 2010

POPULATION

» `*$*-),#"2['5,186 » Target: 13,877 PERSONNEL

» National: 16 » International: 4 CO-ORDINATORS

» Programme: K%*%,+(<)##,& » Field: S)+%,hQ#6,(["/. » Headquarters: <)&3,+%#,(<"/+&%# FUNDING

» g#%!,G-(QNK-(I/+"1,)#( g#%"#(`I/+"1,Q%*a-(?)+%'(<%&>( <"/#!%0-(N/V"#(N"/#*)&%"#-( Q##,#V,+6(N"/#*)&%"#-( S*S BUDGET

» 2010: €969,475

» Kinshasa

» ACTIVITIES Providing Based on a solid partnership with a local organisation, and in liaison with a large network, care and the programme aims to improve access to healthcare for children living on the streets, with a protection for particular focus on girls. Primary healthcare consultations are provided in four clinics in Kinshasa girls living on with referral to appropriate health services, particularly for HIV testing and care. Patients living the streets with AIDS have access to psycho-social support to help them adhere to treatment programmes.

K&*(%;'%2&%*!%3+-;;L&5"2&?+2;*&-#$&L"1#?&>"7%#&;+=+#?&"#&'(%&*'2%%'*&!2"7"'%*&3-2%&5"2&*!%3+63& 7%$+3-;&#%%$*&A2%!2"$13'+=%&(%-;'(@&-#$&!2"'%3'+"#&A*%H1-;&=+";%#3%@/&,*L3("I*"3+-;&-3'+=+'+%*&-#$& professional re-integration support are also provided. Advocacy activities, directed at the authori'+%*<&(-=%&4%%#&$%=%;"!%$&'"&6?('&5"2&'(%&2%3"?#+'+"#&"5&*'2%%'&3(+;$2%#P*&2+?('*/

» RESULTS 16,224 consultations carried out, including 969 in relation to reproductive health (206 pregnancies 7"#+'"2%$&-#$&D]E&>"7%#&*'-2'%$&"#&3"#'2-3%!'+"#@/

» OUTLOOK In 2011, the focus will be on harm reduction among girls living on the streets in Kinshasa. The project will include prevention, treatment for HIV/AIDS, STIs and hepatitis. Sexual violence cases will receive multi-disciplinary support and the capacity of our partners will be strengthened.

M. 17 years old

“Because of my illness, sickle-cell anaemia, my family thought I was a witch and threw me out. On the streets I fell pregnant and my illness caused me so much pain that I decided to kill myself. The educator in the centre found me with a rope already attached to a beam and took me to the psychologist. We .%4J'0)%)4#.I)K#0%E)&E)0%8$6.'")2()+,')&#/.6()#40)%/0)2()0#2/$) well.”

DRC

DOCTORS OF THE WORLD ANNUAL REPORT 2010

DEMOCRATIC REPUBLIC OF CONGO

INTERNATIONAL PROGRAMMES » AFRICA

K,'1%&,(&3,(6+)*/)0(+,&/+#(&"(1,)!,-(&3,(1"1/0)&%"#("G(eastern Democratic Republic of Congo continues to experience violations of human rights, particularly sexual violence. The consequences for the population are critical. MdM provides support by building capacity within civil society and health institutions.

LONG TERM LIFE EXPECTANCY HDI 0.239; RANK

48 YRS 168/169

Source: UNDP 2010

POPULATION

» `*$*-),#"2['3,170 » Target: 9,540 PERSONNEL

» National: 5 » International: 2 CO-ORDINATORS

» Programme: <3+%'&%)#(P)2)0 » Field: D/0%,(\"*%#-( ?)'!)0,(\)+#%!3hS/#6R) » Headquarters: <)&3,+%#,(<"/+&%# FUNDING

» QNK-(gLN?Q-(S*S BUDGET

Tackling sexual violence through a communitybased mental health programme

» L"+*h]%2/(1+"2%#!,

» ACTIVITIES The project continues to reinforce the knowledge and skills of psycho-social counsellors, "5'%#&'(%&62*'&!"+#'&"5&3-;;&5"2&=+3'+7*/&O$O&*1!!"2'*&-&2%*"123%&-#$&%H3(-#?%&3%#'2%&"#&*%H1-;& violence, offering counsellors support activities and an opportunity to exchange experiences. The project also enabled implementation of community-based mental health activities in partnership with six Congolese NGOs in Goma and in the rural environment (awareness-raising, psycho-social 3-2%&-#$&*1!!"2'&>+'(&5-7+;L&-#$&*"3+"I%3"#"7+3&2%+#'%?2-'+"#@/

» RESULTS 310 female victims of sexual violence cared for by 53 psycho-social counsellors trained to support victims.

» OUTLOOK Having trained a pool of community agents to support victims, the project looks to its long-term sustainability by building managerial capacity within civil society organisations involved in tackling *%H1-;&=+";%#3%&A"2?-#+*-'+"#*&'(-'&'(%&3"1#*%;;"2*&(-=%&3"7%&52"7@/

» 2010: €392,722

Elizabeth Psycho-social counsellor

“The knowledge and practices I learned have been enriching. Noone can ever take them away from me. The training I’ve received will stay forever—with my family, my partner, my children and, of course, with me.”

DRC

DOCTORS OF THE WORLD ANNUAL REPORT 2010

DEMOCRATIC REPUBLIC OF CONGO

INTERNATIONAL PROGRAMMES » AFRICA

LONG TERM LIFE EXPECTANCY HDI 0.239; RANK

48 YRS 168/169

Source: UNDP 2010

POPULATION

» `*$*-),#"2['5,130 » Target: 20,000

Tackling HIV/AIDS

» L"+*h]%2/(1+"2%#!,(`["4)()#*(])+%'%4V%(3,)0&3(f"#,'a

» ACTIVITIES Launched in 2003, this programme takes an integrated approach to tackling sexually trans7+''%$&+#5%3'+"#*&AJGM*@&-#$&CMlrKM9J/&O$O&>"2.*&>+'(&;"3-;&*'-.%(";$%2*&A(%-;'(&-1'("2+'+%*&-#$& ;"3-;&"2?-#+*-'+"#*@&'"&N"+#';L&$%=%;"!&-#$&*'%%2&'(%&!2"?2-77%/&G%3(#+3-;<&+#*'+'1'+"#-;&-#$&6#-#cial support provided by MdM enabled implementation of a complete package of activities to tackle HIV in each of the programme areas.

PERSONNEL

» National: 22 » International: 0 CO-ORDINATORS

» Programme: Q0(S"/#,+(M)0%V"-( N+i*i+%!(D)!F/,& » Field: \%00>(J%2)3,+)-( ?)'!)0,(\)+#%!3hS/#6R) » Headquarters: <)&3,+%#,(<"/+&%# FUNDING

» S/0&%h0)&,+)0(G/#*'(`gLK?( )#*(<"+*)%*a-(K/&!3(S%#%'&+>( "G(N"+,%6#(QGG)%+'-(S*S BUDGET

» 2010: €961,837

The plan includes three STI services, one testing and counselling service and one location for !2%=%#'+"#&"5&7"'(%2I'"I3(+;$&'2-#*7+**+"#&A,OGUG@&-3'+=+'+%*&+#&\"7-<&"#%&CMl&-#$&"#%&,OGUG& service in Karisimbi, support for a provincial blood transfusion service that covers two health zones and a network of 12 local organisations under the umbrella of the FOSI platform for awareness-raising activities.

» RESULTS 5,130 patients were monitored, 1,425 received antiretroviral treatment, 4,783 people were tested AQaS&CMl&!"*+'+=%@<&WEE<EEE&!%"!;%&2%-3(%$&4L&->-2%#%**I2-+*+#?&-3'+=+'+%*/

» OUTLOOK G(%&;"3-;&.%L&!;-L%2*&+#=";=%$&+#&'(%&6?('&-?-+#*'&CMl&(-=%&2%-3(%$&'(%&2%X1+2%$&;%=%;&"5&%H!%rience to be able to takeover the arrangements that are in place. MdM provides technical and 6#-#3+-;&*1!!"2'&'"&%#*12%&'(%&*1*'-+#-4+;+'L&"5&'(%&-3'+=+'+%*/&G(%&$2-*'+3&2%$13'+"#&+#&51#$+#?&5"2& HIV projects, however, threatens to compromise this objective. Isidore Kalimira President of a Congolese HIV organisation

LK6')%"&'0)*#/-2*.)%/0).6')!#!84%.2#/)02(!4%*'&'/.()6%,') made us forget the issue of HIV in this high-prevalence region. Humanitarian organisations and UN agencies have set up emergency programmes, ignoring any anti-AIDS activities. Patients have been abandoned and left to die.”

DRC

DOCTORS OF THE WORLD ANNUAL REPORT 2010

DEMOCRATIC REPUBLIC OF CONGO

INTERNATIONAL PROGRAMMES » AFRICA

8#('"/&3h,)'&(KH<-(&3,(3/6,(])&)#6)(1+"2%#!,(%'(*%2%*,*(%#(&R"=(the cobalt belt in the south and the rural, agricultural #"*#',$'%4*'$1"%4D'T#$!#$2,Q#'+,&%",)%7'F4,)4'91"+*"&'%4*')1$P,)%'#"*#7',&'#'%"#$&,%,1$'#"*#'F4*"*'%4*'4*#/%4'&2&%*8'"*8#,$&' *<%"*8*/2'("#!,/*D'\41/*"#',&'*$+*8,)',$'/#Q*&,+*'#"*#&'#$+'P1.",&4*&'#/1$!'%4*'",6*"&'#$+'%4*')188.$,)#%,1$'"1.%*&D'N+N' is supporting the health authorities. LONG TERM LIFE EXPECTANCY HDI 0.239; RANK

48 YRS 168/169

Source: UNDP 2010

POPULATION

» `*$*-),#"2['3 675 PERSONNEL

» National: 26 » International: 3 CO-ORDINATORS

» Programme: Xavier Joubert » Field: Q4i0%,(K,V"+*,-( ?)'!)0,(\)+#%!3hS/#6R) » Headquarters: <)&3,+%#,(<"/+&%# FUNDING

» g#%&,*(L)&%"#'(`g#%!,G-( gLK?a-(Q4,+%!)#(I.1+,''-( S*S BUDGET

» 2010: €304,969

Preventing and dealing with epidemics

» ])&)#6)(1+"2%#!,-(M)#6)#>%@)(*%'&+%!&(`BB(3,)0&3(f"#,'a

» ACTIVITIES Support for the health authorities, particularly on training and supervision of health service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introduced health mapping.

» RESULTS T<WRa&3-*%*&'2%-'%$<&+#3;1$+#?&a]a&3(+;$2%#&1#$%2&6=%<&>+'(&-&5-'-;+'L&2-'%&"5&DS/

» OUTLOOK Z";*'%2%$&4L&!-2'#%2*(+!*&'(-'&(-=%&4%%#&5"2?%$&"=%2&7"2%&'(-#&6=%&L%-2*&>+'(&'(%&$+*'2+3'&(%-;'(&& authorities, and based on a capacity-building approach, MdM plans to withdraw in 2011. The organisation is preparing to handover responsibilities to the relevant authorities.

DRC

DOCTORS OF THE WORLD ANNUAL REPORT 2010

DEMOCRATIC REPUBLIC OF CONGO

INTERNATIONAL PROGRAMMES » AFRICA

48 YRS 168/169

Source: UNDP 2010

POPULATION

» `*$*-),#"2['29,090 » Target: 203,735 PERSONNEL

» National: 26 » International: 3 CO-ORDINATORS

» Programme: Xavier Joubert » Field: Q4i0%,(K,V"+*,-( ?)'!)0,(\)+#%!3hS/#6R) » Headquarters: <)&3,+%#,(<"/+&%#

Supporting local health services

» ])&)#6)(1+"2%#!,-(M)#6)#>%@)(*%'&+%!&(`BB(3,)0&3(f"#,'a

» ACTIVITIES This project launched in 2006 aims to improve the accessibility and quality of primary healthcare 5"2&'(%&?%#%2-;&!"!1;-'+"#&"5&G-#?-#L+.-<&'(2"1?(&-&'%3(#+3-;<&6#-#3+-;&-#$&"!%2-'+"#-;&!-2'#%2*(+!& with the provincial and district health authorities. This programme, carried out under the auspices of the national health policy, has four components: supporting the district management steering team; supporting the staff of Kongolo zone to improve the quality of care in the general hospital A+#3;1$+#?& '(%& 7-'%2#+'L& 1#+'@n& *1!!"2'+#?& '(%& +#'2"$13'+"#& "5& -& 7+#+717& !-3.-?%& "5& -3'+=+'+%*& +#& (%-;'(& 3%#'2%*n& -#$& 5%%$+#?& +#'"& '(%& 2%=+%>& !2"3%**& "#& (%-;'(& *L*'%7& 6#-#3+#?& '"& !2"7"'%& '(%& accessibility of care for vulnerable groups.

» RESULTS R<WRW&3(+;$2%#&1#$%2&"#%&L%-2&";$&=-33+#-'%$&AFT/DS&3"=%2-?%@<&T<FF]&>"7%#&*%%#&4L&^"#?";"& CPN.

FUNDING

» I/+"1,)#(g#%"#(`I/+"1,Q%*a-( Q4,+%!)#(I.1+,''-(S*S BUDGET

» 2010: €1,179,397

ETHIOPIA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

M3,(J"4)0%(+,6%"#(%#(&3,('"/&3h,)'&("G(I&3%"1%)- is one of the least developed areas in the country. The health services #"*',$#+*i.#%*D'S))*&&'%1'4*#/%4)#"*',&'5#"%,)./#"/2'+,(-)./%',$'%4,&'"*!,1$7'#$+'%4*',$%*"$#/')1$P,)%'F4,)4',&'1$!1,$!',$' the area isolates the population, making inhabitants even more vulnerable. In addition, the region is regularly affected by epidemics. LONG TERM LIFE EXPECTANCY 56.1 YRS HDI 0.328; RANK 157/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['24,000 » Target: 320,369 PERSONNEL

» National: 67 » International: 8 CO-ORDINATORS

» Programme: [i+)+*(?)'!)0 » Field: <0)%+,(S)+&,0h8FV)0 » Headquarters: \,+&+)#*(\+iF/,2%00, FUNDING

» I<7A-(QNK-(S*S BUDGET

» 2010: €609,318

Improving provision of healthcare

» ],V+%(K,3)+-(J"4)0%(+,6%"#

» ACTIVITIES MdM is strengthening the availability and quality of secondary care provided by Kebri Dehar hospital. Training and equipment are provided to support antenatal care within the hospital maternity unit and to support the surgical and blood transfusion services. MdM is also supporting the hospital management in data collection and the organisation of the central pharmacy. In outlying areas, which we were allowed to return to in April 2010, six health posts are supported, and community health workers and traditional birth attendants have been trained.

» RESULTS Every month, an average of 130 antenatal consultations are carried out in Kebri Dehar hospital.

» OUTLOOK In 2011, MdM aims to gradually withdraw from the hospital and to transfer activities to the national staff. The support for the health posts in the outlying areas in Kebri Dehar will continue. Finally, MdM plans to carry out needs assessments in other regions of the country.

GUINEA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

Q&(&3,(,#*("G(!3)"&%!(,0,!&%"#'-(4)++,*(V>(2%"0,#!,-(Q013)(<"#*i was elected president of Guinea. The economic and social context remains fragile, and the situation in prisons is worrying. With a local partner, MdM is tackling malnutrition in prisons and aims to improve detention conditions.

LONG TERM LIFE EXPECTANCY 58.9 YRS HDI 0.340; RANK 156/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['827 detainees » Target: 1,524

Improving prisoner health

» ]%#*%)(1+%'"#

» ACTIVITIES The objective of the partnership between MdM and the organisation Kindianaise Assistance to Detainees (KAD) is to improve detention conditions in Kindia central prison in terms of the environment (hygiene and sanitation, improvements, refurbishment and maintenance of the !2%7+*%*@<& (%-;'(& A7%$+3-;& 3"#*1;'-'+"#*<& *1!!;L+#?& -& !(-27-3L<& #1'2+'+"#-;& *1!!"2'& 5"2& !%"!;%& >+'(&7-;#1'2+'+"#@<&-#$&2%+#'%?2-'+"#&A%$13-'+"#<&;+'%2-3L<&+#3"7%I?%#%2-'+#?&-3'+=+'+%*@/

PERSONNEL

» National: 1 » International: 0 CO-ORDINATORS

» Programme: ?3%0%11,(A+!%,+ » Field: <,00"/(\)0*i » Monitoring: H3u#,hQ01,'( H,6%"#)0(K,0,6)&%"#

O$O&!2"=+$%*&'%3(#+3-;<&6#-#3+-;&-#$&7"2-;&*1!!"2'&'"&^K9/

» RESULTS In 2010, 224 detainees were treated and 827 received care from KAD for malnutrition, in partnership with the ICRC.

FUNDING

» S*S

» OUTLOOK

BUDGET

MdM plans, context permitting, to increase support for income-generating activities as well as looking for new funders for the programme so that KAD can become increasingly independent.

» 2010: €16,637

LIBERIA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

Q04"'&(',2,#(>,)+'()G&,+(&3,(,#*("G(&3,(!%2%0(R)+- Liberia continues the process of reconstruction. Despite strong political will, the health system remains fragile and the government’s contribution to the health sector is limited in relation to the scale of the needs. In collaboration with the Ministry of Health and the local health authorities, MdM supports the implementation of health reforms and training of healthcare workers. LONG TERM LIFE EXPECTANCY 59.1 YRS HDI 0.300; RANK 162/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['114,449 » Target: 220,000 PERSONNEL

» National: 63 » International: 10 CO-ORDINATORS

» Programme: ?)&+%!@(7%+&f » Field: Q0%!,(9)3)#%)# » Headquarters: \,+&+)#*(\+iF/,2%00, FUNDING

» K[hI<7A-(QNK-(S*S-( S<S\ BUDGET

» 2010: €1,876,936

Improving the provision of healthcare for rural populations

» \"#6(!"/#&>

» ACTIVITIES @,@$_#&]-,"!$."SV)-S(0$(),$/)()S-(0$!*__&#. for the reconstruction of the health system, to ensure the continuity of care at all levels. The organisation has been actively involved in steering recent policies on community mother and child health, mental health, tackling HIV/AIDS, health 6#-#3+#?& -#$& (17-#& 2%*"123%*/& G%#& (%-;'(& 5-3+;+'+%*& -2%& *1!!"2'%$& +#& '(%& !2"=+*+"#& "5& ?%#%2-;& consultations and mother and child health consultations (preventing STIs, prevention, testing and 2%$13+#?&7"'(%2I'"I3(+;$&'2-#*7+**+"#&"5&CMl@/ Gbarnga health centre has been refurbished and expanded. The centre was inaugurated in De3%74%2&4L&'(%&g+4%2+-#&!2%*+$%#'&-#$&+*&#">&'(%&3"1#'2LP*&62*'&212-;&("*!+'-;&*!%3+-;+*%$&+#&7"'(%2& -#$&3(+;$&(%-;'(3-2%&-#$&"4*'%'2+3&3-2%&Aaa&4%$&3-!-3+'L@/ Psychiatric consultations and psychological support sessions are provided (training specialist (%-;'(3-2%&*'-55@/ Awareness-raising activities on different themes—such as gender-related violence—are being held in villages, in order to strengthen the relationships between communities and health services. Finally, the programme supports the county medical school and ongoing professional education to help tackle the shortage of human resources for health in rural areas.

» RESULTS QQ`<``F&?%#%2-;&3"#*1;'-'+"#*&+#&DEQE<&Q<`F`&4+2'(*&A+#3;1$+#?&'2-#*5%2*@<&D<Daa&CMl&'%*'*&5"2&!2%gnant women and 5,505 BCG vaccinations for children.

» OUTLOOK MdM continues to support the county’s health services, in close collaboration with other NGOs. We will step up efforts to support the medical training programme, to consolidate the county obstetric reference hospital’s activities and improve the supervision and co-ordination skills of the local health authorites. MdM will also be involved in the development of national policies.

MADAGASCAR

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

S)*)6)'!)+(%'('&%00(G)!,*(R%&3()(1"0%&%!)0()#*(,!"#"4%!(!+%'%':(International sanctions against the current government are destabilising public policies. MdM continues to work with vulnerable groups—victims of natural disasters and political violence, prisoners and children needing surgical care.

LONG TERM LIFE EXPECTANCY 61.2 YRS HDI 0.435; RANK 135/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['187 PERSONNEL

» National: 6 » International: 1 CO-ORDINATORS

» Programme: <3+%'&"13,(A&&,#R),0*,+ » Field: Nivo Ramanonjisoa » Headquarters: J&i13)#%,(K,+"f%,+ FUNDING

» ?+%#!%1)0%&>("G(S"#)!"-(S*S

Cardiac surgery for children

» Antananarivo

» ACTIVITIES This programme provides medical aid to Madagascan children affected by congenital or non-congenital cardiac abnormalities. Surgery is often the child’s only hope for survival. The project, which was launched in 1996, accounts for more than 80% of the operations carried out +#& O-$-?-*3-2& +#& '(+*& *!%3+-;+*'& 6%;$/& G(%& !2"N%3'& +*& +#'%?2-'%$& +#'"& 3-2$+-3& *12?%2L& 3-2%<& 52"7& diagnosis to follow-up. The paediatric cardiac team, made up of cardiologists, cardiac surgeons and anaesthetists from Réunion, visits twice a year to perform closed heart surgery in partnership with the Madagascan team. Children who need open heart surgery are treated in Réunion or on mainland France, with several partners: La Ribambelle, La Chaîne de l’espoir and Mécénat Chirurgie Cardiaque.

» RESULTS 510 consultations were provided for 187 children. 22 closed heart surgery operations were performed in Antananarivo and 29 medical evacuations for open heart surgery took place.

BUDGET

» 2010: €57,151

» OUTLOOK In the medium term, MdM will develop strategies which enable more children to receive surgery in Madagascar, by building the capacity of Madagascan partners through training and mentoring. The project will also improve access to cardiac surgery for the most vulnerable groups.

MADAGASCAR

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

S)*)6)'!)+(%'('&%00(G)!,*(R%&3()(1"0%&%!)0()#*(,!"#"4%!(!+%'%':(International sanctions against the current government, are destabilising public policies. MdM continues to work with vulnerable groups—victims of natural disasters and political violence, prisoners and children needing surgical care.

LONG TERM LIFE EXPECTANCY 61.2 YRS HDI 0.435; RANK 135/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['113,274 » Target: 113,274 PERSONNEL

» National: 17 » International: 3 CO-ORDINATORS

» Programme: I44)#/,00,(H)!3"/-( K"4%#%F/,(<">,f » Field: Q0V)#(\"##,&h<)''"# » Headquarters: J&i13)#%,(K,+"f%,+ FUNDING

» K8?I<7A-(S*S BUDGET

» S)+")#&',&+)()#*(J)4V)2)(*%'&+%!&'

Minimising » ACTIVITIES Having implemented more than 12 emergency programmes to help victims of cyclones and the health `&&,-)UX$+#&DEE]&O$O&*%'&1!&-&$+*-*'%2&2+*.&2%$13'+"#&A9dd@&!2"?2-77%&'"&!2%!-2%&'(%&3"771risks of nities to deal with these consequences of tropical depressions. cyclones and The pilot project in Maroantsetra and Sava region has four components: supporting the health P11+,$!

*L*'%7&A7%#'"2+#?<&%!+$%7+";"?+3-;&*12=%+;;-#3%<&!2"=+*+"#&"5&2-$+"*@<&+7!2"=+#?&3"771#+'LI4-*%$& +$%#'+63-'+"#& -#$& '2%-'7%#'& 5"2& *%=%2%& -31'%& 7-;#1'2+'+"#& +#& (%-;'(& *%2=+3%*<& +7!2"=+#?& 3-2%& 5"2& victims of natural disasters (training rescue workers and an emergency medical team, developing -&3"#'+#?%#3L&!;-#<&!2"=+*+"#&"5&%X1+!7%#'@&-#$&%*'-4;+*(+#?&-&3"771#+'LI4-*%$&-!!2"-3(&'"& disaster risk reduction (participatory analysis of areas of weakness, awareness-raising through a '2-$+'+"#-;&*+#?+#?&3"#'%*'<&3"771#+'LI4-*%$&7+32"I!2"N%3'*@/

» RESULTS K&7-!!+#?&%H%23+*%&"#&)""$&-2%-*&>-*&3-22+%$&"1'/&K&2%*31%&!;-#&-#$&-#&%7%2?%#3L&'%-7&(-=%& been established. 168 rescue workers and 91 nutrition agents were trained and equipped.

» 2010: €331,325

» OUTLOOK Following project evaluations, MdM is developing community-based health and mentoring of health workers to improve the local foundations of the project. A capitalisation process has been 3-22+%$& "1'& A2%!"2'& -=-+;-4;%& "#& O$OP*& >%4*+'%@& -#$& +;;1*'2-'%*& '(%& 2%;-'+"#*(+!& 4%'>%%#& (%-;'(& and DRR, as well as providing an interesting perspective on other potential projects on this issue.

Rabi Jules Deputy mayor of Anjanazan

“The main thing that MdM has brought, is to make us more %=%"').6%.).#)(8>>'")>"#&)*E*4#/'()%/0)-##0()2()/'2.6'")/%.8"%4) or fate. It is obviously not possible to avoid them, but we can minimise the impact of these unpredictable weather events, face up to them and get back on our feet.”

MADAGASCAR

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

LONG TERM LIFE EXPECTANCY 61.2 YRS HDI 0.435; RANK 135/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['5,600 » Target: 13,000 PERSONNEL

» National: 23 » International: 1

Healthcare for prisoners

» L"+&3()#*(<,#&+)0hO,'&(S)*)6)'!)+

» ACTIVITIES MdM aims to improve the situation of prisoners in 20 prisons, by working with the health services (refurbishing the medical wards, providing equipment, training nurses, treating severe 7-;#1'2+'+"#@&-#$&4L&3-22L+#?&"1'&-$="3-3L&-#$&'2-+#+#?&-3'+=+'+%*&+#&2%;-'+"#&'"&.%L&(%-;'(&$%'%27+#-#'*&A!2+*"#&"=%232">$+#?<&(L?+%#%<&(17-#&2+?('*@/ MdM is also supporting local organisations in the implementation of other activities: preserving social links, preparing for re-integration, individual legal support.

CO-ORDINATORS

» Programme: Pascale Luciani Lehoucq » Field: <i0%#,([i0%# » Headquarters: J&i13)#%,(K,+"f%,+

0=%2&'(%&;-*'&6=%&L%-2*<&O$O&(-*&$%=%;"!%$&#17%2"1*&'"";*<&*13(&-*&'2-+#+#?&7"$1;%*<&>(+3(& are now seen as exemplary methods. In partnership with other organisations working in prisons, including the International Committee of the Red Cross, MdM is supporting the Ministry of Justice in humanising detention conditions in Madagascar.

FUNDING

» I/+"1,Q%*-(QNK-(S*S BUDGET

» 2010: €422,736

» RESULTS In 2010, MdM’s work reached 5,600 prisoners in 20 institutions in the country.

» OUTLOOK 2011 will see the programme expanded into a new geographical area—six new prisons in the central west area of the country. A process of capitalisation will also be started, along with evaluations of the prisons which MdM is withdrawing from.

MALI

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

S)0%(%'()(*,1)+&/+,(1"%#&()#*(&+)#'%&(!"/#&+>(G"+(4)#>(4%6+)#&':(It is also, however, a place which many Africans, who &1.!4%'%1'"*#)4']."15*'%4"1.!4'S/!*",#7'N#.",%#$,#7'N1"1))1'#$+'j,92#7'-$+'%4*8&*/6*&'(1"),9/2'"*%."$*+'%1D'T4,&'5"1H*)%' aims to build the capacity of two local organisations (AME and ARACEM) to support and provide care to people forcibly returned to Mali. LONG TERM LIFE EXPECTANCY 49.2 YRS HDI 0.309; RANK 160/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2[ 1,061 » Target: 2,500 PERSONNEL

» National: 5 » International: 1 CO-ORDINATORS

» Programme: \+%6%&&,(S){&+, » Field: N+)#n"%',(S)+F/%' » Headquarters: 8')V,00,(\+/)#*

Improving access to mental healthcare for forcibly returned migrants

» \)4)@"-(])>,'()#*(L%"+"(&"R#'(%#(&3,(J)3,0

» ACTIVITIES MdM is training the staff of our two partner organisations so that they can better welcome, listen to and provide psychological support to migrants who have been forcibly returned. The project also aims to set up a referral network, made up of national professionals with enhanced skills in treating psychological trauma. Finally, this skills transfer process will be supplemented with an awareness-raising and information campaign on migration in general and the traumatic impact of forcible return, in order to tackle the discrimination which migrants often face.

» RESULTS Q<EWQ&7+?2-#'*&*%%#&4L&KOY&-#$&KdKUYO&A-'&;%-*'&-#&+#'%2=+%>&-#$&-&3"1#*%;;+#?&*%**+"#@/

FUNDING

» gLK?-(S*S

» OUTLOOK

BUDGET

This is a priority issue for the organisation. MdM wants to create links between migrant projects in France and overseas. In 2011, activities concerning the physical health of migrants will be expanded and the advocacy activities further reinforced by supporting the local networks to improve the collection of relevant data.

» 2010: €77,444

T.D. 32 year-old single Malian man with no children. He lived in France for 10 years and was deported in April 2010 because he did not have a visa

“I am not a thug. I’ve never had any problem with people, or with the police. I need to return to France to be able to work. I do not have any work here and live like a beggar. This is no life!”

MALI

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

S)0%(%'("#,("G(&3,(1""+,'&(!"/#&+%,'(%#(QG+%!)- with a mainly rural population. Very often women marry young, they have )4,/+"*$'1$*'#(%*"'%4*'1%4*"'#$+'!,6*'9,"%4'#%'418*D'^9&%*%",)'-&%./#&7')#.&*+'92'/1$!'+*/,6*",*&'F,%41.%'#$2'8*+,)#/')#"*7' can lead to chronic incontinence and discrimination against affected women.

LONG TERM LIFE EXPECTANCY 49.2 YRS HDI 0.309; RANK 160/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['140 » Target: 1,079 PERSONNEL

» National: 4 » International: 0 CO-ORDINATORS

» Programme: \+%6%&&,(S){&+,-( S)+%,hI0%')V,&3(7"!3,& » Field: N+)#n"%',(S)+F/%' » Headquarters: 8')V,00,(\+/)#* FUNDING

» L"+R,6%)#(<3/+!3(Q%*-(S*S BUDGET

» 2010: €115,348

Providing care and psychological support to women with obstetric -&%./#&

» S"1&%(+,6%"#

» ACTIVITIES The programme provides women in Mopti region with psychological support and help to re-integrate into families and communities. It also carries out awareness-raising and prevention -3'+=+'+%*&+#&'(%&3"771#+'+%*/&O$OP*&>"2.&%#-4;%*&2%!-2-'"2L&*12?%2L&5"2&"4*'%'2+3&6*'1;-*<&3-2ried out by Malian surgeons in Sominé Dolo hospital in Mopti, to be performed. MdM ensures the quality of the surgery by regularly sending surgeons to offer further training and to operate on complicated cases. Psychological support is provided at several opportunities for the patient and her companion. Awareness-raising sessions to encourage deliveries in health centres are carried out throughout Mopti, amongst community leaders and health agents.

» RESULTS QWa&"!%2-'+"#*&3-22+%$&"1'&"#&Q`E&!-'+%#'*/&QTE&>"7%#&4%#%6'%$&52"7&!*L3(";"?+3-;&*1!!"2'/

» OUTLOOK O$O& (-*& 4%%#& >"2.+#?& '"& 3-2%& 5"2& =%*+3"I=-?+#-;& 6*'1;-*& +#& O"!'+& *+#3%& QFFT/& K& >+'($2->-;& strategy has been introduced to ensure complete handover to the hospital’s trained surgeons in 2013. A local organisation will gradually take over the psychological support activities.

NIGER

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

A2,+(&3,(0)'&(&3+,,(*,!)*,'(L%6,+(3)'(,.1,+%,#!,*(+,1,)&,*(G""*(!+%',': In Tahoua region, the nutritional situation started to particularly deteriorate in 2007, and 2010 was a critical year. To augment the arrangements in place in the districts, MdM launched an emergency programme in April 2010.

EMERGENCY LIFE EXPECTANCY 52.5 YRS HDI 0.261; RANK 167/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['19,645 » Target: 33,900 PERSONNEL

» National: 27 » International: 2 CO-ORDINATORS

» Programme: D"v0(P,(<"++, » Field: S)4"/*"/(\)++" » Headquarters: 8')V,00,(\+/)#*

Supporting care for malnourished children

» M)3"/)(+,6%"#-(],%&)-(QV)0)@()#*(M!3%#&)V)+)*,#(*%'&+%!&'

» ACTIVITIES MdM provided refresher training for health staff on malnutrition treatment protocols, impro=%$&'(%&"2?-#+*-'+"#-;&3-!-4+;+'+%*&"5&'(%&$+*'2+3'&7-#-?%7%#'&'%-7*<&+7!2"=%$&'(%&)">&"5&+#5"2mation, trained community workers to identify cases of malnutrition, equipped and supported nutritional recovery centres which care for complicated cases. Finally, MdM facilitated the distribution of nutritional supplies provided by the World Food Programme and Unicef, and built up a supply to be able to cope with gaps in provision.

» RESULTS 19,645 children treated in three districts. Three intensive nutritional recovery and education 3%#'2%*&AUdYbM@&-#$&``&"1'!-'+%#'&3%#'2%*&5"2&#1'2+'+"#-;&2%3"=%2L&-#$&%$13-'+"#&AUdYbKJ@&2%ceived support.

FUNDING

» I<7A-(S*S

» OUTLOOK

BUDGET

The project will be completed in February 2011. MdM is going to integrate a nutrition component into a large integrated family planning programme in Illéla district, because projects in the region have shown that the problem of child malnutrition is directly linked to the length of time 4%'>%%#&!2%?#-#3+%*&A4+2'(&*!-3+#?@/

» 2010: €587,490

A young mother 18 years old, inpatient in Abalak CRENI with her seven month-old baby

“Since we were admitted to the CRENI, the nurses have really looked after my son. They were always there to give him water and medicine. Luckily this care is free, otherwise people would have crossed their arms and watched my son die.”

NIGER

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

L%6,+-(%#(&3,(J)3,0(+,6%"#-(%'(%#()(#,)+(!"#'&)#&('%&/)&%"#("G(#/&+%&%"#)0(!+%'%':(One of the factors involved is the high fertility rate—7.1 births per woman of reproductive age. The programme proposes an integrated approach, in partnership with the national health system, communities themselves, religious leaders and local organisations.

LIFE EXPECTANCY 52.5 YRS HDI 0.261; RANK 167/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['8,245 » Target: 71,858 PERSONNEL

» National: 15 » International: 1 CO-ORDINATORS

» Programme: D"v0(P,(<"++, » Field: S)4"/*"/(\)++" » Headquarters: 8')V,00,(\+/)#* FUNDING

» I/+"1,Q%*-(QNK-(S*S BUDGET

» 2010: €387,013

LONG TERM

» M)3"/)(+,6%"#-(],%&)-(QV)0)@()#*(M!3%#&)V)+)*,#(+,6%"#'

Improving treatment for malnutrition and family planning services

Community networks are trained to run skills development centres and deliver workshops on #1'2+'+"#<&-*&>%;;&-*&21#&3"1#*%;;+#?&*%**+"#*&A?2"1!&$+*31**+"#*&"#&5-7+;L&!;-##+#?@&+#&!-2'#%2*(+!& with health centres. They are trained to distribute contraceptives to women in possession of a !2%*32+!'+"#&52"7&-&X1-;+6%$&(%-;'(&>"2.%2/&K>-2%#%**I2-+*+#?&-#$&-$="3-3L&-3'+=+'+%*&-;*"&'-.%& place: theatrical events, sermons from the imams and thematic workshops with the authorities.

» ACTIVITIES

» RESULTS Increase of 20% in contraceptive coverage, of 25% in the rate of antenatal consultations and of 42% in assisted deliveries.

» OUTLOOK The relevance of a programme which acts on both nutrition and birth spacing has now been demonstrated. MdM would like, therefore, to launch a programme of support in Illéla district in the south of Tahoua region. The objective is to improve access to nutrition and family planning services.

An imam

“Women’s rights are not taken into account. For many people women only have duties. There is a failure of responsibility and people do not think about education for children. Religion says that God nourishes everyone. We must not forget that God also said to educate our children and to offer them a good standard of living.”

RWANDA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

HR)#*)(%'(!"4%#6("/&()(0,6)0(1+"!,''('&)+&,*(%#(CEEZ and based on widespread public participation (Gacacas juridictions). This process involved the survivors reliving the traumas linked to the 1994 genocide which killed more than a million people. MdM is helping the organisation IBUKA to provide psychological support to survivors.

LIFE EXPECTANCY 51.1 YRS HDI 0.385; RANK 152/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['66,647 PERSONNEL

» National: 26 » International: 0 CO-ORDINATORS

» Programme: [%00,'(N"/!)/* » Headquarters: <)&3,+%#,(<"/+&%# FUNDING

» I/+"1,)#(g#%"#(`I/+"1,Q%*a-( S*S BUDGET

» 2010: €96,228

LONG TERM

» ]%6)0%j\/3"+"-(]%V,3"-([)&"#*,-(]%V%0%f%-(\/'"6"()#d S/')#f,(',!&"+'

Medical and psychological support for genocide survivors

The project is concerned with the psychological and social recovery of survivors of the Rwandan genocide. The victims involved in the Gacacas receive support via therapeutic outreach groups to deal with traumas and to develop social links. The programme also aims to develop the skills of medical and paramedical staff (training, exchange of best practices and capitalisation on %H!%2+%#3%@/&O$O&!2"=+$%*&+#*'+'1'+"#-;&*1!!"2'&'"&MZc^K&"#&3";;-4"2-'+"#&7%'("$*/

» ACTIVITIES

» OUTLOOK In 2011, after the Gacacas&(-=%&6#+*(%$<&'(%&!2"?2-77%&>+;;&4%&%H!-#$%$&'"&"'(%2&-3'"2*&+#&'(%& 7%#'-;&(%-;'(&6%;$&>"2.+#?&>+'(&*12=+="2*/&K&5"217&5"2&%H3(-#?%&>+;;&4%&*%'&1!<&+#=";=+#?&-;;&2%;%vant stakeholders from civil society and institutions.

SAHEL

INTERNATIONAL PROGRAMMES » AFRICA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

NIGER, MALI, BURKINA FASO

M3,',(&3+,,(!"/#&+%,'()+,(+)#@,*(2,+>(1""+0>()!!"+*%#6(&"(gLK?U'(3/4)#(*,2,0"14,#&(%#*,.- largely as a result of par%,)./#"/2'#/#"8,$!'4*#/%4',$+,)#%1"&D'S))*&&'%1'4*#/%4)#"*'"*8#,$&'6*"2'/,8,%*+7'8#,$/2'9*)#.&*'1('-$#$),#/'19&%#)/*&D'`2' 5"16,+,$!'!*$*"#/'&.551"%'%1',$&%,%.%,1$#/'#$+'$1$G!16*"$8*$%#/'5#"%$*"&7'%4*'5"1H*)%'#,8&'%1'"*816*'-$#$),#/'19&%#)/*&' to healthcare in a way that is sustainable. LONG TERM Niger LIFE EXPECTANCY 52.5 YRS HDI 0.261; RANK 167/169 Burkina Faso LIFE EXPECTANCY 53.7 YRS HDI 0.305; RANK 161/169 Mali LIFE EXPECTANCY 49.2 YRS HDI 0.309; RANK 160/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['16,028 » Target: 377,928 PERSONNEL

» National: 36 » International: 7 CO-ORDINATORS

» Programme: M3%,++>(<"4&,-( D"v0(P,(<"++, » Field: A0%2%,+(I2+,/. » Headquarters: 8')V,00,(\+/)#* FUNDING

» I/+"1,)#(g#%"#-(QNK-(S*S BUDGET

» 2010: €810,471

Improving access to primary healthcare

» ],%&)-(`L%6,+a-(]"+"(`S)0%a()#*(KX%V"(`\/+@%#)(N)'"a

» ACTIVITIES

An economic study of health districts&>+;;&%#-4;%&'(%&2%7"=-;&"5&6#-#3+-;&4-22+%2*&'"&3-2%&+#&-& way which is sustainable in the long term. At the same time, work aimed at improving the geographical accessibility of care has been started (refurbishing outlying health services, implementing *'2-'%?+%*&-#$&3"#*";+$-'+#?&2%5%22-;&#%'>"2.*@/&Y55%3'+=%&$%;+=%2L&"5&-&7+#+717&!-3.-?%&"5&3-2%& services is still a key concern, particularly in relation to mother and child healthcare, malaria and malnutrition. The remaining activitives are reinforcement of management capacity within health facilities, supporting supervisors and involving non-governmental actors. Partnerships with subregional stakeholders will enable the sharing and dissemination of information on the project’s -3(+%=%7%#'*/&K$="3-3L&-3'+=+'+%*&"#&'(%&2%7"=-;&"5&6#-#3+-;&4-22+%2*&>+;;&-+7&'"&+#)1%#3%&!14;+3& health policies.

» RESULTS 595 referrals were made in Keita district in Niger, thanks to the cost-pooling system.

» OUTLOOK M#& DEQQ<& 7%'("$*& 5"2& 2%7"=+#?& 6#-#3+-;& 4-22+%2*& >+;;& 4%& !2"!"*%$& 5";;">+#?& 3"7!;%'+"#& "5& '(%& economic study. There are growing worries, however, about the deteriorating security situation in the Sahel region which threatens the implementation of the project.

SOMALIA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

S,+@)-(cE@4(G+"4(S"6)*%'3/-(%'(3"4,(&"()+"/#*(CEE-EEE(1,"10,- most of them are from minority clans or have been +,&5/#)*+'92'%4*')1$P,)%'F4,)4'4#&'9**$'+*&%"12,$!'%4*'"*!,1$'&,$)*'k,#+'`#""*'(*//',$'>YY>D'0,%4'$1'#+8,$,&%"#%,1$7'#$+' since taken over by Al-Shabab militia, Merka still lacks accessible, quality health services.

LONG TERM LIFE EXPECTANCY HDI NC; RANK

50.4 YRS NC

Source: UNDP 2010

POPULATION

» `*$*-),#"2['82,000 » Target: 100,000 PERSONNEL

» National: 26 » International: 3 CO-ORDINATORS

» Programme: \,+#)+*(D/)# » Field: ?3%0%11,(K/+)#* » Headquarters: J&i13)#,(\,+*"/0,& FUNDING

» KN8K BUDGET

» 2010: €706,290

Medical aid for the populations affected by crises

» S,+@)-(P"R,+(J3)V,00,-(J"/&3(J"4)0%)

» ACTIVITIES The project seeks to improve the population’s access to primary healthcare by supporting three health centres, providing 24-hour maternity care and organising emergency obstetric referrals to hospital. It also aims to improve the quality of care provided, by maintaining the infrastruc'12%&+#&?""$&>"2.+#?&"2$%2&A>+'(&-!!2"!2+-'%&%X1+!7%#'@<&4L&!2"=+$+#?&(+?(IX1-;+'L&7%$+3+#%*&-#$& by training medical staff. Finally, the project would like to improve co-ordination of those involved in health promotion and hygiene, particularly in epidemic situations.

» RESULTS Nearly 41,000 general medical consultations were carried out in 2010, as well as 4,400 antenatal consultations.

» OUTLOOK B+'(&2%7"'%&3"I"2$+#-'+"#&52"7&b-+2"4+&A'(%&"#;L&!"**+4;%&>-L&"5&>"2.+#?@<&'(%&!2"N%3'&*'21??;%*& to expand geographically or to increase the provision of care. In 2011, MdM will study the most appropriate ways of working to be able to return to Somalia.

“We are so grateful to MdM for giving us access to quality services and free medicines.)M2J')','"E#/')'4('3)@7,')G'/'+.'0I)@) will never forget the help that the medical staff have given people, whether from majority or minority clans, and rich or poor alike.”

SUDAN

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

8#(&3,(4"/#&)%#"/'(D,V,0(S)++)()+,)()&(&3,(X/#!&%"#("G(&3+,,(K)+G/+(1+"2%#!,'-(access to healthcare has been extre8*/2'/,8,%*+'(1"'),6,/,#$&'&,$)*'%4*'&%#"%'1('%4*')1$P,)%D'T4,&',&'9*)#.&*'1('#'5"#)%,)#//2'$1$G*<,&%*$%'4*#/%4'&2&%*8'#$+'%4*' +,(-)./%,*&',$'%"#6*//,$!'%1'"*(*""#/')*$%"*&D'3,!4%,$!'9*%F**$'%4*'k.+#$*&*'#"82'#$+'%4*'kjS'"*9*/&'4#&'5"1/1$!*+'%4,&' situation throughout the year. LONG TERM LIFE EXPECTANCY 58.9 YRS HDI 0.379; RANK 154/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['72,600 » Target: 184,000 PERSONNEL

» National: 188 » International: 5 CO-ORDINATORS

» Programme: Di+u4,(P)+!3i » Field: S%!3),0(?"00" » Headquarters: H)13)v0(["+6,/ SOURCES DE FINANCEMENT

» I<7A-(<7N-([,+4)#(S%#%'&+>( "G(N"+,%6#(QGG)%+'-(S*S BUDGET

» 2010: €1,479,541

Supporting civilians in Jebel Marra

» D,V,0(S)++)-(J"/&3(K)+G/+

» ACTIVITIES Since February 2010, we have had to considerably cut-back our work in the Jebel Marra,&4%3-1*%&"5&'(%&"#?"+#?&3"#)+3'/&G(%&"2?-#+*-'+"#&3"#'+#1%$&'"&4%&!2%*%#'<&(">%=%2<&!-2'+31larly since MdM is the only organisation working in the area. Four medical clinics are operational A+#&9%2-<&[->-<&\1;174-+<&-#$&_-;;1N-(@/&G(%*%&3;+#+3*&!2"=+$%&!2+7-2L&(%-;'(3-2%<&2%!2"$13'+=%& (%-;'(3-2%<&#1'2+'+"#-;&7"#+'"2+#?&5"2&3(+;$2%#&1#$%2&6=%&-#$&(%-;'(&%$13-'+"#&-3'+=+'+%*/&G(%L&-;*"& refer cases to Nyala hospital.

» RESULTS Each month an average of 6,000 general medical consultations, 800 reproductive health consultations and 20 referrals are carried out.

» OUTLOOK M#&_%421-2L&DEQQ<&O$O&>-*&"563+-;;L&+#5"27%$&"5&'(%&J"1'(&9-2512&?"=%2#"2P*&$%3+*+"#&'"&%H!%;& the organisation from the region. All of MdM’s work in Sudan has, therefore, been suspended.

TANZANIA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

K,'1%&,()(G)00(%#(&3,(6+"R&3("G(&3,(789lQ8KJ(,1%*,4%! which today affects 6.5% of the Tanzanian population, people who use drugs, still more numerous in Dar es-Salaam, have a worrying prevalence of the virus. This group is particularly stigmatised and has no access to healthcare. Against this backdrop, MdM has launched a harm reduction project with Tanzanian institutions and civil society. LONG TERM LIFE EXPECTANCY 56.9 YRS HDI 0.398; RANK 148/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['200 » Target: 500 PERSONNEL

» National: 8 » International: 2 CO-ORDINATORS

» Programme: ?)&+%!@(\,)/2,+%,-( N)&%4)(Q''"/)V » Field: Sandrine Pont » Headquarters: J&i13)#%,(K,+"f%,+

Pilot project tackling HIV/ AIDS among people who use drugs

» K)+(,'hJ)0))4-(M,4,@,(4/#%!%1)0%&>

» ACTIVITIES Given the extreme vulnerability of Tanzanian drug users to the HIV/AIDS epidemic, as well as to hepatitis B and C, MdM launched an exploratory mission in early 2010. This was followed by a three month discussion with those already working in Dar es-Salaam (needs assessment, -#-;L*+*&"5&!-2'#%2*(+!*&-#$&"!!"2'1#+'+%*@/&K&!-2'#%2*(+!&-?2%%7%#'&>-*&*+?#%$&>+'(&'(%&O+#+*'2L& "5&C%-;'(&-#$&"#%&"5&'(2%%&71#+3+!-;+'+%*&+#&AG%7%.%@/&G>"&G-#h-#+-#&b\0*&-;2%-$L&>"2.+#?&>+'(& drug users have started to work on the project in partnership with MdM. 912+#?&'(%&;-*'&X1-2'%2&"5&DEQE&'(%&>"2.&"#&'(%&*'2%%'*&6#-;;L&*'-2'%$<&%#-4;+#?&62*'&3"#'-3'&>+'(& drug users and improving our understanding of places where drug users go to inject.

» RESULTS A team of street outreach workers has been established. A workshop with 50 participants was held to launch the project and a mapping exercise of injection locations was carried out.

FUNDING

» S*S BUDGET

» 2010: €88,688

» OUTLOOK In 2011, MdM plans a rapid evaluation of the drug users’ practices and experiences. The project will also make harm reduction material and information available, provide HIV and hepatitis screening, and enable access to medical and social services. Particular attention will be paid to the needs of female injecting drug users.

TANZANIA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

])6,+)(+,6%"#-(%#(#"+&3hR,'&(M)#f)#%)-(%'(1)+&%!/0)+0>(',2,+,0>()GG,!&,*(V>(&3,(789lQ8KJ(,1%*,4%!-(R3%!3(&"*)>()GG,!&'( _:dk("G(M)#f)#%)#':(M3,(+,6%"#(%'(%#G)4"/'(G"+(3)2%#6(',,#(&3,(5+'&(Q8KJ(!)','(%#(B^cZ:(8#(CEBE-(S*S(R%&3*+,R(G+"4( &3,(+,6%"#(3)2%#6(3)#*,*("2,+()!&%2%&%,'(&"(&3,(3,)0&3()/&3"+%&%,'()#*(&"()(0"!)0(L[A(R3"(R%00(!"#&%#/,(&"(3,01(&3"',( )GG,!&,*(V>(&3,(%00#,''()#*(&"(563&()6)%#'&(&3,(,1%*,4%!. LONG TERM LIFE EXPECTANCY 56.9 YRS HDI 0.398; RANK 148/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['2,175 PERSONNEL

» National: 22 » International: 3 CO-ORDINATORS

» Programme: S%!3,0(<)>+"0 » Field: ?%,++,(I:K:(J)00)3( (until 31/03/10) » Headquarters: J&i13)#%,(K,+"f%,+ FUNDING

» <"0/4V%)(g#%2,+'%&>-(S*S BUDGET

» 2010: €177,986

Tackling HIV/AIDS

» ])6,+)(+,6%"#-(L6)+)-(\%3)+)4/0"()#*(<3)&"(*%'&+%!&'

» ACTIVITIES For 17 years MdM has supported the Tanzanian AIDS programme in Kagera region and has introduced several pioneering projects. In 1992, the project took care of HIV-positive children and offered testing and treatment for opportunistic infections in hospital and via home-based care. The programme also included awareness-raising activities on prevention methods and protection against HIV/AIDS. In 1997, a local NGO, TADEPA, was created to take over the community-based activities. At the time it was supported by MdM, but has since become independent. In 1999, MdM expanded the programme to include a pilot project on prevention of mother-to-child transmission. Since 2004, the programme has provided antiretrovirals to the 840,000 inhabitants of three districts. In 2010, MdM withdrew from this region and carried out a study to identify the good practices which can be shared with other HIV/AIDS programmes.

» RESULTS Between 2007 and 2010, around 63,000 women were tested and more than 1,400 pregnant women received prophylactic care and more than 2,100 received antiretroviral treatment.

» OUTLOOK At the same time as the Kagera project was drawing to an end, an exploratory mission in Dar esSalaam evaluated the needs of drug users in relation to HIV/AIDS. This led to the launch of a harm reduction project in the town, a place particularly affected by the increase in drug use.

Sindimo TT&L%-2*&";$<&b-L-4"*"*+<&6=%&3(+;$2%#

“I live 9km from Kikomakoma clinic. I’ve been receiving antiretroviral treatment since 2008. Before I got this treatment I couldn’t do anything. I was too exhausted. I get better and better with the treatment and I know that without it I would no longer be here. I speak freely about the illness with my neighbours and my family. I have had my four youngest children tested, and all are HIV-negative.”

ZIMBABWE

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » AFRICA

M3,(3,)0&3('%&/)&%"#(%#(|%4V)VR,(!"#&%#/,'(&"(V,(!3)+)!&,+%',*(V>(3%63(4"+&)0%&>(+)&,'-(related to the high prevalence of HIV/AIDS, the collapse of the health system in recent years and the drastic shortage of health workers in the country. These issues are particularly bad in Chipinge, a poor and isolated district where MdM is the only health NGO present.

LONG TERM LIFE EXPECTANCY HDI 0.140; RANK

47 YRS 169/169

Source: UNDP 2010

POPULATION

» `*$*-),#"2['23,500 » Target: 285,000 PERSONNEL

» National: 51 » International: 3 CO-ORDINATORS

» Programme: 9%#!,#&(N)/!3,++, » Field: D"f,G(*,(]"#%#6 » Headquarters: J&i13)#%,(K,+"f%,+ FUNDING

» I/+"1,)#(g#%"#(`I<7Aa-( SNJ-(S*S BUDGET

Tackling HIV/AIDS and providing primary care

» <3%1%#6,(*%'&+%!&-(S)#%!)0)#*(1+"2%#!,

» ACTIVITIES MdM is aiming to help improve primary healthcare, particularly for pregnant women and children, in three hospitals and 23 clinics in the district. The activities include training nurses, improving the supply of medicines and refurbishment. An ambulance service has also been introduced. MdM is also supporting the decentralisation of HIV testing and treatment for both HIV and "!!"2'1#+*'+3&+#5%3'+"#*/&G(%&$+*'2+3'&("*!+'-;<&#">&-1'"#"7"1*<&-#$&6=%&#%>&3;+#+3*&(-=%&4%%#& accredited to be able to provide treatment. At the community level, the focus is on home-based care and the creation of nutritional gardens for people living with HIV, awareness-raising among young people and care for vulnerable orphans A!2"=+$%$&4L&'(%&m?2-#$7"'(%2*&"5&'(%&(%-2'P@/&G(+*&>"2.&(%;!*&'"&2%$13%&*'+?7-<&'"&+#32%-*%&'(%& uptake of tests and to improve adherence to treatment programmes.

» RESULTS 223 caesarians have been carried out. 356 health agents and 125 nurses have been trained. 25,147 people have been tested for HIV and 1,570 orphans supported.

» 2010: €1,247,686

» OUTLOOK MdM plans to consolidate this integrated mother and child health programme to improve the X1-;+'L<&-=-+;-4+;+'L&-#$&-33%**&'"&7-'%2#-;&-#$&3(+;$&(%-;'(&*%2=+3%*&A+#3;1$+#?&CMl&*%2=+3%*@&-#$<& therefore, to increase the number of children receiving antiretroviral treatment. A new programme in the poor and overcrowded areas of Harare is being considered.

Wilbert Mangava

“My wife and I fell ill in 2007. I joined the MdM home-based care programme after I tested HIV-positive. After a year of antiretrovirals I feel better, I’ve got my strength back and gained weight. My wife encouraged me to go back to my work as an electrician. For many people I am an example because we have survived and got our lives back. We take out treatment and have managed to send our children to school.”

AFGHANISTAN

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » ASIA

O%&3(^Ek("G(&3,("1%/4('"0*(%#(&3,(R"+0* produced in Afghanistan, domestic consumption is growing. In 2009, there were an estimated 1.5 million people using drugs, mostly in Kabul. The number of heroin injectors is growing exponentially and this is the major mode of transmission for HIV/AIDS and hepatitis. These drug users face, among other things, repressive policies and discrimination in terms of accessing healthcare. LONG TERM LIFE EXPECTANCY 44.6 YRS HDI 0.349; RANK 155/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['900 » Target: 150,000 PERSONNEL

» National: 39 » International: 3 CO-ORDINATORS

» Programme: [/>(<)/''i-( A0%2%,+(S)6/,& » Field: A0%2%,+(9)#*,!)'&,,0, » Headquarters: 9)0i+%,(\+/#,0 FUNDING

» O"+0*(\)#@-([0"V)0(N/#*-( J%*)!&%"#-(O7A-(gLQ8KJ-( gLAK<-(S*S BUDGET

» 2010: €653,807

Harm reduction programme to tackle AIDS and viral hepatitis

» Kabul

» ACTIVITIES Since 2006, MdM has been developing an ambitious programme of harm reduction. G(%&62*'&!-2'&"5&'(+*&+#3;1$%*&!2%=%#'+"#&-#$&-33%**&'"&!2+7-2L&(%-;'(3-2%&-#$&'"&'2%-'7%#'/&G(%& second part of the project concentrates on a resource and training centre for local actors involved in the struggle against HIV/AIDS. O"2%&'(-#&DTE&$21?&1*%2*&(-=%&4%#%6'%$&52"7&>%%.;L&(%-;'(&7"#+'"2+#?&-'&'(+*&(%-;'(&3%#'2%/&M#& O-L&DEEF<&O$O&!2%*32+4%$&'(%&62*'&-#'+2%'2"=+2-;&'2%-'7%#'*&+#&'(%&3"1#'2L&-#$&*%'&1!&'(%&62*'& *%;5I(%;!&?2"1!*&5"2&!%"!;%&;+=+#?&>+'(&CMlrKM9J/&_2"7&O-23(&DEQE<&'(%&62*'&7%'(-$"#%&'2%-'7%#'& was dispensed in partnership with the health authorities.

» RESULTS 110,000 syringes have been distributed, 70 people treated with methadone and six received antiretroviral treatments. 49 local NGO members were trained in harm reduction.

» OUTLOOK MdM will support the creation of an independent Afghan organisation involved in harm reduction.

BURMA (MYANMAR)

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » ASIA

M3,(!")'&)0('&+%1("G(&3,(8++)R)**>(K,0&)(R)'(3%&(V>(!>!0"#,(L)+6%'(%#(S)>(CEEc:(More than two years on, there are still major reconstruction needs. Some villages have not returned to the living conditions they had before the cyclone, since 8*#$&'1('5"1).",$!'(11+'B)#%%/*7'",)*'-*/+&7'-&4,$!'91#%&C'F*"*'81&%/2'+*&%"12*+D'N+N',&'&%,//'%4*'1$/2',$%*"$#%,1$#/'8*+,)#/' organisation present in this stricken area.

LIFE EXPECTANCY 62.7 YRS HDI 0.451; RANK 132/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['145,000 » Target: 208,461 PERSONNEL

» National: 30 » International: 1 CO-ORDINATORS

» Programme: N+)#n"%',( J%2%6#"# » Field: Anne Lancelot » Headquarters: [/%00)/4,( 7/"#(*,(],+4)*,!

LONG TERM

» ?>)1"#(M"R#'3%1(

Supporting community healthcare systems

Our involvement concerns 137 villages which do not have any health services and concentrates on three main areas: the training and supervision of community health agents, the creation, or the reactivation of, village health committees and their mobilisation towards preven'+"#<&-#$<&6#-;;L<&(%-;'(&%$13-'+"#&*%**+"#*&+#&'(%&=+;;-?%*/

» ACTIVITIES

This programme is part of the national health policy. MdM is actively involved in the role of strengthening the healthcare system in the Delta following the cyclone, along with the Ministry for C%-;'(&-#$&"'(%2&"2?-#+*-'+"#*&Ab\0*&-#$&cb&-?%#3+%*@/

» RESULTS 48,845 consultations were carried out by 126 trained community health agents. 131 health com7+''%%*&>%2%&32%-'%$&"2&2%-3'+=-'%$/&RR<]]W&!%"!;%&4%#%6'%$&52"7&(%-;'(&%$13-'+"#&*%**+"#*/

FUNDING

» K[(I<7A-(IglLJQ-(S*S BUDGET

» 2010: €259,828

» OUTLOOK In 2011, the project will concentrate on maternal and infant health. MdM plans to set up funding— managed by the village health committees—enabling referral to hospitals, facilitating emergency "4*'%'2+3&3-2%&-#$&5"2&%7%2?%#3+%*&+#&3(+;$2%#&1#$%2&6=%/ Aye Aye Mar 26 years old, inhabitant of Hmaw Bi in Pyapon village

“My family isn’t very rich, we survive thanks to our little corner shop. I always wanted to do something to help my village, but I never thought I’d have the means. I have become a community health agent after having been trained by the Ministry of Health and MdM. I work as a volunteer, and I am very proud to be able to help my village”

BURMA (MYANMAR)

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » ASIA

8#(L"2,4V,+(CEBE-(&3,(&%63&0>h!"#&+"00,*(6,#,+)0(,0,!&%"#'(!"#5+4,*(&3,(4%0%&)+>(+,6%4,(%#(\/+4):(Poverty continues to rise, due to restrictive economic policies and under-investment in health and education. The AIDS epidemic is predominant among the most exposed populations (sex workers and drug users). A quarter of people in need of antiretrovirals (ARV) obtained treatment, in most cases this was provided by international NGOs. LONG TERM LIFE EXPECTANCY 62.7 YRS HDI 0.451; RANK 132/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['9,671 » Target: 41,000 PERSONNEL

» National: 167 » International: 5 CO-ORDINATORS

» Programme: N+)#n"%',(J%2%6#"# » Field: Anne Lancelot » Headquarters: [/%00)/4,( 7/"#(*,(],+4)*,! FUNDING

» I/+"1,Q%*-(Z(K%',)','(N/#*-( K/&!3(%#'&%&/&%"#)0(G/#*%#6-( K[(I<7A-(IglLJQ-(ON?-( ?J8-(S*S BUDGET

» 2010: €1,336,795

Prevention and care for sexually transmitted infections (STIs) and HIV/AIDS

» ])!3%#(J&)&,(`S>%&@>%#)(}(S",6)/#6a()#*(m)#6"#

» ACTIVITIES In Yangon, MdM provides comprehensive care for female and male sex workers and gay men, through different activities: health education (STIs, HIV/AIDS, tuberculosis, hepatitis, repro$13'+=%&(%-;'(<&!2%=%#'+"#<&#1'2+'+"#<&1*%&"5&3"#$"7*@<&%#'%2'-+#7%#'<&*%;5&%*'%%7<&;%?-;&-$=+3%<& weekly support groups, training for volunteer peer educators, diagnosis and treatment for STIs and opportunistic infections, screening services, and access to antiretrovirals, general medical consultations, hepatitis screening, vaccinations against hepatitis B and nutritional support. In Kachin state, we offer drug users a medical and social support similar to that offered in Yangon with, in addition, a needle exchange programme and access to methadone.

» RESULTS 949 people on antiretroviral treatment and 69 on methadone. In 2010, 3,654 sex workers, 2,779 gay men and 3,238 drug users attended at least one prevention activity. 1,200,000 condoms and 1,592,000 syringes were distributed.

» OUTLOOK In 2011, provision will be increased, thanks to the opening of a new site in Kachin (a second site !;-##%$&5"2&f-#?"#&+#&DEQD@/&,2%=%#'+"#&'"";*&>+;;&4%&+7!2"=%$<&#"'-4;L&>+'(&'(%&+#+'+-'+"#&"5&-&!+;"'& scheme of a hotline and webpage for gay men in Yangon.

Taryar Gay man, August 2010

“When I arrived at the MdM clinic I had a fever and enormous spots on two sides of my neck. I was like a skeleton, and my CD4 count was very low. I was treated by MdM for opportunistic infections and put on ARV treatment from March 2010. I have joined the support group and met many other patients. I #8'/.)Q2'%1'4#6*'"*)16*"*+'82'",!4%&'#$+'9*$*-%*+'("18' access to all the health services.”

INDIA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » ASIA

I2,#(&3"/63(8#*%)(%'(+,!"6#%',*()'()#(,!"#"4%!(1"R,+-(a large part of its population continues to be excluded from %4*'+*6*/158*$%'5"1)*&&D'K$'%4*'&4#$%2%1F$&'1('l#,5."7'1$*',$'>@')4,/+"*$'&%,//'+,*&'9*(1"*'%4*'#!*'1('-6*D'k,$)*'@AAW7' the Midi-Pyrénées delegation has been involved with the most disadvantaged groups in order to improve their access to healthcare, paying particular attention to mother and child health. LONG TERM LIFE EXPECTANCY 64.4 YRS HDI 0.519; RANK 119/169 Source : UNDP 2010

POPULATION

» `*$*-),#"2['3,000 » Target: 5,000

Mother and child healthcare

» BB('3)#&>(&"R#'(%#(D)%1/+

» ACTIVITIES In 2010, the programme in partnership with the Indian organisation JKSMS, trained 50 volunteer community health workers. Training these people, who live in the shantytowns, will perpetuate the activities of the programme and bolster the health knowledge of the community 4%#%63+-2+%*/&b%-2;L&DaS&"5&'(%&-3'+=+'+%*&!2%=+"1*;L&*%'&1!&4L&'(%&[^JOJ&*"3+-;&>"2.%2*&(-=%& now been handed over to the community health workers.

PERSONNEL

» National: 9 » International: 1 CO-ORDINATORS

» Programme: 8')V,00,(7)%#f,0%#-( S)>)(P)1"+&, » Field: O%00>(\,+6"6#i » Monitoring: S%*%h?>+,#,,'( H,6%"#)0(K,0,6)&%"#-(M"4( O%#6,G,0* FUNDING

» S*S-(S%*%h?>+,#,,'(H,6%"#)0(<"/#!%0-(Une foulée pour la vie()''"!%)&%"#-(Solidarité en pays de Save()''"!%)&%"#-( Q+2,0(9">)6,'-(V/'%#,''( school events BUDGET

» 2010: €61,348

In parallel, the team has continued to show their presence, almost daily, in the shantytowns and strengthens ties with the Jaipur health authorities. The team continues to raise awareness through interactive theatre, traditional methods and group or individual interactions to improve healthcare access for the populations.

» RESULTS In 2010, 50% of pregnant women chose to give birth in a healthcare setting, compared to only 20% at the beginning of the project in 2007.

» OUTLOOK With the aim of transferring activities and responsibilities, MdM will focus on supporting its Indian !-2'#%2& [^JOJ& -#$& >+;;& *'2%#?'(%#& '(%& .#">;%$?%& "5& '(%& 4%#%63+-2L& !"!1;-'+"#*/& O"2%"=%2<& -& particular effort will be undertaken to convince the Jaipur authorities to takeover the programme, partially or in its entirety. Aalia Trained as a community health worker

“@.7().6')+"(.).2&').6%.)=')6%,')G''/)$2,'/).6')*6%/*').#)2&!"#,') things in the shantytown. So I volunteered to be trained as a community health worker. Now I can convince other women to take care of their health and that of their family. I’ve seen too many women cry over the loss of a child and I don’t want that to happen again.”

INDONESIA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » ASIA

8#( &3,( 3%630)#*'( "G( O,'&,+#( ?)1/)j"#,( "G( &3,( 4"'&( %'"0)&,*( +,6%"#'( "G( &3,( R"+0*—access to healthcare remains limited. The numbers of cases of AIDS has risen to the highest in the country (2.4%), and experts estimate that it will reach Wh',$'-6*'2*#"&D'K$'%4,&'+,(-)./%'&,%.#%,1$7'N+N'4#&'&*%'.5'#'5"1!"#88*'1('&*<.#/'#$+'"*5"1+.)%,6*'4*#/%4'B"#,&,$!'#F#reness and supporting diagnosis and treatment for people living with HIV/AIDS). LONG TERM LIFE EXPECTANCY 71.5 YRS HDI 0.600; RANK 108/169 Source : UNDP 2010

POPULATION

» `*$*-),#"2['5,080 » Target: 60,000 PERSONNEL

» National: 16 » International: 2 CO-ORDINATORS

» Programme: ?)&+%!%)([)%00)+*hA0"@"',-( Remco van de Pas » Field: S)/+"(O,V,+(H"'%&" » Headquarters: [/%00)/4,( 7/"#(*,(],+4)*,! FUNDING

» I/+"1,Q%*-(<"+*)%*-(S*S BUDGET

Improving access to sexual and reproductive health

» Western ?)1/)

» ACTIVITIES MdM intends to make the programme sustainable by strengthening the capacity of its local partners: the District Health Bureau, the Student Club and the organisation Primari. With them, MdM organises and leads sessions raising awareness on sexual and reproductive health for the communities. Also the organisation develops and distributes information, education and communication material focused on HIV/AIDS. The programme also supports the operation of two screening centres, organises training for health personnel, community health agents and peer educators, and advocates for access to healthcare for the population.

» RESULTS `]&3"771#+'L&(%-;'(&-?%#'*&>%2%&'2-+#%$&+#&DEQE<&-*&>%;;&-*&QR&!%%2&%$13-'"2*&-#$&6=%&*1!%2=+sors. More than 5,000 people participated in the HIV/AIDS awareness-raising sessions.

» OUTLOOK MdM will focus on the sustainability of the programme by strengthening the capabilities of the local partners, advocating access to health and supporting the HIV/AIDS component of the project.

» 2010: €282,151

Bua Wonerengga Community health agent working with MdM for six years

“Before attending the workshop that was held in Nepal at the end of September 2010, I had only vague plans and dreams in my head. But after having listened to my colleagues who work with MdM in other countries, I was motivated to improve my knowledge and abilities so as to be able to help my community”

LAOS

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » ASIA

O%&3( Y:Bk( "G( 1/V0%!( ,.1,#*%&/+,( ',&( )'%*,( G"+( 3,)0&3-( the health situation in the People’s Republic of Laos remains extremely unfavourable, especially in the area of perinatal care. The maternal mortality rate is still one of the highest in South-East Asia. In the targeted districts, more than 90% of women give birth in their homes, without help from skilled health workers.

LIFE EXPECTANCY 65.9 YRS HDI 0.497; RANK 122/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['27,680 » Target: 89,986 PERSONNEL

» National: 2 » International: 3 CO-ORDINATORS

» Programme: J&i13)#,(J)%#&(Pi6,+ » Field: 8')V,00,(K,!"/& » Headquarters: [/%00)/4,( 7/"#(*,(],+4)*,! FUNDING

» QNK-(S*S BUDGET

» 2010: €38,173

LONG TERM

» <3)41)'')@(1+"2%#!,-(J"/@3"/4)()#*(S"/#0)1)4"@(*%'&+%!&'

Pilot programme: safe motherhood

An expatriate team made up of one general co-ordinator, one medical co-ordinator and one -$7+#+*'2-'"2&(-=%&4%%#&>"2.+#?&*+#3%&K1?1*'&'"&*'-2'&'(%&!2"?2-77%/&K#&"563%&>-*&"!%#%$&+#& Vientiane. In October, an evaluation mission validated the programme proposal.

» ACTIVITIES

Since its arrival in the country, MdM has been participating, together with national groups, in the evaluation of the new national strategy on mother and child health, which notably includes the setting up of a system for free healthcare throughout the whole country.

» RESULTS The provincial authorities have granted MdM permission to set up a programme in Laos. MdM is >-+'+#?&5"2&6#-;&!%27+**+"#&52"7&'(%&?"=%2#7%#'/

» OUTLOOK G(%& "563+-;& *'-2'& "5& -3'+=+'+%*& >+;;& (-!!%#& -*& *""#& -*& '(%& -?2%%7%#'& +*& *+?#%$& >+'(& '(%& g-"'+-#& government. A study on the practices and knowledge regarding maternity in the communities is, however, scheduled for the beginning of 2011. Our programme looks at supporting the training of midwives, (pregnancy, deliveries, neonatal 3-2%<&4+2'(&*!-3+#?@<&'2-+#+#?&=+;;-?%&=";1#'%%2*&+#&'(%&!2"7"'+"#&"5&7-'%2#-;&(%-;'(<&2%5124+*(+#?& health centres and promoting a system of free mother and infant healthcare.

A woman living in the Mounlaparnok district, during the research

“I have never been to the health centre to monitor my pregnancy. I didn’t know it was important. I gave birth on my own, with my husband, as I did with my other children. I was worried that giving birth in the health centre would have been too expensive. But it is dangerous. In another village, a woman died whilst giving birth.”

NEPAL

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » ASIA

L,1)0(3)'()4"#6(&3,(3%63,'&(4)&,+#)0()#*(%#G)#&(4"+&)0%&>(+)&,'(%#(&3,(R"+0*:(In Sindhulpachowk district, maternal and "*5"1+.)%,6*'4*#/%4'-!."*&'#"*'5#"%,)./#"/2'#/#"8,$!['1$/2'bh'1('9,"%4&'%#Q*'5/#)*',$'4*#/%4'&*"6,)*&7')185#"*+'F,%4'%4*' national average of 20%. Throughout 2010, moreover, the political and security situation remained fragile and unstable.

LONG TERM LIFE EXPECTANCY 67.5 YRS HDI 0.428; RANK 138/169 Source : UNDP 2010

POPULATION

» `*$*-),#"2['4,500 » Target: 14,000 PERSONNEL

» National: 12 » International: 1 CO-ORDINATORS

» Programme: ?)&+%!@(\)6/,& » Field: J/f)##,(J&,%# » Headquarters: 9)0i+%,(\+/#,0 FUNDING

» J)#"5-(S%&'/%-(N,0%''%4"-( S*S

Services combining micro-$#$)*'#$+' reproductive health

» J%#*3/1)0!3"R@(*%'&+%!&

» ACTIVITIES The programme looks at improving the access to, and the quality of, maternal, neonatal and obstetric emergency care provided in 10 health centres. MdM supports, among others, 7+32"6#-#3%&?2"1!*&;%$&4L&>"7%#&52"7&1#$%2!2+=+;%?%$&3-*'*/&G(%*%&3"74+#%$&*%2=+3%*&3"#'2+bute considerably to the improvement of health services in Sindhupalchowk district. For the most part these activities enable the emergency obstetric services to run on a 24-hour basis, and make +'&!"**+4;%&5"2&7%$+3-;&*'-55&'"&4%#%6'&52"7&'2-+#+#?/&G(%&1*%&"5&2%5%22-;*&(-*&-;*"&4%%#&+#32%-*%$/& The women receive information on risks connected with pregnancy and childbirth and they have better access to antenatal care. Finally, this programme helps mobilise the community, particularly concerning questions relating to reproductive health.

» RESULTS WE&(%-;'(&!2"5%**+"#-;*&>%2%&'2-+#%$&+#&2%!2"$13'+=%&(%-;'(<&Q<EEE&>"7%#&4%#%6'%$&52"7&->-reness-raising and 10,000 homes had access to emergency obstetric support funds.

BUDGET

» 2010: €176,513

» OUTLOOK The programme, which covered 12 cantons since 2007, ended in December 2010. Now a new programme will commence in 10 new cantons in Sindhupalchowk district.

PAKISTAN

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » ASIA

8#( CEBE-( &3,( )+4>( !"#&%#/,*( %&'( "1,+)&%"#'( )6)%#'&( %#'/+6,#&'- in the tribal Pashtun areas, forcing civilians to move towards the foothills. In consequence there has been a dramatic rise in the health needs of these areas. In the summer, %4*'*<)*5%,1$#/'81$&11$'"#,$&')#.&*+'P11+,$!'#/1$!'%4*'9#$Q&'1('%4*'m,6*"'K$+.&'#$+'%4*'n#9./'m,6*"7'5/.$!,$!'#'/#"!*7' already fragile population into a health emergency. EMERGENCY LIFE EXPECTANCY 67.2 YRS HDI 0.490; RANK 125/169 Source : UNDP 2010

POPULATION

» `*$*-),#"2['70,000 » Target: 145,888 PERSONNEL

» National: 136 » International: 5 CO-ORDINATORS

» Programme: S)+!(M>+)#& » Field: S)+!(9)#(*,+(S/00,# » Headquarters: J&i13)#,(\,+*"/0,&

Medical assistance for the victims of crises

» ]3>V,+(?)@3&/#@3R)(`]?]a(1+"2%#!,

» ACTIVITIES MdM provides mobile primary healthcare to the civilian populations affected by the crises, whether man-made or natural. This includes a programme of nutritional support, and preparing 5"2&%!+$%7+3*<&7-+#;L&3(";%2-&A7"#+'"2+#?&-#$&3"#'+#?%#3L&!;-##+#?@/&K&;-2?%&*'1$L&"#&"4*'-3;%*& '"& (%-;'(3-2%& -33%**& A%3"#"7+3<& ?%"?2-!(+3<& *"3+";"?+3-;@& (-*& 4%%#& 3-22+%$& "1'& +#& '(%& Z1#%2& and Swabi districts, in order to identify needs at the end of the acute crisis resulting from military operations. Thanks to trained personnel, used to mounting a rapid response, MdM was immediately able to +#32%-*%&'(%&#174%2&"5&7"4+;%&3;+#+3*&*"&-*&'"&3"=%2&!-2'&"5&'(%&)""$%$&-2%-*&"5&U(-2*-$$-&-#$& Nowshera districts. In Kohat, where MdM was already present, a centre caring for cases of acute diarrhoea was set up in order to respond to the needs of the whole district.

FUNDING

» I<7A-(N+,#!3(S%#%'&+>("G( N"+,%6#(QGG)%+'(<+%'%'(<,#&+,-( S)+%)(J&+""&(N"/#*)&%"#-( A/,'&(N+)#!,(N"/#*)&%"#-( ?)+%'(<%&>(<"/#!%0-(H"%(\)/*"%#(N"/#*)&%"#-(S*S BUDGET

» 2010: €1,274,780

» RESULTS More than 120,000 consultations carried out, nearly 3,000 pregnant women were monitored and D<EFR&!%"!;%&'2%-'%$&5"2&$+-22("%-&A"5&'(%*%<&TaF&>%2%&*%=%2%;L&$%(L$2-'%$@/

» OUTLOOK M#& '(+*& *+'1-'+"#& "5& %H'2%7%& +#*'-4+;+'L<& O$O& >+;;& 3-22L& "#& +'*& *'2-'%?L& *!%3+63-;;L& '"& 2%*!"#$& '"& emergencies in three ways: mobility, in order to reach people affected by the crises wherever they are; immediate response, in order to have a potential for rapid assessment and response; and performance, to optimise the acceptability, safety and effectiveness of actions.

A woman of 23 years old at Amankhot, accompanied by her two-year old son

“He is my only child. He is too weak, even to get up, and he cries all the time. He is my only reason for living, my support for the future.”

PAKISTAN

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » ASIA

8#(?)@%'&)#-(R"4,#(R3"()+,(2%!&%4'("G(2%"0,#!,()+,(2,+>("G&,#(4)+6%#)0%',* and their access to healthcare and protection remains limited. Since the Punjab Department of Social Affairs opened the Dar ul-Amans (DUA), translated as ‘houses 1(' 5*#)*o7' %4*&*' F18*$' #$+' %4*,"' )4,/+"*$' 4#6*' %4*' 51&&,9,/,%2' %1' -$+' "*(.!*' F,%4,$' %4*&*' 41.&*&' #$+' %1' 9*$*-%' ("18' appropriate support. There are 34 DUA across the province. LONG TERM LIFE EXPECTANCY 67.2 YRS HDI 0.490; RANK 125/169 Source : UNDP 2010

POPULATION

» `*$*-),#"2['8,000 » Target: 13,000 PERSONNEL

» National: 47 » International: 4 CO-ORDINATORS

» Programme: \)+V)+)(M,#(])&, » Field: <0)+%'',(\+/#,00, » Headquarters: 9)0i+%,(\+/#,0

Struggling against domestic violence towards women

» ?/#X)V(1+"2%#!,

» ACTIVITIES Victims of physical, sexual and/or psychological violence—in need of comprehensive care -#$& *1!!"2'e6#$& 2%51?%& +#& '(%& 9cK/& G(-#.*& '"& -& 3;"*%& 3";;-4"2-'+"#& 4%'>%%#& O$O& -#$& '(%& Department of Social Affairs, the programme can now help these women by bringing them medical, legal and psychosocial assistance. MdM is involved in the 34 DUA in Punjab, particularly by building capacity within the Department of Social Affairs by way of training, with the objective that the department delivers suitable services which meet the needs of the residents and their children. In addition, civil society organisations are involved in the delivery of services and made aware of the issue of violence against women, to ensure the continuity of the care.

FUNDING

» I/+"1,Q%*-(QNK-(??H-( D)1)#,',(,4V)''>

» RESULTS

BUDGET

FEE&>"7%#&4%#%6'%$&52"7&7%$+3-;&3"#*1;'-'+"#*<&QD<aEE&52"7&!*L3(";"?+3-;&3"#*1;'-'+"#*&-#$& 3,500 from legal assistance.

» 2010: €547,076

» OUTLOOK From 2011, MdM will focus on strengthening the relationship between the regulatory authorities and civil society, with a long-term view to the sustainability of the programme. A young Afghan woman

pK'P*+'n#9./'%1'*&)#5*'#$'#""#$!*+'8#"",#!*D'I crossed the Pakistani border and was forcibly married. Finally I found refuge in a Dar ul-Aman where I have stayed for two years. I was lucky to be directed to a shelter where today I am learning to read and write. I am also having training to become a seamstress.”

DOCTORS OF THE WORLD

RUSSIAN FEDERATION

ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » ASIA

M3,(%#*%6,#"/'(1"1/0)&%"#'("G(&3,([+,)&(L"+&3()+,(!"#G+"#&,*(R%&3(3,)0&3(+%'@' caused by their economic and social situation. Alcoholism and tuberculosis, in particular, present major public health problems in these areas. MdM supports the NGO Community Health Partnership in the strengthening of its network of community health agents and in its advocacy towards the regional authorities. LONG TERM LIFE EXPECTANCY 67.2 YRS HDI 0.719; RANK 65/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['98 » Target: 135 PERSONNEL

» National: 2 » International: 1 CO-ORDINATORS

» Programme: Q+4,00,(P,1,++, » Field: Julia Krikorian » Headquarters: 9%"0)%#,([)6#,& FUNDING

» S*S-(J)#"5

Supporting a community health programme for the indigenous populations

» [+,)&(#"+&3()#*(J%V,+%)

» ACTIVITIES In 2010, MdM signed a partnership agreement with the NGO Community Health Partnership AUC,@&>+'(&'(%&-+7&"5&(%;!+#?&'(%7<&52"7&#">&1#'+;&DEQD<&'"&*'2%#?'(%#&-#$&4%3"7%&-1'"#"7"1*&+#& their activities. In this context, MdM and CHP have together hosted training for health agents and specialists in addiction in Yakutsk. Another objective of this co-operation is to promote innovative methods of care for patients being treated for tuberculosis, as well as high-risk drinkers in Yakutsk and in the independent district of Nenetsia.

» RESULTS 10 health agents and 88 health professional (general practitioners, addiction specialists and psy3(+-'2+*'*@&>%2%&'2-+#%$&+#&DEQE/

BUDGET

» 2010: €188,483

» OUTLOOK In 2011, the partnership with the NGO Community Health Partnership will continue with a new agreement aimed at MdM’s gradual withdrawal between now and 2012.

DOCTORS OF THE WORLD

RUSSIAN FEDERATION

ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » ASIA

M3,+,()+,(',2,+)0(4%00%"#(4%6+)#&'(%#(S"'!"R-(and most of them are undocumented, without legal and free access to healthcare. Their insecure living and working conditions make them particularly vulnerable to injuries related to accidents in the work place, and to infectious and sexually transmitted diseases. MdM aims to provide medical care to these socially excluded groups. LONG TERM LIFE EXPECTANCY 67.2 YRS HDI 0.719; RANK 65/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['1,215 » Target: 20,000

Access to healthcare for migrants

» S"'!"R

» ACTIVITIES In 2008, MdM set up an emergency hotline and developed a referral system for a network of doctors known as ‘friends to migrants’. Activities to prevent infectious diseases have also been developed, in conjunction with local organisations helping migrants. In February, an evaluation recommended that the management of the hotline should be transferred to a local partner organisation. MdM’s activities drew to a close at the end of May 2010.

PERSONNEL

» National: 4 » International: 1

» RESULTS

CO-ORDINATORS

1,215 people were referred to healthcare providers following a call to the hotline.

» Programme: D/0%,(\,00,#6,+ » Field: Julia Krikorian » Headquarters: 9%"0)%#,([)6#,&

» OUTLOOK

FUNDING

» S*S BUDGET

» 2010: €71,646

As part of a European and cross-border approach to the problem of migration, MdM intends to re-evaluate the health needs of migrants from different countries, including the Russian Federation, over the course of 2011.

VIETNAM

DOCTORS OF THE WORLD

ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » ASIA

789lQ8KJ()11,)+,*(%#(9%,&#)4()&(&3,(V,6%##%#6("G(&3,(B^^E':'K%'"*8#,$&')1$-$*+'F,%4,$'%4*'8#"!,$#/,&*+'#$+'&%,!8#tised groups (drug users, prostitutes, gay men), but the risk of general widespread propagation remains high. With a national prevalence rate of 0.5% (275,000 cases) and 10,000 deaths annually, HIV/AIDS represents a public health priority.

LIFE EXPECTANCY 74.9 YRS HDI 0.572; RANK 113/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['9,000 » Target: 115,000 PERSONNEL

» National: 26 » International: 3 CO-ORDINATORS

» Programme: Karine P)!"4V,-(S)/*(P,4"%#, » Field: A0%2%,+(N+)#!3% » Headquarters: 9)0i+%,(\+/#,0

LONG TERM

» 7)#"%()#*(7"(<3%(S%#3(<%&>

Prevention and treatment programme for people living with HIV

The programme is developed in partnership with the health services of Hanoi and Ho Chi Minh City. It aims to prevent and reduce the risks at injection sites and places of prostitution, thanks to peer educators who instruct and raise awareness, distribute condoms and needles, and who offer anonymous and free screening. Medical treatment is also provided for those who test positive. Patients have access to antiretrovirals and treatment for opportunistic infections. _+#-;;L<& 7"2%& ?%#%2-;& *1!!"2'& +*& +#& !;-3%& 5"2& !-'+%#'*& "#& -& !*L3("*"3+-;& ;%=%;<& +#& "2$%2& '"& 6?('& against prejudice.

» ACTIVITIES

» RESULTS Prevention has involved 8,740 people, 4,940 people have been tested and 2,730 patients re3%+=%$&7%$+3-;&-#$r"2&*"3+-;&3-2%&A"5&>(+3(&Q<]aE&-2%&"#&-#'+2%'2"=+2-;*@/

FUNDING

» S*S-(?Q<M-(gLQ8KJ-( N+,#!3(,4V)''>

» OUTLOOK G(%&?2-$1-;&'2-#*5%2&"5&'>"&*+'%*&AO$O&*1!!"2'*&5"12@&+*&1#$%2&$+*31**+"#&>+'(&'(%&;"3-;&-1'("2+'+%*/

BUDGET

» 2010: €1,096,185

Huyen 30 years old, patient since 2008

“I had myself tested and my CD4 count was very low. In addition, I was diagnosed with tuberculosis. I immediately received treatment and I was vaccinated against hepatitis B. The team gave me psychological support and in three months, my CD4 count has risen.”

BULGARIA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » EUROPE

M3,(3,)0&3!)+,(+,G"+4'('&)+&,*(%#(\/06)+%)(%#(CEEE-(introduced a system of paid health insurance. But most Roma are excluded from this system either because of lack of information on their rights, or because of lack of money to pay the 5"*8,.8&D'T4*'-!."*&'#"*'5#"%,)./#"/2'#/#"8,$!7'*&5*),#//2',$'"*/#%,1$'%1'6#)),$#%,1$7',$(#$%'81"%#/,%27'42!,*$*'5"#)%,)*&' and reproductive health. LONG TERM LIFE EXPECTANCY 73.7 YRS HDI 0.743; RANK 58/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['850 » Target: 5,000

Better access to healthcare for Roma

» L)*,f3*)(*%'&+%!&-(J0%2,#

» ACTIVITIES In 2010, an MdM team oversaw the existing training of health mediators, as far as it is recognised in Bulgaria. Training modules on antenatal healthcare and on hygiene were created and disseminated. Finally, a vaccination campaign was supported, notably with door-to-door distribution of information to families.

PERSONNEL

» National: 8 » International: 1 CO-ORDINATORS

» Programme: ?)&+%!@(<"#&"%' » Field: S)+6)+%&)(J)0&,+% » Headquarters: 9%"0)%#,([)6#,& FUNDING

» S*S-(&3,([,+4)#(H,%#"2)V%'(N"/#*)&%"# BUDGET

» 2010: €126,620

» RESULTS 125 people were trained in prenatal and postnatal healthcare, and hygiene. 850 homes were =+*+'%$&-#$&Q<WEE&!%"!;%&+#5"27%$&-4"1'&'(%&4%#%6'*&"5&=-33+#-'+"#/

» OUTLOOK In 2011, health education will focus on nutrition and family planning. A hygiene centre will be set up in the heart of the Nadezhda quarter and will be directly accessible to the local communities. A social worker will be recruited to aid the reintegration of the Sliven Roma into the Bulgarian social security system. In addition, a conference among health professionals is planned for the end of the year.

MOLDOVA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » EUROPE

S"0*"2)(%'("#,("G(&3,(4)%#(!"/#&+%,'(%#(&3,(R"+0*(G"+(3/4)#(&+)G5!@%#6:(The number of victims is estimated at around ZA7AAA'#$+'1$/2'#'(*F'#"*',+*$%,-*+'#$+'%#Q*$')#"*'1(D'T4*'6,)%,8&'&.((*"'("18'8#$2'+,((*"*$%'542&,)#/'#$+'8*$%#/'4*#/%4' 5"19/*8&7'#$+'*$)1.$%*"'+,(-)./%,*&'F,%4'"*,$%*!"#%,1$D'N+N'4#&'"#,&*+'#F#"*$*&&'#81$!'#'/#"!*'$*%F1"Q'1('5"1(*&&,1nals and in the north of the country offers multidisciplinary support.

LIFE EXPECTANCY 68.9 YRS HDI 0.623; RANK 99/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['750 » Target: 2, 600 PERSONNEL

» National: 13 » International: 1

LONG TERM

» \)0&%()#*(&3,('/++"/#*%#6()+,)

Preventing human %"#(-)Q,$!

MdM is raising awareness "5& '(%& !(%#"7%#"#& "5& (17-#& '2-563.+#?& +#& *3("";*& -#$& -7"#?*'& vulnerable adolescents and is organising a regional media campaign. Following the training of and awareness-raising amongst professionals, a network has been set up to identify victims.

» ACTIVITIES

Multidisciplinary care has been organised for the victims to ensure provision of medical, psychological, social and legal support, as well as professional help towards reintegration. This is provided via a network of national and local partners and the intervention of two mobile teams.

CO-ORDINATORS

» Programme: N+)#n"%',(?)++"& » Field: Laura Pasquero » Headquarters: 9%"0)%#,([)6#,& FUNDING

» QNK-(S*S BUDGET

All these activities are carried out in partnership with local organisations, under the umbrella of the #-'+"#-;&2%5%22-;&*L*'%7&5"2&=+3'+7*&"5&(17-#&'2-563.+#?/

» RESULTS 170 schoolchildren, adolescents in institutions and students received information, 380 professio#-;*&>%2%&'2-+#%$&-#$&*1!!"2'&>-*&!2"=+$%$&'"&DEE&#%>&3-*%*&"5&(17-#&'2-563.+#?/

» 2010: €186,367

» OUTLOOK In 2011, MdM will begin its withdrawal and progressively transfer the activities to the programme’s public sector and voluntary sector partners.

ROMANIA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » EUROPE

K,'1%&,(X"%#%#6(&3,(I/+"1,)#(g#%"#()#*(&3,('&+/!&/+)0(+,G"+4'("G(&3,(B^^E'-(Romania does not seem to be able to over)18*',%&'51/,%,)#/',$&%#9,/,%2'#$+'*)1$18,)'+,(-)./%,*&D'T4,&'&,%.#%,1$'4,$+*"&'%4*'!16*"$8*$%o&'F1"Q'1$')4,/+'5"1%*)%,1$D' ?1)%1"&'1('%4*'01"/+o&'cS\S'"*!,1$#/'+*/*!#%,1$'&.551"%&'%4*'F1"Q'1('%4*'\^cKK'1"!#$,&#%,1$'#$+'),6,/'&1),*%2',$'%4*'-!4%' against the abuse and abandonment of children.

LIFE EXPECTANCY 73.2 YRS HDI 0.767; RANK 50/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['303 » Target: 457 PERSONNEL

» National: 1 » International: 0 CO-ORDINATORS

» Programme: 7i0t#,(?%!"# » Field: S:(9,+,' » Headquarters: ?Q<Q(+,6%"#)0( *,0,6)&%"#-(8')V,00,(S)0)2)0

LONG TERM

» J)&/(S)+,

Protecting children and supporting the organisation COPII

MdM carries on professional exchanges in order to support the Romanian organisation, U0,MM/&G(%&"2?-#+*-'+"#&-;*"&>"2.*&'"&2%'12#&3(+;$2%#&A+#&!-2'+31;-2&#%>I4"2#*@&>("&(-=%&4%%#& placed with social services to their natural families. The return of the infant is supported by invol=+#?& !14;+3& (%-;'(3-2%& >"2.%2*& A+#& ("*!+'-;*<& 9,U<& 71#+3+!-;& *"3+-;& *%2=+%*@<& 2-+*+#?& ->-2%#%**& amongst childcare assistants to encourage the existence of family ties and interventions with the mother and the extended family.

» ACTIVITIES

_+#-;;L<&O$O&1#$%2'"".&-&2%'2"*!%3'+=%&3"771#+'L&*'1$L&ADEEWIDEEF@&"#&'(%&-4-#$"#7%#'&"5& children in Satu Mare region in order to provide Romanian stakeholders with a better understanding of the causes of abandonment, of possible solutions and potential areas for communitybased co-operation.

FUNDING

» \"/!3,'h*/hH3u#,(K%'&+%!&( <"/#!%0-(1+%2)&,(1)+&#,+'3%1-( S*S BUDGET

» 2010: €4,393

» OUTLOOK In 2011, MdM will continue the prevention activities with mothers who are in a vulnerable socioeconomic situation and/or showing signs of pregnancies at risk. The project will also continue to 7"4+;+*%&;"3-;&.%L&!;-L%2*&A=";1#'-2L&*%3'"2<&+#*'+'1'+"#-;&-#$&+#&'(%&3"771#+'L@<&1*+#?&'(%&2%3"77%#$-'+"#*&"5&'(%&*'1$L&-*&-&*'-2'+#?&!"+#'&-#$<&6#-;;L<&O$O&>+;;&(%;!&U0,MM&4%3"7%&7"2%&-1'"nomous.

SERBIA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » EUROPE

QG&,+( >,)+'( "G( #,6"&%)&%"#( R%&3( 0"!)0( )/&3"+%&%,'-( the Savski Venac substitution treatment centre, supported by MdM, 15*$*+',%&'+11"&',$'`*/!"#+*',$'^)%19*"'@AAYD'T4,&'5,/1%'5"1H*)%7'%4*'-"&%'%1'9*'#%%#)4*+'%1'#')*$%"*'(1"'5",8#"2'4*#/%4)#"*7' has allowed better access for drug users to treatment and appropriate services.

LONG TERM LIFE EXPECTANCY 74.4 YRS HDI 0.735; RANK 60/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['120 » Target: 2,500 PERSONNEL

» National: 4 » International: 1 CO-ORDINATORS

» Programme: ?)&+%!@([)''4)## » Field: D/0%,#(<"00,&&, » Headquarters: 9%"0)%#,([)6#,&

Access to substitution treatment

» \,06+)*,

» ACTIVITIES The establishment of the Savski Venac centre caused, in effect, a minor revolution at the heart of the Serbian health system. Working within a centre for primary healthcare, the MdM teams were able to establish an innovative approach, in close co-operation with the personnel of the centre, and with the medical and psyco-social services, whilst still being respectful of drug users, who until now have been heavily stigmatised. As well as work carried out to raise awareness among health professionals, a large network of contacts was established to ensure continuity in the care provided outside the centre. The team in Savski Venac has also provided tech#+3-;&*1!!"2'&5"2&'(%&32%-'+"#&"5&#%>&*14*'+'1'+"#&3%#'2%*<&6#-#3%$&4L&'(%&\;"4-;&_1#$<&+#&DEQE/

» RESULTS QDE&!-'+%#'*&4%#%6'%$&52"7&3-2%&*!%3+63&'"&'(%+2&#%%$*&A>+'(&-&FaS&2%'%#'+"#&2-'%@<&7"2%&'(-#&QEE& patients are enrolled on the waiting list.

FUNDING

» S*S BUDGET

» 2010: €130,154

» OUTLOOK The management of the Savski Venac centre, today partially autonomous, will be completely transferred to the local authorities at the end of 2011. This last year will therefore be spent preparing for MdM’s withdrawal by organising specialised training and the handover of daily activities.

A female patient

“In the centre I feel safe and free to express myself. The staff 42(.'/).#)E#8I)K6'E)6'4!'0)&').#)+/0)%)N#G)2/).6')2/08(."2%4)*4'%/2/$) sector. The doctors help me to overcome hepatitis C. I must confess that they have taught me to live and to work with the illness. At the hospital it is not at all the same approach. For example, my partner, who is also on methadone, receives no support whatsoever.”

COLOMBIA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » LATIN AMERICA

J%#!,(CEEZ-(S*S(3)'(V,,#('/11"+&%#6(+/+)0(%#*%6,#"/'(1"1/0)&%"#'(and Afro-Colombians, isolated because of the ar8*+')1$P,)%D'T4*'19H*)%,6*',&'%1'(#),/,%#%*'%4*,"'#))*&&'%1'4*#/%4)#"*'#$+'%1'#+61)#%*'%4*,"',$)/.&,1$',$%1'%4*'$#%,1$#/'4*#/%4' &2&%*8D' T4*' 1"!#$,&#%,1$' )1$)*$%"#%*&' ,%&' *((1"%&' ,$' %4*' #"*#&' 1(' ,$%*$&,-*+' )1$P,)%7' F4*"*' %4*"*' #"*' )/#&4*&' 9*%F**$' illegal groups, cocaine eradication campaigns and military operations. LONG TERM LIFE EXPECTANCY 73.4 YRS HDI 0.689; RANK 79/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['5,000 » Target: 16,000 PERSONNEL

» National: 10 » International: 4 CO-ORDINATORS

» Programme: <3+%'&%)#(H)66%"0%-( ])+%#)(S"+)0,' » Field: 9%!,#&,([)2%*%) » Headquarters: m2,'(P,(<"+6#, FUNDING

Access to health care for populations affected by armed )1$P,)%

» Atrato

» ACTIVITIES MdM carries out prevention activities, as well as providing medical consultations, for groups >("&-2%&+*";-'%$&4L&'(%&;"3-;&?%"?2-!(L&"2&4L&-27%$&3"#)+3'/&O"4+;%&3;+#+3*<&>(+3(&-2%&"2?-#+*%$& in close collaboration with Colombian health services, use dug-out canoes to reach the communities. By training community volunteers we can develop health promotion projects, carry out activities to tackle malnutrition and monitor pregnant women and young children. Looking ahead to the closure of the project in mid-2011, MdM has strengthened the prevention and health education approaches, improved training for key players in the community and redoubled efforts to encourage the health authorities to take responsibility.

» RESULTS 18 mobile clinics and 18 health promotion and prevention sessions have taken place in 18 communities.

» QI<8K-(S*S BUDGET

» 2010: €359,336

» OUTLOOK The closure of the project and MdM’s withdrawal from Atrato region is planned for the end of June 2011. Communication activities are planned to highlight the problem of lack of access to health 3-2%&5"2&7-2?+#-;&!"!1;-'+"#*&3-1?('&1!&+#&'(%&-27%$&3"#)+3'<&*13(&-*&'(%&Y74%2-&!"!1;-'+"#<& that MdM has been working with since 2004.

COLOMBIA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » LATIN AMERICA

LIFE EXPECTANCY 73.4 YRS HDI 0.689; RANK 79/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['8,450 » Target: 10,700 PERSONNEL

» National: 16 » International: 4 CO-ORDINATORS

» Programme: <3+%'&%)#(H)66%"0%-( ])+%#)(S"+)0,' » Field: 9%!,#&,([)2%*%) » Headquarters: m2,'(P,(<"+6#, FUNDING

» I<7A-(<8KQ-(S*S BUDGET

» 2010: €583,131

LONG TERM

» S,&)-([/)2%)+,

Access to health care for rural populations and indigenous victims of armed )1$P,)%

MdM has set up mobile clinics offering medical and psychological consultations to the com71#+'+%*&!-2'+31;-2;L&-55%3'%$&4L&'(%&3"#)+3'<&+#&3";;-4"2-'+"#&>+'(&'(%&*'-'%I21#&(%-;'(&*%2=+3%*/& ,-2'+31;-2&-''%#'+"#&+*&?+=%#&'"&>"7%#&"5&2%!2"$13'+=%&-?%&-#$&3(+;$2%#&1#$%2&6=%<&-*&>%;;&-*&'(%& victims of violence and their families. In addition, the programme looks at increasing the active involvement of the communities, their organisations and their leaders, through training focused on psychological support and on sexual and reproductive health. This practice of strengthening the communities, as well as lobbying the health authorities, promotes the establishment of health services in areas where they have been lacking.

» ACTIVITIES

» RESULTS 87 mobile clinics took place and, of these, 17 were organised in collaboration with the health -1'("2+'+%*<&(%;!+#?&]<`aE&4%#%63+-2+%*/

» OUTLOOK MdM cannot withdraw from certain areas without an improvement in security conditions and more effective support from the health authorities. As part of a strategy of supporting the popu;-'+"#*&>"2*'&-55%3'%$&4L&'(%&3"#)+3'<&O$O&>+;;&*'%!&1!&+'*&-3'+=+'+%*&+#&'(%&71#+3+!-;+'+%*&"5&O%'-<& and Guaviare in the north.

COLOMBIA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » LATIN AMERICA

POPULATION

» `*$*-),#"2['4,000 » Target: 8,200 PERSONNEL

» National: 5 » International: 4 CO-ORDINATORS

» Programme: <3+%'&%)#(H)66%"0%-( ])+%#)(S"+)0,' » Field: 9%!,#&,([)2%*%) » Headquarters: m2,'(P,(<"+6#, FUNDING

» I<7A-(S*S BUDGET

» 2010: €284,308

Access to health care for rural populations and indigenous victims of armed )1$P,)%

» Nariño

» ACTIVITIES MdM brings a programme of mobile clinics to the heart of the indigenous Awas reserve, in close co-operation with the health centre managed by the indigenous UNIPA organisation. The joint teams dispense medical care focusing on monitoring pregnant women and children, vaccinations, nutritional monitoring, family planning, and the detection of cases of malaria and tuberculosis. At the same time MdM’s intervention includes health promotion, prevention and training activities, supporting community leaders and indigenous health promoters.

» RESULTS 21 mobile clinics were set up in collaboration with the indigenous organisation UNIPA, helping `<EEE&4%#%63+-2+%*/

» OUTLOOK In 2011, the focus will be on advocacy for culturally appropriate healthcare for the Awa population. MdM will conduct a study on the relevant health needs, which will help UNIPA in its advocacy %55"2'*&5"2&"563+-;&2%3"?#+'+"#&"5&-&*!%3+63&(%-;'(&!;-#&-#$&6#-#3+-;&3"=%2/

GUATEMALA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » LATIN AMERICA

A#(C^(S)>(CEBE-(!>!0"#,(Q6)&3)(&"/!3,*(#,)+0>(_E(!"44/#%&%,'-(and affected more than 50,000 people. MdM undertook to support local partners in their future project in the Escuintla and Suchitepéquez departments, by way of a donation, enabling them to mount an immediate response to the needs of the populations and to prevent the outbreak of diseases )1$$*)%*+'F,%4'P11+,$!D

LIFE EXPECTANCY 70.8 YRS HDI 0.560; RANK 116/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['1,049 » Target: 10,000 PERSONNEL

» National: 9 » International: 1 CO-ORDINATORS

» Programme: ?%0)+([%+)/.J>02%,(\%)#!3% » Field: Q/+i0%,(P,+">,+ » Headquarters: I+#,'&"(7,++,+) FUNDING

» S*S BUDGET

» 2010: €48,090

EMERGENCY

» I'!/%#&0)()#*(J/!3%&,1iF/,f(*,1)+&4,#&'

Helping the population in the wake of cyclone Agatha

Activities consisted of a donation to the local NGO Associacion de Mujeres Madre Tierra (a 3"771#+'L&"2?-#+*-'+"#&"5&212-;&5%7-;%&>"2.%2*@&-#$&'"&'(%&(%-;'(&3%#'2%*&"5&'(%&'>"&9%!-2'7%#'*& A!2"'%3'+=%&%X1+!7%#'&-#$&7%$+3-;&'2%-'7%#'&5"2&*.+#&$+*%-*%*@/&O%$+3-;&3"#*1;'-'+"#*&>%2%&-;*"& carried out in Suchitepéquez department.

» ACTIVITIES

» RESULTS Suchitepéquez: 1,049 people treated in eight communities. Escuintla: distribution of medication, boots and waterproofs for 2,000 people.

» OUTLOOK These emergency actions encouraged a strengthening of ties with the local partners, with a view to opening an MdM project on sexual and reproductive health in Escuintla and Suchitepéquez departments.

GUATEMALA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » LATIN AMERICA

S)#>(,.1"+&%#6(%#*/'&+%,'(`maquilas) and agro-food industries are concentrated in Guatemala. They employ a predominantly female work force, which is very deprived and badly paid, often victims of violations of their right to health. Since 2006, MdM has been running a programme aimed at promoting the effective application of these rights, and, in particular, access to healthcare for these women. LONG TERM LIFE EXPECTANCY 70.8 YRS HDI 0.560; RANK 116/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['6,811 » Target: 10,000 PERSONNEL

» National: 5 » International: 1 CO-ORDINATORS

» Programme: ?%0)+([%+)/.-( J>02%,(\%)#!3% » Field: Q/+i0%,(P,+">,+ » Headquarters: I+#,'&"(7,++,+) FUNDING

» QNK-(S*S BUDGET

» 2010: €109,163

Protecting the health of maquila workers and those in the agro-food industry

» <3%4)0&,#)#6"()#*(J)!)&,1iF/,f(*,1)+&4,#&'

» ACTIVITIES During the three years of this project, the female workers and their families (-=%&4%#%6'%$& from outreach activities, including medical consultations and strengthening of their knowledge and skills concerning the right to health. At the same time, the project made those responsible in '(%&O+#+*'2L&5"2&C%-;'(<&'(%&\1-'%7-;-#&M#*'+'1'%&"5&J"3+-;&J%312+'L&AM\JJ&+#&+'*&J!-#+*(&-32"#L7@<& '(%&O+#+*'2L&5"2&B"2.&-#$&'(%&*'-'%&*%2=+3%*&->-2%&"5&(17-#&2+?('*&3"##%3'%$&>+'(&(%-;'(e$+56culty of access to healthcare and violation of the right to health of women working in the maquilas. K*&!-2'&"5&+'*&-$="3-3L&-3'+=+'+%*<&+#&K!2+;&DEQE&O$O&(%;$&'(%&62*'&+#'%2#-'+"#-;&3"#5%2%#3%&"#&'(%& right to health for women working in these industries. More than 300 people participated.

» RESULTS 6,811 medical consultations were carried out for the female workers and their families, 131 women were trained as health promoters.

» OUTLOOK In September 2010, the project was transferred to the local partner Associacion de Mujeres en Solidaridad AKOYJ@/&O$O&;-1#3(%$&-&!2"N%3'&>(%2%&'(%&"4N%3'+=%&+*&'"&!2"7"'%&'(%&2+?('&'"& sexual and reproductive health for female textile industry workers in Escuintla and Suchitepéquez departments.

GUATEMALA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » LATIN AMERICA

POPULATION

» Target: 7,500 PERSONNEL

» National: 7 » International: 2 CO-ORDINATORS

» Programme: ?%0)+([%+)/.-( J>02%,(\%)#!3% » Field: Q/+i0%,(P,+">,+ » Headquarters: I+#,'&"(7,++,+) FUNDING

» QNK-(S*S BUDGET

» 2010: €65,989

Enabling access to sexual and reproductive health for the female workers of the maquilas

» I'!/%#&0)()#*(J/!3%&,1iF/,f(*,1)+&4,#&'

» ACTIVITIES The last two months of 2010 were dedicated to the administrative opening of the project and the recruitment of the local team. Since January, premises have been opened and medical consultations have already started for women working in the maquilas and the food processing industries, and their families.

» OUTLOOK In 2011, the objective is to implement the planned project activities, and to make this new MdM activity highly visible in these departments, in partnership with the Associacion de Mujeres en Solidaridad&AKOYJ@&-#$&Madre Tierra, a women’s association that carries out community-based training activities on sexual and reproductive health.

HAITI

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » LATIN AMERICA

M3,(,)+&3F/)@,("#(BC(D)#/)+>(CEBE(0,G&(4"+,(&3)#(CEE-EEE(*,)*-(ZEE-EEE(R"/#*,* and 2.3 million people were dis5/#)*+D'T4*'J#,%,#$'!16*"$8*$%'/1&%'%41.&#$+&'1('1(-),#/&'B=AhC'#$+'#'4.!*'5#"%'1(',%&'Q*2',$("#&%".)%."*'F#&'+*&%"12*+D' Present in Port-au-Prince since 1994, MdM France rallied in the days following the disaster to respond to the urgent surgical needs of the victims. EMERGENCY LIFE EXPECTANCY 61.7 YRS HDI 0.404; RANK 145/169 Source : UNDP 2010

POPULATION

» `*$*-),#"2[ 798 PERSONNEL

» National: 320 » International: 28 CO-ORDINATORS

» Programme: J"13%,(P)'',++,-( Anne Urtubia » Field: S>+%)4(?"4)+,0 » Headquarters: \0)#*%#,(<"#&)4%# FUNDING

» I<7A-(J&,+#'&/#*,#-( <0%#&"#-(PUA+i)0-(J)#"5-( 9%#!%-(?)+%'(<%&>(<"/#!%0-( 9)0(*UA%',([,#,+)0(<"/#!%0-( L"+*h?)'h*,h<)0)%'(H,6%"#)0(<"/#!%0-(J)%#&hr&%,##,( <"/#!%0-(S/#%!3-(S)+%)( J&+""&(N"/#*)&%"#-(S*S BUDGET

» 2010: €500,000

Medical and surgical care in the wake of the earthquake

» O,'&,+#(*,1)+&4,#&-(?"+&h)/h?+%#!,(4,&+"1"0%&)#()+,)-(?"+&h)/h?+%#!,(!"44/#,

» ACTIVITIES On 15 January, MdM sent a surgical team to set up surgical activities in Port-au-Prince university hospital. The organisation progressively equipped the operating block, and worked closely with other international organisations on the ground, enabling resources and workload to be *(-2%$&A'2+-?%&-#$&!"*'I"!%2-'+=%&3-2%@/&K'&'(%&%#$&"5&'(%&%H%23+*%<&O$O&(-#$%$&'(%&!2"?2-77%& over to the hospital team, over the course of a week, and donated the equipment that had been put in place.

» OUTLOOK 917 surgical operations carried out, of which 16% were orthopaedic interventions, and 78.4% concerned reconstructive surgery and care.

HAITI

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » LATIN AMERICA

M3,(,)+&3F/)@,("#(BC(D)#/)+>(CEBE(0,G&(4"+,(&3)#(CEE-EEE(*,)*-(ZEE-EEE(R"/#*,*(and 2.3 million people were dis5/#)*+D'T4*'J#,%,#$'!16*"$8*$%'/1&%'%41.&#$+&'1('1(-),#/&'B=AhC'#$+'#'4.!*'5#"%'1(',%&'Q*2',$("#&%".)%."*'F#&'+*&%"12*+D' Present in Port-au-Prince since 1994, MdM France rallied in the days following the catastrophe to respond to the urgent surgical needs of the victims. EMERGENCY LIFE EXPECTANCY 61.7 YRS HDI 0.404; RANK 145/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['151,036 » Target: 323,581 PERSONNEL

» National: 320 » International: 28 CO-ORDINATORS

» Programme: J"13%,(P)'',++,-( Anne Urtubia » Field: S>+%)4(?"4)+,0 » Headquarters: \0)#*%#,(<"#&)4%# FUNDING

» I<7A-(J&,+#'&/#*,#-( <0%#&"#-(PUA+i)0-(J)#"5-( 9%#!%-(?)+%'(<%&>(<"/#!%0-(9)0( *UA%',(<"/#!%0-(L"+*h?)'h *,h<)0)%'(H,6%"#)0(<"/#!%0-( J)%#&hr&%,##,(<"/#!%0-( S/#%!3-(S)+%)(J&+""&( N"/#*)&%"#-(S*S BUDGET

» 2010: €4,177,014

» O,'&(*,1)+&4,#&-(?"+&h)/h?+%#!,()#*(%&'(4,&+"1"0%&)#()+,)- Delmas and(<)rrefour

Reducing the » ACTIVITIES ensured free of charge provision of the Minimum Health Package in 10 temporary impact of the MdM 3;+#+3*/&Y55"2'*&>%2%&3"#3%#'2-'%$&"#&'(%&3-2%&"5&!2%?#-#'&>"7%#&A2%!2"$13'+=%&(%-;'(@&-#$&"#& earthquake 3(+;$2%#&1#$%2&6=%&A*L*'%7+3&#1'2+'+"#-;&*32%%#+#?@/ on physical and mental As well as medical care, MdM set up psycho-social care in the communities, through discussion groups, educational games and activities aimed at children and adolescents, awareness raising in health the communities and psychological consultations. MdM also guarantees medical, psychological and legal support for victims of violence, in partnership with four hospitals.

» RESULTS 196,930 free medical consultations were carried out in the MdM clinics.

» OUTLOOK The arrangements for the temporary clinics are not intended to be continued in their entirety. In close collaboration with the Ministry of Health, MdM will ensure the handover of the clinics to three health centres, as part of a more integrated plan for mother and child health.

HAITI

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » LATIN AMERICA

N%#)#!%)0(V)++%,+'-(1""+()!!,''(&"(3,)0&3(',+2%!,'-(G""*(%#',!/+%&>~(J#,%,'41/+&'%4*'"*)1"+'(1"'%4*'F1"&%'-!."*&'(1"'81ther and child health on the American continent. One in 37 Haitian women of child-bearing age runs the risk of death during pregnancy. It is in this context that MdM has been working in the mostly rural department of Grand’ Anse since 1989.

EMERGENCY LIFE EXPECTANCY 61.7 YRS HDI 0.404; RANK 145/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['43,658 » Target: general population PERSONNEL

» National: 50 » International: 1 CO-ORDINATORS

» Programme: J"13%,(P)'',++,-( Anne Urtubia » Field: S>+%)4(?"4)+,0 » Headquarters: \0)#*%#,(<"#&)4%# FUNDING

» 2010: €1,353,273

Reducing maternal and infant mortality

» [+)#*UQ#',(*,1)+&4,#&

» ACTIVITIES MdM supplies and supports eight rural health centres and six rural maternity units, with '(%&-+7&"5&*%''+#?&1!&52%%&3-2%&5"2&!2%?#-#'&>"7%#&-#$&3(+;$2%#&1#$%2&6=%&&L%-2*&";$/ At the same time, MdM has set up a drop-in nutritional screening programme, and looks after the most severe cases of malnutrition. A unit for nutritional stabilisation has been set up in Jeremie hospital, to care for malnourished children who need to be hospitalised. In February, completely free healthcare was set in motion and the number of supported health 3%#'2%*&>-*&+#32%-*%$&'"&2%*!"#$&'"&'(%&+#)1H&"5&$+*!;-3%$&!%"!;%&5";;">+#?&'(%&%-2'(X1-.%/

» RESULTS T`<aFW&3(+;$2%#&1#$%2&6=%&-#$&F<EWD&!2%?#-#'&>"7%#&4%#%6'%$&52"7&7%$+3-;&3"#*1;'-'+"#*&"=%2& the duration of the project.

» OUTLOOK As the only medical group present in Grand’Anse department, MdM will continue its actions in DEQQ& '"& !2"7"'%& -33%**& '"& (%-;'(3-2%& 5"2& !2%?#-#'& >"7%#& -#$& 3(+;$2%#& 1#$%2& 6=%/& O$O<& +#& partnership with FAO and the German Red Cross, will also intensify its efforts in treating cases of 7"$%2-'%&7-;#1'2+'+"#&+#&'(%&-2%-*&+$%#'+6%$&+#&DEQE/

HAITI

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » LATIN AMERICA

QV',#&(G+"4(7)%&%(G"+(#,)+0>()(!,#&/+>-(!3"0,+)(+,)11,)+,*(on 19 October in Artibonite. By 29 December, 3,481 deaths #$+'>bW7=@>')#&*&'4#+'9**$'1(-),#//2'"*)1"+*+D';1%'4#6,$!'9**$'%"#,$*+',$'%4*'+*%*)%,1$'#$+'+*#/,$!'F,%4'%4,&'+,&*#&*7' )188.$,%2'4*#/%4'#!*$%&'#$+'8*+,)#/'5*"&1$$*/'(1.$+'%4*8&*/6*&',$'+,(-)./%2D'N+N'+*),+*+'%1'&*%'.5'#'"*&51$&*'%1'%4*' emergency in the two departments where it was already operating. EMERGENCY LIFE EXPECTANCY 61.7 YRS HDI 0.404; RANK 145/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['4,707 » Target: 37,660 PERSONNEL

» National: 370 » International: 28 CO-ORDINATORS

» Progamme: J"13%,(P)'',++,-( Anne Urtubia » Field: S>+%)4(?"4)+,0 » Headquarters: \0)#*%#,(<"#&)4%# FUNDING

» 2010: €481,827

Fighting against a cholera epidemic

» O,'&(}([+)#*UQ#',(*,1)+&4,#&'-(?"+&h)/h?+%#!,(4,&+"1"0%&)#()+,)-(K,04)'(}(<)++,G"/+

» ACTIVITIES In order to prevent the spread of cholera, MdM organised community meetings, educating about the disease and methods of prevention, and distributed soap.

» RESULTS 4,707 cases of cholera were treated by MdM.

» OUTLOOK In order to prevent a new cholera epidemic, and to ensure it is able to react quickly and effectively, MdM will, in 2011, incorporate into all of its programmes epidemiological monitoring, an early warning system, training personnel to deal with epidemics, a contingency plan and an emergency stock of essential medicines and medical and logistical equipment.

MEXICO

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » LATIN AMERICA

S*S(%'(3,01%#6(&"(%41+"2,()!!,''(&"(&3,(3,)0&3('>'&,4(both for the indigenous communities—who face perilous life )1$+,%,1$&'#$+'-$+'%4*8&*/6*&',&1/#%*+7'5#"%/2'9*)#.&*'1('%4*,"'51/,%,)#/'"*&,&%#$)*'%1F#"+&'%4*'!16*"$8*$%g#$+'#/&1'(1"' %4*'8,!"#$%'515./#%,1$&',$'%4*'&1.%4'1('\4,#5#&'k%#%*7'F4*"*'8,!"#%,1$'P1F&'#"*'81&%'&,!$,-)#$%D'N+N'"*&51$+&'%1'%4*' needs expressed by these communities, whilst respecting their rights. LONG TERM LIFE EXPECTANCY 76.7 YRS HDI 0.750; RANK 56/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['1,356 (direct), 44,879 (indirect) PERSONNEL

» National: 6 » International: 2 CO-ORDINATORS

» Programme: N0)2%)(J&,)-( N+i*i+%F/,(<)++%, » Field: <)+0"'(I'!"V)+ » Headquarters: I+#,'&"(7,++,+) FUNDING

» I/+"1,)#(g#%"#-(S*S BUDGET

» 2010: €163,993

Promoting the right to health for the indigenous populations

» Q0&"'(+,6%"#-(<3%)1)'

» ACTIVITIES MdM supported the Tzotzil, Tzeltal, Tojolabal and Chol indigenous populations in sustaining the autonomy of their health system. MdM also organised training for local health representatives in order to better manage health problems. Responsibility for primary healthcare has been taken up by the health promoters, and particular attention has been paid to integrating women into these activities. In addition, advocacy action has taken place to make the state authorities aware of the rights of these communities.

» RESULTS 147 trainers and 1,209 health promoters were trained, 72 workshops on the health system and the right to health were organised over three years.

» OUTLOOK These activities driven by MdM haves enabled the consolidation of a true right to health, with the !2"N%3'&'-.%#&5"2>-2$&4L&;"3-;&-3'"2*&-#$&'(%&=%2L&!%"!;%&>("&4%#%6'/&K&#%>&!2"N%3'&>+;;&*'-2'&1!& in the same State. It aims to promote the right to health for migrant women, female sex workers and domestic workers.

MEXICO

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » LATIN AMERICA

POPULATION

» Target: 2,000 PERSONNEL

» National: 2 » International: 1 CO-ORDINATORS

» Programme: N0)2%)(J&,) » Field: <)+0"'(I'!"V)+ » Headquarters: I+#,'&"(7,++,+) FUNDING

» QNK-(S*S BUDGET

» 2010: €37,593

Promoting access to sexual and reproductive health for migrant women, female sex workers and domestic workers

» M)1)!3/0)-(<3%)1)'

» ACTIVITIES This new project intends to improve access to care and education on sexual and reproductive health for women working in the sex trade and female employees in the home, in Tapachula and Huixtla. MdM will set up training workshops to raise awareness of sexual and reproductive health, and to help women understand their rights to access the Mexican health system. MdM will also carry out awareness-raising and lobbying among medical personnel and local authorities about violence against women, which will ultimately make medical care and adequate legal support possible for women affected by violence.

» OUTLOOK The project will start in 2011. The activities mentioned will be put in place, as well as partnerships with the Ministry of Health and local NGOs.

NICARAGUA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » LATIN AMERICA

8#( CEEB-( 6%2,#( &3,( '%f,( "G( &3,( *"4,'&%!( )#*( ',./)0( 2%"0,#!,( 1+"V0,4-( particularly against women and children, the government has made this issue a public health priority. MdM is involved with the victims in one of the poorest regions, where social and health conditions constitute a risk factor for violence.

LIFE EXPECTANCY 73.8 YRS HDI 0.565; RANK 115/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['3,096 » Target: 10,000 PERSONNEL

» National: 3 » International: 1 CO-ORDINATORS

» Programme: H"V,+&(<3)0/0,)/-( S)+6)+%&)(["#f)0,f » Field: <)+4,#(H"*+%6/,f » Headquarters: I+#,'&"(7,++,+) FUNDING

» QNK-(S*S-(Junta de Andalucia BUDGET

» 2010: €112,368

LONG TERM

» ?/,+&"(<)V,f)'-(L"+&3(Q&0)#&%!(Q/&"#"4"/'(H,6%"#

Multidisciplinary care for victims of domestic and sexual violence

MdM has set up a multidisciplinary network, bringing together voluntary sector and institutional partners, in order to provide medical, legal and social support for victims of violence. At the same time, MdM trained and raised awareness amongst health professionals and people from voluntary sector partners and civil society to help better identify and deal with cases of violence. MdM set up a system to provide medical care to victims, and organised training workshops and awareness building activities orientated towards the male population to show them new types of family relationships based on respecting the dignity and rights of each individual.

» ACTIVITIES

» RESULTS T<EFW&!%"!;%&4%#%6'%$&52"7&'(%*%&-3'+=+'+%*&A>"7%#<&3(+;$2%#<&-$";%*3%#'*<&3"771#+'L&;%-$%2*<& (%-;'(&!%2*"##%;<&;"3-;&b\0*@/

» OUTLOOK At the end of June 2010, MdM concluded the handover of the project to the local partners, members of the network. MdM aims to extend its activities in the region with a new project promoting access to sexual and reproductive health for women.

NICARAGUA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » LATIN AMERICA

LONG TERM LIFE EXPECTANCY 73.8 YRS HDI 0.565; RANK 115/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['4,023 women » Target: women over 25 years old in San Bartolo and Quilali PERSONNEL

» National: 1 » International: 1

Tackling cervical cancer

» o/%0)0%-(L/,2)(J,6"2%)(*,1)+&4,#&

» ACTIVITIES Since October 2007, MdM has helped and trained medical workers in Quilali and San Bartolo to screen and treat pre-cancerous cervical lesions. One doctor and three nurses have been trained. Consultations and treatments are carried out through mobile clinics in the villages, in order to reach the greatest number of women possible.

» RESULTS O"2%&'(-#&a<WQF&*7%-2&'%*'*&>%2%&3-22+%$&"1'&A`<EDT&+#+'+-;&*32%%#+#?*<&Q<aFW&5";;">&1!*@<&TQT& pre-cancerous cervical lesions, screened and treated.

CO-ORDINATORS

» Programme: Q##,hS)+%,(P,!3)+&%,+O%00%)4(J)41%,&+" » Monitoring: QF/%&)%#,(H,6%"#)0(K,0,6)&%"# FUNDING

» S*S

Five women suffering from advanced cervical cancer were diagnosed and transferred to the capital for treatment.

» OUTLOOK The team is now autonomous and the Ministry of Health has taken over the programme. Tackling cervical cancer has become a national priority.

PERU

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » LATIN AMERICA

K,'1%&,( &3,( %41+"2,4,#&( %#( &3,( 3,)0&3( '%&/)&%"#-( there are still huge problems in relation to sexual and reproductive health. The situation amongst adolescents is particularly worrying with high numbers of unwanted pregnancies, illegal abortions and maternal mortality. MdM is improving access to sexual and reproductive health in the most disadvantaged quarters of Lima. LONG TERM LIFE EXPECTANCY 73.9 YRS HDI 0.723; RANK 63/169 Source : UNDP 2010

POPULATION

» Target: 47,500 PERSONNEL

» National: 15 » International: 2 CO-ORDINATORS

» Programme: S)+>',(\"'!)4,+%!<3+%'&%#,(\)&)+* » Field: L)#!>(S,06)+ » Headquarters: I+#,'&"(7,++,+)

Promoting sexual and reproductive health amongst adolescents

» Three districts in the south of Lima

» ACTIVITIES MdM has organised a community awareness campaign around sexual and reproductive (%-;'(& -#$& =+";%#3%& -?-+#*'& -$";%*3%#'*<& 5"2& .%L& 6?12%*& +#& '(%& 3"771#+'+%*<& 2%;+?+"1*& ?2"1!*& and civil society. A campaign has been launched for the government to make this a priority. As a 2%*1;'&"5&'(%&'2-+#+#?&"5&?2"1!*&"5&-$";%*3%#'*&-#$&'(%&32%-'+"#&"5&QE&*!%3+63&71#+3+!-;&3%#'2%*<& young girls have access to information on sexual and reproductive health, educational material and methods of contraception. Educational sessions are also led by school teachers in the area. Finally, the personnel in the 10 health centres have received technical training, enabling them to give quality attention to pregnant adolescents.

» RESULTS 32,000 condoms distributed, 250 teachers trained, 3,856 adolescent girls followed training >"2.*("!*<&QE<]EE&4%#%63+-2+%*&'2-+#%$/

FUNDING

» Q##,#V,+6(N"/#*)&%"#-( S*S-(QNK BUDGET

» 2010: €42,145

» OUTLOOK MdM withdrew from this project at the beginning of 2010, but plans to stay in Peru and to continue to work on sexual and reproductive health for women of reproductive age in the Villa el Salvador district, in the south of Lima.

URUGUAY

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » LATIN AMERICA

J%#!,(CEEB(%#(g+/6/)>-(!%2%0('"!%,&>()!&%2%'&'(3)2,(3,01,*(to bring about a change in legislation regarding women with unwanted pregnancies, but without actually obtaining the decriminalisation of abortion. MdM is supporting a pilot project developed by two local NGOs (MYSU and Iniciativas Sanitarias) and hopes to spread this through a network of Latin American NGOs working on this issue. LONG TERM LIFE EXPECTANCY 76.7 YRS HDI 0.765; RANK 52/169 Source: UNDP 2010

PERSONNEL

» National: 7 » International: 1 CO-ORDINATORS

» Programme: D,)#([/,++%#%-( <)4%0)([%/60%)#% » Field: \0)#!)(Q+,2)0" » Headquarters: m2,'(P,(<"+6#, FUNDING

» S*S BUDGET

» 2010: €53,226

Promoting sexual and reproductive health

» ?)>')#*/-(Q+&%6)'()#*(<,++"(P)+6"(K,1)+&4,#&'

» ACTIVITIES AV"$ /#!.$ _V(!"$ &%$ .V"$ _#&a"S.$ b4B3BT4B33c$ V(!$ .V#""$ '(-)$ (#"(!1$ supporting the development of two local NGOs in three new provinces to improve care for women with unwanted pregnancies, preparing a national campaign raising awareness of this issue and for the de-criminalisation of abortion; and organising a meeting in Montevideo for Latin American NGOs to share practical experience.

» RESULTS J'-2'+#?&1!&'(%&62*'&'2-+#+#?&*%**+"#*&5"2&(%-;'(&!%2*"##%;&+#&'(2%%&#%>&!2"=+#3%*/

» OUTLOOK This project looks at sensitising public opinion and decision-makers on the establishment of a protocol for pre/post abortion medical care and on the proper application of the law on the right to sexual and reproductive health in relation to de-criminalisation of the right to abortion.

EGYPT

DOCTORS OF THE WORLD

ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » MIDDLE EAST

I6>1&(3)'()#(,.&+,4,0>(3%63(1"1/0)&%"#(*,#'%&>: 75 million inhabitants are concentrated into 6% of the country’s one 8,//,1$'&i.#"*'Q,/18*%"*&D'K$'#++,%,1$7'+*81!"#54,)'!"1F%4',&'&,!$,-)#$%D'K$'\#,"17'#'),%2'1('#"1.$+'@A'8,//,1$',$4#9,%#$%&7' there are a large number of street children. MdM has been working in the area since 2004, and has launched a programme for promoting access to healthcare for this vulnerable population. LONG TERM LIFE EXPECTANCY 70.5 YRS HDI 0.620; RANK 101/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['3,600 » Target: 25,000 PERSONNEL

» National: 10 » International: 2 CO-ORDINATORS

» Programme: H)/0(7,%4)## » Field: S)+%@)(S)!!" » Headquarters: 8')V,00,(\+/)#* FUNDING

» K+"'"'-(S*S BUDGET

» 2010: €173,644

Promoting the right to health for street children

» [+,)&,+(<)%+"

» ACTIVITIES The project concentrates on three main objectives. It aims to widen the knowledge, the attitudes and the practices of the street children with regards to their health. It also aims to facilitate access to quality healthcare for them, as well as prevention, with the aid of partner NGOs, social workers and psychologists. Finally, the project looks at improving the medical care available for street children by supporting networks and through lobbying activities.

» RESULTS QWT&M#5"27-'+"#<&Y$13-'+"#&-#$&U"771#+3-'+"#&AMYU@&*%**+"#*&>%2%&3-22+%$&"1'&5"2&QaE&3(+;$2%#<& six training sessions in physical and mental health were provided for 200 health workers, 1,302 consultations were carried out in Basma Clinic.

» OUTLOOK MdM’s withdrawal from this programme is scheduled for the end of 2011. With this in mind, emphasis will be placed even more next year on strengthening the abilities of the partner organisations, so that eventually activities to meet health needs are included in their programmes.

Mahmoud Dardir Facilitator Information, Education, Communication activities

“Working with street children is important, because nobody cares about them any more. The community itself considers them as enemies: it doesn’t understand why these children have decided to leave the security of the home. We can have an impact through games and educational activities, which help to create relationships of trust.”

IRAQ

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » MIDDLE EAST

8#(1"'&hR)+(8+)F-(&3,(2%"0,#!,()6)%#'&(!%2%0%)#(1"1/0)&%"#'(!"#&%#/,': Since the withdrawal of American troops from Iraqi towns on 30 June 2009, there have been growing numbers of attacks in the country. Although the Kurdish region has seen apparent prosperity, its future remains fragile and its political situation unstable. The country is faced with a notable &41"%#!*'1('4*#/%4)#"*'5*"&1$$*/7'8#$2'1('F418'4#6*'P*+'#9"1#+D LONG TERM LIFE EXPECTANCY HDI NC; RANK

68.5 YRS NC

Source: UNDP 2010

POPULATION

» `*$*-),#"2['230 PERSONNEL

» National: 2 » International: 1 CO-ORDINATORS

» Programme: S)+%,hQ#6,(J%0%!)#% » Field: Erwin Temmerman » Headquarters: L)&3)0%,(["*)+*

Supporting emergency healthcare, mother and child health and mental health

» K"3/@-(L%#,R)-(I+V%0-(]%+@/@-(J/0)>4)#%>)3-(K%>)0)-(],+V)0)

» ACTIVITIES MdM’s activities aim to strengthen the abilities of healthcare personnel. Training in prehospital medicine has been offered to doctors, in conjunction with the medical training centre C-7-$&O%$+3-;&U"2!"2-'+"#&ACOU@<&>(+3(&>+;;&%#-4;%&'(%7&'"&2%*!"#$&'"&%7%2?%#3+%*&+#&^+2.1.<& b+#%>-<&9+L-;-&-#$&+#&'(%&^d\&2%?+"#&AY24+;<&J1;-L7-#+L-(&-#$&9"(1.@/&K7"#?&"'(%2&'(+#?*<&'(%& training helps the integration of mental health into primary healthcare, with a view to improving diagnosis and providing better care for psychological problems and psychiatric illnesses.

» RESULTS QF&!-2-7%$+3*&4%#%6'%$&52"7&Y7%2?%#3L&O%$+3-;&G%3(#+3+-#&AYOG@&'2-+#+#?<&aE&7+$>+=%*&-#$& traditional birth attendants were trained and equipped, 160 medical personnel participated in awareness-raising activities.

FUNDING

» KQ7-(JK<-(S*S

» OUTLOOK

BUDGET

MdM plans to support primary healthcare centres in the rural areas of Ninewa, Erbil, Kirkuk, Sulaymaniyah and Diyala governorates. The programme has several components: training midwives, mental healthcare, training in emergency response, and health education for the population in general.

» 2010: €374,980

Rizgar 37 years old, paramedic in Erbil

“I am glad that I did the MdM training. I now feel that I am able to pass on the information and skills that I learned to my colleagues. Certain people have told me that, despite 25 years experience in healthcare, they have discovered, with MdM, techniques that they did not know before.”

LEBANON

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » MIDDLE EAST

P,V)#"#(%'("#,("G(&3,(4)%#(3"'&(!"/#&+%,'(G"+(?)0,'&%#%)#(+,G/6,,':(^('%4*&*7'b=h'/,6*',$'>@'1(-),#/')#85&7'.$+*"'%4*' auspices of the UN agency for Palestinian refugees (UNRWA). This is also one of the countries where living conditions for this population are hardest. UNRWA provides primary care in the camps, but no mental healthcare is offered. Since 2007, MdM has decided to support access to this type of healthcare.

LIFE EXPECTANCY HDI NC; RANK

72.4 YRS NC

Source: UNDP 2010

POPULATION

» `*$*-),#"2['605 » Target: 43,000 PERSONNEL

» National: 14 » International: 1 CO-ORDINATORS

» Programme: N+)#!,(Q++,'&)&-( H,,4(S)#'"/+ » Field: r4%0%,(\">,+ » Headquarters: L)&3)0%,(["*)+* FUNDING

» S*S BUDGET

» 2010: €255,613

LONG TERM

» M+%1"0%-(L)3+(,0h\)+,*()#*(\)**)R%(1)0,'&%#%)#(!)41'-(L"+&3(P,V)#"#

Mental health and psychological support for refugees

MdM’s programme takes place in two refugee camps, with provision of psychiatric and psychological consultations in UNRWA clinics. The focus is on expanding the scope of mental health training, started in 2009, for the UNRWA and Palestinian Red Crescent health workers, as well as training for local organisations’ support workers. The objective is to enable early detection of patients, and to refer patients and help them to reintegrate into society once their condition has improved.

» ACTIVITIES

» RESULTS 5,200 psychological and psychiatric consultations and home visits were carried out.

» OUTLOOK After two and a half years working on mental health, we have begun to document the programme that has been running in the north, enabling a complete analysis of the activities to be carried out. G(+*&>+;;&(%;!&1*&'"&$%6#%&-#&+#'%2=%#'+"#&*'2-'%?L&5"2&-&#%>&!2"N%3'<&>(+3(&3"1;$&4%&$%=%;"!%$&+#& the south of the country, helping the Palestinian and Lebanese populations.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

PALESTINIAN TERRITORIES

INTERNATIONAL PROGRAMMES » MIDDLE EAST

M3,(8'+),0%(,4V)+6"("#(&3,([)f)('&+%1(continues to have disastrous consequences on the living conditions of the population, where 80% depend on help from abroad. Delivery of supplies and maintenance of equipment are severely restricted, #$+'8*+,)#/'5*"&1$$*/')#$$1%7',$'%4,&'&,%.#%,1$7'9*$*-%'("18'%4*')185/*8*$%#"2'%"#,$,$!'%4#%'F1./+'*$#9/*'%4*8'%1'*$&."*' quality healthcare.

LIFE EXPECTANCY HDI NC; RANK

73.9 YRS NC

Source: UNDP 2010

POPULATION

» `*$*-),#"2['18,533 » Target: 534,998 PERSONNEL

» National: 21 » International: 1 CO-ORDINATORS

» Programme: S)+%,(H)X)V0)&-( Anne Kamel » Field: A0%2%,+(N)/+%&&, » Headquarters: L)&3)0%,(["*)+* FUNDING

» I<7A-(S*S

LONG TERM

» [)f)('&+%1

Access to primary and secondary healthcare

Having assisted in the opening of emergency rooms in 11 primary healthcare centres in the Gaza Strip, MdM will now support their operation by training and supervising medical teams in emergency care, and by ensuring provision of essential medicines and medical equipment.

» ACTIVITIES

MdM has organised training in orthopaedic surgery in three hospitals, in order to improve the techniques of the Gazan surgeons. To prevent diseases linked with water, health education sessions have been organised for the population, and particularly for the women.

» RESULTS There was a 29% increase in consultations in the emergency rooms of the 11 MdM-supported (%-;'(3-2%&3%#'2%*&+#&'(%&62*'&*+H&7"#'(*&"5&DEQE/

BUDGET

» 2010: €974,644

» OUTLOOK In 2011 the focus will be on linking the primary health centres with the new hospital, in collaboration with MdM Spain, with a focus on emergency preparedness.

DOCTORS OF THE WORLD

ANNUAL REPORT 2010

PALESTINIAN TERRITORIES

INTERNATIONAL PROGRAMMES » MIDDLE EAST

A#(&3,(O,'&(\)#@-(&3,(1"1/0)&%"#('&%00('/GG,+'(2%"0,#!,(!"##,!&,*(R%&3(&3,(',&&0,4,#&(,.1)#'%"#-(as the freeze has not held. Mental health remains the poor relation where health services are concerned, and suffers from a lack of resources. After years of violence, this type of care is becoming indispensable, but the Palestinians only have limited access to care. MdM works to improve mental healthcare opportunities, and helps with the detection and care of problems, especially in children. LONG TERM LIFE EXPECTANCY HDI NC; RANK

73.9 YRS NC

Source: UNDP 2010

POPULATION

» `*$*-),#"2['11,039 » Target: 130,380 PERSONNEL

» National: 21 » International: 1 CO-ORDINATORS

» Programme: S)+%,(H)X)V0)&-( Anne Kamel » Field: A0%2%,+(N)/+%,&&, » Headquarters: L)&3)0%,(["*)+*

Mental healthcare and psychosocial support for children

» Nablus and Jenin

» ACTIVITIES MdM interacts with children by way of psycho-social activities&(%;$&+#&6=%&=+;;-?%&*3("";*& on the outskirts of Nablus. The teachers are also trained in these activities and psychologists are '-1?('&(">&'"&+$%#'+5L&3(+;$2%#&>+'(&*!%3+63&7%#'-;&(%-;'(&#%%$*<&-#$&'"&(%;!&'(%7&2%-3(&-!!2"priate services. There are also discussion groups for parents. M#&'(%&!2+7-2L&(%-;'(&3%#'2%*&"5&'(%*%&6=%&=+;;-?%*<&O$O&'2-+#*&(%-;'(&!%2*"##%;&'"&+$%#'+5L<&'"&;+*'%#& to, to care for and refer people showing psychological problems. In Nablus medical-psychological community centre, which MdM helped to create, the teams have been trained to help set up a referral system among the MdM-supported primary health centres. Finally, MdM supervises the medical-psychological community centre staff in Jenin.

FUNDING

» I<7A-(S*S-(QNK BUDGET

» 2010: €676,924

» RESULTS 1,257 children participated in the psycho-social activities either run by or supervised by MdM.

» OUTLOOK In 2011, MdM will continue to prioritise work in the outlying areas made vulnerable by the proximity to the settlements, and to work on both mental health issues and primary healthcare support.

SYRIA

DOCTORS OF THE WORLD

ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » MIDDLE EAST

Q0,1(6"2,+#"+)&,(%'(&3,(4"'&(*,#',0>(1"1/0)&,*()#*("#,("G(&3,(1""+,'&(%#(J>+%):(The population has to deal with inequality in access to healthcare, the private system being the principal alternative to the public healthcare system. MdM, in partnership with the Red Crescent, aims to help launch and support new health centres.

LONG TERM LIFE EXPECTANCY 74.6 YRS HDI 0.589; RANK 111/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['42,000 » Target: 126,000

Access to primary healthcare

» Q0,1(6"2,+#"+)&,

» ACTIVITIES MdM supports eight health centres with medical equipment and medicines. A health education component has been set up thanks to the development of methods and the organisation of '2-+#+#?&-#$&3"#5%2%#3%*&'-2?%'+#?&7-+#;L&>"7%#&A2%!2"$13'+=%&(%-;'(@&-#$&*3("";&!1!+;*&A!2%=%#'+"#&-#$&"2-;&(%-;'(3-2%@/&_+#-;;L<&'(%7-'+3&>"2.*("!*&(-=%&4%%#&"55%2%$&'"&$"3'"2*&-#$&#12*%*& from the Red Crescent, for instance, on laparoscopic surgery or mental health.

PERSONNEL

» National: 5 » International: 1 CO-ORDINATORS

» Programme: S)+%,hQ#6,( Silicani » Field: [/,0)(J,@3#%)!32%0% » Headquarters: L)&3)0%,(["*)+* FUNDING

» K+"'"'-(S*S BUDGET

» 2010: €281,762

» RESULTS `D<aRa&3"#*1;'-'+"#*&>%2%&3-22+%$&"1'&+#&DEQE/&Qa<EFR&!%"!;%&4%#%6'%$&52"7&(%-;'(&%$13-'+"#& sessions, three medical thematic workshops were held, with 88 participants.

» OUTLOOK In 2011, the project will continue, with the three main areas of work to encourage the quality and sustainability of the activities. In relation to health education, the focus will be on the establishment of internal systems to ensure the continuity of the project.

TURKEY

DOCTORS OF THE WORLD

ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » MIDDLE EAST

K/,(&"(%&'('&+)&,6%!(6,"6+)13%!)0(1"'%&%"#-(%&'(!"44,+!%)0(%#$/,#!,()#*(%&'(1+".%4%&>(&"(&3,([+,,@(!")'&-(Turkey attracts migrants from North Africa, sub-Saharan Africa, the Middle East and Asia. The project, developed together with the Turkish association Tohav, looks at people disadvantaged by a political and legal system that steers them away from any possibility of regularisation, access to healthcare and appropriate treatment.

LIFE EXPECTANCY 72.2 YRS HDI 0.679; RANK 83/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['8,!"#$%&' and displaced persons living in the Kumpaki area. » Target: undocumented migrants and internally displaced persons. PERSONNEL

» National: 1 » International: 0

LONG TERM

» 8'&)#V/0

Respecting human rights and access to healthcare for migrants

MdM provides medical and social aid to undocumented migrant populations living in the Kumpaki neighbourhood. The activities include listening, care, social support and referral to spe3+-;+*'&*%2=+3%*e'(%&!2"N%3'&3"74+#%*&!2"=+*+"#&"5&3-2%&+#&6H%$&;"3-'+"#*&>+'(&"1'2%-3(&-3'+=+'+%*& in the areas where the migrants live.

» ACTIVITIES

M#& -$$+'+"#<& -$="3-3L& >"2.<& 4-*%$& "#& 6%;$& %H!%2+%#3%& -#$& 3-*%& *'1$+%*<& 3-;;*& 5"2& '(+*& ?2"1!P*& rights to be respected, at both the local and European levels. MdM and Tohav are involved in encouraging the development of Turkish civil society and promoting human rights, which includes the right to health, for migrant populations.

CO-ORDINATORS

» Programme: \,+#)+*([+)#X"# » Monitoring: ?Q<Q(H,6%"#)0( K,0,6)&%"#-(8')V,00,(S)0)2)0 FUNDING

» \"/!3,'h*/hH3u#,(6,#,+)0( !"/#!%0-(S*S BUDGET

» 2010: €50,857

» OUTLOOK O$O&>+;;&1*%&'(%&-$="3-3L&-3'+"#&-*&-&'"";&5"2&3(-#?%<&4"'(&"#&-#&"!%2-'+"#-;&;%=%;&A7"$+63-'+"#& "5&3122%#'&G12.+*(&;%?+*;-'+"#&-#$&2%*!%3'+#?&2+?('*@&-#$&"#&-&!";+'+3-;&;%=%;&A"4N%3'+=%&-2?17%#'*& on the impact of European immigration and asylum policies that condemn migrants to insecurity -#$&$+*32+7+#-'+"#@/

YEMEN

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL PROGRAMMES » MIDDLE EAST

M3,(!"#$%!&(V,&R,,#(&3,(7"/&3%(+,V,0'()#*(&3,(6"2,+#4,#&($)+,*(/1()6)%#(%#(&3,('/44,+("G(CEE^-(signaling the start of the sixth war, more intense and longer than the previous ones. Large numbers of people are again displaced. Despite %4*')*#&*-"*'&,!$*+',$'3*9".#"2'@A>A7'%4*')1.$%"2'"*8#,$&'6*"2'.$&%#9/*'#$+'4*#/%4'&*"6,)*&'4#6*'$1%'"*G15*$*+'%4*,"' doors. MdM, already in Saada governorate since 2007, brought aid to the badly affected populations, enabling continuous access to healthcare. LONG TERM LIFE EXPECTANCY 63.9 YRS HDI 0.439; RANK 133/169 Source: UNDP 2010

POPULATION

» `*$*-),#"2['199,650 » Target: 233,000 PERSONNEL

» National: 36 » International: 5 CO-ORDINATORS

Primary healthcare for the populations affected by %4*')1$P,)%

» J))*)()#*(7)XX)3(6"2,+#"+)&,'

» ACTIVITIES In Hajjah governorate, from January to July 2010, mobile clinics (for general consultations, 7-'%2#-;&(%-;'(&-#$&(%-;'(&%$13-'+"#@&'"".&!;-3%&+#&'(2%%&$+*'2+3'*&>(%2%&'(%&$+*!;-3%$&!%"!;%& coming from Saada had gathered. Since May, MdM has been maintaining eight primary healthcare centres with the aim of ensuring that provision of healthcare is sustainable in the long-term. In Saada governorate, mobile clinics have carried out consultations in 12 sites in areas affected 4L&'(%&3"#)+3'&*+#3%&[-#1-2L&DEQE/

» Programme: N+)#n"%',(D,)#'"# » Field: <+%'&%#)(M3,2,#"& » Headquarters: L)&3)0%,(["*)+*

» RESULTS

FUNDING

» OUTLOOK

» I<7A-(I/+"1,Q%*-([,+4)#( S%#%'&+>("G(N"+,%6#(QGG)%+'-( S*S BUDGET

» 2010: €735,043

Hajjah: 300 health education sessions and 13,100 consultations were carried out. Saada: 33,776 consultations were carried out.

G(%&!2+7-2L&(%-;'(3-2%&!2"N%3'&>+;;&6#+*(&-'&'(%&%#$&"5&O-23(&DEQQ&+#&C-NN-(&?"=%2#"2-'%/&M#&J--$-& governorate, MdM will continue its mobile clinic activities and will offer direct support to the health centres, if security conditions in the area permit.

ARGENTINA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL NETWORK

CONTACT DETAILS

» Médicos del Mundo Argentina Alberti 48 - Ville Vs. As. Tel/Fax: (00 54 11) 4954 0080 www.mdm.org.ar medicosdelmundo@mdm.org.ar CONTACT

» President: G. Basile medicosdelmundo@mdm.org.ar BOARD OF DIRECTORS

» President: G. Basile Vice-Chair: J. Meritano, M. Gorban General secretary: C. Tcholakian Treasurer: A. Dones Other board members: A. C. Cafaro, D. Cordoba, P. Sala, N. Lucatelli, M. Barrio, R. Cimbaro, J. Radesca Registered as a charitable organisation under Argentinian law in November 1998.

ACKNOWLEDGEMENTS

» Union of South American Nations

(Unasur), National Institute against Discrimination, Xenophobia and Racism (Inadi – Argentina), French embassy in Argentina, Buenos Aires association of health professionals, Credicoop Bank Argentina, Argentinian national bank, Argentinian civil society consultative council, Baxter Foundation, Bambini Foundation, Navarrese Viole Foundation, HSBC, OTC AECID Argentina, OTC AECID Peru, OTC Aecid Haití, Alliance française Buenos Aires, L´Oreal

» NATIONAL PROJECTS

» INTERNATIONAL PROJECTS

MdM Argentina works with socially excluded groups and rural populations that are mainly indigenous. Some programme examples: k&K33%**&'"&(%-;'(&5"2&2"1?(&*;%%!%2*&+#&Z1%#"*&K+2%*n k&O+?2-'+"#&-#$&(%-;'(&>+'(&-#&32"**I31;'12-;&(%-;'(&!2"motion strategy in Buenos Aires and Córdoba, working with migrant organisations; k&C%-;'(&!2"7"'+"#&>+'(&'(%&*"3+-;&7"=%7%#'*&"5&Z1%#"*& Aires province; k&J'2-'%?L&'"&!2"7"'%&(%-;'(&-#$&X1-;+'L&"5&;+5%&+#&'(%&"1'lying areas of the Toba Qom community in Rosario (Fe !2"=+#3%@n k&M#'%?2-'%$&3(+;$&!2"'%3'+"#&-#$&-33%**&'"&(%-;'(&4L&'(%& Childhood and Health group team; k&Y#=+2"#7%#'-;&(%-;'(&+#&'(%&-2%-*&-#$&'(%&3+'+%*&"5&U1%#ca Matanza-Riachuelo, in Buenos Aires province.

At the international level, MdM Argentina concentrates its work in Central and South America: In Peru, the organisation is currently developing a project to improve sovereignty and food security. In Paraguay, MdM Argentina has set up a project to reinforce the primary healthcare strategy in family health units and cross-culturality in the indigenous rural populations in San Pedro district. In Haiti, MdM Argentina continues a post-emergency project: health promotion and prevention in the agricultural and 6*(+#?&3"771#+'+%*&+#&gj"?-#%/ In Bolivia, MdM Argentina carries out exchange and training activities (family, community-based and cross-cultural health 7"$%;@& +#& 3";;-4"2-'+"#& >+'(& '(%& Z";+=+-#& O+#+*'2L& "5& C%-;'(& and Sport. In Chile, MdM’s Argentinian delegation carried out a project in Bío-Bío and Araucanía regions affected by the earthquake and tsunami of February 2010.

» COMMUNICATION AND EVENTS MdM Argentina has carried out a number of advocacy events. To name a few examples, MdM Argentina: k&3"#'+#1%*&'"&4%&"#%&"5&'(%&#-'+"#-;&3"I"2$+#-'"2*&"5&'(%& Argentinian Social, Health and Environment Forum; k& !2"7"'%$& -#$& !-2'+3+!-'%$& +#& '(%& $%4-'%*& "5& '(%& Qst Global Conference on Universal Social Security Systems +#&Z2-*+;+-&AZ2-h+;@<&+#&9%3%74%2&DEQE/

BELGIUM

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL NETWORK

CONTACT DETAILS

» Médecins du Monde Belgique Rue de l’Éclipse, 6 1000 Brussels Belgium Tel +32 (0)2 648 69 99 Fax +32 (0)2 648 26 96 www.medecinsdumonde.be CONTACT

» info@medecinsdumonde.be EMPLOYEES (14)

» General Director: P. Verbeeren Medical Director: E. Hesse `*/!,.8'+*&Q'1(-)*"[' S. Heymans \1$!1'+*&Q'1(-)*"[' P. Pauwels N#/,'+*&Q'1(-)*"['E. Richard J#q%,'+*&Q'1(-)*"['G. Fuks Human resources: A. Saunders Director’s assistant: A. Al Badaoui Marketing manager: D. Baise Communication managers: N. Rodembourg, P. Stam Finance managers: C. Stocquet, J.-M. Hoebanckx Accounts: A. Pierson BOARD OF DIRECTORS

» President: M. Degueldre Vice-president: E. Struys Secretary: P. Deltour Other board members: D. Van Osta, P. Viart, E. Gatera, S. Braekeveldt, J. Bourgaux Established as an association under Belgian law in May 1999.

ACKNOWLEDGEMENTS

» DGD, ECHO, WBI, SPP Intégration

Sociale, Inami, Consortium 12-12, the national lottery, Peterbroeck foundation, Delacroix support fund, P&V, Umicore, Ageas, ING, Lhoist, L. Bégault, PSF, Euro RSCG.

» NATIONAL PROJECTS Brussels k&Healthcare and Advice Clinic In 2010 there were increases in: – asylum seekers, because of a shortage of capacity in mainstream services; – nationals from more recent EU member states. 2,735 social consultations, 2,222 medical consultations and 355 psychological consultations were carried out. k&Samu social and Winter Plan for homeless people 4,000 night-time consultations made possible by more than 60 volunteers. k&Listening service for young women (Talk with her) Those involved in the project are considering new developments. Antwerp k&Healthcare and Advice Clinic The issue of access to healthcare is becoming more -#$& 7"2%& $+5631;'& 5"2& 1#$"317%#'%$& 7+?2-#'*& $1%& '"& increasingly restricted access to Emergency Medical Aid.

» INTERNATIONAL PROJECTS Mali k& Caring for vulnerable children in Bamako, supporting several Malian organisations and working directly with 4%#%63+-2+%*o&Q<RQQ&7%$+3-;&3"#*1;'-'+"#*<&QEW&3-*%*&5"2&& psychological monitoring, with an advocacy component. k& Health emergency in the east of Mali by deploying mobile teams. k& Supporting the Youwarou Circle, an area that is `&&,",$!"]")$'&).V!$($R"(#X$(),$-)$d-,(0$#"U-&)e Democratic Republic of Congo Supporting 45 health centres and three hospitals in Kasaï: construction of four maternity units and two clinics, provision of medicines, equipment and supplies, super-

vision of health centres and hospitals and training health agents. Haiti 2$ 9"0(*)SV$ &%$ F".-.$ O&f]"$ '(."#)-.R$ *)-.X which is now open 24 hours a day and serves 300,000 inhabitants. 1,000 deliveries. 2$A(S^0-)U$SV&0"#($-)$7-__"!$,"_(#.'").1$One cholera treatment centre, three smaller units, nine oral re-hydration posts and 550 health workers have been trained.

» COMMUNICATION AND EVENTS k& U"#5%2%#3%& "#& -33%**& '"& (%-;'(3-2%& 5"2& !2%?#-#'& >"men and vulnerable children. k&Exil, Exit? exhibition at the Gare du Midi, in October 2010 AQE<EEE&=+*+'"2*@/ k&O"4+;+*-'+"#&-*&!-2'&"5&'(%&32+*+*&+#&2%3%!'+"#&*%2=+3%*&5"2& asylum seekers. Creation of an emergency solidarity fund to contribute to housing costs for people seeking refugee status.

CANADA

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL NETWORK

CONTACT DETAILS

» Médecins du Monde Canada R338, rue Sherbrooke-Est Montreal, QC, H2X 1E6 Canada Tel: 514 281 8998 Fax: 514 281 3011 info@medecinsdumonde.ca www@medecinsdumonde.ca CONTACT

» info@medecinsdumonde.ca EMPLOYEES

» General Director: A. Bertrand P. Boudreault, A. Houle, I. Mas, I. Francoeur, S. Beauchamp, B. Mille, S. Djelidi, R. Rajaonarison, V. T. Huynh, M. Banh, L. Jean, M. Diota BOARD OF DIRECTORS

» President: N. Bergeron Vice-president: C. Galand Treasurer: F. Scarborough Secretary: H. Duong ^(-)*"'BF,%41.%'%4*'",!4%'%1' vote): A. Bertrand Other board members: AZ. Brabant, V. Morel, L. Rocheleau, M.E. Goyer, S.-R. Hypollite, M.-R. B. Lajoie m*!,&%*"*+'#&'#'$1$G5"1-%'1"!#$,sation under part III of the Quebec company law in May 1996.

ACKNOWLEDGEMENTS

» Canada International Development

Agency (CIDA), United Nations Population Fund, Quebec Ministry for International Development, Unicef, Canadian Centre for Decentralised Fund Management for Haiti, Canada Fund for Local Initiatives (CFLI) in Haïti, Les Œuvres du Cardinal Léger, Martin Duquette pharmacies, AstraZeneca Canada Inc., Familiprix, J. Armand Bombardier Foundation, the Montreal m*!,1$#/'^(-)*'(1"'J*#/%4'#$+'k1),#/' Services, Bazinet and partners, and Human Resources and Skills Development Canada (Sipli programme).

» NATIONAL PROJECTS The Montréal project, launched in 1999, aims to provide healthcare to nomadic populations and other marginalised and excluded groups in Quebec. In collaboration with community-based organisations in Montreal, the project provides psychological support and clinical supervision for front-line community-based staff. Doctors of the World undertook a needs assessment in Quebec City and plans to develop a programme targeted at vulnerable migrants without health insurance.

» INTERNATIONAL PROJECTS In Haiti, seven projects are implemented in partnership >+'(&'(%&J-+#'%IU-'(%2+#%Ig-4"12j&C"*!+'-;&AU("*3-;@&+#&'(%& Cité-Soleil area of Port-au-Prince: k&%7%2?%#3L&!2"?2-77%&5";;">+#?&'(%&%-2'(X1-.%&"#&QD& January 2010. MdM provided care to more than 7,000 people and dispensed around 12,000 consultations in Cité-Soleil via mobile clinics; k& 3(";%2-& 2%*!"#*%& !2"N%3'o& ->-2%#%**I2-+*+#?& 3"7!"#%#'&ADE&42+?-$%*&-#$&QR&2%(L$2-'+"#&!"*'*@&-#$&3(";%2-& treatment; k& !2%=%#'+"#& "5& 7"'(%2I'"I3(+;$& '2-#*7+**+"#& "5& CMl& !2"gramme; k&2%!2"$13'+=%&(%-;'(&!2"N%3'&-+7*&'"&+7!2"=%&'(%&X1-;+'L&"5& care offered to pregnant women, and /or women of childbearing age and/or victims of sexual violence; k& +#'%?2-'%$& 3-2%& !2"?2-77%& 5"2& !%"!;%& ;+=+#?& >+'(& CMlr AIDS: prevention, care and treatment (including antiretrovi2-;&'2%-'7%#'@<&*1!!"2'&?2"1!&-#$&#1'2+'+"#-;&*1!!"2'/ In the Dominican Republic, the project to improve healthcare for the population of San Luis and the surrounding bateys is focused on increasing and improving access to primary healthcare, as well as supporting a programme of prevention of mother-to-child transmission of HIV.

In Nicaragua, the project to improve sexual and reproductive health is targeted at women affected by violence and sexual aggression in Matagalpa district.

» COMMUNICATION AND EVENTS k&K#&%=%#'&5"2&'(%&QEth anniversary of the Montréal project. k& 02?-#+*-'+"#& "5& `D& +#5"27-'+"#& -#$& ->-2%#%**I2-+*+#?& sessions for 3,182 people in secondary schools, universities and hospitals in Quebec, covering issues such as poverty, AIDS and women’s health. k&02?-#+*-'+"#&"5&+#'%2-3'+=%&3"#5%2%#3%*&>+'(&L"1#?&*%3"#$-2L&*3("";&!1!+;*&AQ`IQR&L%-2I";$*@&"#&*%H1-;&(%-;'(<& in partnership with the Sexperts group.

» FINANCIAL SUPPORT Colombia: programme on access to primary healthcare and psychological support programme for the population -55%3'%$&4L&3"#)+3'&AO$O&_2-#3%@/

GERMANY

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL NETWORK

CONTACT DETAILS

» Aerzte der Welt e.V Baumbachstr. 15 81245 Munich Germany Tel: +49 89 45 23 081 - 0 Fax: +49 89 45 23 081 - 22 Website: www.aerztederwelt.org Email: info@aerztederwelt.org EMPLOYEES

» Director: M. Gemeiner Recruitment: ?e$>")-`(V German project co-ordination: M. Chenevas Secretary: S. Erwied, T. Maier-Teyka, Health and development: Dr L. Feszczak International projects assistant/Fundraising: K. Radmüller Communication: D. Perrot, K. Schulze MedMobil Stuttgart: I. Scherrenbacher Open.med project assistant: =e$:g^!"^,(h Association established under German law on 19 March 1999

BOARD OF DIRECTORS

» President: H.-J. Zenker Vice-president: P. Rosenstiel Honorary president: W. Schilli Treasurer: R. W. Schmitt, K. Wieners Other board members: M. Heinzlmann, B. Stambul, F. Scheffer, K. Schwenzer, H. Schneider, N. Schmidt, G. Lauer, P. Schwick

» NATIONAL PROJECTS k&U"#'+#1+#?&'(%&-3'+=+'+%*&"5&'(%&"!%#/7%$&!2"N%3'&(%-;'(care and advice clinic in Munich. k&9%=%;"!7%#'&"5&'(%&O%$O"4+;&!2"N%3'&+#&J'1''?-2'<&'-2?%'%$&-'&!%"!;%&+#&$+5631;'L&-#$r"2&("7%;%**<&!-2'+31;-2;L&4L& opening new extra sessions.

situation in Haiti. k&g-1#3(&"5&'(%&Y12"!%-#&(%-;'(&!2"5%**+"#-;*&$%3;-2-'+"#& on access to healthcare for all without discrimination, in cooperation with the HUMA network.

» FINANCIAL SUPPORT

k& G(2%%& Opération Sourire missions were carried out in Cambodia (in Kampong Cham, O Reang Ov and Phnom,%#(@/

k&f%7%#o&-33%**&'"&!2+7-2L&(%-;'(3-2%&-#$&3"771#+'LI based medicine. k& C-+'+o& !2+7-2L& (%-;'(3-2%& -#$& 7"'(%2& -#$& 3(+;$& (%-;'(3-2%&A\2-#$PK#*%@/ k&Z1;?-2+-o&!2+7-2L&(%-;'(3-2%/

» COMMUNICATION AND EVENTS

» HUMAN RESOURCES SUPPORT

k&["+#'&!2%**&3"#5%2%#3%&>+'(&C-#$+3-!&M#'%2#-'+"#-;&-#$& Munich City Council following the earthquake in Haïti. k&Qst anniversary of the MedMobil project in Stuttgart. k& 02?-#+*-'+"#& "5& -& 3"#3%2'& >+'(& '(%& 71*+3-;& ?2"1!& G(%& Soulmates, in aid of the open.med project in Munich, in partnership with the RosenTon agency. k&,2%*%#'-'+"#&"5&'(%&!("'"?2-!(+3&%H(+4+'+"#&Exil, Exit? at the winter Tollwood festival in Munich: more than 12,000 visitors attended, opening with a round-table discussion on the plight of undocumented migrants in Europe and in Germany. k&U"I"2?-#+*-'+"#&"5&'(%&QDth Humanitarian Aid in Theory and Practice congress in Berlin, with the involvement of several MdM representatives. k&YH(+4+'+"#&"5&-&2%'2"*!%3'+=%&"5&'(%&g1+*&l-;'1%w-&(17-nitarian photography prize in Munich at the Instituto Cervantes; opening with a round-table discussion on co-ope2-'+"#&4%'>%%#&b\0*&-#$&'(%&7%$+-/&G(%&g1+*&l-;'1%w-& DEQE&!("'"*&>%2%&-;*"&*(">#&+#&^-154%12%#&A^1#*'(-1*@/ k&,2%*%#'-'+"#&"5&'(%&%H(+4+'+"#&The Forgotten People of the Shantytowns of Jaipur&+#&O1#+3(&A,-*+#?%2&_-42+.@/ k& ,2%*%#'-'+"#*& +#& *%=%2-;& *3("";*& +#& O1#+3(& -4"1'& '(%&

k& Opération Sourire in Cambodia: 16 volunteers (surgeons, anaesthetists, paediatricians, nurses, operating '(%-'2%&-**+*'-#'*@/ k&G>"&\%27-#&$"3'"2*&>%#'&'"&'(%&6%;$&>+'(&O$O&_2-#3%&& Ab%!-;&-#$&Y'(+"!+-@/

» INTERNATIONAL PROJECTS

GREECE

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL NETWORK

CONTACT DETAILS

» Médecins du Monde Grèce Sapfous Street, 12, 10553 Athens, Greece Tel: + 210 32 13 150 Fax: + 210 32 13 850 info@mdmgreece.fr http://www.mdmgreece.gr BOARD OF DIRECTORS

» President: N. Kanakis Vice-president: C. Angelidis 2nd Vice-president: S. Kloudas General Secretary: E. Mouloudaki Treasurer: C. Skolarikos 2nd General Secretary: F. Olympitis Other Board Members: I. Giannakopoulos, I. Mouzalas, A. Androutsos ACKNOWLEDGEMENTS

» Vodafone, Interamerican/Eureko

Achmea Foundation, NovoNordisk

» NATIONAL PROJECTS

» INTERNATIONAL PROJECTS

2$=W-!.")S"$&%$%&*#$_&0RS0-)-S!&+#&K'(%#*&A*+#3%&QFFR@<& G(%**-;"#+.-& A*+#3%& DEEQ@<& U(-#+-& A*+#3%& DEER@& -#$& ,+2%1*I,%2-7-& ADEEF@/& G%-7*& "5& =";1#'%%2& $"3'"2*<& nurses, social workers and psychologists provide medical care, including medicines, and psychological support to people who do not have access to healthcare.

Algeria Supply of medicines and medical consumables and improving the pharmaceutical management system in Sa(2-"1+&2%51?%%&3-7!*&AG+#$"15<&K;?%2+-@/ Uganda Supporting the medical departments of Monte and Gulu villages. Tanzania Early detection and treatment project for diabetes in the rural area of Ifakara.

2$9"%*U"$%&#$(!R0*'$!""^"#! The reception centre for asylum seekers dispensed services to more that 271 people, mainly people who originally came from Afghanistan. With capacity to accommodate 70 people, the centre offers social support, food and shelter and is open 24-hours a day. Mobile medical outreach units MdM Greece has set up four mobile outreach units providing primary healthcare to people with only limited access to health services. The outreach projects include: k&g+'"<&-&!-%$+-'2+3&7%$+3-;&-#$&$%#'-;&1#+'&>(+3(&*%2=+3%*& remote areas; k&M2+*<&-#&"!('-;7";"?+3-;&1#+'&"55%2+#?&"!('-;7+3&*%2=+3%*& to children and older people with serious eye problems; k& d"7-<& 1#+'*& "55%2+#?& >%%.;L& 7%$+3-;<& !(-27-3%1'+3-;& and psycho-social support to Roma in settlements in the suburbs of Athens, Thessalonkia and Chania. Athens street project Harm reduction programme. The unit runs weekly sessions to provide primary healthcare, along with HIV and (%!-'+'+*&AZ&-#$&U@&'%*'+#?<&5"2&!%"!;%&>("&1*%&$21?*/&G(%& programme promotes needle exchange and offers psychological support.

» COMMUNICATION AND EVENTS k&DEQE&7-2.%$&'(%&DEth anniversary of MdM Greece. The organisation celebrated the event by organising a major concert on 24 September. k& 0#& Q]& O-L<& O$O& \2%%3%& "2?-#+*%$& -& CcOK& 3"#5%rence, focusing on children and pregnant women. During this event, the health professionals declaration on the right to health for all was signed. k& 912+#?& DEQE<& O$O& \2%%3%& "2?-#+*%$& *%=%2-;& !2%**& conferences and participated in numerous events and festivals, including the 15th festival against racism in Athens, the Micropolis festival in Athens, a press conference on Athens, a town in the middle of a humanitarian crisis to mark the 20th anniversary. k&J%7+#-2*r3"#5%2%#3%*o&'>"&'2-+#+#?&*%7+#-2*&5"2&(%-;'(& !2"5%**+"#-;*& -#$& 4%#%63+-2+%*& "#& 32"**I31;'12-;& 5-3'"2*& and access to healthcare, education and work. k&0#&TQ&03'"4%2<&O$O&\2%%3%&"55%2%$&+'*&*%2=+3%*&$12+#?& the 28th Athens classic marathon.

JAPAN

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL NETWORK

CONTACT DETAILS

» Médecins du Monde Japan PMC Building 4F 1-23-5 Higashi-Azabu Minato-ku, Tokyo 106-0044 Japan Tel: 0081 3 3585 6436 Fax: 0081 3 3560 8073 http://www.mdm.or.jp CONTACT

» info@mdm.or.jp EMPLOYEES

» P. Helfter (Director) S. Hatanaka, Y. Kumano, N. Kuroyanagi, A. Nakamura, M. Seki, Y. Uehara BOARD OF DIRECTORS

» President: G. Austin Other Board Members: A. Bourdé, P. David, F. Foussadier, M. Harada, H. Isomura, A. Kiuchi, N. Oura, N. Yamada, S. Terashima, S. Yoza

» NATIONAL PROJECTS Launched in April 2010, the Tokyo Project works with homeless people with psychological problems, and carries out the following activities: k& 7%$+3-;& 3"#*1;'-'+"#*& -#$& +$%#'+63-'+"#& "5& !%"!;%& >+'(& psychological problems during food distribution services organised in the area; k&2%?1;-2&7%%'+#?*&>+'(&'(%&7"*'&7-2?+#-;+*%$&!%"!;%&4L& way of weekly patrols; k& 7%$+3-;& -#$& !*L3("I*"3+-;& 5";;">I1!& 5"2& !%"!;%& +$%#'+6%$n k& J"3+-;& J.+;;& G2-+#+#?& *%**+"#*& A3"".+#?<& !-L+#?& 5"2& !123(-*%*<&'-.+#?&'(%&41*i@&'"&+7!2"=%&+#'%?2-'+"#&"5&*%2=+3%& users into the community; k& '2-+#+#?& *"3+-;& !2"5%**+"#-;*& -#$& =";1#'%%2*& +#& 7%#'-;& health problems.

» INTERNATIONAL PROJECTS In 2010, MdM Japan carried out Opération Sourire mis*+"#*&+#&U-74"$+-&AZ-''-74-#?@&-#$&Z-#?;-$%*(&A9(-.-@/& Japanese teams also participated in the mission organised by MdM France to Madagascar. In total, nearly 200 surgi3-;&"!%2-'+"#*&>%2%&3-22+%$&"1'&$12+#?&'(%*%&6=%&7+**+"#*& "=%2&'(%&L%-2/&G(%&6#-;&7+**+"#&"5&'(%&L%-2<&+#&Z-#?;-$%*(<& >-*&-;*"&'(%&"33-*+"#&'"<&5"2&'(%&62*'&'+7%<&'2-#*5%2&*.+;;*& from MdM Japan to MdM UK and MdM Netherlands.

» COMMUNICATION AND EVENTS Advocacy As well as advocacy for affordable healthcare and against the shortage of health workers during meetings with the Ministry of Foreign Affairs and the World Bank, there was -& !-2'+31;-2& %7!(-*+*& "#& !2%!-2-'+"#& 5"2& '(%& 65'(& G".L"& M#'%2#-'+"#-;&U"#5%2%#3%&"#&K52+3-#&9%=%;"!7%#'&AG+3-$@/ The launch of Tokyo Project generated a lot of interest from the government (members of the Minister of Health’s

cabinet visited the programme; meeting with the Minister "5&C%-;'(@/ Mobilisation In June 2010 MdM Japan launched a campaign to raise awareness among the Japanese general public of the humanitarian situation in DRC and to inform them about MdM’s programmes in the country. The Congophone campaign highlights the fact that 80% of the world’s coltan, an essential component for mobile phones, comes from Congolese mines—as a way of illustrating how daily lives in Japan are inextricably linked with those in DRC. Communication k& \""$& 7%$+-& 3"=%2-?%& +#& DEQE<& >+'(& `a& 7%#'+"#*& "2& broadcasts over the year, mainly on the following themes: Tokyo Project launch, Congophone advocacy campaign, !2"6;%*& -#$& +#'%2=+%>*& >+'(& O$O& [-!-#& =";1#'%%2*& -#$& staff. k& d%?1;-2& !-2'+3+!-'+"#& +#& 3"#5%2%#3%*& -#$& *%7+#-2*& +#& secondary schools and universities, with the Ministry of Foreign Affairs and the Japan Women Medical Doctors Association.

» FINANCIAL SUPPORT TO MDM FRANCE PROGRAMMES

Haiti: earthquake emergency; Yemen: primary healthcare; Nepal: mother/ child health; Sahel: primary healthcare; DRC: primary healthcare; Mali/Chado&6*'1;-*n&Pakistan: )""$*&%7%2?%#3Ln&Liberia: mother/child health.

» HUMAN RESOURCES SUPPORT Opération Sourire Bangladesh: 13 volunteers participated. Opération Sourire Cambodia: seven volunteers participated. Opération Sourire Madagascar: three volunteers participated.

NETHERLANDS

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL NETWORK

CONTACT DETAILS

» Dokters van de Wereld Nieuwe Herengracht 20 1018 DP Amsterdam Netherlands Tel: 0031 20 465 2866 Fax: 0031 20 463 1775 info@doktersvandewereld.org www.doktersvandewereld.org CONTACT

» info@doktersvandewereld.org EMPLOYEES

» Director: M. Koppe A. de Jong, R. Arts, M. Wellie, E. Van Puffelen, S. Zwaan, E. Mohieldin, S. Voogt, A.M. Scholten, B. Jurg, A. Bovend’eerdt, M. Sellmeijer, A. Duijnstee, P. Schermers » Employees who left the team in the past year: J. van Kilsdonk, A. Duijnstee, S. Godschalk BOARD OF DIRECTORS

» President: F. Sivignon Secretary: M. Diaz Treasurer: C. van Rijn Other Board Members: H. Peters, B. Juan, R. Van der Pas Registered as a charity under Dutch law on 28 April 1997.

ACKNOWLEDGEMENTS

» NATIONAL PROJECTS

» FINANCIAL SUPPORT

O$O& b%'(%2;-#$*& A9".'%2*& =-#& $%& B%2%;$@& 3"#'+#1%*& '"& develop projects for vulnerable groups in the Netherlands -#$&+'*&"=%2*%-*&'%22+'"2+%*&A*13(&-*&'(%&91'3(&K#'+;;%*@/

DRC: HIV/AIDS. Zimbabwe: HIV/AIDS. M#$"#%*+-&AB%*'%2#&b%>&\1+#%-@o&CMlrKM9J&-#$&!2+7-2L& healthcare. Pakistan: emergency. Haiti: emergency. Nepal. b+?%2&-#$&U(-$&AJ-(%;@/ Liberia. Colombia. Opération Sourire.

Roma populations Advice and training for stateless Roma. Undocumented migrants programme k&M7!2"=+#?&-33%**&'"&(%-;'(3-2%&5"2&1#$"317%#'%$&7+grants in Amsterdam, the Hague and Rotterdam: - preparation of health insurance documents for undocumented migrants; - providing information to undocumented migrants; k& K33"7!-#+7%#'& '"& (%;!& 1#$"317%#'%$& 7+?2-#'*& -3cess healthcare. Curaçao Reproductive health programme and HIV/AIDS prevention.

» INTERNATIONAL PROJECTS MdM Netherlands has ongoing international projects in Indonesia and Serbia. In Indonesia the programme in Aceh-Bener Meriah aims to improve access to healthcare for mothers and children. In Serbia, the programme, in partnership with the local NGO VEZA, concentrates on HIV/AIDS prevention amongst people who use drugs.

» Aids Fund/SBL, Cordaid, Ministry of

Foreign Affairs (Matra, MFS), Innovatiefonds Zorgverzekeraars, Maria Stroot Foundation, Commissie PIN, Skan Fund, Stichting Maagdenhuis, NutsOhra Fund, Stichting Doen, Stichting Janivo, Kerk in Actie, De Nationale Postcode Loterij, Euro RSCG, MPG, Sandra van Noord - Bureau voor tekst en redactie, CCI IT Group, Hampshire Inn Amsterdam, Sibiu Design, Youngwoods, Senshake, 100 % NL, BNR Newsradio, National Geographic, QMusic, Radio 538, RTL, SBS, Skyradio and all of our volunteers, interns and thousands of private donors.

» COMMUNICATION AND EVENTS k& K2'+3;%*& "#& 1#$"317%#'%$& 7+?2-#'*<& d"7-<& C-+'+& -#$& Pakistan. k&Opération Sourire in the media, Perspective campaign and free advertising campaigns. k&Exil, Exit? exhibition at the Leidseplein in Amsterdam. k&Teken voor zorg&3-7!-+?#&-#$&!%'+'+"#&ACcOK@/ k&Dam-tot-damloop race in Amsterdam, sponsored by 100 runners who collected 17,000 euros for MdM.

» HUMAN RESOURCES SUPPORT Seven international staff participated in MdM France programmes: Liberia: A medical advisor and a nurse; Ethiopia: A nurse; Indonesia, Jakarta base: A general co-ordinator; Colombia, Meta: A logistician administrator; Burma, Pyapon: A co-ordinator; Pakistan, Lahore: A programme co-ordinator.

PORTUGAL 1/2

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL NETWORK

CONTACT DETAILS

» Médicos do Mundo Portugal Av. de Ceuta, Sul, Lote 4, Loja 1 1300-125 Lisbon Tel: + 351 213 619 520 + 351 213 619 521 Fax: + 351 213 619 529 www.medicosdomundo.pt mdmp-lisboa@medicosdo mundo.pt CONTACT

» Operations Director: J. Blasques joaoblasques@medicosdo mundo.pt EMPLOYEES

» International Programmes Department: M. Sacchetti, A. Oliveira National Programmes Department: C. Fernandes Communication, Marketing and Fundraising Department: J. Branco, R. Pereira Administration, Finance and Donations Division: C. Paiva (Financial Director), P. Serra, M. Tavares, D. Mameri Human Resources and Volunteer Department: F. Cordeiro BOARD OF DIRECTORS

» President: A. Antunes Vice-president: A. Andrade Vice-president: P. C. Seixas Treasurer: C. Palma Other Board Members: C.-V. Velho, F. Luís ACKNOWLEDGEMENTS

» LAlto Comissariado da Saúde

CSIDA (Coordenação Nacional para a Infecção do VIH/sida) – HIV/AIDS Programme, European Commission Direcção-Geral da Saúde, Gebalis, National Insurance Institute, Escolhas programme (3ª geração), Rede de Fundações Europeias (Projecto Epim), Esso-Bloco, Calouste Gulbenkian Foundation, Global Fund, Institute of Hygiene and Tropical Medicine, Ipad - Instituto Português de Apoio ao Desenvolvimento, NPCS – Núcleo Provincial de Combate ao VIH/sida, UNAIDS, Plan International, Sidaction, Unicef.

» NATIONAL PROJECTS 2$A"#S"-#($bDcG,(,"1$Health programme for older people +#&O-'"*+#("*&A,"2'"@/ 2$8EM6$i$Unidade Habitacional de Santo António: medical care for migrants in the detention centre. 2$ D6MM61 Support centre to improve social and health conditions for homeless people, sex workers and migrants in Porto. 2$Mente sã em corpo são: Promotion of safe behaviours to prevent HIV/AIDS, targeting mainly adolescents in Alentejo. 2$Lisboa Oriental Activa (LOA): supporting the residents of the Picheleira area of Lisbon in relation to prevention of cardiovascular disease. 2$ Viver Saudável: Health programme for older people ;+=+#?&+#&,+3(%;%+2-&Ag+*4"#@/ 2$Rotas para a Saúde: Supporting shantytown residents and sex workers in Seixal. 2$ Saúde pa nos Bairro: Supporting residents in areas where large numbers of undocumented migrants live, mainly people who have come from lusophone African countries and the Roma population of Loures region. 2$ Sementes: Supporting excluded children and adoles3%#'*&52"7&,+3(%;%+2-&Ag+*4"#@/ 2$SER Dia: Diabetes project amongst the residents of the Lisbon metropolitan region. 2$ VALE a Pena Prevenir: Prevention of obesity, hypertension, tobacco and excessive consumption of alcohol, diabetes and raised cholesterol in the Alcântara valley (Lis4"#@/ 2$ Mensanus: Supporting people suffering from mental health problems by promoting social inclusion and protecting their rights. 2$ Saúde Móvel: Supporting homeless people and migrants in the Lisbon region. 2$Estilus: Raising awareness of the risks associated with drug use among young people in Porto. 2$G)$>&0-)(1$Project involving a network of schools to pro-

mote social integration of young people of working age in Z-+22"&x1+#'-&$-&J%22-&Ag"12%*@/

» INTERNATIONAL PROJECTS Angola Improving primary healthcare: basic healthcare in Mavinga province. Guinea-Bissau Tadja bu bida: tackling HIV/AIDS (Bissau, Bafatá and the Z+N-?y*&+*;-#$*@/ M#'%?2-'%$&!2"N%3'&A>-'%2<&*-#+'-'+"#&-#$&(L?+%#%@&+#&Z+"7bo region schools: public health and prevention. Timor-Leste Project to promote community health, particularly mother and child health. Mozambique Rural schools in Namaacha: health education and provision of healthcare for AIDS orphans. Chókwè-Tisuna Muzototo: integrated malaria control project in Chókwè region. São Tomé e Príncipe Community life support: national project to prevent and tackle HIV/AIDS and STIs. International network projects k& CcOKo& *1!!"2'+#?& -33%**& '"& %**%#'+-;& (%-;'(3-2%& 5"2& undocumented migrants and asylum seekers.

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INTERNATIONAL NETWORK

» COMMUNICATION AND EVENTS k&YH(+4+'+"#&"5&>"2.&4L&`F&-2'+*'*&A!-+#'+#?<&*31;!'12%<&3%2-7+3*&-#$&N%>%;*@&+#&-+$&"5&O$O&,"2'1?-;P*&>"2.&+#&C-+'+/ k&M7!2"=%7%#'&"5&'(%&,-L*("!&51#$2-+*+#?&3-7!-+?#/ k&,-2'+3+!-'+"#&+#&'(%&Trd Dias de Desenvolvimento, sponsored by IPAD. k& _2%%& *32%%#+#?& -#$& 7%$+3-;& 3"#*1;'-'+"#*& A'(%& 0%+2-*<& x1%+N-*&-#$&U%1'-&-2%-*&"5&g+*4"#@/ k&_-3%I'"I5-3%&51#$2-+*+#?&3-7!-+?#/ k&_+?('&U(";%2-&7-23(&+#&\1+#%-IZ+**-1/ k&,2"7"'+"#&"5&%$13-'+"#&-#$&(%-;'(&-3'+"#&+#&J%+H-;/ k& M#-1?12-'+"#& "5& -& !("'"?2-!(+3& %H(+4+'+"#& -4"1'& >-'%2<& sanitation and hygiene in Biombo region schools.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

SPAIN 1/2

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL NETWORK

CONTACT DETAILS

» Médicos del Mundo España Conde de Vilches 15 28028 Madrid Tel: 91 543 60 33 Fax: 91 543 79 23 informacion@medicos delmundo.org www.medicosdelmundo.org

Doctors of the World has headquarters (in autonomous 3"771#+'+%*@&"2&2%!2%*%#'-'+=%&"563%*&+#&DE&'">#*&-32"**& the country. These organisations have developed around 100 inclusion projects and programmes (national pro?2-77%*@&-#$&*"3+-;&7"4+;+*-'+"#&-3'+=+'+%*/

CONTACT

MdM Spain provides health, psychological and/or social support to groups of people suffering from exclusion (sex workers, migrants, people who use drugs, homeless !%"!;%&%'3/@

» Organisational development director: R. Schleissner BOARD OF DIRECTORS

» President: Á. González Vice-president with responsibility for social inclusion: F. Noya 2nd Vice-president with responsibility for international development: J. L. Engel General Secretary: P. G. Rotellar Treasurer: A. M. Aburto Member with responsibility for communication: D. L. Arteche Member with responsibility for human rights: M. del Río Member with responsibility for equality: M. Y. Rodríguez External social mobilisation expert: M. F. Martín Internal social mobilisation expert: S. Martín Member with responsibility for the international network: H. Bertevas Member with responsibility for the strategic plan: E. Rodríguez

» NATIONAL PROJECTS 2$ F#"]").-&)$ &%$ %"'(0"$ U")-.(0$ '*.-0(.-&)$ (),$ "'powerment of sub-Saharan women with a view to cross-cultural issues, gender and community-based health. MdM Spain has led in the way in helping to reduce and eradicate this practice in girls and adolescents among the sub-Saharan population living in Spain. This project has been developed in Aragón, Catalonia and Navarro and is funded by the Ministry of Health, Social Policy and Equality. 2$D#&!!TS*0.*#(0$!&S-(0$(),$V"(0.V$'",-(.-&)$_#&a"S. International migration creates new communities and multiethnic groups. Linguistic, religious and cultural factors 3-#&(-=%&-&*'2"#?&+#)1%#3%&"#&'(%&2%;-'+"#*(+!&4%'>%%#& migrant communities and host societies. Since October 2007, MdM Spain has been developing a project where health mediators build bridges which facilitate communication and good relations between health !2"5%**+"#-;*& A!2+7-2L& -#$& *!%3+-;+*'& 3-2%& !2"=+$%2*@& +#& Talavera de la Reina, Tolède and Alcázar de San Juan AU-*'+;;-Ig-&O-#3(-@&2%?+"#*&-#$&!%"!;%&"5&U(+#%*%<&O"roccan or Romanian origin.

» INTERNATIONAL PROJECTS 2$='"#U")SR$(),$SV&0"#($#"!_&)!"$-)$E(-.Following the earthquake which hit Haiti in January 2010, MdM Spain responded immediately by sending equipment, medicines and an emergency team. Once the immediate emergency was over, the work focused on mother and child healthcare in six rural clinics in Petit Goâve and supporting mother and child health services in Notre-Dame hospital. The start of the cholera epidemic, declared across the country in October, led to the setting up of a cholera treatment centre with 50 beds, and a diarrhoea treatment unit A*%=%#&4%$*@<&-*&>%;;&-*&!2%=%#'+"#&-3'+=+'+%*/ 2$M.#")U.V")-)U$.V"$V"(0.V$!R!."'$.&$-'_#&]"$!"W*(0$ and reproductive health in six municipalities in Chinandega and Nicaragua districts This project aims to consolidate the local health system capacity in order to improve sexual and reproductive health. Further work is carried out to improve the quality and empathy of neonatal care and care during and just after delivery through a national humanising childbirth strategy, while recognising the need for emergency care at times. This work emphasises gender equality in terms of the right to health, and includes working with men on a new concept of masculinity which does not involve domination or control. 2$ G'_#&]-)U$ .V"$ V"(0.V$ &%$ .V"$ _&_*0(.-&)$ &%$ >*")(ventura, Colombia, with a special focus on the most vulnerable groups: populations displaced by the S&)`-S.$(),$%"'(0"$V"(,!$&%$V&*!"V&0, This project seeks to reduce morbidity and mortality due to tuberculosis within the Buenaventura population by introducing a detection, diagnosis and treatment protocol, by pursuing an outreach strategy to detect cases in the villages with limited access to health services and

SPAIN 2/2

INTERNATIONAL NETWORK

by following a contact tracing protocol for newly detected cases. Activities to increase awareness and develop understanding of how to prevent and treat the disease are also included.

» COMMUNICATION AND EVENTS 2$DRS0"$&%$/]"$,&S*'").(#-"!$&)$V*'()$.#(%/S^-)U$ for sexual exploitation MdM Spain set up a series of documentaries in nine Spa#+*(&'">#*<&>+'(&'(%&!2"N%3'+"#&"5&*+H&6;7*&>(+3(&+;;1*'2-'%& '(%& *'"2+%*& 4%(+#$& %-3(& (17-#& '2-563.+#?& %H!%2+%#3%<& 4%L"#$&'(%&6?12%*&-#$&7%$+-&7%**-?%*/

» FINANCIAL SUPPORT FOR MDM FRANCE PROGRAMMES Colombia: primary healthcare. Nicaragua: gender-related violence. South-Sudan: emergency.

DOCTORS OF THE WORLD ANNUAL REPORT 2010

SWEDEN

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL NETWORK

CONTACT DETAILS

» Läkare i världen Sverige Box 39006 SE-100 54 Stockholm Sweden Tel: +46 8 664 66 87 Fax: +46 8 663 66 86 www.lakareivarlden.org info@lakareivarlden.org EMPLOYEES

» Director: L. Gamble C. Lidén BOARD OF DIRECTORS

» President: M. Morin Vice-president: M. Halmin Treasurer: K. Fransson Other Board Members: A. Dorazio, L. Lavicka, M. Rickman Törnqvist, K. Meseret Andersson, I. Gasser, L. Jansson Substitutes: J. Mair, A. Björkman, K. Johnsson, D. Berlin Registered as a charitable organisation under Swedish law in October 1991.

ACKNOWLEDGEMENTS

» Right to Health Network, Care

Initiative, RBK advertising agency, Swedish Red Cross, Unilabs, Noaks ark, Stockholm City Project.

» NATIONAL PROJECTS Medical and social centre in Stockholm In 2010 MdM Sweden continued to run the medical centre for undocumented migrants in Stockholm that has been established since 1995. In total, 488 undocumented migrants, of which 60% were women, came to the MdM clinic in 2010. These service users included 66 different nationalities and a third of service users were from Mongolia. k&d-!+$&CMl&'%*'+#?&+*&-=-+;-4;%&"#3%&-&7"#'(&+#&'(%&3;+#+3/ k&J+#3%&J%!'%74%2&DEQE&!*L3(";"?+*'*&"55%2&'>+3%I7"#'(ly consultations outside the usual clinic opening times. k&O$O&=";1#'%%2*&!2"=+$%&;%?-;&-$=+3%&+#&2%;-'+"#&'"&(17-#& rights and Swedish law, and can also advocate on behalf of people.

» ADVOCACY 2$>"(#-)U$j-.)"!! Two collections of testimonies were published in 2010: one comprised 13 testimonies from undocumented migrant families with children, and the other concerned testimonies from migrants and volunteers. MdM Sweden A>+'(&51#$+#?&52"7&CcOK@&-;*"&!14;+*(%$&-&7-?-h+#%&AgMl@& which included testimonies, articles and statistics. 2$G)%&#'(.-&)$(),$%&#'(.-&) The main part of MdM Sweden’s work is to inform health professionals and patients on rights relating to access to healthcare.

» COMMUNICATION AND EVENTS 2$M.*,R In January 2010, the Ministry of Social Affairs launched a study on how to improve access to healthcare for undocumented migrants and asylum seekers in Sweden. The results of the study will be available in May 2011 2$D&)%"#")S" On 26 November, MdM Sweden was one of the organisers of a conference in Stockholm on the the rights of

undocumented migrants to access healthcare in Sweden. The aim was to raise public opinion on this topic, and to generate public debate. 2$600$M.&S^V&0'\!$SV-0,#")$V(]"$.V"$#-UV.$.&$V"(0.Vcare Following MdM Sweden’s advocacy work, all children in Stockholm county have had the same rights to access healthcare as Swedish children since October 2010. 2$<*),#(-!-)U _"2& '(%& 62*'& '+7%<& J>%$%#& "2?-#+*%$& -& 51#$2-+*+#?& 3-7paign to raise funds for MdM’s emergency work. Thefunds were sent to Haiti and Pakistan. 2$E8@6 On 23 February, the HUMA network organised a debate between politicians, health professionals and journalists on access to healthcare for undocumented migrants, in the run up to the September elections. 2$F&]"#.R$('&)U$=*#&_"()$S-.-Y")! In 2010 MdM Sweden started to participate in a project 21#& 4L& '(%& J'"3.(";7& U+'L& ,2"N%3'& A-#& b\0@& '"& !2"=+$%& access to healthcare for European citizens without residency status.

SWITZERLAND

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL NETWORK

CONTACT DETAILS

» Médecins du Monde Suisse Rue du Château-19 2000 Neuchâtel Switzerland Tel: +41 (0)32 725 36 16 Fax: +41 (0)32 721 34 80 www.medecinsdumonde.ch administration@medecins dumonde.ch CONTACT

» pascale.giron@medecinsdu monde.ch EMPLOYEES

» P. Giron-Lanctuit, M.-C. Wittwer Perrin, K. Almeida, M. Crettenand, L. Rossi BOARD OF DIRECTORS

» President: N. Humbert Vice-president: X. Onrubia, D. Schmid Secretary: T. Tschoumy Treasurer: M. Machenbaum Other Board Members: Y. Groebli, V. Kernen, C. Persoz, A-P. Pittet Organisation established under Swiss law in April 1994.

» NATIONAL PROJECTS Health and Migration Network: to facilitate access to healthcare and promote health for vulnerable miU#().!$-)$7"*SVf."0$S().&) k&K&!;-3%&'"&>%;3"7%<&;+*'%#&'"&-#$&!2"=+$%&?1+$-#3%&'"& people seeking healthcare. In 2010, the focus was on the development and consolidation of the medical and social network that has been established. Night sessions: to provide a low-threshold service for female sex workers in Lausanne k& G(%& !2"N%3'& >-*& *1*!%#$%$& +#& DEQE& 4%3-1*%& "5& '(%& organisational problems experienced by our partner organisation, which will restart its activities in 2011. k&G(%&!2"N%3'&-+7*&'"&+7!2"=%&-33%**&'"&'(%&(%-;'(&*L*tem and to promote health. A nurse-led session, in places where sex workers are active, answers questions and carries out prevention activities, with a focus on the medical aspects of prevention.

» INTERNATIONAL PROJECTS Haiti: rebuilding post-earthquake capacity in relation .&$_#-'(#R$V"(0.VS(#"$(),$)*.#-.-&)$-)$O#(),$O&f]"$ (),$F".-.$O&f]" Following the earthquake in January 2010, it was necessary to adapt the existing health and nutrition programme to meet the new needs and to re-establish a health system providing a comprehensive service (general medical consultations, reproductive health consultations, vaccination, nutritional screening, individual follow-up for women -#$&3(+;$2%#&%'3/@/ Haiti: cholera epidemic response in October 2010 MdM Switzerland rapidly set up a cholera treatment centre in Grand Goâve and four cholera treatment units linked to the clinics. These facilities aimed to provide care to people with the disease and to help prevent the spread of the epidemic.

Palestinian territories: strengthening the child psychiatry reference centre in Hebron district k&O$O&J>+'h%2;-#$&*1!!"2'%$&'(%&+7!;%7%#'-'+"#&"5&'(%& ,-;%*'+#+-#& O+#+*'2L& "5& C%-;'(P*& 62*'& 3"771#+'L& 7%#'-;& health centre for children and adolescents. MdM also organised intensive training in order to build capacity among the centre’s personnel. To date, the centre has seen more than 280 service users, mainly between six and 12 years old. Mexico: tackling tuberculosis in the marginalised indigenous communities of Tzeltal forest, in Chiapas k& O"#+'"2+#?& 7+**+"#& 3-22+%$& "1'& +#& %-2;L& DEQE& -*& !-2'& "5& the takeover of project activities by San Carlos hospital at the end of 2009. Benin: supporting sickle cell anaemia treatment in Abomey district hospital k&K&42-#3(&>-*&"!%#%$&+#&b"=%74%2&DEQE&'"&!2"=+$%&?Lnaecological consultations, child and family support and specialist medical care.

» COMMUNICATION AND EVENTS k&\%#%2-;&!14;+3&->-2%#%**I2-+*+#?&3-7!-+?#&Health is not a luxury to highlight the failures of unfair health systems. MdM Switzerland teams were present for three days in three towns with a limousine which had been turned into an ambulance for the occasion. k&U"#5%2%#3%&+#&g-&U(-1HI$%I_"#$*&"#&'(%&2";%&"5&(17-nitarian action in the Palestinian Territories chaired by Professor Nago Humbert, President of MdM Switzerland, and with the Federal Councillor Micheline Calmy-Rey.

UNITED KINGDOM

DOCTORS OF THE WORLD ANNUAL REPORT 2010

INTERNATIONAL NETWORK

CONTACT DETAILS

» Doctors of the World UK 14 Heron Quays London E14 4JB United Kingdom Tel: +44 20 7515 7534 Fax: +44 20 7515 7560 info@doctorsoftheworld. org.uk www.doctorsoftheworld. org.uk CONTACT

» Director: S. Wright swright@doctorsoftheworld. org.uk EMPLOYEES

» Director: S. Wright, E. Middleton, F. Qureshi, S. Soldati, C. Allum, L. Ottisova, T. Pastena BOARD OF DIRECTORS

» J. Hughes, R. Rogers, R. Lion, S. Pickworth, Lord Rogers of Riverside, A. Cavey, S. Hargreaves, B. Gazzard, C. Giboin, W. Farah Registered as a charity on 13 January 1998.

ACKNOWLEDGEMENTS

» AstraZeneca, Awards for All, Barclays

Bank, Barrow Cadbury, Big Lottery Fund, Boots, Cabot Hall, Canary Wharf Group, City Parochial Foundation, Clifford Chance, Department for International Development (DfID), Fres4-*/+&7'Jeune Chambre de commerce francobritannique, Leagas Delaney, London to Paris Bike Riders 2010, London Catalyst, McKinsey, Medsin, Microsoft, MVM Charitable Trust, Rayne Foundation, Refugee Community Development Fund, Tudor Trust.

» NATIONAL PROJECTS k& _+5'(& -##+=%2*-2L& "5& ,2"N%3'o& g"#$"#<& '(%& !2"?2-77%& aiming to improve access to healthcare for vulnerable groups. k& G(2%%& >%%.;L& *%**+"#*& -#$& "#%& 7"#'(;L& J-'12$-L& 3;+nic provide healthcare and advice to help people access healthcare. k&01'2%-3(&-3'+=+'+%*&'-.%&!;-3%&+#&*%H1-;&(%-;'(&3;+#+3*&-#$& with community organisations. k&K&'%-7&"5&]E&=";1#'%%2*&A51;;I'+7%&-#$&!-2'I'+7%@/ k&G2-+#+#?&7%$+3-;&>"2.%2*<&-$7+#+*'2-'+=%&*'-55&-#$&3"7munity organisations in order to improve understanding of the rules concerning access to healthcare, thus enabling better access to healthcare for the most vulnerable people. k&O%74%2&"5&'(%&CcOK&#%'>"2./

» INTERNATIONAL PROJECTS Exploratory mission for Opération Sourire in Bangladesh.

» COMMUNICATION AND EVENTS Some key events: k&O$O&c^&2%*!"#$%$&'"&'(%&c^&Z"2$%2&K?%#3L&Ac^ZK@& consultation, calling for a person’s health to be taken into account before the government decides to disperse asylum seekers. k&J147+**+"#&"5&-&2%*!"#*%&'"&'(%&9%!-2'7%#'&"5&C%-;'(P*& public consultation on the proposed National Health Ser=+3%&AbCJ@&2%5"27*/ k&d-$+"&42"-$3-*'*&"#&*%=%2-;&#-'+"#-;&-#$&2%?+"#-;&2-$+"& stations featuring our volunteers in Haiti, Liberia and Burma (BBC Radio 4, BBC World Service, BBC Radio Three U"1#'+%*<&ZZU&d-$+"&0H5"2$<&ZZU&d-$+"&\1%2#*%L@/ k& U"#5%2%#3%*& "2?-#+*%$& 4L& O$O& c^& A"#%& "#& 3;+7-'%& change and health and a conference supported by the CcOK&#%'>"2.@&>%2%&2%!"2'%$&+#&'(%&7%$+3-;&!2%**&A*13(& -*&ZO[&Z;"?*<&ZOK&b%>*<&g-#3%'/J'1$%#'/3"7@/

k& ,14;+3-'+"#& "5& -& 7"#'(;L& %;%3'2"#+3& #%>*;%''%2& *%#'& '"& donors, volunteers and sponsors. k&02?-#+*-'+"#&"5&'(%&ath London to Paris bike ride. Fortynine cyclists from the UK, France and Belgium collected more than 70,000 euros for MdM. k&G>%#'LI5"12&21##%2*&>("&!-2'+3+!-'%$&+#&'(%&d"L-;&,-2.*& half marathon raised more than 10,500 euros for Doctors of the World UK. k& ,-2'+3+!-'+"#& +#& TQ& 5"217*& '"& !2%*%#'& 9"3'"2*& "5& '(%& World’s work to potential future volunteers (doctors, nurses, midwives, psychologists, surgeons, logisticians, -$7+#+*'2-'"2*&-#$&*'1$%#'*@/

» FINANCIAL SUPPORT k&J"7-;+-o&7%$+3-;&-+$&!2"?2-77%&5"2&$+*!;-3%$&!%2*"#*/ k& J1$-#& A9-2512@o& 7%$+3-;& -+$& !2"?2-77%& 5"2& $+*!;-3%$& persons. k&O-$-?-*3-2o&Action Enfance. k&C-+'+o&%-2'(X1-.%&2%*!"#*%/ k&,-.+*'-#o&)""$&2%*!"#*%/

» HUMAN RESOURCES SUPPORT k&Y'(+"!+-o&K&$"3'"2&-#$&-#&+#'%2+7&7%$+3-;&3"I"2$+#-'"2/ k&C-+'+o&K#&%7%2?%#3L&*12?%"#&-#$&-&;"?+*'+3+-#/ k&Z127-o&K#&-$7+#+*'2-'"2/ k&g+4%2+-o&K&2%!2"$13'+=%&(%-;'(&3"1#*%;;"2&-#$&-&(17-#& 2%*"123%*&"563%2/ k&9-2512o&K&7%$+3-;&3"I"2$+#-'"2/ k&Z-#?;-$%*(o&K&5-3+-;&*12?%"#&-#$&-&;"?+*'+3+-#/ k&,-.+*'-#o&K&$"3'"2/ k&b%!-;o&K&?%#%2-;&3"I"2$+#-'"2/