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RM-EN-2005

VIEWS: 159 PAGES: 153

									05
MÉDECINS DU MONDE
A   N   N   U   A   L   R   E   P   O   R   T   2 0 0 5
                                          02/03




,,   I do not ask your race or
     your religion, I ask you what
     your pain is.
                  ”       Louis Pasteur
> Composition of the Board and Executive
Committee of Médecins d u Monde
General Assembly and Board Meeting held on 14 and 15 May 2005


President                                      Deputy Treasurer                         Deputy Board Members
> Dr Françoise JEANSON,                        > Dr Pierre MICHELETTI,                  > Dr Arnaud BOURDÉ,
General practitioner, Bordeaux                 Public health doctor, Grenoble           Anaesthetist-resuscitation specialist,
                                                                                        Saint-Denis de la Réunion
Vice-Presidents                                International projects representative    > Dr Laurence BOURGEOIS-GENET,
> Dr Olivier BERNARD,                          reporting to the President               Hospital doctor, Château-Thierry
Paediatrician, Marseille                       > Joseph DATO,                           > Dr Régis GARRIGUE,
> Dr Patrick DAVID,                            Nurse, associate professor at Grenoble   Emergency doctor, Lille
Anaesthetist-resuscitation specialist, Reims   University
                                                                                        Former Presidents
General Secretary                              Board Members                            > Dr Bernard GRANJON,
> Dr Bernard JUAN,                             > Dr Thierry BRIGAUD,                    Gastroenterologist, Marseille
Company director, Montpellier                  General practitioner, Paris              > Dr Jacky MAMOU,
                                               > Dr Frédérique DROGOUL,                 Paediatrician, Paris
Deputy General Secretary                       Psychiatrist, Paris                      > Dr Claude MONCORGÉ,
> Dr Fabrice Giraux                            > Dr Pascale ESTECAHANDY,                Anaesthetist-resuscitation specialist, Paris
General practitioner, Paris                    Hospital doctor, Toulouse
                                               > Dr Françoise SIVIGNON,
Treasurer                                      Radiologist, Paris, Amsterdam
> Pierre KEMPF,
Assistant hospital director, Vichy
                                                             04/05




 > Table of Contents
 03   WELCOME
 04   BOARD MEMBERS
 06   ACKNOWLEDGEMENTS

      POLITICAL STANDPOINT
 07   OUR AIM

 17   2005 IN FIGURES

      TESTIMONIES
 19   MÉDECINS DU MONDE IN PICTURES

      PROJECTS
 35   ATLAS OF INTERNATIONAL PROJECTS
 36       Map of international projects
 38       Country files

104   ATLAS OF MISSION FRANCE
104       Map of French actions
105       Introduction to Mission France
107       Action files
116       Contacts

      PROJECT SUPPORT
119   MdM MOBILISATION

129   THE REPRESENTATION NETWORK
130   REGIONAL OFFICES
139   INTERNATIONAL OFFICES

      OPERATIONS
143   ORGANISATION
144       Association Life
146       Department news
147       The Médecins du Monde International network
148       Sister associations and local partners
150       Médecins du Monde and civil society in France
152       Médecins du Monde and international institutions
> Acknowledgements:
Our private : A 13, A2P et associés, Adonix application et services, A Novo, Pradines Abbey, ACB Xerox, ADCS, Affival, Aladin, AMCM, Amicale cardiologue de Paris, Amicale des
sapeurs-pompiers de Poitiers, Amitiés loisirs Gouvernes, Antin résidences, Arasim, Arche promotion groupe Arcade, Assurances médicales Ales, Arrfliv, Aubry artist and painter, Axalto
international SAS, Beat SA, Beaulieu sports, Begon Bonneau, Herbert Bouchard SCP, BHV, Bretagne Enchères, Brossard - Saveurs de France, Camif solidarité, Capa télévision,
Carrefour DMG, Carte et Services, CGMI, Champion, Charpentier travaux publics, Chercheminippes, Risle-Gospel choir, Club Méditerranée, Soroptimist Club, CMP, Codara SA,
Cofiroute, Comanaging SAS, Meyzieu Social Work Committee, Comptoir des voyages, Consort Netcom, Construction mécanique de l'Isère, Crédit coopératif, Croissy-sur-Seine tennis
club, Decobat SARL, Desmarez SA, Diager SA, Divers et Imprévus, Eberle SA, Echanges & Solidarités, En apparence, Entraide majolane, Equus SA, Eric Bompard SA, Euro Assurance,
Euro information service, Eurofeu SA, Factum finance, Fermod, Finaler Friedrich, Football breton solidaire, Heilbronn Fiszer FHF, Geste, GFS SA, Go Voyages, Goéland productions,
Grands Moulins de Strasbourg, Hammerson France, Hilti France, Hydrosystem, ING fixations, Ifcic, Impact Immo, Intermed exportation, Iveco France, JP Chaussures, Kahn et associés,
Keyrus, la Baguetterie, la Boutik, la Mimetaine, la Ronde des âges, le Canard enchaîné, Leclerc Siplec, Leo Pharma, l'Esprit de sel, le Coin du feu bookshop, Logicacmg SAS, Lowendal
Group, Marc Orian, Marie Marchand multimédia SARL, MBP France, Mc Racing, Medi-Science, Mohn Media, Mondial Assistance, Mr and Mrs Peters, Munch Sa, Nec, New Deal HBC,
New Deal Sarl, Oddo, Olives Arnaud Sa, Opera Paris, Orange Réunion, Optimege, Ouest Affiche, Peugeot Citroën automobile, Peep Ass school library, Pierson Meunier export SA, Nièvre
département bailiffs office, Polypore Europe SA, Prima Solutions, Production La Prade SARL, Renzo Piano Building Workshop, Readers Digest Selection, Reuters, Rotary Clubs of
Gordes, Toulouse Ouest and Papeete-Tahiti, Rousseau, RS Com SA, SACD, SAFI, SA IFB, Sagone SA, Saulnier Blache SARL, See Velado, Sers, SFR, Sham, Smith And Nephew SAS,
SNPE group, Sodang, Sofisol, Solutys, Sonia Rykiel SA, Sopag Maine Parking, Stade Rennais FC, Stratégie investissement, Suzuki France, TAP Services, Taxi Jocelyne Perree, TBWA,
Techmo Systems SA, Techni Alarme, Tele2 France, Temex, TF1, La Michaudière Theatre, Théatre de la Tête noire, Top Famille, TV5 monde, UFG, ULIF, UNIM, Vialtis Fournisseurs, Vivendi,
Voyageurs du monde, Wargny Katz (SCP), Wegener DM.
Foundations: Annenberg Foundation, Arradon Foundation, Bois Brillou Foundation, Club Méditerranée Foundation, Deniber Foundation, Drosos Foundation, Florindon Stiftung, Fondation
de France, Fondation de Lille, GlaxoSmithKline Foundation, Johaniter Foundation, Mantegna Stiftung Foundation, Niarchos Foundation, Sancta Devota Foundation, Seviajer Foundation,
Sternstunden Foundation, Vinci Foundation, Union des blessés de la face et de la tête.
The works councils and employees of: Agefi, Banque de France, Caisse d'épargne Ile-de-France Paris, CCSO social, Cetim Senlis, Georges Dumas Clinic, CPAM Sélestat, CPR, Crédit
agricole Centre France, Crédit coopératif, Crédit foncier de France, Galeries Lafayette, GlaxoSmithKline, IBM Eurocoordination, Marsh, Natexis Banques populaires, Nestlé Waters, Vosges
Prolabo, PTC Nestlé, Réel, Thalès, UES LCF, UFG, Screg Sud-Ouest, Wyeth Pharmaceuticals.

Public partners:
Of our international projects: Administration des biens et des majeurs protégés, Association des régions de France, Canadian International Development Agency (CIDA),
Centre For Disease Control And Prevention, Chaîne du bonheur (Suisse), Columbia University, communauté d'agglomération du bassin d'Aurillac, Cordaid, Department For
International Development, Dutch ministry for Development Cooperation, ECHO, Embassy of Canada, Europeaid, German, French and Japanese Foreign Affairs ministries,
Global Fund to fight Aids, tuberculosis and malaria, Ile-de-France SAFER Joint United Nations Programme on HIV/Aids, IOM, Lille education authority, PACT, Population servi-
ces international, PACA region, Radio-protection and Nuclear Safety Institute, Rhône-Alpes region, Rouen chamber of commerce and industry, Swiss Development and
Cooperation Department, United Cities againsy Poverty, UNDP, UNICEF, UNFPA, UNOCHA, United Nations Office on Drugs and Crime, USAID, World Bank.
Town halls: Aigremont, Audincourt, Bassens, Behren-lès-Forbach, Bonnelles, Bourg-lès-Valence, Brioux-sur-Boutonne, Chilly-Mazarin, Drancy, Garlin, Goussainville, Lacroix-
Falgarde, Le Croisty, Le Crouesty, Lormont, Paray-Vieille-Poste, Paris, Paris 17e, Petrosella, Saint-Estève, Saint-Jean-de-Gonville, Saint-Sylvestre-sur-Lot, Sucy-en-Brie,
Toulouse, Tréport, Val-d'Isère.
Of our regional international projects: département councils: Bouches-du-Rhône, Alpes-de-Haute-Provence, Gironde, Charente-Maritime, Vosges, Doubs, La Réunion, Midi-
Pyrénées, PACA ; regional councils: Provence-Alpes-Côte d'Azur and Rhône-Alpes; Presidency of the Regions, prefecture of the Guadeloupe region.
Of our French projects: the Army, CNAM (National Health Insurance Office), CAF (Family Allowance Fund), CMR (Regional health offices), CPAM (health insurance offices),
CRAM (regional health insurance offices), CCAS (Social Action Community Centres), Rouen CHU (University Hospital) CDAG (free anonymous screening centre), Nantes PASS
(access to healthcare service), CDAG, CISIH (HIV treatment and information centre) CHUl and CHRS (Accommodation and Social Rehabilitation Centre), département-level
councils, FNPEIS (regional health education and information councils), DIV (Interdepartmental Delegation to the City), DGS (Directorate General of Health), DGAS (Directorate
General for Social Action), DDTEFP (Département-level labour departments), DRASS and DDASS (regional and département-level branches of Ministry of Health), Fonds natio-
nal de prévention (National prevention fund), town halls, ministries, MILDT (Interdepartmental Mission for the Fight against Drugs and Drug Addiction), OFDT (French Monitoring
Centre for Drugs and Drug Addiction), prefectures, Rouen reception centre for travellers, Poitier town-hospital network, URCAM (Regional unions of health insurance offices).

Our partner associations: Aides, ALC Nice, Alerte Group, Alsace group of associations working with people involved in prostitution, les Amis du Bus des femmes, Amnesty
International, ANEF, Association of French regions, ATD Fourth World, Avenir et Coopération, Brittany Football League (and the clubs of Brittany), Communication and Action
for Access to Treatment Association, Congregation of the Augustinian Sisters, CSF, DAL, DHL Liens, Drug Users Self-Support and Harm Reduction Association, D'une rive à
l'autre, Emmaüs, Emmaus Committee, Entraide majolane, Federation of associations for housing provision (Fapil), le Foyer association, French Campaign for the Right of Asylum,
French Harm Reduction Association, Friends of Marist Community, Gisti, Health Networks Coordination Initiative (CNR), Health Without Frontiers, Humanitarian Bank,
Humanvillage, IFHR, Inadaptés des Po association, International Harm Reduction Association (IHRA), IOP (International Prison Monitoring Centre), LDH, Max Havelaar,
Mouvement du Nid, National Union of the Associations of Reception and Social Reintegration (Fnars), ODSE (Foreigners' Right to Health Monitoring Centre), Passerelle la santé
sans frontières, Pays de la Loire Planning Centre, Pays de Retz Doctors' Association, Pharmacie humanitaire internationale, Platform against Trafficking in Human Beings, Rasko,
the Red Cross, Rimbaud Mobile Team, Restos du Cœur, St-Benoît hostel, Sanatatea association, Stade Rennais FC, Secours catholique, Sid'espoir, Sonacotra hostel, SOS
Drogue internationale (SOS DI), SOS Femmes, Strasbourg Psychiatrists and General Practitioners' Collective on exclusion from health care, Support for the Victims of Bam
Group, Techno Plus, Travellers' Association, UNIOPSS, Veille sociale, Vialtis.

And all our other partners who have supported our work in France and abroad during 2005, as well as our individual donors.
        > Our aim




07/16
> Combating oblivion
After twenty-five years of providing care to the most vulnerable populations, of fighting against the dictator-
ship of violence, inhumanity and abandonment, 2005 gave us the opportunity to give a dual focus to
Médecins du Monde's anniversary: commitment and forgotten crises. By changing our slogan to highlight
again our objective of bringing the populations we support out of oblivion, we are pointing out our distinc-
tiveness in the confusion lying in wait for international humanitarian action today.



                                      > Consider the context …
     UN Reform
     We are paying particular         In a context of global struggle against terrorism, the pursuit of murderous conflicts
     attention to the replacement
     of the Commission on
                                      as in Darfur or Chechnya or enduring political crises as in Haiti, the 60th birthday
     Human Rights, which has          of the UN saw the drawing up of a mixed assessment of a vital multilateral policy
     lost all power and
     credibility, with a Human        whose credibility and real impact require reform which the states were incapable of
     Rights Council which would       adopting in its entirety.
     sit permanently.
                                      Ten years after the Srebrenica massacre, the slow reconstruction of the Balkans illus-
     Post-crisis contexts             trates how fragile the return to peace between its peoples is, although this is a vital
     Amongst these regions,           prerequisite to a stable and lasting reconstruction. The same can be said for many
     MdM is working in DRC,
     Liberia, Angola,                 regions in the world where there is a great temptation for the international community to
     Afghanistan, Kosovo and
     Serbia.
                                      speed up the reconciliation process. However, no peace is lastingly viable unless it is
                                      shared and anchored in the communities involved.
                                      The cancellation of the multilateral debt of the poorest countries by the G8 states in
                                      July was accompanied by a promise to double aid to Africa between now and 2010.
                                      However, against that good news, we need to set the distressing assessment of the
                                      progress towards the Millennium Development Goals (MDGs) after 5 years. The gap
                                      between rich and poor is increasing everywhere, burdening the future of more than a
                                      billion people in the world, whereas radicalism of all kinds feeds on the sources of
                                      poverty and real or perceived injustice.
                                                                                                                                      08/09




In October, contrary to generally accepted ideas, the Human Security Centre announced a
fall in the number of conflicts in the world since the end of the cold war, although it said
                                                                                               ,,  “It is through, and thanks
                                                                                               to, medical work that we can
that violence experienced by civilians now came more from internal conflicts, state            denounce and bear witness
repression or poor governance, phenomena which exacerbate poverty, hunger and lack             to injustice, and we try to
of access to healthcare. Because of its distinctive medical focus, Médecins du Monde           treat its consequences as
must respond to violence of this kind.
                                                                                               well as its causes.”

> ... Respond to it with care and                                                                                          ”
     testimony
In disasters
The start of the year was marked by the tsunami which ravaged South East Asia
in December 2004. Right from the start, we were working in Indonesia and Sri Lanka,
caring for victims and survivors, and we then supported the rebuilding of health systems.
In the face of the enormous number of agencies involved and the resulting confusion,                  Tsunami
                                                                                                      impartiality,
and the ruthless competition of some of those involved who were more interested in                    proximity
gaining a higher profile than providing rational and quality support for the populations,             and partnership
we took pains to carry out our work according to our principles, and based on survivors'              In Indonesia and Sri Lanka,
                                                                                                      we chose to intervene in
needs rather than the money we had available. At Mallavi, as well as dealing with the                 areas which were in danger of
consequences of the tsunami, our aim was to ensure we were in place should the                        being overlooked by
conflict between the rebels and the government army break out again. Our project there                international aid, either
                                                                                                      because they were hard to
was extended for a minimal period so that we would be on the spot should the situation
                                                                                                      reach (such as Calang in
deteriorate. These principles were presented clearly to our donors who then authorised                Aceh) or because they were
their gifts to be reallocated to other projects, thus enabling us to open programmes in               subject to political
                                                                                                      disturbances (such as Mallavi
areas which were just as legitimate, but forgotten by the media, such as the suburbs of
                                                                                                      in Sri Lanka); our projects
Jakarta or the prisons of Madagascar.                                                                 were set up to support local
                                                                                                      workers.
It was because of these principles that we could respond in a major way to the aftermath
of the violent earthquake which devastated Pakistan. Getting aid to those living
in the deep-sided and isolated valleys was particularly complex and to begin with many
victims were unable to get any aid. We were present from the very first
     Pakistan                         days, and our surgical and medical teams were able to cope with the influx of injured
     At Mansehra, more than           whose health was worsened by the previous lack of access to healthcare in these
     2,000 operations were car-
     ried out in precarious           neglected regions. Once the first emergency phase was over, we followed the victims to
     conditions; at Thakot, our       the camps set up on the outskirts of the major cities, then into more distant camps that
     health post received bet-
     ween 50 and 100 patients         had sprung up and which had received no aid at all.
     each day; at Kaghan, our         Today, we are being very vigilant about the conditions survivors are returning to, as these
     mobile clinics saw between
     40 and 70 people per day.        must respect people's rights and choices. We are particularly concerned about
                                      the situation of women, who have been made even more vulnerable in a country where
,,  In Pakistan, the
 teams' living and
                                      their rights are flouted on a daily basis and where impunity prevails for those subjecting
                                      these women to violence. In the Dar-ul-Aman (refuges), our care for women who are the
                                      victims of domestic violence is also aimed at fighting for their protection and their rights.
 working conditions
 were particularly                    In conflicts
 difficult, with                      Although 2005 was marked by these disasters, as an NGO we have a legitimate role in
 uninterrupted work,                  conflicts and this must be strengthened, especially in Darfur, where our programme in
 housing in tents and                 Kalma has been supplemented by mobile clinics in isolated villages inhabited by the
 long walks at                        different ethnic groups involved in the conflict. In the face of this human disaster which is
 altitude to reach                    becoming entrenched and to which no one can see an end, we have denounced, alone
 isolated villages                    and in partnership with others, the crimes committed by the Janjaweeds, the violence

                            ”         against women, and the pressure put on those involved in humanitarian action, which
                                      endangers our work and the local staff working alongside us. Beyond humanitarian aid,
                                      only the massive political commitment of the international community, going beyond the
     Putin's Law
                                      interests of individual states, and strong resolutions from the Security Council will be able
     Openly opposing this anti-
     freedom law, MdM has star-       to bring an end to this neglected war.
     ted a joint mobilisation brin-   In Chechnya, the normalisation displayed is totally fictitious. So that nobody can dispute
     ging together the medical
     charities working in Russia      it, President Putin has introduced a law in the name of Russian national security condemn-
     together with human rights
     charities. In conjunction
                                      ing local organisations and expelling international NGOs “guilty” of freedom of speech.
     with partners from Russian       In Iraq, civil war has followed the failure of the American and British intervention. The
     civil society, this coalition
     has lobbied the European         human rights in the name of which the armies intervened are flouted by those supposed to
     authorities to get President     defend and protect them while terrorism kills more people each day and the humanitarian
     Putin to withdraw the law.
                                      situation is now disastrous. In this situation, where an expatriate presence is impossible,
                                      Médecins du Monde wants to find a response appropriate to the health needs
                                                                                                                                  10/11




without endangering those involved. Our past involvement in the region means we can              Iraq
consider action directed from outside the country, relying on a trusted local network. This      As part of its support for the
                                                                                                 journalist Florence Aubenas,
is possible operationally and support at a distance must, amongst other                          kidnapped with her team
things, allow us to respond to the main request of doctors who have stayed                       member in December 2004,
                                                                                                 MdM has become a
in Iraq which is to bear witness to the humanitarian disaster which the Iraqi                    spokesperson for
                                                                                                 humanitarian workers who,
population is living through today.                                                              together with journalists, are
Despite the reconstruction process which has begun, the end of the war in DRC is still           being led to intervene in
                                                                                                 contexts which are all the
accompanied by dozens of deaths each day of victims of the ongoing humanitarian crisis,          more dangerous in that their
                                                                                                 activities are often confused
the armed bands who continue to hold sway in the east of the country, and of social              with civilian and military
breakdown. We have strengthened our presence in the abandoned areas, and have begun              operations.
work in Kalemie, where we are treating, amongst others, countless women who are
victims of rape.
Whether it is the death of Arafat or the election of Hamas, the construction of the Wall or
the evacuation of the Gaza settlements, the Palestinian people continually face one              Palestinian Territories
emergency or another. Where we used to support high-tech medicine, we are now caring             MdM is involved in primary
for diseases caused by poverty. We are supporting a bloodless health service for a popu-         health care, preparations for
                                                                                                 emergency situations and
lation which is suffering the harsh health consequences of the political situation, despite      mental health work.
amazing resilience. We must bear witness to the health of populations, the lack
of access to healthcare and the shortage of structures and healthcare staff.

In lasting crises
The urgency of intervening in Niger divided the Association, setting those supporting an
economic analysis of the famine against those supporting a structural analysis. Media and
humanitarian frenzy followed the “revelation” of this food crisis which is now being forgot-
ten once again. At the end of 2005, we started paediatric medical work in partnership with
Action Against Hunger, each bringing our skills to give overall, quality care to children. The
principle of repeating this partnership in other programmes has been launched within the
association.                                                                                     Liberia
                                                                                                 MdM is involved in primary
                                                                                                 health care, mental health
Other areas, less reported in the news, have caught our attention. Liberia, Angola,              care, and the shortage of
                                                                                                 healthcare staff.
Afghanistan and DRC are all countries devastated by long conflicts, states that have
                                 completely broken down, with health systems which do not exist for the majority of
                                 the population who cannot pay for private healthcare. NGOs provide the majority of
Colombia
                                 healthcare due to a lack of staff and health structures.
MdM is involved in primary       In Colombia, the last country in conflict in Latin America, the most vulnerable
healthcare, maternal and         civilian populations are the hostages of violence but they have also been totally
infant health and amongst
minorities.                      abandoned by a privatised health system which offers little access to the poorest.

                                 In addition to its medical activities and in order to carry out advocacy
                                 work, Médecins du Monde is studying the actual access to care from
                                 which the most vulnerable populations will benefit in the reconstruc-
                                 tions planned by international donors and private companies.
                                 The number of new projects, regional international projects (Guatemala, Burkina
The People's                     Faso, Algeria and Bulgaria) or wider programmes (Mongolia, Borneo, Peru, etc),
Health Movement
                                 continues to grow. Although each one involves a specific population, the problem of
A global network of health
workers and organisations        financial exclusion from healthcare is systematic. In this area, it is vital that we
(mainly from southern
countries) fighting for access   involve southern healthcare staff in promoting access to healthcare for everyone.
to health care for everyone.     Our presence at the People's Health Assembly, organised by the People's Health
Working closely with
vulnerable populations and       Movement at Cuenca, allowed southern doctors to identify us as a partner commit-
the daily experience of
access to care are at the
                                 ted to the most vulnerable and supporting existing initiatives. The nature of our work
basis of this movement,          shows clearly that we are committed to medical care for the most vulnerable and
which aims to make the right
to health recognised as a        that we support involvement in favour of healthcare workers in the South. These
priority in health policies at   networks encourage partnerships which will make it easier to get involved in new
local, national and
international levels.            regions.

Support for                      In the fight against infectious diseases, 2005 will have been marked by
involvement
of the South                     the withdrawal of the Global Fund to fight Aids, tuberculosis and malaria
It is for this purpose that we   from Burma as a result of the constraints imposed by the ruling military junta on
are currently taking part in
the “Health personnel in the     humanitarian organisations, sadly symbolising the subordination of health to political
South: a fatal shortage”         issues. A whole vulnerable population, which had benefited from long-term
campaign to ask the French
state to strengthen its          psychological and therapeutic care, has been abandoned, and local workers, trained
support for health policies.
                                 with the prospect of a pull-out, have been forsaken. We condemned this decision
                                 and have asked the Global Fund to reconsider its position or to put alternative
                                                                                                                                  12/13




funding mechanisms in place. We have called on the French Minister for Foreign
Affairs to vehemently make known French protests with respect to the human rights
violations suffered by the Burmese population.

Another disappointment with regard to Aids has been the integration in Indian law of
                                                                                                 Pharmaceutical
the WTO-imposed constraint in a law guaranteeing the preservation of patents for                 patents in India
pharmaceutical products. Despite amendments softening the law, the possibility                   Amendments allow generics
of supplying southern countries with effective treatments at affordable prices remains           already produced in the
                                                                                                 country to be exempt from
a vital issue.                                                                                   this law, in exchange for the
                                                                                                 payment of “reasonable
                                                                                                 royalties” to licence holders.
In Asia, as in Africa, fifteen years of experience amongst peoples affected by                   New medicines which have
                                                                                                 not yet been copied will be
HIV/Aids provide experiences of differences but also of constraints overcome                     protected but subject to
as regards feasibility, operational methods and social and anthropological approaches.           “compulsory licensing” in the
                                                                                                 event of a health crisis.
After fighting for access to medication and setting up clinical and technical reference
programmes, and in the face of the expansion of the epidemic, we must now devise and
apply means for dealing with Aids as part of primary healthcare, and strengthen
the testimony of MdM's international network in this direction.

In access to healthcare for migrants
Although the western media revealed the dramas of Ceuta and Melilla, the
identical conditions experienced by migrants on the Mexican-American border
have passed unreported. We have been working in a reception centre for
expelled migrants in Tijuana for a year and have gathered testimonies which echo
those collected in France and in Europe. Physical or regulatory barriers are being
erected everywhere to protect wealth which has never been so poorly distributed
across the world. This major question should be more of an issue for us
as a northern organisation, and we should be committed to protecting
these people whose only crime is to seek a better life.
                                                                                          ,,  In Morocco, a health
                                                                                           project amongst African
Lobbying for an amendment to the European directive “on the return of foreigners           migrants is due to start in
                                                                                           the coming weeks.
in an irregular situation” that condemns sick foreigners expelled without a
guarantee of healthcare in their country of origin, to a certain death, setting up the                                   ”
                                    Averroès project, and the progress with the French access to healthcare monitoring
Averroès Project                    centre, and more recently the European monitoring centre, are all initiatives which
The aim is to build a network       embody the reality of migration, too often reduced to a statistical phenomenon
of field medical organisations
covering the 25 European            grossly overused by politicians searching for a scapegoat. In the coming years we
Union states asking, amongst        will continue this work in favour of human rights.
other things, all the states that
are signatories to the              Today, access to care, reconstruction, migrants' health, violence against
European convention to
ensure access to healthcare
                                    women; tomorrow, street children, indigenous peoples, health in
and preventive medicine to all      prisons. The same themes are emerging from our international activity
foreign residents, regardless
of whether they are in the          as those which we are involved with in France and in Europe.
country legally or illegally,       Understanding them in a cross-disciplinary way helps us to analyse their
under the same conditions -
and with the same level of          many aspects and to develop clear advocacy, which is more convincing,
resources - as those offered
to nationals.                       and therefore more effective in modifying in a lasting way the scandals
                                    to which we bear witness.




Advocacy
                                    > In France too
Launched this year, the
advocacy service will let us        Health policy for the most vulnerable populations has continued to decline
compile statements and
proposals to strengthen our
                                    this year. Although the public health act perpetuates the harm reduction programmes, it
capacity to put pressure on         constrains them financially and prohibits testing, the only approach that effectively creates
the authorities.
                                    a link with individuals. Although the health insurance reform encourages access to mutual
                                    insurance for people living just above the CMU (Universal Health Insurance) threshold, we
                                    are now seeing how it complicates access to healthcare for those excluded and increases
                                    the cost of care and hospitalisation for them. Even though the “access to emergency
                                    care” circular slightly lessens the health and human consequences of the decrees limiting
                                    access to AME (state medical aid) for those without residence papers, it is quite useless
                                    when a new law encourages the police to pursue these people even in hospitals and
                                    healthcare and reception centres. Finally, although the Ceseda law (on foreigners entering
                                    and staying in the country and the right of asylum) retains regularisation for healthcare, it
                                    makes access to health for foreigners much more difficult. Whether through the media or
                                    legal proceedings, we will continue to fight against these laws of suspicion and inhumanity
                                    which weigh on the most vulnerable.
                                                                                                                                   14/15




Our reception, care and orientation centres (CASOs), like our projects
outside centres, measure the decline in access to healthcare on a daily
                                                                                            ,, This policy is
                                                                                             repressive, complex and
basis. With the setting up of the ICPC (International Classification of Primary Care),       incoherent at the same
we are hoping to bear witness more to the impact of exclusion and poverty on                 time and is undoubtedly
health. We are careful observers; however, it is by preserving our calling to                made at the expense of
disappear that we will be able to avoid the pitfalls of our work being institutionalised.
                                                                                             the health of the poorest.
The autonomy of the “methadone buses” and the harm reduction proj-
                                                                                             As our country is not
ects under conditions which allow them to continue their work was won
                                                                                             choosing to give care to
after a major struggle in 2005. A federation bringing together the organisations
                                                                                             everyone, we will
born out of these actions allows Médecins du Monde to continue to be active and to           continue to fight against
be a forerunner, observing, in particular, the growth in the consumption of products         this injustice, which is
and fighting for the health of users and for their recognition, in France and abroad.        unworthy of the country
                                                                                             of the rights of man.
Life on the streets is torture. Sleep deprivation and lack of food ruin health.
Despite the belated recognition by the law of health-stop beds this summer, and
                                                                                                                                   ”
despite some magnificent community initiatives, all our teams have noticed how the
number of people living on the streets is increasing and how their health is deterio-
rating. The expulsions without re-housing last summer are just making the situation                Community
                                                                                                   initiatives
worse. It was to oppose a policy which manages misery instead of combating                         For the last three years, the
it that the Paris homelessness project called on public opinion and the                            Night Hostel in Bordeaux, for
                                                                                                   example, has welcomed
government by making the homeless visible by distributing tents, symbols                           those who have nowhere
                                                                                                   else to stay, without
of the shortages of which they are the victims.                                                    conditions.


No health without a roof, no health under an insalubrious roof or within walls
containing lead. This is another motivation for our commitment to the fight for a
binding right to housing. Our presence amongst squatters, who organise a paral-
lel life to society in alternative places, once again marks Médecins du Monde's ability
to adapt and our desire to leave no-one on the margins of society.
,,  Echoing the twenty-five
 years of commitment brought
                                   Finally, between here and over there, Médecins du Monde's adoption
                                   service has enabled 315 children this year to find a family. Amongst them,
 to light by the Rondeau           28 suffer from curable diseases, and only the distinctive medical work of Médecins
 exhibition, the theme of          du Monde means they can leave the orphanages. It is the stated desire of the
 forgotten crises, the slogan of   Association to encourage the adoption of these children with specific needs who
                                   were not able to be adopted in their country of origin.
 our new campaign, was
 embodied in the
 presentations made by local
 workers on that occasion.
                                   > The organisation
                           ”       We celebrated our 25th birthday in a very warm atmosphere. The general assembly
                                   was a time of celebration, but the proposal to reform our articles of association
                                   meant that it was also a time of reflection. Although it was not passed, it led to many
                                   discussions focussed on our healthcare work and the importance of volunteers, on
                                   our medical identity and on the perspectives in which we wished to commit a charity
                                   born out of both humanitarian action and political debate.

                                   I would like to thank everyone who, by their work in the field or support, here and
                                   over there, provide care, protect populations and advocate the cause of the victims.
                                   It is the commitment of each one of us which makes Médecins du Monde a credible,
                                   independent and innovative NGO.

                                   Dr Françoise Jeanson
                                   President of Médecins du Monde
                                   21 April 2006
 2005 in figures                                                                                                                        16/17




• MdM's structure                                                              • MdM's balance:
     (at 31/12/2005, in FTE):

415 volunteers went out to the field
150 short-term field staff (full time equivalents)
1,300 volunteers at head office, in the provinces and Mission France
                                                                               48.2                                    million Euros
                                                                                                                       in 2005


16 regional offices
                                                                               Distribution of expenses by
4 international representation offices                                         department (excludes exceptional items):
1,556 members                                                                                       1.0%       Communication
                                                                                                               and information costs
153 paid staff (full time equivalent) at head office and 17 paid field staff                        7.1%       Administration/head office costs
13 paid staff in regional delegations                                                               18.2%
                                                                                                    73.1%
                                                                                                               Fundraising costs
                                                                                                               International
66 paid staff on Mission France and Harm Reduction projects                                                    and domestic projects
                                                                                                    0.2%       Costs of seeking sponsors
                                                                                                    0.4%       Costs of other forms of appeal

                     i.e.     249
                  paid staff in total

                                                                               Origin of resources
• The MdM international                                                        (excludes exceptional items):


network:
                                                                                                    62%        Public generosity
12 international offices                                                                            35%
                                                                                                    2%
                                                                                                               Public grants
                                                                                                               Private grants
Argentina, Belgium, Canada, Cyprus, France, Greece, Italy, Portugal,                                1%         Other
Spain, Sweden, Switzerland, United States

73    million Euros budget
in 2004 (budget N-2)
2005 in figures
• International:                                      • France:
                                                                      medical consultations in
                 international projects               40,039 CASOs for 20,324 patients
93               in 51 countries
                 (excluding new bases and
                 projects, and excluding adoption)
                                                                   dental consultations carried out in
                                                      5,744 10 towns for 2,576 patients
                                                                    i.e.   45,783
                                                                    consultations in total in 21 Reception,
Geographical distribution                                           Care and Orientation Centres (CASOs)
of MdM's programmes:
Africa
Latin America
Asia
Eastern Europe
Middle East
Central Asia
                      4
                      4
                             13
                            12
                                  18
                                            38


                                                      85               mobile community projects
                                                                       in 23 towns, carried out by
                                                                       761 volunteers

                                                      14 Harm Reduction programmes
                                                      More than 70,000 HR contacts
                                                      10,000 contacts with people
                                                      involved in prostitution, through 6 projects
Geographical distribution of
expenses of international
projects:                                             Distribution of Mission France
                                                      expenses in 2005:
Africa                                           43
Asia                                   24
                                                                           41%   Harm Reduction
Latin America                12                                            39%   CASOs
Eastern Europe              10                                             11%   Outside centres
Middle East             6                                                  8%    Mission France co-ordination
                                                                           1%    Hospital sponsorship
Central Asia           5
                        > MdM in pictures




                19/34
HENK VISSCHER
South-East Asia
Rebuilding after
the tsunami
Six months after the tidal wave
which affected Indonesia and
Sri Lanka in December 2004,
MdM's teams have gradually
brought their emergency
projects to an end.
“Our desire is not to replace
the health staff in the long term
but, on the contrary, to help
them to get hospitals, health
centres and health posts back
on their feet,” says Frédéric
Penard, the programme co-
ordinator in South-East Asia for
the Emergency desk. The
Indonesian and Sri Lankan
health structures are
recovering.



Mexico
In transit,
in danger
                                    MdM




                                          MdM
“I am a doctor in Tijuana,
where the Association is
carrying out an access to
health programme among the
migrant population,” explains
Jorge Arellano Estrada, a
local doctor. “I do prevention
work amongst migrants. Each
afternoon I go to Casa del
Migrante, the largest
migrants' hostel in the town,
and to Casa Madre Assunta,
for women and their children.
I hold consultations and
answer their questions. As I
am in contact with them on a
daily basis, friendships have
developed. Each week, I also
give a talk on AIDS
awareness and prevention. I
am trying to identify migrants
who are at risk because of
their behaviour and I tell them
about the different ways HIV
can be transmitted. I am also
trying to remove the taboos




                                          MICHEL REDONDO
and help change attitudes
about this disease.”
                                           20/21

                      Pakistan
                      Adapting
                      day by day
                      Following the earthquake
                      which struck Pakistan on 8
                      October 2005, an emergency
                      project was set up to provide
                      aid to the victims. “The first
                      three weeks were devoted to
                      giving medical care to the
                      injured, in particularly difficult
                      conditions,” explains José
                      Luis, a general practitioner.
                      The work was then continued
                      by setting up permanent
                      consultations in several camps
                      for displaced persons, in the
                      outskirts of Islamabad for
                      displaced people from
                      Kashmir, and around
                      Mansehra for displaced
                      people from the Kaghan valley.




                      Women
MdM




                      taken for targets
                      In addition to the post-
                      earthquake project, MdM is
                      running a project to help
                      women seeking help in
                      refuges called Dar-ul-Aman.
                      Each year, in the Punjab
                      region alone, hundreds of
                      women are burned by fire or
                      acid. The programme plans to
                      provide global care for these
                      women within three refuges. It
                      includes medical help,
                      hygiene awareness sessions,
                      psychological support and
                      legal help. Practical training
                      also helps social and
                      economic reintegration. For
                      example, the Association
                      organises therapeutic theatre
                      sessions during which the
                      women act out their own
                      stories in front of the other
                      residents and the Pakistani
                      staff in the refuges.
HENK VISSCHER




                MdM
Forgotten faces
Long protected by their
isolation, indigenous people
today are the victims of
their confrontation with the
modern world. Their
habitat, environment and
culture are threatened. And
they are now affected by
many infections or diseases
related to ethno-stress
(alcohol or drugs). The
Association's objective is to
support these little-known
people, who are forgotten
by the international
authorities more often than
not. Projects aimed at them
are usually organised in
difficult conditions and
workers have to adapt to
very specific ways of life.
“To carry out a project, we
must first of all know the




                                REINER SPRUIT/MdM
social and cultural
environment well. This
approach is specific to
MdM's ethnic minority
group,” explains Franck
Desplanques, the group co-
ordinator. “This leads us to
begin our medical work by
sending an ethnologist or
anthropologist to study the
distinctive features of these
communities,” he adds. In
Indonesia for example,
projects have been built
around two indigenous
peoples: the Dani tribe,
living in West Papua, who
make up 1% of the
population but more than
42% of cases of AIDS
nationally, and the Punan
on the island of Borneo,
who receive no healthcare
in the heart of the forests,
and who are exposed to
many diseases when they
emigrate to the cities.




                                   DAVID DELAPORTE
                                                                                    22/23


                     ,,
                     Russia, Nenets people



                               Before intervening,
                               we tried to understand
                               the codes, taboos and marks of respect of this
                               society, as well as how they view the body and
                               illness. The Nenets people are just as much at
                               ease with a lassoo for capturing reindeer as with
                               a computer keyboard. They know that their
                               survival involves opening up to modernity. It was
                               therefore essential to understand the whole of
                               that culture. A farmer cannot consider leaving his
                               herd for six months to receive hospital treatment.
FRANCK DESPLANQUES




                               It would endanger his whole family's survival. We
                               must keep this in mind when we consider long
                               treatments such as for tuberculosis. In terms of
                               training, we have developed a very pragmatic
                               educational approach. We have trained health
                               technicians in the remotest corners of the region.
                               Some have continued to work well, others not. It
                               depends greatly on the involvement of the
                               doctors in each district. Without support from the
                               local authorities, this work would not have been
                               effective. Now the Russians have taken over the
                               the programme and we are trying to build on
                               this experience in other regions of Siberia.

                               ARMELLE DESPLANQUES-LEPERRE,
                                                                              ,,
                               Project Co-ordinator
FRANCK DESPLANQUES
Opération Sourire
Reconstructive
surgery
Each year, some thirty short-
term projects across Africa
and Asia are involved in
putting the smile back on
children's faces. Volunteer
surgeons, nurses and
anaesthetists perform
operations to cure congenital
deformities, harelips, burns
or the after-effects of war
trauma. Opération Sourire
has just celebrated its 15th
birthday. In 2005, teams
worked in 12 countries:
Benin, Cambodia, Chad,
Eritrea, Ethiopia, Laos,
Madagascar, Mali, Niger,
Mongolia, Pakistan and
Rwanda. “In the countries
where we work, surgery is
                                CATHERINE HENRIETTE




often only used in
emergencies,” explains Dr.
François Foussadier, the
project co-ordinator.
“Performing operations for
functional and morphological
reasons was sometimes
considered worthless by our
local colleagues. It was only
after they had seen the
results that they understood
how much these operations
transformed patients' lives.”
The Opération Sourire
volunteers also train local
teams. “When the Opération
Sourire surgeons arrived in
Niger in 1996, they made me
aware of reconstructive
surgery as they knew that I
was interested,” says Issa, a
young 29-year old Nigerian
surgeon. “They taught me to
carry out skin grafts, and
today, I am the only one in
Niamey who knows how to
do them.”
                                        24/25

                      The Homeless
                      Re-establishing
                      access
                      to healthcare
                      In 2005, 80% of the work
                      carried out in France was
                      through mobile
                      programmes which allowed
                      teams to go out and meet
                      the most deprived people,
                      and especially the
                      homeless. “We met
                      Béatrice at the station
                      during one of our rounds,”
                      says Marie-Thérèse
                      Raymond, a psychologist
                      and co-ordinator of the
                      homelessness project in
                      Poitiers. “She was pregnant
                      but she did not know
                      exactly how far on she was
                      and had never been
                      monitored. What struck me
                      was that her arms were all
                      scratched. Our doctor
                      thought that it was a mental
                      illness. As I talked with
MdM




                      Béatrice, I realised that it
                      was simply her way of
                      expressing her anguish. She
                      had just arrived in Poitiers,
                      not knowing anyone, with
                      nowhere to live, no income,
                      no papers, and she was
                      expecting a baby. Who
                      wouldn't be distressed in
                      such a situation? It was
                      one of the worst situations
                      of distress that I have ever
                      come across. I directed
                      Béatrice to our care centre.
                      With the project's midwife
                      and social worker, we got
                      her back on her feet.
                      Recently, she came to thank
                      us. She had somewhere to
                      live, a job and papers and
                      she had a wonderful baby in
                      her arms. It is by people like
                      her that I measure how
                      valuable our project to the
                      homeless is.”
CÉDRIC HELSLY




                MdM
Sudan, Darfur
Forgotten crisis
As the conflict between the
rebel movements and the
governments intensifies, the
health situation in Darfur
continues to worsen.
Refugees, most of them
women and children, are
fleeing the fighting and
heading for the camps where
the living conditions remain
extremely precarious. In the
Kalma camp, MdM''s care
centre includes a
hospitalisation unit, delivery
room, 4 consultation rooms for
curative care, vaccination
services, etc.
“Sudan is set for a lasting
crisis. The south is fading from
our memories, but Darfur in




                                   THIERRY DUDOIT/L’EXPRESS
the west is being violently
shaken while tensions have
grown in the east,” says a
worried Laurent Joseph, the
project co-ordinator. The
Association is also denouncing
the worsening of security
conditions and the obstacles
the population faces to have
access to healthcare.


Afghanistan
Hope in midwives
“The role of NGOs is to
encourage sufficient
autonomy amongst the
Afghans so that they don't
need us any more,” explains
Florence Maurin, medical co-
ordinator of the project
supporting mother-and-child
health centres in Kabul and
Herat. “In addition, when I
see the student midwives
being trained in our clinics, I
am very hopeful. I am
convinced that we must build
using these generations. I
believe that it is thanks to




                                   / mdm
them that we will see a real
reconstruction process in this




                                       JANE BIRMANT
country which has become in
some way my own.”
                                                                                    26/27


                    ,,
                    Chechnya



                               Our country is
                               devastated and
                               occupied
                               by an army that carries out many acts of
                               repression against civilians. Houses are
                               looted, people are faced with many acts of
                               violence, humiliations, arrests or even total
                               disappearances. Psychological trauma
                               affects young and old. As a psychologist,
                               my work involves training doctors at Grozny
                               hospital so that they can detect its
                               symptoms in their patients. Then they send
SÉBASTIEN GEORGES




                               these people to me so that we can start
                               one-to-one work. This initial contact
                               sometimes also lets us reach other family
                               members who would not have come to the
                               hospital, but who are also suffering serious
                               problems. Drawing is my main means of
                               getting children to talk about and express
                               the trauma they have been through, as they
                               are often haunted by tragic scenes. These
                               scenes often re-emerge through their
                               behaviour, in nightmares, aggressiveness,
                               withdrawal into themselves, and memory
                               problems. In this way, we can reconstruct
                               each child's story.

                               KHAPTA, Chechen psychologist
                               for the project at Grozny hospital
                                                                               ,,
DR
AIDS
Prevention,
care and training
Every six weeks, AIDS
produces as many victims as
the tsunami did. In 2005, the
Association carried out a
study in 20 countries where
the MdM international
network works. This study
showed that the lack of
availability of medicines is not
the only obstacle to access
to antiretroviral treatments
(ARVs). Some countries are
incapable of coping with the
epidemic even when they
have ARVs. In effect, there
are far too few health
professionals with AIDS
training and the treatments
offered in hospitals are often
a very long way from the
primary health centres.
Prevention, care and training




                                         LAHCÈNE ABIB
are therefore the three main
objectives of these projects,
which are being carried out in
about ten countries across
the world.
Setting up programmes to
fight AIDS is not always easy.
For example, Burma devotes
only 2.2% of its health
budget whereas 45% is
destined for the army. How
can this gap be reduced?
“Our aim is to make civil
society more aware of this
epidemic,” explains
Françoise Sivignon, the
project co-ordinator in
Burma. Thirteen years after
the project began, attitudes
have begun to change as the
epidemic is now considered
the 3rd public health priority
nationally.




                                         / VOUS ÊTES ICI
                                            BRUNO FERT
                                   MdM
                                 28/29

               Cambodia
               Treatment
               gives hope
               More than 400 million
               people across the world
               suffer from mental,
               neurological or psycho-
               social problems. These
               invisible evils have many
               causes: armed conflicts,
               political violence, forced
               displacements, exclusion
               from healthcare systems,
               etc. These complex
               situations do not make
               treatment easy, especially
               as these problems are often
               stigmatised. “Because of
               very strong cultural
               pressure, people are
               ashamed to talk about
               psychological illnesses,”
               says Emmanuel Dignonnet,
               co-ordinator of the mental
               health programme in the
LAHCÈNE ABIB




               Palestinian Territories. In
               Nablus, living conditions
               have deteriorated strongly.
               “The check points, the
               repeated incursions, the
               occupation and destruction
               of houses are all traumatic
               events.” In this sensitive
               area, teams have set up
               information campaigns,
               training and theatre projects
               in schools with a view to
               breaking the isolation. In
               Liberia, another country
               scarred by fourteen years of
               war, it was necessary to
               open a mental health
               programme. “The body
               cannot be well if the mind is
               ill, especially when you are
               dealing with children
               traumatised by war,” says
               Akemoh Maroe, a mental
               health worker. Boys have
               seen scenes where close
               relatives were killed; girls
               have been used as sex
               slaves… Today these young
               people are receiving
LAHCÈNE ABIB




               psychological treatment.
The Roma
Deep-rooted
discrimination
There are more than 2 million
Roma throughout the
European Union and they have
a history of great
discrimination against them
since their arrival in the 14th
and 15th centuries. Is this
simple misunderstanding of
this population or is it racism?
In France, their life expectancy
is 15 to 20 times lower than
that of the French population
and their infant mortality rate is
5 times higher. Each year,
many families are expelled
from sites where they have
settled. Their illnesses are
related to poor living
conditions and to their lack of
access to healthcare in
France. The Association is
continuing its community




                                        JULIEN DE WECK
health work in sites, with a
particular focus on children
and mother-and-child health. It
deals with more than 3,000
people in France.



DRC
Rebuilding health
War, poverty, malnutrition and
lack of healthcare have
caused the death and
displacement of millions of
people in Democratic
Republic of Congo. Many
initiatives are being carried out
in the country to put the health
system back on its feet,
especially in North Katanga,
with a view to fighting AIDS. In
Goma, specialist
consultations, anonymous
and free screening and ARV
treatments are now available.




                                     / VOUS ÊTES ICI
In Kinshasa, a programme to
help reintegration has been
set up for street children.




                                        BRUNO FERT
                                                          30/31

                                     Mental Health
                                     Caring for
                                     invisible evils
                                     More than 400 million people
                                     across the world suffer from
                                     mental, neurological or
                                     psycho-social problems.
                                     These invisible evils have
                                     many causes: armed
                                     conflicts, political violence,
                                     forced displacements,
                                     exclusion from healthcare
                                     systems, etc. These complex
                                     situations do not make
                                     treatment easy, especially as
                                     these problems are often
                                     stigmatised. “Because of very
                                     strong cultural pressure,
                                     people are ashamed to talk
                                     about psychological
                                     illnesses,” says Emmanuel
                                     Dignonnet, co-ordinator of the
                                     mental health programme in
                                     the Palestinian Territories. In
                                     Nablus, living conditions have
VALÉRIE DUPONT




                                     deteriorated strongly. “The
                                     check points, the repeated
                                     incursions, the occupation
                                     and destruction of houses are
                                     all traumatic events.” In this
                                     sensitive area, teams have set
                                     up information campaigns,
                                     training and theatre projects
                                     in schools with a view to
                                     breaking the isolation. In
                                     Liberia, another country
                                     scarred by fourteen years of
                                     war, it was necessary to open
                                     a mental health programme.
                                     “The body cannot be well if
                                     the mind is ill, especially when
                                     you are dealing with children
                                     traumatised by war,” says
                                     Akemoh Maroe, a mental
                                     health worker. Boys have
                                     seen scenes where close
                                     relatives were killed; girls have
                                     been used as sex slaves…
                                     Today these young people are
                                     receiving psychological
                                     treatment.
SÉBASTIEN GEORGES




                    VALÉRIE DUPONT
Haiti
Escalation
of violence
“Like all human beings, we
are dreamers. He who stops
dreaming can sink into
violence,” says Professor
Toussaint, a Haitian
sociologist. Currently, the
country is seeing an
escalation of violence
politically and socially. That is
why, in Port-au-Prince in
particular, the Association is
treating victims of this
violence by providing them
with medical, psychological
and legal support, but also by
training local staff.

Angola
Street children
                                     / PHANIE




Since the end of the civil war,
                                      VÉRONIQUE BURGER




MdM has been providing
medical support to the
weakest populations in
Huambo province and in
Lobito. “It was becoming
urgent to open a programme
giving street children access to
hygiene and healthcare,”
explains Luc Jarrige, the
project co-ordinator. “The
beneficiaries, aged between 7
and 15, form a population who
has been totally forgotten by
the health authorities and the
main sponsors.” In Huambo
province, another programme
is aimed at children suffering
from malnutrition.

Népal
Fighting against
HIV
Nearly half the Nepalese
population lives below the
poverty line. This is the first of
a long list of alarming
indicators (life expectancy,
infant mortality, illiteracy). For
the past ten years, MdM has
                                      STÉPHANE LEHR




been running a programme
against STIs and HIV.




                                                         MdM
                                                              32/33

                                        Child Buddy Scheme
                                        Energy
                                        transfusion
                                        Since 1988, a project has
                                        been aimed at isolated
                                        children in hospitals in Paris
                                        and the surrounding area. It is
                                        run by volunteers who provide
                                        emotional support to these
                                        weakened children, who are
                                        separated from their families
                                        while they are hospitalised.
                                        “One day, a buddy noticed
                                        that a child would not answer
                                        to his first name,” recalls
                                        Catherine Peterman, the
                                        project co-ordinator. “A long
                                        telephone conversation with
                                        the parents made her realise
                                        that the first name on his
                                        passport that the hospital was
                                        using was not his usual name.
                                        The next day, the child's face
                                        finally lit up. This support is all




                       PASCAL DELOCHE
   PASCAL DELOCHE




                                        the more valuable as a nurse is
                                        not always available to do this
                                        job.” More than 1,500 children
                                        from foreign countries, the
                                        provinces or a DDASS (local
                                        health authority) have already
                                        benefited from it.
                                        Lead poisoning
                                        Illness of poverty
                                        Child lead poisoning is a little-
                                        known scourge. Yet, 150,000
                                        to 300,000 children are
                                        potentially exposed to this
                                        risk in France. This lead
                                        poisoning, caused by
                                        absorbing or inhaling paint
                                        dust in dilapidated or
                                        unhealthy housing, leads to
                                        disasters. It stunts a child's
                                        psychomotor development.
                                        Since 1993, there has been a
                                        specific project fighting
                                        against this disease by
/ L’OEIL PUBLIC




                                        finding and protecting these
                                        children.
   SOPHIE BRANDSTROM
,,   Colombia



     The war here cannot
     always be seen.
     However, there is definitely a guerrilla war
     going on between the FARC and the United
     Self-Defence Forces of Colombia (AUC).
     These armed groups carry out drugs
     trafficking on a large scale. One group claims
     to protect small coca producers against large
     capital, while others profit from this manna to
     build up their presence outside the urban
     areas they control. The population is not free
     to choose which side it supports. It just




                                                           MICHEL REDONDO
     submits! On top of selective executions there
     is repression from one side and assassination
     attempts and attacks on police stations by the
     other which leave the civilian population
     undefended and victims of this war most of
     the time. Security measures for the team are
     drastic: boats are clearly identified, flags fly
     over accommodation centres, and T-shirts
     and jackets with the Médecins du Monde
     dove emblem are worn at all times. Travel
     outside the villages or at nights is not allowed.


                                               ,,
     Logistical self-sufficiency is total. The danger is
     not seen, but it is felt and it is permanent.


     CHRISTIAN RAGGIOLI,
     Project Co-ordinator




                                                           MICHEL REDONDO
 >Atlas of international projects




35/118
 Les missions internationales
  Médecins du Monde’s




                                                                                                      Cuba      1
                                                                                                                           Haiti   1 3
                                                                Mexico   2   1

                                                                                 Guatemala 1                          Dominican Republic   1

                                                                                  El Salvador   1




                                                                                          Colombia
                                                                                            l         2 1




                                                                                                     Peru      1


                                                                                                                                               Brazil   1

         Emergency: a situation where people's lives                                                        Bolivia    1
         and livelihoods are in immediate danger
     x * Response: involvement through substitution.
         (natural disaster, armed conflict, etc.)


         Crisis: situation where people's basic needs are                                             Argentina        1
         not being met in the long term (civil war, forgotten
         conflict, HIV pandemic).
     x * Response: technical assistance and mobilisation
         of local resources.


          Development: support for meeting the needs or
          carrying out the policies expressed by local
     x * partners, community or administration in a
          situation where there are insufficient resources.
          Response: partenarship and transfer of skills.



* X: number of projects per country.
                                                                                                                                                                                                           36/37
                                                                                                                                                                                                           42/37
de Médecins du Monde
 international projects
                                                                                           Russia       1
                                                          Belarus         1
                                                                                                                                                    Mongolia       1

                                                                          Moldavia     1

                                                       Bulgaria   3           Turkey       2
                                                                                                    Chechnya            1
                                        Serbia     1

                                                                                                                             Afghanistan     2
                                        Kosovo 2                                                                                                                       China   1
                                                           Lebanon        1         orgia
                                                                                  Georgi        1

                                                             Egypt    1
           Morocco       1


                             Algeria      1                            Palestinian Territories          3                                  Nepal   1
        Burkina Faso     1
                                                                                                                            Pakistan   1 1
                                                                                                                                                                               Vietnam   2 1
                                 Mali    1 1                                                                                                           Burma 1
Equatorial Guinea    1
                                        Benin      1
                                                              Chad     1

                                                                                                    Ethiopia        1   1                                              Cambodia     1
                                                                  Sudan       1   1
           Liberia   1                                                                                                                       Sri Lanka    1    1
                                                                                               Uganda       1
Democratic Republic of Congo        4 1

           Ivory Coast       3
                                                                      Tanzania         3                                                                                                       Indonesia   4

                                  Angola       3




                                                                      Zimbabwe 1
                                                                                           Madagascar           4
Adoption
                                    In 2005 adoption work was carried out by 212 staff and volunteers at head office and
Countries of intervention
    and associated                  14 regional offices. As the leading authorised adoption body (OAA) in France and the
   countries in 2005                only OAA integrated in a medical NGO, the aims of Médecins du Monde's adoption proj-
         Albania
          Brazil                    ect are to affirm its humanitarian purpose by defending the most vulnerable people (chil-
        Bulgaria                    dren, the first victims of economic and environmental crises, insecurity or geopolitical
          China
                                    conflicts), to defend their fundamental rights (the right to a family to grow up in, access
        Colombia
         Russia                     to healthcare and the right to education), to find families for children who have not been
        Vietnam                     able to be adopted in their country of origin, and to facilitate the adoption of children
                                    with special needs (i.e. 119 children, that is to say 37.7% of the children adopted in
Co-ordinators                       2005).
> Project: M. Brugière, F. Giraud
> HQ: G. André-Trevennec

Sources of funding
> adopting families, MAI, MdM
                                    Families for children
Budget                              Activities: 1,634 letters received at head office, the files were     Outlook:
> 2005: 374,000 euros               examined during 30 commission meetings.                               Develop the distinctive
                                    459 applications were accepted, but the withdrawal rate,              features of the Médecins
                                    which runs at between 27 and 30%, must be taken into consid-          du Monde OAA: complex
                                    eration when giving provisional figures for 2006.                     adoptions and its
                                    Children who come to France through Médecins du Monde are             professionalism.
                                    monitored within their family for two years through 6 scheduled
                                    contacts. Some of these contacts with a report are requested by
                                    the countries of origin.
                                    • In 2005, 1,441 post-adoption home visits to families were car-
                                    ried out, i.e. a 35% increase.
                                    • 315 children were adopted by 281 families.
                                    • 27 children came from European countries (Russia, Bulgaria,
                                    Albania).
                                    • 222 children came from Asia (China, Vietnam).
                                    • 66 children came from Latin America (Colombia, Brazil).
                                    • Administrative problems with Eastern Europe and difficulties
                                    with Vietnam limited the number of children coming from those
                                    countries.
                                    In 2005, 3 major areas were worked on and implemented:
                                    • the overhaul and updating of administrative procedures: cre-
                                    ation of country reference systems and of performance indica-
                                    tors to monitor activities;
                                    • more in-service training and setting up of an integration day for
                                    adoption;
                                    • the development of complex adoptions:siblings, older children,
                                    children with specific medical needs.
                                                                                                                                                                                                     38/39
 Afghanistan
Attempts at normalisation and providing security are continuing in Afghanistan. A new phase
in the political reconstruction process was completed with the parliamentary elections held in
September 2005, but many challenges still remain. The issues involved in institutional and
socio-economic reconstruction are still a real challenge for both the Afghan authorities and the
international community. In addition, the donors' plan involved sub-contracting primary health-
care to NGOs for reconstructing the health system. After a study which highlighted that this
devalued and removed responsibility from Afghan medical staff, MdM decided not to take part
in this form of privatisation.




                                                                                                              Sources: Human Development Report 2005; MICS UNICEF
Ensuring women have access to healthcare                                                                                                                                 Mortality




                                                                                                              2003; The State of the World in 2006 (p. 238), “Securing
                                                                                                                                                                         > infant: 115‰
                                                                                                                                                                         > maternal: 1,600/100,000
Kaboul
                                                                                                                                                                         Life expectancy
Activities:      MdM supports 2 mother and child health cent-             Outlook:                                                                                       > at birth: years
res in Kabul. Two of the four centres opened in 1995 have already         Pass the remaining two                                                                         HDI
been transferred to another NGO (MSF Switzerland). There are 3            MCHs to a local NGO                                                                            > not known
parts to the programme:                                                   capable of maintaining




                                                                                                              Afghanistan's Future”
                                                                                                                                                                         Actual GDP/inhabitant ($)
• ensuring women have access to healthcare (medical consulta-             the level and quality of                                                                       > 206
tions in paediatrics, gynaecology and obstetrics, vaccination cam-        current services. In April                                                                     International delegation
paigns, basic health and hygiene education);                              2005, set up a pilot                                                                           > MdM Canada
• training local healthcare staff;                                        harm reduction project
o ensuring the renovation of health infrastructure and supplying drugs    amongst drug users in
                                                                                                                                                                         Beneficiaries
and equipment.                                                            Kabul. Organise an                                                                             > directly project 1: 36,000
Female doctors, nurses and midwives have been able to work unhin-         exploratory mental                                                                             > directly project 2: 415,000
dered since the Taliban left.                                             health project in Kabul in
Progress bar at 31/12/2005                                                June 2006.                                                                                     Staff
                                                                                                                                                                         > local project 1: 18
1995                                    2006                                                                                                                             > expatriate project 1: 2
                                                > Project
                                                  progress                                                                                                               > local project 2: 30
                                                                                                                                                                         > expatriate project 2: 2

Mother and child protection                                                                                                                                              Co-ordinators
                                                                                                                                                                         > project 1: G. Causse
Herat                                                                                                                                                                    > field 1: F. Maurin
                                                                                                                                                                         M. Otambekova
Activities:      MdM runs a mother and child health programme             Outlook:                                                                                       > project 2: G. Causse
in 3 clinics in the city of Herat around 4 areas of work:                 MdM's withdrawal process                                                                       > field 2: F. Maurin
• direct involvement with the population (consultations in paediatrics,   and the transfer to a local                                                                    M. Otambekova
gynaecology, obstetrics, general medicine, vaccination campaigns,         NGO (Coordination of                                                                           > HQ: N. Bréchet
basic health and hygiene education);                                      Humanitarian Assistance),                                                                      Sources of funding
• training local health staff (including women doctors, nurses and mid-   which will take over running                                                                   > project 1: MdM, Florindon
wives);                                                                   our 3 clinics in partnership with                                                              Foundation, Santa Devota, Isle of Man
• renovating health infrastructure and supplying drugs and equipment;     the Ministry of Health, have                                                                   Overseas Aid Committee
                                                                                                                                                                         > project 2: MdM, SDC and
• ongoing partnership with local health authorities.                      been agreed. 2005 thus mar-                                                                      Florindon Foundation
                                                                          ked the end of thirteen years of
Progress bar at 31/12/2005                                                MdM's providing primary and                                                                    Budget
1992                                 04/2006                              mother and child healthcare in                                                                 > 2005 project 1: 216,309 euros
                                                > Project \npro-
                                                  gress                   Herat.
                                                                                                                                                                         > 2005 project 2: 270,642 euros
Algeria
                                                                                  An unstable social environment, still very high unemployment and a lack of transparency in
                                                                                  the use of oil resources make Algeria a fragile country where there are many inequalities.
                                                                                  Despite the start of a programme aimed at containing the housing and infrastructure crisis
                                                                                  amongst other things, many Algerians continue to live in harsh conditions. Problems with
                                                                                  access to healthcare are real, especially for chronic diseases.
                                 Rapport sur le développement humain 2005, PNUD




Mortality
> infant: 35‰
                                                                                  Community health project
Life expectancy                                                                   Constantine (El Gamas district)
> at birth: 71.1

HDI
                                                                                  Activities: The project involves assistance for two local         Outlook:
> 0.722; ranked 103/177                                                           organisations: the Constantine local committee of the Social      The project is going to run for
                                                                                  Development Agency (ADS) and the El Gamas district                two years and will only require
PIB/habitant ($)                                                                  residents' association. After consulting the local population     follow-up work. This will allow
> 2,090                                                                           and health workers and after an epidemiology survey, the          us to focus our efforts in 3
                                                                                  demand that emerged was for asthma treatment, which had           directions:
                                                                                  been neglected for essentially economic reasons.                  • getting the health and politi-
Beneficiaries                                                                     The following happened in 2005:                                   cal authorities to take full
> directly: 1,200
> indirectly: 15,000                                                              • February 2005: an agreement was signed between MdM              charge of treating chronic
                                                                                  and the Algerian Republic's ADS in Constantine;                   asthma to ensure the work
Co-ordinators                                                                     • June 2005: training on asthma was given to two local            continues;
> project: R. Allemand                                                            committee doctors in Grenoble;                                    • asthma prevention and
> follow-up: DR Rhône-Alpes -
Grenoble                                                                          • a spirograph was supplied to the district polyclinic;           housing improvements in the
                                                                                  • two health educators worked amongst the population;             district;
Sources of funding>                                                               • a booklet explaining asthma was produced;                       • work with the Constantine
Grenoble city council,                                                            • basic drugs for chronic asthma were bought and sup-             health monitoring centre on
Isère department council, MdM,
concerts, dedicated gifts                                                         plied;                                                            harm prevention campaigns,
                                                                                  • swimming pool sessions for asthmatic children were orga-        campaigns against addiction
Budget                                                                            nised;                                                            to smoking and HIV/AIDS
> 2005: 36,446 euros                                                              • in October 2005, a seminar on community health was              prevention.
                                                                                  organised in Constantine.

                                                                                  Progress bar at 31/12/2005
                                                                                  02/2005                         12/2007
                                                                                                                            > Project
                                                                                                                              progress
                                                                                                                                                           40/41
  Argentina
The fragile recovery of the Argentinian economy should not let us forget that 38 million
Argentinians are considered poor and are often excluded from the welfare protection sys-
tem by the increase in moonlighting. The people have many demands in terms of health,
education and increased purchasing power. Rural populations are particularly concerned

             Argentine
by healthcare access problems.


Increasing access to care for women and                                                                                          Mortality
                                                                                                                                 > infant: 17‰
children




                                                                                           Human Development Report 2005, UNDP
                                                                                                                                 Life expectancy
                                                                                                                                 > at birth: 74.5
Abra Pampa, Puna Jujeña, Jujuy province
                                                                                                                                 HDI
Activities:     This project helps improve the rural        Outlook:                                                             > 0.863; ranked 34/177
population's access to healthcare through:                  MdM is particularly targe-
• mother and child treatment, protection and monitoring;    ting community health                                                PIB/habitant ($)
                                                                                                                                 > 3,524
• monitoring women to reduce cervical cancer and sexually   together with the indige-
transmitted infections;                                     nous NGO WARMI and is                                                International delegation
• strengthening health prevention and promotion.            continuing the project to                                            > MdM Argentina - local projects
Progress bar at 31/12/2005                                  build a new maternity
01/04/2003                 31/08/2006                       hospital at Abra Pampa.
                                        > Project
                                          progress                                                                               Beneficiaries
                                                                                                                                 > directly: women and children
                                                                                                                                 > indirectly: general population,
                                                                                                                                  health promoters and medical
                                                                                                                                  staff (in hospital and health
                                                                                                                                  centres)

                                                                                                                                 Staff
                                                                                                                                 > local : 5
                                                                                                                                 > expatriate: 1

                                                                                                                                 Co-ordinators
                                                                                                                                 > project: B. Koepcke
                                                                                                                                 > field: M. Idiart
                                                                                                                                 > HQ: F. Stea (MdM France)
                                                                                                                                 and R. Timpano (Buenos Aires)

                                                                                                                                 Sources of funding> UE, MdM
                                                                                                                                 Budget
                                                                                                                                 > 2005: 195,751 euros
Angola
                                                                                       The civil war which lasted twenty-seven years is making the democratic process a
                                                                                       delicate one, even if the signing of peace agreements and ending of hostilities have
                                                                                       led to better prospects for international assistance, especially that aimed at children.
                                                                                       52% of children show signs of malnutrition and the illiteracy rate (58%) is one of the
                                                                                       highest in Africa. The aftermath of war and drought, especially in Huambo province
                                                                                       and part of Bie province, are not helping to improve one of the most difficult situa-
Mortality                                                                              tions.
> infant: 154‰
                                     Rapport sur le développement humain 2005, PNUD.




Life expectancy
> at birth: 40.8
                                                                                       Treating moderate malnutrition
                                                                                       North, Huambo province (Mungo and Bailundo towns)
HDI
> 0.445; ranked 160/177                                                                Activities: As in 2004, the operation in Mungo involves:           Outlook:
                                                                                       • running, in conjunction with the WFP, a permanent                The outlook for 2006 is identi-
Actual GDP/inhabitant ($)                                                              supplementary feeding centre and two mobile centres                cal in part to that for 2005.
> 975
                                                                                       (providing curative care, vaccinations and nutritional support);   MdM is continuing to transfer
International delegation                                                               • supporting the town's primary healthcare structures (staff       specific renutrition structures
> MdM Espagne                                                                          management, supplying drugs, vaccinations and supplies).           to the Ministry of Health by
                                                                                       In Bailundo, the project focuses mainly on:                        integrating them with existing
                                                                                       • support for Bailundo Ministry of Health's permanent supple-      health structures. The monthly
Beneficiaries                                                                          mentary feeding centre;                                            assessment of activities with
> directly: 3,500                                                                      • staff training;                                                  the Mungo health structures
> indirectly: 20,000                                                                   • curative care.                                                   through the involvement of the
Staff                                                                                                                                                     mother and child health
> local : 30                                                                           Progress bar at 31/12/2005                                         (MCH) nurses from the
> expatriate: 4                                                                        06/2003                          12/2005                           Huambo province mother and
                                                                                                                                  > Project
                                                                                                                                    progress              child health programme will
Co-ordinators
> project L. Jarrige                                                                                                                                      also be included amongst the
> general co-ordinator: D. Chappaz                                                                                                                        activities for 2006.
> HQ: O. Mouzay

Sources of funding> FSD, MdM
Budget
> 2005: included in the mother and
 child health project budget (see
 opposite).
                                                                                                                                   42/43




Mother and child health                                                                                    Beneficiaries
                                                                                                           > directly: 80,000
North, Huambo province (Mungo and Bailundo towns)                                                          > indirectly: 325,000
Activities: We are continuing to develop the current integrated          Outlook:                          Staff
mother and child health (MCH) programme in partnership with              Continue to gradually increase    > local : 15
the local network of traditional midwives and MCH nurses within the      the quality of peripheral         > expatriate: 6
peripheral health structures of the north of the province and in the     actions and ensure their long-
                                                                                                           Co-ordinators
referral hospital at Bailundo. 2005 has seen the continuation of these   term continuity. Training and     > project: L. Jarrige
activities set up by MdM when the project started:                       support of Angolan medical        > general coordinator: D. Chappaz
• monitoring the network of MCH nurses supervising all the tradi-        staff remain important aspects    > HQ: O. Mouzay
tional midwives;                                                         which will allow them, in the
                                                                                                           Sources of funding
• supervision of paediatric consultations and the vaccination pro-       longer term, to move towards      > FSD, German Foreign Ministry
gramme;                                                                  efficient autonomy.
• training in prevention and treatment of the main STIs;                                                   Budget
• family planning;                                                                                         > 2005: 379,772 euros
• structural support and recycling of staff from the maternity unit to
the Bailundo referral hospital;
• renovation of an operating theatre, training a theatre medical team,
training doctors in emergency surgery techniques.

Progress bar at 31/12/2005
01/12/2003                       31/12/2006
                                               > Project
                                                 progress



Care for street children                                                                                   Beneficiaries
Lobito town, Benguela province                                                                             > directly: 65,000
                                                                                                           > indirectly: 2,000
Activities: To increase the efficiency of the care given to              Outlook:
street children and their access to it, MdM is continuing its acti-      Continue the process of           Staff
                                                                                                           > local : 10
vities which include:                                                    complete autonomy for the         > expatriate: 1
• building, equipping and supplying a health centre with drugs in        health centre, and best
conjunction with the local authorities;                                  management of all health          Co-ordinators
• agreements have been made with local hospitals to deal with            care for street children at the   > project: L. Jarrige
                                                                                                           > general coordinator: D. Chappaz
more serious diseases, with the objective of letting street child-       health centre or in the hospi-    > HQ: O. Mouzay
ren access the Angolan health system by themselves;                      tals.
• six street educators are responsible for making a list of all the                                        Source of funding
street children, making contacts with their living places and car-                                         > UBS
rying out surveys in order to plan joint activities with partners wor-                                     Budget
king more specifically in the education and professional training                                          > 2005: 124,196 euros
of street children. The possibility of envisaging a process of family
reintegration has to be assessed with each child.


Progress bar at 31/12/2005
06/2004                             12/2006
                                               > Project \npro-
                                                 gress
Benin
                                                                             Benin is one of the eighteen poorest countries which benefited from the debt cancel-
                                                                             lation agreed by the G8 countries in 2005. Benin's economy continues to struggle.
                                                                             The cotton sector (the country's main resource) is in deficit. We are seeing the sad
                                                                             growth of the HIV/AIDS epidemic. 68,000 people, including 5,700 children, are now
                                                                             living with the infection. 34,000 children are orphans.


Mortality
> infant: 91‰
                                                                             Dealing with the HIV/AIDS epidemic
                                       Human Development Report 2005, UNDP




                                                                             Ouidah and Come
Life expectancy
> at birth: 54.0                                                             Activities: Activities aim to respond to the AIDS epidemic         Outlook:
HDI                                                                          in Benin's particularly affected cities. We are continuing our     In January 2006, the staff trai-
> 0.431; ranked 162/177                                                      preventive measures in the fight against HIV/AIDS through          ning programme ended, the
                                                                             education and raising awareness (amongst women in parti-           renovation is nearly complete,
Actual GDP/inhabitant ($)                                                    cular) and support for those who are ill, with our local partner   and the first patients being
> 517
                                                                             Africare, who is skilled in involving the community. We are        treated with ARVs will be
                                                                             continuing our voluntary, anonymous and free screening acti-       included in the active file.
                                                                             vities and treatment of AIDS patients. To do this, MdM is trai-
Beneficiaries> directly: 600                                                 ning Beninois staff and renovating health centres to increase
                                                                             local capacity so that we can move towards Beninois staff gai-
Staff                                                                        ning autonomy
> local: 5
> expatriate: 3
 (1 medical co-ordinator)                                                    Progress bar at 31/12/2005
                                                                             01/2005                       31/12/2006
Co-ordinators
> project: P. Beze Beyrie
                                                                                                                        > Project
                                                                                                                          progress

> HQ: A. Belaïd

Sources of funding
> Paris city council, French Foreign
 Ministry, Dutch Foreign Ministry

Budget
> 2005: 366,157 euros
                                                                                                                                                                    44/45
 Byelorussia
Alexander Lukashenko's regime is becoming increasingly harsh: personal liberties are
restricted and the structural reforms needed have not been carried out. In addition,
the health consequences of the Chernobyl nuclear disaster have been rationalised by
the government whereas the number of cancers and other congenital deformities due
to radiation continues to increase. The people living in the area at risk have not been
evacuated. On top of that, as the soil affected by radioactivity is still being cultivated,
the people are subject to chronic contamination through the food grown there.
                                                                                                                                          Mortality
                                                                                                                                          > infant: 13‰




                                                                                                    Human Development Report 2005, UNDP
                                                                                                                                          Life expectancy
                                                                                                                                          > at birth: 68.1
Preventing radioactive contamination                                                                                                      HDI
Chechersk district                                                                                                                        > 0.786; ranked 67/177

Activities: MdM's work is aimed at improving the health            Outlook:                                                               Actual GDP/inhabitant ($)
                                                                                                                                          > 1,770
of women and children living in areas with radioactive             The people are beginning to
contamination. The CORE (Cooperation for Rehabilitation)           take responsibility for them-
programme, in which the European Union is taking part, has         selves and exchanges have
                                                                                                                                          Beneficiaries
been set up with the aim of improving the living conditions of     led to noticeable changes in                                           > directly: 2,800 children between
those living in the contaminated districts. This project has       risky eating habits. This pro-                                         3 and 15 years old and 400 pregnant
been set up by three partners (IRSN, ACRO and Médecins             gramme should lead to fur-                                             women and new-borns
du Monde) and is coordinated by Médecins du Monde. It              ther improvements in this                                              > indirectly: local health
                                                                                                                                          professionals, the whole population
focuses on three areas:                                            area.                                                                  of the district
• carrying out a health assessment of 2,800 children in
Chechersk district in partnership with the Institute for Nuclear                                                                          Staff
Radioprotection and Safety (IRSN);                                                                                                        > local: 1 half-time co-ordinator
• improving radiological quality, in partnership with ACRO                                                                                Co-ordinators
(Association for Controlling Radioactivity in the West), and                                                                              > project: M. Costa,
raising awareness about the risks of contamination through                                                                                 C. Georgescauld (RT)
radioactivity;                                                                                                                            > field: T. Gloukhova
                                                                                                                                          > HQ: A. Landaes
• maternal care, actions for and with women (supply of food
supplements, raising awareness of the risk of complications                                                                               Sources of funding
during pregnancy, etc.).                                                                                                                  > Tacis (EU), IRSN, DGSNR, MdM

                                                                                                                                          Budget
Progress bar at 31/12/2005                                                                                                                > 2005: 10,221 euros
13/08/2005                    12/08/2007
                                           > Project
                                             progress
Bolivia
                                                                         The still poverty-stricken Andean regions have welcomed the coming to power of
                                                                         the Movement towards Socialism led by Evo Morales, the first indigenous presi-
                                                                         dent of Bolivia. As well as agrarian reform and the redistribution of natural resour-
                                                                         ces, child labour is an important area of work in a country which is one of the poo-
                                                                         rest on the continent.


Mortality
> infant: 53‰
                                   Human Development Report 2005, UNDP




Life expectancy
> at birth: 64.1

HDI                                                                      Protecting the health of children at work
> 0.687; ranked 113/177
                                                                         Potosí, San Cristobal district
Actual GDP/inhabitant ($)                                                Activities: Since 2002, MdM has been working in Potosi,             Outlook:
> 892
                                                                         a mining town in the Andean cordillera, to ensure children          The long-term future of the
International delegation                                                 receive access to healthcare and to prevent work-related risks.     project after MdM leaves is
> MdM Spain                                                              Several activities are being carried out:                           the team's major concern.
                                                                         • health education: workshops for child workers and nur-            It involves working in part-
                                                                         sery teachers in San Cristobal district;                            nership, which will be a
Beneficiaries                                                            • access to healthcare structures: material support and             major issue in 2006: the trai-
> directly: 1,100                                                        raising awareness of staff concerning traditional medicine;         ning of college teachers to
> indirectly: 9,000                                                      • accidents in the mines: training on emergency care and            run health education works-
Staff                                                                    treating the injured;                                               hops, partnership with the
> local: 5                                                               • depression amongst adolescents: creating a support                town council for the work
> expatriate: 0                                                          structure for adolescents facing problems;                          with young people, partners-
                                                                         • young children at work: raising awareness amongst insti-          hip with health structures to
Co-ordinators
> project: L. Liron, D. Masson                                           tutions and the population of the consequences on 6-8 year          replenish first aid kits, and
> field: I. Tapia                                                        olds of working.                                                    partnership with an Italian
> follow-up: DR Rhône-Alpes                                                                                                                  NGO on the mine safety
 Bourgogne (S. Bret)                                                     Lastly, in partnership with a Lyons-based organisation, MdM         project, etc.
Sources of funding                                                       is supporting a group of local young people with its projects.
> private partnerships, towns in                                         In the long term, the aim is to create a youth centre-type struc-
 Rhône-Alpes, MdM                                                        ture which would offer recreational activities as alternatives to
                                                                         child work.
Budget
> 2005: 25,309 euros
                                                                         Progress bar at 31/12/2005
                                                                         2002                              12/2007
                                                                                                                     > Project progress
                                                                                                                                                                      46/47
 Brazil
The corruption scandals which have shaken the government of president Luiz Inácio
Lula da Silva have delayed the completion of the major reforms intended, amongst
other things, to redistribute cultivable land for the benefit of “landless” rural commu-
nity. Despite the efforts made as part of the “Bourse Famille” (Family Purse) pro-
gramme, the Nordeste continues to be a particularly disadvantaged and sensitive
region in health terms.

                                                                                                                                            Mortality




                                                                                                      Human Development Report 2005, UNDP
                                                                                                                                            > infant: 33‰
Training healthcare workers                                                                                                                 Life expectancy
                                                                                                                                            > at birth: 70,5
Ceará State
                                                                                                                                            HDI
Activities: The programme is run amongst the landless              Outlook:                                                                 > 0.792; ranked 63/177
community in the rural districts of Tururu, Itapipoca,
                                                                   Our local partner, the                                                   GDP/inhabitant ($)
Amontada, Trairi and Itarema in Ceará state in order to reduce
                                                                   Landless Workers'                                                        > 2,788
the morbidity and mortality rates for the most common
                                                                   Movement (MST) will conti-
illnesses encountered in this population. As well as training
                                                                   nue its activities in the follo-
healthcare workers, the whole population of the area has been
                                                                   wing areas:
given health, hygiene and prevention awareness training and                                                                                 Beneficiaries
                                                                   • encouraging the integra-                                               > directly: 5,000
education and, alongside, has benefited from consultations. In
                                                                   tion of the CHWs into the
addition, the recognition of the landless community by the local                                                                            Staff
                                                                   local health services;
health structures has improved.
                                                                   o allowing the 4 CHW trai-                                               > local: 3
Through this work, MdM has concluded a cycle of projects                                                                                    > expatriate: 1
                                                                   ners to continue training
aimed at improving overall health in the communities under-
                                                                   • HWs in other rural com-                                                Co-ordinators
going agrarian reform, by training community health workers                                                                                 > project: J. Achouline, J. Guerrini
                                                                   munities with MST in Ceará
(CHWs), the main people involved in prevention in the isolated
                                                                   state and nationally;                                                    > field: G. Sekhniashvili
rural communities of Ceará.                                                                                                                 > HQ: M.-Y. de Penanster-Rosny, Y.
                                                                   • developing a series of                                                  Le Corgne
Progress bar at 31/12/2005                                         seminars on health, with the
12/2004                          12/2005                                                                                                    Sources of funding
                                           > Project
                                             progress
                                                                   trained trainers, under the
                                                                   supervision of two Brazilian                                             > Aquitaine regional council,
                                                                                                                                             miscellaneous gifts, MdM
                                                                   MST doctors, trained in
                                                                   Cuba.                                                                    Budget
                                                                                                                                            > 2005: 144,201 euros
Bulgaria
                                                                           The economic situation in Bulgaria is improving gradually with the arrival of the new
                                                                           government led by Sergei Stanichev but social inequalities persist: out of a total popula-
                                                                           tion of 8 million, 1.1 million Bulgarians are living below the poverty line. The health situa-
                                                                           tion is precarious, and life in the specialist institutions (institutions for disabled people,
                                                                           orphanages and prisons) is particularly difficult. In addition, the Roma community's situa-
                                                                           tion is still worrying and Bulgaria's EU membership may well be delayed if efforts are not

Mortality
                                                                           made in this area.
> infant: 14‰
                                     Human Development Report 2005, UNDP




Life expectancy
> at birth: 72.2                                                           Mother and child protection
HDI                                                                        Roma district of Nadezhda, in Sliven
> 0.808; ranked 55/177
                                                                           Activities: The programme has been set up in a former                Outlook:
GDP/inhabitant ($)                                                         ghetto, now a Roma district, where around 20,000 people              Bearing in mind the size of
> 2,539                                                                    live. The population's sanitary conditions are deplorable (almost    the problem this population
                                                                           complete lack of water, sewerage and electricity in the dis-         faces, the programme is
                                                                           trict). The Roma are victims of segregation and have a much          becoming national in 2006,
Beneficiaries                                                              higher unemployment and illiteracy rate than the Bulgarian           and will be supported by the
> directly: Roma mothers                                                   average.                                                             Eastern Europe desk.
and children
> indirectly: Roma families                                                A Mother and Child Health clinic has been set up by                  International funding will be
                                                                           MdM's regional delegation in Corsica. It bears the name of           sought to provide the clinic
Staff                                                                      Dr Edouard Delahayes, the project co-ordinator who died in           with resources more appro-
> local: 4                                                                 a road accident on the way to Bulgaria. The team is made             priate to the situation: increa-
> expatriate: 1
                                                                           up of an expatriate co-ordinator and Bulgarian staff: a pae-         sing the strength of the
Co-ordinators                                                              diatrician, midwife, nurse and social worker.                        team, sending an expatriate
> project: P. Contois                                                      Mother and child consultations are organised to pick up              medical co-ordinator for 18
> field: L. Lamarque                                                       pregnancies at risk and childhood diseases, and to refer             to 24 months, seeking pre-
(until end of 2005)
> follow-up: MIR RD Corsica                                                patients needing it to the general Bulgarian health service.         mises where child vaccina-
(until end of 2005,                                                        Health information and training sessions are organised for           tion campaigns can be orga-
then national project)                                                     mothers and children and, in particular, a school for mothers        nised by local doctors, orga-
                                                                           has been developed. A public health survey was carried out           nising training and co-ordina-
Sources of funding
> collectivité régionale de Corse,                                         in the poorest part of the district, known as the “district of the   tion meetings, setting up a
 MdM                                                                       naked”, to pick up the weakest people and support them.              pre-hospitalisation hygiene
                                                                           Progress bar at 31/12/2005                                           centre, etc.
Budget
> 2005: 78,089 euros                                                       03/2004                              12/2009
                                                                                                                           > Project
                                                                                                                             progress
                                                                                                                                48/49




Help for children                                                                                      Staff
Sofia                                                                                                  > local: part-time secretary

Activities: MdM 's activities have two aspects:                                                        Co-ordinators
• contact with Bulgarian institutions and NGOs which                                                   > project: F. Parrot
                                                                                                       > follow-up: DR Aquitaine
are involved with children, to distribute information on our
programme.                                                                                             Source de financement
• support for the work of the “Child and his symp-                                                     > MdM
toms” project. MdM supports the “Development for
                                                                                                       Budget
Children and Families” Foundation which funds the 6 trai-                                              > 2005: 12,763 euros
ning modules for paediatric institutions' staff. After selec-
ting the institutions to receive this training, the Foundation
provides help in organising the modules. The lectures and
case studies examined during the different modules are
then published for each year of training in French and in
Bulgarian.
Progress bar at 31/12/2005
03/2004                            12/2009
                                             > Project
                                               progress




Training staff from                                                                                    Beneficiaries
                                                                                                       > directly: 150 professionals
paediatric institutions                                                                                > indirectly: 396 education or day
                                                                                                       centre specialists,
                                                                                                       360 families and 1,220 children
Throughout the country (+ training in Sofia)
                                                                                                       Staff
Activities: The “Child and his symptoms” project is run in            Outlook:                         > local: projects co-ordinator
two ways:                                                             In four and a half years, the    1/2 FTE, secretary 1/4 FTE
• each year six training modules are organised in Sofia for staff     staff of most of the institu-
from 8 institutions and 4 centres for disabled children. They are     tions for disabled children in   Co-ordinators
                                                                                                       > project: F. Parrot
given jointly by French volunteer trainers from the CIEN (Centre      Bulgaria will be trained.        > follow-up: DR Aquitaine
interdisciplinaire de l'enfant) who are paediatric psychiatrists or
psychologists, and by members of the Belgian charity “Enfant                                           Sources of funding
et Espace” (Child and Space). This training is followed up and                                         > Aquitaine regional council, mis-
                                                                                                        cellaneous gifts
evaluated by a specific written programme and implemented by
the Social Activities and Practice Institute in Sofia;                                                 Budget
• two visits per year are made to the institutions and cen-                                            > 2005: 13,806 euros
tres, by “supporters” appointed by the Bulgarian project co-
ordinator. They organise team meetings to prepare the modules
together with them. These visits provide specific training for the
whole staff of each institution.

Progress bar at 31/12/2005
01/01/2005                      30/06/2009
                                             > Project
                                               progress
Burkina Faso
                                                                         Even though it has become the leading cotton producer in Africa for the first time, the
                                                                         country, led by the same man for eighteen years (re-elected in November 2005), remains
                                                                         very poor. As well as a disappointing economic assessment, the health situation is dis-
                                                                         astrous. Mothers' poor knowledge of how to monitor children (partial or total lack of
                                                                         knowledge of childhood illnesses and the hygiene measures to avoid them), together
                                                                         with difficult access to health centres, is behind the high infant mortality rate in this
                                                                         country.
                                   Human Development Report 2005, UNDP




Mortality                                                                It should also be noted that the spread of HIV at all social levels, and the absence of
> infant: 107‰
                                                                         prevention and screening make an already worrying situation even worse.
Life expectancy
> at birth: 47,5

HDI
> 0.317; ranked 175/177
                                                                         Access to oral
GDP/inhabitant ($)                                                       healthcare programme
> 345
                                                                         Diébougou (Sud-Ouest)
                                                                         Activities: Having realised that no-one was providing        Outlook:
Beneficiaries                                                            oral healthcare in the region, MdM set up several activi-
> directly: 60,000                                                                                                                    Run the dental surgery and
> indirectly: 180,000                                                    ties. These include:
                                                                                                                                      continue to train the medical
 (the whole of the province)                                             • setting up a dental surgery (refurbishing the
                                                                                                                                      staff. A dentist began work
                                                                         premises);
Staff                                                                                                                                 in the dental surgery in
                                                                         • staff training (training a dentist at the university);
> local: 1 (dentist in training)                                                                                                      March 2006 while waiting for
                                                                         • developing an oral ailments prevention programme
                                                                                                                                      a second dentist to comple-
Co-ordinators                                                            in schools and villages in Diebougou province with the
                                                                                                                                      te his training.
> project: F. Ben Soussan                                                aim of improving the oral health of the population of this
> field: Abbé Séverin Dabbiré                                            region.
> HQ: P. De Botton
> follow-up: DR PACA (M. Semat)
                                                                         Progress bar at 31/12/2005
Sources of funding                                                       2005                             2007
> MdM and private partners                                                                                       > Project
                                                                                                                   progress

Budget
> 2005: 1,116 euros
                                                                                                                                                                       50/51
 Burma
Burma is going through a major socio-economic crisis and the government has redu-
ced health spending to a minimum (0.4% of GDP). However, HIV is ravaging a coun-
try where prostitution and the use of injectable drugs are very widespread: more than
680,000 may be carrying the virus. The criminalisation of drug users and prostitutes
makes MdM's work more difficult. In addition, the withdrawal of the Global Fund
(which had undertaken to pay 98 million dollars over five years) is making the current
situation worse. Today, the HIV prevalence rate is up to 43% amongst prostitutes and




                                                                                                       Human Development Report 2005, UNDP
                                                                                                                                             Mortality
to 90% amongst drug users.                                                                                                                   > infant: 76‰

                                                                                                                                             Life expectancy
                                                                                                                                             > at birth: 60.2
Preventing HIV transmission
                                                                                                                                             HDI
Myitkyina (Kachin) and Yangon                                                                                                                > 0.578; ranked 129/177
Activities: MdM's work is focused on preventing HIV and               Outlook:                                                               Actual GDP/inhabitant ($)
STI transmission in Myitkyina and Yangon in order to reduce           MdM hopes to continue                                                  > not known
HIV/AIDS and STI transmission in the population and amongst           administering ARVs to pro-
people at risk - prostitutes and intravenous drugs users - and to     stitutes in Yangon and to
offer access to healthcare and treatment of opportunistic infec-      start methadone substitution                                           Beneficiaries
tions.                                                                in Kachin state. We must                                               > directly: 9,000
Its work is concentrated amongst prostitutes (HIV/AIDS pre-           also strengthen links with the                                         > indirectly: 50,000
vention sessions, free treatment of STIs and OIs, workshops in        vulnerable groups, and
                                                                                                                                             Staff
drop-in centres and condom distribution) and drug addicts (pro-       continue to gather testimo-                                            > local: 100
motion of harm reduction methods in shooting galleries, needle        nies.                                                                  > expatriate: 6
distribution and prevention/ education sessions in drop-in cen-
tres).                                                                                                                                       Co-ordinators
                                                                                                                                             > project: F. Sivignon
In addition, MdM is continuing its welfare support and AIDS edu-                                                                             > field: A. de Suremain
cation/prevention activities in prisons, where prostitutes and drug                                                                          > HQ: V. Pardessus
addicts can often be found in a country where the law is very
repressive against these groups of people. ARVs began to be                                                                                  Sources of funding
                                                                                                                                             > MdM, Novib, UNODC/UE,
administered in Yangon in May 2005. At the end of December,                                                                                   PSI/Usaid
43 prostitutes were receiving treatment.
                                                                                                                                             Budget
Progress bar at 31/12/2005                                                                                                                   > 2005: 577,703 euros
01/01/2002                      30/06/2010
                                             > Project
                                               progress
Cambodia
                                                                           With growth of 6.3%, Cambodia's economic situation has gradually been improving
                                                                           since the end of the civil war. But the AIDS endemic is widespread and the govern-
                                                                           ment has made it a public health priority. The HIV prevalence rate in Cambodia (2%)
                                                                           is the highest in the region. International tourism, internal migration, poverty, human
                                                                           trafficking and prostitution are all factors propagating HIV/AIDS in the country.


Mortality
> infant: 97‰
                                                                           Priority to HIV
                                     Human Development Report 2005, UNDP




Life expectancy
> at birth: 56.2                                                           Phnom Penh
HDI                                                                        Activities: MdM's project is aimed at reducing the                      Outlook:
> 0.571; ranked 130/177                                                    transmission of STIs/HIV and caring for infected patients,              Between now and December
                                                                           offering medical and welfare support to destitute patients suf-         2006, 2,000 patients will be
GDP/inhabitant ($)                                                         fering from HIV, raising the population's awareness and trai-           regularly monitored in the
> 315
                                                                           ning medical staff.                                                     consultation centre. 521 of
                                                                           In 2005, the project focused on:                                        them will receive ARVs.
Beneficiaries                                                              • specialist consultations for the treatment of patients suffe-         A joint venture with
> directly: 120,000                                                        ring from AIDS (OIs and ARVs);                                          Pharmaciens Sans Frontières
> indirectly: 400,000                                                      • training doctors (ARVs and OIs);                                      should enable us to provide
                                                                           • informing patients about the illness and the available treat-         450 additional people with
Staff
> local: 59                                                                ment and services;                                                      access to ARVs.
> expatriate: 4                                                            • hospital treatment of opportunistic infections;
                                                                           • developing a continuum of care, assistance and support
Co-ordinators                                                              networks for people living with HIV/AIDS;
> project: E. Peterman
> field: P.-R. Martin                                                      • supporting Cambodian NGOs set up by people who are
> HQ: V. Pardessus                                                         HIV-positive.
                                                                           The aim of treating opportunistic infections and providing
Sources of funding                                                         access to ARVs is to reduce the morbidity and mortality rates
> projet : Global Fund, Elton John
Aids Foundation, MdM
                                                                           linked to AIDS, and thus to provide patients with a better qua-
                                                                           lity of life. That is, an active social life for a longer time, figh-
Budget                                                                     ting against exclusion, and reducing the economic impact (on
> 2005: 596,389 euros                                                      family and society) of the illness.
                                                                           Progress bar at 31/12/2005
                                                                           01/04/1999                       30/08/2010
                                                                                                                          > Project
                                                                                                                            progress
                                                                                                                                                                    52/53
 Chad
In this country where the local economy remains extremely dependent on external aid,
poverty has reached unsuspected levels. Even if the gross domestic product remains
one of the highest in the continent, the government is no longer managing to pay the
backlog of salaries or retirement pensions. The prevalence of certain diseases such
as malaria is not just due to lack of healthcare infrastructure but also to lack of hygie-
ne and the permanent consumption of contaminated products, two risks to which
children are the most exposed (5,000 abandoned young people survive in the middle
                                                                                                                                          Mortality
of effluents). The political instability persists and, in the east of the country, the mas-                                               > infant: 117‰




                                                                                                    Human Development Report 2005, UNDP
sive influx of Sudanese refugees is adding to the insecurity.
                                                                                                                                          Life expectancy
                                                                                                                                          > at birth: 43.6

Primary health for street children                                                                                                        HDI
                                                                                                                                          > 0.341; ranked 173/177
N’Djamena                                                                                                                                 Actual GDP/inhabitant ($)
                                                                                                                                          > 304
Activities: Medical treatment of wounds and traumas               Outlook:
suffered by children living in precarious situations and          MdM will support ITS (eva-
picked up in the street. MdM's project has allowed welfare        luation, help with running the
                                                                                                                                          Beneficiaries
workers to be trained and children to be educated in health       circuit) and will help find new                                         > directly: 5,000 children including
and hygiene matters:                                              sponsors for 2007.                                                       30 leaders
• 64 workers from 20 local structures have been trained;          The project is due to end in                                            > indirectly: 30 social workers and
• 2,800 children have attended educational sessions;              November 2006.                                                           20 health workers
• a suitable teaching tool has been produced by MdM and                                                                                   Staff
made available to local structures.                                                                                                       > local: 5
In 2005, a medical and welfare support circuit, based on a                                                                                > expatriate: 1
third-party paying system relying on local sponsors, was set
                                                                                                                                          Co-ordinators
up on a permanent basis. It has provided access to primary                                                                                > project: P. Estecahandy,
healthcare for more than 3,000 children, especially affected                                                                               J. Boncompain
by violence.                                                                                                                              > field: R. Lange
In partnership with UNICEF Chad, training and prevention work                                                                             > follow-up: DR Midi-Pyrénées
involving 40 peers has reduced the incidence of HIV/AIDS                                                                                  Sources of funding
amongst young people living on the street.                                                                                                > MdM, FSD, private regional and
MdM is withdrawing at the end of 2005 and will ensure the                                                                                  local partners (in N'Djamena,
continuity of the programme through an agreement signed                                                                                   and Midi-Pyrénées)
with a hand-over structure, the ITS (Institut Tropical Suisse).                                                                           Budget
Progress bar at 31/12/2005                                                                                                                > 2005: 123,483 euros
01/12/2001                       12/2005
                                           > Project
                                             progress
Chechnya
                                  2005 was a particularly violent year for Chechnya: repression against civilians remains
                                  a daily occurrence, and this is in the name of Russia's fight against terrorism. In
                                  response to that, several assassination attempts were carried out by Chechen guer-
                                  rillas. The population lives in fear and poverty, hospitals are obsolete and many people
                                  still do not have access to primary healthcare.


Mortality
Life expectancy
HDI
Actual GDP/inhabitant ($)
                                  Supporting victims of conflict
International delegation          Grozny, Gudermes, Urus-Martan, Argun, Kurchaloy
> no data specific to Chechnya    Nozhay-Iurt and Vedeno Districts
                                  Activities: In 1999, for security reasons, MdM had to adopt          Outlook:
                                  a “remote control” system for the project from its Moscow base.      In 2006 we plan to extend
Beneficiaries                     MdM's work is focused on improving surgical care, primary            PHC activities into Vedeno
> directly: general population:   and secondary healthcare and setting up mental health                district, as well as to set up
85,592 from February to October   assistance. More specifically, our work involves:                    a psychology consultation
2005                              • co-ordinating and supplying 7 hospitals in Chechnya's main         surgery in a Grozny polycli-
Staff                             cities (medical and surgical equipment);                             nic from January 2006. In
> local: 14                       • co-ordinating and supplying 3 rural hospitals with essential       addition, MdM is compiling a
> expatriate: 2                   drugs and medical consumables;                                       publication, Chechen Words,
                                  • supplying 11 medical and obstetrics centres with essential         a collection of testimonies of
Co-ordinators
> project 1: J. Dato              drugs and medical consumables;                                       Chechens' lives since the
> field 1: P. Baril               • mental health awareness and training of medical staff in Grozny.   beginning of the war. At the
> HQ: A. Landaes                                                                                       end of 2005, we also ope-
                                  Progress bar at 31/12/2005                                           ned a similar programme in
Source of funding                 1995
> ECHO                                                                                                 Daghestan (Khassaviourt
                                                                               > Project
                                                                                 progress              district).
Budget
> 2005: 971,912 euros
                                                                                                                                                                            54/55
 China
China is seeing strong economic growth, but there is still a lot of social inequality in the
country, and 2005 saw many protest movements: living conditions in rural areas are very
precarious. In addition, more than a million Chinese may be affected by the AIDS virus
which is spreading quickly across the country. The stigmatisation and discrimination
suffered by people living with HIV, along with a lack of awareness about the epidemic
are the two main obstacles to the fight against AIDS. Drug users, who are particularly
affected by AIDS and hepatitis C, are the subject of a policy of repression, and harm
                                                                                                                                               Mortality
reduction is still very under-developed in the country.                                                                                        > infant: 32/43‰
                                                                                                                                               (male/female)




                                                                                                         Human Development Report 2005, UNDP
                                                                                                                                               Life expectancy
                                                                                                                                               > 70.0/73.0 (male/female)
Preventing the HIV/AIDS epidemic                                                                                                               HDI
                                                                                                                                               > 0.755; ranked 85/177
and reducing risks amongst drug users                                                                                                          GDP/inhabitant ($)
Chengdu (Sichuan)                                                                                                                              > 1,100

Activities: The project began at the end of 2002 in partner-         Outlook:
ship with the Centre of Disease Control (CDC) in Chengdu. The        The current political context is
                                                                                                                                               Beneficiaries
first phase saw the implementation in three voluntary detox cen-     favourable to setting up pilot                                            > directly: 500 (phase 1),
tres of awareness, information and education activities              projects for caring for drug                                              1,500 (phase 2) new project
on preventing HIV/AIDS and hepatitis C and on harm                   addicts (the first trials with                                            > indirectly: 30,000
reduction aimed at drug users and centre staff, but also at the      needle exchanges and metha-
                                                                                                                                               Staff
medical, administrative and political authorities. The new pro-      done treatment have been                                                  > local: 1
ject, started at the beginning of November 2005, plans to open       authorised).                                                              > expatriate: 2
three drop-in centres gradually in different districts. Each         Plans for 2006:
will welcome users and provide information, basic hygiene ser-       • setting up 2 drop-in centres                                            Co-ordinators
                                                                                                                                               > project: B. Luminet, R. Baglioni
vices and a needle exchange programme (in the centre and on          in identified districts to give                                           > field: D. Chamla puis
the street with peers). At the same time, awareness, informa-        drug users access to informa-                                              C. Montigny, N. Rennes
tion, prevention and education activities will be carried out        tion and prevention of the diffe-                                         > HQ: V. Pardessus, E. Martinon
amongst staff, drop-in centre volunteers and the medical, admi-      rent means of transmitting
                                                                                                                                               Source of funding
nistrative and political authorities. These activities should mean   HIV/AIDS and hepatitis C;                                                 > MdM
that a network focused on harm reduction amongst drug users          • setting up street work by
can be set up in the districts concerned, and that the people        identifying peers;                                                        Budget
and the authorities will start to have a different image of users    • training medical staff, volun-                                          > 2005: 79,936 euros
in their minds.                                                      teers and providing information
                                                                     to the public security forces of
Progress bar at 31/12/2005                                           the districts concerned to
01/12/2002                     31/12/2008                            ensure the work can continue.
                                             > Project
                                               progress
Colombia
                                                                           The FARC and the paramilitary organisations maintain solid support in the provinces,
                                                                           although internal security is the primary concern of Alvaro Uribe's government. At the
                                                                           heart of the war zones, the civilian populations are often the first to suffer from chan-
                                                                           ges in the balance of power and are subject to the full force of the violence as well as
                                                                           its social and economic repercussions. In this context, uncertainty and inequalities
                                                                           have a strong hold, especially with respect to access to healthcare, as the transfor-
                                                                           mations of the Colombian health system are having consequences which are still dif-
Mortality
> infant: 18‰                                                              ficult to assess.
Life expectancy
> at birth: 72.4
                                     Human Development Report 2005, UNDP




HDI                                                                        Civilian populations' access to healthcare
> 0.785; ranked 69/177
                                                                           Meta Region
GDP/inhabitant ($)                                                         Activities: The rural population of this region is stigmatised     Outlook:
> 1,764
                                                                           by the simple fact of living in a war zone, which complicates      The south of the country,
International delegation                                                   access to health centres for security reasons. MdM's aim is to     where the FARC's economic
> MdM Spain                                                                facilitate or restore access to healthcare for the most vulnera-   and military interests are
                                                                           ble through mobile health squads for mothers and children          concentrated, is the object
                                                                           and training of teachers on sexual and reproductive health.        of a vast government offen-
Beneficiaries                                                                                                                                 sive aimed particularly at
> directly: women and under 5s                                             Progress bar at 31/12/2005                                         penetrating the FARC's his-
> indirectly: civilian war victims                                         01/11/2005                    31/12/2006                           toric areas and at eradica-
Staff
                                                                                                                      > Project
                                                                                                                        progress              ting the coca crops. We can
> local: 7                                                                                                                                    expect movements of civi-
> staff expatriate: 3                                                                                                                         lians leaving these areas
                                                                                                                                              where tension is likely to
Co-ordinators                                                                                                                                 grow. In addition, the elec-
> project: C. Raggioli, S. Sisco
> field: C. Escobar                                                                                                                           tions due in spring 2006 are
> HQ: M. Ethvignot                                                                                                                            likely to lead to an escalation
                                                                                                                                              in the conflict. MdM's health
Sources of funding                                                                                                                            response in an increasingly
> French Foreign Ministry, MdM
                                                                                                                                              unstable situation depends
Budget                                                                                                                                        on the team's capacity to
> 2005: 298,373 euros                                                                                                                         adapt to changes in the
                                                                                                                                              situation.
                                                                                                                              56/57




Access to healthcare for the victims of armed conflicts                                              Beneficiaries
Rio Medio Atrato Region                                                                              > directly: Emberas Indian
                                                                                                      population, especially women
Activities: In this strategic region, where the struggle to      Outlook:                             and children
control the access corridors to the Pacific, Panama and the      The upsurge of the conflict,        Staff
interior of the country is being played out, the paramilita-     which affects the entire            > local: 13
ries' advance, the increasingly significant presence of the      Colombian population, is            > expatriate: 4
Colombian navy and the FARC's resistance are again for-          already causing new displa-
                                                                                                     Co-ordinators
cing the black and indigenous populations, the victims of        cements of communities              > project: C. Raggioli, S. Sisco
permanent blockades, to move in order to avoid further           living along the different tribu-   > field: V. Gavidia
repression for supposed collaboration with one of the armed      taries of the Atrato. MdM's         > HQ: M. Ethvignot
groups. Médecins du Monde is providing direct medical            permanent presence
                                                                                                     Sources of funding
assistance to the indigenous Emberas communities,                amongst these doubly-stig-          > ECHO, MdM
especially the women and children who find it difficult to get   matised minorities is a gua-
access to healthcare as they live in the middle of the armed     rantee of an appropriate            Budget
confrontation.                                                   humanitarian response.              > 2005: 475,003 euros
Progress bar at 31/12/2005
01/05/2005                   30/04/2006
                                           > Project
                                             progress




Promoting the right to health                                                                        Staff
Bogota                                                                                               > expatriate: 1
Activities: As part of the “Access to healthcare” project,       Outlook:                            Co-ordinators
MdM has carried out a study, from practices in the field, of     Presentation of report in           > project: C. Raggioli
the consequences of privatising the Colombian health system      2005.                               > field: L. Muller, S. Zambrano
                                                                                                     > HQ: F. Stea, M. Ethvignot
on access to healthcare for the populations monitored by
MdM.                                                                                                 Sources of funding
Progress bar at 31/12/2005                                                                           > ECHO, MdM
01/09/2004                    28/02/2005
                                           > Project
                                             progress
                                                                                                     Budget
                                                                                                     > 2005: 10,810 euros
Cuba
                                                                        Strategic links with Venezuela and an increasingly lucrative tourist economy have
                                                                        allowed Cuba to maintain relative stability despite shortages and tropical storms.
                                                                        On the other hand, the HIV/AIDS transmission prevention system, which made
                                                                        Cuba the Caribbean state least affected by the epidemic, is being affected more
                                                                        and more by the deepening inequalities and the explosion of prostitution.


Mortality
> infant: 6‰
                                                                        Café Salud - HIV/AIDS prevention
Life expectancy
> at birth: 77.3                                                        Centro Habana, Havana
                                  Human Development Report 2005, UNDP




HDI                                                                     Activities: The Café Salud project is aimed at preventing         Outlook:
> 0.817; ranked 52/177                                                  HIV/AIDS and sexually transmitted infections (STIs) in the wor-   • Consolidate information,
                                                                        king-class areas of Centro Habana. It mainly targets 15 to 25     education and communica-
PIB réel/habitant ($)                                                   year olds, the group most affected by the epidemic in Cuba.       tion activities in Café Salud
> nc
                                                                        The project trains health promoters amongst young people          by reinforcing the promoters'
International delegation>                                               and they spread awareness, information and STD prevention         training.
MdM Spain                                                               messages in the various districts. It is based on a reception     • Make the project ongoing
                                                                        and activity centre, the Café Salud, which organises dynamic      by supporting the Cuban
                                                                        epidemic prevention activities (theatre, karaoke, etc) and also   partners already involved in
Beneficiaries                                                           visits the different districts to raise awareness amongst the     running Café Salud.
> directly: 13,673,15                                                   whole population of Centro Habana. The Cuban public health        • Attempt to reproduce the
 to 25 year olds                                                        partners associated with the project are involved in the pro-     project in other provinces in
                                                                        grammes so that it can continue in the long term.                 the country in partnership
Staff
> expatriate: 1                                                                                                                           with the health authorities.

Co-ordinators                                                           Progress bar at 31/12/2005
> project: G. Robert                                                    01/02/2004                    31/03/2005
> field: I. Raud
> HQ: F. Stea, Y. Le Corgne                                                                                        > Project
                                                                                                                     progress


Sources de financement
> French Foreign Ministry, MdM,
Cuban partners

Budget
> 2005: 51,687 euros
                                                                                                                                                                  58/59
 Dominican Republic
The economic situation in Dominican Republic remains inconsistent and, although indica-
tors are encouraging overall, the recovery has not had the expected effect on living condi-
tions in the country. Politically, the serious crisis of its Haitian neighbour continues to lead
to an influx of illegal immigrants, who are taking refuge in the Dominican mountains under
the sometimes hostile eyes of the local population, and are very often in need of emergency
healthcare.

                                                                                                                                         Mortality
                                                                                                                                         > infant: 29 ‰
Promoting fundamental rights
                                                                                                                                         Life expectancy
Bahoruco                                                                                                                                 > at birth: 67.2




                                                                                                   Human Development Report 2005, UNDP
Activities:      The programme aims to give access to             Outlook:                                                               HDI
primary healthcare to the isolated Haitian population             MdM is withdrawing but is in                                           > 0.749; ranked 95/177
living and working in the coffee growing areas of Bahoruco. It    contact with several local
involves training community health technicians (CHTs), giving     institutions, including the                                            Actual GDP/inhabitant ($)
                                                                                                                                         > 1.893
health education to leaders of the groups of sugar cane cut-      Catholic Church and the
ters, carrying out medical consultations and, finally, training   Dominican health authorities.                                          International delegation
and developing a young people's theatre group as part of                                                                                 > MdM Espagne
HIV/AIDS prevention work.

Progress bar at 31/12/2005                                                                                                               Beneficiaries
01/2005                          12/2005                                                                                                 > directly: 12,000 à 20,000
                                           > Project
                                             progress
                                                                                                                                         Staff
                                                                                                                                         > local: 4
                                                                                                                                         > expatriate: 1

                                                                                                                                         Co-ordinators
                                                                                                                                         > project: S. Châlons
                                                                                                                                         > field: A. Nombela
                                                                                                                                         > HQ: F. Stea, Y. Le Corgne

                                                                                                                                         Sources of funding
                                                                                                                                         > Catholic church and Actmon
                                                                                                                                          locally, MdM

                                                                                                                                         Budget
                                                                                                                                         > 2005: 77,322 euros
DRC
                                                                  After the pillaging of 1992, which led to the collapse of all public structures, this vast
                                                                  country with impressive mineral wealth has been through two wars since 1996. This
                                                                  is the largest humanitarian crisis since the Second World War: nearly 4 million
                                                                  Congolese have died from common illnesses (malaria, diarrhoeic illnesses, measles, etc)
                                                                  through lack of access to care in this widespread climate of insecurity; 20 million are
                                                                  malnourished. After three years of prevarication, the international community has been
                                                                  mobilised in a big way to support the political transition through the United Nations' lar-
Mortality
                            Human Development Report 2005, UNDP




> infant: 129‰                                                    gest peacekeeping mission, which should make the next elections safe.
Life expectancy
> at birth: 43.1

HDI
> 0.385; ranked: 167/177                                          Programme for an integrated fight against HIV
Actual GDP/inhabitant ($)                                         Goma
> 107
                                                                  Activities: The work aims to respond in an integrated            Outlook:
                                                                  way to the AIDS epidemic in the eastern region of the
                                                                                                                                   Continue the activities
                                                                  Democratic Republic of Congo which has been particularly
Beneficiaries                                                                                                                      that have been started and
> directly: 43,200                                                affected by the war. The activities are as follows:
                                                                                                                                   developed in order to
> indirectly: 480,000                                             • strengthening the capacities of those involved in local
                                                                                                                                   consolidate them.
                                                                  institutions and in civil society in the fight against HIV,
Staff                                                             strengthening co-ordination between the different parties;
> local project 1: 46
> expatriate: 1                                                   • supporting social involvement and prevention activities;
> expatriate rear base: 3                                         • running three sexually transmitted infections treatment
                                                                  services;
Co-ordinators                                                     • running a voluntary, anonymous and free screening centre;
> project: F. Jacquet
> field: P. Sallah                                                • running a treatment service for HIV-positive patients; medi-
> country: A. Talibo                                              cal and psychosocial monitoring, prevention and treatment of
> HQ: C. Courtin                                                  opportunistic infections, access to antiretroviral drugs.
Sources of funding                                                Progress bar at 31/12/2005
> Global Fund/UNDP, Dutch                                         01/08/2003                   31/07/2006
 Foreign Ministry, MdM
                                                                                                            > Project
                                                                                                              progress
Budget
> 2005: 494,149 euros
                                                                                                                                     60/61




Supporting street children                                                                                  Beneficiaries
Kinshasa                                                                                                    > directly: 2,500
Activities: the programme is pursuing its objectives which               Outlook:                           Staff
are to reintegrate and resocialise street children through:              As well as continuing our cur-     > local: 35
• quality reception in a specialist centre: Pekabo;                      rent activities, organise night    > expatriate: 1
• psychosocial support, educational activities (educational thea-        visits for educators, extend the   Co-ordinators
tre: Tam-tam), reintegrating children into families, PHC. MdM is         STI/AIDS programme                 > project: D. Cannet
extending its programme on STIs/AIDS amongst vulnerable chil-            amongst street children, make      > field: N. Beaulieu
dren and especially street girls, through treating STIs and HIV          the Pekabo reception centre        > country: X. Joubert, A. Talibo
                                                                                                            > HQ: C. Courtin
prevention. We are strengthening our networking with all the             autonomous, and strengthen
child reintegration organisations working at the same time on            the partnership with Africare      Sources of funding
the fight against HIV/AIDS.                                              (make the network dynamic,         > Paris city council, French Foreign
                                                                         design work tools to deal bet-      Ministry
Progress bar at 31/12/2005                                               ter with the healthcare and        Budget
01/01/2004                        31/12/2006                             reintegration of street children   > 2005: 405,606 euros
                                                >   Project
                                                    progress             in DRC).
                                                                                                            Partnership
                                                                                                            > Africare


Fighting against epidemics                                                                                  Beneficiaries
Kalemie and Kongolo - North Katanga Province, Tanganyika Province                                           > directly: 258,537
                                                                                                            > indirectly: 561,182
Activities: Reacting to epidemic emergencies (cholera, meas-             Outlook:
les, meningitis and shigellosis) is effective, and especially the pre-   In the long term, continue to      Staff
vention of cholera involving chlorinating water supply points in         develop the preventive and         > local: 359
                                                                                                            > expatriate: 9
Kongolo and Kalemie thanks to local chlorine production. This            curative activities so that
novel activity was developed through a joint venture with a Swiss        morbidity and mortality rates      Co-ordinators
company who supplied the equipment needed. The process has               improve for the epidemic dis-      > project: A. Thiriat
been extended successfully to Kalemie.                                   eases being monitored,             > field: K. Touré (Kongolo then
                                                                                                            Kalemie), G. Kouplo (Kongolo)
The early warning system is in operation.                                thanks especially to close         > pays: X. Joubert, puis A. Talibo
The curative treatment of cases is provided by cholera treatment         monitoring and the provision       > HQ: C. Courtin
centres in Kongolo and Kalemie and in the health centres of Kalemie      of the necessary inputs.
health area, mainly thanks to staff training and the regular supply                                         Sources of funding
                                                                                                            > MdM own funds (Kongolo:
of the necessary inputs.                                                                                    response to epidemics) and
                                                                                                            ECHO (Kalemie: “epidemics”
Progress bar at 31/12/2005                                                                                  programme integrated with PHC)
01/01/2005                       31/12/2005
                                               > Project
                                                 progress
                                                                                                            Budget
                                                                                                            > global 2005: 1,745,007 euros
                                                                                                            (PHC programme Kalemie and
                                                                                                            improvement of the Kongolo health
                                                                                                            situation)
DRC
Beneficiaries                     Providing access to quality healthcare
> directly: 180,000
> indirectly: 350,000             Kongolo (North Katanga)

Staff                             Activities: As part of community involvement, the project               Outlook:
> local:175                       aims to provide access to quality healthcare in 25 health               Develop current activities
> expatriate: 4                   centres and 5 advance health posts in Kongolo area. Five                through strengthening exis-
                                  aspects are being developed:                                            ting work and as a stronger
Co-ordinators
> project: A. Thiriat             • setting up a minimum set of activities in health training             response to epidemics and
> field: K. Touré                 responding to national PHC standards;                                   treatment of STIs (sexually
> country: X. Joubert             • providing essential drugs, consumables and equipment;                 transmitted infections)
> HQ: C. Courtin                  • strengthening the capacities of the area's central office;
Source de financement             • training health centre staff;
> ECHO 100%                       • epidemiological monitoring and fight against epidemics
                                  including cholera.
Budget
> 2005: 849,457 euros             Progress bar at 31/12/2005
+ 53,748 euros allocated to the
                                  01/01/2005                       31/12/2005
fight against epidemics
                                                                                 > Project
                                                                                   progress




Beneficiaries
                                  Developing medical services
> directly: 78,537                Kalemie (North Katanga)
> indirectly: 211,182
                                  Activities: As part of this project, MdM is organising:                 Outlook:
Staff                             • the signing and implementation of a memorandum of unders-             Develop current activities by
> local: 44 paid staff and        tanding with the health authorities;                                    strengthening existing work
140 subsidised staff
> expatriate: 5                   • light renovation/equipping and restoration of the technical side      and as a stronger response
                                  of functional health structures;                                        to epidemics.
Co-ordinators                     • building and equipping of two health centres with the invol-
> project: A. Thiriat             vement of the population in the villages of Mulange and Fatuma
> field: K. Touré
> country: X. Joubert             (Kalemie health area);
and A. Talibo                     • monthly supply of mosquito nets treated with insecticides and
>HQ: C. Courtin                   of drugs;
Source de financement
                                  • replenishment of traditional midwives' kits;
> ECHO 100%                       • supervising activities to monitor the quality of healthcare, health
                                  centre performance, and staff development with respect to ratio-
Budget                            nal instructions and treating cases;
> 2005: 878,309 euros             • a workshop for monitoring health activities in the two health
                                  areas each quarter;
                                  o supplying screening tests, consumables for transfusions and
                                  equipment for use in the fight against HIV.

                                  Progress bar at 31/12/2005
                                  01/02/2005                      31/12/2005
                                                                                > Project
                                                                                  progress
                                                                                                                                                                   62/63
 Egypt
The Egyptian government's economic policy, despite being acclaimed by the World
Bank, cannot hide the social divisions within the country. Although the authorities and
civil society are more aware of the problem, a large number of women and children,
often thrown onto the street, are in effect deprived of access to care for social, eco-
nomic or cultural reasons. The number of street children in Cairo is still unknown and
there is a worrying increase in the number of young mothers living on the street with
their babies, while there are not enough reception structures to monitor these people
                                                                                                                                         Mortality
on a permanent basis.                                                                                                                    > infant: 33‰




                                                                                                   Human Development Report 2005, UNDP
                                                                                                                                         Life expectancy
                                                                                                                                         > at birth: 69.8
Promoting reproductive health                                                                                                            HDI
Cairo                                                                                                                                    > 0.659; ranked 119/177
Activities:     Project supporting the Egyptian NGO Hope           Outlook:                                                              PIB réel/habitant ($)
Village to set up a reception and reintegration centre as well     Continue the project, which                                           > 1,220
as a mobile unit for young pregnant girls and adolescent           effectively started in August
mothers living on the street.                                      2005 after a six months'
The activities are aimed at organising and providing:              pilot project.                                                        Beneficiaries
• training sessions on reproductive health;                                                                                              > directly: 800 young girls and 3,600
o psychological support for Hope Village staff and for the young                                                                           children, 150 medical staff, social
                                                                                                                                           workers and psychologists.
girls taken in by the pilot centre;                                                                                                      > indirectly: 110,000 young girls
• partnerships with the public hospitals;                                                                                                  and 3,000 children
• information, education and communication (IEC) sessions
on reproductive health for girls and boys taken in by the cen-                                                                           Staff
                                                                                                                                         > expatriate: 2
tre, as well as for street children leaders, the organisations                                                                           > local: 6
working with street children and traditional midwives;
• integrating MdM in the Street Children network to share and                                                                            Co-ordinators
communicate with the NGOs of the Street Children network.                                                                                > project: R. Heimann,
                                                                                                                                          M.-A. Silicani
                                                                                                                                         > field: I. Bruand
                                                                                                                                         > HQ: S. Alary
Progress bar at 31/12/2005
  01/08/2005                  31/07/2008                                                                                                 Sources of funding
                                           > Project
                                             progress
                                                                                                                                         > Drosos Foundation, MdM

                                                                                                                                         Budget
                                                                                                                                         > 2005: 35,625 euros
Ethiopia
                                                                              With a population of 70 million inhabitants, Ethiopia's health indicators are far below the
                                                                              average for Sub-Saharan Africa. The lack of specialist doctors and surgeons outside the
                                                                              capital means access to surgical care is extremely low in the rural areas of the country
                                                                              where 85% of the total population of the country actually live. A major proportion of mater-
                                                                              nal mortality is due to this shortage.


Mortality
> infant: 112‰
                                                                              Surgery
                                        Human Development Report 2005, UNDP




                                                                              Tigray/Axum
Life expectancy
> at birth: 47.6                                                              Activities: Having trained an operating theatre team, and a            Outlook:
                                                                              health officer and anaesthetist nurse to provide emergency surgery,    Training of teams, in conjunction
HDI                                                                           we are transferring our training activities to Axum, where needs       with trainers from Tigray, must
> 0.367; ranked 170/177                                                       are greater. Our work has 3 aspects:                                   be continued for two years. A
Actual GDP/inhabitant ($)                                                     • transfer of knowledge in surgery and obstetrics;                     new session started in March
> 97                                                                          • training full operating theatre teams to work in peripheral health   2006 for nine months. The inte-
                                                                              centres;                                                               gration of the first session in
                                                                              • access to care for the most destitute people. This work is mainly    three health centres will be car-
Beneficiaries                                                                 aimed at general emergency surgery and caesarian sections, to          ried out with support from
> directe project 1: 179,000                                                  reduce mother and child mortality and obstetrical trauma.              MdM. This year MdM will look
> directe project 2: project 2: 200                                           The first training session (3 teams) was completed at the end of       at the possibility of an Ethiopian
  HIV-positive mother-child pairs,                                            February 2006.                                                         team it has trained becoming
4,000 pregnant women
> indirecte project 1: 4,000,000                                              Progress bar at 31/12/2005                                             trainers.
> indirecte project 2: 140,000                                                01/10/2004                      30/09/2007
                                                                                                                            > Project
                                                                                                                              progress
Staff
> local project 1: 4
> local project 2: 6
> expatrié project 1: 5
> expatrié project 2: 1
                                                                              Preventing mother-to-child HIV transmission
                                                                              Mekele
Co-ordinators
> mission project 1: G. Pascal                                                Activities: This project is based on seven aims:                       Outlook:
> mission project 2: M. Saada                                                 • preventing mother-to-child transmission;                             Changes in health policy in
> field 1: O. Evreux
> field 2: M. Gatumo,                                                         • training counsellors for screening centres, transfer of kno-         Ethiopia mean ARV treat-
O. Evreux                                                                     wledge to the Mekele medical staff (one hospital and three health      ments can now be used and
> siège projects 1 et 2: O. Mouzay                                            centres);                                                              they are available free of
                                                                              • setting up an integrated voluntary HIV screening unit as part        charge at Mekele hospital.
Sources de financement
> project 1: UNFPA                                                            of antenatal consultations;                                            The plan is to continue awa-
> project 2: French Foreign Ministry,                                         • raising awareness amongst the community of HIV infection,            reness, training and monito-
 MdM, GSK Foundation,                                                         mother-to-child transmission, and its prevention;                      ring activities following this
 Felissimo, Sternstunden                                                      • gradual rebuilding of the maternity unit;                            initial phase.
Budget                                                                        • supplying drugs, consumables and equipment;
> 2005 project 1: 330,545 euros                                               • advice and practices on infant feeding.
> 2005 project 2: 176,808 euros                                               Progress bar at 31/12/2005
                                                                              01/08/2003                     31/07/2006
                                                                                                                           > Project
                                                                                                                             progress
                                                                                                                                                                           64/65
  Georgia
Two years after the “Rose Revolution”, Mikhael Saakashvili is struggling to keep his
promises of change: Georgia is a poor state, with no energy resources and, despite
notable economic growth due to an energetic struggle against corruption, 52% of the
population still live below the poverty line. A health system reform has been started
but it is still quite muddled.


                                                                                                                                                  Mortality
                                                                                                                                                  > infant: 41‰
Help for reproductive health




                                                                                                            Human Development Report 2005, UNDP
                                                                                                                                                  Life expectancy
Mingrelia Region                                                                                                                                  > at birth: 70.5
Activities: Having assessed the needs, MdM decided to run                Outlook:                                                                 HDI
its reproductive health project in four districts of Mingrelia Region.   MdM is continuing its activities                                         > 0.732; ranked 100/177
The project has several aspects:                                         in Mingrelia region and plans
• renovating health structures;                                          to extend its project into                                               Actual GDP/inhabitant ($)
                                                                                                                                                  > 778
• providing medical equipment, drugs and consumables;                    Abkhazia region.
• setting up stock management systems;
• training medical staff: monitoring pregnancies, neonatal resus-
citation, pregnancy-related diseases, etc.;                                                                                                       Beneficiaries
• improving data collection and epidemiological monitoring;                                                                                       > directly: 4,414
                                                                                                                                                  > indirectly: 50,000
• improving therapeutic protocols and the referral system.
                                                                                                                                                  Staff
Progress bar at 31/12/2005                                                                                                                        > local: 17
09/04                                08/2006                                                                                                      > MCH: 1
                                               > Project
                                                 progress                                                                                         > expatriate: 2

                                                                                                                                                  Co-ordinators
                                                                                                                                                  > project: H. Lepoivre, I. Hermant
                                                                                                                                                  > field: S. Rogic
                                                                                                                                                  > HQ: A. Landaes

                                                                                                                                                  Sources of funding
                                                                                                                                                  > ECHO, MdM

                                                                                                                                                  Budget
                                                                                                                                                  > 2005: 453,244 euros
Guatemala
                                                                          A country characterised by political instability, economic crisis and social and ethnic vio-
                                                                          lence, at the end of the 1980s Guatemala decided on a method of economic development
                                                                          integrated in the globalisation process within the new international division of labour, one of
                                                                          whose main characteristics is getting an increasing number of women into work, especial-
                                                                          ly in the factory sector.



Mortality
> infant: 35‰
                                                                          Assessing the health of working women
                                    Human Development Report 2005, UNDP




Life expectancy                                                           Chimaltenango
> at birth: 67.3                                                          Activities: Carrying out an assessment of the health of women        Outlook:
HDI                                                                       working in the factories and agricultural export businesses in the   At the end of this assessment
> 0.663; ranked 117/177                                                   town of Chimaltenango:                                               work, in 2006 a three-year pro-
                                                                          • field surveys, workplace visits, institutional contacts;           ject will be set up on “women's
Actual GDP/inhabitant ($)                                                 • carrying out medical consultations on the theme of women's         accessibility to healthcare in the
> 2,009
                                                                          health/work;                                                         context of globalisation” in
                                                                          • partnership with Guatemalan organisations working in the eco-      Chimaltenango.
                                                                          nomic and social rights sector on prevention activities concerning
Beneficiaries                                                             women's health and labour rights.
> directly: women from
 Chimaltenango
> indirectly: Guatemalan women
                                                                          Progress bar at 31/12/2005
Staff                                                                     24/01/2005                     31/07/2005
> expatriate: 1 doctor, 1 nurse
 and 1 occasional administrator
                                                                                                                      > Project
                                                                                                                        progress


Co-ordinators
> project: A. Baas
> field: C. Cipolla
> follow-up: RD PACA (I. Malaval)

Sources of funding
> PACA regional council, MdM

Budget
> 2005: 36,860 euros
                                                                                                                                                                               66/67
 Guinea
In spite of ill health, President Conté continues to control the political chess board. In
March 2005, he carried out an extraordinary ministerial reshuffle, and the general econo-
mic situation remains dominated by hyperinflation and the impoverishment of the popu-
lation. Human rights and fundamental freedoms are not respected. Living conditions are
extremely harsh, especially in prisons where sanitary and hygiene measures are repea-
tedly ignored and poor treatment is commonplace. The number of daily deaths continues
to increase.
                                                                                                                                                  Mortality
                                                                                                                                                  > infant: 104‰




                                                                                                            Human Development Report 2005, UNDP
Improving health in prisons                                                                                                                       Life expectancy
                                                                                                                                                  > at birth: 53.7
Kindia                                                                                                                                            HDI
Activities: Kindia central prison houses around 200 inmates              Outlook:                                                                 > 0.466; ranked 156/177
living in very harsh conditions.                                         A major issue for 2006 is to                                             Actual GDP/inhabitant ($)
Since 2001, MdM has been supporting Kindianaise d'Assistance             increase the income-genera-                                              > 459
aux Détenus (KAD, or Kindia Support for Prisoners), a Guinean            ting activities begun in 2005.
organisation made up of volunteers working directly in the prison        There are two objectives: to
to improve health and hygiene. There are several aspects to their        help KAD's financial autonomy                                            Beneficiaries
work:                                                                    (by releasing local resources),                                          > directly: approx 200 prisoners
• training a prisoner in nursing care and running a pharmacy inside      and to facilitate the reintegra-                                         (mixture of men, women and children)
the prison;                                                              tion of inmates when they                                                Staff
o a partnership with the health authorities to treat the most serious    leave prison.                                                            > local: a Guinean charity
cases in Kindia hospital;                                                                                                                         (Kindianaise d'assistance
• nutritional support for those suffering from malnutrition;             In 2006, MdM will help KAD to                                            aux détenus)
• renovation of health infrastructure;                                   launch new activities such as                                            Co-ordinators
• literacy work amongst prisoners;                                       making rattan furniture, as the                                          > project: P. Boucourt et T. Comte
• income-generating activities (sewing, weaving).                        sewing and weaving activities                                            > follow-up: RD Rhône-Alpes
These activities are vital for improving prison conditions. As well as   are proving successful.                                                   Burgundy (S. Bret)
the income they generate, for the prisoners they are the equivalent                                                                               Sources of funding
of a regular job, acquiring skills and simply a regular outing from                                                                               > private partnerships, MdM
their cells.
Progress bar at 31/12/2005                                                                                                                        Budget
                                                                                                                                                  > 2005: 17,919 euros
2000                                 fin 2006
                                                > Project
                                                  progress
Haiti
                                                                                The postponement of the presidential and legislative elections to January 2006 has pro-
                                                                                longed the climate of uncertainty and insecurity which has poisoned the country's politi-
                                                                                cal, economic and social life since the departure of President Aristide, in March 2004. With
                                                                                a background of violence, Haiti continues to face enormous poverty. The health risks lin-
                                                                                ked to lack of access to healthcare and the destitution of the population are still very great.


Mortality
> infant: 76‰
                                                                                Caring for victims of violence
                                                                                Port-au-Prince
Life expectancy
> at birth: 51.6                                                                Activities: The programme aims to reduce the impact of                   Outlook:
                                          Human Development Report 2005, UNDP




                                                                                violence on individuals and promote the multi-disciplinary               MdM wishes to strengthen the
HDI                                                                             care of victims by Haitians (health, justice system, commu-              capacity and quality of the effec-
> 0.475; ranked 153/177                                                         nities). It is based on:                                                 tive treatment of vicims of violen-
Actual GDP/inhabitant ($)                                                       • training healthcare staff in 20 health structures in Port-au-Prince,   ce by working specifically in
> 346                                                                           provided by MdM's team of trainers working in the intervention,          seven health structures in and
                                                                                rehabilitation, research and expertise centre for victims of vio-        around the main shanty towns
International delegations                                                       lence;                                                                   of Port-au-Prince. This work is
> MdM Canada, MdM Switzerland
                                                                                • training doctors and lawyers in giving expert forensic opinions        based on the work already
                                                                                to contribute to the legal recognition of victims of violence;           done in the current programme
Beneficiaries
                                                                                • supporting URAMEL, MdM's Haitian local partner which is                and on close collaboration with
> directly project 1: 512 Haitian pro-                                          fighting against impunity and for the construction of a state sub-       the health authorities and those
 fessionals                                                                     ject to the rule of law;                                                 in civil society engaged in pro-
> directly project 2: 15,000                                                    • strengthening capacity to deal with victims and to collect relia-      moting the rule of law in Haiti.
> iindirectly project 1: the victims of
 violence
                                                                                ble data from at least 20 health structures.
                                                                                Progress bar at 31/12/2005
Staff                                                                           01/12/2003                       31/12/2005
> local project 1: 15
> local project 2: 15
                                                                                                                               > Project
                                                                                                                                 progress

> expatriate project 1: 2
> expatriate project 2: 1                                                       Revitalising the health system
Co-ordinators                                                                   Grande-Anse Region
> project 1: A. Urtubia
> project 2: S. Lasserre                                                        Activities: Renovating and revitalising five clinics and one             Outlook:
> field 1: M. Desmousseaux                                                      health post to improve accessibility, quality of care and institu-       The project meets specific
> field 2: B. Deveaux
> HQ 1 and 2: M.-Y. de Penanster-                                               tional management:                                                       needs to update health cent-
 Rosny, Y. Le Corgne                                                            • training healthcare staff;                                             res which are not working
                                                                                • mobilising and training communities to take part in the health         well.
Sources of funding                                                              system;                                                                  There is a pressing need for
> project 1: French Foreign Ministry,
 MdM                                                                            • providing drugs and medical equipment;                                 training in all the area's health
> project 2: UNDP, MdM                                                          • improving the health information system;                               structures.
                                                                                • renovating health structures;                                          This work will be extended to
Budget                                                                          • supporting the health authorities.                                     other health centres to provide
> 2005 project 1: 301,359 euros
> 2005 project 2: 242,182 euros                                                 Progress bar at 31/12/2005                                               real health coherence in the
                                                                                01/06/2004                       01/04/2006                              area.
                                                                                                                               > Project
                                                                                                                                 progress
                                                                                                                                             68/69




Promoting health through hygiene                                                                                Beneficiaries
                                                                                                                > directly: 8,400 (1,400 familles)
Grande-Anse Region
                                                                                                                Staff
Activities: The general objective is to reduce the mortality                Outlook:                            > local: 8
and morbidity rates caused by faecal related illnesses in                   Considerable community parti-
Roseaux district and to increase the coverage of latrines from 0 to         cipation means that this project    Co-ordinators
                                                                                                                > project: S. Lasserre
28% in eighteen months. Various objectives and activities are being         will be able to continue. After     > field: O. Naval
pursued by MdM: mobilising and raising awareness in the commu-              three years, it is reported that    > HQ: M.-Y. de Penanster-Rosny, Y.
nity, training benefiting families in how to use and maintain the latri-    99% of the latrines are used          Le Corgne
nes, supporting health committees, building latrines and carrying out       and maintained. Requests
                                                                                                                Sources of funding
home visits. Lastly, MdM is making families aware of the problem of         from other neighbouring dis-        > EU, MdM
deforestation by replanting trees with them for each latrine built in the   tricts or communities not yet
residential area.                                                           covered in Roseaux district         Budget
                                                                            make us believe that there is a     > 2005: 113,686 euros
Progress bar at 31/12/2005
01/07/2004                         31/12/2005                               real prospect of reproducing
                                                 > Project
                                                   progress                 this action locally.




Training healthcare staff                                                                                       Beneficiaries
Pilate                                                                                                          > indirectly: 60, 000 inhabitants
                                                                                                                of Pilate spread over 157 km2
Activities: Project supporting Pilate hospital, a semi-private insti-       Outlook:                            in 8 rural sections
tution run by Canadian nuns established in this area many years ago.        Three projects are planned for
MdM's activity combines:                                                    2006:                               Staff
                                                                                                                > local: 31
• a surgical project which sends a full team for fifteen days to carry      • in surgery;                       > expatriate: 7
out around a hundred operations on patients selected by the nuns            • in psychiatry, for an extension
throughout the year;                                                        to Cap Haïtien;                     Co-ordinators
• a mother and child project via a malnutrition screening and treat-        • with a view to adapting the       > project: C. Castaing,
                                                                                                                  P. Carbonnier
ment programme using health workers supervised by the nuns, and             mother and child project to         > follow-up: RD Aquitaine
by training officers, matrons and mothers;                                  address the increase in malnu-
• a psychiatric project training healthcare staff (nuns and nurses)         trition                             Sources of funding
in the diagnosis and treatment of psychiatric illnesses.                                                        > MdM, Association of the friends
                                                                                                                of Sister Madeleine, private donations
Progress bar at 31/12/2005
Since 1980                                                                                                      Budget
                                                 > Project
                                                   progress
                                                                                                                > 2005: 12,907 euros
Indonesia
                                                                         In Indonesia, 240,000 people died or were reported missing as a result of the tsunami of 26
                                                                         December 2004. It was the country most affected by the disaster, and the whole population
                                                                         of Aceh province were hit hard with the destruction of medical infrastructure, a lack of health-
                                                                         care staff, major population displacements and psychological suffering. The whole local health
                                                                         system is being rebuilt. The Indonesian economy was weakened and 16 million households
                                                                         still live below the poverty line. In addition, the AIDS epidemic is worsening fast especially
                                                                         through the use of injectable drugs and prostitution, which are very widespread practices in
Mortality
> infant: 31‰                                                            Indonesia.
Life expectancy
> at birth: 66.8
                                                                         Preventing HIV/AIDS and STIs
                                   Human Development Report 2005, UNDP




HDI
> 0.697; ranked 110/177                                                  Mulia, Puncak Jaya district, West Papua
Actual GDP/inhabitant ($))
> 970
                                                                         Activities: The first phase of the project aims to reduce the pre-       Outlook:
                                                                         valence of STIs and the incidence of HIV/AIDS by improving               The first phase was comple-
International delegations                                                the therapeutic treatment of STIs and the prevention of STI/HIV trans-   ted at the end of February.
> MdM Spain, MdM Canada, MdM                                             mission in this district. 2005 was notable for prevention and social     During the second phase, we
 Greece                                                                  involvement actions (the fight against the discrimination and stigma-    are going to refocus our pro-
                                                                         tisation patients are subject to). An evaluation of the programme car-   gramme on preventing infec-
                                                                         ried out in September 2005 highlighted the decline in access to          tious diseases and extending
Beneficiaries                                                            healthcare mainly due to the decentralisation undertaken by the          the scope of our work to the
> directly project 1: 20,000
> directly project 2: 12,000                                             government since 2002 and to the conflicts between independence          neighbouring sub-district sub-
> indirectly project 1: 40,000                                           fighters and the army which prevent access to villages and prevent       district of Sinak.
> indirectly project 2: 90,000                                           healthcare workers from going there.
Staff                                                                    Progress bar at 31/12/2005
> local project 1: 9                                                     01/08/2004                       15/04/2009
> local project 2: 12                                                                                                   > Project
                                                                                                                          progress
> expatriate project 1: 4
>expatriate project 2: 2

Co-ordinators                                                            Caring for the marginalised population
> project 1: P. Gaillard-Olokose                                         Jakarta
> project 2: A. Bourdé
> field 1: A. Le Garnec                                                  Activities: MdMs work is aimed at helping the marginali-                 Outlook:
> field 2: V. Cauche
> HQ 1 and 2: V. Pardessus                                               sed people of Jakarta. There are four aspects to the project:            • Pursue access to primary
                                                                         • weekly medical consultations in partnership with the local NGO         healthcare (especially for
Sources of funding                                                       Aulia;                                                                   women and under 5s) in
> project 1 Cordaid, MdM                                                 • training Aulia's social workers and community health workers;          Jakarta's northern shanty
> project 2: MdM
                                                                         • setting up a referral system appropriate to this population;           towns.
Budget                                                                   • technical logistics assistance, fundraising and management of          • Raise the population's aware-
> 2005 project 1: 172,824 euros                                          the NGO partner Aulia.                                                   ness about prevention of the
> 2005 project 2: 19,498 euros                                                                                                                    predominant diseases.
                                                                         Progress bar at 31/12/2005
                                                                         05/2005                          31/12/2008                              • Strengthen Aulia's capacities
                                                                                                                        > Project
                                                                                                                          progress                so that it can run its program-
                                                                                                                                                  mes autonomously.
                                                                                                                                          70/71




Caring for the Punans                                                                                          Beneficiaries
                                                                                                               > directly: 800
Kalimantan                                                                                                     > indirectly: 9,000
Activities: The Punans, an indigenous Indonesian people, are lin-        Outlook:                              Staff
ked to Malinau district, whose main town is experiencing major eco-      • Continue medical consulta-          > local: 12
nomic development (forestry exploitation) with negative consequences     tions, in order to help improve       > expatriate 1: 2 (based in Jakarta)
for ecology, society and health. They have no access at all to primary   the Punans' health in three           + 2 doctors (occasional missions)
healthcare. The main health problems identified are malaria, respira-    years.
                                                                                                               Co-ordinators
tory diseases and high infant mortality.                                 Aim: reduce the under 5s' mor-        > project: R. Garrigue
We are involved in:                                                      tality rate by 20%; it is estimated   > field: M.-L. Bry
• mobile clinics lasting a month (3 times/year) in 4 sites;              to be 500‰.                           > HQ: V. Pardessus
• training 5 health workers from the Punan community for a week          • Planned theoretical and practi-
                                                                                                               Source of funding
before each medical project, with application on the field during the    cal training of traditional matrons   > MdM
project;                                                                 by an experienced midwive and
• support for the Adat Punan organisation, which represents              community health workers (pre-        Budget
the interests of the Punans of Kalimantan.                               vention of the predominant dis-       > 2005: 11,822 euros
                                                                         eases).
Progress bar at 31/12/2005                                               • Recognition and protection of
05/2004                          31/12/2008                              the Punans' rights through the
                                               > Project
                                                 progress                Adat Punan organisation.



Helping tsunami victims                                                                                        Beneficiaries
Aceh Besar and Aceh Jaya districts (Aceh province / Sumatra)                                                   > directly: 30,000

Activities: After emergency work lasting three months following          Outlook:                              Staff
the tsunami, during which MdM put a lot of effort into re-establis-      In addition to substitution           > local: 20
                                                                                                               > expatriate: 24
hing access to primary healthcare for the population (permanent          work in the initial emergency
and mobile clinics, vaccinations, nutritional and epidemiological        phase in the first months, it         Co-ordinators
monitoring), the programme has developed around the following            is vital that we reorganise           > project: P. Foldès
focuses:                                                                 and support local health              > field: V. Cauche
                                                                                                               > HQ: Emergency desk
• getting the public primary healthcare system running again             structures and healthcare              then E. Martinon
in Aceh Besar and Aceh Jaya districts;                                   staff as they re-start their
• rebuilding health structures: a district hospital (Lhoknga), two       medium-term activities.               Sources of funding
dispensaries (Seulimeum and Jantho) and health centres;                  Alongside the physical                > MdM, ECHO, territorial local
                                                                                                                authorities
• helping to get the internal medical service of Abidin hospi-           reconstruction of buildings,
tal in Banda Aceh running again (supplying equipment and trai-           MdM is involved in training           Budget
ning teams of nurses);                                                   and supporting medical staff          > 2005: 1,783,940 euros
• developing the treatment of psychological and psychiatric              in order to guarantee access
problems (raising awareness and training medical staff in these          to quality primary healthcare.
problems);
• reacting to emergencies (epidemics, natural disasters, etc) in
Sumatra (three week emergency project in Nias after the earth-
quake in March 2005).
Progress bar at 31/12/2005
28/12/2004                          09/2006
                                               > Project
                                                 progress
Ivory Coast
                                                                         The announcement of the appointment of Charles Konan Banny, hitherto the governor of
                                                                         the Central Bank of West African States, to the post of Prime Minister, and the mainte-
                                                                         nance of the ceasefire by a major international military arrangement have given reason to
                                                                         hope that the overall situation in the country will improve. But it remains divided in two: the
                                                                         north, under the control of the New Forces, and the south, controlled by the loyalist for-
                                                                         ces. The social and economic situation is improverishing the population. In Abidjan, since
                                                                         the departure of a significant number of Europeans, economic activities have collapsed,
Mortality
> infant: 117‰                                                           leading to disastrous unemployment and just as disastrous living conditions for under-age
                                   Human Development Report 2005, UNDP




Life expectancy                                                          children living on the streets.
> at birth: 45.9

HDI
> 0.420; ranked 163/177                                                  Protecting street children
GDP/inhabitant ($)                                                       Abidjan
> 816
                                                                         Activities: MdM has been working with minors since 1996.           Outlook:
                                                                         The current project has three objectives:                          With financial assistance from
                                                                         • the protection and resocialisation of street children            Médecins du Monde, the
Beneficiaries
>directly: 2,500 street children                                         and minors in prison;                                              local NGO MESAD is conti-
> indirectly: 25,000 children                                            • access to primary healthcare;                                    nuing work developed by
 and young people in great                                               • support for a local NGO: MESAD, Movement for                     MdM between December
 difficulty                                                              Education, Health and Development.                                 1996 and June 2003.
Staff                                                                    Its work involves                                                  Since July 2003, the local
> local: 15 paid staff and                                               • a process for resocialising children through street work,        NGO has been seeking fun-
 6 volunteers                                                            accommodation in a reception centre, psychosocial monito-          ding to ensure it can provide
                                                                         ring, support for professional integration and schooling, and      the full programme. The
Co-ordinators
> project: J. Martin                                                     re-establishing family contacts;                                   country's instability does not
> field: K. Kouassi                                                      • offering primary healthcare to children on the street and sup-   encourage funders to fund
> HQ: C. Courtin                                                         port for medical treatment at the Treichville health centre;       such programmes.
                                                                         • work amongst minors in Abidjan prison with the aim of impro-
Source of funding
> MdM                                                                    ving their living conditions, providing physical, psychological
                                                                         and legal protection for minors deprived of freedom, facilita-
Budget                                                                   ting their reintegration on leaving prison;
> 2005: 81,422 euros                                                     • specific STI/HIV prevention activities.

                                                                         Progress bar at 31/12/2005
                                                                         Since July 2003
                                                                                                                    > Project
                                                                                                                      progress
                                                                                                                              72/73




Allowing access to healthcare                                                                         Beneficiaries
                                                                                                      > directly: 120,000
Seguela                                                                                               > indirectly: 300,000
Activities: This post-emergency programme is aimed at pro-           Outlook:                         Staff
viding support for the Seguela regional hospital which is in         A new project in another         > local: 49
a “rebel-held area”. The region is suffering from a breakdown in     hospital is now being develo-    > expatriate: 3
the supply of drugs, especially as most senior medical staff have    ped but will depend on how       Co-ordinators
left for the south. Thanks to supplies of drugs, small medical       the crisis develops and on       > project: A.-J. Pocheron
equipment and to expatriate surgical teams (surgeons and anaes-      political stabilisation, vital   > field: Luc Malingreau
thetists), the Regional Hospital has been able to start working      conditions for activities re-    > HQ: C. Courtin
again.                                                               starting throughout the coun-    Source of funding
Progress bar at 31/12/2005                                           try, and especially for recei-   > ECHO
12/2002                            05/2005                           ving supplies of drugs and
                                             > Project
                                               progress
                                                                     medical staff returning to
                                                                     their posts.
                                                                                                      Budget
                                                                                                      > 2005: 154,806 euros




Access to surgical and obstetric care                                                                 Beneficiaries
Touba                                                                                                 > directly: 4,500
                                                                                                      > indirectly: 192,000
Activities: This post-emergency programme is aimed at                Outlook:
providing surgical support to Touba hospital in a “rebel-held        As the minimum operating         Staff
                                                                                                      > local: 10
area”, cut off from the rest of the country since the distur-        conditions required had not      > expatriate: 5
bances of September 2002. Treatment of trauma and obste-             been met due to lack of col-
tric emergencies does not exist and most qualified senior            laboration between the head      Co-ordinators
medical staff have left for the southern area.                       doctor and the nurses, the       > project: A.-J. Pocheron
                                                                                                      > field: L. Malingreau
MdM's involvement in providing specific drugs and small medi-        project was terminated as of     > HQ: C. Courtin
cal equipment and in renovating the operating theatre and sur-       31 December 2005.
gery department, should allow local staff still in the area to                                        Source of funding
work in good conditions. The presence of an expatriate team                                           > MdM's own funds
made up of an anaesthetist, doctor, logistician and adminis-                                          Budget
trator has allowed the hospital to re-start a minimum of its acti-                                    > 2005: 117,090 euros
vities interrupted during the conflict. Working with local and
institutional staff, these activities should allow better care of
pregnant women and the injured, in the hospital as well as in
the supported health centres.

Progress bar at 31/12/2005
14/09/2005                     31/12/2005
                                             > Project
                                               progress
Kosovo
                                        The negotiations on the final status of Kosovo, which remains a province of Serbia and
                                        Montenegro under international administration, are continually being postponed, whereas
                                        inter-ethnic tensions remain high. Serbs and Albanians still have diametrically opposing
                                        views on Kosovo's future status. The Serbs are unlikely to accept more than wide autono-
                                        my for the province, whereas the Albanians, who make up over 90% of the population, are
                                        demanding independence. Socially, unemployment has reached 60%, and 65% of the
                                        population live below the poverty line.
Mortality
Life expectancy
HDI
Actual GDP/inhabitant ($)
> No specific data for Kosovo           Listening to young people
International delegation                Prishtina
> MdM United States                     Activities: MdM's project is aimed at health prevention amongst           Outlook:
                                        young people aged between 13 and 24. It is run in partners-               At the same time as suppor-
                                        hip with Kosovo's Culture, Youth and Sports Ministry and a local          ting the ministry in its first
Beneficiaries                           NGO (Vita Kosova). Its aim is to set up a reception centre for            year of financial commitment
> directly project 1:                   young people which would be a place of welcoming, listening,              to the programme, MdM
  +/- 250,000 young people
> > directly project 2:                 information, consultation and orienta- tion. Direct (individual psycho-   expects, on the one hand,
between 70 and 100 people/day           logical support, integration in a treatment network, etc) and indi-       to develop activities outside
> indirectly project 1: +/- 1 million   rect assistance (training for youth organisations on the identified       the centre and to promote
  under 24s living in Kosovo province   health topics, and ongoing training of the young people's liste-          the Dëgjo Rininë Centre and,
Staff                                   ning point team) is given.                                                on the other hand, to deve-
> local project 1: 8                    Since 2004, the project has been sponsored by Salon-de-                   lop the local NGO Vita
> local project 2: 2                    Provence's 'Espace Santé Jeunes'.                                         Kosova in its role as pro-
                                        Progress bar at 31/12/2005                                                gramme manager.
Co-ordinators
> project: M. A. Chaud                  2003                                    2006
> mission projet 2: P. Dupin                                                            > Project
                                                                                          progress
> field: G. Alliu
> follow-up project 1: DR PACA
> follow-up project 2: DR PACA

Sources of funding
> project 1: PACA local authorities,
                                        Improving oral health
MdM United States                       Gllogovc
> project 2: MdM
                                        Activities: MdM's project aims to improve oral health in this             Outlook:
Budget                                  region through:                                                           Equivalent work in the Serb
> 2005 project 1: 49,706 euros          • installing two complete dental surgeries at the Gllogovc health         enclave of Hocë e Madne.
> 2005 project 2: 2,057 euros           centre;
                                        • training local practitioners in new dental care techniques.
                                        The project ended in 2005 with an information activity in neigh-
                                        bouring schools on oral hygiene.

                                        Progress bar at 31/12/2005
                                        2004                                    2005
                                                                                        > Project
                                                                                          progress
                                                                                                                                                                    74/75
  Lebanon
Shaken by the assassination in February 2005 of former Prime Minister Rafik Hariri, which
led to the rushed withdrawal of Syrian troops, Lebanon remains an area of tensions. The
country is a genuine crossroads; it houses hundreds of thousands of foreign workers and
forms a transit place for people fleeing wars and dictatorial regimes in the Near East.
Lebanon has not signed the Geneva Convention of 1951 and still refuses to be a recep-
tion country. Migrant workers, refugees and asylum seekers are strongly discriminated
against and are often arbitrarily imprisoned; they suffer from extremely precarious living
                                                                                                                                         Mortality




                                                                                                   Human Development Report 2005, UNDP
conditions.                                                                                                                              > infant:27‰

                                                                                                                                         Life expectancy
                                                                                                                                         > at birth: 72

Access to care for imprisoned migrants                                                                                                   HDI
                                                                                                                                         > 0.759; ranked 81/177
Beirut
                                                                                                                                         Actual GDP/inhabitant ($)
Activities: At the beginning of 2005 MdM started work in          Outlook:                                                               > 4,224
Roumieh central prison in partnership with the Lebanese NGO,      Continue the programme in
Ajem. The work involves the following activities:                 2006: start activities focused
• welcoming new foreign inmates with welfare assistance, direc-   on training and health edu-                                            Beneficiaries
ting them towards the medical team and the welfare and legal      cation in other Lebanese pri-                                          > directly: at least 4,000 people
                                                                                                                                         (already in prison or recently entering
care organisations (including Ajem);                              sons; set up information and                                           prison) at Roumieh central prison.
• medical triage in the wings;                                    awareness activities on                                                > indirectly: approx. 5,500 Lebanese
• medical consultations three times a week and monitoring of      imprisoned migrants' access                                            prisoners in Roumieh prison, the
patients;                                                         to rights amongst the                                                  medical and non medical prison staff
                                                                                                                                         at Roumieh, local teams, project
• welfare and legal follow-up;                                    Lebanese authorities and                                               partners
• rehabilitation and supplying health equipment,                  the general public.                                                    Staff
distribution of blankets and hygiene products;                                                                                           > local: 8
• information sessions for prisoners, communicating IEC (infor-                                                                          > expatriate: 2
mation, education and communication) programmes/ sessions                                                                                Co-ordinators
on scabies and hygiene.                                                                                                                  > project: B. Lambert
Progress bar at 31/12/2005                                                                                                               > field: F. Mawazini puis B. Martin
10/01/2005                    31/12/2008                                                                                                 > HQ: S. Alary
                                           > Project
                                             progress
                                                                                                                                         Sources of funding
                                                                                                                                         > French Foreign Ministry, UNHCR,
                                                                                                                                         MdM

                                                                                                                                         Budget
                                                                                                                                         > 2005: 170,763 euros
Liberia
                                                                     Liberia is emerging from a fourteen year conflict which has cost 250,000 lives, caused the
                                                                     displacement of half the population, and completely devastated social and cultural life as
                                                                     well as the infrastructure and economy. The ceasefire agreement, signed in 2003 by the
                                                                     different factions, and the deployment of a civilian and military mission by the United
                                                                     Nations have engaged the country in an attempt at peace and reconstruction, consolida-
                                                                     ted by a national programme to demobilise and disarm the former fighters. The presiden-
                                                                     tial elections held in October 2005 are a crucial step towards the political stabilisation of
Mortality
> infant: 152‰                                                       the country and, for the international community, are an important challenge to make this
Life expectancy                                                      transition towards full and lasting autonomy successful.
                                    Source: World Bank Report 2003




> at birth: 46.8

HDI
> not known
                                                                     Primary, community
Actual GDP/inhabitant ($)
> 192                                                                and mental healthcare
                                                                     Gbarnga, Bong province
Beneficiaries                                                        Activities: In Bong county, MdM is training and supporting          Outlook:
> directly: 124,678                                                  national healthcare staff from 9 health centres in the following    In 2006, MdM plans to open
> indirectly: 200,506                                                activities:                                                         a 10th health centre,
Staff                                                                • consultations in primary and reproductive healthcare inclu-       Jorwah, on the Guinea bor-
> expatriate: 10                                                     ding STI prevention;                                                der which will offer the same
                                                                     • epidemiological surveillance (malaria, cholera, etc) and nutri-   primary healthcare services.
Co-ordinators                                                        tional monitoring especially for under 5s;                          MdM also wants to be more
> project: P. Hirtz
> field: S. Pont Turco                                               • vaccination services;                                             actively involved in addres-
> HQ: Emergency desk then project                                    • transferring emergencies towards referral hospitals.              sing sexual violence against
transferred to Africa desk: B.                                       MdM is also setting up psychological and psychiatric support        women
Contamin, A. Belaid                                                  services for women and girls who have been the victims of           (SGBV, sexual gender based
Sources of funding                                                   sexual violence.                                                    violence) in Liberia.
> Echo, German and Dutch Foreign
Ministries                                                           Progress bar at 31/12/2005
                                                                     09/2003   poursuite du programme en 2006
Budget
> 2005: 1,065,691 euros                                                                                          > Project
                                                                                                                   progress
                                                                                                                                                                           76/77
  Mali
Mali is one of the transit countries for the migrant populations of Sub-Saharan origin
heading towards Europe. Its immigration policy allows nationals from other African
countries to enter the country without a visa. In addition, it is to Mali that the Algerian
authorities return illegal migrants apprehended on their territory. Women are subject to
the full force of the poor health conditions and the difficulty of accessing healthcare.
Therefore, the high maternal mortality rate (580‰) can be explained by the consequen-
ces of vesico-vaginal type fistulas.                                                                                                           Mortality
                                                                                                                                               > infant:122‰

Health watch amongst migrants                                                                                                                  Life expectancy




                                                                                                         Human Development Report 2005, UNDP
                                                                                                                                               > at birth: 47.9
Tinzaouatene, then Gao                                                                                                                         HDI
                                                                                                                                               > 0.333; ranked 174/177
Activities: Started in September 2005, the pilot project aims       Outlook:
to set up a programme aimed at improving the health and welfare     End the pilot project after                                                Actual GDP/inhabitant ($)
conditions of the migrant populations in transit through Mali and   defining a suitable long-term                                              > 371
to bear witness to rights violations by:                            programme.
                                                                                                                                               International delegation
• observing the living conditions and trajectories of the migrant                                                                              > MdM Belgium
populations in transit;
• evaluating the conditions for migrant populations whereby they
have access to healthcare in Tinzaouatene and Gao regions;
• developing an information network and gathering testimonies of                                                                               Beneficiaries
violations of which the migrant populations are victims.                                                                                       > directly project 1: not defined
                                                                                                                                                because pilot project
                                                                                                                                               > directly project 2: women victims
Progress bar at 31/12/2005                                                                                                                      of vesico-vaginal fistulas
09/2005                           02/2006
                                            > Project
                                              progress
                                                                                                                                               Staff
                                                                                                                                               > local project 1: 1
                                                                                                                                               > expatriate project 1: 1
                                                                                                                                               > local project 2: 7
                                                                                                                                               > expatriate project 2: 1
Surgery of exclusion
                                                                                                                                               Co-ordinators
Mopti Region                                                                                                                                   > project 1: D. Guerroudj
                                                                                                                                               > project 2: J.-M. Colas
Activities: MdM is continuing its programme of prevention           Outlook:                                                                   > field 1: A. Grousset
and treatment of vesico-vaginal fistulas. This has four aspects     Continue training surgeons and                                             > field 2: J.-M. Zino
to it:                                                              a gynaecologist in fistula surgery                                         > HQ project 1: O. Mouzay
• surgical treatment of women;                                      and set up a national project for                                          > HQ project 2: O. Mouzay
• training local surgeons and the operating theatre team;           treating vesico-vaginal fistulas                                           Sources of funding
• spreading prevention messages (on local radio, through            integrating the work carried out                                           > project 1: MdM
theatre);                                                           by Mopti hospital.                                                         > project 2: MdM, Norwegian church,
• literacy sessions for patients who want it.                       Support the growing autonomy                                                AED

Progress bar at 31/12/2005                                          of Mopti hospital until the new                                            Budget
 12/1999                          06/2006                           hospital is built in Sevare.                                               > 2005 project 1: 4,495 euros
                                            >   Project
                                                progress                                                                                       > 2005 project 2: 109,160 euros
Madagascar
                                                                                Great poverty remains the lot of a large majority of Madagascans. Despite annual eco-
                                                                                nomic growth of 6% and debt cancellation in June 2005 by the G8, Madagascans
                                                                                continue to fight for their survival. Awareness of HIV is still insufficient, and the num-
                                                                                ber of people affected continues to grow. The obvious insufficiency of medical and
                                                                                surgical care and difficulty accessing it are making an already alarming situation
                                                                                worse.

Mortality
> infant: 78‰
                                                                                STI/AIDS prevention and education
                                          Human Development Report 2005, UNDP




Life expectancy
> at birth: 55.4                                                                Tulear
HDI                                                                             Activities: The joint venture between Sisal and MdM involves         Outlook:
> 0,499; ranked 146/177                                                         technical support defined by the following activities:               The Sisal team in Tulear has
Actual GDP/inhabitant ($)                                                       • evaluating and supporting human resources and monitoring           done a good job in taking
> 324                                                                           the development of the Tulear centre. Training is also given;        over the centre and in develo-
                                                                                • supporting and mentoring Sisal managers (national co-ordina-       ping the planned programme.
                                                                                tor, technical manager, administrative and financial manager);       MdM will withdraw support at
Beneficiaries                                                                   • providing group training and staff retraining;                     the beginning of 2006 and will
>directly project 1: local team from                                            • providing support for Sisal's institutional capacity;              thus allow Sisal to confirm its
 NGO Sisal (7 people)                                                           • improving management skills                                        autonomy. However, MdM
> directly project 2: at-risk groups
(1,200 sex workers, mining prospectors,                                                                                                              and Sisal will continue to work
young people in or out of school and                                                                                                                 together as privileged partners
Salfa Centrre consultants                                                       Progress bar at 31/12/2005                                           in the fight against STIs/HIV in
> indirectly project 1: groups at risk                                          02/2004                           02/2006                            Madagascar.
of STIs/HIV/AIDS and the general
population of Tulear                                                                                                         > Project
                                                                                                                               progress
> indirectly project 2: 25,000 people

Staff
> local project 1: Sisal team
> local project 2: 6
                                                                                Integrated project to fight against STIs/HIV/AIDS
> expatriate project 1: 1                                                       Ilakaka
> expatriate project 2: 1
                                                                                Activities: After a KAP survey and prior training of the Salfa       Outlook:
Co-ordinators                                                                   (Madagascan NGO) team, the activities will be as follows:            MdM plans to provide tech-
> project 1: C. Ottenwaelder,                                                   • IEC (Information, education, communication) and close              nical support for 24 months,
  C. Vichatzky
> project 2: C. Vichatzky                                                       work amongst at-risk populations;                                    after which MdM should
> field 1: X. Joubert                                                           • prevention, screening and treatment of STIs;                       withdraw from the project
> field 2: Ben Aboubacar                                                        • voluntary, anonymous and free HIV testing and treatment of
> HQ project 1 and 2: O. Mouzay                                                 people living with HIV;
Sources of funding
                                                                                • strengthening local capacity in the fight against STIs/HIV/AIDS.
> project 1: MdM
> project 2: MdM, AFD
                                                                                Progress bar at 31/12/2005
Budget                                                                          12/2004                           12/2006
> 2005 project 1: 9,429 euros
> 2005 project 2: 92,644 euros                                                                                               > Project
                                                                                                                               progress
                                                                                                                                   78/79




Support for health in prisons                                                                         Beneficiaries
Ambanja and Antsiranana                                                                               > directly: 800 prisoners

Activities: This programme is considered as a pilot project, as      Outlook:                         Staff
this is the first time MdM has got involved in prison work in        Extend the pilot project to a    > expatriate: 1 national co-ordinator
Madagascar. The reference plan has six complementary aspects         regional programme, by initia-   Co-ordinators
in order to act on the many factors behind poor prison conditions:   ting and developing this pro-    > project: S. de Carheil
• medical;                                                           ject in other prisons.           > field: O. Bouron
• nutritional;                                                                                        > HQ: O. Mouzay
• rehabilitation;                                                                                     Sources of funding
• sanitation (in partnership with the Swiss NGO Medair, with whom                                     > MdM, French embassy
MdM worked after the Gafilo cyclone);
• welfare and legal;                                                                                  Budget
                                                                                                      > 2005: 91,114 euros
• co-ordination and continuation of the activities to ensure the
effectiveness of the aforementioned aspects.

Progress bar at 31/12/2005
09/2005                           08/2006
                                             > Project
                                               progress




Childhood Action, cardiopathy in children                                                             Beneficiaries
Antananarivo                                                                                          > directly: 600
                                                                                                      > indirectly: families of children and
Activities: A team from Reunion made up of 2 heart sur-              Outlook:                           Madagascan medical staff
geons, 2 paediatric cardiologists and 1 anaesthetist and resus-      MdM plans to continue its
                                                                                                      Staff
citation expert carry out 2 visits each year to Soavinadriana        work in 2006 and is conside-     > local: 4
hospital in Antananarivo. Each visit lasts a week. There are 3       ring a possible consortium       > expatriate: paediatric heart sur-
aspects to the team's activities:                                    with other partners working in     geons, paediatric cardiologists,
• consultations which in 2005 involved 454 patients, including       cardiopathy so that this pro-      anaesthetists and resuscitation
                                                                                                        experts, nurses (4 or 5 people for
191 new cases, 15 cases of closed-heart surgery and 74               ject can continue.                 each medical-surgical visit)
cases of open-heart surgery (medical evacuation).
• surgery, where MdM's surgeons in conjunction with Professor                                         Co-ordinators
Hubert Razafindramboa's local team carry out closed-heart                                             > project: J.-F. Delambre
                                                                                                      > field: N. Ramamonjisoa
operations. 20 operations were carried out in Antananarivo                                            > follow-up: DR océan Indien
and 11 at the regional Félix Guyon Hospital in Saint-Denis,
Reunion, for the open-heart operations;                                                               Sources of funding
• skills transfer, which involves training a Madagascan heart                                         > La Réunion general council, MdM
                                                                                                        Indian Ocean donors
surgeon in Reunion and mentoring of the local team during
each visit.                                                                                           Budget
                                                                                                      > 2005: 71,902 euros

Progress bar at 31/12/2005
1996
                                             > Project
                                               progress
Mexico
                                                                          Social inequalitiies persist in Mexico despite good economic health and the fact that
                                                                          this country is a real commercial power. In the south, Hurricanes Stan and Wilma hit
                                                                          the regions hard where the marginalised Indian populations already live in situations
                                                                          of extreme poverty. In the north, the linea, which many prospective illegal emigrants
                                                                          to the United States cross each day, remains a very precarious at-risk area.


Mortality
> infant: 23‰
                                                                          Improving the community health system
Life expectancy
> at birth: 75.1                                                          Chiapas Region
                                    Human Development Report 2005, UNDP




HDI                                                                       Activities: In Chiapas region, MdM's current programme         Outlook:
> 0.814; ranked 53/177                                                    (it has been working in Mexico since 1998) aims to improve     Setting up a self-managed
Actual GDP/inhabitant ($)                                                 the health of the Tzotzil population. With community sup-      health system provides the
> 6,121                                                                   port, MdM is working to train health promoters and to set up   promise of greater autonomy
                                                                          four micro-clinics to allow these populations to have access   for the Indians, whereas
International delegations                                                 to healthcare.                                                 genuine negotiations bet-
> MdM Spain, MdM Switzerland
                                                                          More than 500 promoters who are responsible for the health     ween the government and
                                                                          of their communities organise their work around three micro-   the Zapatista movement in
                                                                          clinics.                                                       the south of Chiapas would
Beneficiaries                                                                                                                            enable more lasting solutions
> directly: indigenous population                                         Progress bar at 31/12/2005
                                                                          01/01/2003                  31/06/2006                         for managing their health to
Staff
> expatriate: 2
                                                                                                                   > Project
                                                                                                                     progress            be found.

Co-ordinators
> project: T. Brigaud
> field: C. Martin
> HQ: M. Ethvignot

Sources of funding
> EU, MdM

Budget
> 2005: 236,005 euros
                                                                                                                                   80/81




Access to healthcare for the migrant population                                                        Beneficiaries
Tijuana, Mexicali                                                                                      > directly: migrants
Activities: MdM is implementing a project aimed at impro-              Outlook:                        Staff
ving access to healthcare and respecting the right to health           The project will be continued   > local: 1
of migrant populations on Mexico's northern border in the              under the same terms in         > expatriate: 1
towns of Tijuana and Mexicali.                                         2006.                           Co-ordinators
It has the following objectives:                                                                       > project: M.-D. Aguillon
• facilitating healthcare for the migrant populations in Tijuana and                                    et F. Giraud
Mexicali;                                                                                              > field: B. Ponçon
                                                                                                       > HQ: M. Ethvignot
• preventing the transmission of HIV/AIDS/STIs amongst the
migrant population;                                                                                    Sources of funding
• promoting and encouraging the respect of the right to health                                         > MdM, French Foreign Ministry
of the migrant populations on the northern border.                                                     Budget
Progress bar at 31/12/2005                                                                             > 2005: 100,091 euros
04/2005                            03/2008
                                              > Project
                                                progress




Hurricane emergency                                                                                    Beneficiaries
Chiapas (Escuintla, Mapastepec, Huixtla and Tapachula)                                                 > directly: 18,865 people
Activities: Hurricane Stan hit southern Mexico on 4 October.           Outlook:                        Staff
The ensuing floods, rivers breaking their banks and landsli-           The emergency medical treat-    > local: 2
des caused a lot of damage in Chiapas. After evaluating the            ment programme ended in         > expatriate: 1
affected areas between 7 and 13 October and making contact             December 2005.                  Co-ordinators
with the health authorities, the work focused on the town of                                           > project: T. Brigaud
Escuintla, where 84% of the population were affected by the                                            > field: C. Martin
hurricane.                                                                                             > HQ: F. Stea
The activities have involved:                                                                          Sources of funding
• re-establishing access to healthcare for the affected                                                > Mexican Chamber of Commerce
populations of the Sierra Madre Mediana and Alta of Escuintla;                                         (Banamex); French Embassy,
                                                                                                       MdM
• treatment of and surveillance of potential epidemics.
                                                                                                       Budget
                                                                                                       > 2005: 106,207 euros
Progress bar at 31/12/2005
07/10/2005                      15/12/2005
                                              > Project
                                                progress
Moldova
                                                                                 Today Moldova is one of the poorest countries in Europe. The very weak economic
                                                                                 situation and increasing inflation are pushing Moldovans to emigrate en masse to
                                                                                 more prosperous countries. Unfortunately, many of them have fallen into the hands of
                                                                                 human traffickers who insidiously profit from the despair and lack of prospects of
                                                                                 young Moldovans to feed their networks.



Mortality
> infant: 26‰
                                                                                 Preventing trafficking
Life expectancy                                                                  and caring for the victims
                                           Human Development Report 2005, UNDP




> at birth: 67.7
                                                                                 Balti Region, north Moldova
HDI
> 0.671; ranked 115/177                                                          Activities: There are two aspects to MdM's work:                    Outlook:
                                                                                                                                                     Continue the activities.
Actual GDP/inhabitant ($)
                                                                                 • increasing access to prevention services and to ove-
> 463                                                                            rall care for young people in general and young victims of
                                                                                 trafficking or those belonging to at-risk groups, particularly in
International delegation                                                         the context of a partnership with the ATIS Friend of Young
> MdM Greece
                                                                                 People Centre, run by the TDV organisation;
                                                                                 • help the Friend of Young People Centre to continue by
                                                                                 being integrated into the national health system and streng-
Beneficiaries
> directly: nearly 8,000 young people                                            thening collaboration with the regional and national networks
  over two years, of whom around                                                 fighting against human trafficking.
  1,500 are from the most vulnerable
  sectors of the population, and the                                             Progress bar at 31/12/2005
  beneficiaries of the training (team
                                                                                 04/2005                           12/2007
  from the ATIS centre in Balti - 8 peo-
  ple -, members of the victim identifi-                                                                                     > Project
                                                                                                                               progress
  cation network - approx. 60 people)
> indirectly: parents of young people
  attending the centre and the whole
  of the Moldovan population poten-
  tially affected by trafficking.

Staff
> local: 10
> expatriate: 1

Co-ordinators
> project: F. Parrot
> field: L. Ilie
> HQ: A. Landaes

Source of funding
> MdM

Budget
> 2005: 82,038 euros
                                                                                                                                                                    82/83
  Mongolia
A young Asian democracy, Mongolia's economy is gradually taking off but a third of its
population lives below the poverty line and corruption is endemic. In a country where life
has remained focused on a traditional nomadic way of life, alcoholism has become a
serious problem. Women and children are the first victims of alcohol-induced violence.




Fighting against alcoholism                                                                                                               Mortality
                                                                                                                                          > infant: 56‰




                                                                                                    Human Development Report 2005, UNDP
and treating tuberculosis                                                                                                                 Life expectancy
Ulan Bator                                                                                                                                > at birth: 64
Activities: MdM's project is focused on implementing a pro-        Outlook:                                                               HDI
gramme of alcoholism and tuberculosis prevention and               In January 2006 a fifteen                                              > 0,679; ranked 114/177
treatment amongst people living in a district of yurts (Ulan       day training seminar is plan-
Bator shanty towns), who are excluded from access to health-       ned, to be attended by three                                           Actual GDP/inhabitant ($)
                                                                                                                                          > 514
care for administrative reasons.                                   alcohol dependency experts.
Mongolia suffers from a lack of co-ordination and diversity with   We have the following objec-
respect to therapeutic models for alcoholism, as well as struc-    tives for the coming year:                                             Beneficiaries
tural problems for treating tuberculosis. A local team, made up    • screening people living in                                           > directly: 1,500,000
of a doctor, nurse and social worker, has been formed. In addi-    the target yurt districts who                                          > indirectly: 1,500,000
tion, a partnership has been signed with the Ulan Bator addic-     are affected by alcoholism
                                                                                                                                          Staff
tion centre.                                                       and tuberculosis and direc-                                            > local: 3
Progress bar at 31/12/2005                                         ting them towards suitable                                             > expatriate: 2
10/2005                             2006                           structures, with mobile MdM
                                           > Project
                                             progress              medical teams;                                                         Co-ordinators
                                                                                                                                          > project: G. Lacaze and P. Guibé
                                                                   • supporting target popula-                                            > field: O. Delclos (non-med.)
                                                                   tions in irregular situations                                          and C. Durot (med.)
                                                                   so that they recover their                                             >HQ: E. Martinon
                                                                   right to health (working toge-
                                                                                                                                          Sources of funding
                                                                   ther with organisations);                                              > MdM, currently requested (ADB,
                                                                   • training and awareness                                                EU, JICA, etc.)
                                                                   programmes amongst health
                                                                   staff and target populations;                                          Budget
                                                                                                                                          > 2005: 13,915 euros
                                                                   • lobbying of health, police
                                                                   and political authorities with
                                                                   the creation of a co-ordina-
                                                                   tion platform.
Morocco
                                                                                           Moroccan society has been lastingly marked by the mass repression of the “Years of
                                                                                           Lead”. The Equity and Reconciliation Committee (IER), set up on 1 January 2004 by the
                                                                                           current monarch, Mohammed VI, has built up a large number of dossiers with a view to
                                                                                           rehabilitating and compensating the victims of Hassan II's regime. Most of the people who
                                                                                           were tortured and testified at that time have issued strong demands for medical treatment
                                                                                           as well as legal and moral support.
                                          Rapport sur le développement humain 2005, PNUD




Mortality
> infant: 36‰

Life expectancy
                                                                                           Supporting victims of torture
> at birth: 69.7                                                                           Casablanca, Marrakesh
HDI                                                                                        Activities: At the request of organisations and the Reception      Outlook:
> 0.631; ranked 124/177                                                                    and Orientation Centre for Victims of Torture (CAOVT), MdM's       The first training was given
                                                                                           work involves organising two training sessions in psychologi-      in June 2005. Two psychia-
Actual GDP/inhabitant ($)                                                                  cal trauma for a multi-disciplinary team of doctors, psycholo-     trists will evaluate this initial
> 1,452
                                                                                           gists, social workers and reception workers involved in various    training amongst participants
                                                                                           Moroccan organisations dealing with the physical and men-          in March 2006. The second
                                                                                           tal care of victims of torture. This training should allow the     training will then take place
Beneficiaries
> directly: around thirty participants                                                     Moroccans to share practices and encourage the setting up          during the second quarter of
in the training courses                                                                    of a network for caring for victims across the whole of Morocco.   2006.
> indirectly: 29,000 victims of
Moroccan jails
Staff
> expatriate: 2 psychiatrists, 1 doctor                                                    Progress bar at 31/12/2005
  and 1 psychologist monitor the                                                           01/01/2005                       fin 2006
  project and provide the training                                                                                                     > Project
                                                                                                                                         progress

Co-ordinators
> project: J. Beckouche
> HQ: S. Alary

Source of funding
> MdM

Budget
> 2005: 7,889 euros
                                                                                                                                                                  84/85
 Nepal
The coup of 1 February 2005 worsened an already very fragile military and political situa-
tion and most aid programmes were suspended because of the uncertainties over the
country's future. Today Nepal is one of the 10 poorest countries in the world, and no effec-
tive development can be considered in such a political context of conflict. In addition,
AIDS and tuberculosis are continuing to spread across the whole country.


Fighting tuberculosis and HIV                                                                                                           Mortality
                                                                                                                                        > infant: 61‰
Western Regions
                                                                                                                                        Life expectancy
Activities: MdM has been working in Nepal since 1995.           Outlook:                                                                > at birth: 61.6




                                                                                                  Human Development Report 2005, UNDP
The programme which began in 2002 aims to prevent and           In 2006, MdM expects to fina-
control the spread of tuberculosis and AIDS in four dis-        lise its HIV prevention project                                         HDI
tricts in western Nepal: Palpa, Syangja, Gulmi and Argha        and to explore the remote                                               > 0.526; ranked 136/177
Kanchi.                                                         western areas with a view to                                            Actual GDP/inhabitant ($)
During 2005, the work was refocused on the fight against        running an emergency type                                               > 237
AIDS, and concentrated on the target populations only: intra-   project on access to healthca-
venous drug users, migrants, prisoners, prostitutes and their   re for the people in the Maoist                                         International delegations
                                                                                                                                        > MdM United States, MdM
clients.                                                        area, but also to develop a                                             Switzerland
Awareness and information activities have been developed        project amongst migrant
using health educators in the villages, voluntary counselling   populations.
                                                                                                                                        Beneficiaries
and testing centres (VCTs), prisons and hotels at the same                                                                              > directly: 1,150 and 50% of the
time, in conjunction with our local partners, Naulo Gumti and                                                                            prostitutes in Syangja district
Friends of Hope.                                                                                                                        > indirectly: 1,200,000 (population
                                                                                                                                         of 4 districts)
Progress bar at 31/12/2005
01/01/2002                   28/02/2006                                                                                                 Staff
                                          > Project
                                            progress                                                                                    > local:25
                                                                                                                                        > expatriate: 3

                                                                                                                                        Co-ordinators
                                                                                                                                        > project: P. Baguet and O. Lermet
                                                                                                                                        > field: M. Piasecki
                                                                                                                                        > HQ: E. Martinon

                                                                                                                                        Sources of funding
                                                                                                                                        > EU, ICCO, MdM

                                                                                                                                        Budget
                                                                                                                                        > 2005: 198,980 euros
Opération Sourire
Countries of intervention
        in 2005                Opération Sourire's aim is to put a smile back on the faces of those who have been dis-
          Benin
       Cambodia                figured by war, illness and malnutrition and to enable people excluded because of their
         Eritrea               disability to have a social life again.
      Madagascar
           Mali
                               Plastic surgery still does not exist in the health system of many countries because of a
        Mongolia               lack of qualified human resources, equipment and infrastructure. Due to the considera-
          Niger                ble demand for plastic surgery and the complete lack of treatment for patients, the doc-
        Pakistan
        Rwanda                 tors of Opération Sourire are working amongst this forgotten population.




Co-ordinators                  Activities and salient points in 2005
> project: F. Foussadier;
 F. Lauwers                    Activities: 2005 was the year when the Opération Sourire             Outlook:
> HQ: A. Segard                projects' long term future was confirmed. These projects             Opération Sourire's projects
Sources of funding             are more and more vital and becoming locally integrated. In          are continuing, especially on
> private funds, businesses,   particular, they reinforce the training given to local teams.        the training side, to ensure
 foundations                   Opération Sourire's work is thus gradually changing from             that the local teams are inte-
                               replacing local staff to strengthening the skills of local health-   grating their new skills. In this
Budget
> 2005: 324,324 euros          care teams.                                                          context, Opération Sourire
                                                                                                    wants to take part in develo-
                                                                                                    ping and setting up local
                                                                                                    centres, with increased capa-
                                                                                                    city in terms of recruiting
                                                                                                    patients and post-operative
                                                                                                    monitoring. Recruiting local
                                                                                                    staff and strengthening
                                                                                                    management capacity should
                                                                                                    help achieve this objective.
                                                                                                    Projects to build plastic sur-
                                                                                                    gery centres with the involve-
                                                                                                    ment of Opération Sourire
                                                                                                    are being developed in
                                                                                                    Benin, Cambodia and Niger.
                                                                                                                                                                          86/87
Pakistan
The most violent earthquake in Central Asia since 1947 hit Pakistan on 8 October 2005. The
number of victims exceeded 73,000 dead and 70,000 injured, including many children and
young people. Nearly 70% of homes in Kashmir were destroyed, and help could only reach
the area by air until roads were cleared and repaired.
In this emergency situation, women continue to be deprived of their most basic human
rights on a daily basis and are the victims of violence and killed, often for matters of honour.


Emergency help for earthquake victims                                                                                                        Mortality
                                                                                                                                             > infant: 81‰




                                                                                                       Human Development Report 2005, UNDP
NWFP Province and Islamabad                                                                                                                  Life expectancy
                                                                                                                                             > at birth: 63
Activities: The day after the earthquake, the work was organi-       Outlook:
sed around three sites:                                              In 2006 MdM will seek to                                                HDI
• Mansehra (NWFP), where a surgical team came to support             widen its work by getting                                               > 0.527; ranked: 173/177
Pakistani teams to operate on earthquake victims;                    involved in mobile consulta-
• Thakot and Balakot (NWFP), where permanent and mobile pri-         tions in the smallest camps                                             Actual GDP/inhabitant ($)
                                                                                                                                             > 304
mary healthcare teams operated, thus providing an initial contact    which have sprung up in
with emergency services for the population in these two areas.       NWFP and in Islamabad. The                                              International delegations
Once the immediate emergency had passed, Médecins du Monde           need to support people as                                               > MdM Greece, MdM Cyprus
                                                                                                                                             This project is carried out in
got involved in helping homeless and displaced people through the    they return to their home areas                                          partnership with MdM Spain
winter by providing primary healthcare in Islamabad where a clinic   will be assessed along with
(for general consultations, reproductive health, community health,   the need for longer term sup-
etc.) was opened in camp H11, and in Mansehra, where a similar       port for rebuilding and reacti-                                         Beneficiaries
structure was set up in Jabba camp.                                  vating health services.                                                 > directly project 1: 50,000
                                                                                                                                             > directly project 2: 4,500 women
Progress bar at 31/12/2005                                                                                                                   and 360 children
09/10/2005                                                                                                                                   > indirectly project 2: 300,000
                                             >   Project
                                                 progress
                                                                                                                                             Staff
                                                                                                                                             > local project 1: 20
                                                                                                                                             > local project 2: 10
                                                                                                                                             > expatriate project 1: 16
Helping women victims of domestic violence                                                                                                   > expatriate project 2: 2
Sargodha, Lahore, Faisalabad and Gujranwala                                                                                                  Co-ordinators
Activities: A 9-month pilot project with the aim of providing        Outlook:                                                                > projects 1 and 2: B. Ten Kate
                                                                     Continue the activities and                                             > field 1: D. Defrade
medical, psychological and legal assistance to women                                                                                         > field 2: M. Jactat / C. Buffet
                                                                     extend to 8 Dar-ul-Aman in                                              > HQ 1: desk Urgence
victims of domestic violence was set up in the Dar-ul-Aman in
Sargodha (Punjab). The activity was then gradually extended to
                                                                     the Punjab. The project has                                             > HQ 2: N. Bréchet
                                                                     7 aspects including medical
three new refuges in Lahore, Faisalabad and Gujranwala. This pro-                                                                            Sources of funding
                                                                     assistance, psychological
gramme stresses the involvement of civil society and government                                                                              > project 1: Dutch Foreign Ministry,
                                                                     support, legal assistance                                                Memisa Belgium, MdM
authorities, and on training the Dar-ul-Aman staff, a guarantee of
the viability of such work.
                                                                     and training for the staff of                                           > project 2: French Embassy in
                                                                     the Dar-ul-Aman and other                                                Khartoum
Progress bar at 31/12/2005                                           Punjabi institutions, and
                                                                                                                                             Budget
2004                                  2008                           government executives, etc.                                             > 2005 project 1: 490,736 euros
                                             >   Project
                                                 progress
                                                                                                                                             > 2005 project 2: 100,310 euros
Palestinian Territories
                                                                                         The emergency continues in the Palestinian Territories despite the relative calm of 2005.
                                                                                         Although the settlements have been dismantled and the Israeli army does not intend to
                                                                                         penetrate inside the Gaza strip, it remains a hermetically sealed area, subject to consi-
                                                                                         derable restrictions and air raids. In the West Bank, the Palestinian Authority, which is
                                                                                         bogged down in the difficult task of administration post-Arafat, is struggling to find solu-
                                                                                         tions for healthcare and the fight against poverty, amongst other things, bearing in mind
                                                                                         the Israeli security pressure and the impact of the construction of the separation wall on
Mortality
> infant: 22‰                                                                            the people's access to healthcare.
                                        Rapport sur le développement humain 2005, PNUD




Life expectancy
> at birth: 72.5

HDI                                                                                      Improving emergency treatment
> 0.729; ranked 102/177                                                                  Gaza Strip
Actual GDP/inhabitant ($)
> 1,026
                                                                                         Activities: There are three parts to the programme:              Outlook:
                                                                                         • improving the civilian population's knowledge of first         MdM will continue all its acti-
International delegations                                                                aid, and of how to treat emergencies before the emer-            vities in 2006.
> MdM Cyprus, MdM Switzerland                                                            gency services arrive, in the Gaza strip between now and the
                                                                                         end of 2006 (training trainers amongst 74 paramedics from
                                                                                         the UNRWA health centres, 56 teachers, then training 1,200
Beneficiaries                                                                            school children in the UNRWA refugee camps, integration of
> directly: 1,300 trainers, teachers,                                                    BLS in the UNRWA school curriculum from the start of the
 school children and hospital staff                                                      2005-2006 academic year;
> indirectly: 1,400,000 people living
 in the Gaza strip                                                                       • a programme to train Emergency Medical Technician
                                                                                         (emergency ambulance EMTs) trainers in the two
Staff                                                                                    Palestinian Red Crescent Society training institutions in Gaza
> local: 8                                                                               and Ramallah, and setting up a new initial and ongoing trai-
> expatriate: 3 permanent
 and doctors for short periods                                                           ning programme;
                                                                                         • developing and setting up a reference “Plan for an
Co-ordinators                                                                            influx of injured or sick patients” within the emergency
> project: R. Garrigue, M. Rajablat                                                      department of Shiffa hospital (Gaza City).
> field: V. Miollanay puis D. Trani
> country: P. Villedieu                                                                  Progress bar at 31/12/2005
> HQ: S. Alary                                                                           01/01/2005                      fin 2007
Sources of funding                                                                                                                  > Project
                                                                                                                                      progress
> DAH, MdM

Budget
> 2005: 320,219 euros
                                                                                                                                 88/89




Mental health                                                                                         Beneficiaries
                                                                                                      > directly: 3,000
Nablus district in the West Bank                                                                      > indirectly: 3,000

Activities: Nablus district is the most strictly sealed off dis-     Outlook:                         Staff
                                                                                                      > local:11
trict of the Palestinian Territories. MdM is determined to improve   MdM is going to continue         > expatriate: 2
the treatment of mental health problems there through:               the activities it was involved
• a campaign amongst the Palestinian people to remove the            in in 2005, start three liste-   Co-ordinators
stigma of mental illness through booklets, posters, TV ads and       ning points (reception cent-     > project: R. Garrigue, M. Rajablat
                                                                                                      > field: T. Groh, puis
radio programmes;                                                    res with a therapeutic aim)       L. Robin, puis C. Thévenot
• mental health training for medical and paramedical staff in        and especially help to set up    > country: P. Villedieu
the primary healthcare centres and for mental health profes-         two medical and psychologi-      > HQ: S. Alary
sionals;                                                             cal community centres (one
                                                                                                      Sources of funding
• support for a “theatre in schools” activity, transferred to a      in Nablus and one in Jenin)      > French Foreign Ministry, MdM
local organisation;                                                  in partnership with the
• mental health seminars;                                            Palestinian Health Ministry.     Budget
• activities in two literary cafés for men in Nablus town cen-       Consultations will be taken      > 2005: 333,058 euros
tre and Balata refugee camp;                                         over by the Palestinian Red
• setting up a mobile mental health consultation service in          Crescent Society.
eight villages in Nablus district, also providing awareness and
training sessions for primary healthcare staff in the dispensa-
ries involved.

Progress bar at 31/12/2005
01/01/2005                        fin 2007
                                             > Project
                                               progress




Access to healthcare and the Wall
West Bank                                                                                             Beneficiaries
                                                                                                      > directly: 13,000 (mobile clinics),
Activities: Since May 2004, MdM has been developing                  Outlook:                         39,000 (Aizaria station)
activities aimed at providing medical support to the peo-            The Wall programme ended
ple affected by the Wall and bearing witness to its impact           in April 2005.                   Staff
on health:                                                                                            > local: 3
                                                                                                      > expatriate: 2
• setting up an ambulance station in the Aizaria enclave, east
of Jerusalem, in partnership with the Palestinian Red Crescent                                        Co-ordinators
Society; training ambulance men;                                                                      > project: R. Garrigue, M. Rajablat
• improving ante- and post-natal monitoring for women with                                            > field: K. Peters et L. Weisgerber
                                                                                                       pour l’advocacy
at-risk pregnancies; treatment of under 5s in 10 villages around                                      > country: P. Villedieu
Jenin and Bethlehem;                                                                                  > HQ: S. Alary
• equipping a laboratory in Rantis village, in an enclave north-
east of Ramallah.                                                                                     Sources of funding
                                                                                                      > MdM, French Consulate in
Progress bar at 31/12/2005                                                                            Jerusalem
01/04/2004                     30/04/2005
                                             > Project
                                               progress
                                                                                                      Budget
                                                                                                      > 2005: 109,587 euros
Peru
                                                                   As the 2006 elections approach, Alejandro Toledo's government is desperately trying
                                                                   to appease the discontent and social movements, whose main demands in 2005 were
                                                                   for a salary increase, a review of agricultural policy and improved living conditions.
                                                                   However, unemployment and great poverty continue to cause deep disquiet in
                                                                   Peruvian society, especially in Lima, where more than a third of the population live on
                                                                   less than two dollars a day.

Mortality
> infant: 26‰

Life expectancy
> at birth: 70
                                                                   Promoting sexual and reproductive health
                                                                   Lima
                             Human Development Report 2005, UNDP




HDI
> 0.762; ranked 79/177                                             Activities: The project aims to improve access to pre-                 Outlook:
                                                                   ventive and curative care with respect to sexual and                   The following activities will be
Actual GDP/inhabitant ($)                                          reproductive health for 10 to 19 year olds. It works in three          implemented:
> 2,231                                                            districts of the southern cone of Lima, around 9 existing health       • a mass awareness cam-
Délégation internationale                                          structures and through:                                                paign (such as a concert for
> MdM Espagne                                                      • community awareness through trained promoters working                young people);
                                                                   within the districts to locate isolated young mothers and pre-         • two awareness campaigns
                                                                   gnant teenagers who do not have access to the health struc-            per district (six in total);
                                                                   tures; a massive awareness campaign with more than two                 • training 45 peer teenagers;
Beneficiaries                                                      campaigns per district; support for local health structures            • opening nine centres for
> directly: 47,246,10
 to 19 year olds                                                   through renovation and equipment, and healthcare staff trai-           young people;
                                                                   ning; work with schools;                                               • renovating and equipping
Staff                                                              • identifying reception and meeting places exclusively for tee-        nine health structures;
> local: 5                                                         nagers. Supplied by the town councils, these are listening and         • activating a network of key
> expatriate: 1
                                                                   awareness centres which provide contact with local health pro-         people.
Co-ordinators                                                      fessionals;
> projects: M. Boscaméric,                                         • developing a local network of those interested in caring for
 C. Batard
> field: N. Gravier
                                                                   teenage mothers: local government (town halls), basic welfare
> HQ: Y. Le Corgne                                                 organisations, and public and private institutions of civil society.

Sources of funding                                                 Progress bar at 31/12/2005
> Annenberg Foundation                                             01/10/2005                      30/09/2008
(United States), MdM                                                                                             > Project
                                                                                                                   progress

Budget
> 2005: 7,956 euros
                                                                                                                                                                     90/91
 Russia
Despite a hardening of policy and its stated desire to strengthen control over civil socie-
ty, Vladimir Putin's regime enjoys some popularity and this is because the Russian eco-
nomy is prospering. However, the situation of the indigenous peoples is increasingly cri-
tical, and the arrival of thousands of migrants in these remote areas (thanks to the inten-
sification of gas exploitation) has led to a demographic imbalance and an increase in eth-
nocultural stress. The lack of access to healthcare of these isolated indigenous peoples
is alarming: some previously contained illnesses such as tuberculosis and diphtheria are
                                                                                                                                           Mortality
reappearing, and their life expectancy is much lower than that of Russians.                                                                > infant: 16‰ (40.9‰ amongst the
                                                                                                                                             indigenous Yamal peoples)




                                                                                                     Human Development Report 2005, UNDP
                                                                                                                                           Life expectancy
                                                                                                                                           > at birth: 65.3 (48 for the
Helping isolated indigenous peoples                                                                                                        indigenous Yamal people)

Moscow                                                                                                                                     HDI
                                                                                                                                           > 0.795; ranked 62/177
Activities: As it is concerned with improving the primary health       Outlook:                                                            Actual GDP/inhabitant ($)
of the indigenous people without disturbing their way of life which    The 6 participating regions                                         > 3,018
is often based on nomadism, MdM has sought to encourage the            must implement CHW pro-
                                                                                                                                           International delegation
training of indigenous nomadic health officers, to work in             grammes in 2006-2007, for                                           > MdM United States
support of the existing structures (dispensaries and the Sanaviation   which MdM will provide
programme sending doctors and emergency services to remote             training for the CHWs and
areas).                                                                the booklet of training and
                                                                                                                                           Beneficiaries
MdM therefore organised a public health seminar with the aim           work and will support the                                           > indirectly: 100,000
of training Russian doctors to run and evaluate community health       different stages as an
worker (CHW) programmes for these indigenous peoples.                  expert reference.                                                   Staff
Using MdM's expertise and experience, based on running CHW                                                                                 > local: 3
                                                                                                                                           > expatriate: 2
programmes amongst Nenets nomads in the autonomous Yamal-
Nenets district between 1994 and 2001, this training seminar was                                                                           Co-ordinators
attended by 18 doctors from 6 regions.                                                                                                     > project: F. et A. Desplanques
It was divided into three main parts:                                                                                                      > field: P. Baril
                                                                                                                                           > HQ: A. Landaes
• presentation of features of CHW programmes;
• complete revision of the content of the booklets developed for                                                                           Source of funding
previous CHW programmes, with the addition of two sections on                                                                              > MdM
alcoholism and tuberculosis;
                                                                                                                                           Budget
• awareness of project management and programme evaluation                                                                                 > 2005: 21.609 euros
by MdM's teaching team writing a practical guide including “recom-
mendations”.


Progress bar at 31/12/2005
12/2005                               2007
                                              > Project
                                                progress
El Salvador
                                                                         The damage caused by Hurricane Stan and the violence of the maras (organised bands
                                                                         whose income is mainly from drugs racketeering and trafficking) make it difficult to deve-
                                                                         lop education systems, housing and access to healthcare, which are still insufficient,
                                                                         especially in the regions most affected by the civil war. MdM is concentrating its work on
                                                                         health assistance to the most vulnerable peoples of Morazán.



Mortality
> infant: 32 ‰                                                           A community health programme
                                   Human Development Report 2005, UNDP




Life expectancy                                                          Morazán Region
> at birth: 70.9

HDI
                                                                         Activities: The project involves providing support to our             Outlook:
> 0.722; ranked 104/177                                                  local partner, Doctors for the Right to Health (MDS), to              In 2006, the impact of the
                                                                         implement programmes concerning basic health services, envi-          management and IT training
Actual GDP/inhabitant ($)                                                ronmental decontamination, food security, nutrition, childhood-       of MDS staff will be evaluated
> 2,277
                                                                         related healthcare and training of promoters. The support involves:   to decide if any changes are
International delegation                                                 • management training for all MDS staff;                              needed. This training should
> MdM Spain                                                              • developing the organisation's communication system;                 mean the organisation is bet-
                                                                         • renewing IT equipment and software training;                        ter run and organised.
                                                                         • disinfection, training and prevention in 20 groups of houses,       Developing the organisation's
Beneficiaries                                                            as part of environmental decontamination campaigns;                   communication system will
> directly: 7,000                                                        • digging a well and a septic tank for the staff living quarters,     enhance the value of MDS's
> indirectly: 42,000                                                     next to the El Tablon healthcare centre in Morazán.                   work and make it easier to
Co-ordinators                                                            The project was disturbed in October 2005 by hurricane Stan           find new financial backers.
> project: J.-L. Pesle                                                   which caused considerable damage and 72,000 victims in the
> suivi: DR Rhône-Alpes-Grenoble                                         country. Doctors for the Right to Health put in a lot of work
                                                                         during the emergency and was able to care for 572
Source of funding
> MdM                                                                    people.

Budget                                                                   Progress bar at 31/12/2005
> 2005: 14,203 euros                                                     10/2004                            10/2007
                                                                                                                      > Project
                                                                                                                        progress
                                                                                                                                                   92/93
  Serbia
The union of Serbia and Montenegro is politically unstable because of the uncertainties over
the status of the neighbouring regions - Bosnia-Herzegovina and Montenegro - and of cer-
tain Serbian regions such as Voivodine and Kosovo. Following the conflicts and socio-eco-
nomic upsets which shook this region in the 1990s and the clear absence of significant
international cooperation, Serbia and Montenegro is also experiencing economic difficul-
ties. The provision of healthcare has clearly deteriorated and the HIV epidemic is growing,
especially amongst injectable drug users, although it is not possible to obtain clear infor-
mation on the epidemiological level.                                                                                     Mortality
                                                                                                                         > infant: 14‰

                                                                                                                         Life expectancy
                                                                                                                         > at birth: 73
Harm reduction
                                                                                                                         HDI
Belgrade




                                                                                                       WHO Report 2005
                                                                                                                         > not known
Activities: MdM's work amongst intravenous drug users has                Outlook:                                        Actual GDP/inhabitant ($)
several aspects:                                                         Support the local organisa-                     > not known
• street work amongst drug users via a mobile unit; this                 tion VEZA as part of the
aspect of the work involves exchange of sterile equipment and            transfer of the needle
spreading prevention messages aimed at drug users, near where            exchange programme which
                                                                                                                         Beneficiaries
they live while respecting their way of life (street work by peers and   began in 2005. Set up a                         > directly: 568
professionals);                                                          methadone programme.                            > indirectly: 1,704
• setting up a drop-in centre for intravenous drug users;
• raising awareness about the health risks linked to drug use                                                            Staff
                                                                                                                         > local: 7
and prevention activities;                                                                                               > expatriate: 1
• training those working with drug users.
                                                                                                                         Co-ordinators
Progress bar at 31/12/2005                                                                                               > project: P. Beauverie
10/2003                                 2009                                                                             > field: C. Debeaulieu
                                               > Project
                                                 progress
                                                                                                                         > HQ: A. Landaes

                                                                                                                         Sources of funding
                                                                                                                         > French Foreign Ministry, MdM

                                                                                                                         Budget
                                                                                                                         > 2005: 232,418 euros
                                                                                                                          Veza support: 45,673 euros
Sri Lanka
                                                                         Officially, a truce is in force between the government and the Liberation Tigers of Tamil
                                                                         Eelam (LTTE), but the peace process is still blocked and violence is increasing. The tsu-
                                                                         nami in 2004 weakened the country's economy and the population, already weak, suffe-
                                                                         red the full consequences of this. The Sri Lankan health system, however, is still conside-
                                                                         red a model for developing countries despite a fall in expenditure. But the health indica-
                                                                         tors do not take account of the area under LTTE control, which suffers from a serious lack
                                                                         of healthcare staff.
Mortality
> infant: 13 ‰

Life expectancy
> at birth: 74
                                                                         Renovating health structures
                                                                         Mallavi, Tunukkai and Naadankandal - Mullaitivu district
HDI
> 0.751; ranked 93/177                                                   Activities: MdM is responsible for renovating and sup-                Outlook:
                                   Human Development Report 2005, UNDP




                                                                         porting health structures in the Manthal East and Tunukkai            Several exploratory projects
Actual GDP/inhabitant ($)
> 948                                                                    divisions (Mullaitivu district).                                      were carried out in the northern
                                                                         The work in the Mallavi area is focused around 4 areas:               area and showed that health
Délégations internationales                                              • renovating and re-equipping Mallavi hospital (opening a new         needs were covered. The work
> MdM Spain, MdM Portugal,                                               operating theatre and emergency department, reorganising the          in Mallavi hospital will be
 MdM Cyprus, MdM Greece,
 MdM USA, MdM Belgium,
                                                                         out-patients consultation service, pharmacy, maternity unit, etc.;    suspended once the renovation
 MdM Argentina                                                           • re-organising and training local medical staff;                     work is complete. The work will
                                                                         • supplying the hospital and two health centres with drugs and        be monitored from HQ (working
                                                                         medical equipment;                                                    with a Sri Lankan co-ordinator
Beneficiaries                                                            • raising the authorities' awareness of problems encountered by       for any emergencies), as the
> directly project 1: 35,900                                             the hospital (funding, human and material resources).                 desire is to consider a longer
> directly project 2: 80,000                                                                                                                   term project.
                                                                         Progress bar at 31/12/2005
Staff                                                                    15/01/2005                      30/03/2006
> local project 1: 20
> local project 2: 10
                                                                                                                       > Project
                                                                                                                         progress
> expatriate project 1: 7

Co-ordinators
> project 1: C. Giboin, A. Cavey
                                                                         Emergency aid to tsunami victims
> project 2: P. Foldès                                                   Kinnya Division - Trincomalee district
> field 1: S. Brignano
> field 2: C. Giboin                                                     Activities: Kinnya hospital, the referral centre for some 80,000      Outlook:
> HQ 1: Emergency desk                                                   people, was destroyed by the tsunami in December 2004. In conjunc-    After the hospital had been
 then V. Pardessus
> HQ 2: Emergency desk                                                   tion with MdM Spain, the work has involved urgently re-establishing   rebuilt and the Sri Lankan
                                                                         access to primary healthcare for the people of Kinnya living in a     authorities had re-establis-
Source of funding                                                        displacement camp, through mobile consultation services. More         hed primary healthcare MdM
> projects 1 and 2: MdM                                                  than 2,000 consultations were carried out in this way by our teams    was able to gradually with-
Budget                                                                   during the first weeks of the emergency amongst tsunami victims,      draw in February 2005. The
> 2005 projects 1 and 2:                                                 while epidemiological monitoring was re-established.                  logistics and administrative
631,944 euros                                                                                                                                  base in Colombo was retai-
                                                                         Progress bar at 31/12/2005                                            ned to support the teams in
                                                                         28/12/2004                      20/02/2005
                                                                                                                       > Project
                                                                                                                         progress
                                                                                                                                               Mallavi, in northern Sri
                                                                                                                                               Lanka.
                                                                                                                                                                               94/95
 Sudan
Following the Peace Agreements signed in January 2005 in southern Sudan, there have
been population movements in the region. These are of people who had fled during the
20 years of fighting in southern Sudan which ravaged these provinces and who are now
returning to their home areas. The consequences of the war are disastrous socially as
well as in terms of health and nutrition. The quality of healthcare is still deteriorating. In
addition, although the social and political recomposition of southern Sudan is a fairly
positive development, it is not happening without causing some local tensions between
                                                                                                                                                 Mortality
the different communities in the area.                                                                                                           > infant: 63‰

                                                                                                                                                 Life expectancy
                                                                                                                                                 > at birth: 56.4




                                                                                                           Human Development Report 2005, UNDP
Emergency medical care                                                                                                                           HDI
                                                                                                                                                 > 0.512; ranked 139/177
Kalma, Dereij, Nyala - Southern Darfur
Activities: MdM has set up a PHC centre in Kalma camp, equip-          Outlook:                                                                  Actual GDP/inhabitant ($)
                                                                                                                                                 > 412
ped with a hospitalisation unit and delivery room, in conjunction      Continue community healthcare
with the health agencies already working there including ACF which     activities, occasional support                                            Délégations internationales
is treating malnutrition. It includes 4 curative consultation posts,   work (water distribution, instal-                                         > MdM Greece, MdM Canada
ante- and post-natal healthcare consultations, vaccination servi-      lation of diarrhoea treatment
ces, a medical analysis laboratory, quick testing for malaria and a    centres, nutritional screening,
pharmacy.                                                              vaccination), logistical and                                              Beneficiaries
Outside the camp, MdM is also involved in mobile camps in Dereij       human resources support and                                               > directly project 1: 50,000
                                                                                                                                                 > directly project 2: 50,000 (town)
camp amongst groups of displaced people around Nyala.                  setting up an isolation camp in                                           > indirectly project 1: 100,000
                                                                       the event of a cholera epide-                                             > indirectly project 2: 150,000 (region)
Progress bar at 31/12/2005                                             mic.
14/07/2004                          indéfini                                                                                                     Staff
                                                > Project
                                                  progress
                                                                                                                                                 > local project 1: 100
                                                                                                                                                 > local project 2: 1
                                                                                                                                                 > expatriate project 1: 17
                                                                                                                                                 > expatriate project 2: 1 + surgical
                                                                                                                                                  teams
Primary healthcare and surgery                                                                                                                   Co-ordinators
Malakal                                                                                                                                          > projects 1 and 2: L. Joseph, J. Larché
                                                                                                                                                  (+ project 2: G. Isserlis)
Activities: The project aims to improve the quality of care            Outlook:                                                                  > field 1: M. Pomarel, N. Seris
given by the surgery unit of Malakal general hospital and to           Continue training started in                                              > field 2: F. Makpolo, N. Pilet
guarantee access to it for more people, focused on 4 main areas:       November 2005 and                                                         > HQ project 1: desk Urgence,
                                                                                                                                                  B. Contamin
• renovating then equipping the surgery unit;                          renovation work started in                                                > HQ project 2: O. Mouzay, B. Contamin
• training staff involved in surgical treatment;                       September 2005.
• putting management systems for surgical consumables in place;                                                                                  Sources of funding
• putting a data collection and transmission system in place.                                                                                    > project 1: DAH, German Foreign
                                                                                                                                                  Ministry, DFID, ECHO
                                                                                                                                                 > project 2: French Embassy, MdM
Progress bar at 31/12/2005
25/11/2004                           indéfini                                                                                                    Budget
                                                > Project
                                                  progress
                                                                                                                                                 > 2005 project 1: 1,615,861 euros
                                                                                                                                                 > 2005 project 2: 204,952 euros
Tanzania
                                                                                 This is the East African country with the highest growth (6.9% in 2005), but, like a
                                                                                 certain number of African countries, poverty is not declining. The HIV prevalence
                                                                                 rate is one factor responsible for this failure. Around 7% of the adult mainland popu-
                                                                                 lation lives with HIV and antenatal consultations have shown prevalence rates bet-
                                                                                 ween 5% and 15% in certain regions, even if these rates have definitely fallen in the
                                                                                 last ten years. The number of AIDS orphans now stands at nearly 2 million.

Mortality
> infant: 104‰

Life expectancy
> at birth: 46                                                                   Preventing mother-to-child transmission of HIV
                                           Human Development Report 2005, UNDP




HDI                                                                              Bukoba
> 0.418; ranked 164/177                                                          Activities: The programme for preventing mother-to-foetus                  Outlook:
Actual GDP/inhabitant ($)                                                        transmission of HIV has 3 aspects to it:                                   Continue to transfer all acti-
> 287                                                                            • training hospital staff;                                                 vities to Bukoba regional
                                                                                 • monitoring women during pregnancy: screening, prescribing                hospital. Strengthen the
International delegation                                                         AZT, information on transmission by breast-feeding;                        assistance aimed at HIV-
> MdM Belgium
                                                                                 • monitoring women and their babies after delivery.                        positive mothers so that they
                                                                                 Progress bar at 31/12/2005                                                 can continue to benefit from
                                                                                 01/08/2002                        30/06/2005                               ARV treatments.
Beneficiaries
> directly project 1: 3,350                                                                                                       > Project
                                                                                                                                    progress
> directly project 2: hospital staff and
  their families, HIV-positive pregnant
  women and their families, patients
  with an advanced HIV infection
> indirectly project 1: 510,230                                                  Access to effective antiretroviral
> iindirectly project 2: educators,
  nurses                                                                         combinations
Staff                                                                            Bukoba
> local project 1: 10
> local project 2: 10                                                            Activities: The aim is to allow HIV-positive pregnant women and            Outlook:
> expatriate project 1: 1                                                        their families, patients with an advanced HIV infection, and hospital      Continue all these
> expatriate project 2: 2
                                                                                 staff and their families access to antiretrovirals. To facilitate access   activities in 2006.
Co-ordinators                                                                    to these treatments, MdM is using the HAART (Highly Active
> projects 1 and 2:                                                              Antiretroviral Therapy) programme. This therapy programme is inten-
P. Tattevin                                                                      ded to reduce the incidence of transmission, especially from mother
> general co-ord projects 1 and 2:
  S. Davies
                                                                                 to child.
> HQ 1 and 2: C. Courtin                                                         Progress bar at 31/12/2005
                                                                                 01/10/2004                               2009
Sources of funding
> project 1: MARC foundation,                                                                                                    > Project
                                                                                                                                   progress
  AIDS Fund
> project 2: Columbia University

Budget
> 2005 project 1: 181,047 euros
> 2005 project 2: 179,878 euros
                                                                                                                        96/97




Treating opportunistic infections                                                               Beneficiaries
Bukoba                                                                                          > directly: 500
                                                                                                > indirectly: 510,430
Activities: MdM is continuing its programme of HIV pre-           Outlook:
vention and treatment of opportunistic infections by sup-         Continue process of making    Staff
porting Tadepa. Three aspects have been developed:                the local NGO Tadepa auto-    > local: 20
                                                                                                > expatriate: 1
• prevention (peer training, education by peers, access to        nomous and gradual withdra-
condoms);                                                         wal of MdM.                   Co-ordinators
• psychomedical (counselling, treating opportunistic diseases);                                 > project: P. Tattevin
• transfer of skills.                                                                           > general co-ord: S. Davies
                                                                                                > HQ: C. Courtin
Progress bar at 31/12/2005
                                                                                                Source of funding
01/08/2004                    30/04/2005                                                        > MdM, French Foreign Ministry
                                           > Project
                                             progress
                                                                                                Budget
                                                                                                > 2005: 53,317 euros
Turkey
                                                                              Le début des négociations concernant l’adhésion de la Turquie à l’Union européenne relance
                                                                              la question du respect des droits de l’homme dans un pays où les minorités, les détenus, les
                                                                              opposants politiques et les défenseurs des droits humains sont souvent victimes de mauvais
                                                                              traitements. Malgré un réel effort législatif et des engagements concernant le traitement judi-
                                                                              ciaire des actes de torture, la persistance de certaines pratiques demeure préoccupante.
                                                                              De surcroît, le regain d’agitation kurde fait craindre de nouvelles tensions à l’intérieur du pays.

Mortality
                                        Human Development Report 2005, UNDP




> infant: 33‰
                                                                              Caring for the most destitute
Life expectancy
> at birth: 68.7                                                              Ayasma shanty town

HDI
                                                                              Activities: Medical and welfare care of the inhabitants, mainly     Outlook:
> 0.750; ranked 94/177                                                        displaced Kurds, of Ayasma district:                                Monitor health, continue cur-
                                                                              • healthcare for women and children;                                rent activities and prepare to
Actual GDP/inhabitant ($)                                                     • social and educational activities aimed at children, young        close the centre at the end of
> 3,399                                                                       people and women.                                                   2006. Examine whether to
                                                                              In partnership with Solidarité et Liberté (a Marseilles-based       transfer the project to another
                                                                              organisation):                                                      suburban area of Istanbul hou-
Beneficiaries                                                                 • local partnership implementing a medical and welfare pro-         sing mainly displaced Kurds.
> directly project 1: pregnant women                                          ject combining healthcare, education and training (pre-school
 and infants
> directly project 2: human rights                                            education, literacy);
  defenders and prisoners who are                                             • human rights monitoring , especially the right to health.
  victims of state violence
> indirectly project 1: 4,000                                                 Progress bar at 31/12/2005
                                                                              2004                                2006
Staff                                                                                                                    > Project
                                                                                                                           progress
> local project 1: 5 paid staff and
occasional volunteer workers as it is
officially illegal to give permanent
assistance.
> expatriate project 2: 6 on
                                                                              Supporting the victims of political violence
occasional projects                                                           Istanbul
Co-ordinators                                                                 Activities:       MdM provides medical and psychosocial             Outlook:
> project 1: G. de Castelnau                                                  assistance to human rights defenders fighting against Turkish       Monitor how the situation
> project 2: B. Granjon                                                       repression, through:                                                develops and adapt MdM'S
> follow-up projects 1 and 2:
DR PACA
                                                                              • supporting human rights defenders in three organisations (IHD,    actions.
                                                                              Goc'Der, Tuhad);
Source of funding                                                             • assistance in trials of human rights defenders;
> projects 1 and 2: Bouches-du-                                               • testifying; a second assessment of patients whose state of
 Rhône department council
                                                                              health was judged compatible with their being reimprisoned by
Budget                                                                        doctors close to the government was sent to the European
> 2005 project 1: 13,627 euros                                                Court of Human Rights, and led to suspension measures and
> 2005 project 2: 7,534 euros                                                 sanctions against the original doctors.
                                                                              Progress bar at 31/12/2005
                                                                              2002                                2006
                                                                                                                         > Project
                                                                                                                           progress
                                                                                                                                                              XX/99
                                                                                                                                                              98/99
 Uganda
From the beginning of the devastation caused by the HIV epidemic, Uganda set up pre-
vention programmes. However, even if the prevalence of HIV-positivite people seems to
have fallen, more than two million Ugandans, according to estimates, are infected by the
HIV virus, i.e. 10% of the population. It is true that many efforts have been made to redu-
ce the epidemic but life expectancy (47 years) still shows the damage caused by this ill-
ness. Despite everything the country has maintained an astonishing growth rate of 7%
per year, helped by a great deal of debt relief.
                                                                                                                                      Mortality
                                                                                                                                      > infant: 81‰




                                                                                                Human Development Report 2005, UNDP
Supporting the local NGO CIPA in its fight                                                                                            Life expectancy
                                                                                                                                      > at birth: 47.3

against HIV                                                                                                                           HDI
                                                                                                                                      > 0.508; ranked 144/177
Kooki County, Rakai District
                                                                                                                                      Actual GDP/inhabitant ($)
Activities: A joint venture with local NGO CIPA has been         Outlook:                                                             > 249
set up to ensure prevention activities such as education acti-   With financial support from
vities, raising awareness of community leaders and women,        MdM in 2005, the NGO
and training sessions on STIs/AIDS will continue. It involves    CIPA should be operationally                                         Beneficiaries
promoting behavioural changes and condom use in rural areas,     and technically autonomous                                           > indirectly: 172,000
improving treatment for AIDS patients and establishing a         by 2006.
referral system for screening and treating people who                                                                                 Staff
                                                                                                                                      > local: 4 (provision of 46 others to
are HIV positive.                                                                                                                      the local NGO)

Progress bar at 31/12/2005                                                                                                            Co-ordinators
04/2001                      31/12/2005                                                                                               > project: D. Sevelinge
                                          >   Project
                                              progress                                                                                > field: C. Gulyetonda
                                                                                                                                      > HQ: O. Mouzay

                                                                                                                                      Source of funding
                                                                                                                                      > MdM

                                                                                                                                      Budget
                                                                                                                                      > 2005: 48,676 euros
Vietnam
                                                                  The Vietnamese economy is growing rapidly, posting growth of 8%. However, 8%
                                                                  of the population, i.e. 1.4 million households, still live below the poverty line. In addi-
                                                                  tion, 263,000 people carry the HIV virus in a country where the use of injectable
                                                                  drugs and prostitution are common practices. Government policy on these issues
                                                                  is repressive which does not help work amongst these at-risk groups.


Mortality
> infant: 19‰

Life expectancy
                                                                  Developing medical services
> at birth: 70.5                                                  Bac Kan and Thai Nguyen provinces
                            Human Development Report 2005, UNDP




HDI                                                               Activities: The liberalisation of the 1980s deeply affected      Outlook:
> 0.704; ranked 108/177                                           the Vietnamese primary healthcare system. Local health posts     This project was completed in
                                                                  found that they had been deprived of their traditional public    October 2005 and reached
Actual GDP/inhabitant ($)                                         funding, and this had an effect on the quality of the service    its objectives. The joint ventu-
> 482
                                                                  and the access to healthcare of vulnerable groups. In this       re with Hanoi Medical
International delegation                                          context, promoting preventive health by village health workers   University is continuing
> MdM Canada                                                      amongst the most disadvantaged groups (women, children           through a community-based
                                                                  and ethnic minorities) is a priority.                            access to healthcare pro-
                                                                  In 2005, this preventive health programme developed the fol-     gramme for vulnerable
Beneficiaries                                                     lowing activities:                                               groups (including drug users
> directly: 10,000                                                • mother and child healthcare (health education, integra-        and prostitutes) in Tay Ho dis-
> indirectly: 275,000
                                                                  ting the national programme at local level);                     trict in Hanoi.
Staff                                                             • improving health staff's skills;
> local: 14                                                       • access to water and sanitation for homes in three local
> expatriate: 1                                                   authorities (construction of water distribution networks, pit
Co-ordinators                                                     latrines, organisation and maintenance, education, etc.)
> project: F. Novel                                               • nutrition and prevention of childhood illnesses (com-
> field: A. Pinon                                                 munity development through mothers' groups).
> HQ: V. Pardessus                                                • institutional development of the Hanoi Medical
Sources of funding                                                University (HMU).
> EU, AESN, MdM
                                                                  Progress bar at 31/12/2005
Budget                                                            01/11/2000                   31/10/2005
> 2005: 283,424 euros                                                                                       > Project
                                                                                                              progress
                                                                                                                                   100/101




Access to community-based healthcare                                                                       Beneficiaries
Hanoi                                                                                                      > directly: 4,000
                                                                                                           > indirectly: 25.000
Activities: This access to community-based healthcare pro-             Outlook:
gramme for vulnerable groups (including drug users and pro-            Between now and the end of          Staff
                                                                                                           > local: 7
stitutes living with HIV/AIDS), in Tay Ho and surrounding districts,   2006, 300 patients will be          > expatriate: 2
is the result of a joint venture between Hanoi Medical University      screened for HIV/AIDS, 50
(HMU), the people's committee and Tay Ho district health ser-          patients will receive antiretro-    Co-ordinators
vices, the sub-department for Social Affairs for the Prevention        virals and 25,000 people will       > project: K. Lacombe
                                                                                                           > field: A. Pinon
of Social Ills (HSSEP) and MdM. At the request of HSSEP, HMU           be contacted by the mobile          > HQ: V. Pardessus
and MdM proposed offering care, treatment and assistance for           teams and clubs.
people living with HIV/ AIDS at district level in the context of                                           Source of funding
public health services and social action.                                                                  > Usaid (PACT)
At the end of 2005, the following activities had been set up:                                              Budget
• a day care centre was opened as part of a district health-                                               > 2005: 15.496 euros
care centre (HIV testing, primary health consultations, STIs,
opportunistic infections, ARV treatment);
• 2 mobile teams (prevention, needle exchange, condom dis-
tribution, treatment at home);
• solidarity groups;
• training for healthcare staff and social workers.
Progress bar at 31/12/2005
08/2005                            08/2008
                                              > Project
                                                progress




Preventing and treating HIV
Ho Chi Minh City
                                                                                                           Beneficiaries
Activities: This new three-year programme is based on                  Outlook:                            > directly: 6,500
                                                                                                           > indirectly: 266,000
the previous programme (PHC for the homeless including                 Continue STI and HIV/AIDS
prostitutes and drug users) and the existing structure (day            screening, increase access to       Staff
care centre and mobile teams) and is aimed at the same                 treatment for opportunistic         > local: 6
groups of people.                                                      infections and STIs. Continue       > expatriate: 3
During the first year of the project the focus was on:                 training staff in HIV prevention,   Co-ordinators
• treating all cases of STIs screened in the day care centre;          diagnosis and treatment of          > project: K. Lacombe
• training local staff in HIV prevention and screening for HIV         HIV-related illnesses and admi-     > field: V. Trias
infection;                                                             nistering ARVs. Increase the        > HQ: V. Pardessus
• setting up an HIV screening centre within the day care centre.       number of patients on ARV (53       Source of funding
                                                                       patients on 31/12/05 150            > Usaid (PACT)
Baromètre au 31/12/2004                                                expected on 31/12/06).
20/12/2004                       19/12/2007                                                                Budget
                                              > Project
                                                progress                                                   > 2005: 526,990 euros
Zimbabwe
                                                                              The economic situation in this southern African country is disastrous. Living condi-
                                                                              tions are increasingly harsh and the impact of the HV/AIDS pandemic is devastating.
                                                                              26% of the population is HIV-positive. Since the explosion of the HIV/AIDS epidemic,
                                                                              life expectancy has fallen from 52 years in 1990 to 36 years in 2005. A third of the
                                                                              adult population is HIV-positive and each day around a hundred new born infants
                                                                              become HIV-positive.
Mortality                                                                     Out of a total population of 12 million inhabitants, there are around 800,000 orphan
> infant: 78‰                                                                 children. It is estimated that nearly 20% of these are HIV-positive. In addition, 90% of
Life expectancy                                                               Zimbabweans affected by the virus and requiring antiretroviral treatment do not have
> at birth: 36.9
                                        Human Development Report 2005, UNDP




                                                                              access to it.
HDI
> 0.505; ranked 145/177

Actual GDP/inhabitant ($)
> 639                                                                         Reducing the impact of HIV/AIDS
                                                                              Chipinge
Délégations internationales
> MdM Spain and MdM Canada                                                    Activities: After a pilot phase of HIV/AIDS information and       Outlook:
                                                                              prevention which began in May 2004, MdM France, in part-          In 2006, our teams will work
                                                                              nership with MdM Canada, MdM Spain and FACT (a local              on consolidating our activities
Beneficiaries                                                                 NGO), is now developing a global approach for the whole of        and setting up antiretrovirals
> directly project 1: 350,000 inhabi-                                         Chipinge district combining:                                      in Chipinge hospital to bring
 tants of Chipinge district
> indirectly project 1: 30 community                                          • community information and awareness;                            the possibility of treatment
 health workers in Chipinge                                                   • running information and screening centres;                      closer to the communities.
                                                                              • running home assistance services for immobilised HIV-posi-
Staff                                                                         tive patients;
> local: 30
> expatriate: 5                                                               • psychosocial and therapeutic support for orphans and vul-
                                                                              nerable children;
Co-ordinators                                                                 • support for the preventive and curative activities of 4 dis-
> project: C. Moncorgé                                                        trict hospitals and 44 dispensaries (preventing mother-to-child
> field: F. Azam
> HQ: N. Bréchet                                                              transmission, reducing the incidence of STIs, preventing and
                                                                              treating opportunistic illnesses, setting up and monitoring ARV
Sources of funding                                                            treatments);
> MdM, EU, HIVOS                                                              • training staff and community health workers;
Budget                                                                        • perational analysis of this model designed on a global scale,
> 2005: 486,932 euros                                                         on a community basis, with a view to expanding and repli-
                                                                              cating it in other districts, provinces and countries.
                                                                              Progress bar at 31/12/2005
                                                                              05/2004                          12/2007
                                                                                                                         > Project
                                                                                                                           progress
                                                                                                                                          102/103
  Future projects
> New projects 2006
Month       Country       Town/Region            Theme
January     Rwanda        Kigali                 • Mental health work amongst genocide survivors
            Chad          N'Djamena              • Street children
            Daghestan     Khassaviourt           • Support for primary and secondary healthcare structures

March       Niger         Keita                  • Improving the population's health, especially for under 5s, pregnant women
                                                   and breast-feeding mothers
            EEritrea      Afabet                 • Improving maternal health through obstetric surgery
            Nicaragua     Puerto Cabezas         • Domestic violence
            Nepal         Dadeldhura             • Access to healthcare programme

April       Bolivia       Potosí and Sucre,      • Access to diagnoses on environmental health
                          Pilco Mayo river
            China         Shanxi                 • Early, quality treatment of people living with HIV
            Afghanistan   Kabul                  • Harm reduction programme
            Kosovo        Rahovec                • Dental project
            Romania       Satu Mare              • Preventing child abuse

June        Serbia        Belgrade               • Methadone project
            Guatemala     Chimaltenango          • Project denouncing lack of access to healthcare for women working in the maquillas (factories)

September   Algeria       Algiers                • Sexual violence



> Exploratory projects 2006
Month       Country       Town/Region            Theme

January     Brazil        Maranhao, Pernam-      • Street children, rubbish tip sorters, people in Quilombos
                          buco and Para states
            South Sudan   Upper Nile             • Access to healthcare for returnees
                          (Koddok and Tonga)
            Morocco       Rabat                  • Access to healthcare for migrants

February    Laos          Xekhong and            • Mother and child health
                          Saravane provinces
            India         Jaipur                 • Access to healthcare in the Jaipur shanty towns
            Senegal       Podor, Gamadji Saré    • Access to health care for scattered rural populations
            Nicaragua     San Bartolo            • Maternal health/cervical cancer screening
            Yemen         -                      • Identifying a target population

March       Sri Lanka     Mallavi                • Support for surgical activities
            Russia        -                      • Migrants
            Lebanon       Bekaa and Tyre         • Access to healthcare for elderly people in Palestinian refugee camps

April       Ecuador       Tungurahua            • Intercultural health project
            Kosovo        South Serbia, Strepse • Access to healthcare for minorities in enclaves
            China         Qinghai               • Access to healthcare for Tibetan people

May         Afghanistan   Kabul                  • Mental health
                                                 • Primary healthcare amongst Kuchi nomads
            Burundi       -                      • Access to healthcare
            Uganda        Northern Uganda        • Access to healthcare for IDPs (internally displaced persons)
         oiccajA
                                           selliesra M
                                                                                                                               uaP
                                                                                                   esuol uoT                                  ennoyaB
                                                                 reilleptno M
                                          ecnevorP                                                                                                                             ennayuG
                       eciN                 -ne-xiA
                                                                                                                              xuaedroB                               enneyaC
                                          elbonerG
                                                                                                                      emluognA                                                noinuŽR
                                                         snoyL
                                                                                                               sreitioP
                                                                                                                                                                 sineD-tniaS
                                      nonaseB
                                                                                                                          sregnA         setnaN
                                                                                                                                         senneR
                   gruobsartS           ycnaN                                              siraP
                                                                                sineD .tS .lP
                                         zte M
                                                                                                        neuoR
                                                                                                                   ervaH eL
                                                                  senneicnelaV                                                                                      centre
actions             in prostitution                                                                                                               actions           and guidance
Harm reduction      People involved                                                                                                               Local mobile      Free health-care
                                                                                       sialaC
                                                                                Action in France
  Introduction to Mission France                                                                     104/105




> A few steps forward, many steps back
 Answers in the field of exclusion
 For the 19th year, Mission France has managed to      authorities to provide the hospital at last with a
 considerably reduce the damage caused by legisla-     PASS (permanent service offering access to
 tors in the area of exclusion from healthcare. In     healthcare).
 2005, the neediest people continued to be stigmati-   • In Guyana, the law is ignored, reinterpreted and
 sed, those without papers have become the scape-      not enforced. The shortage of medical staff is des-
 goats for the government and the poorest are now      troying the access to healthcare system. CMU (uni-
 perceived as profiteers or even fraudsters. The       versal health insurance) and AME (state medical aid)
 increase in the number of checks, the suspicion and   are widely refused by professionals. MdM's Mission
 arrests reinforce deep social decay shown by the      France has set up a healthcare centre and is focu-
 continual rise in the number on income support and    sing especially on pregnant teenagers.
 who are thrown out of rented accommodation.           • In the housing crisis, the strictly unacceptable
                                                       has become a daily occurrence. We meet families
 Faced with this deterioration of social relations-    with children on the street, who remain there! Urban
 hips, Médecins du Monde's Mission France has          space has been reshaped so that it is no longer pos-
 responded in various ways.                            sible to lie down or take refuge there. Making the
 • Migrants in the Calais area are not asylum see-     unacceptable visible was what the Paris
 kers but want to migrate to the United Kingdom.       Homelessness project did when it acquired tents for
 While waiting for the chance to cross the Channel,    the homeless: people could no longer ignore what
 they are forced to take refuge in woods or makes-     used to be just a shadow under a porch. We continue
 hift shelters. When tracked down by the police,       our efforts to seek a reaction from the authorities.
 they are sometimes forced to leave duvets and         • For sick homeless people, we have made a
 clothes which they had found hard to obtain.          major contribution to making healthcare hostel beds
 A project involving healthcare and bearing witness    more permanent. The working group led by the
 is ongoing, a forum has been organised in Paris,      Social Work Directorate General has drawn up clear
 and a strong call has been made to local health       and ethical specifications. Definite progress.
 Introduction aux missions France


• State medical assistance will once again           • Drug users are surrounded by new double-
have been the government's focus in the midd-        edged institutional measures. Although some
le of the summer… Decrees making access to           advances have been made, RdR policies recei-
healthcare for those without papers even more        ve little funding and are burdened by a heavy
difficult were issued at the end of July. Hours of   administrative yoke. Most of MdM's RdR wor-
discussions between associations and the             kers will be forced to set up autonomous asso-
ministry were necessary before they agreed to        ciations to meet these new requirements, but
write a circular limiting the damage.                are likely to find themselves in a federation
• The health insurance reform removes the            intended to bear witness to the advances nee-
possibility of healthcare centres run by associa-    ded in risk reduction related to the use of
tions referring patients for additional examina-     psychoactive substances.
tions. On MdM's initiative, a collective sent 10     Our projects continue to provide these skills in
questions to the Health Ministry concerning the      new and dynamic ways. In 2005, the biennial
consequences of this reform on the neediest          meetings of those involved in Mission France
people. After seven months, we received an           enriched the 212 participants and provided a
answer the substance of which was that people        forum to think about how to improve the quali-
with problems should overcome them!                  ty of our practices, and about the challenges
• Médecins du Monde in Europe decided to             we need to take up in the area of prevention,
bear witness to how difficult it is for those        treating mental illnesses as well as the suffering
without papers to get access to healthcare, and      caused by living conditions and past trauma.
to fight against the expulsions of seriously ill
foreigners to countries where they will not                                    Nathalie Simonnot,
receive care - to fight, therefore, against, a                        Mission France co-ordinator
death sentence which albeit administrative is
actually fatal! This is the purpose of the Access
to Healthcare Monitoring Centre in Europe set
up in 2005. It took some 900 letters, 50 mee-
tings with MEPs and a cross-disciplinary inves-
tigation in 5 countries.
                                                                                                                                       106/107
  The homeless and poorly housed
 Housing is a fundamental right; however, many people do not have access to it.
 Today in France there are approximately 100,000 homeless people and more than 3
 million are in sub-standard housing. The fires in dilapidated Paris hotels (nearly 50
 dead, most of them children) and the suburban riots have put the housing crisis back
 at the heart of public debate. Nearly 61% of patients seen by Mission France are
 homeless or live in sub-standard housing.

> Housing, a fundamental right                                                                              Number of homeless in
                                                                                                            France
                                                                                                            > 86,500 people (source Insee, institute
                                                                                                             for economic and statistical
 Since 1993                                                                                                  information)
 Activities: Faced with the problems of people living in the               Outlook:
                                                                                                            Number of poorly housed
 street who are too marginalised and weakened to make use                  Continue field work amongst      > > 3.2 million (source Abbé Pierre
 of the public structures, MdM has developed mobile actions.               the most needy people             Foundation)
 There are two objectives:                                                 (street work, welfare and
 • to inform people of their rights to access to healthcare,               medical treatment, medical       Most common conditions
                                                                                                            > dermatology problems, trauma, psychia-
 and refer and accompany them to public structures;                        consultations and nursing         tric problems, psychological suffering,
 • to see those without sickness cover in healthcare cent-                 care in accommodation hos-        ENT and respiratory infections
 res until they regain their rights. Every year, MdM takes action,         tels, work in partnership with
 in winter and in summer, requesting accommodation and long-               health and accommodation
 term housing. From its experience on the ground, MdM is                   structures, involvement in       Number of projects
 continuing to bear witness to the harmful consequences                    the “cold weather plan”) and     > 16
 to health of the lack of housing as well as of poor hou-                  political action (bearing wit-
                                                                                                            Number of volunteers
 sing. The discontinuity and unsuitability of accommodation                ness, lobbying institutions to   > 182
 worsen the health of the neediest. Teams in France work throu-            set up long-term accommo-
 ghout the year watching the situation in the context of patrols,          dation structures suitable to    Contacts with homeless
 medical consultations in accommodation centres and nursing                the needs of the homeless).      > approx. 10,000
                                                                                                            > 17.8% of people seen in CASOs are
 beds, etc. In 2005, DGAS (the Social Work Directorate General)                                               homeless, and 43.4% live in insecu-
 asked MdM to take part in a thinktank and to draw up speci-                                                  re housing
 fications formalising “healthcare hostel beds” and this led to
 a circular on how these beds should operate and be funded.                                                 Characteristics
                                                                                                            of homeless seen in CASOs:
 In December 2005, the Paris homelessness project was hea-                                                  > 26% are women
 vily involved in distributing “igloo” tents to the homeless and                                            > 60% are under 35
 to alerting the authorities to the urgent need to overhaul their                                           > 8.6% are minors
 accommodation provisions.                                                                                  > 75% do not have the right to sick-
                                                                                                              ness cover
 Types of work                                                                                              Sources of funding
 > > Medical and welfare consultations, patrols: Le Havre,                                                  > Local health authorities, town coun-
   Marseilles, Metz, Nice, Paris, Strasbourg, Toulouse, Valenciennes.                                        cils, department councils, etc.
 > > Medical consultations for the homeless in “healthcare hostel beds”:
   Bordeaux, Grenoble, Lyons, Strasbourg, Toulouse.
 > Ecoute santé (Health Listening post): Angoulême.                                                         Main partners
 > Consultations with other associations (Restos du cœur,                                                   > Abbé Pierre Foundation, Secours
 Salvation Army, Abbé Pierre centres, Secours catholique, Aides,                                             catholique, Emmaüs, Red Cross,
 Point écoute santé jeunes…): Grenoble, Le Havre, Lyons, Metz,                                               Restos du cœur, Samu social, DAL,
 Nancy, Nantes, Reunion, Toulouse, Valenciennes.                                                             local charities (Péniche, Amis de la
 > Consultations in emergency accommodation centres: Lyons,                                                  rue, le Fournil, GAF, Enfants du
   Metz, Nice, Toulouse.
 > Welfare and health work in squats: Bordeaux, Paris.                                                       monde, Droit de l'homme EMDH),
                                                                                                             etc.
Migrants
 All projects (healthcare
centres, mobile projects)                      The 2003 law on immigration and the 2004 law on asylum have already made it har-
 see immigrants in their                       der to obtain a residence permit and refugee status, but the planned reform of the
       programmes
 (in healthcare centres,                       rules for foreigners entering and staying in the country and the right of asylum risks
30% are asylum seekers).                       making a difficult situation even more difficult for prospective immigrants, asylum
                                               seekers and sick foreigners. The state medical aid reform of 2004 and July 2005
                                               makes it even harder for foreigners living irregularly in France to get access to health-
                                               care. The health insurance reform which requires people to choose a regular doctor
Beneficiaries
> 89% of patients seen for the first           also penalises homeless people including migrants. More than 89% of patients in
  time are foreigners
> 60% of them are illegal and 30%              Médecin du Monde's healthcare centres are foreigners: they have more problems in
  have applied for asylum
                                               getting sickness cover as they do not know their rights or how to acquire them.
Country of origin
> Algeria, Romania, Morocco, Cameroon,
 Tunisia, etc. (Other nationalities turn up
 in different centres)                        > Facilitating access to healthcare
Main conditions                                Since 1986…
> osteo-articular, ENT, gastro-enterolo-
  gy, psychiatry, dermatology, gynae-
                                               Activities:                                                               Outlook:
  cology-obstetrics, psychological             • Healthcare centres: In 2005, the 21 healthcare centres                  MdM continues to work
  problems                                     saw 89% foreigners and carried out 45,783 medical consul-                 towards each person, wha-
> 88% of foreigners seen have not              tations. The main obstacles to access to healthcare and rights            tever his administrative sta-
  acquired the right to health insu-
  rance when they are seen at a
                                               quoted by people are lack of access to an address, financial              tus, having immediate
  healthcare centre for the first time         difficulties, poor knowledge of rights and systems, adminis-              access to health insurance
                                               trative difficulties and the language barrier. MdM plays a brid-          and being referred to exis-
                                               ging role and, where possible, refers people to the public health         ting health structures.
                                               and welfare systems. Journeys into exile, often the source of             Mission France is continuing
Number of projects
                                               major psychological and physical suffering, are taken into                to develop HIV, hepatitis and
> all programmes (centres, mobile              account, and psychological support work is being developed.               STI prevention and scree-
 actions and harm reduction pro-               The Paris and Marseilles CASOs have set up a specific                     ning programmes, as well as
 grammes)                                      HIV/hepatitis/STI prevention and screening programme.                     programmes for treating
Number of volunteers
                                               • CAFDA (Committee for asylum-seeking families)                           migrants' psychological suf-
> nearly 2,000                                 Project: MdM has set up reception, health and referral consul-            fering. The European Access
                                               tations for newly-arrived asylum-seeking famlies with a part-             to Healthcare Monitoring
Sources of funding                             ner, CAFDA. In 2005, CAFDA received and housed more than                  Centre (started in 2004) lob-
> Regional & local health authorities,
 department councils, regional coun-
                                               5,000 people of 79 nationalities. 1,298 people (of 51 different           bies European Union institu-
 cils, regional and national health            nationalities) newly arrived at CAFDA were seen by the MdM                tions and bears witness to
 insurance offices (CRAM, CPAM),               team in 2005, i.e. 462 families.                                          the difficulties of getting
 etc.                                                                                                                    access to healthcare for
                                               Types of work
Partners
                                                                                                                         people living in insecure
                                               > All the projects provide consultations, dispense prevention messa-      situations, on the basis of
> CASP, Cimade, Gisti, LDH, Anafé              ges and refer migrants to partners and public health systems.
(National association helping foreigners       Testimonies on insecure living conditions linked to administartive sta-   data collected on the ground
at borders), CFDA (Committee for the           tus, the length of proceedings and housing difficulties are the basis     (MdM works in 11 European
right to asylum), Comede, involvement          for specific work to restrict the decline in migrants' rights.
in ODSE (European monitoring centre
                                                                                                                         Union countries).
for access to healthcare), local or regio-
nal association committees, etc.
                                                                                                                                  108/109
  Children
 Children are needier when faced with exclusion, poverty and illness. According to a
 CERC (Council for Employment, Income and Social Cohesion) report, 2 million children
                                                                                                           GUYANE

 in France live below the poverty line and the number of isolated minors is estimated at
 40,000. In addition, an INSEE (the national institute for economic and statistical infor-
 mation) survey shows that 16,000 children are homeless. As well as paediatric monito-
 ring in healthcare centres, Médecins du Monde has initiated projects to fight against
 lead poisoning, aimed at locating and protecting children from this. The Buddy project
                                                                                                          Beneficiaries
 provides support to children separated from their families by hospitalisation.                           > 1,693 children (under 15s) were
                                                                                                           seen in healthcare centres in 2005


> Protecting isolated victims                                                                             Main conditions
                                                                                                          > ENT, pneumology, lead poisoning,
                                                                                                          serious illnesses requiring long
 Buddy Project 1988 >… / Lead poisoning project 1993 >…                                                   periods of hospitalisation
 Activities:                                                             Outlook:                         Sources of funding
 • Hospital buddies: “an energy transfusion”. Buddies visit              • Buddies:                       > Local health authorities, CPAM
 the child they support three times a week, including once               Set up the project in the        (health insurance office),
 during the weekend. The visits mean they can support isola-             provinces in MdM's regional      department councils, etc
 ted children while they are in hospital. They also help to break        delegations in Marseilles and
 down loneliness, the children's needs are listened to and they          Lyons. Make a link with
                                                                                                          Buddies
 are given the strength to fight on. The volunteer makes contact         Saint-Denis hospital in          > number of children with buddies in
 with the nursing team and helps maintain the relationship with          Reunion. Develop training for    2005: 111
 the child's family in terms of respecting his or her identity and       volunteers and co-ordinators     > number of volunteers:
 culture. Buddies are monitored by experienced co-ordinators,            to improve the quality of lis-   92 in Paris, 14 in Guyana
                                                                                                          > buddy partners:
 and always complement the nursing team. At the end of 2005,             tening and presence              6 AP-HP (Paris) hospitals, 6 long-
 the project was introduced in Cayenne hospital.                         amongst the children in          stay centres in the Paris area,
 • Lead poisoning: lead poisoning affects the central nervous            hospital.                        Cayenne hospital in Guyana
 system. The consequences are irreversible and there is no               • Lead poisoning:
                                                                                                          Lead poisoning
 treatment. Young girls who are poisoned pass the lead on to             Despite withdrawing at the       > number of children affected:
 their babies twenty years later.                                        end of 2004, Mission France      85,000 poisoned, of which only
 MdM's work involves locating unhealthy housing so that fami-            in Bordeaux is staying in        5% screened (Inserm (national
 lies are warned and informed and affected children are pro-             contact with the families        medical research institute) figures
                                                                                                          1999)
 tected. Child screening and protection activities are carried           monitored for four years.        > number of projects: 2
 out in connection with state services, health workers, MCW,             MdM's Suburbs project            > number of volunteers: 21
 paediatricians, school doctors and local hygiene services.              wants to consolidate its net-    > lead poisoning partners:
 MdM is calling for a voluntarist policy to fight against child lead     work so that the fight             Association of lead poisoning-
                                                                                                            affected families, Pact Arim, local
 poisoning.                                                              against child lead poisoning       health authorities, local hygiene
                                                                         can continue without MdM,          services, MCW, doctors, hospitals,
 Types of work                                                           who will then be able to
 > Lead poisoning project: seven towns in Hauts-de-Seine, Poitiers.      work in other towns around
 Locating, screening, protecting children, involvement of institutions   Paris. The Poitiers team is
 and medical staff.
 > Hospital buddies: Paris and the Paris area; Guyana.                   continuing its work.
 Personalised monitoring of hospitalised children away from their
 families.
 > Healthcare centres: paediatric consultations, referrals to MCW.
 > All healthcare centres see children.
Roma
                                            The Roma have suffered racial discrimination and poverty in their countries of origin
                                            and are now living in deplorable conditions in France in shanty towns or squats.
                                            Repeated expulsions make them ever needier and make their lives even more inse-
                                            cure. Often forced into acting clandestinely, the Roma are often refused access to
                                            healthcare, and more generally, to their fundamental rights.


Main conditions
> illnesses linked to living conditions,
                                           > Supporting expelled families
  delay in accessing healthcare (in         1992, Suburbs Project: the 1st programme amongst migrant Roma
  France and in their country of
  origin), and psychological trauma         Activities: MdM continues to visit places where the Roma                 Outlook:
  caused by repeated expulsions             live to help them get access to healthcare and their rights (uni-        Continue local health work
                                            versal health insurance and state medical aid). This health              on the ground, with an
Epidemiological                             watch is aimed particularly at health education and promo-               emphasis on children and
characteristics
>Early neonatal mortality (0-1 month)       tion, schooling for children, help for access to drinking water          rights to health, and conti-
nine times higher, infant mortality         and mother and child health. The mobile project amongst                  nue to develop mother and
(0-1 year) five times                       Roma in Lyon visited 17 places in 2005 and met nearly 1,000              child health work. As part of
higher, life expectancy 15 to 20            people, 56% of them women. The expulsion policy to which                 the Romeurope collective,
years below that of the French
population                                  Roma are subject aggravates their already insecure living condi-         MdM will continue to work
(Romeurope data, 1998)                      tions even more. All their affairs are often destroyed, and              alongside other member
                                            contacts with healthcare structures and schools broken, etc.             associations against the
                                            Their wandering forces them to settle in shanty towns, thus              discrimination and human
                                            making it harder to access their fundamental rights and delaying         rights violations of which the
                                            or preventing the work of the medical and welfare teams wor-             Roma are victims in France
Number of projects
>4                                          king amongst them.                                                       (expulsions from living pla-
                                                                                                                     ces, police harassment,
Number of beneficiaries                     Types of work                                                            arrests, removals from the
> approx. 3,500 of whom more than           > Health prevention and education, primary healthcare, help for chil-    area, etc) and to improve
  2,000 in Ile-de-France (estimate)         dren's schooling, access to drinking water, implementing sanitary        access to fundamental rights
                                            measures, etc
Number of volunteers                        > Antenatal work: preventing terminations, monitoring pregnancies,       for migrant Roma in France
> 76                                        information on contraception, child vaccinations, MCW support and        (right to health protection,
                                            in family planning centres.
                                            > Bearing witness to living conditions, repeated expulsions, obstacles   housing, work and educa-
Sources of funding
> Local health authorities,                 to access to healthcare and rights.                                      tion).
                                            > Involvement of Roma family support committees, health workers,
department councils, etc.                   town councils and state services.
Partenaires
> Alpil, ASAV, ATD Fourth World,
  LDH, MRAP, Roma family support
  collectives, Romeurope, sector
  MCW, town councils, PASS (per-
  manent access to healthcare ser-
  vice, etc.…
                                                                                                                                  110/111
  Travellers
 Although the Besson law on travellers is not complied with, insofar as only 15% of
 towns with more than 5,000 inhabitants have fulfilled their obligations concerning
 sites for travellers, other plans do threaten them.
 In December 2005, a French MP managed to have an amendment to the national
 budget passed instituting a tax on caravans. This state tax (of several tens of euros
 per m2), which is not in any way a housing tax, does not give any welfare rights for
 housing. Associations defending travellers' rights are calling for this tax to be with-
                                                                                                          Number of beneficiaries
 drawn as it is neither legitimate nor fair. They reaffirm the priority of having caravan                 > approx. 100 families
 housing recognised with all the welfare rights related to housing, and are asking to                     Main conditions
 take part in the authorities laid down by the law, namely the National Consultative                      > depression, insomnia, cardiovas-
                                                                                                           cular diseases, addiction pro-
 Committee, for all subjects concerning travellers, and Halde (the high authority in the                   blems linked to living conditions
                                                                                                           and life style
 fight against discrimination and for equality).
                                                                                                          Social characteristics
                                                                                                          > isolation, lack of schooling,

> Facilitating access to fundamental rights
 Since 1997…
                                                                                                          desocialisation



                                                                                                          Number of projects
 Activities: MdM's mobile teams have two aims: to meet                 Outlook:                           >2
 travellers whre they live and help them to have their rights reco-    Continue activities to impro-
 gnised.                                                               ve hygiene, living and health      Number of volunteers
 In fact, there are very few sites for them, and where they exist,     conditions for travellers, faci-   >7
 the living conditions are very insecure: no sewers, poor access       litating their access to public    Sources of funding
 to running water and electricity, the presence of rats, a lack        health and welfare structures      > Regional health authorities and
 of toilets. MdM is carrying out the following activities:             and more generally to citi-         health insurance agencies
 • support, listening and referral activities;                         zenship. The expert status
                                                                                                          Partners
 • activities aimed at facilitating access to healthcare,              acquired by the MdM                > Relais accueil gens du voyage,
 rights and schooling for children;                                    Bordeaux team has allowed           co-ordinating body for work
 • lobbying the public administrations to ask for sites to be          it, together with Gypsy asso-       amongst travellers, Centre social
 created for travellers.                                               ciations and personalities          des Alliers, LDH, CCAS (local
                                                                                                           social work centres), schools,
                                                                       working with the traveller          town councils, etc.
 Types of work                                                         community, to create a co-
 > Listening, psychological support, prevention and information mes-   ordinating body whose aim
 sages.
 > Primary healthcare, help for schooling and access to housing,       is to contribute to putting in
 referral to other public welfare and health structures.               place suitable conditions for
 > Lobbying town councils, health institutions and professionals to    the traveller community.
 improve hygiene, living and health conditions; actions to recognise
 citizenship.                                                          MdM's teams are involved
 > Involvement in department-level consultative committees for the     with several authorities
 plan to deal with travellers.
                                                                       including the department-
                                                                       level consultative commit-
                                                                       tees for the plan to deal
                                                                       with travellers.
People working in prostitution
                                             The internal security law which created the offence of passive soliciting and the mas-
                                             sive police presence contribute to the repressive situation which restricts access to
                                             healthcare and to prevention material for people working in prostitution. These peo-
                                             ple are exposed to risks of sexually transmitted infections; they are sometimes drug
                                             addicts and in certain cases the victims of trafficking. They are in an extremely vul-
                                             nerable situation, made worse by being criminalised.

Characteristics
> people mainly from Eastern Europe,        > Support through prevention and information
 Sub-Saharn Africa and China, either         Since 1999 as a theme in its own right
 holding tourist visas, applying for
 asylum or staying illegally, someti-
 mes the victims of trafficking.
                                             Activities: In a climate marked by a clear increase in vio-               Outlook:
                                             lence against them, people working in prostitution find them-             The projects want to work
Sex, age                                     selves in an extremely vulnerable situation with less access to           on and develop the testimo-
> mainly 20 to 40 year old women,            associations and prevention material. Accommodation diffi-                ny aspect, especially on the
 transgendered people, men and               culties and slow access to rights are additional obstacles to             consequences of the internal
 sometimes minors
                                             getting healthcare. M éd eci ns du Monde 's work particu-                 security law on health and
Main conditions                              larly involves mobile activities, health promotion and                    welfare for people working in
> gynaecology conditions, illnesses          harm reduction concerning prostitution practices, with                    prostitution.
 linked to street conditions, psycho-        welfare, medical, administrative and legal support. The
 logical illnesses linked to stress, iso-
 lation and ill-treatment, addictions
                                             teams are keen to give information, adapted and translated if
                                             necessary, on risks linked to STIs, HIV, hepatitis and on rights.
                                             • In Le Havre, MdM has had to stop its work, as the police
                                             presence everywhere has led to the people working in prosti-
                                             tution disappearing completely from the streets.
                                             • In Poitiers, as part of the Abri collective, MdM started work
Number of projects
> 6 mobile teams/projects working            amongst people working in prostitution in September 2005.
 amongst people involved in prosti-          • In Rennes, the exploratory project carried out in 2005 did
 tution, in the street, often in close       not lead to setting up a specific programme.
 collaboration with CASOs and harm
 reduction programmes linked to
 drug use                                    Types of work
                                             > All our programmes offer referrals to screening for HIV, VHB and
Number of beneficiaries                      VHC, distribute prevention material, listen, promote people's rights,
> very hard to obtain data, probably         inform and refer to public structures.
 around 1,000                                > Metz: an itinerant structure set up with Aides.
                                             > Montpellier: as well as evening work in the city centre, a daytime
Number of volunteers                         weekly visit is organised on the main roads.
> 117                                        > Nantes: physical accompaniment to hospitals and for any health
                                             care, for access to rights, to file complaints, and to courts for cases
                                             of soliciting. Help to register for literacy courses. Set up thematic
Partners                                     health workshops.
> Cabiria, Amis du bus des femmes,           > Paris: information adapted and translated into Chinese, support
 Aides, local health authorities,            and referral with interpreters.
 Gasprom, Platfrom for the fight             > Poitiers: patrols set up as part of a collective.
 against human trafficking, anony-           > Rouen: a rota for bus visits set up, thanks to synchronisation with
 mous screening centres (CDAG),              work of the Aides association and an infectious diseases screening
 health insurance office (CPAM), town        project.
 councils, family planning centres,
 psychiatric emergency care, Samu
 social
                                                                                                                                112/113
  HR & Needle Exchange
 The decree of 14 April 2005 legally recognises the harm reduction (RdR) policy. It has
 now been proved that needle exchange programmes are effective: they reduce need-
 le and straw sharing, and therefore the risk of transmitting AIDS or hepatitis C. They
 also greatly reduce the risk of overdoses and allow drug users to be referred to health
 and welfare structures. This public health approach allows marginalised users to have
 access to welfare, healthcare, information, referral and support systems.

                                                                                                       Most common conditions
                                                                                                       > risks of infections linked to the

> Going to a marginalised population
                                                                                                       intravenous use of drugs (VHC, VIH,
                                                                                                       VHB), abcesses, psychiatric co-mor-
                                                                                                       bidity, dental problems, psychologi-
                                                                                                       cal problems linked to exclusion
 1996, granting of access prevention kit licence to Ministry of Health                                 > risks of marginalisation, discri-
 Activities: The distribution of sterile equipment, which            Outlook:                          mination and social harm
 is fundamental to reducing the risks of taking drugs,               Encourage measures to             Report from our programmes
 means contact can be made with an often marginalised                make exchanges with users         > clear development towards poly-
 population who, without these programmes, would not                 easier along the line of saliva   consumption of injected and non-
 have access to information and public treatment struc-              tests for screening hepatitis     injected products. Persistence of
                                                                                                       strong prevalence of hepatitis C
 tures. Having made contact, the teams can pass on preven-           C. The development of poly-       amongst injecting users
 tion messages, listen and refer drug users on medical, welfare      consumption requires new
 or legal matters such as accommodation, rights, regularising        tools to be created, especial-
 legal situations, withdrawal, post-treatment care and substi-       ly linked to crack consump-
 tution treatments. In Paris saliva tests to screen for hepatitis    tion. Since January 2006,
 C are offered and, as well as allowing medical treatment if the     needle exchange program-          Number of beneficiaries
                                                                                                       > factive file of nearly 2,600 IVDUs
 result is positive, also mean that the team can talk to the per-    mes have been recognised           from 12,500 visits to mobile units
 son and give him more help. Other tools are used in this harm       as medical and welfare insti-      and permanent centres. More than
 reduction process according to the context: inhalation straws       tutions and are funded by          19,000 other contacts (for informa-
 for sniffers, crack pipe mouthpieces to avoid burns and VHC         health insurance as                tion, referrals and requests other
                                                                                                        than for material)
 contamination, Sterifilt to filter non-injectable substances at     CAARUDs (Centres for sup-
 the end of the needle. The field teams are continually involved     porting harm reduction for        Number of volunteers
 in research and survey work on tools and prevention messa-          drug users) on condition that     > 35 in multidisciplinary teams
 ges to improve their effectiveness. The street work often com-      they carry out specific work
                                                                                                       Sources of funding
 plements the work carried out in the mobile units.                  (reception, referral, support,    > mainly the state via local health
                                                                     etc).                              authorities, local authorities, health
                                                                     As part of the move to beco-       insurance offices (CPAM), the
                                                                     ming CAARUDs, the Paris,           National Fund for Health Prevention,
 Types of work                                                                                          Education and Information (FNPEIS),
 > 4 mobile structures: buses, vans and teams on foot amongst drug   Bordeaux and Marseille pro-        town councils, Ile de France regional
 users in the street or in squats.                                   grammes must leave MdM in          health insurance office (CRAMIF)
 > 1 permanent centre in Bordeaux, 1 permanent needle exchange       2006 and become autono-
 centre in Paris and Marseille.                                                                        Partners
 > Sterile injection material made available in all CASOs            mous associations set up by
 > 236,808 needles given, 36% used needles returned.                                                   > Department of Health, MILDT
                                                                     the field teams supported by       (Interdepartmental Committee for the
                                                                     MdM.                               fight against drugs and drug addic-
                                                                                                        tion), OFDT (French monitoring cent-
                                                                                                        re for Drugs and Drug Addiction) and
                                                                                                        all RdR structures in towns where we
                                                                                                        work.
Methadone Buses
                                         As methadone subsitution relieves withdrawal sensations, it reduces the risks linked
                                         to drug use, as well as helping the social and health reintegration of drug users, who
                                         are particularly vulnerable and often marginalised.




Drug users
                                        > Local work on a daily basis
> approx. 200,000 injectors              Since 1998

Main conditions
                                         Activities: The programmes are aimed at particularly mar-            Outlook:
> HIV, VHB, VHC contamination            ginalised users not covered by any other structure, and offer        In Paris, the team has been
 amongst injectors, psychiatric          services at the level of need suited to the user's situation. A      involved in a think-tank with
 co-morbidity, psychological             methadone dose is delivered daily to the patients on the pro-        the help of a philosopher on
 suffering linked to exclusion           gramme. Patients are included from the day they request it,          innovative therapeutic practi-
                                         in the permanent centre after a medical interview. The pro-          ces which should lead to a
                                         grammes are aimed at treating opiate dependency by star-             written paper in 2006. In
                                         ting and continuing methadone substitution treatment.                Marseille, the team has for-
Number of projects
> 2 methadone buses                      The programme includes monitoring the most problematic               med an RdR platform which
                                         users; the aim is to refer patients to other structures. The buses   offers, in connection with the
Number of beneficiaries                  act as bridges towards more permanent treatment systems.             methadone bus's services,
> active file: 767 in 2 towns            They are parked close to places where drugs are taken and            several types of work adap-
Number of contacts                       provide a place where people can be seen and referred for            ted to the people encounte-
> an average of 100 contacts per         medical, psychological and social care.                              red in squats, nightlife
 day in Paris and 30 in Marseilles                                                                            venues, during street work,
                                         Types of work                                                        etc by offering suitable tools.
Number of volunteers
> 23                                                                                                          These activities are run with
                                         > Mobile healthcare unit manned 7 days a week.
                                         > Local mobile teams.                                                operational partners (ASUD,
Sources of funding                       > Reception in a permanent centre.                                   TIPI, etc.).
> CPAM (health insurance offices),                                                                            On the other hand, during
 local health authorities, Solidarité
 sida, Sidaction; MILDT
                                                                                                              2006, the 2 methadone
 (Interdepartmental committee on                                                                              buses (as well as the NEPs)
 drugs and drug addiction), local                                                                             are going to leave MdM. The
 and regional authorities                                                                                     association GAIA Paris will
Partners                                                                                                      take over running the Paris
> ASUD, TIPI, Aides Provence,                                                                                 CSST (drug addiction cent-
Sleep'in, HAS, emergency accom-                                                                               re) and the association BUS
modation hostels, other drug addic-                                                                           31/32 will take over in
tion treatment centres (CSST) in
Marseilles and Paris
                                                                                                              Marseilles. These 2 associa-
(especially Fernand-Vidal and                                                                                 tions have been set up
Marmottan), hospitals, treatment and                                                                          especially for this purpose
post-treatment institutions, etc.                                                                             by the field teams and will
                                                                                                              continue to have strong links
                                                                                                              with MdM.
                                                                                                                                     114/115
  Raves
 Young people are taking more and more synthetic drugs. But the ban on raves forces
 participants into clandestine behaviour with all the related risks: poor security condi-
 tions, no medical support, nobody present from associations or institutions to provi-
 de prevention messages. The decree of 14 April 2005 banning testing for drugs is a
 real brake on our approach to these people. It was an essential tool for initiating
 discussions about prevention and for making users take responsibility for their
 drug-taking.
                                                                                                             Types of products
                                                                                                             > alcohol, ecstasy, cocaine, and
                                                                                                              other hallucinogens, amphetami-

> Informing about risks
 Since 1997
                                                                                                              nes, heroin, anaesthetic substan-
                                                                                                              ces (GHB, ketamine)

                                                                                                             Health problems
 Activities:       MdM's Raves project is involved in harm                   Outlook:                        encountered
                                                                                                             > headaches, vomiting, dizziness,
 reduction work linked to the use of psychoactive substan-                   Adapt the types of work the      psychological problems, anxiety
 ces. It has two main aspects:                                               projects do to an increasin-     attacks
 • health and prevention: offer places for medical care where                gly difficult context where
 people can be seen and listened to. The teams deal with minor               young people are dispersed      Most common risks
                                                                                                             > dehydration, bad trips,
 cuts and bruises and emergencies. Prevention messages are                   and less and less accessi-       hyperthermia, hypoglycaemia
 given concerning the risks of taking drugs, cultural practices              ble. Develop prevention
 (tattoos, piercing, etc.), and STI, HIV and hepatitis transmis-             tools and flyers, appropriate
 sion, etc;                                                                  to the growing context of       Beneficiaries
 • analysis, on site using TLC (thin-layer chromatogra-                      polyconsumption.                > approximately 40,000
 phy) and testing (until April 2005, when testing was ban-
 ned), and in a laboratory, of the components of the                                                         Sex, age
                                                                                                             > mainly men, average age: 24
 substances in circulation in order to adapt the preven-
 tion messages appropriately. Since 1999, MdM has been                                                       Number of instances of
 involved in the SINTES (National system for identifying toxins                                              treatment
 and substances) programme.                                                                                  > 75 including 3 joint projects
                                                                                                              at teknivals
 In 2005, the Paris Raves project redirected its activities to
 squats. The team sets up RdR stands each Friday evening,                                                    Number of volunteers
 visits around three squats each week and practices TLC ana-                                                 > 180
 lysis to identify the substances contained in the drugs taken.
                                                                                                             Sources of funding
 120 squats were visited and 36 RdR sessions were held in                                                    > Ministry of Health, local health
 Paris (in all, more than 3,400 RdR contacts). The Marseilles                                                 authorities, MILDT (interministerial
 RdR project also extended its activities into squats in 2005.                                                committee on drugs and drug
                                                                                                              addiction), OFDT (French monito-
 Types of work                                                                                                ring centre for drugs and drug
 > All the projects offer first aid, information and substance analysis in                                    addiction), local authorities
 a harm reduction approach linked to drug use.
 > Work in places where young people gather such as free parties,                                            Partners
 teknivals, discotheques, clubs, squats, etc.                                                                > Techno Plus, Aides, Orange
 > In 2005, 78 samples of synthetic drugs were collected, documen-                                            Bleue, ASUD, TIPI, Act Up,
 ted and analysed under the SINTES programme co-ordinated by
 OFDT (French monitoring centre for drugs and drug addiction).                                                Acothé, Nantes daytime reception
                                                                                                              centre, Espace indépendance,
                                                                                                              Sida paroles, Fratrie
>      Contacts                   (CASOs - Free Healthcare and Guidance Centres)

> AIX-EN-PROVENCE                    > GUYANA                             > MONTPELLIER                       > ROUEN
 Philippe ROQUEJEOFFRE Médecins        Sylvie CREGUT                        Tony DA SILVA, Marie-Bernadette     Agathe BONMARCHAND
 du Monde Maison de la Solidarité      Médecins du Monde                    CADILHAC, Margarita GONZALEZ        Médecins du Monde
 Rue Philippe-Solari                   32, rue Vermont-Polycarpe            Médecins du Monde                   5, rue d'Elbeuf
 13100 Aix-en-Provence                 97300 Cayenne                        18, rue Henri-Dunant                76100 Rouen
 Tel.: 04 42 21 45 84                  Guyane                               34090 Montpellier                   Tel.: 02 35 72 56 66
 Fax: 04 42 21 62 48                   Tel./Fax: 05 94 28 36 77             Tel.: 04 99 23 27 17                Fax: 02 35 73 05 64
 medmondaix@wanadoo.fr                 mdmmfcayenne@wanadoo.fr              mdmcaso34@wanadoo.fr                mdmrouen@wanadoo.fr

> AJACCIO                            > GRENOBLE                           > NANCY                             > STRASBOURG
  François PERNIN                      Patrick BAGUET                       Jean-Marie GILGENKRANTZ             Jean-Maurice SALEN
  Médecins du Monde c/o Secours        Médecins du Monde                    Médecins du Monde                   Médecins du Monde
  catholique                           19, rue René-Thomas                  5, rue de l'Armée-Patton            24, rue du Maréchal-Foch
  6, bd Casanova                       38000 Grenoble                       54000 Nancy                         67000 Strasbourg
  20000 Ajaccio                        Tel.: 04 76 84 17 21                 Tel.: 03 83 27 87 84                Tel.: 03 88 14 01 00/01
  Tel.: 04 95 51 28 93                 Fax: 04 76 84 17 58                  Fax: 03 83 28 42 55                 Fax: 03 88 14 01 02
  Fax: 04 95 21 17 13                  mfgrenoble@free.fr                   medmond.nancy@free.fr               mdmalsac@club-internet.fr
  All mail: F. Pernin
  La Gravona                         > LA PLAINE-SAINT-DENIS              > NANTES                            > TOULOUSE
  20000 Ajaccio                        Florence SUZAN                       Philippe JARROUSSE,                 Geneviève MOLINA Médecins du
  Tel.: 04 95 29 90 75                 Médecins du Monde                    Jean Pierre CLAUZEL Médecins du     Monde
  Fax: 04 95 29 94 24                  8-10, rue des Blés                   Monde                               5, boulevard de Bonrepos
  mdmcorse@wanadoo.fr                  93210 La Plaine-Saint-Denis          33, rue Fouré                       31000 Toulouse
                                       Tel.: 01 55 93 19 29                 44000 Nantes                        Tel.: 05 61 63 78 78
> ANGERS                               Fax: 01 55 93 19 30                  Tel.: 02 40 47 36 99                Fax: 05 61 62 04 15
  Isabelle SALAUN, Frédéric VIE        mdm.mission.banlieue@wanadoo.fr      Fax: 02 51 82 38 09                 mdmmidipy.delegation@laposte.net
  Médecins du Monde                                                         mdm.nantes@free.fr
  62, boulevard Saint-Michel         > LYONS                                                                  > VALENCIENNES
  49100 Angers                         Marc CUCHE, Karen FINSTERLE        > NICE                                Eliane LAMORISSE Médecins du
  Tel.: 02 41 43 65 66                 Médecins du Monde                    Bernard AUBIN                       Monde
  Fax: 02 41 43 01 49                  10, rue de Sévigné                   Médecins du Monde                   10-12, rue du Grand-Fossart
  mdm.mdm-angers@wanadoo.fr            69003 Lyon                           34, rue Rossini                     59300 Valenciennes
                                       Tel.: 04 78 89 99 99                 06000 Nice                          Tel.: 03 27 47 40 08
> BESANÇON                             Fax: 04 78 71 75 72                  Tel.: 04 93 16 59 60                Fax: 03 27 30 19 16
  Violaine LLORCA                      mflyon@free.fr                       Fax: 04 93 16 59 61                 mdmvalenciennes@free.fr
  Médecins du Monde                                                         mdmnice@numericable.fr
  Appartement 168003                 > LE HAVRE
  7, rue du Languedoc                  Arlette SEIFFERT                   > PARIS
  25000 Besançon                       Médecins du Monde                    Denis HERMAN, Marc LERICHE
  Tel.: 03 81 51 26 47                 28, rue J.-B.-Eyriès                 Médecins du Monde
  Fax: 03 81 52 70 28                  76000 Le Havre                       62 bis, avenue Parmentier
  mdm.fc@wanadoo.fr                    Tel.: 02 35 21 68 66                 75011 Paris
                                       Fax: 02 35 22 67 33                  Tel.: 01 43 14 81 81
> BORDEAUX                             mdm.lehavre@wanadoo.fr               Fax: 01 47 00 75 53
  Christophe ADAM Médecins                                                  mfparis@medecinsdumonde.net
  du Monde                           > MARSEILLES
  2, rue Charlevoix-de-Villiers        Xavier CARRARD, Georgia COUFFIN    > PAU
  33000 Bordeaux                       et Florence LARMAT Médecins du       Robert LAFOURCADE
  Tel.: 05 56 79 13 82                 Monde                                Médecins du Monde
  Fax: 05 56 52 77 69                  4, avenue Rostand                    12 bis, place de la Monnaie
  mfbordeaux@wanadoo.fr                13003 Marseille                      64000 Pau
                                       Tel.: 04 95 04 56 00                 Tel.: 05 59 83 74 28
                                       Fax: 04 95 04 56 04                  Fax: 05 59 27 22 32
                                       mf.marseille@medecinsdumonde.net     mdmpau@wanadoo.fr
                                                                                                                                         116/117


>    Contacts                     (mobile activities) - Community Medicine

    MOBILE PROJECTS                           > METZ                             TRAVELLERS' PROJECTS                 > TOULOUSE
    STREET WORK                                René MOUTIER, Frédérique CARRIE   > STRASBOURG                          Marie-Pierre BUTTIGIEG
    > LYONS                                    Médecins du Monde                  Catherine FRAPARD                    Médecins du Monde
     Françoise MICHAUD                         11, rue Saint-Pierre               Médecins du Monde                    5, boulevard de Bonrepos
     Médecins du Monde                         57000 Metz                         24, rue du Maréchal-Foch             31000 Toulouse
     1, place du Griffon                       Tél. : 03 87 63 55 91              67000 Strasbourg                     Tél. : 05 61 63 78 78
     69001 Lyon                                Fax : 03 87 66 60 93               Tél. : 03 88 14 01 01                Fax : 05 61 62 04 15
     Tel.: 04 78 29 59 14                      medmond.metz@free.fr               Fax : 03 88 14 01 02                 mdmmidipy.delegation@laposte.net
     Fax: 04 78 29 55 91                                                          mdmalsac@club-internet.fr
     mflyon@free.fr                           > MONTPELLIER                                                           Homelessness Project
                                               Damien CHERET, Clélia VENTURINI   CHILDREN'S PROJECTS                  > MARSEILLE
    > METZ                                     Médecins du Monde                 Child lead poisoning                  Denise CLÉMENT
      René MOUTIER                             18, rue Henri-Dunant              > LA PLAINE-SAINT-DENIS               Médecins du Monde
      Médecins du Monde                        34090 Montpellier                  Claude CHAUDIERES                    4, avenue Rostand
      11, rue Saint-Pierre                     Tél. : 04 99 23 27 17              Mission Banlieue                     13003 Marseille
      57000 Metz                               Fax : 04 99 23 27 18               Médecins du Monde                    Tél. : 04 95 04 56 03
      Tel.: 03 87 63 55 91                     mdm_mtpl@club-internet.fr          8-10, rue des Blés                   Fax : 04 95 04 56 04
      Fax: 03 87 66 60 93                                                         93210 La Plaine-Saint-Denis          mfmarseille@medecinsdumonde.net
      medmond.metz@free.fr                    > NANTES                            Tél. : 01 55 93 19 29
                                               Funambus                           Fax : 01 55 93 19 30                > PARIS
    > POITIERS                                 Paul BOLO                          mdm.mission.saturnisme@wanadoo.fr    Graciela ROBERT,
      La Caravane                              Médecins du Monde                                                       Paul ZYLBERBERG
      Marie-Thérèse RAYMOND Médecins           33, rue Fouré                     Hospital buddies                      Médecins du Monde
      du Monde                                 44000 Nantes                      > PARIS                               62 bis, avenue Parmentier
      21, rue Boncenne                         Tél. : 02 40 47 36 99              Catherine PETERMAN                   75011 Paris
      86000 Poitiers                           Fax : 02 51 82 38 09               c/o coordination Mission France      Tél. (en journée pour mess.) :
      Tel.: 05 49 01 77 77                     mdmfunambus@free.fr                Médecins du Monde                    01 44 92 14 98
      Fax: 05 49 60 28 93                                                         62, rue Marcadet                     Tél. (de 21 h à 23 h) :
      Back-up/Tel.: 05 49 38 45 10            > PARIS                             75018 Paris                          01 43 14 81 74
      Fax: 05 49 38 45 11                      Lotus Bus                          Tél. : 01 44 92 13 10                Fax : 01 43 14 81 51
                                               Chloé CATTELAIN, Marie DEBRUS      Fax : 01 44 92 99 92                 mdm@medecinsdumonde.net
    > SAINT-DENIS DE LA RÉUNION                Médecins du Monde                  parrainage@medecinsdumonde.net
      Médecins du Monde                        62 bis, avenue Parmentier                                              CAFDA Project
      250 bis, rue Général-Rolland - bât. K    75011 Paris                       ROMA-GYPSY PROJECT                   > PARIS
      SHLMR Bouvet - BP 964                    Tél. : 01 43 14 81 61             > LA PLAINE-SAINT-DENIS               Fabrice GIRAUX, Marc LERICHE
      97479 Saint-Denis de la Réunion          Fax : 01 47 00 80 70               Sylvie MONIN                         Médecins du Monde
      Cedex                                    lotusbus@medecinsdumonde.net       Médecins du Monde                    44, rue Planchat
      Tel.: 02 62 21 71 66                                                        8-10, rue des Blés                   75020 Paris
      Fax: 02 62 41 19 46                     > ROUEN                             93210 La Plaine-Saint-Denis          Tél./ Fax : 01 45 49 03 80
      medecinsdumonde.reunion                  Bus prévention                     Tél. : 01 55 93 19 38                mdmcafda2@yahoo.fr
      @wanadoo.fr                              Jean-Jacques PREY                  Fax : 01 55 93 19 30
                                               Médecins du Monde                  mdm.mission.banlieue@wanadoo.fr     WELFARE
    PROSTITUTION PREVENTION                    5, rue d’Elbeuf                                                        SUPPORT PROJECT
    > LE HAVRE                                 76100 Rouen                       POORLY HOUSED PROJECT                > BORDEAUX
     Arlette SEIFFERT                          Tél. : 02 35 72 56 66             Squats Project                        Arnaud WIEHN
     Médecins du Monde                         Fax : 02 35 73 05 64              > BORDEAUX                            Médecins du Monde
     28, rue J.-B.-Eyriès                      mdmrouen@wanadoo.fr                Liane and Guy MAYER                  2, rue Charlevoix-de-Villiers
     76000 Le Havre                                                               Médecins du Monde                    33000 Bordeaux
     Tél. : 02 35 21 68 66                                                        2, rue Charlevoix-de-Villiers        Tél. : 05 56 79 13 82
     Fax : 02 35 22 67 33                                                         33000 Bordeaux                       Fax : 05 56 52 77 69
     mdm.lehavre@wanadoo.fr                                                       Tél. : 05 56 79 13 82                mfbordeaux@wanadoo.fr
                                                                                  Fax : 05 56 52 77 69
                                                                                  mfbordeaux@wanadoo.fr
>     Contacts                    (Harm Reduction)

NEEDLE EXCHANGE BUS                  NEEDLE EXCHANGE BUS                    > PARIS
> ANGOULÊME                          > BORDEAUX                              Valère ROGISSART
 Valérie PATRIER                      Jean-Pierre DAULOUEDE,                 Médecins du Monde
 Médecins du Monde                    Guy MAYER                              62 bis, avenue Parmentier
 22, allée du Champ-Brun              Médecins du Monde                      75011 Paris
 16000 Angoulême                      2, rue des Etables                     Tél./ Fax : 01 43 14 81 69
 Tél. : 05 45 65 11 82 (unit)         33800 Bordeaux                         rave.paris@medecinsdumonde.net
 Tél. : 05 45 65 07 47 (office)       Tél. : 05 56 92 51 89
 Fax : 05 45 61 18 85                 Fax : 05 56 92 03 59                  > TOULOUSE
 (unit and office)                    rdr.mdm.bx@wanadoo.fr                  Olivier DROUAULT, Julien SANCHEZ
 mdm-angouleme-rdr16@aliceadsl.fr                                            Médecins du Monde
                                     RAVES                                   5, boulevard de Bonrepos
HEALTH LISTENING BUS                 > BAYONNE                               31000 Toulouse
> ANGOULÊME                           Jean-Pierre DALOUEDE                   Tél. : 05 61 63 78 78
  Marie-Laure FERRARI                 Médecins du Monde - Bizia              Fax : 05 61 62 04 15
 Médecins du Monde                    (centre méthadone)                     mdmmidipy.raves@laposte.net
 22, allée du Champ-Brun              Centre hospitalier Côte basque BP 8
 16000 Angoulême                      64106 Bayonne                         XBT PROJECT
 Tél. : 05 45 65 11 82 (unit)         Tél. Bizia : 05 59 44 31 00           National SINTES
 Tél. : 05 45 65 07 47 (office)       Raves port. : 06 03 21 21 05          co-ordinating body
 Fax : 05 45 61 18 85                 Tél. Raves : 05 59 44 31 05           > PARIS
 (unit and office)                    Fax : 05 59 44 31 03                   Stéphane LE VU
                                      mdm.bayonne@wanadoo.fr                 Médecins du Monde
HARM REDUCTION                                                               62 bis, avenue Parmentier
> MARSEILLE                          > NANTES                                75011 Paris
 Béatrice STAMBUL                     Anne-Lise GUEGUEN                      Tél./ Fax : 01 43 14 81 69
 Médecins du Monde                    Médecins du Monde                      xbt@medecinsdumonde.net
 4, avenue Rostand                    33, rue Fouré                          s.levu@laposte.net
 13003 Marseille                      44000 Nantes
 Tél. : 04 95 04 56 06/08             Tél. : 02 40 47 36 99
 Fax : 04 95 04 56 07                 Fax : 02 51 82 38 09
 rdr.marseille@medecinsdumonde.net    mdm.nantes@free.fr

NEEDLE EXCHANGE BUS                  > NICE
METHADONE BUS                         Philippe de BOTTON
> PARIS                               Médecins du Monde
 Jean-Pierre LHOMME                   34, rue Rossini
 Médecins du Monde                    06000 Nice
 62 bis, avenue Parmentier            Tél. : 06 08 27 20 94
 75011 Paris                          medecinsdumondenice@free.fr
 Tél. : 01 43 14 81 61
 Fax : 01 47 00 80 70
 secrpes.parmentier
 @medecinsdumonde.net
 bus.methadone
 @medecinsdumonde.net
                      > MdM mobilisation




                119/128
CÉDRIC HELSLY
MICHEL REDONDO   CATHERINE HENRIETTE   VALÉRIE DUPONT




LAHCÈNE ABIB     JULIEN DE WECK        CÉDRIC HELSLY




mdm              mdm                   VALÉRIE DUPONT
                                                                                                                                                                                                  120/121


                   >     January-February
GÉRARD RONDEAU




                                                                                                                                               VALÉRIE DUPONT
                                                                           JOËL ROBINE




                 The tsunami struck South-East Asia on 26 December 2004.                 “Children and War” conference in the Senate.                           Mobilisation following the building of the wall in Palestine.




                 > Key events
                 Tsunami: After this unprecedented humanita-                             lopment and the attacks on their most fun-                             physical and mental health, and freedom of move-
                 rian disaster, MdM got involved through its inter-                      damental rights, so that their suffering, needs                        ment, and for the Geneva Convention to be
                 national network in providing emergency                                 and rights can at last be recognised. More than                        respected. At the same time, fourteen Israeli and
                 medical assistance to tsunami victims, reac-                            forty speakers (humanitarian workers, lawyers,                         Palestinian artists raised awareness amongst
                 tivating healthcare systems in the stricken                             sociologists, psychologists, etc.) took part in the                    Israeli and Palestinian public opinion through their
                 areas and dealing with risks of epidemics. At                           conference talking to an audience of over 210                          pictures of the security barrier and its conse-
                 the same time, at head office, the doors were                           people and trying to call on the public authori-                       quences. The campaign was publicised locally
                 opened two Sundays in a row to welcome peo-                             ties to act by apleading for better protection for                     by the Israeli magazine Ha'ir and the Palestinian
                 ple affected by this drama and provide them with                        children in armed conflicts.                                           paper Al Quds; the report was distributed to the
                 comfort and support.                                                                                                                           authorities of Israel and the Palestinian Territories.
                                                                                         14 and 15 February: campaign on the Wall
                 11 and 12 February: “Children and war, vio-                             and health in Palestine. . Two press confe-
                 lence, trauma and rehabilitation” conference
                 in the Senate. War is the main cause of infant
                                                                                         rences in Tel Aviv and Ramallah, in association
                                                                                         with Physicians for Human Rights (an Israeli medi-                     > And also
                 mortality in the world. Wars almost always involve                      cal organisation) and the Palestinian Red Crescent                     February: Publication of the book by Dr. Jacqueline
                 the whole population directly, so children are killed,                  Society, denounced the destructive effects of                          Ferreira, “Caring for the poorly cared for -
                 wounded or displaced. They are witnesses of                             building the Separation Wall in the West                               Ethnology of a free healthcare centre”, which
                 atrocious violence or forced to take part in it as                      Bank on Palestinians' access to healthcare                             carefully dissects the medical and social care given
                 soldiers, servants or sex slaves. The conference                        and living conditions in the territories. The                          to patients by Médecins du Monde's teams.
                 was organised together with Défenseur des                               publication of the report, “The ultimate barrier:
                 enfants, Enfants réfugiés du monde and the Centre                       the Wall's impact on the Palestinian health sys-                       An exhibition of photos illustrating Roma
                 de recherches sur la paix, and was the opportu-                         tem”, reaffirms MdM's fight to defend the civi-                        living conditions in Romania had been touring
                 nity to denounce the hindrances to child deve-                          lian population's right to healthcare, right to                        France for a year and continued its tour in 2005.
                         >      March
                                                                                                                                      >   And also
                                                                                                                                      7 March: MdM was involved in a day of reflec-
                                                                                                                                      tion on the human rights situation in the
                                                                                                                                      Kurdish South-East. The “Human Rights in
                                                                                                                                      Turkey: a growing reality?” conference was orga-
                                                                                                                                      nised by the Group for Human Rights in Turkey
                                                                                                                                      with the support of FIDH (International Human
/ L’OEIL PUBLIC




                                                                                                                                      Rights Federation).

                                                                                                                                      11 March: Médecins du Monde, Médecins
                                                                                                                                      Sans Frontières (MSF) and Aide Médicale
   SAMUEL BOLLENDORFF




                                                                                                                                      Internationale (AMI) called on the French National
                                                                                                                                      Medical Association (CNOM) to act in the case
                                                                                                                                      of Dr Michele d'Auria, a doctor with the Abbé
                                                                           DR




                                                                                                                                      Pierre Foundation and a former expatriate volun-
                        Project amongst women prostitutes.                      Day of meetings on humanitarian surgery.
                                                                                                                                      teer of MdM, so that he can practise as a doc-
                                                                                                                                      tor in France. He had been accused in Italy of

                        > Key events                                                                                                  acts for which he has since

                        15 March: open letter to the President of               20 March: MdM started lobbying MEPs to ask            19 March: M d M 's surgery meetings.
                        France on the harmful consequences of the               for an amendment to be added to the propo-            Surgeons on humanitarian missions are called
                        internal security law on people involved in             sed European directive on procedures for depor-       to act quickly and to adapt to circumstances
                        prostitution.                                           ting illegal migrants which will be passed in 2006.   using the means available. This day of mee-
                        The internal security law, which represses all,         The text does not take into account the state         tings was an opportunity to compare field expe-
                        even passive, soliciting, puts a lot on pressure        of health of those to be deported, except to          riences, exchange ideas and techniques and
                        on people involved in prostitution, who must            avoid their dying during the transport for their      try together to find answers to all the questions
                        now hide to avoid police repression. These peo-         deportion. As M d M has noted the very poor           which a surgeon on a project faces.
                        ple, exposed to violence and risk of STIs, and          health of a large number of migrants, we
                        suffering from an increasing feeling of insecu-         are calling for an amendment to be added
                        rity, have in fact become even more vulnerable          banning the expulsion of seriously ill peo-
                        since this law was introduced, and the work of          ple and guaranteeing access to healthcare in
                        the Association has become very difficult as            the country, unless it can be proved that these
                        access to people involved in prostitution is now        people will have effective access to appropriate
                        so restricted.                                          treatment and medical care in their countries of
                                                                                origin.
                                                                                                                                                          122/123


                                                                                                                                                                  >   April




                                                            PASCAL DELOCHE
mdm




      Chechnya: MdM provides support to the victims                          Displaced people in Rwanda.                    The quarterly magazine Humanitaire.
      of a continuous political and military crisis.



      H u m a n i t a i re Magazine No.12: “The Kurdish                      28 April: «Tuez-les tous» (Kill them all), a
      question and humanitarian workers.”                                    documentary on the Rwandan genocide (made
                                                                             by R. Glucksman, D. Hazan and P. Mezerette).
      5 April: “Perspectives - Chechnya, Northern                            Screening and discussion on Rwanda orga-
      Caucasus: the Kremlin's calculations in the                            nised by MdM at the Cinéma des Cinéastes.
      region”. This meeting organised at MdM's
      head office was a time for discussions and
      reflection on the political and humanitarian
      future of Chechnya after the assassination of
      the Chechen President Maskhadov.

      19 April: organisation of a meeting to sup-
      port Florence Aubenas and Hussein
      Hanoun, in conjunction with all the French
      international solidarity organisations. Those
      involved in international solidarity, who are inde-
      pendent witnesses and just as threatened in
      certain areas, could not do other than stand
      by the hostages and work for their liberation,
      which took place on 12 June.
      >      May-June
                                                                                                                               with Cinéma des Cinéastes, MdM organised
                                                                                                                               an exhibition on the theme “Victims and/or
                                                                                                                               killers? The child soldiers of Liberia”. Valérie
                                                                                                                               Dupont exhibited her photos and François
                                                                                                                               Margolin presented “Les petits soldats” (The
                                                                                                                               Little Soldiers), a documentary which he made
                                                                                                                               on the tragic situation of children enrolled in the
                                                                                                                               Liberian army. Since January 2005, through its
                                                                                                                               mental health programme, Médecins du Monde,
                                                                                                                               has been involved in helping these child sol-
                                                                                                                               diers to rebuild their lives and reintegrate into
                                                                                                                               society
                                                          VALÉRIE DUPONT




                                                                                                                               18 June: Lyon Migrants Day, meetings,
DR




                                                                                                                               exchanges and dialogue between the people
     MdM's new publicity campaign.                                         Teenager in Liberia.
                                                                                                                               of Lyons and the migrant population.

     > Key events                                                                                                              23 June: MdM jointly signed the declaration
                                                                                                                               calling on the G8 country leaders to quic-
     19 May: launch of MdM's new campaign                                  The people living in Kalma are gradually beco-      kly expand measures to eradicate poverty, give
     on behalf of forgotten crises. During a press                         ming completely dependent on international          access to healthcare and education, and for
     conference, MdM launched its new campaign,                            aid, especially for food, even though the huma-     sustainable development in developing coun-
     which highlights what it is doing amongst popu-                       nitarian organisations having problems in get-      tries.
     lations who have been forgotten. Rather than                          ting supplies.
     seeking to make people feel guilty, it is encou-                      At the same time, the area surrounding the          24-25 June: International day in support of vic-
     raging collective awareness that we are all                           camp where MdM is working is becoming very          tims of torture: MdM was involved in the confe-
     responsible for their being forgotten. The deli-                      dangerous: roaming militias are involved in more    rence organised by the Primo Levi Association,
     berately aged photo from Rwanda, which illus-                         and more violence, pillaging and rape. Insecurity   entitled “Wanderings and loneliness, the
     trates the theme, symbolises the deterioration                        reigns, the camp is less and less viable, and       effects of torture and political violence”.
     of collective memory. The campaign won first                          everything is being done to force the displaced     Médecins du Monde has been involved in the
     prize in the press category in the awards for                         to leave, exposing them to even greater dan-        Primo Levi Association's work for ten years. Its
     solidarity publicity.                                                 gers than in the “open-air prison” that is Kalma    main aim is to offer care and support to victims
                                                                           camp.                                               of torture and political violence living in exile in
     13 May: MdM's general assembly was the oppor-                                                                             France.
     tunity to re-launch our involvement in Darfur,
     because of the increased pressures on the displa-                     >    And also
     ced in Kalma camp. The Sudanese authorities                           19 May: MdM's new Internet site was set
     are pushing displaced people to leave the camp                        up. The site at www.medecinsdumonde.org
     against their will, by trying to “suffocate” them.                    gives a new image, providing better informa-
     Trade is hindered, and the freedom of movement                        tion to the general public concerning MdM's
     of the displaced seriously curtailed.                                 projects. On the fringe of the national
                                                                           Humanitarian Action Exhibition, in partnership
                                                                                                                                                   124/125


                                                                                                                                                          >        July
> Key events
Global action against poverty: as part of the
“2005: no more excuses” platform, MdM was
involved in “Action Mondiale contre la Pauvreté”
(Global Action against Poverty). This internatio-
nal campaign aims to put pressure on Northern
and Southern governments so that they take
concrete and ambitious measures to reach the
MDGs (Millennium Development Goals) adopted
by the United Nations in 2000 to reduce extreme
poverty. Throughout 2005, there was a campaign
to call on political decision-makers with respect
to the international agenda, especially on 1 July




                                                                                                               mdm
2005, World White Band Day, on the eve of
                                                     DR




the G8 conference. That day, people in over 100           The campaign for White Band Day.                           Free healthcare and guidance centre (CASO).
countries wore white bands and thereby ans-
wered yes to our call. Meetings were also orga-
nised throughout France.                                  Committee of Social Rights ruled against France            Humanitaire magazine, special edition No.
                                                          in its decision of 3 November 2004 in which it             2 “What health for migrants in Europe?”,
AME-CMU (State medical aid - universal                    recalled that those without papers and their chil-         which took up the proceedings of the Migrants
health insurance): MdM got involved against               dren must receive effective medical assistance             Workshops held in December 2004 at MdM's
the reforms restricting access to healthcare              in accordance with the European Social Charter.            head office, attended by Didier Fassin and Louis

                                                          > And also
for people on low income and illegal forei-                                                                          Mermaz.
gners and, at a joint press conference, denoun-
ced the aberration of the situation which involves        People's Health Assembly: M é d e c i n s d u              MdM has associated itself with the «Contrôlez
requesting proof of identity and residence from           Monde took part in the 2nd People's Health                 les armes», the French section of the world-
those without papers in order to receive care,            Assembly which took place in Cuenca                        wide platform “Control Arms” campaign (laun-
which leads to the most destitute being exclu-            (Ecuador). The issues of access to health world-           ched by Amnesty International), which calls for
ded from healthcare. Two decrees complicating             wide, and especially in poor countries, were               an international treaty on the arms trade.
access to AME still further were issued by the            presented and discussed in their diversity by              Each year, over 500,000 people across the world
government on 28 July 2005: from now on,                  health professionals and beneficiaries from the            are killed by bullets, and no effective control is
migrants with irregular status must provide proof         whole world (1,500 people from 82 countries):              exercised on the arms trade. It is estimated that
they have lived in France for three months. This          the right to health, HIV-AIDS, gender and wome-            80 to 90% of the small arms in circulation were
makes it almost impossible for these highly inse-         n's health, environmental health, militarisation           originally traded legally.
cure and vulnerable people to get access to               and territorial occupation, health system reforms,
healthcare. An appeal to withdraw these decrees           traditional medicine, etc.
was made to the Council of State by MdM, Aides,
LDH (Human Rights League), MRAP (Movement                 11 July: Françoise Jeanson and Bernard
against Racism and for Friendship between                 Granjon's opinion column in the Libération new-
Peoples) and GISTI (Immigrant Information and             spaper: “11 July 1995: a day of shame”, for
Support Group). Moreover, the Council of Europe's         the ten years since the Srebrenica massacre.
 >     August-September
> Key events                                         ment to act, in an open letter to the Minister for
                                                     the Interior, Nicolas Sarkozy.
                                                                                                          in Gaza for two weeks, reporting on their
                                                                                                          actions amongst the most destitute in daily
“Chill Août Tour” (Chill August Tour): orga-         Reacting to further expulsions which threw           accounts in a log published on MdM's web-
nised by the Paris squats project, this tour star-   already destitute families on to the streets, MdM    site.
ted on 8 August 2005 and had several aims,           again denounced the insecure living conditions       15 August: alongside strong association invol-
including strengthening the existing set-up for      of thousands of homeless people or those occu-       vement during 2005, F. Jeanson denounced
MdM's different squats projects (Paris, Poitiers,    pying unhealthy and insecure housing. MdM            the new reforms to the AME system which res-
Marseilles, etc) and starting squats projects in     also linked up with the group “Pour un droit au      trict access to healthcare for highly vulnerable
other towns, sharing and transferring harm reduc-    logement opposable” (For a binding right to          people in an opinion column in L'Express
tion knowledge, organising workshops on drugs        housing), so that people suffering from sub-         magazine, “Save state medical aid”
analysis and distribution of harm reduction mate-    standard housing can excercise their right to        16 August: opinion column by F. Jeanson
rial, and testimonies. The tour ended at the tek-    housing before the competent authorities.            and D. Cannet in the La Croix newspaper:
nival organised between 25 and 29 August                                                                  “Mothers weep for their children”, on the
attended by 45,000 people.                                                                                postponement of high-risk elections in
6 September: urgent appeal for real solu-
tions to be provided for the problem of sub-
                                                     > And also                                           Democratic Republic of Congo.
                                                                                                          26 August: opinion column by P. Micheletti
standard housing.                                    Palestinian Territories: during the withdra-         “The end of the without frontiers”, in the
In the face of the inadequate housing policies       wal from the Gaza strip, , Florence Traullé. a       Libération newspaper.
proposed, MdM again called on the govern-            journalist on Nord Eclair, followed MdM's teams




 >     October
> Key events
17 October: on the International Day for the         21 October: MdM denounced the with-                  ticising the funding funding provided by the
Eradication of Poverty, MdM's Mission                drawal of the Global Fund, which had been            Fund for several months. Meanwhile, MdM,
France organised a testimony day. This event         working in Burma since April 2005. This co-          which has been working for fifteen years in
was firstly an opportunity to hear about the dif-    ordinated multilateral funding device fighting       Burma, has noticed that its work (especially
ficulties faced by the patients helped by MdM        against AIDS, tuberculosis and malaria was           amongst prostitutes and drug addicts), toge-
(extreme poverty, lack of access to housing and      due to fund several programmes to the tune           ther with that of other NGOs was having a
healthcare, etc) and the undeniable effects on       of 98 M$ over five years. However, for the first     significant impact on the HIV epidemic. By
their health. It was also an opportunity to argue    time, the Global Fund decided to withdraw            stopping all its funding, the Global Fund is
for access to healthcare for everyone, hindered      from a country to which it had made com-             preventing us from responding actively to an
by restrictive changes to the law which prevent      mitments, justifying this reversal on the weight     endemic disease which is ravaging this coun-
the most vulnerable people from receiving pro-       of constraints imposed by the military junta         try, and is annihilating all local initiatives.
per care. Today, the fundamental right that is       on humanitarian organisations. In actual fact,       7 October: the first stage of MdM's 25th anni-
the right of access to healthcare is flouted to      the Fund's managers seem to have yielded             versary, the exhibition of photos by Gérard
the detriment of the weakest.                        to pressure from one of its main funders, the        Rondeau was presented in a national pre-
                                                     United States, whose Congress had been cri-          view by the Provence-Alpes-Côte d'Azur
                                                                                                                                                          126/127


 >     October (cont'd)                                                                                                                     >      Novembre
region, in Marseilles. “Missions : Médecins
[jusqu'au bout] du Monde”, (Missions :
                                                       > Key events
Doctors {to the ends} of the World) highlights         M dM celebrates its 25th birthday!
the daily work of MdM's teams throughout               MdM's 25th birthday was an opportunity for all
the world. It provides a subjective view of            the Association's staff and volunteers to look
MdM's work and history. G. Rondeau has fol-            back over a quarter of a century of humanita-
lowed teams of French doctors for many years           rian experience and to renew everyone's com-
from Niger to Russia, Iraqi Kurdistan to besie-        mitment to damaged populations. Interventions
ged Sarajevo, and from New York (where                 in crises which receive little or no media atten-
Doctors of the World USA is based) to Paris,           tion make up a large part of MdM's activities.
and pays homage to them in this exhibition.            By placing its anniversary under the ban-
A book containing these photographs has                ner of the forgotten crises and commit-




                                                                                                             CÉDRIC HELSLY
also been published.                                   ment, MdM wishes to recall that humanitarian
                                                       crises persist well after the media disappear

> And also
                                                       and that our NGO's role is to bring them out of
                                                       this often criminal oblivion. So, civilian involve-                   MdM's 25th birthday party.
                                                       ment is essential so that these crises are dealt
MdM's teams which went to Pakistan after
                                                       with on a political level in the long term.
the earthquake which ravaged the north of the
                                                       Through forums, open days, exhibitions and
country shared their experience in a blog publis-                                                                            ving over 120 public health experts, health wor-
                                                       film screenings, the whole network was invol-
hed on the Le Monde newspaper's website.                                                                                     kers and academics and over 70 NGOs and
                                                       ved in bearing witness, and proposing and
After the first emergency phase, devoted to                                                                                  community groups. More than a report on health
                                                       reflecting on new perspectives, without for-
providing relief to the injured in the remote areas                                                                          inequalities, it offers an assessment by civil
                                                       getting to pay homage to the field workers and
north of Islamabad, MdM extended its work by                                                                                 society of the actions and policies of the
                                                       their efforts.
getting involved with the displaced gathered in                                                                              main institutions which influence health
makeshift camps.                                                                                                             worldwide. The report was supplemented by
                                                       On 4 and 5 November, humanitarian wor-
                                                                                                                             Global Action for Health, an advocacy docu-
                                                       kers, sociologists, academics and health pro-
                                                                                                                             ment which proposes a timetable for actions
                                                       fessionals gathered at MdM's head office to
                                                                                                                             that health associations can develop as of now.
                                                       exchange views on the direction and issues at
                                                       stake for humanitarian action. Three forums
                                                       were organised: “Humanitarian aid: views from
                                                       elsewhere”, led by Didier Fassin, “Humanitarian
                                                       action in disasters”, attended by Rony Brauman

                                                                                                                             > And also
                                                       and Jean-François Mattéi, and “Prospects for
                                                       the humanitarian action of tomorrow”, atten-
                                                       ded by Olivier Weber.
                                                                                                                             25 November: Opération Sourire celebrated
                                                       5 November: launch of the first report from                           its 15th birthday in Phnom Penh. 200 people,
                                                       the Global Health Watch. Médecins du Monde                            including former patients and the first surgeons,
                                 The book              organised the launch in France of Global Health                       gathered for this anniversary, recalling the impor-
                                 of photographs by
                                 Gérard Rondeau:       Watch 2005-2006. This alternative report to                           tance of plastic surgery for children who can
                                 “Missions: médecins   that published each year by the WHO is the                            have a normal life again and regain the desire
                                 [jusqu'au bout] du
                                 monde”.               fruit of a vast international joint venture invol-                    to smile.
                 >      December
                                                                             get off the street. MdM asked for a ban on put-       9 December: international call for the right
                                                                             ting anyone who has been offered accommoda-           to health. MdM supported the initiative by Mary
                                                                             tion back on the street. Since the morning of         Robinson (the former United Nations High
                                                                             21 December when MdM launched Operation               Commissioner for Human Rights) and Paul Hunt
                                                                             “Coup de Poing” (Punch), teams have been              (the United Nation's Special Reporter on the
                                                                             criss-crossing Paris offering tents to people         Right to Health) who launched a call for the right
                                                                             living on the street. These tents are distress        to health, signed by over 30 former heads of
                                                                             beacons and symbolise the roof which society          state and government then open for NGOs to
                                                                             should be capable of supplying to everyone. They      sign. In particular, the text asked for govern-
                                                                             are not solutions to the homelessness problem:        ments to act to promote access for eve-
                                                                             on the contrary, they represent the current absence   ryone to healthcare, water and food, and
                                                                             of a practical solution. This is why MdM called on    to strengthen health systems and abolish
                                                                             members of parliament to act by sending the press     user fees for basic healthcare.
CÉDRIC HELSLY




                                                                             file to each of them. On 31 December, MdM and
                                                                             Restos du Cœur jointly organised a patrol through     10 December: organisation of a photo exhibi-
                                                                             Paris. Four buses criss-crossed the capital offe-     tion at MdM's head office, entitled “Calais ou
                Operation “Coup de Poing” (Punch) on 21 December in Paris.
                                                                             ring homeless people meals, presents as well as       l'inhumanitaire au quotidian” (Calais or inhu-
                                                                             igloo tents.                                          manitarian action on a daily basis), along
                                                                                                                                   with a forum bearing witness to the situation of
                > Key events                                                 9 December: creation of the French group
                                                                             supporting the adoption of an additional
                                                                                                                                   migrants in transit in Calais.

                15 December: assessment of aid given to                      optional protocol to the United Nations               13 December: Françoise Sivignon's opinion
                tsunami victims. At the request of the “Comité               Covenant on Economic, Social and Cultural             column denouncing the withdrawal of the Global
                de la Charte” (Charter Committee), MdM repor-                rights (1966) of which MdM is a part, so that         Fund from Burma was published in the La Croix
                ted on its post-tsunami activities in South-East             these rights (including the right to health) can be   newspaper.
                Asia. After the relief work in the first weeks, MdM          the object of legal appeal, including at interna-
                got involved in medium-term work, by helping                 tional level. The Group is calling for the imminent   Humanitaire Magazine No. 13:
                to re-organise local health structures and                   adoption of a text which will offer real guarantees   “Humanitarian action in disasters”.
                supporting health staff in Indonesia and Sri                 to victims by including a non-derogable right of
                Lanka. In all, MdM received over 9.75 million                appeal to international law.                          Forum on “Violence against women, here
                euros in the form of donations to help tsunami                                                                     and over there”. On Human Rights Day on 10
                victims.
                                                                             >   And also                                          December, MdM organised a forum to denounce
                                                                                                                                   violence against women, illustrated especially by
                21 December: for lack of a roof, a tent. Living              1 December: “The international community              the Darfur crisis in Sudan, where rape is com-
                on the street means being in danger of death.                must keep its promises!” On World AIDS Day,           monly used as a weapon.
                Reacting to the public authorities' lack of action           MdM's international network again launched an
                concerning emergency accommo-dation, despite                 appeal having noted the considerable gap bet-
                several homeless people having died of cold at               ween states' commitments on AIDS and the situa-
                the beginning of the winter, MdM took action by              tion in the field, and the major impact of the
                demanding concrete measures so that the home-                shortage of doctors and nurses on the treatment
                less can have permanent accommodation and                    of patients.
  >The representation network




129/142
>     Alsace                                                                >      Aquitaine
Contact details
> Regional delegation:
                                 > Key events                               Contact details
                                                                            > Regional delegation:
                                                                                                             > Key events
24, rue du Maréchal Foch          Publicity events                          2, rue Charlevoix-de-Villers      Publicity events
67000 Strasbourg                                                            33300 Bordeaux
Tél. : 03 88 14 01 00             and activities                            Tél. : 05 56 79 13 82             and activities
Fax : 03 88 14 01 02              • Local Internet site: presentation of    Fax : 05 56 52 77 69              • Participation in the regional mee-
Mission France :                  the delegation and its activities.        medecinsdumonde.bx                tings of the Aquitaine regional coun-
03 88 14 01 01                    • Information for students and            @wanadoo.fr                       cil's decentralised co-operation and
mdmalsac@club-internet.fr
http://medecinsdumonde-           secondary school pupils.                                                    solidarity development body.
alsace.org/                       • Concert by the Soroptimist                                                • Local social forum with MdM
                                  Club-Service for a collection of          Board Members>                    stand.
                                  hygiene products and blankets.            Regional Representative:          • Exhibition and sale of pictures with
                                  • Screening of the film Caravan 55        Françoise Parrot                  proceeds going to MdM.
Board Members                     at the Odyssée cinema.                                                      • Meeting with the Réseau Santé
> Regional Representative:                                                  > Secretary:
 Dr Maryvonne Le Gac              • Presentation of Gérard Rondeau's         Savine Baudet                    Solidarité (Health and Solidarity
                                  book, 25 ans de Mission, at FNAC.                                           Network) and Secours Catholique on
> Secretary:                      • Concert by the Obernai choir with       > Treasurer:                      the topic of “the new poor in
  Dr Paul-André Befort                                                        Marc Denise
                                  proceeds going to MdM.                                                      France”.
> Treasurer:                                                                > Other Members:                  • Global action “2005 no more
  Jean Litzler                                                               Patrice Billecocq                excuses”: white band operation
                                  Partnerships                               François Cougoul                 organised by MdM in Bordeaux with
> Other Members:                  • Group of psychiatrists and general
                                                                             Jean-Pierre Daulouède
                                                                                                              involvement of other organisations.
 Aloyse Kriegel                                                              Marie-Germaine Mazeran
 Catherine Frapard                practitioners on exclusion from health                                      • Organisation of Mission France's
 Dr Pierre Rosenstiel             care and AME (state medical aid) and      > Secretary of the delegation:    national days on 7, 8 and 9 October
 Dr Jean-Maurice Salen            CMU (universal health insurance) res-      Marie-Christine Chauveau         (around 220 participants).
> Secretary of the delegation:
                                  trictions.                                > Number of Members:              • International Day for the
 Brigitte Fanteguzzi              • Group of organisations working           133                              Eradication of Poverty.
                                  with people involved in prostitution.                                       • Day to meet with all adopting
> Section Adoption :              • 115 and its partners: Maraude                                             families or in the process of adopting.
  Colette Minard-Rosenstiel
                                  Ville (Town Patrol), Restos du Cœur,                                        • Lecture and debate on “Tsunami -
> Number of Members:              etc.                                                                        Pakistan” with invitation to donors
 71                               • Illkirch town.                                                            from Gironde: a hundred participants
                                  • Alerte group.                                                             at Bordeaux 2 university.


                                  Other activities
                                  • Adoption: 8 children arrived in
                                  Alsace; work with ASE (state
                                  childcare services) to give better
                                  information to couples seeking
                                  approval.
                                  • Setting up a trial exploratory
                                  project in Gamadji Saré, Senegal,
                                  started in the context of meetings       > Pau branch:
                                                                            Contract:
                                  with the town of Illkirch.                Robert Lafourcade
                                                                            Tel.: 05 59 83 74 28
                                                                                                                               130/131


>     Brittany                                                           >     Corsica
Contact details
> Regional delegation:
                               > Key events                              Contact details
                                                                         > Regional delegation:
                                                                                                         > Key events
19, rue Balzac                  Publicity events                         Résidence «La Gravona» bât. A    Publicity events
56270 Ploemeur                                                           Rue des Romarins
Tél. : 02 97 86 27 50           and activities                           20090 Ajaccio                    and activities
kerduellic.hochet@wanadoo.fr    • Presentation of MdM in information     Tél. : 08 75 33 18 99            • Participation in “Nurse” day.
                                centres: Lorient, Vannes.                Tél./Fax : 04 95 10 25 49        • Participation in associations' forum.
                                • Work in partnership with other         mdmcorse@wanadoo.fr              • Participation, with testimony, in
                                                                         http://perso.wanadoo.fr/
                                Breton associations to raise funds for   mdmcorse                         Regional International Project in
Board Members
> Regional Representative:      South-East Asia after the tsunami.                                        Bulgaria, and fund raising at Young
 Marie-Elizabeth Hochet         • Participation in association forums.                                    People's Market.
                                • Involvement in the International Day
> Secretary:                    for the Eradication of Poverty and       Board Members
 Valérie Bergeron                                                        > Regional Representative:
                                signature of petitions.                                                   Partnerships
                                • Publicity work to set up a new          François Pernin                 • With Ajaccio town council's CCAS
> Treasurer:
 Christophe Perron              press campaign: “We care for those       > Secretary:                     (social work centre), MCH and
                                whom the world is slowly forgetting.”     Catherine Contois               Education Inspectorate in the
> Other Members:
 Xavier Guillery,
                                                                                                          context of the Regional International
                                                                         > Trésorière :                   Project in Bulgaria.
 Jean Godefroy                                                            Corinne Girardin
                                Other activities                                                          • Co-founder of an inter-association
> Number of Members:            • Adoption: three teams in Ille-et-      > Other Members:                 platform, setting up a winter night
 37
                                Vilaine and Morbihan.                     Anne Galeani,                   shelter with medical and
                                • Harm reduction: work at four            Denise Giacomoni                psychological consultations. Plan for
                                                                          Michèle Iborra,
                                raves.                                    Jean-Pierre Lucciani,           a permanent day centre is being
                                • Setting up the Regional                 Isabelle Serain,                developed.
                                International Project in Mali.            Myrtha de Tollenaere
                                • Exploratory project in Romania.
                                                                         > Number of Members:
                                • Exploratory vulnerability project in    30
                                Lorient and Vannes.
>    Franche-Comté                                                   >      Ile-de-France
Contact details
> Regional delegation:
                             > Key events                            Contact details
                                                                     > Regional delegation:
                                                                                                   > Key events
7, rue du Languedoc           Publicity events                       62 bis, avenue Parmentier      Publicity events
Appt 168 003                                                         75011 Paris
25000 Besançon                and activities                         Tél. : 01 43 14 81 99          and activities
Tél. : 03 81 51 26 47         • Meeting with Franche-Comté           Fax : 01 48 06 68 54           • Work in high schools and training
Fax : 03 81 52 70 28          Solidarité to assess the position of   mdm.idf@medecinsdumonde.net    schools for nurses and other
mdm.fc@wanadoo.fr             each participant in the association                                   paramedic professions.
                              created for tsunami victims.                                          • Stands at national events in Paris, in
                              • Participation in a regional press                                   conjunction with the publicity
                              conference to defend a mother of       Board Members                  department at head office, and at
Board Members                                                        > Regional Representative:
> Regional Representative:    Iranian origin, whose two children      Philippe Pluvinage            local events in Ile-de-France.
 Jacques Guitard              have been taken away from her.                                        • Involvement in the International Day
                              • Invitation by FR3 Franche-Comté to   > Secretary:                   for the Eradication of Poverty at Paris
> Secretary:                                                          Karen Segas
 Violaine Llorca              speak about MdM's 25 years.                                           City Hall
                              • Presence at MdM's 25th birthday      > Treasurer:                   • Organisation of a forum on “Calais:
> Treasurer:                  celebrations in Paris and discussion    Claude Martine                inhumanitarian action on a daily
 Bernard Badey                on the possibility of setting up a                                    basis.”
                              Regional International Project in      > Other Members:               • Participation in the forum “An equal
> Other Members:                                                      Maria Melchior
 Philippe Boulhaut            Franche-Comté.                          Marie Debrus                  right to health for foreign residents?”
 Marie-Claire Tisserand                                               Catherine Peterman            at the XIXth arrondissement town hall.
 Jean-François Viel
                                                                     > Secrétaire
                                                                      de la Regional delegation:
                                                                      Anne Le Guelec                Publications
                                                                                                    • Three issues of the Le Fil,
                                                                     > Number of Members:           newspaper each with 600 copies.
                                                                      400
                                                                                                    Partnerships
                                                                                                    • MdM's Nord-Pas-de-Calais office
                                                                                                    for the Calais project.

                                                                                                    Other activities
                                                                                                    • Organising recruitment of new
                                                                                                    volunteers for projects in
                                                                                                    Ile-de-France.
                                                                                                    • Exploratory project in Moroccan
                                                                                                    access to healthcare for
                                                                                                    Sub-Saharan migrants in the context
                                                                                                    of a Regional International Project.
                                                                                                                         132/133


>     Languedoc-Roussillon                                             >     Lorraine
Contact details
> Regional delegation:
                             > Key events                              Contact details
                                                                       > Regional delegation:
                                                                                                   > Key events
18, rue Henri Dunant          Publicity events and activities          5, rue de l’Armée Patton     Publicity events and activities
34090 Montpellier                                                      54000 Nancy
Tél. : 04 99 23 27 17         • Participation in the International     Tél. : 03 83 27 87 84        • Information evening for donors.
Fax : 04 99 23 27 18          Day for the Eradication of Poverty in    Fax : 03 83 28 42 55         • Participation in meetings on the
mdmlr34@wanadoo.fr            Montpellier.                             del.lorraine1@free.fr        following subjects:
                              • Presentation of MdM and its                                         - Town Health Project in the Haut du
                              projects in the nurse preparatory                                     Lièvre district of Nancy;
Board Members                 school at the Red Cross school in        Board Members>               - Student health: meetings with the
> Regional Representative:    Grabels.                                 Regional Representative:     university health service and social
 Mady Mercier                 • Participation in an evening            Anne-Marie Worms             workers;
                              organised by children's choir in                                      - project to work with the Sonacotra
> Secretary:                                                           > Secretary:
 Claude Aiguesvives           Castries with proceeds going to            Monique Ulrich
                                                                                                    hostels in partnership with the Nancy
                              tsunami victims.                                                      preventive medicine centre.
> Treasurer:                  • Day of involvement in “2005, no        > Treasurer:                 • Meeting with the Strasbourg office
 Françoise Jourdan            more excuses” against poverty in           Anne-Marie Marchetto       on 9 December.
> Other Members:              Montpellier amongst drivers.             > Other Members:             • Television interview on M6 in
 Antonio Da Silva             • Stand at the associations' fair in       Lucien Gbetro              October 2005.
 Delphine Peronne             Montpellier.                               Véronique Gorsic           • Article in L'Est républicain
 Mansoureh Yaghmaie-Astruc                                               Marie-Pascale Verdenal     (Est Magazine) on 12 December
                                                                         Jean-Marie Gilgenkrantz
> Secretary                                                                                         2005.
 of the delegation:           Partnerships                             > Lorraine Regional
 Magali Ibanez                • Proposed partnership with the            Projects:
                              Dentistry School in Montpellier,           Nancy RM :                 Partnerships
> Number of Members:                                                     Jean-Marie Gilgenkrantz
 87                           amongst 5th and 6th year dentistry         Metz RM :
                                                                                                    • University medicine (several
                              students.                                  René Moutier               meetings).
                                                                         Mission Adoption RM :      • Nancy town council (reflection on
                                                                         René Moutier               the Town Health Workshop).
                              Other activities                                                      • Sonacotra hostels, Nancy
                              • Presentation of projects 'here and                                  (prevention).
                              over there': training for going to                                    • Nancy preventive medicine centre.
                              projects abroad, recruitment of state
                              nurses for international projects, job
                              descriptions.                                                         Other activities
                                                                                                    • Plan for a Regional International
                                                                                                    Project in Burkina Faso: exploratory
                                                                                                    project in January 2005. The project,
                                                                                                    modified during the process, is still at
                                                                                                    the planning stage.
 >    Midi-Pyrenees
 Contact details
 > Regional delegation:
                              > Key events
 5, boulevard de Bonrepos      Publicity events                        excuses” and the International Day    Other activities
 31000 Toulouse
 Tél. : 05 61 63 78 78         and activities                          for the Eradication of Poverty.       • Various events with proceeds
 Fax : 05 61 62 04 15          • Various activities in secondary       • Internal meetings: Opération        going to MdM: cross-country race
 mdmmidipy.delegation          schools, nursing colleges, schools,     Sourire, working meeting on           (with Foulée pour la Vie, Solidarité
 @laposte.net                  etc; visit by nursing students to the   “improving CASO (free healthcare      en pays de Save), drama, concert,
                               office.                                 and guidance centre) practices”,      gala, tennis competition, auction,
                               • Organisation of a public meeting      meeting on articles of association,   craft exhibition and sale, fashion
 Board Members                 on the “Asia Emergency”.                meeting on Pakistan.                  parade, etc
 > Regional Representative:    • Stands at the associations' day.                                            • Organisation of “6 hours for
  Dr Florence Rigal            • Organisation with Amnesty of a                                              Chechnya” by Albi branch.
 > Secretary:                  conference on violence against          Editions et publications              • Adoption: someone on duty
  Marie-Pierre Buttigieg       women.                                  • Quarterly newspaper Lettre et       Mondays between 2 and 6 p.m.
                               • Participation in a drama activity,    débats.                               • Sorting drugs: 14 tonnes of
 > Treasurer:                  forum in Mirail district for Women's                                          unused drugs collected.
  Luis Garcia
                               Day.
 > Other Members:              • Participation in a lunch-debate in    Exhibitions
  Dr Pascale Estecahandy       a centre for the unemployed.            • Photo exhibition on Chad and
  Monique Drevon               • Participation in “2005, no more       Opération Sourire, Cambodia.
  Dr Frédéric Sananes

 > Project Co-ordinator:
  Tom Wingefeld

 > Secretary
  of the delegation:
  Isabelle Malet




> Albi branch:
 Contact: Nicole Cany
 Tel.: 05 63 45 08 15
                                                                                                                             134/135


>      Nord-Pas-de-Calais                                               >     Normandy
Contact details
> Regional delegation:        > Key events                              Contact details
                                                                        > Regional delegation:
                                                                                                          > Key events
10-12, rue du Grand Fossart                                             5, rue d’Elbeuf
59300 Valenciennes
                               Publicity events                                                            Publicity events
                                                                        76100 Rouen
Tél. : 03 27 47 40 08          and activities                           Tél. : 02 35 72 56 66              and activities
Fax : 03 27 30 19 16           • International Day for the              Fax : 02 35 73 05 64               • JRegional day Rouen-Le Havre on
mdmvalenciennes@free.fr        Eradication of Poverty in partnership    mdmrouen@wanadoo.fr                19 November 2005.
                               with local organisations.
                               • Participation in area health                                              New activity:
                               programme in Valenciennes.                                                  • Setting up a Mediation-Health
Board Members>                                                          Board Members
                               • Presentations in nursing schools.      > Regional Representative:         space in the Hauts de Rouen area of
> Regional Representative:
  Guy Dehaut                   • Participation in associations' forum    Christian Cartier                 Rouen.
                               for Valenciennes area.
> Project co-ordinator:                                                 > Secretary:
  Eliane Lamorisse                                                       Agathe Bonmarchand

> Secretary:                   Partnerships                             > Treasurer:
  Fabienne Ducatez             • Emergency accommodation asso-           Michel Joly
                               ciations, CHRS (Accommoda-tion
> Treasurer:                                                            > Other Members:
                               and Social Reintegration Centre), day     Arlette Seiffert
  Christiane Ficheroulle
                               centres: AJAR, APE, Midi-Partage,         Jean-Jacques Prey
> Other Members:               POSE, etc.                                Mireille Vache-Picat
  Elisabeth Dusart             • Rimbaud mobile team
  Charles Lejeune                                                       > Secretary
                               • PASS (healthcare access centres)        of the delegation:
  Claudine Leleu
                               (Espace Baudelaire).                      Claudie Hauduc
> Number of Members:           • Boutique Solidarité (drop-in
  33                           centre).
                               • SOS Bébé - assistance for families
                               in financial difficulty.
                               • Avenir et Coopération
                               - humanitarian action logistics.


                               Other activities
                               • Assistance to Calais refugees
                               (drugs, sleeping bags, medical
                               consultations).
                               • Collection of glasses reconditioned
                               by an optician.
                               • Collection and sorting of drugs (as
                               part of Cyclamed) to run our centre.
                               Surplus sent to Africa through Avenir
                               et Coopération according to
                               demand.
                                                                        > Antenne du Havre :
                                                                         Responsable : Arlette Seiffert
                                                                         Tél. : 02 35 21 68 66
                                                                         mdmlehavre@wanadoo.fr
>     Indian Ocean                                                             >      PACA (Provence-Alpes-Côte d’Azur)
Contact details
> Regional delegation:
                                   > Key events                                Contact details
                                                                               > Regional delegation:
                                                                                                            > Key events
250 bis, rue du Général Rolland     Publicity events                           4, avenue Rostand             Publicity events
Bât. K - SHLMR Bouvet                                                          13003 Marseille
BP 964                              and activities                             Tél. : 04 95 04 59 60         and activities
97479 Saint-Denis Cedex             • Mailing for Childhood Action: press      Fax : 04 95 04 59 61          • Organisation of monthly
Réunion                             releases, fundraising appeal.              mdmpaca@medecinsdu            conferences on MdM's international
Tél. : 02 62 21 71 66               • Mission France: organisation of a        monde.net                     and national work:
Fax : 02 62 41 19 46
medecinsdumonde.reunion             Christmas meal for the homeless.                                         - International projects: Colombia,
@wanadoo.fr                                                                                                  Burkina Faso;
                                                                                                             - Tsunami emergency;
                                                                               Board Members
                                    Publications                               > Regional Representative:    - Health for all Africans, in Africa and
                                    • Newspaper Mission n° 38.                  Ariane Junca                 in France;
Board Members
> Regional Representative:                                                                                   - The tsunami, one year on.
                                                                               > General Secretary:          • Lecture and discussion on peace
 Gilbert Potier                                                                 Simone Varenne Blanc
                                    Training                                                                 for Israel-Palestine with Stéphane
> Secretary:                        • Training for the post of administrator   > Treasurer:                  Hessel, a former French ambassador
 Mireille Beaufils                                                               Philippe Dupin
                                    for the Antananarivo secretariat.                                        to the United Nations, Mr. François
> Trésorière :                      • University diploma on “treating HIV                                    Roux, a lawyer practising in
                                                                               > Other Members:
 Agnès Rovere                       infection and hepatitis B and C”            Denise Clément               Montpellier, and Blandine
                                    obtained by Dr. C. Ralaivao, a paid         Marie-Agnès Chaud            Chelini-Pont, a historian.
> Other Members:                                                                Olivier Bernard
  Blandine Megroian
                                    member of staff of the Ilakaka project.                                  • Participation in a round-table on
                                                                                Pierre-François Pernet       local radio: “The tsunami one year
  Gilles Bourdiol
  Christophe Ottenwaelder                                                      > Project Co-ordinator:       on”.
  (RM Tuléar)                       Other activities                            Isabelle Bouju Malaval       • 25 years of Médecins du Monde:
> Secrétaire                        • Mission France: medical and social                                     exhibition of photographs by Gérard
                                    consultations at the Boutique              > Accounts:                   Rondeau at the regional council,
 de la Regional delegation:                                                     Ghislaine Vincenti
 Claudie Pante                      Solidarité (drop-in centre)                                              press conference, round table and
                                    (Abbé-Pierre Foundation)                   > Secretaries                 running 5 “citizens' cafés” for two
> Autres membres actifs :                                                       of the delegation
  Philippe de Chazournes
                                    in Saint-Denis and Saint-Pierre.                                         months based around national and
                                                                                Anne-Marie Combe             international projects, for an
  Marie-Claude Castex                                                           Martine Semat
  Sophie Agbaglo                                                                Daniel Imbert                audience of schoolchildren and
  Mélanie Maillot                                                                                            students.
  Pascale Lehoucq                                                              > Number of Members:
  Frédéric Le Bot
                                                                                158
  Jean-Luc Michel
  Dominique Rabouille
  Jean-François Delambre
  (RM Action Enfance)
  Philippe Jeu (Indonesia RP)
  Arnaud Bourde (Tsunami RP)
  Sylvie de Carheil (Prison RPs)
  Claudia Vichatzky
  (Ilakaka RP)

> Number of Members:
 36
                                                                                                                                136/137


>     Pays de la Loire
Contact details
> Regional delegation:
                             > Key events
33, rue Fouré                 Publicity events                      • Presentation of MdM to the             Other activities
44000 Nantes
Tél. : 02 40 47 36 99         and activities                        Institut de Formation de Santé           • Involvement in many
Fax : 02 51 82 38 09          • Talks in secondary schools,         dans l'Ouest (IFSO) (Western             conferences, in France, on
mdm.nantes@free.fr            nursing schools and the nursing       France Health Training Institute).       prostitution, trafficking and violence
                              college of Nantes and Lorient.        • Open days at the Nantes office         against women.
                              • Talk at the conference organised    and mobile units on the
                              by the Paris ASTI (Solidarity with    International Day for the
Board Members
> Regional Representative:    Immigrant Workers Association) on     Eradication of Poverty.
 Paul Bolo                    prostitution.                         • Talk at a meeting of the Rennes
                              • Participation in the National       co-ordinating body on prostitution.
> Secretary:                  Congress of notaries in Nantes        • Day of action as part of World
 Anne-Lise Guéguen
                              (stand).                              AIDS Day.
> Trésorière :                • Organisation of short courses for   • Visit of the Prostitution project by
 Nicole Neyrat                spring at Nantes University.          two members of the Donors'
                                                                    Committee for two days.
> Other Members:
 Philippe Jarrousse
 Hélène Lepoivre
 Jean-Pierre Clauzel
 Marion Gassiot

> Secretary
 of the delegation:
 Corinne Lepert

> Number of Members:
 80
 >     Poitou-Charentes                                                    >    Rhône-Alpes–Bourgogne
 Contact details
 > Regional delegation:
                                 > Key events                              Contact details
                                                                           > Regional delegation:
                                                                                                             > Key events
 22, allée du Champ Brun          Publicity events                         1, place du Griffon                Publicity events
 16000 Angoulême                                                           69001 Lyon
 Tél. : 05 45 65 07 47            and activities                           Tél. : 04 78 29 59 14              and activities
 Fax : 05 45 61 18 85             • ”Musiques métisses” (mixed-race        Fax : 04 78 29 55 91               • In Grenoble, organisation and
 desede@tiscali.fr                music): with the bus present.            lyonmdm@wanadoo.fr                 involvement in the International Day
                                  • Partnership with the lycée                                                for the Eradication of Poverty.
                                  Marguerite.                                                                 • In Lyon, organisation of a day of
                                  • Performance of the play Ils                                               testimony on the health of migrants.
 Board Members                                                             Board Members
 > Regional Representative:       s'aiment (They love each other), with    > Regional Representative:         • Testimonies and various talks
  Marie-Laure Ferrari             proceeds going to MdM, in                 Michèle Roelens                   concerning the problems of getting
                                  Angoulême supported by a radio                                              access to healthcare for highly
 > Secretary and Deputy           programme with Radio Attitude.           > Secretary:                       vulnerable people.
  Regional Representative:                                                  Isabelle Hermant
  Daniel Reiss
                                  • Tea party on 31 December 2005                                             • Conferences on humanitarian
                                  for the most destitute.                  > Treasurer:                       action, emergency projects,
 > Treasurer:                     • Concert in Poitiers with proceeds       Pierre Micheletti                 development, the media and
  Hubert Lacombe                  going to MdM.                                                               humanitarian work.
                                                                           > Other Members:
 > Deputy Treasurer:              • Radio programme with Radio              André-Jean Pocheron
                                                                                                              • Meetings with primary and
  Philippe Boulanger              Accord in Angoulême on the                Robert Allemand                   secondary pupils in Villeurbanne:
                                  “Journée de la précarité” (Day of         Félicie Monneret                  testimonies of childhood in war, in
 > International Project          Poverty).                                 Edith Chabal                      partnership with the Maison du Livre,
  Co-ordinators + CCN
  (National Advisory
                                  • MdM stand in Poitiers during           > Secretary                        de l'Image et du Son (Book, Image
  Committee)                      Solidarity Week.                          of the delegation:                and Sound Centre) in Villeurbanne.
  Fabienne Drieu,                 • Exhibition of drawings by child         Clothilde Guillerm                • In Grenoble, support for the
  Patrick Bouet                   tsunami victims, in Poitiers.                                               national publicity campaign “We care
  (représentant au CCN)                                                    > Project Co-ordinator:
                                                                            Sophie Bret
                                                                                                              for those whom the world is
 > Other Member:                                                                                              gradually forgetting” (more than 500
  Myriam Massé                    Partnerships                             > Number of Members:               display spaces offered).
                                  In Angoulême:                             environ 160                       • Golf competitions, concerts,
 > Secretary
  of the delegation:
                                  • Les gens du voyage (Travellers)                                           picture sales, partnerships with local
  Paule de Sède                   association;                                                                businesses.
                                  • Omega (town council - CCAS
                                  (local social work centre));
                                  • PASS (Access to healthcare centre)                                        Exhibitions
                                  Angoulême and EMAPASS (PASS +                                               • Touring photo exhibition on the
                                  mobile addictions team) Ruffec.                                             Bolivia project: “The child workers of
                                  In Poitiers:                                                                Potosí”.
> Angoulême branch                • Restos du Cœur;                                                           • Touring photo exhibition on the
 (outside centre
 project):                        • CRI;                                                                      health of migrant people.
 Contact: Marie-Laure Ferrari     • Town Hospital Network.                                                    • Touring photo exhibition on
 Tel.: 05 45 65 11 82                                                                                         Afghanistan, Chechnya and “Street
 Needle exchange programme                                                > Antenne de Grenoble :             people in Grenoble”, South-East Asia,
 co-ordinator: Valérie Patrier                                             Responsable : Jean-Pierre Vidal
                                                                           Tél. : 04 76 84 17 31
                                                                                                              Indonesia - Tsunami: beyond death is
> Poitiers branch:                                                         mdm.grenoble@free.fr               life”.
 Contact: Patrick Bouet                                                    Coordinateur : Pierre Bourgey
 Tel.: 05 49 01 77 77
                                                                                                                                                     138/139


 >      Germany
 Contact details
 > Bureau international
                                   > Key events
 Aerzte der Welt                      Financial support for projects               Publicity events                             Projects:
 Thalkirchner Str 81
 Kontorhaus 1                         • Afghanistan: mother and child              and activities                               • Two Opération Sourire projects in
 81371 München                        protection programme.                        • Celebration of 5 years of Aerzte           Cambodia (Kampong Cham and
 Allemagne                            • Angola: mother and child health            der Welt in Germany and collection           Phnom Penh).
 Tél. : 00 49 89 62 42 09 55          programme in Huambo North                    of two cheques from Sternstunden             • Planning a local project in Munich
 Fax : 00 49 89 65 30 99 72
 info@aerztederwelt.org               province.                                    for Cambodia and Ethiopia.                   (primary healthcare for people
 www.aerztederwelt.org                • Ethiopia: prevention of mother-to-         • “23 artists for Médecins du                without medical insurance such as
                                      child HIV transmission programme             Monde” - sale of lithographs with            migrants and those without
 Contacts :                           in Mekele.                                   proceeds going to MdM France,                papers):
 Dr Lecia Feszczak, Monika
 Kleck, Gertrud Wimmer                • Pakistan: programmes                       organised by the Oppenheim bank              - redefining the concept;
                                      supporting government refuges for            in Munich.                                   - beginning to build up a network
 Association under German             women victims of domestic                    • Three information letters made             of volunteers;
 law, constituted 19 March            violence and emergency aid for               available on the internet and sent           - co-operation with other partners
 1999
                                      earthquake victims.                          to donors, volunteers and partners.          in the field.
                                      • Niger: Opération Sourire project.          • Articles in national and regional          • Three exploratory projects in
 Board of directors                                                                newspapers on projects in                    Batticaloa in Sri Lanka:
 > President:                                                                      Cambodia and Sri Lanka.                      assessment of an idea to improve
   Pr Wilfried Schilli                Human Resources support                      • Sternstunden TV on Bavarian TV             the local hospitals' surgical
                                      for projects                                 (short film on the project in                structures, through training
 > Vice-President:
   Dr Pierre Rosenstiel               • 10 German expatriate volunteers            Batticaloa in Sri Lanka).                    orthopaedic surgeons to comply
                                      went out to international projects.                                                       with hygiene standards and
 > Treasurer:                                                                                                                   surgery techniques.
   Rolf-Michael Schlegtendal

 > Other Members:
   Dr Klaus Wieners
   Dr Béatrice Stambul
   Dr François Scheffer
   Pr Albrecht Pfleiderer
   Pr Norbert Schwenzer
   Andreas Jungk




> Acknowledgements: The German Foreign Ministry, the City of Munich, Johanniter, Freiburg University, Tübingen University, The Munich European Patent Office, Martin
  Medizintechnik, mibeg Verlag, Sueddeutsche Zeitung, Stethosglobe, Munich Eine-Welt-Zentrum, Munich Nord-Sued-Forum, Bayerischer Rundfunk, Sternstunden e.V., M-Net
  Munich, Sofa-lx-systems, Sonja Schultes & Hersberger, www.helpdirect.org, www.malinet.de, www.zdf.de/zdfde/inhalt (ZDF Spendenforum), Ansell Healthcare Europe, Ansell
  GmbH, Excognito Agentur für Public Realtions, Internationale Spedition Heinz Huber, O.D.C. Fruchthandels GmbH, Alter Hof, Gastronomie Firma Paul Hartmann AG, Euro
  RSCG LIFE Munich, Neumeister - Kunstauktionshaus München, Oppenheim jr. & Cie Bank. KGaA, Vermop - Professional Cleaning Systems, Vogtland Philharmonie Greiz
  Reichenbach, Tagesheimschule an der Hochstraße Munich
 >     Japan
 Contact details
 > International Office:            > Key events
 Médecins du Monde Japon
 PMC Building 6F
                                       Financial support for projects               Human resources support                       • Publication of articles on
 1-23-5 Higashi-Azabu,                 • Bolivia: Health and child workers          for projects                                  Médecins du Monde and
 Minato-ku, Tokyo 106, Japon           in Potosi project.                           • 12 Japanese expatriate workers              Opération Sourire in national and
 Tél. : 00 81 3 35 85 64 36            • Cambodia: Opération Sourire                went out to international projects.           regional newspapers, and high
 Fax : 00 81 3 35 85 11 34
 info@mdm.or.jp
                                       project in Phnom Penh.                                                                     circulation weeklies, and a short
 http://www.mdm.or.jp                  • China: Chengdu project - AIDS              Publicity events                              spot in a programme on the state
                                       prevention                                   and activities                                radio station NHK.
 Contacts :                            • Ethiopia: mother-to-child HIV              • Organisation of photo exhibitions           • Publication of a newsletter
 Prune Helfter, Kehko
 Takayama, Nao Kuroyanagi,
                                       transmission prevention                      presenting MdM's HIV projects and             distributed to donors, volunteers
 Tatsuya Kishi ( all staff)            programme.                                   emergency programmes in                       and partners.
                                       • Indonesia: emergency and post-             Indonesia and Pakistan in very
 Association under Japanese            tsunami reconstruction                       busy places such as the corridors
 law, constituted 10 October
 2000
                                       programme.                                   of the Tokyo underground.
                                       • Madagascar: Opération Sourire              • Presentation of MdM's HIV
                                       project in Antananarivo.                     projects on a stand at the
 Board Members                         • Pakistan: emergency                        international AIDS conference in
 > Board of Directors                  programme.                                   Kobe.
   President:                          • DRC: programme supporting                  • Organisation of a charity dinner
   Gaël Austin                         street children.                             at the French embassy attended
 > Other Members:                      • Sudan: emergency programme                 by over 200 people, with the
   Yasuko Arai                         in Darfur province.                          voluntary involvement of renowned
   Dr Arnaud Bourde
   Dr Patrick David                    • Sri Lanka: emergency and                   chefs and artists.
   Dr François Foussadier              post-tsunami reconstruction
   Masako Harada
   Akitane Kiuchi                      programme.
   Dr Norihiko Oura
   Dr Satoshi Yoza




> Acknowledgements: Air France, Air Tahiti Nui, Akebono Brake, Alsok, Aman Resorts, Asahi Pretec, Bristol Meyers Squibb Group, Chanel, Cn-Intervoice, French
  Chamber of Commerce and Industry in Japan, French Embassy in Japan, Felissimo Corporation, Ferris University, Flos, French Blue Meeting, French Food Culture Center, Ginza
  Gallery (Circle Club), Global Tank, Greeting life, Hyogo International Association, Impresario, JANIC, JICA, Members of the Agricultural Order of Merit in Japan, Å@Mitsui
  Sumitomo Insurance, Nippon Koa Insurance, NTT Data, Sanyu Network, Shibaura Institute of Technology, Shiseido, Sompo Japan Insurance, Sonia Rykiel, Tanabé Seiyaku, The
  TIE Corp. Tout le monde vœux, Yokohama French Film Festival.
                                                                                                                                                                 140/141


 >     The Netherlands
 Contact details
 > International Office:            > Key events
 Dokters van de Wereld
 Rijswijkstraat 141 A
                                      Financial support for 10 programmes          Publicity events                              gramme to improve access to health
 1062 ES Amsterdam                    (through direct marketing) and the fol-      and activities                                care for those without papers in
 Pays-Bas                             lowing projects, by project funders:         • Interviews with Dutch volunteers in         Amsterdam. Distribution of medical
 Tél. : 00 31 20 465 2866             • Burma: harm reduction for risks lin-       the Dutch media (radio,                       documents to those without papers
 Fax : 00 31 20 463 1775
 info@doktersvandewereld.org
                                      ked to drug addiction programme              newspapers and magazines).                    (Medoc) and
 www.doktersvandewereld.org           • Indonesia (West Papua):                    • Organisation of a press trip to             information campaign amongst those
                                      minorities' access to healthcare pro-        Papua, Indonesia and publication of           without papers and health professio-
 Contacts :                           gramme.                                      articles in four magazines.                   nals on access to
 Nadjehda Brouwer-
 Richardson, Reinier Spruit,
                                      • Tanzania: AZT programme.                   • Transparency Prize won for the              healthcare.
 Resy Arts, Anna Miranda              • Benin: AIDS programme.                     publication of Dokters van de
 Scholten, Arianne de Jong,           • DRC Goma: AIDS programme.                  Wereld's 2004 annual report.
 Sacha Godschalk,                     • Madagascar: HIV/AIDS prevention            • Three publications on Dokters van
 Corinne Eisma ( all staff).
 Marian van Keuk, Gerd
                                      programme.                                   de Wereld's international
 Beckers (co-ordinators)              • Zimbabwe: financial support for            activities, aimed at donors, sponsors
                                      FACT for HIV/AIDS prevention.                and volunteers.
 Association under Dutch law          • Indonesia (Papua Paniai): HIV/AIDS
 constituted 28 April 1997
                                      prevention programme in Primari.
                                      • Pakistan: emergency                        National projects
                                      programmes.                                  • Roma and Sinti: health
                                      • Liberia: primary healthcare                programme for Roma and Sinti,
 Board of directors
 > President:                         programme.                                   especially women. Training and
   Dr Barbara ten Kate                                                             health education in Roma and Sinti
                                                                                   communities in the Netherlands.
 > Secretary:                         Human resources support                      Partnerships with LSRO (Dutch orga-
   Dr Dirkjan Pot
                                      for projects                                 nisation for Roma and Sinti) and
 > Treasurer:                         • 10 Dutch expatriate volunteers went        other organisations.
   Casper van Rijn                    out to work on international projects.       • Undocumented migrants: pilot pro-
 > Other Members:
   Howard Teunisse
   Bernard Juan
   Françoise Sivignon




> Acknowledgements: Aids Fund, Cordaid, Dutch Ministry for Development Cooperation, ICCO, Oxfam Novib, NCDO, Nora Tol Virtual Publishing, Stichting Lions, STOP
  AIDS NOW, Zicht nieuwe media ontwerpers, Sandra van Noord - Bureau voor tekst en redactie, Ordina, Haute Finance, Paradiso, Tom van der Leij, Capi Lux Vak, and all our
  volunteers, trainees and thousands of private donors.
 >      United Kingdom
 Contact details
 > International office:
                                    > Key events
 Médecins du Monde UK                 Financial support for projects              to celebrate Médecins du Monde's            Projects
 34th Floor
 One Canada Square                    • Cambodia: antiretroviral therapy          25th birthday and raise awareness           • Development of a national project
 Londres E14 5AA                      programme in Phnom Penh.                    amongst the French community in             to improve access to healthcare for
 Royaume-Uni                          • Sudan Darfur: programme of                London of the work of Médecins              vulnerable people groups in East
 Tél. : 020 7516 9103                 medical aid to displaced people.            du Monde UK.                                London: registration with the
 Fax : 020 7516 9104
 info@medecinsdumonde.org.uk          • Sudan: surgery programme at               • Launch of the web site                    Healthcare Commission (regulatory
 www.medecinsdumonde.org.uk           Malakal.                                    www.medecinsdumonde.org.uk                  body), recruitment and training of a
                                      • Afghanistan: mother and child             • Publication of News (twice), an           team of 33 volunteers, refurbish-
 Contacts :                           health programme in Kabul.                  information newsletter on MdM               ment of premises to create two
 Karen McColl, Michelle
 Hawkins, Isabelle Raymond,           • Tsunami: emergency programme.             UK's activities, distributed to             medical rooms, creation of a
 Claire Loussouarn,                   • Cuba: Café Salud programme in             donors and volunteers.                      network of local partners,
 Dorothy Muthuri,                     Havana.                                     • Publicity: preparation of a press         fundraising to fund the project.
 Elinor Middleton ( all staff). .                                                 pack for the launch of a national           • Participation in the European
 Association under English law,                                                   project: “Project: London”, and             survey on access to healthcare for
 constituted 13 January 1998          Human resources support                     organisation of a press conference          undocumented migrants in Europe.
                                      for projects                                in January 2006.
                                      • 21 MdM UK expatriate volunteers
                                      went out to international projects.
 Board Members
 > Board of directors:
   Dr David Barnes
   Dr Laurence Bioteau                Publicity events and activities
   Janice Hughes                      • Interviews with MdM UK
   Robert Lion                        volunteers in the British media and
   Dr Sarah Pickworth
   Lord Rogers of Riverside
                                      publication of articles on Médecins
   Roo Rogers                         du Monde (newspapers,
                                      magazines, online, radio, TV).
                                      • Reception at the French
                                      Ambassador to the UK's residence




> Acknowledgements: Alliance Pharmacy, Department For International Development (DFID), the Elton John AIDS Foundation, Isle of Man Overseas Aid Committee,
  Canary Wharf Group, Clifford Chance, Chubb Insurance, Cubana, the French Embassy, the Frontline Club, Lonely Planet, MEDSIN, Nomad Travel Stores, Richard Rogers
  Settlement, SS Robin, the Sahara Trekkers, Sylvan Technical Services, Thames Wharf Charity, Tower Hamlets Primary Care Trust and all our volunteers and donors.
      > The organisation




143/153
> Médecins du Monde
and its management
Médecins du Monde's organisation is based on board members with experience overseas, volunteers in France, volun-
tary workers for international operations, and a permanent paid staff. The support of hundreds of thousands of
donors ensures Médecins d u M onde's financial independence. Thanks to this diversity, MdM operates perma-
nently on the basis of debate, the views of civil society and the operational efficiency of its programmes for benefi-
ciaries. As a result there is a strong and original organisational structure which is distinctive amongst large NGOs.



> Decision-making                           management.                                    analysing contexts, modes of
  authorities                               To carry out its task properly the Board       intervention, and drawing on the
Once a year, MdM's members (1,562 in        relies on:                                     experience of projects. The Association
2005) meet in the General Assembly          • an advisory structure of Association         has five continental groups, eight
(GA), the highest decision-making body      members;                                       thematic groups and a France group
and the only one with the authority to      • a permanent operational structure;           including the Mission France and Harm
amend the articles of association. The      • joint decision-making bodies bringing        Reduction steering committees. The
GA elects the twelve members of the         together permanent staff and Association       members of the advisory groups are
Board of Management for three years,        members;                                       elected according to the internal
to which are added three substitutes.       • the regional offices.                        regulations.
From amongst its members, the Board
elects the President and the                > The advisory structure                       > The permanent
organisation's Officers for one year: the   This includes the continental groups             operational structure
Vice-Presidents, Treasurer, Deputy          and thematic groups. Each of these             This is led by two Directorates. The
Treasurer, General Secretary and Deputy     groups, made up of volunteer members           Humanitarian Aid Directorate includes
General Secretary and a Representative.     with overseas experience involved in           the international operations
The Board, the organisation's executive     projects, proposes or issues an opinion        department, the Mission France
body, meets monthly and takes any           on the continent or theme for which it is      co-ordinating body, project logistics,
decisions concerning the organisation's     responsible. Their role is vital in terms of   the adoption department and the
                                                                                                                      144/145




communication department. The               each week and examines strategic           > The Donor Committee
Management Directorate includes the         decisions concerning projects, passe       The Donor Committee is made up of a
human resources department, the             au crible les décisions bearing witness,   dozen co-opted members and it provi-
development department, the finance         political lobbying and publicity. Other    des constructive criticism and consen-
and IT systems department and the           joint decision-making bodies are the       sual analysis on MdM''s projects, ratios
legal department. Non-strategic             human resources group and the              or communication strategy. It is given
operational decisions are made each         management group who meet each             funding to go and evaluate projects in
week during a project meeting for           month to define human resources and        France and abroad. Through its presi-
project-related decisions and at a          management policies which are              dent, it can express its views to the
management meeting for other                finalised and ratified by the Board.       Board and the general assembly.
aspects. International programmes are
managed by the programme's medical          > The regional
co-ordinator, who is responsible to the       delegations                              This specific set-up encourages debate
Head of Project who deals with aspects      In the regions, MdM has set up regio-      at all levels. It allows MdM to be an acti-
of policy or specific expertise and is in   nal delegations. Elected every two         ve association which is both politically
operational contact with the desk           years, the regional colleges represent     and financially independent. It encoura-
officer at head office or the project       the Association in the regions. The        ges voluntary commitment by health
officer in some regional offices. Heads     delegations carry out international or     workers in the service of the most
of Projects are proposed by the             regional projects, within the overall      destitute and vulnerable people, and has
different internal bodies and ratified by   framework defined by the Board. All the    a constant concern for the quality and
the Board.                                  board members, Heads of Projects,          effectiveness of its international or local
                                            group co-ordinators, regional and          projects.
> The joint decision-                       board representatives meet three times
  making bodies                             a year for a National Advisory Council
They include the Management                 meeting.
Committee, which brings together the
staff members involved in management
> Department news
All the head office departments support the programmes run by the organisation amongst the most vulnerable people in
France and abroad. These departments must be run in a way which guarantees effective institutional, human, logistical, finan-
cial and budget support for projects, but also makes them answerable to our funders and donors. In 2005, work was develo-
ped in the humanitarian action, human resources and management areas.

> Humanitarian action                              > HR
• The year was marked by emergency and             The response to the emergencies in Asia and           relationship between MdM France and the
reconstruction work as a result of the earthqua-   Pakistan translated into a 50% rise in the            international secretariat was strengthened
kes in Asia and Pakistan. MdM demonstrated         number of expatriate volunteers sent on               during the year.
how reactive its emergency department is, as it    international projects in 2005. Moreover, the
was among the first teams to intervene on
several sites. This was possible by the
                                                   number of paid staff on the international
                                                   projects increased significantly.
                                                                                                         >Management up to
                                                                                                           31/12/2005
                                                   > Management
presence of long-term projects in Indonesia
and Pakistan at the time of the disasters.                                                               Humanitarian Action Directorate:
• In this context, the humanitarian action         • The start of the year was marked by a large         Dr Michel Brugière
directorate and the international operations       influx of gifts (due to the Asian tsunami). In        Management and HR Directorate:
department continued to develop international      addition, the plan to reduce appeals, tested in       François Dupré
projects which increased in number and             2004, yielded significant results as did the syste-   International Operations Department:
financial volume (higher volume of activity than   matic offer to set up standing orders as a better     Dr Gilles Raguin (until 1 August 2005)
the Association's in 2000, which means finan-      way for donors to support MdM.                        Mission France Co-ordinating Body:
cial growth of over 30% compared to 2004).         • The policy of partnership with businesses was       Nathalie Simonnot
• The institutional development department         reinforced.                                           Finance and I.T. Systems Department:
increased and diversified programmes' financial    • The setting up of a financial monitoring tool       Catherine Duffau
resources through representation offices and       and a budget plan common to all MdM's                 Administration and Legal Department:
actions in the field. These resources increased    projects was completed in 2005.                       François Rubio
by 50% between 2004 and 2005.                      • The international offices continued to              Publicity and Development Department:
• The MdM Europe project expanded with the         develop in the United Kingdom and the                 Isabelle Finkelstein
construction of the European Observatory and       Netherlands, and were reorganised in                  Adoption Dept :
the launch of national projects in the United      Japan and Germany. In addition, the                   Dr Geneviève André-Trevennec
Kingdom and the Netherlands.
                                                                                                                                             146/147



> Médecins du Monde's
  International Network
Twelve delegations, nine in Europe (Belgium, Cyprus, France, Greece, Italy, Portugal, Spain, Sweden and
Switzerland) and three in the Americas (Argentina, Canada and the United States) were members of Médecins du
Monde's international network in 2005.

The International Board (IB), whose task is to      provide the international network with an overall   > Operational
set the network's main policy directions, met       and exhaustive view of the offices and their           co-ordination
twice in 2005. The presidents or vice-presidents    activities by the end of 2006.                      The international network worked together to
of eleven of the network's twelve international                                                         provide aid to tsunami victims and then to
delegations took part in the discussions.           The Presidents:                                     victims of the earthquake which hit Pakistan. The
The International Executive Committee (IEC),        Argentina: Dr Silvana Reinoso                       co-ordination of operations implemented by the
which is responsible for drawing up an annual       then Dr Alicia Luna                                 different international offices was provided in
action plan based on the IB's policy directions,    Belgium: Dr Michel Degueldre                        both cases by the International Secretariat.
and for monitoring its operations, met five times   Canada: Dr Réjean Thomas                            The joint pilot programme in Zimbabwe aimed at
in 2005.                                            Cyprus: Dr Elias Papadopoulos                       “reducing the impact of the HIV/AIDS epidemic
The International Secretariat (IS), led by a        France: Dr Françoise Jeanson                        on vulnerable orphans and children” in Chipinge
new director from January 2005, continued to        Greece: Dr Socrates Mitsiadis                       district, implemented as a partnership between
ensure the network ran well and to co-ordinate      then Dr Eleftheria Parthenopoulou                   MdM Canada, MdM Spain and MdM France,
the delegations' activities. The IS, made up of a   Italy: Dr Faustino Boioli                           entered its operational phase.


                                                                                                        > Priorities for 2005
team of five people, also worked on improving       Portugal: Dr Mario de Sousa
the network's organisation, especially by           (temporarily Mrs Claudia Amaral)
carrying out work on the operational co-ordina-     then Dr Rui Portugal                                In accordance with the decisions made in 2004
tion of emergency projects and on harmonising       Spain: Dr Teresa Gonzalez                           by the International Board, the themes of
tools and security rules. In accordance with the    Sweden: Dr Anders Bjorkman                          HIV/AIDS and migrants were the subject of
decisions made in 2004 by the International         Switzerland: Dr Nago Humbert                        considerable sharing and consultation across
Board, 2005 saw the launch of the process of        United States: Dr Victoria L. Sharp                 the network.
evaluating the international delegations.
This fair, standardised and planned process will
> Sister organisations
  and local partners
Médecins du Monde bases its work around local partners to provide links that will ensure the work will continue.
If no partners exist, MdM supports the setting up of sister organisations, which are often formed on the initiative
of, and based around, MdM's local team. They gradually become autonomous and are supported for one to two
years on average. The structures thus created remain MdM's natural partners in the region.



> In Europe                                 • Russia, Saint-Petersburg                  Activities: fight against AIDS, harm
• Bosnia-Herzegovina, Sarajevo              Humanitarian Action Foundation              reduction.
DUGA (Drop-in and psychological             Set up in 1993, autonomous for its          • Uganda, Kyotera
support centre for children and young       street children's work since 2003 and       CIPA (Community Initiative for the
people). Set up in 1994, autonomous         for harm reduction since 2005.              Prevention of HIV-AIDS/STIs).
since 2002. info_duga@yahoo.com             www.humanitarianaction.org                  Set up in October 2003, autonomous
Activities: assistance to children, fight   Activities: assistance to children, fight   since December 2005.
against AIDS.                               against AIDS, harm reduction.               cipacp@yahoo.com
• Poland, Warsaw                                                                        Activities: fight against AIDS.
Nobody's Children Foundation                > In Africa
Set up in 1990, autonomous since 2003.      • Mozambique, Maputo                        ORGANISATIONS REQUIRING
www.fdn.pl                                  Meninos de Moçambique                       SUPPORT FROM MDM
Activities: assistance to children.
• Romania, Bucharest
                                            (Children of Mozambique)
                                            Set up in 2000, autonomous since 2001.
                                                                                        > In Latin America
                                                                                        • El Salvador
FICF (International Foundation for          Fax: + 258 30 41 16
                                                                                        MDS (Doctors for the Right to Health).
Children and Families). Set up in 1993,     Activities: Assistance to children.
                                                                                        Set up in 1998.
autonomous since 2003.                      • Madagascar, Tulear
                                                                                        www.mds.org.sv
Fax: + 40 21 311 19 15 / 23 05              Sisal Association (Doctors for the
                                                                                        Activities: promoting the right to health.
Activities: assistance to children.         Right to Health). Set up in 2002, auto-
                                            nomous since 2005.
                                                                                                                     148/149


> In Africa                                 Set up in 2000.                           Set up in 1988.
• Tanzania, Bukoba                          Activities: assistance to prisoners       www.egyhopevillage.com
Tadepa (Tanzania Development                • Rwanda, Kigali                          Activities: assistance to children
and Prevention of AIDS). Set up in          Ibuka (Remembrance and Justice)           • Lebanon, Antelias
2001.                                       Set up in 1995.                           Ajem (Justice and Mercy Association)
Activities: fight against AIDS.             Activities: defending the rights of       Set up in January 1998.
• Ivory Coast, Abidjan                      genocide victims.                         ajem@intracom.net.lb
Mesad (Movement for Education,              • DRC, Kinshasa                           Activities: assistance to refugees, asylum
Health and Development).                    AED (Assistance to disadvantaged          seekers and imprisoned migrants.
Set up in 2001.                             children)                                 • Morocco, Casablanca
mesad_ci@yahoo.fr                           Set up in 1966.                           Medical Association for the
Activities: assistance to children, fight   Activities: assistance to young people.   Rehabilitation of Victims of Torture.
against AIDS.                               • Zimbabwe, Chipinge                      Set up in January 2001.
                                            FACT (Family Aids Caring Trust).          caovt@menara.ma
> In Europe                                 Set up in 1987.                           Activities: assistance to victims of torture.
• Bulgaria, Sofia                           Activities: fight against AIDS.
Association Enfant et Espace (Child         • Madagascar, Antananarivo, Ilakaka       > In Europe
and Space Association).                     Salfa (Malagasy Lutheran Church)          • Moldova, Balti
Set up in July 2005.                        Set up in July 1987.                      TDV (Youth for the Right to Live)
Activities: assistance to children.         Activities: primary healthcare.           btdv@mtc-bl.md
def@bulinfo.net                                                                       Activities: assistance to children
• Serbia, Belgrade                          > In Latin America                        • Bulgaria, Sliven
VEZA. Set up in June 2005.                  • Haiti, Port-au-Prince                   Fondation pour la Santé du Peuple
vezango@gmail.com                           URAMEL (Medico-legal research             Rrom (Roma Health Foundation). Set
Activities: fight against AIDS, harm        and action unit).                         up in 1999. mngrf-sl@mbox.digsys.bg
reduction.                                  Set up in July 2002.                      Activities: primary healthcare.
                                            www.uramel.net
SOUTHERN                                    Activities: promoting justice in          > In Asia
PARTNER ASSOCIATIONS                        partnership with health professionals.    • Indonesia, Jakarta

> In Africa                                 > In the Middle East
                                                                                      Yayasan Aulia. Set up in 1984.
                                                                                      ypmaulia@cbn.net.id
• Guinea, Kindia
                                            • Egypt, Cairo                            Activities: right to health and education
KAD (Kindia Prisoner Assistance).
                                            Hope Village                              and community organisation.
> Médecins du Monde
  and civil society in France
                                                          MdM



       Leadership and                   Thematic platforms                                     Geographical platforms
       co-ordination groups             > Health and social                                    > Mixed commissions
       > SUD co-ordinating body - CCD    • UNIOPSS - Alerte Group                              > Palestine platform (observer)
       > CNVA                            • CNLE
       > FONJEP                          • Foreigners' right to health monitoring centre
       > Charter Committee               • Platform for the fight against human trafficking
       > UNOGEP                          • French co-ordinating body for the right to asylum
                                         • Romeurope
                                         • International Harm Reduction Association
                                         > Funding
                                         • AFTA
                                         > Human rights
                                         • CNCDH
                                         > International action
                                         • URD
                                         • Clong Volontariat




> Leadership and                           (Development Co-operation                               the Prime Minister. MdM monitors
  co-ordination groups                     Commission), a joint body informing                     issues related to humanitarian action.
SUD (Solidarity Emergency                  NGOs of the public authorities'                         FONJEP (Youth and popular
Development) Co-ordinating body.           co-operation policy.                                    education co-operation fund)
A co-ordinating body for French            CNVA (National                                          A jointly-managed association bringing
humanitarian and development NGOs          Council of Associations)                                together public administrations and asso-
which it represents in France and          An independent authority attached to                    ciations. It helps associations by making
internationally. As a Board member,        the Prime Minister's office, through                    it easier to do voluntary work. MdM
MdM represents the group in the CCD        which all French associations relate to                 monitors the issue of volunteers.
                                                                                                              150/151




Comité de la Charte
(Charter Committee)
                                         ask questions about the reception of
                                         asylum seekers and refugees.
                                                                                    > Geographical
A committee bringing together            • ODSE (Foreigners' Right to Health
                                                                                      platforms
                                                                                    • Mixed commissions:
associations that call on the public's   Monitoring Centre)
                                                                                    Joint body of NGOs and public
generosity, in accordance with a         • Platform for the Fight against
                                                                                    authorities. Exchanges on ways and
charter and previously established       Human Trafficking.
                                                                                    means of working in a country.
recommendations.                         • French Co-ordinating body for the
                                                                                    • The Palestine platform: Group of
UNOGEP (National Union of                Right to Asylum.
                                                                                    associations. MdM has observer
Fundraising Organisations).              • Romeurope.
                                                                                    status.
                                         • International Harm Reduction
> Thematic platforms                     Association.
Health and social                        Funding
• UNIOPSS (National Inter-federal        • AFTA (French Association for
Union of Private Health and Social       Association Treasurers).
Bodies).                                 Human rights
It works with institutions to have the   • CNCDH (National Advisory
health and social association sector     Committee on Human Rights). It
recognised by European social policy.    formulates opinions and
MdM belongs to the poverty and           recommendations on human rights
exclusion commission of the health       for the Prime Minister.
and Europe groups. Link with the         International action
Alerte group.                            • URD (Emergency Rehabilitation
• CNLE (The National Council for         Development Group): group of relief work
Anti-Exclusion Policy).                  associations working through the
It checks that the government is         humanitarian action quality process.
enforcing all measures in the fight      • Volunteer NGO liaison committee
against exclusion.                       (effective from 2004).
MdM has set up a group to monitor
CMU (universal health insurance), and
> Médecins du Monde and
  international institutions
NGOs that are active in the humanitarian area cannot ignore the international institutions, which are both important
funders and front-line political authorities. Many decisions these days go beyond the national context and relate to
European or global decisions. In order to fully understand this complex situation, Médecins du Monde is involved in
different groups which facilitate access to the international decision-making authorities. At the same time, MdM is
developing partnerships with other international organisations and has kept specific articles of association allowing
it to intervene immediately.


> European Union (EU)                       Concord (the European NGO                 the revision of ECHO's Framework
• The task of ECHO (the European            Confederation for Relief and              Partnership Agreement (FPA) through
Commission's Humanitarian Aid Office)       Development), which provides group        the group set up by Voice to monitor
is to provide assistance and relief to      lobbying of the European Union's insti-   the FPA.
victims of natural disasters or conflicts   tutions and takes part in developing      • MdM France and other member
outside the EU. ECHO has intervened         common positions on European deve-        delegations of the international
in over 85 countries since 1982 and         lopment policy and the major issues in    network regularly attend ECHO's inter-
has an annual budget of over 500            North-South relations.                    vention strategy planning meetings.
million euros.                              • For several years, and especially in
• EuropeAid (Co-operation Office) has       2005, MdM has been very active in         > Council of Europe
the job of implementing the European        Voice, an interface between associa-         (COE)
Commission's external aid. The              tions and ECHO which brings together      • The Council of Europe brings toge-
Commission is one of the main contri-       90 relief NGOs. MdM France is a mem-      ther 46 European states. Set up in
butors of public aid for development.       ber of the “Task Force” in charge of      1949 to defend human rights, its parti-
Over 150 countries, territories or orga-    negotiating with ECHO in the name of      cular focus since 1989 has been to
nisations receive this aid which is         the partner NGOs which are members        help the Central and Eastern European
managed by the Office.                      of Voice. Thus, during the last few       (PECO) countries to implement and
• MdM relates to EuropeAid through          years, MdM has played a large part in     consolidate political reforms.
                                                                                                                      152/153




• MdM's international network has
consultative status with the COE and
                                            This political representation is sup-
                                            plemented by an operational part-
                                                                                         > World Bank (WB)
                                                                                         The World Bank (WB) is one of the
is part of OING Service, a liaison          nership agreement which MdM has
                                                                                         most important sources of aid for
group for NGOs with this status.            with the HCR. There is an information
                                                                                         develop- ment, especially for the AIDS
                                            exchange partnership between OCHA
> United Nations (UN)                       and MdM and keeps an operational
                                                                                         issue.
                                                                                         It works in 100 client countries with the
• The Economic and Social Council           eye on Reliefweb.
                                                                                         aim of assisting the poorest peoples
(ECOSOC) is the main organ of the UN        • Some MdM projects are in contact
                                                                                         and countries.
co-ordinating the economic and social       with the United Nations Development
activities of the UN and its specialist     Programme (UNDP) through operatio-
bodies and institutions. MdM's interna-     nal collaboration and a policy, notably
tional network has special consultati-      on the theme of children in conflicts.
ve status which means that it can           The same occurs with the United
carry out lobbying activities, especially   Nations Children's Fund (UNICEF) with
of the Human Rights Commission.             which MdM works on several projects.
It has observer status in this subsidiary   • MdM is a member of the
organ of ECOSOC and is one of the           International Council of Voluntary
few medical NGOs present in this            Agencies (ICVA), a network of NGOs
public arena classifying human rights       involved in human rights, which
breaches. At the commission's annual        concentrates on humanitarian issues
meeting, MdM can intervene on each          relating to refugees.
agenda item and submit texts.               ICVA brings together over 80 internatio-
• MdM's international network has           nal NGOs. The Council relates to the UN
representation at the World Health          authorities, especially as an interface
Organisation (WHO) and the Office for       with the HCR by tackling different the-
the Co-ordination of Humanitarian           mes such as the link between humanita-
Affairs (OCHA) in the High                  rian workers and the military, or the pro-
Commission for Refugees (HCR)               tection of civilians in armed conflicts.
       WE CARE FOR THOSE WHO THE WORLD IS GRADUALLY FORGETTING.

Head office: 62 rue Marcadet 75018 Paris – Tel. +331 44 92 15 15 – Fax: +331 44 92 99 99 – www.medecinsdumonde.org – Publication manager: Dr. Françoise Jeanson – Chief editor: Giselda Gargano
Editorial committee: Dr. Michel Brugière, Martine Mikolajczyk, Stéphanie Senet – Editorial staff: Raluca Gheorlan, Emmanuelle Harang, Germain Richard, Mame-Seynabou Sall
Acknowledgements: to all participants to the 2005 edition – Design:              Tel. 01 55 34 46 00 (ref. 2MDMRAP005) Copyright: any reproduction of this document is subject to a prior written request.

								
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