Health Sector Cooradination Meeting

HEALTH SECTOR COORDINATION MEETING
August 29, 2001

WHO Humanitarian Assistance Office Skopje

Participants:

• WHO HAO
  Boris Rebac
  Dance Gudeva Nikovska
  
  
• ARC International
  Dejan Krstic
  
  
• AAR Japan
  Gvozden Stojkoski
  Dimitrov Saso
  
  
• IRC
  Daniela Ralis
  Nermin Zitkovic
  
  
• ICRC
  John Gelissen
  
  
• UN OCHA
  Vladanka Andreeva
  
  
• Save the Children UK
  Maja Suslevska
  
  
• ART International
  Lee R. Briggs
  Andrea Anderson
  
  
• UNICEF
  Vasiliki Delimitsou
  
  
• Project HOPE
  Verica Ivanovska
  
  
• European Perspective
  Tanja Bojadziska
  Linda Rushiti
  
  
• IOM
  Marija Nikolova
  Vasil Gajdadziev

WHO HAO - Dr. Rebac gave a brief introduction on the situation in FYROM and information about past week activities. During the past week Macedonian Red Cross have registered increased number of IDPs, the actual number is more than 70 000. Majority of them is from Tetovo. The operation Essential Harvest started August 27, there are first signs that agreement on constitutional changes will be ratified by Macedonian Parliament most probably on Friday this week. There are also some positive signs that this operation will finally establish peace in the country and we can start to think about the return process and reconstruction.

Dr Rebac also passed the information to all participants that there is a new person in UNHCR that is acting as a field officer and he will conduct field missions. If some representatives of international organisations or NGOs want to enter conflict areas, they can join UNHCR team on these trips.

IRC representative explained that there are no major problems to go to Aracinovo, there is a police checkpoint on the way to and at the entrance of the village, but sometimes team has to wait if there is a convoy. Police is checking only ID cards.

WHO HAO is planning to undertake health capacity assessment in accessible areas and later on in villages affected by conflict as soon as security situation allows. This will start most probably next week. Two international consultants will come to work in FYROM in coordination with local health professionals and will prepare 2 questionnaires that will be used in order to get clear picture of the situation in the field.

WHO HAO continues with activities in the health sector to support IDPs. Through its implementing partner IRC, WHO will provide mobile team that will give medical help to returnees to Aracinovo. This service will be part of Gazi Baba (Cento) outpatient clinic, and will go to Aracinovo on daily basis, Monday - Friday and work there for few hours. IRC representative will later give more information about visit to Aracinovo and things that have to be done there in order to establish this service.

Three pharmacies in Skopje that give drugs free of charge to IDPs are operational. WHO receives regular weekly reports prepared by the pharmacists. The main problem is that drugs available in those pharmacies are essential drugs, people often ask for drugs that are not on WHO/UNICEF list. The list of drugs available was distributed to all doctors in PHC clinics, but some of them still prescribe drugs that are not on that list. As it was agreed, ART International will try to fill in the gaps for the additional drugs through Macedonian Red Cross.

UNICEF is running regular activities.
Stress-coping summer centers are now working in the major IDP areas of Skopje and Tetovo. Three summer centers work in Kumanovo; such centers work in Skopje. They offer sports, recreation, psychosocial counseling, health education, early childhood care and development, mine awareness activities.

In order to support medical services in Aracinovo, UNICEF gave medical equipment and supplies to IRC. Assessment on vulnerability of IDPs in host families is ongoing.

AAR Japan is running their usual project in Kumanovo and Skopje (Gorce Petrov and Suto Orizari), providing PHC services for refugees and IDPs. They made data analysis for Kumanovo region. Since the beginning oof the conflict in Kumanovo, May 20, 2001, AAR Japan has assisted 1135 patients. 23% are refugees, 77% IDPs. Nationality: 21% Macedonian (IDPs), 70% Albanians, 14% Serbian, 12% Roma.

The team that works in Kumanovo, reported increased number of people with kidney problems/urinary tract infections today. There is a need to compare this number to the IRC report from PHC services in order to check if it is temporary problem or is connected with water problems in Kumanovo.

AAR Japan will visit collective centers that are far away from the town twice a week and transport patients that need medical assistance to the town and take them back.

IRC is running regular programs for refugees and IDPs.
PHC service for IDPs in Kumanovo gave medical help to 435 patients last week. 45 patients were referred to specialist examination, 23 for hospitalisation. There is a lack of medicines. UNICEF will deliver kit tomorrow.

IRC team visited Aracinovo yesterday. The engineer made assessment of the ambulanta building. There is a need for a minor reconstruction (one wall, windows), in order for ambulanta to be operational immediately. Hopefully, the team can start work on Monday next week. UNICEF donated equipment, kits for physicians and nurses and other items needed. IRC team also had a meeting with the manager of Cento outpatient clinic, to arrange a room for the team and some office equipment that will be moved to Aracinovo.
IRC gives medical help to refugees and IDPs in Suto Orizari and Katlanovo collective centers. Their teams provide medical help and assist with drugs. One outreach advisor is conducting youth activities and health education for women.

Reconstruction works on streets in Suto Orizari are ongoing. The reconstruction of the sewage system finished, there are only 2 cases of watery diarrhea this week.

The problem with IDPs in Suto Orizari outpatient clinic reported last week is solved.

ICRC representative informed participants that they receive applications by 2 doctors that want to be employed by some international organisation. One of them (Dr Kotevski) is IDP and lives in Hotel Pelagonija, the other one is psychiatrist (Dr Pavlov) and offer services for psychiatric treatment. Anyone interested can contact ICRC and get additional information.
In addition, he wanted to explain ICRC activities in order to present clear picture on their activities and why they are reluctant to give information.

ICRC has special mandate and act according to Geneva Convention. Activities in conflict areas are not only medical (mostly surgical), but also they include access to the so-called "prisoners of war", missing people, connection with their families etc. Meetings with both parties involved in the conflict are strictly confidential.

Whenever some international organisation needs information, or assistance by ICRC, they can channel this info through WHO.

Dr. Rebac emphasised that ICRC is only organisation that can go to conflict areas, so the communication with them is necessary in order to channel health assistance to people there. Three months ago, UNICEF and WHO delivered certain amount of drugs for patients in Kumanovo area through ICRC.

OCHA representative and coordinator for UNHCR and Ministry of Labor and Social Policy is attending all coordination and interagency meetings, so she can inform upon request about ongoing activities and brief if something is of interest for this sector. For the past week, she quoted the conclusion that for the host families, only non-food items were delivered and very small quantity of food. She also wanted to emphasise that WHO is coordinating health sector very good.

Save the Children, UK started preliminary preparations in collective centers in Radovis and Strumica. Distribution of hygiene items in collective centers continues. The representative also informed about an individual case hosted in family that may be of interest and some IO can assist them. It is a female patient in the terminal stage, she has no morphine and also lives in very bad conditions. Their team that visited Cicino Selo collective center reported increased number of patients with scabies.

ART International is a rescue and training organization. Their representatives informed that they are ready to support health activities. Several organisations in Germany are willing to assist organizations present in FYROM. ART Int is open for contact if anyone needs some assistance. For medications, organisations have to prepare a letter with request for drugs needed and quantities.

ART International is making Mother/Child assessment in collective centers and is planning small project concerning this issue.

Project HOPE has no activities concerning emergency situation. The procurement of equipment that will be donated to Kozle special hospital for lung diseases in children and Cardiology clinic is ongoing.

EUROPEAN PERSPECTIVE has small projects for rehabilitation of houses that host IDPs, procurement of non-food items (school packages) and rehabilitation of schools. Greek Ministry of Foreign Affairs sponsors these activities.

IOM representative reported on behalf of Handicap International that they are continuing with orthopedic supplies to IDPs with special needs. Also Handicap International provided decubital accessories, diapers and psychiatric assistance for the girl from Kumanovo (the case that was discussed few meetings ago).

IOM is observing the situation in FYROM. Last week they assisted in movements of IDPs to their homes. IOM is looking to investigate more options how to assist vulnerable groups of IDPs. Possible projects that are planned are still not operational.

IOM is looking for possibilities to transport the girl from Kumanovo to specialised clinic out of FYROM and will assist in the transport.


Previous reports

• 22 August 2001