Health Sector Coordination Meeting

HEALTH SECTOR COORDINATION MEETING
September 05, 2001

WHO Humanitarian Assistance Office Skopje

Participants:

• WHO HAO
  Boris Rebac
  Dance Gudeva Nikovska
  
  
• UNICEF
  Vasiliki Delimitsou
  
  
• AAR Japan
  Gvozden Stojkoski
  Saso Dimitrov
  
  
• IRC
  Daniela Ralis
  Nermin Zitkovic
  Rick Brennan
  
  
• American Red Cross
  Judi Harris
  
  
• ICRC
  John Gelissen
  
  
• ART International
  Andrea Anderson
  Robin Matjanoski
  
  
• UN OCHA
  Vladanka Andreeva
  
  
• Handicap International
  Lidija Krstevska
  
  
• European Perspective
  Tanja Bojadziska
  
  
• UNHCR
  Dusko Kunovski
  
  
• IOM
  Vasil Gajdadziev

WHO HAO - Dr. Rebac opened the meeting giving brief introduction on the situation in FYROM and information about past week activities. UN agencies are still not allowed to go to areas around Tetovo and they are waiting for further instructions from UN Security Cell.

WHO and IRC as an implementing partner, finished minor reconstruction works on the existing building in Aracinovo in order to start with Primary Health Care services for returnees. IRC team also moved some office furniture from Gazi Baba clinic, so one room in Aracinovo is adapted and ready to start to work as ambulanta. The main problem is there is no water and electricity in the village, so for now this team will be mobile, settled at Gazi Baba clinic and will travel to Aracinovo every day and work there for few hours. Actually, the team started to work today; IRC representative can give details later. Additional problem is to fond the room for this team in Gazi Baba clinic, because there is lack of space there. Another option is to adapt an ambulanta in the village Zitiste that is on the half way to Aracinovo. WHO visited two locations today and will discuss both options tomorrow with the manager of Gazi Baba clinic.

In Skopje, three pharmacies that give drugs free of charge to IDPs are operational. WHO prepared and distributed to all participants report on drug consumption made for the period 31/07 - 31/08. Also, according to lists prepared by pharmacists who work in those pharmacies, WHO prepared a list of drugs that are not available in kits provided by WHO and UNICEF and are most frequently asked for by patients. This list is a matter of further discussion, in order to plan future supplies, as some of the drugs on that list are very expensive, some are not proven to be efficient or are not used at all in Western countries.
An update on PHC services for IDPs in Kumanovo region will be given later by IRC representative.

WHO HAO is still in process of looking for the consultants who will undertake health capacity assessment in accessible areas and later on in villages affected by conflict as soon as security situation allows. As he explained at the previous meeting, two international consultants will come to work in FYROM in coordination with local health professionals and will prepare two questionnaires that will be used in order to get clear picture of the situation in the field.

UNICEF is running regular activities. Last week UNICEF donated medical supplies, small medical equipment and other medical materials to IRC teams that provide PHC to IDPs in Kumanovo and returnees to Aracinovo. These include emergency health kit with essential drugs, physician kit, public nurse kit, mother and child health care kit, medical bags, safety boxes and water tanks.

UNICEF donated minerals and vitamin tablets to the Ministry of Health for further distribution according to the needs.

Health education activities for IDPs in Kumanovo are ongoing. In Skopje, these health education activities have finished.

The third immunisation campaign for Kosovo refugees is ongoing this week.

The vulnerability assessment in IDP communities (host families and collective centers) is ongoing.

IRC is running regular programs for refugees and IDPs. This week Director for health programs (HQ) arrived in FYROM and will arrange a meeting with WHO. PHC service for IDPs in Kumanovo gave medical help to 373 patients last week. Thirty one patients were referred to specialist examination, 13 for hospitalisation. Pharmacists in central hospital pharmacy will prepare list of medicines available for prescription for IDPs.
Dr Rebac informed that WHO would also prepare report on consumption of drugs in Kumanovo for the past period.

IRC team started to give PHC services in Aracinovo yesterday. On Monday, the team arranged the room with the furniture and items needed for everyday work. Hopefully, the problem with the room for the team in Gazi Baba or Zitiste will be solved soon.
IRC health team supported by UNHCR gives medical help to refugees and social cases in Suto Orizari and Katlanovo collective centers. One outreach advisor is conducting youth activities twice a week. Health education for women in reproductive age finished in Katlanovo and will continue with other groups.

Reconstruction works on streets in Suto Orizari are ongoing. The reconstruction of the sewage system has been finished. No new infectious diseases were reported.

IRC support refugees from Radusha that were moved to two hotels in Skopje. IRC mobile medical team visits them twice a week.

American Red Cross has regular activities for health education in host families in Skopje and Kumanovo region. ICRC donated equipment was moved from the outpatient clinic in Malina Mala that is not operational because it is in the conflict area, to village of Umin Dol.

For ICRC the last week was pretty quiet as they have activities in conflict areas. There is increased number of requests for drugs mostly from patients with chronic diseases (insulin for example). ICRC representative received a request from IOM about the patient (IDP from Kumanovo) that has to be assisted with insulin.

Dr Rebac suggested this information to be checked because WHO donated supply of insulin to the Ministry of Health for all patients registered for period of 6 months. All IDPs registered in the Macedonian Red Cross can also take insulin in existing facilities.

ICRC has meeting with the Deputy Director of Medical Center Kumanovo. Medical center has to close some surgical departments because there is lack of anesthetics and other medications. In general, ICRC found that there is serious shortage in medical supplies, especially in affected areas. There is urgent need to solve this problem and find mechanisms how to supply all necessary things at this stage.

ICRC started to project budget for year 2002. For emergency related activities, ICRC foresaw larger problems in the future, most probably by the beginning of the next year, and planned activities according to those estimations.

Dr Rebac informed that WHO does not want to act as a supplying agency and will discuss with Ministry of Health about their plan how to deal with this situation in the future.
ICRC will also try to arrange a meeting with the Ministry of Health to address these issues.

ART International is doing fund raising for its activities. One German bank will sponsor some activities. ART Int works in close cooperation with WHO and Ministry of Health.
ART activists identify problem with garbage disposal in Suto Orizari. There is huge amount of garbage that has to be moved to central dumping site. Hopefully, military will assist them. Also, ART Int. will assist in street reconstruction in Suto Orizari, after assessment that is ongoing.

OCHA representative and coordinator for UNHCR and Ministry of Labor and Social Policy visited 3 collective centers in Dojran and Gevgelija. There are 170 IDPs in Gevgelija and 121 in Hotel Polin, 121 in MRC summer camp and 170 in other facilities in Dojran. After conversation with IDPs it seems that they are generally satisfied with the conditions there. Something has to be arranged in those towns for medical supplies, as there is a lack of medicines. There is also a need for winter clothing and there is no heating system in facilities. As additional problem, there is a need for milk for the great number of children hosted there.

UNICEF received information that every manager of facilities that are hosting IDPs receives 400 MKD/day per person. This sum is enough to cover all necessary food and hygiene products, as well as heating and electricity bills.

There is a need to check this information, because managers complained that they did not receive anything so far.

Handicap International has no operational activities in the field. They finished the project sponsored by UNHCR and assisted 500 IDPs with special needs. HI is making assessment on needs of 300 more IDPs with special needs. HI donated some equipment for Medical centers, mostly decubital accessories and materials.

IOM is still observing the situation in FYROM and make necessary preparations. Some activities started in Kumanovo region, most probably representative will inform and explain it at the next meeting. IOM is in permanent contact with the Crisis center about finalisation of projects for IDPs. IOM has established so far very good cooperation with ART International, Handicap International, AAR Japan, IRC and WHO.

EUROPEAN PERSPECTIVE has small ongoing 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.

UNHCR has lot of work as they have cooperation activities with the Crisis management group established by the Government. Assessment is ongoing to provide wood for host families for the coming winter. Also, UNHCR will provide winter clothes. Another project in process of planning is for repair works for both collective centers and host families. There will be some minor repairs due to the forthcoming winter.

There is possibility to extend the project with Handicap International.

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. Correction of numbers given in the previous Minutes: since the beginning of the conflict in Kumanovo, May 20, 2001, AAR Japan has assisted 1135 patients. 23% are refugees, 77% IDPs. Nationality: 21% Macedonian (IDPs), 17% Albanians, 50% Serbian, 12% Roma.

AAR team gave medical help to 40 patients/day in Kumanovo. Also team started to give medical help to social cases in Kumanovo region.

AAR Japan started visiting collective centers that are far away from the town twice a week. The team transport patients that need medical assistance to the Medical center and take them back.

AAR Japan received a request from NGO from Tetovo for supplying some food and hygiene items. They will send it to WHO by e-mail.

Previous reports

• 29 August 2001
• 22 August 2001