Health Sector Coordination Meeting

HEALTH SECTOR COORDINATION MEETING
October 24th, 2001

WHO Humanitarian Assistance Office Skopje


Participants:

Maria Cristina Profili Head of Office WHO HAO
Boris Rebac WHO HAO
Dance Gudeva Nikovska WHO HAO
Kristin Vasilevska Medical Faculty Skopje
Dusko Kunovski UNHCR
Saso Dimitrov AAR Japan
Samir Hadziabduli IOM
R. Golsby-Smith ICRC
Nermin Zitkovic IRC
Kevser Loki IRC
Biljana Simjanovska Handicap International
Judi Harris American Red Cross
Silva Pesic OCHA


Dr. Rebac, WHO HAO opened the meeting giving brief overview on past week activities.
WHO HAO finished the statistical analysis on data collected through Rapid health assessment in the crisis regions of Skopje, Tetovo and Kumanovo. Special thanks to Dr Kristin Vasilevska, Associate Professor of epidemiology and statistics at the Medical Faculty Skopje, that helped WHO in analysis of the questionnaires.

Basically, material that has been distributed in this meeting consists information on 4 main issues regarding the Ambulantas: status and needs for reconstruction/rehabilitation of the existing buildings, medical staff, medical equipment (according to the standardised list recommended by the Ministry of Health) and drug supplies. WHO HAO is still working on the narrative part of the final report. The final report will be shared with all interested parties once it is finished.

Dr Maria Cristina Profili, Head of Office WHO HAO, gave short explanation on tables and coding system that was used in statistical analysis and is included in the report. She hopes that all agencies and other organisations can find essential and helpful details needed for further planning of projects.

ICRC representative stressed that according to the information they received form the team that went in the field, nobody has visited Lipkovo to make the assessment. Also for Radusa, ICRC was asked to provide one doctor for the Ambulanta, but according to the information present in the WHO report, there are 2 doctors and 1 nurse working there.

Dr Rebac talked to the person from the Medical Center Kumanovo that had visited Lipkovo, together with representative of MCIC on October 05, 2001. They found no medical staff in the Ambulanta that day, so they spoke to the people around and fill the questionnaire according to their observation that day.

Concerning Radusha, there is a problem with interpretation of the data in the questionnaire, because the interviewers state that the ambulanta is totally destroyed and looted, but they also put the information that two doctors (most probably before the conflict) worked there. This information has to be revised again.

Yesterday, at the Interagency meeting, WHO HAO was asked to assist to IDPs that are returning back to villages that are now considered as safe. Macedonian Red Cross will start new registration at the beginning of November, so the figures will be clearer. WHO HAO will have to reorganise services for IDPs, especially in Kumanovo and work with mobile teams in the field (Lipkovo municipality). According to information received in the past few days, the general impression is that the situation is slowly becoming normal, most of the Ambulantas are working again both in Kumanovo and Tetovo.

The problem with referring the patients for hospital treatment and specialist examination in Kumanovo is still present. Dr Rebac has a meeting today with Dr Zarko Sutinovski, person appointed by the Ministry of Health to be in charge for contact with Kumanovo health authorities. Basically, in Kumanovo the problems in general funding of the Medical center and functioning of the overall hospital services is under question. There is a need for further discussion between international community and Ministry of Health. It seems that there is lack of political will to solve this problem.

Today is UN day, and especially this year, UN and its Secretary General won the Nobel price for their efforts towards peace. Celebration for this occasion took place in Holiday Inn.
WHO HAO finally managed to open the facility in Tetovo that will serve as community mental health service for people with mental illnesses. The opening ceremony is tomorrow, October 25, 2001 at 14:00 p.m. All interested international agencies and NGOs are invited.

IRC is running regular programs for refugees and IDPs. The number of patients in the Primary health care service for IDPs in Kumanovo is decreased last week with average 65 patients/day. In Aracinovo, the number of patients is approximately 40/day. The pathology is upper respiratory tract infections and chronic diseases. IRC is still waiting for written approval by WHO to buy some medicines locally.

IRC health team supported by UNHCR gives medical help to refugees and social cases in Suto Orizari and Katlanovo collective centers. There is increased number of upper respiratory tract infections and people with head lice. IRC doctors provided the patients with enough shampoo, but most probably patients are not using it.

American Red Cross is continuing with health education programs for IDPs in host families and collective centers. Almost 1000 people during October and more than 2500 since the beginning in September participated in those activities, mostly IDPs hosted in families in Kumanovo. Health education activities will continue for IDPs hosted in two hotels in Kumanovo and also for Skopje.

ICRC team has visited village Matejce last week. The doctor that used to work in the Ambulanta before the conflict started to work again. ICRC has provided basic equipment (physician kit), so the doctor can provide basic medical services. ICRC team will visit villages Otlja and Nikustak this week. There is a doctor working in the Ambulanta that travel on daily basis from Kumanovo. It is easier to travel now, because UNHCR has organised bus that is going on daily basis from Kumanovo to the villages. Also it is easier for people that live in those villages to travel to Kumanovo if they need special services.

IOM has finished the field assessment on health care needs. IOM team went to Tetovo and met the Director of the Medical center. It was agreed to pay special attention on tuberculosis. Another meeting is scheduled for tomorrow, with the Director of the Special hospital for TB and lung diseases in Lesok. IOM did the same assessment in Kumanovo and will start an epidemiological survey on screening for TB and public awareness.

AAR Japan has regular activities in Kumanovo, Skopje and Tetovo. Their teams have given medical help to more than 500 patients last week.

UNHCR have activities in the health sector through its main 3 implementing partners - WHO, IRC and Handicap International. Handicap International has organised distribution of diapers for disabled people.

Regarding the problem mentioned by IRC in Suto Orizari collective center, UNHCR could make small repairs and painting of the rooms.

The project with WHO and IRC is under revision for possible extension.

Dr Rebac pointed that there is a need to readjust the services according to the needs. At the moment, noone is aware how many people are IDPs, so WHO will monitor and evaluate the situation after receiving figures from Macedonian Red Cross.

Dr Kristin Vasilevska as representative of the Epidemiology and statistic department of the Medical Faculty Skopje pointed that international community, especially agencies that have activities in the health sector have to be aware of people coming back from neighboring countries and moving from place to place, since they can transfer communicable diseases. WHO has program for eradication of polio and acute flaccid paralysis. People that work on this program reported problems in regions of Tetovo and Kumanovo that were mostly affected by the conflict for a longer period.

Handicap International has finished the distribution of 100 000 diapers for IDPs and returnees. Three partner NGOs have distributed them to the beneficiaries identified in Tetovo, Kumanovo and Skopje. Handicap International is waiting the shipment of wheel chairs, diapers, crutches and other orthopedic supplies.


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