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Health Sector Coordination Meeting |
HEALTH SECTOR COORDINATION MEETING
October 31st, 2001
WHO Humanitarian Assistance Office Skopje
Participants:
Boris Rebac WHO HAO
Dance Gudeva Nikovska WHO HAO
Jasuko Kikuchi AAR Japan
Gala Toschi Movimondo
Simonetta Rossi APS
Silvana Onceva IFRC/MRC
Vasiliki Delimitsou UNICEF
Samir Hadziabduli IOM
John Gelissen ICRC
Nurie Halili IRC
Kevser Loki IRC
Biljana Simjanovska Handicap International
Judi Harris American Red Cross
Vladanka Andreeva OCHA
Andrea Anderson ART International
Robin Matjanoski ART International
Neuman Hans ART International
Maja Suslevska Save the Children UK
Dr. Rebac, WHO HAO opened the meeting by distributing the unedited draft
of the Rapid Health Assessment prepared by WHO HAO. He stressed again
that WHO HAO wants to thank all international organisations, NGOs and
local professionals that helped in preparing of the questionnaires and
supporting the assessment.
This report includes summarised findings received from the questionnaires.
If some organisation needs more detailed information for some specific
Ambulanta, they can ask and WHO will provide the original questionnaires.
Also, this report can be updated later with informations received from
international organisations.
UNICEF representative suggested distribution of the
questionnaires that were used in the field, so if anyone goes for field
visit, could fill it and add more information.
In addition, Dr Rebac gave a brief explanation on the
content of the report. Informations are separated for all Ambulantas in
the three regions. Basically, material that was distributed on this meeting
consists information on status and needs of Medical centers/Health centers
and Ambulantas in the three conflict affected regions.
Needs for reconstruction - one third of all Ambulantas requested complete
reconstruction. This information has to be rechecked, as some Ambulantas
stated that they need complete reconstruction due to the poor maintenance
in previous period and others are damaged in the conflict activities.
Some Ambulantas requested partial reconstruction marked with codes, e.g.
R= roof, P = painting, etc.
Medical staff - what is clear from the report for all three regions is
unequal distribution of the staff. Some facilities are overstaffed; some
were closed prior to the conflict because there is lack of staff.
Equipment - there are some unrealistic requests that does not match with
the primary health services that this facilities provide. Included are
only needs for basic equipment according to the standardised list recommended
by the Ministry of Health. Some Ambulantas stated that they do not have
very basic equipment, as sthetoscope and sphygmomanometer.
Drug supply - as very broad answers were received, WHO presented them
as most needed groups of drugs.
Finally, Dr Rebac stressed that WHO HAO is available for any question
or comments concerning this report.
ART International would like to have the list of equipment
recommended by the Ministry of Health. IFRC/MRC will provide them with
this list that was published in the official gazette.
American Red Cross is continuing with health education
programs for IDPs in host families and collective centers. They will start
with these activities in Tetovo. In Skopje, they finished the program
in collective centers Stiv Naumov and Hotel Pelagonija and will start
in Olimpisko selo and Hotel Kristal in Kumanovo. Today, ARC and ICRC teams
made field visit to Lipkovo municipality. There is an urgent need for
medicines in ambulanta in Slupcane. If any international organisation
or NGO is able to provide medications, contact ARC.
ART International is expecting one shipment with drugs
from Germany and will contact all organisations before distribution.
Dr Rebac suggested them to try to make selection on drugs and help local
professionals with generic names and different dosages.
ART International - physician from Germany will arrive together with the
shipment and will help in distribution and monitor the prescriptions.
IOM has finished the field assessment on health care
needs. As they plan project with emphasis on tuberculosis, they have regular
contacts with the TB dispensaries in Tetovo and Kumanovo.
Handicap International has finished the distribution
of 100 000 diapers for IDPs and returnees. They also have received the
shipment with orthopedic supplies. Partner NGOs will distribute them to
the beneficiaries identified in Tetovo, Kumanovo and Skopje. In Kumanovo,
there is a problem with beneficiaries that started to go back to their
homes. Local NGO that assist in distribution in Kumanovo will help to
find those people and distribute the orthopedic items to their homes.
ART International is in process of collecting information
on IDPs with chronic diseases, over the age of 65 and 0 - 12 years old.
They will provide these beneficiaries with flu vaccine as well as for
the professionals that will work with them. These activities are conducted
in cooperation with representative from the Ministry of Health, Dr Kostovska.
This is planned to be a pilot program, after the end of the flu season,
ART International will prepare a final report with information how many
people were immunised, side effects and other reactions.
Dr Rebac suggested these activities to be coordinated
with the Institutes for Public Health in the respected regions.
ICRC representative informed that ICRC started to reduce their medical
staff, one health delegate leave the country today, the other will travel
next week. Practically, according to their mandate, their job is over
and other international organisations should continue to deal with the
problems in the future.
ICRC team that went in the field during last week reported that the Ambulanta
in Radusha is completely damaged and there is a need for urgent and complete
reconstruction. The team also met the doctors that worked in that Ambulanta
prior to the conflict, they are ready to go back and work there as soon
as conditions are normal. The local community is looking to solve this
problem taking into consideration an opportunity to use a private house
as temporary solution.
The representative again stressed some observations during monitoring
of the RHA. In some of the villages in Tetovo region, there are Ambulantas
established by international organisations during Kosovo crisis in 1999.
They are equipped completely, buildings are new, but nobody is working
there. This fact has to be taken into consideration if any IO is planning
to build or reconstruct some facility.
Dr Rebac added that it should be a recommendation for
all agencies, if anything is planned to be donated or build, to take into
consideration the possibility for staffing and integration in the existing
health system.
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 53 patients/day. In Aracinovo, the number of patients
is increased with approximately 50/day or in total 253-patients/last week.
IRC is receiving requests almost every day from villages in Lipkovo municipality
(Lojane, Vaksince) for providing medications. Private doctors make most
of the requests. Also, IRC was called by OSCE to provide medications for
the villages in Skopje region (Mojance, Grusino).
Dr Rebac replied that it is very difficult at this moment
to balance private and public sectors and control if private doctors are
charging patients for drugs. Also, at this point this is very sensitive
issue. WHO will arrange a meeting with IRC next week and explore the possibility
to organise mobile team that will visit those villages, as most probably
the primary health care services for IDPs in Kumanovo hospital will be
closed soon.
ICRC representative informed that Ministry of Health has cut the budget
for the Medical centers up to 50%. The question is whether they can provide
medical services with that amount of money or new problems will arise
very soon.
WHO and ICRC can organise meeting with the Ministry of Health and discuss
this issue.
IRC health team supported by UNHCR gives medical help to refugees and
social cases in Suto Orizari and Katlanovo collective centers.
UNICEF has regular activities. Concerning emergency,
the shipment of drugs they expected to arrive changed its destination
to Afganistan, so UNICEF will wait for the next shipment.
IFRC/Macedonian Red Cross has established info center
for psychosocial support of IDPs. They are also providing specific medications
for IDPs. From November 25, 2001, they will have updated figures on number
of IDPs.
APS is Italian NGO that just opened their office in
Skopje. They plan some activities and projects for economic development.
APS looks for the possibility to assist in reconstruction of the special
hospital for TB and lung diseases in Leshok.
MOVIMONDO is Italian NGO that will assist in housing
reconstruction. They are interested for the RHA report.
AAR Japan has regular activities - providing primary
health care for refugees, IDPs and social cases in Kumanovo, Skopje and
Tetovo.
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