Category: News

FOR QUALITY HEALTH EVEN DURING AN EMERGENCY

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What is happening in Tigray? In this region of Ethiopia, the population is severely affected and living in precarious conditions due to the recent war, which has also undermined the health system. Because of the lack of fuel and availability of cash, vulnerable groups, in particular mothers and children, have been suffering from insufficient provision of health services. In addition, for the past two years, health care workers have not been receiving salary, and the health facilities have not been supplied with medical equipment and drugs.

Since the Federal Government of Ethiopia and the Tigray People’s Liberation Front signed the peace agreement, committing to create stability and retrieve the services in the region, Doctors with Africa CUAMM, starting from June 2022, has been implementing the project “Emergency support to equitable and safe access to quality health in Tigray Region”, supported by EU Humanitarian Aid (ECHO) funding, directly targeting three health facilities in the region: St. Louise Eye Clinic in Mekelle, St. Mary Health Centre in Edaga Hamus, and Kidane Mihret Hospital in Adwa.

The activities offered to strengthen the health team

CUAMM has organised several trainings in Adwa, in Edaga Hamus in Adigrat and in Mekelle. Among these, the training on basic emergency maternal obstetrics and neonatal care aimed to build capacity for health care workers, particularly midwives, on antenatal care, delivery and postnatal care services. Moreover, the training on community management of acute malnutrition was carried out to develop health care workers’ capacity to treat and support malnourished patients, considering that 50.3% of pregnant and lactating women and 22.7% children are suffering from global acute malnutrition (OCHA). These training sessions involved 50 participants. Furthermore, training on infection prevention and control and on health management inform system were organised, also in Mekelle, involving 70 participants.

These training helped the collaboration and coordination among different health facilities in the area, to improve the access to the health services. «Considering the last two years of conflict in the country, – affirms Yonas Tadesse, CUAMM Humanitarian coordinator – the provision of training to the health staff of the targeted health facilities and of the nearby health centres in Tigray is fundamental, leading to a better access to quality health service. By providing capacity-building to the staff, they can feel more motivated, willing to grow their skills and capacities to support mothers, children and vulnerable groups, as well as earn an income to sustain their families».

CUAMM also organised the “Referral pathway coordination workshop” targeting representatives of the health facilities of the area, aiming at coordinating the response to the challenges of the context.

«The referral – says one of the participants – is necessary and life-saving: due to the lack of cash and fuel, in the last two years people were unable not only to provide food, but also to find transportation to reach the health facilities. In addition, health facilities were not supplied with drugs, and the unpaid staff was often unable to reach the workplace and provide services».

According to OCHA, 83% of health facilities do not provide maternal services including prenatal care and deliveries, causing a dramatic surge of maternal deaths, 276 in 2021. At the end of 2021, after the first 13 months of conflict, the Tigray Health bureau reported the decline of the ANC services provision from 94% to 16% as well as of PNC from 73% to 19%. Deliveries assisted by trained health staff went from 81% to 21%, while pregnant and lactating women in acute malnutrition increased from 32% to 78%.

The first results thanks to the CUAMM project

By the end of January, thanks to the Referral Pathway system, CUAMM was able to support 86 patients, by providing fuel for ambulance and autonomous transportation, as well as access to medicines. Of these 86 patients, 9 were referred from the IDPs sites to St. Louise Eye Clinic in Mekelle, 40 from St. Mary Health Centre in Edaga Hamus to Adigrat Hospital and another nearby facility, and 37 from Kidane Mihret Hospital in Adwa to Adigrat Hospital.

«In St. Mary Health Centre in Edaga Hamus, – says Yonas – no MCH service was provided since the start of the conflict. Thanks to CUAMM, a pharmacist and a midwife were hired, allowing the restart of the services in September. So far 70 mothers gave birth safely at St Mary HC. Furthermore, in Kidane Mihret Hospital in Adwa, 3 women in severe conditions were referred, and thanks to the work of the senior gynaecologist and of the paediatrician 3 complicated surgeries were performed to save the women and their babies after caesarian sections».

Continuous presence, support for the fragile health system and investment in capacity building: these are the instruments CUAMM has been putting in place to enhance safe access to quality health services and reduce maternal and child deaths in Tigray.

http://ec.europa.eu/echo/

This document covers humanitarian aid activities implemented with the financial assistance of the European Union. The views expressed herein should not be taken, in any way, to reflect the official opinion of the European Union, and the European Commission is not responsible for any use that may be made of the information it contains.

THE VISIT OF WORLD DIABETES FOUNDATION IN FREETOWN

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The visit of a delegation from the World Diabetes Foundation to the Republic of Sierra Leone ends today. A one week duty travel alongside CUAMM workers to see firsthand what has been achieved so far and what can still be done in diabetes care to respond to what WHO has labeled as pressing public health problem. Together with the delegation, other important stakeholders took part in the visit as the representatives from the Ministry of Health and Sanitation (MoHS), the Directorate of Non-Communicable Diseases (NCD), the health authorities from PCMH and Pujehun district and the COMAHS (College of Medicine and Allied Health Sciences).

On field meetings between the urban area of Freetown and the rural districts around were scheduled to see firsthand the results of a collaboration that WDF and CUAMM started in 2017 with a first pilot project on gestational diabetes mellitus (GDM). Main results were the integration of a dedicated area for Diabetes Screeing (IDS) within the PCMH in Freetown – the referral hospital and the creation of specific spaces in the PHUs (Peripheral Health Units) in the western area of the country. 14.231 women took part in screening at the IDS clinic in the PCMH, 4.296 at the PHUs thanks to the project. Among the results, the creation of a referral system to the IDS clinic at the PCMH for patients diagnosed in the PHU; the design of the first Protocol for Integrated Diabetes Screening for all patients and the development of the first operational research on diabetes during pregnancy “A simplified diagnostic procedure for the detection of gestational diabetes mellitus in resource-poor settings: results and challenges.”

“Considering that the management of Gestational Diabetes Mellitus/ Diabetes in Pregnancy is limited in services provided in the routine activities done to pregnant women attending ANC. In Sierra Leone, WDF project which support the screening, follow up and management of pregnant women positive with diabetes, had not only helped the good outcome of the mother pregnant but it had also contributed to strengthening Sierra Leone profile on Maternal and infant morbidity and mortality.” Said José Moniz Da Silva- CUAMM Project Manager during the meeting with WDF delegation.

A two-year new project followed the pilot one allowing to extend the GDM screening service to rural areas as Pujehun district, in the southern province of the country where around 234.000 people live. Over two years, GDM screening services were introduced not only in Pujehun hospital but also in 5 BeMONC (Basic Emergency Obstetric and Newborn Care). Among the results: training sessions on GDM and data collection addressed to MoHS health workers, activities on nutrition education; follow-up of cases at risk for hyperglycemia during pregnancy (HIP) and training on the job to improve the quality of health services with the support of a expert. 17.682 women received the GDM screening compared to the 10.933 estimated. Over the length of the project advocacy activities on prevention, screening and GDM addressed to MoHS were also introduced in government policies and strategies for noncommunicable diseases.

As stressed by the management team at the PCMH, the integration of such services within the facilities represents a strength since integrated care can increase the system-level efficiency of treatment.

Currently 24 million adults are living with diabetes in Africa and only 46% of them know their health status. Lack of testing facilities and equipment, inadequate number of trained health personnel, poor access to health facilities and services are some of the barriers to diabetes testing. According to WHO the figure is projected to rise by 129% to 55 million by 2045. Over 70 years of presence in Africa, Doctors with Africa has witnessed the rise of numerous non-communicable diseases such as diabetes, little-known and neglected conditions. The partnership with World Diabetes Foundation permitted to implement interventions to bring about a change in health systems, engaging communities, local activists, health authorities and Ministry of Health.

 

Quelimane the cycling town

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“Once upon a time there was a little red bike that felt as fast as a racing car”. This is the story of a red bike with broken wheels unable to perform as it wish. Actually, it is more than this. This is the story of a child who suffers from undiagnosed health conditions and rides his red bike. Actually, it is way more than that. It is the story of a collaboration between the “A. Frattini” Arts High School in Varese and a little town in Mozambique, named Quelimane, where Doctors with Africa Cuamm works to tackle “Noncommunicable diseases”, with the support of the World Diabetes Foundation.

This story is about diabetes, especially type 1, that affects particularly children and the young. Maura Lucchini is an internist from Varese, she is 48 years old and mother of two. Previously, she spent two years in Uganda with CUAMM, three years in South Sudan, one year in Mozambique. Maura chose to invest her time and energies on this project because she thinks it is worth it.

“I started by training – says Maura, because this is a neglected disease. From August on, I have worked with doctors, nurses, nutritionists and psychologists both from Quelimane, in the province of Zambesia and Beira, Sofala province. I am now meeting the activists who works within the communities. We take care of the patients who get to the hospital when their health conditions aggravated. This is not enough. We have to go seek the patients in suburbs, villages and schools because type 1 diabetes is a hidden yet life-threatening disease, hence it is crucial to shed a light on it through the work of the activists”.

Africa is experiencing an increasing prevalence of noncommunicable diseases even though data are few and incomplete. In the sub-Saharan Africa region, less than one in 10 countries has published data on the incidence or prevalence rates of young people with type 1 diabetes. In Ethiopia, for example, the annual incidence was estimated at 2.1/100,000 (1995-2008) and in Tanzania and 1.8-1.9/100,000 (2010-2015).

Continuous and consistent follow-up of patients is limited, and many children and youth die before being diagnosed or accessing treatment, also contributing to the low incidence and prevalence rates estimated. This is where the commitment of Doctors with Africa CUAMM in providing health care and training comes from. Caring patients who seek treatment and training health workers and activists is a time-consuming effort that does not bring valuable results in a short time yet, it represents the commitment to the promotion of development for the future of the next generations.

What makes a difference, once again, is community outreach activities. And because good begets good, Maura dragged her friend Andrea and his students into this adventure.

“Andrea is a friend, says Maura, he is a teacher and member of both a theatre company and a band where also Alessandro plays, he was diagnosed with type 1 diabetes at the age of 16”.

By telling them about my job, we came up with the idea of engaging his students from the class I H, in writing a play script. Performances are an effective mean to train and educate in Mozambique, that is why once I received the script about the red bike and the “Wheelness”, I had it translated into portuguese and scheduled the exhibition to perform both in Quelimane on January 27th and in Biera on 31st in occasion of two health fairs dedicated to diabetes. Hoping that one day at least Andrea and Alessandro, if not the students themselves, will visit us here to witness what we have done, together”.

On these two days, in addition to the play, a multidisciplinary team (pediatrician, general practitioners, nutritionists, psychologists, nurses) informed the children and personal kits with a backpack, glucometer, notebook, and colored pencils were handed out.

Beside, a radio commercial also designed by the Frattini High School students and translated into local dialects was broadcast by local radios.

Students from Varese claimed:

“We enjoyed participating in this project and it is nice that it is coming to fruition. We hope that we can be useful to someone in the world, in our own way. This experience tought us to better use words, as we knew we were addressing them to sensitive people far away from us. It’s good to try to turn sensitivity into strength, to care and to heal, to keep going and never give up.” Finally, Prof. Minidio concludes, “A school that is open to dialogue and debate with the world can enable us to achieve the educational goals set by the UN Agenda 2030.”

JUST IN TIME In Low Resource Settings

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SHEDDING LIGHT ON NEGLECTED TROPICAL DISEASES

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30 January marks World Neglected Tropical Diseases Day, a group of infectious and parasitic diseases that mainly affect developing countries. More than a billion people in the world are affected, more than half live on the African continent. CUAMM and AMREF are turning the spotlight on this issue, focusing on Nodding syndrome, on which they work together in South Sudan.

The two organisations also make up the Nodding syndrome alliance (NSA), an alliance established with the aim of responding to the needs of people with epilepsy through integrated, multi-sectoral action to strengthen the resilience of patients and that of their communities.

«In a landscape where donors are increasingly reluctant to provide long-term funding – says Chiara Scanagatta, CUAMM’s head of projects in South Sudan – and cooperation between partners is more complex, the NSA is a really positive experience, because it allows us to unite our voices into a stronger one to do advocacy and promote more appropriate policies with local authorities and stakeholders».

Being chronic or long-term diseases, there is a need for continuity in treatment and care, which cannot only be clinical, but integrated with social and economic rehabilitation. From the need for constant resources to the involvement of families to whom dedicated support is guaranteed.

«From April 2020 to December 2022 – Chiara continues – 920 patients are regularly followed at the primary health care centre in Mundri and 300 at Lui. A challenging job, but one that we are determined to carry on, together and with dedication».

South Sudan, protagonist of one of the worst humanitarian crises of all time, is one of the countries most affected by neglected tropical diseases. Most of the population lives in extreme poverty with limited access to basic health services. The conditions of insecurity and political instability that accompanied the civil war have further compromised the country’s ability to cope with NTDs.

These include NS, a degenerative epileptic syndrome, endemic in South Sudan. It mainly affects children between 5 and 15 years of age and is characterised by episodes of sudden and repeated head jerks (hence the name “nodding syndrome”), with devastating effects on physical and neurological development.

Why they are called neglected diseases

They are called neglected diseases because they do not receive the necessary attention and funding for their prevention and treatment.  These diseases can cause irreversible damage to people’s health and productivity and contribute to endemic poverty in affected countries.  There are twenty NTDs currently recognised by the World Health Organisation, among them dengue, leishmaniasis, rabies and onchocerciasis, known as “river blindness”, associated with the development of Nodding syndrome.

THE PRIDE OF ENSURING A DIFFERENT ENDING

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«I want to remember the story of a mother, with two different endings. Memunatu is a 26-year-old woman in her second pregnancy who lives in Bonthe, a remote village in Sierra Leone. With her husband, she was very scared because two years ago, in her first pregnancy, she had gone into labour at home and when she arrived at the hospital to give birth, the doctor was not there. Therefore, she had first been sent to the UBC hospital in Muttru, an hour and a half away both by boat and by car. Then, due to the lack of a dedicated resource person, she was referred to the hospital in Serabo, another hour by car. When they arrived there, it was too late and the twins she was expecting died during the caesarian section. When I met her, I saw the fear of that woman and her husband, almost their resignation that they would also lose their next baby.

Seeing that, again, something was wrong, the husband urgently called the Red Cross operator, saying that his wife was about to give birth and needed help. The Red Cross operator called me on the private line because the husband could not get to the hospital directly and, in the end, we managed to send a boat to pick her up. She arrived at the hospital after a three-hour journey, we had already prepared the operating theatre and thirty minutes later mother and baby were fine! That is precisely why the outcome of this story means so much to me. It is an expression of CUAMM’s commitment in the field and carries a message of hope. We cannot save everyone, but even one makes a difference».

People and skills

«Let me recap my experience. I spent the last 4 years in Sierra Leone. This was my first long professional mission outside of my country. A different and challenging context and therefore an intense experience but always with a strong willingness to “get in the game” and learn. I started working in Bonthe as medical doctor focused on maternal and child health; then I moved to Pujehun and Freetown where I held a more advanced role with more responsibilities. I’ve definitely learnt and grown a lot and I want to thank CUAMM for this because it has always believed in me and invested in my training. Whenever I was faced with a complex situation or had doubts about how to manage it, I could always count on the support of doctor Enzo Pisani who was based in Freetown.

I’ve become an EmONC Advisor, an Emergency Obstetric and Newborn Care advisor, and I’ve trained 37 clinical mentors across the Country who are now mentoring 292 healthcare workers in the 16 districts of Sierra Leone on the seven “signal functions” as per WHO standard, seven key obstetric services that has been identified as critical to basic emergency obstetric and newborn care. It has been a capacity building pathway and I am proud of it.

Sierra Leone consistently ranks as one of the deadliest places on Earth to have a baby, particularly in some districts such as Bonthe, a remote island in the south of the Country. It can be reached by boat and during the rainy season it is all flooded with water and mud. Therefore, access to health services in this area, particularly to assisted deliveries, is very complex due to its location and the characteristics of the context. So personal life is not easy there: we were the only expats and my wife was the only one with white skin, besides the fact that we didn’t speak local languages. In Pujehun the accessibility to services is “easier”, however the maternal mortality rate is still very high. Several factors determine this:  firstly, the lack of qualified human resources and the few that do exist live in the biggest cities. Many health workers are volunteers, meaning that they do not receive a salary, or at least not regularly, and this severely undermines their motivation and their commitment to work. Moreover, mainly for cultural reasons, people in the villages tend to rely on traditional healers».

This is the meaning of CUAMM’s commitment to give mothers and children another chance.

© Photographs by Valeria Scrilatti

IN EASTERN EUROPE

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IN EASTERN EUROPE

With our heart in Africa, at the outbreak of a war on our doorstep, Doctors with Africa CUAMM has offered support to healthcare facilities in Ukraine by sending medicines, equipment and consumption material. In addition, food, essential goods and equipment to cope with the low temperatures were also delivered while psychological support was offered to the most vulnerable. These are CUAMM’s main levels of commitment which was later extended to Moldova, where medical personnel was sent to serve in two refugees shelters and Poland, where training activities were delivered in UNICEF “Blue Points”. A solidarity that involves many people and goes beyond borders.

 

IN UKRAINE

The war that broke out in February 2022 shows no sign of ceasing. Destruction, violence and atrocities are under everyone’s eyes every day. There are approximately 5 million displaced persons and 8 million refugees. Launched in Chernivtsi city, on the Romanian border where CUAMM collaborates with the local association VRB, the intervention has now been extended to 42 hospitals in 9 different Oblasts. The intervention consists in providing a broad logistic and healthcare support by distributing medicines, medical equipment and kits, food and essential goods, as well as tents, clothing and equipment to cope with the cold winter. In addition, throughout the intervention psychological support was offered to the population harshly hit. The Ukrainian healthcare system was also reinforced with the provision of 4 ambulances for the referral of patients to hospitals and mobile clinics. VRB volunteers, involved in material distribution to the most at-risk areas played a key role along with institutions and companies such as AICS, OCHA, UNICEF, UHF, Caritas, Veneto Region, Gilead and many citizens who offered their time to help the Ukrainian population.

 

IN MOLDOVA

Moldova is one of Europe’s poorest nations and struggles to give adequate response to the crisis of refugees fleeing Ukraine. CUAMM’s work, in accordance with the Ministry of Health and the WHO, focuses on 2 reception centers in Chisinau, the capital of Moldova, were over 300 refugees are accomodated. Thanks to doctors and nurses who alternate from Italy, basic health screenings are performed also in mobile clinics and drugs are distributed, especially to chronically ill patients.

 

IN POLAND

Of the 8 million Ukrainian refugees seeking asylum in European countries, more than 1.5 million were accomodated in Poland. In the cities of Warsaw, Krakow and Przemysl CUAMM has offered UNICEF volunteers working at the “Blue Points” some training activities. A total number of more than 100 operators took part in the activity focusing on psychological, healthcare and legal assistance.

 

IN ITALY, BY THE SIDE OF REFUGEES

As the war started, CUAMM offered support to young boys and girls housed in the Minor Seminary in Rubano, in collaboration with the Diocese of Padua. A group of CUAMM volunteers has also been active at the Immigration Office at the Police Headquarters in Padua where a increase in Ukrainian requests and accesses was registered after the Russian invasion. Throughout the year, about about 6.800 hours of volunteering were spent to respond to over 22.000 asylum requests.

 

Read the stories

EQUALIZE: A CALL TO ACTION AGAINST AIDS

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We must fight the inequalities that hold back progress in HIV prevention and treatment. This is the message, a strong call to action from the United Nations, on the occasion of World AIDS Day, which happens every first of December.

Doctors with Africa CUAMM is committed effectively to contributing to the fight against HIV infection, first of all by making testing accessible even in the last mile. Many activities have been organised during the two weeks, from 21 November to date, in some of CUAMM’s eight countries of intervention.

«In Tanzania – explains Chiara Didonè, project manager of programme on HIV financed by AICS, led by the University of Florence – in particular, in the district of Shinyanga, in synergy with local institutions, as is CUAMM’s practice, we have promoted three days of awareness-raising on HIV in the villages of Tinde, Ihalo and Didia. Each activity began by recalling that World AIDS Day is celebrated on 1 December, an opportunity to raise awareness about a problem that is still widespread. Since the target groups are heterogeneous – mothers, children, adolescents – we chose to focus on a few key messages for greater effectiveness: prevention, the importance of testing and treatment, and combating social stigma. In all three information campaigns the Tanzanian authorities participate, together with the representative of the “Konga group”, an association of HIV+ patients. On the day in Tinde 300 people took part, in Ihalo 150 and 170 were tested. Today in Didia we expect 300 more».

«I thank CUAMM – says a young villager from Ihalo – for coming so far to offer a very important service, such as HIV testing, to the entire population. The closest health facility is half an hour away by car and the road is not always easily accessible, especially during this period, the rainy season, so having the possibility to be tested at home is a salvation».

«Also in Mozambique, in the province of Tete – reports Laura Villosio, CUAMM doctor –  we participate in the World AIDS Day with various initiatives, together with the authorities of the country, the provincial service and civil society. This is an opportunity to address sexual health among adolescents, the target group of our activities. In Mozambique, according to 2017 estimates, there are five new infections per year per 1,000 inhabitants. In addition, 38 per cent of infections between 15 and 59 years of age fall in the 15-24 year old population. Therefore, many young people are HIV-positive and many children are born HIV-positive. Today, CUAMM in Tete takes part in a health fair where our activists, together with the technical team, promote information sessions and plays. Of course, everyone has the opportunity to be tested for HIV; we also offer an invitation to take the Covid-19 vaccine. Today’s Day was preceded by fifteen days of activism in remote villages, also on the topic of HIV».

CUAMM AND UNICEF SUPPORT REFUGEES POPULATIONS IN MOLDOVA

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Promotion of healthcare assistance for refugees and emergency preparedness among health workers are at the core of the intervention that aims to provide quality health sevices to vulnerable populations fleeing the Ukranian conflict in Moldova.

CUAMM Doctors with Africa in partnership with The United Nations Children’s Fund (UNICEF), launches a project in Chisinau, Moldova, to promote healthcare assistance for refugees and boost emergency preparedness among health workers in peripheral facilities hence strengthen the capacity at national level.

Refugee families, vulnerable groups and mothers and children fleeing the Ukranian conflict can now access safe and quality healthcare assistance in Chisinau where two health centres are being supported with provision of lifesaving drugs, essential supplies, consumables, PPEs and medical equipment. The centres also offer vulnerable groups access to multiple services such as informative sessions and distribution of informative materials on health and hygiene promotion plus specifically child-tailored materials, routine immunization, health checks on vaccination coverage and NCDs prevalence to vulnerable populations. The centres accommodate between 150 and 250 people (the number varies depending on the refugees’ movements), mostly of Roma ethnicity and/or from Azerbaijan or Armenia. These are women, men, children, and the elderly.

Lack of human resources and specialized professionals in peripheral facilities can undermine the response capacity putting people who seek healthcare services at risk. For this reason education is a key component of the intervention implemented by CUAMM in collaboration with UNICEF that encompasses a training programme in Emergency Preparedness with the ultimate goal of improving medical teams’ emergency response capabilities at all levels.

Following consultations with the Ministry of Health and in partnership with UNICEF, emergency preparedness trainings and assessment have been designed to foster health workers’ capabilities. A 20-hour training paths of mentors (key medical and non-medical staff) in Emergency Medical Services (EMS) in each of the three targeted hospitals will be offered to ensure adequate response in case of health-related disasters while in the same facilities trained mentors will deliver a 10-hour mentoring paths to 100 medical and non-medical staff under the supervision of CUAMM. Additionally, assessment of management and clinical gaps in emergency preparedness and disaster response in the 3 concerned hospitals, establishment of an emergency medicine consultative coordination body at the hospital level (in each of the 3 hospitals), and development of a training package for hospitals’ staff will be included.

This comprehensive training program seeks to achieve a multiplier effect both establishing and institutionalising mentoring as a model of continuing professional development and leading to a significant and sustained impact on emergency preparedness hence enabling the healthcare staff of the Institute of Mother and Child, the Emergency Hospital, and the Republican Hospital in Chisinau to effectively respond to the ongoing refugee crisis and address future emergencies.

Since the beginning of the war in Ukraine, Moldova have sheltered the largest number of refugees: 89.000 refugees have been registered in the country. Starting from April 2022, CUAMM has been operating in Chisinau – the capital of Moldova – where the team provided basic medical care to the Ukrainian population through Emergency Medical Teams. The assistance offered aims not only at ensuring continuity of treatment and follow-up to Ukrainian refugees, as well as preventing the deterioration of minor illnesses; but also preventing the already fragile Moldovan health structures from being overwhelmed by the influx of refugees.

 

 

 

 

 

 

 

FROM EMERGENCY TO RESILIENCE

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«Intervention continues in Ethiopia for displaced people, refugees and host communities in the Somali region, with a project financed by the Italian Agency for Development Cooperation, implemented by the International Committee for the Development of Peoples (CISP), in collaboration with Doctors with Africa CUAMM and Action Aid. CUAMM works, in particular, in the woredas of Aw-Bare, bordering Somalia, and Boklomayo, on the border with Kenya, where more than 10,000 IDPs and more than 120,000 refugees from Somalia are concentrated, living in five refugee camps.

Overall, the project is implemented in an area that is in a state of humanitarian crisis due to conflicts between ethnic groups and opposing forces that have led to the displacement of whole communities, compounded by frequent droughts, repeated flooding and the relentless spread of epidemics. In addition, with a weak health system poorly equipped with drugs and tools, the combination of these factors makes the vulnerability of host communities, displaced persons and refugees high.

In this context, where resources are scarce or inaccessible for many of the families, the lives of girls are continually endangered, in a strongly patriarchal society in which women are involved in domestic work, child-rearing, agricultural work and water supply, but have no power.

With the combination of humanitarian, environmental, epidemic and economic crises, girls and women are among the most vulnerable and CUAMM, through its intervention, decided to take action, providing support and tools to improve their sanitary conditions and protect them. In mid-November, the distribution of hygiene and sanitation kits began to 6,000 women, including 4,300 (70%) from displaced and refugee communities, and 1,700 (30%) from host communities.

The distribution reached women with disabilities, single mothers, pregnant and breastfeeding women, and was integrated during the information and awareness-raising campaign as part of the health education programme. The aim is that the women and girls involved will not only benefit from training in health, hygiene, prevention and reduction of disease transmission, but will also be provided with tools to start putting into practice the good habits suggested by community health workers and volunteers. The hygiene kit contains two bars of soap suitable for washing clothes, a bar of body soap and a washable and reusable cloth pad. CUAMM field team collected positive feedback from the beneficiaries, who received and appreciated the kit that will enable them to save some money they would otherwise have had to spend at the market where prices are constantly rising.

CUAMM’s commitment therefore aims to provide solutions and tools that will have a lasting impact over time, especially with activities concerning the implementation of awareness-raising campaigns on good hygiene practices for the prevention and recognition of Covid-19, the training of health workers in health centres and community workers. Finally, the provision of protective equipment, materials and drugs. The urgency of the context translates into the need to work at the community level on infection prevention, the adoption of healthy behaviour and the recognition of signs of illness, improving the training of health workers and encouraging people to go to health centres».