Doctors with Africa CUAMM Tanzania, together with the local partner organization TAHEA, hosted the annual consortia meeting of “Accelerating Stunting Reduction Programme” from the 29th to 31st of January. Among local and international partner organizations, UNICEF and Regional and District Nutrition officers participated in the meeting.
Stunting is the impaired growth and development that children experience from poor nutrition, repeated infection and inadequate psychosocial stimulation, as explained by the World Health Organization (WHO). Especially the first years of a child’s life, the first 1000 days from conception to the age of two, is a crucial period for timely intervention. “Accelerating Stunting Reduction Programme” aims to reduce stunting prevalence in the southern highlands regions of Tanzania: Iringa, Njombe, Mbeya and Songwe, where the needs are greatest among other regions of the country. With the coordination of UNICEF Tanzania, the programme has been implemented by three consortia, each one of them covering different regions; in particular, CUAMM and TAHEA are intervening in Iringa and Njombe.
As entering the 5th year of the programme, the final year, the main agenda of the meeting was to review the progress of handing over the activities to the respective local government bodies in order to ensure sustainability of the programme impact.
«The programme has gained its momentum. It is not only the partner organization who is leading the programme, but also the local government bodies have been deeply engaged, taking their ownership in nutrition issues. It has been a great team play» – claimed Ruth Nkurlu, UNICEF Southern regional programme coordinator, distinguishing the programme with other nutrition interventions around the country -. «Furthermore, because of the holistic approach of this programme implementation, meaningful behaviour changes are witnessed from the community level to the local government authorities».
Even though the programme is approaching its end, the need is still very high. The fight against malnutrition is not over yet. The Iringa Regional Nutrition officer appreciated CUAMM-TAHEA’s interventions in the region highlighting how it has strengthened the nutrition management system from the community level to the district and the regional level, sensitizing and empowering the local government authorities, which is the key to sustainability.
Sustainability cannot be achieved by working alone. Doctors with Africa CUAMM will continue its journey fighting against malnutrition alongside the local government and the local and international partners.
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Christian Blind Mission (CBM) Uganda in partnership with Doctors with Africa CUAMM have launched a new project for eye care in Northern Uganda: “Foreseeing Inclusion: Eye Health and Disability Inclusion in Northern Uganda”. This three years’ project, funded by the Italian Agency for Development Cooperation, will be implemented in three districts of Arua, Kitgum and Lamwo. The launch was officiated by Dr. Joyce Moriku Kaducu, the State Minister of Health-Primary Health Care, and the Italian Ambassador H.E Massimiliano Mazzanti, along with other local government and districts officials.
According to the Uganda national census 2014, Northern Uganda accounted for 32% of all individuals with visual impairment with 75% avoidable blindness. Poor coverage of basic and secondary level eye care services largely contributed to this. The situation worsened even more in 2017, due to the increase of South-Sudanese refugees and the consequent overcrowding of the existing eye health facilities. The project, in collaboration with the Ministry of Health, arose from the need of the communities in the 3 districts and aims at contributing to the reduction in the prevalence of avoidable blindness by 2021, in line with the 4th Eye Health Action Plan 2016-2020.
«Awareness raising activities and primary prevention on eye defects are essential and they should be the key pillars of the project – the Minister Hon. Joyce Moriku Kaducu emphasized –. I support the decision to implement the project into those districts where the burden is really high among the locals and the refugees from South Sudan».
Dr. Peter Lochoro, CUAMM’s Country Representative in Uganda, gave a highlight of the work of CUAMM in Uganda especially in West Nile for over 50years: «I am grateful to the Ministry of Health for giving CUAMM the platform for implementing our projects and the local governments for integrating our work for better service delivery». «West Nile region remains a priority for the Italian government and I hope this project is just the beginning of many other bigger projects supported by the Italian government» concludes the Italian Ambassador Massimiliano Mazzanti, highlighting CUAMM’s long-lasting intervention thanks also to the welcoming nature of the locals.
As of yesterday we are back in lockdown, most of us here in Italy once again living in a so-called “red zone”. The numbers of confirmed cases of COVID-19, intensive care unit admissions and deaths from the virus continue to rise. Schools have closed and families have been brought to their knees. There is much pain and fear, and pandemic fatigue is setting in. Worse, we no longer even have the energy to envision a better future.
But there is light at the end of the tunnel, and its name is vaccines. Availability is limited: we don’t have enough doses in Italy, and the situation is far worse in Africa. We need more, enough for everyone. This is why COVID-19 vaccine patents must be suspended, so that production can be ramped up. This must be done urgently if we want to prevent the development of new variants that could jeopardize all the progress made up until now. Yet unbelievably, not even during the World Trade Organization meeting last week was an agreement reached on waiving intellectual property rights for the vaccines. India and South Africa continue to press their case while the United States, United Kingdom and European Union Commission argue against it, despite numerous appeals – including one by the World Health Organization signed by CUAMM and many others – asking that these rights be suspended even just temporarily.
Despite all of this, vaccines have begun trickling into Africa thanks to the COVAX initiative and donations from China. While still too few given the size of the continent’s population, they are beginning to arrive – to Sierra Leone (100,000), Mozambique (200,000), Angola (600,000), South Sudan (700,000), Uganda (900,000) and Ethiopia (2,200,000).
CUAMM is now making available our on-the-ground human and logistical resources (personnel, pickups, motorbikes, refrigerators and so on) to local vaccination systems, but these systems are very fragile, and the needs are infinite. We need to do more, devoting every last bit of energy to strengthening logistics, personnel and communities, and providing tools and training; and all of this has to be done right away. That’s why we’ve launched our A Vaccine for Us All initiative, because when greater quantities of the vaccines finally arrive to Africa, distribution mechanisms are going to have to be ready to go and effective. We’ve already seen the challenges faced in Italy; just imagine the situation in the vulnerable countries where CUAMM maintains a presence. They need our hard work and support, and we need everyone’s help in order to provide it. The challenge is daunting, and will require both hearts and minds, but we won’t back down. We need to transform vaccines into actual “shots in the arm”, starting with our local doctors and nurses, who are at especially high risk of infection, and then moving on to everyone else. From Mozambique, where the number of cases is soaring because of the country’s proximity to South Africa, our own Giovanni Putoto puts it in a nutshell, reminding us how “Alongside the appeals, there is so much concrete work that needs to get done”. As always, CUAMM is on the ground ready to do its part, side by side with our local partners.
Thank you for joining us in the enormous challenge called A Vaccine for Us All. Only by working together will we be able to save ourselves from this pandemic.
Papà, Dad, Père, Pai, Baba, Embo, Fa, Abba, Aabe, Aabba, Abo. These are just some of the words used to call dads in Africa.
Fathers are often marginal figures in this continent, as parental responsibilities are mainly a duty of women. Anyhow, their active role in the family is essential for the health of children. Singi is Richard’s father and is an example of how the involvement of fathers in the family can make a difference.
Singi and his family live in the Simiyu region, Tanzania. The case of little Richard was reported by community health workers during a home visit in which they noticed that the child was very weak, unable to walk and under-weight. They suggested to bring him to the nearest dispensary in order to start a treatment for malnutrition.
The father immediately took charge of the situation and took him to the dispensary.
“After only two weeks Richard started gaining weight, walking and eating on his own and after four weeks he was discharged. I kept following the advices I received from the health workers and once at home we tried to provide our son with a balanced diet” says Singi.
Singi participated in the cooking demonstrations to understand how to use the food he could afford in order to support his son’s growth and development.
“I am very happy and grateful to the health community workers for giving me the opportunity to take care of my child to the fullest. Now I am committed to sharing my experience with the community and above all to the other fathers because I want to encourage them to be attentive to the health of their children”.
On Father’s Day we want to remember the many fathers we meet every day on our work in Africa; doctors, nurses, community workers and drivers who work in our projects, but our thought also goes to all the fathers of the children we meet in the hospitals and health centers we support.
«I was 16 years old when I had my first child. Now, I am 22 and I have been pregnant three times. Two of my children died of malnutrition, before they reached the age of one. I gave birth to my first two children at home only receiving one antenatal care visit and not receiving assistance after my delivery. Things finally changed when I was pregnant with my third child, because I received a free transport voucher that enabled me to deliver my baby at the nearest health facility, Ariba HC II. As soon as I went into labour, I called boda boda (motorbike) that took me to the health centre and I gave birth to my baby that night. The health personnel took care of us and ensured due vaccinations for my baby. A health worker gave me advice on family planning and how to take care of my child at best».
Jiuliet Tino lives in Oyam district, Uganda and is one of the women who over the last year has benefited from the free transport voucher scheme promoted by Doctors with Africa CUAMM within the project “Mothers and Children First. 1,000 Days” and thanks to the support of the Symphasis Foundation. As many other in the region, her family lives with very little money: that is why her children have suffered of malnutrition but she could never afford health care.
In Uganda, many women face the same challenges as Juliet. In particular, Oyam District, located in a rural post-conflict region in the northern part of Uganda, has one of the highest maternal mortality rate. More than a half of the population live below the poverty line and still the high majority of pregnant women receive only one over the four antenatal care visits (ANCs) recommended by WHO, as well as less than a half of them use institutional delivery services. Affordable transport and long distances to the nearest health facility are key obstacles in accessing maternal and new-born services for poor women in Oyam district. Motorized vehicles (boda bodas, cars) serve most communities but the cost of transport challenges care access and assistance.
For this reason, the purpose of CUAMM’s project in Oyam “Mothers and Children First. 1,000 Days”, thanks also to the support of Symphasis Foundation, working with the district Health Management Team (DHMT), is to improve both access to the health system and quality of maternal and newborn health services. CUAMM successfully contributed to promote incentives mechanisms in the community, such as a free transport voucher system and motorbike ambulances. «Voucher scheme is a really fundamental tool – Susan Achan, a midwife in Ariba HC II, adds –. It leads to increase the number of safe deliveries, providing village health teams with the opportunity to share health messages and additional services to mothers and babies».
Just like Juliet, Brenda Akot is another one of the many women who benefited from this effective service, and today she is happy with her child.
«CUAMM saved me and my baby’s life. Do not stop your work here. Look out for more mothers like me and help them. We know that when a mother dies, her children are less likely to survive We want a Uganda where no mother dies because she cannot afford the transport to reach the health facility. We want a Uganda where every woman has the right to a safe and assisted delivery».
All these women’s words demonstrate how transport voucher scheme has played a critical role in accessing safe and quality maternal and child healthcare.
As the number of cases of COVID-19 rises again in Lombardy and in Italy in general, the hospital of Carate Brianza is prepared to face a new wave of the epidemic. Doctors with Africa CUAMM has provided the health facility with new equipment to ensure the safety of health workers and people accessing the hospital through the emergency room: over 25,000 patients only in 2020. The donation has been funded by the U.S. Government through the United States Agency for International Development (USAID) in the framework of CUAMM’s project “Italian Response to Covid-19” (IRC-19).
Last January, eight gazebos were provided, to be used as frontline reception spaces, allowing health staff to screen suspected cases of COVID-19 outside the hospital, improving the flow of the patients and avoiding overcrowding in the facility. Also eleven new stretchers have been made available since November 2020, while screens have been ensuring more privacy and smarter use of the spaces. Thirty dispensers of hand sanitizer have been distributed around the hospital, to guarantee high standards of hygiene.
Today Doctors with Africa CUAMM officially delivered the new equipment to the management of the hospital. Marco Trivelli, General Director of ASST Brianza, attended to the ceremony, together with Ezio Goggi, Medical Director of the area, Davide Moro, doctor from the hospital of Carate Brianza, and Andrea Atzori and Veronica Censi from Doctors with Africa CUAMM.
Marco Trivelli, General Director from ASST Brianza, stated, “We thank Doctors with Africa Cuamm for their support to the hospital of Carate Brianza, especially over the last two years. Their contribution is particularly important today, as our health system is under pressure for a new emergency, considering the frightening increase of cases of COVID-19. Today I would like to acknowledge the work of Davide Moro in strengthening the collaboration between our hospital and Doctors with Africa CUAMM, and the commitment of our anaesthetist Mauro Brighenti in several missions of Doctors with Africa CUAMM.”
Andrea Atzori, Chief of Party of Doctors with Africa CUAMM’s IRC-19, stated, “Our project aims to create more resilient healthcare facilities and communities and to provide training for health workers broadly across Italy. As CUAMM we already supported the Hospital of Carate Brianza last year, during the first peak of the pandemic, providing PPE and a ventilator. We wanted to share the know-how developed in many years of work in epidemics in Africa: our experience in the field shows that to be sustainable, each intervention has to be developed in accordance with local counterparts. Even this time we are responding to specific requests coming from the hospital and we are glad to help them thanks to the U.S. Government, which through USAID is supporting a number of initiatives in Italy, aiming at reducing the impact of the COVID-19 epidemic.”
USAID, which funds IRC19, is the U.S. Government’s premiere development organization operating in more than 100 countries worldwide.
This press release is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of Doctors with Africa CUAMM, recipient of the Fixed Amount Award (FAA) No. 7200AA20FA00013 and do not necessarily reflect the views of USAID or the United States Government.
Doctors with Africa CUAMM is starting an intervention in Tigray, Ethiopia in the coming weeks. Thanks to funds allocated by the CEI, through Caritas Italiana, and in partnership with the Ethiopian Catholic Church, the intervention will focus on the area between Adigrat and Makellè, the region’s main cities, and will support three health centers, managed by different religious congregations, severely damaged or destroyed in the conflict that started last November 4th.
These centers are the Idaga Hamus center, not far from Adigrat, almost entirely destroyed in the conflict, and the health centers of Shire and Alitena, in the central area near Adua. There is a shortage of life-saving drugs, health aids, equipment, clean water, and electricity.
CUAMM will also supply medicines and medical materials to the Ayder government hospital in Makellé, which has also been severely impacted. Along with repairing the centers, the health personnel also has to be motivated to return to providing care and relief to the people.
“An estimated 5 million people are in need of food. That is about 70% of a total of 7 million people (the population of Tigray),” says Riccardo Buson, CUAMM’s representative in Ethiopia. “The health system is almost completely decimated. An unknown number of health centers have been looted and health workers, not having been paid, have left their jobs. WHO estimates that only 22% of health facilities are functioning. The people need everything, but food and health care first and foremost. The area in which we will be working for about the next 9 months extends from Adigrat to the north to Makellè to the south. The entire area is still extremely unstable. Up until now, no one could come in and communications were blocked. Some signs of improvement have been seen in recent days, and since February 26, humanitarian flights have also reopened to reach the two cities.”
The director of CUAMM Don Dante Carraro explains the choice to act here: “The situation in Tigray is very bad. According to the little information that makes it to us, people are desperate and fleeing because they are afraid of massacres and violence. They are leaving their homes and hiding from the rebels, with no clean water or food for days. ‘It’s a cry for an urgent humanitarian emergency’: these are the heartfelt words of the bishop of Adigrat, Msgr. Tesfaselassie Medhin. How can we remain indifferent in the face of such a dire request, in the face of such extreme need? When the bishop asked us to intervene and told us about the situation, we decided that something had to be done. We have been active in Ethiopia since 1980 aiming to help develop the health system. We are currently in Gambella, in the west, in Wolisso, in the center, not far from Addis, and in South Omo, in the south. For 10 years we have also worked in Adigrat, in a center for the disabled. At CUAMM, we do not retreat in the face of emergencies. We roll up our sleeves and try to find solutions, to offer practical answers, starting with small but essential actions such as rebuilding a health center and supplying lacking medicine.”
Since November 4, a conflict sparing no one has struck Tigray, in northern Ethiopia. There have been massacres, violence, ethnic cleansing, hundreds of faithful and pilgrims killed, and temples and monasteries destroyed, as recently confirmed by Amnesty International. There are at least 222,413 internally displaced persons in the Tigray region and 63,600 internally displaced persons in the neighboring regions of Amhara and Afar. According to the UNCHR, as of January 12, 2021, approximately 57,500 people have crossed the border into Sudan, mainly from Tigray. Ethiopia has a population of over 109 million and 80 ethnic groups. In Tigray, a northern region similar in size to Italy’s Lombardy and Piedmont together, there are 7 million people, mostly Tigrayans, 6% of the entire Ethiopian population. When Prime Minister Abiy, of Oromo ethnicity, came to power in 2018, relations between Tigers and the rest of the country became strained, leading to conflict and civil war.
In addition to the new front in Tigray, CUAMM continues to work in the rest of the country, especially trying to stem the spread of Covid 19 as much as possible. Doctors with Africa CUAMM recently launched the campaign, “A vaccine for us!”
Women are central to Doctors with Africa CUAMM’s commitment to health, and they are also on the front lines of acting for change. Women are 55% of the expatriate human resources of Doctors with Africa CUAMM; European and African professional women are working at the forefront in the fight against maternal mortality, as well as against malnutrition, HIV, and non-communicable diseases. They manage projects, mediate with local authorities, decide how to use funds, and often are balancing work and raising children as well.
For Women’s Day, Doctors with Africa CUAMM is spotlighting two stories from the field: Inocencia Fumo, a Mozambican doctor, and Martha Nyabel, a South Sudanese project manager.
“If we study, we can be what we want”
Inocencia Fumo is 36 years old, comes from Nampula, in the north of Mozambique, but has lived in Beira for sixteen years, where she was able to study medicine thanks to a scholarship. She says that being a woman helped her get the scholarship, but then as a young doctor she had to deal with the distrust of some patients, especially older men, who were not used to being treated by a young woman doctor. Years and experience solved this problem. Now she has three daughters and works with Doctors with Africa CUAMM managing a project to fight diabetes and hypertension. She sees education as the key:
“I always tell my three daughters that the important thing is that they go to school: everything starts from there. If we are educated, we women can go where we want, do and be what we want. When they don’t feel like going to school, I show them that I go to work even when I don’t feel like it, because now I’m doing what I studied for, what I’ve always wanted to do. I’d like them to become strong women, with positive attitudes, who are not afraid to follow their dreams and not afraid to fall down. Because by falling down we can get up again and keep going. It was my father who first encouraged me to study. There weren’t many fathers who thought like him, but I was the first in the family to graduate, and then he graduated too and now he’s a lawyer, and my mother, who studied mathematics, also graduated.”
“My personal success”
Martha Nyabel, a South Sudanese woman from the state of Jonglei, worked for three years in Nyal, an extremely rural area of South Sudan, where Doctors with Africa CUAMM implemented an emergency project for refugees fleeing conflict and hunger. She has dedicated herself to bringing health services to the furthest outposts, succeeding in building an emergency operating room and coordinating several mobile clinics. Patience and perseverance are her key qualities, as she says:
“This project has improved the lives of many people. It is a true joy for the community and for me too. I experience it as a personal success. These were three intense years: the first year was really extreme. Sometimes I found myself thinking, “What the hell am I doing here?” and also “Be patient, wait.” Now I can see all these smiles on people’s faces because of our efforts. I worked hard to complete this project, so now I’m happy!”
Aaditya Sharma Dalooa is 29 years old, speaks 6 languages, and comes from Mauritius. He is a cultural mediator for the Municipality of Bari, in Puglia, and for the Casa Cultura Association. He meets with immigrants in Puglia, laborers who live in the informal settlements, and he helps them get oriented in the labyrinth of Italian bureaucracy. He translates documents for them, gives advice on how to apply for a residence permit or how to keep in order all the papers needed for all the different procedures.
“I came to Italy with my family in 2009. My mom, my dad, and my brother,” says Aaditya. We chose Italy to build a future, to give us a chance at a dignified life. And we found it. I already had a science diploma, but it wasn’t recognized here in Italy as a course of study, so I had to go to high school for three years. Then I enrolled in university and I still have two exams to do plus a thesis to graduate in Literature and European Union Law. In the meantime, I took courses to become a cultural mediator, which let me find a part-time job, thanks to CUAMM as well.”
The informal settlements in Foggia are one of the saddest parts of the situation in Italy. Immigrants, mostly men from Africa, live in very precarious, often degrading conditions. They work under the table in the fields, picking tomatoes, asparagus, olives, and grapes. From 4:00 in the morning to 5:00 in the evening for €2.50 per hour. They have no rights, no recognition because if you have no fixed residence, you can’t ask for an ID, which takes 9–10 months anyhow. With an expired residence permit, the only chance to make money is working under the table.
Aaditya goes with the Doctors with Africa CUAMM Bari camper-clinic every time it visits the eight settlements of Casa Sankara and Arena in the Province of San Severo, where about 650 people live, as well as to the farmhouses of Borgo Cicerone (San Marco in Lamis) and Pozzo Terraneo (Cerignola). These are very isolated properties, where around a hundred immigrants find shelter, mostly men from Africa, from Senegal, Gambia, Burkina Faso, and Nigeria.
Aaditya explains, “These are buildings far from everything, without water, electricity, or windows. Nobody comes here, no services, no ambulances if someone is sick. There is not even a way to get to a supermarket. Thanks to CUAMM and to the IRC-19 project, food kits adequate for 1 month are distributed. Every time we bring the kits, I am moved to see how these people can hardly wait to get the package in their hands to open it and be able to eat. And so when they hear that the camper with the doctors is coming for the visits, they greet them as ‘saviors.'”
This is all made possible through the indispensable role of the cultural mediator who helps doctors communicate with immigrants and helps them overcome their natural fear and mistrust to let themselves be checked and helped.
“I like this work very much. Thanks to the CUAMM team that works so hard to help these people who no one thinks about, and thanks to the support of USAID, we are really making a difference for these people.”
From the start of the project through January, 2,200 food kits, or 33,300 meals, were distributed.
This story is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility of Doctors with Africa CUAMM, recipient of the Fixed Amount Award (FAA) No. 7200AA20FA00013 and do not necessarily reflect the views of USAID or the United States Government.
