Refugees in Africa: those who stay, those who heal

While borders and barriers become stronger and stronger across Europe, in 2024, 73% of the world’s refugees found shelter in low- and middle-income countries.

Data are reported in the latest UNHCR report, published ahead of World Refugee Day to shed a light on the lives of people forced to flee.

Uganda is currently among the top hosting countries in Africa. With 1.8 million refugees, it ranks fifth globally and first in Africa. In Uganda’s West Nile region, most refugees come from South Sudan, Sudan, and the Democratic Republic of Congo.

“Conflicts are increasing, and people keep arriving in desperate, emergency conditions,” says Joseph Katetemera, CUAMM Project Manager in West Nile. “Uganda keeps its doors open, even though funding is rapidly declining. To date, overcrowding in camps is a serious issue, and USAID cuts have led to severe underfunding. People must rely solely on their own resilience to survive.”

CUAMM has been working to support refugees in the region since 2022, with the most recent project running through March 2025. The focus has been on providing primary health services, emergency obstetric care, and psychosocial support.

Over the last year alone: 2,777 women gave birth safely, over 14,500 people received care during 100 outreach sessions in villages, 1,042 patients accessed life-saving medications. Special attention was given to people with disabilities, with the construction of accessible latrines, provision of hygiene kits, and inclusive training sessions.

“One of the key achievements, I believe, is that we were able to perform more than 2,000 surgeries on refugees, including over 600 people blinded by cataracts,” says Katetemera. “The story that stays with me most is that of Atizuyo Gladys, a woman who had been blind for eighteen years. Because of her condition, she had lost everything—even the small shop she once ran to support herself. She was ostracized by the community, who believed she had been cursed. Only her family and husband stayed with her. I’ll never forget the day she regained her sight after the surgery: it was the day she saw her children’s faces for the very first time. She even reopened her small business, thanks to a fundraising effort organized in her support.”

Stories like that of Atizuyo give hope in a country where the situation remains critical and the strain is starting to show. And the pressure isn’t limited to Uganda— it also threatens countries like Ethiopia. In Gambella region, near the border with South Sudan, the crisis is deepening. The region currently hosts five refugee camps with over 375,000 South Sudanese, with an additional 50,000 arrivals due to the escalating conflict.

“The situation is truly dire: we’re trying to expand the camps because there’s simply no more space,” explains Daniel Frehun, CUAMM Area Manager in Gambella.

The camps are located in remote areas, often far from water sources and services. Yet CUAMM remains committed. Active in Gambella since 2018, CUAMM currently provides full healthcare services at two health posts in the Ngunyyiel camp and collaborates with community structures in three additional camps.

Activities include: health promotion, preventive care (vaccinations, nutritional screening), treatment, with special attention to women and children. A key initiative is the “tea talks”—informal gatherings led by community health workers, many of whom are refugees themselves, to raise awareness among women of reproductive age.

“These are moments when concerns surface, challenges are shared, and trust is built,” says Daniel.

In a context plagued by recurrent health emergencies—from cholera to the recent Mpox outbreak—the presence of trained personnel and consistent commitment becomes vital.

“Many partners are leaving, but we are staying. Even with fewer resources, we continue working side by side with the community.”

He closes with a message that goes beyond statistics:

“What has struck me most in these four years alongside refugees is their resilience and sense of humanity. I’ve witnessed profound suffering, caused by poverty and repeated health emergencies. Yet they’ve never stopped showing strength, gratitude, and hope. One mother in the Ngunyyiel camp even named her son after ‘CUAMM’, in gratitude for the care she received during her pregnancy.”

 

“Refugees are not just victims. They are mothers, fathers, and children who once lived in peace and still dream. Today, they continue to support their communities with dignity. We see them, we listen to them, and we walk alongside them.”

CUAMM meets CAR President in Bangui

A visit to the Central African Republic to closely follow the constant, daily, and dedicated work of CUAMM teams on the ground. This was the goal of the visit paid by Director General Father Dante Carraro to Bangui, where efforts continue in support of the Pediatric Complex—the only pediatric hospital in the country—and the project to build a midwifery school in Bossangoa.

The mission also became an opportunity for a special meeting:  Father Dante Carraro together with Ambassador Filippo Scamacca del Murgo and CUAMM Country Representative – Marina Panarese were received for the first time yesterday at La Renaissance, the presidential palace by the President of the Central African Republic, Faustin-Archange Touadéra. An institutional visit aimed at strengthening cooperation efforts in the country, and at highlighting and appreciating CUAMM’s commitment to maternal and child health and education.

Among the topics discussed were: the strong involvement of Italian Cooperation in the country’s development; the collaboration between CUAMM and the Ministry of Health; and the results that this synergy is producing.

“Italian Cooperation’s support in the health sector is essential, and the work of organizations like CUAMM proves it,” said Ambassador Filippo Scamacca del Murgo. “The results are already visible in terms of improved health infrastructure, reduced child mortality, and the provision of free, quality care for children and their families.”

The President also mentioned the new, major challenge launched by the Minister of Health, Pierre Somsé, and taken on by CUAMM last year: the construction of a midwifery school in Bossangoa—the first in the country to offer training opportunities outside the capital.

“The school is the result of a long-standing collaboration with the Ministry of Health and reflects our way of working with Africa. We started by supporting the Pediatric Complex in Bangui, then moved to the smaller hospital in Bossangoa, and now—thanks to the results achieved—we are ready for this new challenge, strongly supported by Minister Pierre Somsé, who also participated in our Annual Meeting last year in Turin,” said Father Dante Carraro.

Through the midwifery school construction project, CUAMM’s commitment in the country takes a step forward—making education a tool to accelerate development, improve health indicators, and offer growth opportunities to the many young people who can and want to be part of this change.

“We are grateful to Italy and CUAMM for their support to our country. Investing in education is a priority for the development of the Central African Republic, and we are confident this school will be a crucial starting point,” said President Faustin-Archange Touadéra, who expressed his full agreement in renewing the cooperation efforts between the countries.

 

Sickle Cell Disease a forgotten NCD

Every year on June 19, the global community observes World Sickle Cell Disease Day—a vital opportunity to raise awareness of one of the most widespread yet often overlooked genetic blood disorders. Established by the United Nations in 2008, this day calls attention to the daily challenges faced by people living with sickle cell disease (SCD) and other haemoglobin disorders, emphasizes the importance of early diagnosis and quality care, and advocates for the implementation of effective prevention strategies.

Sickle Cell Diseases (SCD) is considered a non-communicable disease (NCD) along with the so called “Big Five”: cardiovascular diseases (including high blood pressure), cancer, lung diseases, diabetes, and mental health conditions. Such diseases are chronic conditions that are not spread from person to person and represent a growing public health concern in the African region.

In Sierra Leone NCDs contribute significantly to morbidity and mortality. Limited diagnostic and treatment facilities make early detection and effective management difficult. Many cases remain undiagnosed or mismanaged due to lack of awareness and healthcare resources. For that reason, CUAMM is actively engaged in Pujehun district through the PEN-Plus project. PEN-Plus is an integrated care delivery strategy focused on increasing the accessibility and quality of chronic care services for severe NCDs. Since 2023, CUAMM is supporting the General Hospital—the district’s main hospital—in providing free consultations and care for chronic patients in one of the 2 NCDs Clinics of Sierra Leone.

In this framework, CUAMM is committed to providing multidimensional support, which include, in addition to patient treatment, continuous training of hospital staff and supporting the government in integrating NCDs procedures into national policies. As well as that, the organization is active at the community level throughout the District to raise awareness and spread knowledge on NCDs.

Two years after the start of activities, the clinic registers over 1,000 enrolled patients who receive regular, specialized care and periodic follow-ups, ensuring them a better quality of life. More than half of these patients are being treated for hypertension and Sickle Cell Disease.

Sickle Cell Disease, a genetic blood disorder that causes chronic pain, organ damage, and frequent hospitalizations, is particularly widespread due to the high carrier rate in the population.

Blood disorders, also known as haemoglobin disorders are inherited blood diseases that affect how oxygen is carried throughout the body. These disorders fall mainly into two categories: sickle-cell disease and thalassaemia. Globally, approximately 5% of the population carries trait genes for haemoglobin disorders. Each year, over 300,000 babies are born with severe forms of these diseases. Although inherited from two generally healthy parents, these conditions can have serious health consequences.

Managing and Preventing the Burden

While the burden of haemoglobin disorders is significant, it can be effectively reduced through integrated management and prevention programmes. Disease management includes early diagnosis, regular monitoring, and comprehensive care. However, the most cost-effective approach combines treatment with prevention strategies, such as: carrier screening, genetic counselling and prenatal screening.

CUAMM’s Commitment in Pujehun

To mark this year’s World Sickle Cell Disease Day, CUAMM led a series of public awareness initiatives in Sierra Leone’s Pujehun district, where access to reliable health information is often limited. These included:

  • Two radio talk shows, broadcast via community radio—an essential communication channel in rural areas—focusing on early detection, care options, and social support.
  • An educational session at Pujehun Secondary School, empowering students with basic knowledge about symptoms, prevention, and the importance of seeking care.
  • A street theatre performance in the central market, using local storytelling and drama to spread messages of awareness, empathy, and inclusion.

These activities highlight CUAMM’s ongoing commitment to supporting communities affected by sickle cell disease and promoting informed choices for healthier futures.

Blood bank as a lifeline in Karamoja

In a region historically plagued by severe blood shortages and high maternal and child mortality, a remarkable transformation is underway. Since the establishment of the Moroto Blood Bank in September 2022 the Karamoja subregion is witnessing tangible improvements in healthcare delivery—especially in emergency care and maternal health. The service was established by Doctors with Africa CUAMM with support from the Embassy of Ireland in Uganda (IrishAid) and serves as collection, storage, and sistribution centre in the region.

This facility, the first of its kind in Karamoja, has revolutionized blood transfusion services by dramatically reducing the distance and time required to obtain life-saving blood.

“Before the opening of the blood bank in Moroto, the hospitals in Karamoja relied on blood from Mbale (300 km away) and Nakasero (500 km), with delivery delays of up to five days. These delays often resulted in preventable deaths, particularly among mothers and children” said Dr. Lilly Achayo Boxtell – CUAMM Project Manager.

Thanks to the Moroto centre, which now serves nine transfusion sites across nine districts, blood is more accessible for Karamoja’s 1.4 million residents. Blood collection numbers have risen significantly—from 8,063 units in the first project phase (Nov 2021–Oct 2023) to 11,439 units in the ongoing second phase (Nov 2024–May 2025), with efforts still ongoing.

Results are being collected in terms of improved health outcomes. Maternal deaths in the region have dropped from 28 at baseline to 12 by October 2023. Nationally, Uganda’s Maternal Mortality Ratio has declined from 336 to 189 per 100,000 live births between 2016 and 2022, according to the Uganda Demographic and Health Survey. The under-five mortality rate in Karamoja has also decreased from 102 to 56 per 1,000 live births, in part due to the availability of safe blood for children suffering from severe malaria and anemia.

To ensure blood continues reaching those in need, Doctors with Africa CUAMM, together with the Ministry of Health Uganda, Uganda Blood Transfusion Services (UBTS), Moroto Regional Referral Hospital, district local governments, and local communities, have implemented a comprehensive strategy:

  • Community engagement through radio shows, community dialogues, educational dramas, donor testimonials, and information campaigns.
  • Mobile blood drives in public places like markets, schools, barracks, offices, and on occasion of cultural events like the Karamoja Cultural Gala.
  • Capacity building for healthcare workers through training, mentorship, and technical support.
  • Infrastructure development, including equipment procurement and installation at Moroto and the supported transfusion sites.

However, challenges remain: Karamoja’s cultural conservatism and sparse population contribute to low blood donation rates, especially among those unfamiliar with the practice. Addressing this requires ongoing community sensitization and storytelling, highlighting real-life success stories and the power of donation to save lives.

“Blood donation in Karamoja is more than a medical act—it’s an act of solidarity. Every unit collected is a life preserved,” said Dr. Lilly Achayo Boxtell.

As this vital work continues, CUAMM remains committed to ensuring no mother or child dies for lack of blood, standing with the people of Karamoja to strengthen the region’s health system, one drop at a time.

Tender for supply of medical drugs, consumables, and equipment

Doctors with Africa CUAMM, under the project titled “Promoting protection and access to health and nutrition services for internally displaced people and vulnerable communities in emergency situations (AID 07/12282/ETH),” is launching a flexible, simplified procedure to select a supplier of medical drugs, consumables, and equipment.

01 Invitation form

02 Contract Notice

03 Instructions to Bidders 

Annex I – Tender Form

Annex II & III – Technical Specifications technical offer_HFs & mobile clinic 

Annex IV – Financial offer 

Annex V – Administrative Compliance Grid 

Annex VI – Evaluation Grid

Annex VII – Contract Form 

Annex VIII – Special Conditions

Annex IX – General Conditions 

Annex X – Checklist  

Accelerate 2050 sharing experiences to drive impact

Accelerate 2050 is a global conference that brings together institutional leaders, international organizations, UN agencies, companies, foundations, think tanks, universities, and civil society representatives from all over the world to create and nurture a dialogue on major global challenges, particularly in view of the 2030 Agenda and the Sustainable Development Goals (SDGs).

This year the event was held in Brindisi, Apulia and we had the opportunity to participate in it. As an international NGO committed to protecting and promoting access to healthcare in Sub-Saharan Africa, we have been invited to contribute to the panel dedicated to international cooperation under the theme “Early-stage climate & health ventures: war stories from founders & investors”. Together with fellow speakers Brian Fairhurst – Anthropogenic and Paul Sebastien – African Carbon Solutions, Andrea Atzori – Head of International Relations shared both our experience and expertise by underlining the intersection that exists between climate and health.

The WHO estimates that climate change will cause 250,000 additional deaths per year between 2030 and 2050, mostly from malnutrition, malaria, diarrhea, and heat stress.

As Doctors with Africa CUAMM we see firsthand the trend especially in the most vulnerable settings where children and pregnant women bear the highest burnt. To better respond to their health needs, we work in collaboration with health authorities, from first to third level ensuring the continuity of care. In addition, we also intervene at community level by promoting a bunch of activities including: training and sensitization on nutrition, WASH and IPC, community engagement, screening, data collection and monitoring.

«In the current global scenario, climate change is not only an environmental issue — it’s a social and economic disruptor that deepens poverty, forces migration, weakens food and water security, and undermines mental and physical health mainly affecting women and children – claimed Andrea Atzori. – These challenges are complex, interconnected, and cross-sectoral that’s why as CUAMM we are committed to adopting a integrated approach to address the issue».

The Clean Cooking program, discussed during the panel is indeed a model of such approach as it stands right at the intersection of health, climate, gender equity, and sustainable development. Designed to be scalable, sustainable, and adaptable to local contexts, the program is an effective tools to monitor communities’ habits and health status  therefore implement adequate strategies.

Ukraine No truce

Three years ago, we launched an intervention in the country with the twofold objective of providing support to the civilian population affected by the conflict and equipping healthcare facilities in need with consumables, equipment and emergency kits needed to ensure care—particularly in areas closest to the front line.

It is precisely the medical logistics activity to have distinguished CUAMM’s intervention in the country from the beginning. Based on the Health Request Planning and Response Tool developed by the WHO, this activity, in line with Strategic Objective 113 of the 2023 Ukraine Humanitarian Response Plan (HRP) and Health Cluster Objective 114, also contributed to the cluster’s core activity: “Procure, prepare, and distribute essential medicines, medical equipment, and consumables to healthcare facilities.”

“The greatest needs have always been surgical instruments and emergency kits, especially for facilities located right on or near the front line. Sutures, needles, forceps, surgical scissors—as well as trauma management and care tools like neck collars, spinal boards, and evacuation stretchers—are the most requested supplies,” said Francesco Belotti, CUAMM Project Manager in Ukraine.

Among the most at-risk facilities are those in the Donetsk region, which a few months ago, as the front line advanced, were ordered to evacuate.

“These were two healthcare facilities that suddenly found themselves just a few kilometers from the fighting. The entire area was evacuated, and healthcare staff were relocated elsewhere. As a result, the nearest remaining healthcare posts became reference points without the real capacity to manage care. That’s exactly where we redirected our distribution” claimed Francesco Belotti.

The Donetsk region, together with the Kherson and Sumy regions, is among the hardest hit by the most recent attacks. Last week according to local authorities, 45 civilians were reportedly killed.
Meanwhile, 500 people were evacuated from areas near the front line in the Donetsk and Sumy regions, where homes, schools, hospitals, and infrastructure were also damaged or partially destroyed.

Today, as the conflict shows no signs of ending, on the contrary it becomes more intense in the Dnipropetrovsk region, the need to ensure access to care and assistance remains, as noted by Andrea Atzori, CUAMM Head of International Relations.

“Medical logistics has been at the heart of CUAMM’s work in Ukraine for three years now. Today, giving continuity to the intervention is important in order to ensure the functioning of health facilities in distress, provide health services to the population and facilitate the reconstruction phase,” said Andrea Atzori – Head of International Relations of CUAMM.

Since first medical logistics operations, started in July 2024 and recently completed, we have involved eleven healthcare facilities located in Dnipropetrovska and Donetska oblasts, reaching a target population of 30,400 people.
The medical logistics activity is part of the SAFE-UKR project: Support and Assistance for Families in Emergency in Ukraine, which is part of a €46.5 million initiative funded by the Italian Agency for Development Cooperation (AICS) that reaches over 900,000 people affected by the Ukrainian crisis.

 

Invitation for the provision of Engineering consulting service

The NGO Doctors with Africa CUAMM, with its projects implementated in different regions of Ethiopia, is lunching a simplified procedure for the privention of engineering consulting service.
01 Invitation form
02 Contract Notice
03 Instructions to Bidder
ANNEX I – Tender Form
ANNEX Ia – Declaration of Honour
Annex II & III – Technical Specifications technical offer
ANNEX IV – Legal Identity form
Annex IX – Contract Form
Annex X – Special Conditions
Annex XI – General Conditions for Service Contracts

 

Supply of Dignity kit

Doctors with Africa CUAMM, under the project “Promoting protection and access to health and nutrition services for internally displaced people and vulnerable communities in emergency situations – AID 07/12282/ETH” is launching the  simplified procedure to select an eligible supplier of Dignity Kit.

01 Invitation form 

02 Contract notice

03 Instructions to bidders

Annex I – Tender Form

Annex Ia – Declaration of Honour 

Annex II & III – Technical Specifications technical offer 

Annex IV – Legal Identity form

Annex V – Financial Identification

Annex VI – Financial offer

Annex VII – Administrative Compliance Grid

Annex VIII – Evaluation Grid    

Annex IX – Contract Form 

Annex X – Special Conditions 

Annex XI – General Conditions for Service Contracts

Annex XII – Checklist 

Diagnosis, treatments, resources tools that save lives

Bethel is a two-year-old boy whose story is told by Alessio Tabuso – an Italian resident in Bangui, Central African Republic. We hear from him on a Friday during a short break he manages to carve out. It’s a special day at the Paediatric Hospital – CHUPB as a neonatologist from Dakar has come to give training sessions. It’s an opportunity no one wants to miss — neither doctors nor nurses — and so the wards are temporarily empty.

“We have so many patients, both in pediatrics and in intensive care unit, and the health workers are only a few. This is a great opportunity for them, but someone still needs to stay on duty. So, we’re rushing around — we’re used to it!” Alessio tells us.

As he begins to recount this story of care, Alessio starts from the end — partly because the ending is pretty unusual and far from guaranteed, and partly because emotions are still running high.

“I was in the corridor during rounds this morning then I heard a woman screaming my name. When I turned around, I saw Bethel running toward me while his mother smiled from a distance. The first thing I thought? The boy can see!”

It’s a story that begins with a hug yet, it reveals the numerous challenges in providing care in Central African Republic, where every day healthcare providers struggle with diagnostic difficulties, a lack of medical equipment, shortages of medicines, and insufficient and underqualified human resources. These are elements that — in a country ranked among the lowest on the Human Development Index — make access to healthcare a ever ending struggle.

When Bethel arrived at the hospital, he had fever and was vomiting. He wouldn’t stop crying. After a few questions, the doctors realized he already went to a peripheral health center, in Picola Barbi, a few dozen kilometers from the capital. The local healthcare staff had tried treating him for several days with broad-spectrum antibiotics and antimalarial drugs, without any success.

“Vague symptoms common to many illnesses make diagnosis harder. Health personnel in health posts do what they can with what they have but time goes on and the risk of the patient’s condition worsening increases,” Alessio explained.

And that’s exactly what happened with little Bethel, who was transferred to CHUPB only after a week of ineffective treatment.

“When he arrived here, his body had already lost muscle tone and he was barely conscious. Holding him in my arms felt like holding puppet.”

The loss of muscle tone, combined with a state of unconsciousness and persistent fever, often points to tuberculous meningitis — a severe form of TB that unfortunately, due to diagnostic challenges and a lack of timely treatment, mainly affects children. If not promtly treated the diseases can have severe consequences to the health, including brain damage, hearing loss, vision loss, seizures, stroke, and eventually death. Upon admission to the hospital, the doctors were informed of two seizure episodes and immediately started antibiotic therapy while ordering a series of tests to rule out the worst-case scenario.

“Tuberculous meningitis is an infection of the meninges that primarily affects children and can, unfortunately, have devastating consequences. Identifying the bacterium in time and starting the correct treatment is crucial to prevent paralysis, coma, and ultimately death,” said Alessio.

To confirm or rule out their suspicion, the doctors performed the GeneXpert test. Needless to say, this type of test is only available in the capital. The results confirmed the presence of Mycobacterium tuberculosis in the gastric fluid, and the little patient’s condition worsened dramatically in the following hours.

Bethel experienced a prolonged seizure, the doctors observed signs of increased intracranial pressure, and the situation became even more critical when blood tests revealed dangerously low sodium levels (severe hyponatremia). Intervention was needed, but had it not been gradual it would have caused itself neurological damages. The team implemented a therapy that was carefully administered over several days.

These were long, tense days and Bethel’s life was hung by a thread.

“The little boy recovered after about ten days of intensive treatment. When we discharged him, he was in good general condition but was supposed to return in the following days for follow-up visits” Alessio explained. “Unfortunately, families here often lack the means to travel, and I hadn’t seen Bethel again — until this morning, when, to my surprise, he came running toward me. He was doing well, and he could see!”

Bethel’s life was saved by a care system that allowed him to receive the attention and treatment he needed at the country’s one and only tertiary-level pediatric hospital. The follow-up visits he attended showed no signs of damages to the eyes, a consequence of the disease that can also result in permanent vision loss. CUAMM teams work tirelessly at the CHUPB to support both the paediatric ward and the intensive care unit to ensure children like Bethel adeguate and timely care. Our commitment at the hospital is financially supported by the European Union.

 

FRENCH VERSION

 

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