ANNUAL REPORT 2006

ANNUAL 

REPORT 2006 

Médecins du Monde

‘ 

We do not inherit the 

Earth from our parents, 

we borrow it from our 

children...’ 

Native American proverb 

Quoted by Jean-Pierre Dupuy in ‘Petite métaphysique des tsunamis’ 

ANNUAL REPORT 2006 1

Contents 

4 

12 

16 

18 

46 

62 

82 

96 

109 

110 

112 

116 

117 

134 

137 

147 

157 

175 

176 

Cover photo credits : 

OUR AIM 

2006 FIGURES 

INTERNATIONAL PROJECTS 

Map of international projects 

Africa 

Latin America 

Asia 

Eastern Europe 

Middle East 

Future projects 

Adoption 

Operation Sourire 

MISSION FRANCE 

Map 

Programmes 

Contacts 

MOBILISATION 

REPRESENTATION NETWORK 

OUR ORGANISATION 

ACKNOWLEDGEMENTS 

GLOSSARY 

Josselin Amalfi - Sophie Brändström - Véronique Burger/Phanie - Paskal Chelet-Roux - David Delaporte - Thierry Dudoit/L’Express - Sébastien Duijndam - Valérie Dupont - Isabelle Eshraghi - 

Franck Ferreira - Bruno Fert - Catherine Henriette - G. Herbaut/L’Oeil public - Stéphane Lehr - Jacky - Naegelen/Reuters - Michel Redondo - Elisabeth Rull/Item - Lizzie Sadin

¨ OUR AIM 

03/13 >CONTENTS

Facing up to the 

challenges 

‘It is on this basis,that we have the best 

chance of being able to access victims and to 

monitor the security of our teams and our 

local partners.’ 

In a global context where humanitarian action 

becomes more complex and more dangerous 

by the day, it is worth emphasising three principles: 

Médecins du Monde is an association,independent of party political or religious influence. 

It is therefore important to repeat that our activities are quite separate from governmental 

foreign policy and also to be watchful that they are, as they should be, dissociated from all types of 

armed intervention.This is critical to the credibility of our identity and our position and, therefore, 

to our capacity to reduce the risks associated with being manipulated for the purpose of any form 

of ethnic, political or religious radicalisation. 

Médecins du Monde must maintain an ‘innovative’ and challenging approach,in France 

and overseas. Our activities are driven by our concern to work in areas neglected by national and 

international authorities.They are also driven by a desire to remind institutional decision-makers, 

whenever possible, of their duties and responsibilities, particularly by encouraging them to take over 

the activities initiated by our teams. 

Médecins du Monde is an association and,as such,our actions reflect the diverse 

concerns of our members.However,this does not prevent us from taking on projects 

which are innovative,or which focus on particular geographic areas,at the instigation 

of the Board of Directors. 

Guided by these principles,our activities in France and overseas combine 

medical practice with advocacy,which is achieved through testimony 

or by lobbying for change on behalf of the populations we 

work with. 

>CONTENTS

INTERNATIONAL CRISES 

Fortunately, there were few natural disasters in 2006. In Indonesia, Java and Sumatra were hit by 

earthquakes and floods and these were our main emergency programmes of this type. Our teams 

already working in Indonesia,with support from headquarters,were able to respond quickly and effectively. 

Similarly, the teams in Madagascar were able to respond to the recent floods. 

Natural disasters, however, are not the only emergencies.Although these are often lethal and can be 

overwhelming in the scale of their destruction,in most cases they receive immediate aid without question. 

Until the tsunami, we had never questioned the role of humanitarian organisations in this type 

of emergency response.Today,we must step back and assess whether this unprecedented event was 

a definitive turning point or a major exception in humanitarian aid. 

There are also chronic crises and other emergencies which are perpetuated by man. 

The solutions are always political and require the involvement of all the protagonists. 

Experience has taught us that real peace cannot be imposed from outside.It has also helped us realise 

how often it is unrealistic,even dangerous,in these contexts to support humanitarian action which would 

only serve as an excuse for political paralysis. It is within these narrow constraints that we have to be 

able to work and to establish our position. 

Two places are particularly representative of the tensions which create such restrictive operating conditions 

and limit what we can do. 

Darfur, is a longstanding and deadly conflict that reached the height of its violence in 2003.It is a conflict 

with many,complex origins including rivalry between sedentary farmers and nomadic pastoralists, 

exacerbated by climate change. It is a conflict fanned by ancient tensions, and dependent on the indifference 

and inaction of the central government in Khartoum as well as acts of repression towards the 

population of this distant province. It is also the result of many foreign 

interventions,particularly from politically turbulent neighbouring 

countries,such as Chad and Libya.Finally,given the mix of com- 

munities present, it is a conflict which stirs up ethnic tension and 

hatred. 

We cannot look at this as simply an ethnic or religious conflict.To 

do so would be to ignore the political responsibilities and economic 

interests which are also implicated in this violence.We cannot 

only view events through the prism of religious radicalisation 

at the expense of detailed analysis of the local situation. 

>CONTENTS 

INDONÉSIA 

Our team in Indonesia reacted immediately 

to the announcement of an 

earthquake and mobilised human 

resources and supplies from the MdM 

programme in Jakarta for an evaluation 

and provision of primary care.At 

the same time,the MdM international 

delegations and offices were on 

standby to provide support. 

‘Every day our teams face these elements of complexity 

according to the changing situation,which 

makes or breaks alliances between groups,witnessing 

the unstable and opportunistic nature of 

agreements between different armed factions.’ 

¨ OUR AIM ANNUAL REPORT 2006 5

DARFUR 

We are currently studying the conditions 

for a potential return. If such 

conditions are reached, we will take 

a position and assess the opportunity, 

and the possibility to speak out, 

taking into account the possible consequences 

for the NGOs who have 

chosen to stay. Given the complexity 

of the local situation,there is a delicate 

balance between ineffective,and 

even dangerous, declarations and 

resigned acceptance of violence 

which, as well as targeting humanitarian 

workers, may signal a return 

to the massacres of 2003.By the time 

the General Assembly meets,we will 

certainly have clarified our position 

concerning a possible return to 

the field. 

‘GAZA STRIP – The impact of the 

international embargo and Israeli army 

attacks on the health of the population’ 

Médecins du Monde, Survey 2006 

This study provided evidence of the 

ongoing deterioration in the health 

system, the economic collapse and 

the destruction of a large part of 

the essential infrastructure. 

SOUTH LEBANON REPORT: 

“Consequences of the summer 2006 

conflict on the living conditions and 

health of civilians in South Lebanon” 

Decisions about military intervention cannot be based on discussions with humanitarian organisations 

or on testimonies which we are no longer in a position to provide, while modern communications 

systems enable observation of the slightest details on the planet.Should we risk the present and future 

work of NGOs by making them play the role of detonator in international conflicts when such communication 

systems exist? This relates to our long-term capacity to intervene throughout the Arab- 

Islamic world and risks adding to the list of places which are inaccessible or very dangerous for 

humanitarian organisations, such as Iraq,Afghanistan and Sri Lanka 

In January 2007, we decided to withdraw our teams from Darfur because we considered that 

the risks were no longer acceptable when compared with our limited access to the populations living 

outside the camps near Nyala, where our programme was based. 

We challenge dogmatic posturing and we are careful to ensure that our own analyses are always put 

into context. 

In contrast to Darfur,where the context makes public discussion difficult,in relation to the Gaza Strip 

we made strong representations to the different political actors responsible for the deterioration in the 

living conditions and the health of the population since the embargo which followed Hamas election 

victory in January and the resumption of Israeli incursions in June.In order to confirm what we suspected, 

and before speaking out to denounce the deterioration in access to healthcare, it was vital to document 

the medical facts.Through a survey carried out both before and after the Israeli incursion of 28 

June, the M decins du Monde team documented the rapid deterioration in access to water, food and 

healthcare and the presence of symptoms linked to the psychological suffering of residents.Taking 

account of the risk of destabilisation which could accelerate this deterioration,and given the quality and 

impartiality of our data,we made some recommendations to the members of the Quartet (EU,Russia, 

US and UN), the Palestinian authorities and the Israeli government calling for a resumption of financial 

support.The reliability of this research,taken on board by several institutions,enabled us to directly alert 

the European Commission to problems with the temporary mechanism implemented to compensate 

for the loss of international aid. 

The war between Israel and Lebanon also took place in the same region in 2006.The team working 

on the long-term project in Lebanon played an essential role in setting up the work, with local 

actors, to help the most vulnerable populations in south Lebanon. MdM published a report on the 

consequences of this conflict. 

>CONTENTS

Political lobbying for a resumption of European emergency funding 

(ECHO) for programmes in Iraq was another important issue 

during the year. In cooperation with other NGOs, this enabled us 

to release major funding for the refugee population.In addition,we 

are continuing discussions with European representatives in order 

to obtain funding for aid to the population still in Iraq. 

Regarding long-term programmes, access to healthcare 

and prevention for all is still the issue central to all our projects.All 

over the world, against a background of privatisation of health 

services,we always work with the same vulnerable groups.Within 

this context,our projects and our medical activities must also seek 

to question and to highlight the deficiencies of,or even damage done 

by,governments and international institutions. A medical NGO 

cannot ignore the economic or trade mechanisms which 

insidiously undermine health systems and the health of 

the most vulnerable populations. 

On such issues, advocacy is important work and is complementary to healthcare which treats the 

symptoms but not the causes of problems. By highlighting the mechanisms which lead to crisis situations, 

advocacy helps protect affected populations and raises public awareness of these issues. 

From now on,our activities in Haiti,Niger,Liberia and the Democratic Republic of Congo,will 

combine healthcare with advocating for stronger health systems. M decins du Monde takes a position on 

issues such as cost-recovery,the shortage of health professionals and financing health systems.The 

solutions to problems affecting access to healthcare for the most vulnerable populations in developing 

countries lie in the north and, because of globalisation, health is now a global issue. For these reasons, 

we can no longer be content to restrict ourselves to only providing healthcare, if we really want to 

be effective.We must adapt our medical activities to take into account the political and financiall realities 

that impact on the long-term sustainability of these activities.This is why we have helped to create the 

European network ‘Action for Global Health’ which will work towards the achievement of the 

Millennium Development Goals (MDGs) for health by 2015.Goals which western governments,including 

France,are already committed to striving to achieve for developing countries. 

Although the reconstruction of health systems is a priority for M decins du Monde, we should also 

take a stronger stand on a number of issues relevant to our current and future programmes:women s 

health, environmental health and migration and health (including for migrants, refugees or internally 

displaced people). 

>CONTENTS 

‘The political interpretation of our healthcare 

activities should be systematic in all of our programmes,in 

order to provide material for our 

testimony and advocacy work.The conditions for 

disseminating this information,however,have to 

be carefully considered and weighed up. 

Chechnya,Afghanistan and Colombia, 

among others,illustrate the difficulties.’ 

MDGs 

We are working with organisations 

representing Germany,Italy,Spain and 

the United Kingdom along with a secretariat 

in Brussels,to lobby governments 

for the achievement of the 

health-related MDGs (maternal 

health,infant mortality,infectious disease) 

promoting a global approach 

to health. 


TRAINING 

This involves strengthening skills 

around caring for the most disadvantaged, 

social and health inequalities 

and geographical inequalities in healthcare 

provision. 

Our messages are always based on our field experience.The quality of our medical activities must be 

exemplary and we aim for this standard by rigorously monitoring our practices.As part of this work, 

a project on the quality of pharmaceuticals used in our programmes began in 2006 and this 

is an important step forward. 

>IN FRANCE 

‘20 years after the opening of the first reception, 

care and orientation centres (CASOs) we would 

have liked to see the Mission France programmes 

declining.On the contrary,they are expanding.’ 

When it comes to caring for vulnerable groups, MdM has a strong public image built on 20 years 

of action.The operation ‘For lack of a roof,a tent’ last winter was a symbolic programme which 

mobilised citizens and brought results. 

M decins du Monde contributed to the electoral debate at the time of the presidential and 

parliamentary elections, just as we had done in 1995 and 2002.We put forward a number 

of proposals to improve access to healthcare for the most disadvantaged.These included: access to 

healthcare for the most vulnerable (CMU,AME, PASS), action to tackle health affected by homelessness 

and poor accommodation (rough sleepers, lead poisoning), the mental health of people living 

on the streets,and tackling stigma among scapegoat groups (Roma,sex workers,asylum seekers,undocumented 

migrants and drug users). 

We can further strengthen our role in these issues, while staying faithful to our vocation to change 

practices, by getting involved in the academic sector. Specifically, we can contribute to the development 

of course content for the initial and optional training of medical students.Today we 

should be able to change practice in French medical faculties, while taking the opportunity to open 

these places to other professional groups, such as other health 

professionals and social workers. 

The 2006 review of health professionals’ freedom to 

practice, a mechanism which we now know resulted in a desertification 

of disadvantaged urban areas and isolated rural areas,has 

revealed a unanimous desire from health professionals to modify 

these conditions.In France,as elsewhere,it is important to address 

the root causes of problems, not just their effects. 

Concerning harm reduction activities, M decins du Monde 

handed over a number of activities and programmes in 2006.The previous year, the Board decided to 

provide technical and financial support, which enabled smooth handover of these projects to partner 

organisations created for this purpose.We will play a full part in the co-ordination of harm reduction 

organisations,demonstrating our commitment to this issue in which we have always led the way.This is 

even more necessary as there are growing signs that the government is withdrawing from this issue and 

>CONTENTS

is implementing more repressive policies.We will remain vigilant, reactive and innovative in these areas 

which continue to be within our remit. Our interest in this issue is also demonstrated by a number of 

our international projects — such as Afghanistan,China and Serbia — where we have taken advantage of 

the expertise that M decins du Monde has built up in harm reduction. 

>ADOPTION 

In 2006,the Board confirmed its desire to continue with the international adoption activities.This programme 

constitutes a particular form of international solidarity towards an especially vulnerable 

group,abandoned children.In the same spirit,M decins du Monde has also confirmed its desire to emphasise 

the adoption of siblings or of children with particular health needs. 

With the recent changes in the law in France, we are beginning to consider new questions such as 

adoption by single parents or by same-sex couples. Beyond the changes in the law, we will 

also have to discuss the issues internally and manage the issues arising from this very specific action 

within our organisation. 

>THE INTERNATIONAL NETWORK 

‘Following the results of presidential elections and,considering the programme of 

the elected candidate,MdM will stay vigilant on the question of access to healthcare 

for all and to the situation of the most vulnerable,particularly migrants.’ 

The development and strengthening of Médecins du Monde’s international network 

is another main area of development for our organisation. We do not always take full 

advantage of our international representation. Nonetheless, some progress has been made 

throughout the year, particularly with closer collaboration between the French and Spanish delegations 

on advocacy issues (Palestinian Territories and the MDGs).There is similar collaboration 

with the International Representative Offices. 

The Averroes project also contributes to strengthening operational and policy links. Some of 

our main themes, such as migrants or harm reduction, make this kind of arrangement essential. 

We must, however, do more work on the emergence of a European M decins du Monde entity. 

It seems desirable to take a pragmatic approach, which aims to support the emergence of delegations 

where there are strong human resources.The question of opening international delegations 

or representative offices in southern countries must also be considered, but, once again, where 

there are strong human resources. 

>CONTENTS 

SAME-SEX COUPLES AND 

ADOPTION 

In order to take a position, we are 

holding meetings with relevant 

experts,for example during the conference 

on types of parenting, and 

reviewing existing analysis on these 

issues. 

AVERROES 

The Averroes project aims to ensure 

equitable access to healthcare for 

migrants throughout Europe by 

establishing a European network 

across the 25 EU member states. 


REGIONAL STRATEGIES 

We note that in 2006, the regular 

presence of desk officers and the 

Director of International Operations 

at the continental group meetings has 

reinforced the coherence of our activities 

and enhanced co-ordination. 

>WITHIN MÉDECINS DU MONDE 

We are working towards the implementation in 2008 of resouces for the continental groups 

to help them produce analyses and regional strategies. However, we also need to address the 

poor participation in the recent election for continental group representatives. 

In recent months,a working group,made up of M decins du Monde members,has been charged with 

looking at the question of our regional delegations and our model of decentralisation.Their 

conclusions will then be debated in the different consultative and decision-making groups within 

the organisation. 

At the same time, a process has been launched to open a new regional delegation in Clermont- 

Ferrand and discussions are currently underway. 

In a similar vein, we proposed that the possibility of an active property acquisition policy 

should be seriously reviewed. Every year we spend sizeable sums on rent for our different activities 

in France and for the regional delegations premises. It is clear that M decins du Monde will 

have long-term involvement in issues relating to healthcare, poverty and exclusion.The purchase 

of premises does not signify any change in our decision to, wherever possible, handover to public 

services.This proposal aims to reduce, in the meantime, our running costs in France so that we 

can do more and do it better, both at home and abroad .This confirms, our desire to build strong 

regional foundations for M decins du Monde. 

>THE ORGANISATION 

Our organisation, and all those who are involved in it, are there to serve our projects. Growth, 

through the reinforcement of M decins du Monde France and by the development of the international 

network, should therefore be seen as a means to reach the volume of activities which 

makes our work in the health domain more effective and more transparent.This depends on two 

factors: human resources (including volunteers) and the development of our financial resources. 

Concerning human resources, various mechanisms have been put in place,including the recruitment 

of overseas volunteers from both northern and southern countries (with a view to southsouth 

solidarity). Our presence and our visibility must be strengthened in universities and the contribution 

of our international network needs to be enhanced. Other options, such as mentoring 

of less experienced volunteers by former field volunteers, should also be explored.These issues 

relating to human resources for field programmes have all been included in the portfolio of the 

new human resources director. 

>CONTENTS

Increasing and diversifying our financial resources is equally crucial for reasons of operational 

effectiveness, independence and security. Given the current polarisation of humanitarian 

contexts, money is often associated with a particular country. M decins du Monde must be able 

to access sufficient private funds and must also have geographic and institutional diversification of 

funders.This project started at the end of 2005, and efforts in this direction have continued and 

have been strengthened. On another financial issue, the previous General Assembly asked us to 

evaluate options for investing our financial reserves in ethical funds . Future partners have been 

identified. 

At the end of this first year as President, I want to tell you how much of a pleasure it has been 

to work with the Board and with each of you in the implementation of these different projects. 

I have confidence that the strong dynamic which we have at our disposal will enable us to face 

up to the challenges ahead and to ensure coherence and cohesion of our organisation towards 

all those who have the confidence to support us or to be involved in our actions. 

Dr Pierre Micheletti 

President, Médecins du Monde 

7 May 2007 

>CONTENTS 

¨ OUR AIM ANNUAL REPORT 2006 

11

2006 in 

figures 

>BUDGET 

53.2 

Expenditure 

1% 

8% 

20% 

71% 

Income 

59% 

35% 

4% 

2% 

communication 

administration 

development 

programmes 

public generosity 

institutional grants 

private grants 

other 

million euros in 

2006 

>HUMAN RESOURCES 

219 

paid staff in 

France 

430 

volunteers 

went to the 

field 

127 

field volunteers 

350 

monitoring and 

technical 

support 

missions 

Value of volunteer contributions and gifts in kind:20 million euros 

>CONTENTS 

1,600 

local staff 

working on 

international 

projects 

1,400 

volunteers in 

France 

16 

regional 

delegations 

> INTERNATIONAL 

NETWORK 

11 

international delegations 

Argentina, Belgium, Canada, Cyprus, 

France, Greece, Portugal, Spain, 

Sweden, Switzerland, United States 

90.25million euros 

5 representative offices: 

Germany, Italy (office of MdM- 

Spain), Japan, Netherlands, 

United Kingdom

INTERNATIONAL PROGRAMMES 

91 programmes in 51 countries 

Geographical distribution 

of programmes: 

Africa 

Asia 

Latin America 


Middle East/North Africa 

Central Asia 

>MISSION FRANCE 

33,148 

medical consultations in 21 

CASOs (Healthcare and Guidance 

Centres) for16,948 patients 

84 

mobile community projects in 23 

towns, carried out by 655 volunteers, 

including 6 programmes 

among people working in prostitution, 

with more than 10,700 contacts. 

5 

10 

13 

14 

20 

34 

5,342 

dental consultations carried out in 

10 towns for 2,254 patients 

14 

harm reduction programmes linked to 

drug use, carried out by 269 volunteers. 

More than 82,700 harm reduction 

contacts. 

Geographical distribution of international 

programme expenditure: 

Africa 

Asia 

Latin America 


Middle East/North Africa 

Central Asia 

38,490 

medical consultations 

>CONTENTS 

5 

8 

9 

10 

18 

50 

¨ 2006 FIGURES ANNUAL REPORT 2006 

13

INTERNATIONAL 

PROGRAMMES 

14/108 

>CONTENTS

CONTENTS 

Thierry Duboit/L’express

x* 

x* 

x* 

Mexique 

Emergency: a situation where people’s lives and livelihoods 

are in immediate danger (natural disaster, armed conflict etc.). 

Response: substitution programme. 

Crisis: situation where people’s basic needs are not being met in 

the long-term (civil war, forgotten conflict, HIV pandemic). 

Response: technical assistance and mobilisation of local 

resources. 

Development: support for meeting the needs or carrying out the 

policies expressed by local partners, communities or authorities in a 

situation where there are insufficient resources. 

Response: partnership and capacity building. 

* X – number of projects per country. 

2 

Guatemala 

1 

Salvador 

1 

Colombie 

2 

Pérou 1 

Bolivie 

Argentine 

Nicaragua 1 

>CONTENTS > 

2 

1 

Haïti 

3

Guinée 

Libéria 

Maroc 

1 

1 

Côte d’ivoire 

2 

Burkina Faso 1 

Algérie 

1 

Mali 

Serbie 

Rép. dém. 

du Congo 

3 1 

Angola 

Kosovo 

1 

2 

Bénin 

4 

1 

2 

Bulgarie 

Niger 1 

1 

Biélorussie 1 

2 

Tchad 

Moldavie 

Liban 1 1 

Egypte 1 

Tanzanie 

Zimbabwé 

1 

Roumanie 1 

1 

Turquie 

Soudan 1 2 

Géorgie 

Erythrée 1 

1 

2 

1 

Ter. Palestiniens 

Rwanda 1 

1 

Tchétchénie 

Irak 

3 

Madagascar 

1 

Yémen 

Ethiopie 

3 

1 

Ouzbékistan 1 

1 

1 

1 

Afghanistan 

Pakistan 

>CONTENTS 

1 

1 

3 

Népal 

1 

Birmanie 

Sri Lanka 1 

Mongolie 1 

1 

Chine 

2 

Cambodge 

Vietnam 

1 

1 

1 

Indonésie 

5

AFRICA » 

» EMERGENCY: 

Situation where people’s lives and livelihoods are in immediate danger (natural 

disaster, armed conflict etc). Response: substitution programme. 

» CRISIS: 

Situation where people’s basic needs are not being met in the long-term (civil 

war, forgotten conflict, HIV pandemic). Response: technical assistance and 

mobilisation of local resources. 

» DEVELOPMENT: 

support for meeting the needs or carrying out the policies expressed by local 

partners, communities or authorities in a situation where there are insufficient 

resources. Response: partnership and capacity building. 

>CONTENTS

ANGOLA p.24>25 

ALGERIA p.26 

BENIN p.27 

BURKINA FASO p.28 

CHAD p.29 

DRC p.30>31 

ERITREA p.32 

ETHIOPIA p.33 

GUINEA p.34 

IVORY COAST p.35 

LIBERIA p.36 

MALI p.37 

MADAGASCAR p.38>39 

MOROCCO p.40 

NIGER p.41 

RWANDA p.42 

SUDAN p.43 

TANZANIA p.44 

ZIMBABWE p.45 

>CONTENTS 

INTERNATIONAL PROGRAMMES ¨ AFRICA ANNUAL REPORT 2006 

19

MADAGASCAR 

Lepela, 16 years old, has been 

in Ambanja prison since 

2 May 2005. 

‘At 13, I fell in love and married a man 

who was over 30 years old. He started 

to beat me regularly. One day he 

wanted to strangle me but I defended 

myself with a knife. 

Since then, I’ve been locked up here 

and I don’t have any contact with my 

family.The thing that I find hardest is 

the food.We have manioc for every 

meal.The other prisoners share the 

food their families bring with me, 

maybe because I am the youngest 

here.We also need clothes, soap and 

things to do. In the rooms, the heat is 

unbearable during the day and at night 

we have to protect ourselves from 

rats. I had a bad cough but its better 

now. I still have terrible toothache. 

For now, I still haven’t had a trial and I 

don’t know what is happening with my 

case. Nobody tells me anything. I know 

that there is risk that I’ll get a life 

sentence but I don’t have any way to 

pay for a lawyer.’ 

>CONTENTS 

Lizzie Sadim

CONTENTS 


21

(1) Alexandre Godard 

(2) Paolo Pellegrin/Magnum photos 

>CONTENTS 

» In 2006, MdM carried 

out community health 

projects and supported 

periodic water 

distribution and 

vaccination campaigns in 

the Darfur region of 

southern Sudan (1 and 

7) which has been 

devastated by conflict. 

Despite the end of 

hostilities, the treatment 

of malnutrition in 

Angola (3 and 9), 

primary care and 

mental health care in 

Liberia (2),AIDS 

treatment in the 

Democratic Republic of 

Congo (5) and the 

protection of street 

children in Ivory Coast 

(8) are essential for the 

survival of civilian 

populations. In Mali (4), 

it is not war that 

isolates, but obstetric 

fistulas which affect 

many women.They then 

become excluded 

because of their 

resulting incontinence, 

but the training of 

Malian surgeons enables 

these women to have 

better access to 

treatment today (6).

CONTENTS 

(8) Stéphane Lehr 


(6) Jean Achache 

(7) MdM 

(5) Jacky Naegelen/Reuteurs 

(4) Véronique Burger/Phanie 



23

ANGOLA 

Four consecutive years of peace, following 27 years of civil war, have enabled Angola to open up 

again to international aid, so the government is now in a position to build up social services. More 

than three million refugees,mainly women and children,have returned home since the end of the 

civil war in 2002.The children show signs of malnutrition. Unexploded bombs, left over from the 

war, presents a major security threat which prevents people in some parts of the country from 

returning to agriculture. 

CHOLERA EMERGENCY 

Benguela and Huambo Provinces 

Activities 

Prevention and health education activities began with the 

first phase of the project (April 2006) and continued until 

the end of August. These were carried out in rural and 

urban areas in Benguela province (Lobito town) and 

Huambo provinvce (Mungo and Bailundo towns) in 

collaboration with the regional and town health authorities. 

CARING FOR STREET CHILDREN 

Lobito town – Benguela Province 

Activities 

To improve the quality of care for street children and their 

access to it, MdM’s activities include: 

• training and awareness-raising of health professionals in 

Lobito about conditions affecting street children; 

• setting up a monitoring system in health facilities to 

ensure that street children are being cared for by the 

Angolan health system; 

• ongoing training for six street educators responsible for 

linking children with the network of private, 

governmental and voluntary organisations which support 

children in the process of re-socialisation; 

• improving access to literacy classes, school education 

and vocational training in partnership with local 

institutions; 

• access to administrative status for recognition of the 

children’s citizenship; 

• individual assessments for the process of family 

reintegration. 

Outlook 

Project closed at the end of August 2006. 

Progress bar at 31/12/2006 

04/2006 08/2006 

> Project progress 

Outlook 

Individual support and medical care for 

street children in the town’s health posts 

and hospitals. 


06/2004 12/2008 


>CONTENTS 

Mortality 

> infant: 154 ‰ 

Life expectancy 

> at birth: 40.7 

HDI 

> 0.439; rank: 161/177 

GNP/capita ($) 

> 1,258 

International delegations 

> project 1: MdM Spain 

> project 2: MdM France 

Beneficiaries 

> direct, project1: 594,260 

> direct, project 2: 350 

> indirect, project 1: 1,188,522 

> indirect, project 2: 2,000 

Staff 

> local, project 1: 10 


> expatriates, project 1: 5 


Co-ordinators 

> programme: L.Jarrige 

> general co-ordinator: D.Chappaz 

> headquarters: O.Mouzay 

Funding 

> project 1: ECHO 

> project 2: UBS, MdM 

Budget 

> 2006 project 1: 203,608 euros 

> 2006 project 2: 208,678 euros

TREATING MODERATE MALNUTRITION 

Bailundo and Mungo 

Activities 

In Mungo town: 

• in collaboration with the World Food Programme, 

running a supplementary feeding centre and two 

mobile feeding centres; 

• supporting the primary healthcare structures in the 

town. 

In Bailundo town: 

• supporting the Bailundo Ministry of Health’s 

supplementary feeding centre; 

• staff training. 

MOTHER AND CHILD HEALTH 

North Huambo province (Bailundo town) 

Activities 

In 2006, the activities continued, including: 

• monitoring the network of mother and child health 

(MCH) nurses who supervise the traditional 

midwives; 

• paediatric consultations and a vaccination 

programme; 

• training on prevention and treatment of sexually 

transmitted infections (STIs); 

• family planning; 

• logistics support and the transfer of staff from the 

maternity unit to the Bailundo referral hospital. 

Outlook 

Following the handover of the feeding 

centres to the Ministry of Health, MdM 

withdrew from this part of the programme 

in September 2006. The 2007 activities 

include monthly evaluation of Mungo 

health services activities by mother and 

child health nurses from the Huambo 

province programme. 


06/2003 31/01/2007 


Outlook 

Continue to gradually improve the 

quality of peripheral actions and 

ensure their long-term continuity by 

training and mentoring Angolan 

medical staff. 


01/12/2003 31/12/2006 


>CONTENTS 


> MdM Spain 

Beneficiaries 

> direct: 3,500 

> indirect: 20,000 

Staff 

> local: 30 

> expatriate: 4 

Co-ordinators 


> field: D. Chappaz 


Funding 

> FSD, MdM France 

Budget 

> 2006: 50,000 euros 


> MdM Spain 

Beneficiaries 

> direct: 80,000 


Staff 

> local: 15 


Co-ordinators 


> field: D. Chappaz 


Funding 

> FSD, German Ministry of Foreign Affairs, 

MdM 

Budget 


25 

INTERNATIONAL PROGRAMMES ¨ AFRICA ANNUAL REPORT 2006

ALGERIA 

Despite considerable economic growth and a sizeable reduction in external debt, 

Algeria remains a fragile country.There are widespread inequalities, and poverty and 

unemployment endure. Expansion of the oil trade, which is the main source of wealth 

in the country, has not been accompanied by structural reforms for the population. 

Problems with access to healthcare, particularly for chronic diseases, and violence 

against women, still exist. 

CARING FOR WOMEN AFFECTED BY VIOLENCE 

Algiers 

Activities 

In 2006, MdM focused on preventing and treating 

physical and psychological problems affecting women 

and children who are victims of violence. The programme 

consists of: 

• ensuring the smooth running of a free and anonymous 

telephone help line and supporting a multi-disciplinary 

listening network; 

• strengthening the knowledge and skills of people 

working on the issue of violence and promoting 

exchange of knowledge and practices; 

• improving and developing prevention and 

awareness-raising activities; 

• supporting lobbying of the authorities. 

COMMUNITY HEALTH PROJECT 

Constantine (El Gamas district) 

Activities 

This ongoing programme supports the outreach team 

of Constantine Social Development Agency and the El 

Gamas residents’ association in relation to asthma 

treatment.The programme aims to: 

• examine, diagnose and treat screened children; 

• enable a group of children to benefit from sport in 

the swimming pool; 

• provide medicines. 

>CONTENTS 

Outlook 

This programme will enable MdM to 

establish a reliable picture of the legal 

processes and the capacity of the 

shelters, but also to create a network 

of voluntary and institutional partners. 


07/2006 07/2009 


Outlook 

Efforts will focus on: 

• treating 100% of the serious asthma 

cases; 

• preventing asthma and improving living 

conditions; 

• working with Constantine health 

observatory on the prevention of HIV 

and smoking prevention 


02/2005 07/2008 


Mortality 

> infant: 35‰ 



HDI 

> 0.728; rank: 102/177 

GDP/capita ($) 

> 2,616 

Source: Human Development Report 2006, UNDP 


> projects 1 and 2: MdM Spain 

Beneficiaries 

> for the whole project: 1,060 

> direct, project 2: 1,200 


Staff 

> local. project 1: 3 

> expatriate. project 1: 1 

Co-ordinators 

> project 1 : J. Masson, M. Bruyns 

> project 2 : R.Allemand 

> monitoring project 2 : Rhône-Alpes DR - 

Grenoble 

Funding 

> project 1 : French Ministry of Foreign 

Affairs, MdM 

> project 2 : Grenoble council; Isère 

Regional Council; MdM; specific donations 

Budget 



BENIN 

Benin has one of the few democratic governments in Africa and has achieved relative 

economic stability.Thomas Boni Yayi has been president of the Republic since 6 April 2006, 

having obtained 75% of the votes in the second round of the presidential elections. He has 

undertaken to reform this mismanaged and poor country into an emerging state. 

Nevertheless, the HIV/AIDS epidemic spread in 2006.Today 87,000 people, including 9,800 

children, live with HIV and 62,000 children are orphans. 

TACKLING THE MAJOR EPIDEMICS – HIV/AIDS 

Ouidah and Comé 

Activities 

The programme’s activities include: 

• prevention/awareness-raising on HIV in partnership 

with 10 Beninese associations and the American 

NGO Africare; 

• training on screening and testing programmes for 

staff of two hospitals in the area and the health 

centres of seven villages; 

• staff training on comprehensive HIV treatment. 

Outlook 

Continued prevention and awarenessraising 

activities with the Beninese 

associations. Decentralisation of 

access to HIV testing in 55 district 

health centres. 

Increasing access to anti-retrovirals 

(ARV) for 1,750 patients on treatment 

programmes and a further 700 on 

ARV treatment by the end of 2008 

and the introduction of new 

treatments. 

Development of prevention of mother 

to child transmission (PMTCT) 

activities 


01/2005 ongoing in 2007 


>CONTENTS 

Mortality 




HDI 

> 0.428; rank: 163/177 


> 498 

Beneficiaries 

> direct: 476 (comprehensive HIV 

treatment) 

> indirect: 100,000 (awareness-raising) 

Staff 

> local: 20 


Co-ordinators 

> programme: P. B. Beyrie 

> field: L. H. Pourteau 

> headquarters: H. Barroy 

Funding 

> MdM, Paris City Council, French Ministry 

of Foreign Affairs, Dutch Ministry of 

Foreign Affairs 

Budget 


27 


BURKINA FASO 

This landlocked African country has some of the worst health statistics in West Africa. 

The crisis in the Ivory Coast seriously affected the country, which depended on 

Abidjan port for more than two-thirds of its foreign trade. Access to primary care 

remains almost impossible for most of the population. 

ACCESS TO ORAL HEALTHCARE 

Diebougou 

Activities 

Given the lack of dental and oral health care in the 

region, MdM implemented a range of activities: 

• setting up a dental surgery (refurbishing the 

premises) and professional training (training a 

dentist at university); 

• development of an oral health education programme 

in schools and villages in Diebougou province; 

• the dental surgery has been operational since July 

2006, with two sessions per week; 

• staff training for the awareness-raising programme. 

Outlook 

Autonomous running of the dental 

surgery; 

Training of a nurse priest in dentistry 

at Ouagadougou university (currently 

in second year); 

Creation of a mobile clinic for initial 

care to visit the most remote villages. 


2006 2008 


>CONTENTS 

Mortality 




HDI 

> 0.342; rank: 173/177 


> 376 

Beneficiaries 

> direct: 60,000 


Staff 

> local: 2 specialist dental nurses and one 

undergoing training 

Co-ordinators 

> programme: F. Ben Soussan 

> field: S. Dabbiré 

> country director: P. de Botton 

Funding 

> MdM and private partners 

Budget 

> 2006: 10,362 euros

CHAD 

In 2006, several factors threatened political stability in Chad: the effects of the flow of 

refugees and militias in the east as a result of the crisis in Darfur, the attempts by Chadian 

rebels to oust President D by from power after 15 years, a severe fiscal crisis and a long 

conflict over the use of oil revenues.The presidential election in May 2006, boycotted by 

the opposition and won by D by after the first round following a constitutional 

amendment which enabled him to present himself for a third mandate, contributed to 

discontent in the country. Health indicators are poor because infrastructure and health 

personnel are lacking, but also because of poor hygiene. Children living on the streets are 

the most exposed. 

TREATING STREET CHILDREN 

N’Djamena 

Activities 

MdM has been working in Chad since 2001, this year 

the programme included: 

• training on HIV prevention for 64 local workers 

and 40 peer educators from the street children 

community, in partnership with Unicef Chad; 

• educational sessions with 2,800 children; 

• producing an educational tool and a list of 7,500 

street children contacts in the healthcare circuit. 

A medical and welfare support network, with a 

system of third-party payments dependent on local 

funders, is run by our partner the Swiss Tropical 

Institute with operational and financial support from 

MdM. In 2006, this circuit enabled access to more 

than 2,300 primary healthcare consultations for 

street children. 

Outlook 

Because of the critical situation in 

recent months, MdM has had to 

continue its support of the Swiss Tropical 

Institute and to delay withdrawal until the 

end of 2007. MdM provides support to 

local associations for micro-projects 

which benefit street children 

(vocational training). 


01/12/2001 12/2007 


>CONTENTS 

Mortality 

> infant: 117 ‰ 



HDO 

> 0.368; rank: 171/177 


> 447 

Beneficiaries 

> direct: 5,000 children including 30 

‘leaders’ 

> indirect: 50 

Staff 

> local: 1 

Co-ordinators 

> programme: P. Estecahandy, 

J. Boncompain 

> monitoring: Midi-Pyrenees Regional 

Delegation 

Funding 

> MdM,Toulouse Council and private 

partners in N’Djamena and in the Midi- 

Pyrenees 

Budget 



29

DEMOCRATIC REPUBLIC OF CONGO 

The war in DRC is one of the bloodiest the world has seen since the end of the Second World 

War. In less than five years, 4 million people will have died. In May 2003, fighting in Ituri province 

quickly spread to Bunia forcing women and children to flee.After three years of transition and 

an exceptional mobilisation by the international community, J. Kabila was re-elected on 29 

October 2006.Today, the government is involved in managing the post-conflict reconstruction 

and the importance of civil society has been confirmed. 

FIGHTING HIV EFFECTIVELY 

Goma 

Activities 

Our programme, aimed at an integrated response 

to the AIDS epidemic, consists of: 

• strengthening the capacity of local authorities in 

the fight against AIDS and in caring for victims of 

sexual violence; 

• improving care for at-risk populations and 

improving the understanding of the epidemiology of 

STIs and HIV among local actors; 

• facilitating anonymous and voluntary testing; 

• providing medical, psychological and social support 

to people living with HIV; 

• in coordination with local partners, developing a 

prevention and care policy for adolescents in 

relation to reproductive health, STIs and HIV. 

PROTECTING STREET CHILDREN 

Kinshasa 

Activities 

The objectives of the project are to reintegrate and 

resocialise street children by: 

• distributing condoms at the sexual health centre 

and during IEC sessions; 

• maintaining a consultation and referral service for 

STIs and an information and counselling service in 

the PEKABO centre; 

• facilitating access to primary healthcare for street 

children supported by 45 NGOs. 

>CONTENTS 

Outlook 

Continuation of activities, institutional 

capacity building and partnership 

building. In addition, setting up special 

units to tackle violence against 

women. 


01/08/2003 31/12/2010 


Outlook 

Reinforcing current activities by 

supporting two day centres for girls 

living on the streets and expanding the 

care network by supporting seven 

health facilities. 


11/01/1999 31/12/2008 


Mortality 

> infant: 129 ‰ 



IDH 

> 0.391; rank: 167/177 


> 114 


International Delegations 

> projects 1 and 2: MdM Belgium 

Beneficiaries 





Staff 



> expatriate, project 1: 1 


Co-ordinators 

> project 1: F.Jacquet 

> project 2:A.Thiriat 

> field, project 1 : P. Sallah 

> field, project 2 : J. Romué 

> country co-ordinator, projects 1 and 2: 

D. Cannet 

> country co-ordinator, project 2:A.Talibo 

> HQ projects 1 and 2: C.Courtin 

Funding 

> project 1: Global Fund/UNDP, Dutch 

Ministry of Foreign Affairs, UNICEF, MdM 

> project 2 : ECHO 

Budget 



SUPPORTING THE HEALTH SYSTEM AND BUILDING LOCAL CAPACITY 

Tanganyika district – Katanga province 

Activities 

The programme aims to improve the quality of 

health services and their accessibility for the 

population of Tanganyika district, by: 

• implementing an action plan focusing on training and 

the accessibility of services for the beneficiary 

populations; 

• involving the communities in the management of 

health programmes through strengthening the capacity 

of local community organisations, health education 

sessions and training; 

• involving the Central Area Offices in the management 

of ‘health areas’; 

• consolidating data collection and epidemiological 

surveillance systems and management tools; 

• training the different actors involved; 

• providing technical support to the management 

teams of the health areas and the medical inspectors of 

the district. 

IMPROVING ACCESS TO HEALTHCARE 

Kalemie and Kongolo (North Katanga) 

Activities 

The programme aims to ensure access to quality 

healthcare in 28 health centres in Kalemie and 25 

health centres and five health posts in Kongolo.There are 

five aspects: 

• implementing a Minimum Package of Activities (MPA) 

in the health centres and supporting the maternity unit 

in the general hospital for obstetric emergencies; 

• providing essential medicines and medical equipment 

supplies; 

• strengthening the capacities of the Central Area 

Offices; 

• training healthcare staff; 

• epidemiological surveillance and tackling epidemics, 

including cholera. 

>CONTENTS 

Outlook 

To help improve the population’s health in 

the 11 health areas of Tanganyika health 

district by improving the quality of health 

services in the long-term by 

implementing an efficient health system. 


01/10/2006 30/08/2009 


Outlook 

In 2007, MdM will be monitoring the 

post-conflict phase, particularly in 

Tanganyika where ensuring the health 

of nearly two million Congolese is one of 

the challenges within the programme 

which we have been developing there 

since October 2006. 


Kalemie: 01/2/2005/Kongolo: 01/4/2002 30/09/2006 


Source : Human Development Report 2006, UNDP 


> MdM Belgium 

Beneficiaries 

> direct: 1,092,270 

> indirect: 1,922,863 

Staff 

> local: 90 


Co-ordinators 

> country: D. Cannet 

> field:A.Talibo/K.Touré 

> headquarters: C.Courtin 

Funding 

> 9 e 

FED, MdM 

Budget 



> MdM Belgium 

Beneficiaries 

> direct: Kalemie – 53,591 

Kongolo – 121,918 

> indirect: Kalemie – 143,334 

Kongolo – 236,000 

Staff 

> local: Kalemie – 29/Kongolo – 37 

> expatriate: Kalemie – 5/Kongolo – 4 

Co-ordinator 

> country: D. Cannet 

> programme:A.Thiriat 

> field: K.Touré 

> country co-ordinator:A.Talibo 

> headquarters: C.Courtin 

Funding 

> Kalemie: ECHO, French Ministry of 

Foreign Affairs, Paris Council, MdM 

Kongolo: ECHO, MdM 

Budget 

> 2006: Kalemie – 520,709 euros 

Kongolo – 605,972 euros 


31

ERITREA 

Eritrea is one of the poorest countries in the world and several consecutive years of 

drought have contributed to food shortages.The disputed border between Eritrea and 

Ethiopia ensures that relations between the two countries remain tense.This situation, 

described as neither war, nor peace , is a constant source of security problems. In this 

context, children and pregnant women are the most vulnerable. 

PRIMARY HEALTHCARE 

Afabet 

Activities 

The programme includes: 

• providing primary healthcare in three health 

facilities and in the communities; 

• health education; 

• supervising Afabet hospital; 

• refurbishing a surgical unit in Afabet hospital along 

with providing equipment and mentoring surgical 

staff. 

Outlook 

Continuing the training of midwives 

and community health workers in 

Afabet region and the mentoring of 

surgical staff in the surgical unit at 

Afabet hospital. 


01/07/2006 31/05/2008 


>CONTENTS 

Mortality 

> infant: 52 ‰ 



HDI 

> 0.454; rank: 157/177 


> 219 

Beneficiaries 

> direct: 7,490 


Staff 

> local:Asmara base – one administrator 

and one logistician.Afabet base – 1 co-ordinator 

and 1 logistician 

> expatriate: 1 permanent general coordinator 

and rotating medical staff, 

1 obstetrician-gynaecologist, 1 nurse 

anaesthetist, 1 theatre nurse,1 midwife and 

1 primary care nurse 

Co-ordinators 

> programme: N. Raffort 

> headquarters: O. Mouzay 

> general co-ordinator: J.Amalfi 

Funding 

> ECHO, MdM 

Budget 


ETHIOPIA 

The disputed border with Eritrea and the increasingly precarious situation in Somalia 

threaten the political stability of Ethiopia. Health indicators in this country of 75 million 

inhabitants are way below average for sub-Saharan Africa.The shortage of specialist doctors 

and surgeons outside the capital make access to surgery difficult in rural areas where more 

than 85% of the population lives. A considerable proportion of maternal mortality is 

attributed to poor access to healthcare in these areas. 

PREVENTING MOTHER-TO-CHILD TRANSMISSION OF HIV 

Mekele 

Activities 

The programme has eight components: 

• prevention of mother-to-child transmission (currently 

with Viramune); 

• referral of pregnant women to the antiretroviral access 

programme at the hospital; 

• training counsellors for screening centres and transfer 

of skills; 

• voluntary HIV testing; 

• awareness-raising/prevention on HIV and mother-tochild 

transmission; 

• rebuilding the maternity unit; 

• provision of medicines, baby milk and other supplies; 

• information and practical advice on infant feeding. 

Outlook 

Changes in health policy mean that use of ARV 

treatments is now permitted and they are 

available free of charge at Mekele hospital. 

Women enrolled in the prevention of motherto-child 

transmission programme are 

systematically referred to the ARV unit for 

treatment. An extension of the awarenessraising 

activities, training and monitoring is 

underway to follow on from the first phase. 


01/08/2003 31/01/2007 


TRAINING IN OBSTETRIC AND SURGICAL CARE 

Tigray/Axum 

Activities 

The programme aims to reduce maternal and infant 

mortality with three main activities: 

• capacity building through transfer of knowledge; 

• training complete surgical teams for the peripheral 

health centres; 

• access to healthcare for the most disadvantaged 

groups, particularly access to general emergency surgery 

and to caesarian sections. 

>CONTENTS 

Outlook 

The training of teams by the Tigray trainers 

will continue for one year. A third training 

session began in February 2007 for nine 

months.The training of an Ethiopian trainer 

for the surgery programme, due to start in 

March,will last for a year. 


01/10/2004 31/12/2007 


Mortality 

> infant: 110 ‰ 



HDI 

> 0.371; rank: 170/177 


> 114 


Beneficiaries 

> direct, project 1: 200 HIV positive 

mothers and their babies, 4,000 pregnant 

women 



> indirect, project 2: 4,000,000 

Staff 





Co-ordinators 

> project 1: M.Saada 

> project 2: G. Pascal 

> field, project 1: O.Evreux 

> field, project 2: D. Getachew/ 

O. Evreux 


Funding 

> project 1: French Ministry of Foreign 

Affairs, MdM 

> project 2: UNFPA, MdM 

Budget 



33 


GUINEA 

On top of the disastrous economic situation, Guinea has been experiencing increasing 

political instability with ministerial reshuffles and the dismissal of the Prime Minister.The 

mass discontent has driven the unions to call several general strikes.The nomination 

of one of President Cont s supporters as Prime Minister provoked a rebellion. In 

February 2007, intervention by the army to re-establish order following a state of 

siege decreed by the President resulted in 112 deaths and a thousand people were 

injured. Disowned by the Parliament because of the state of siege, the President was 

forced to nominate a consensus Prime Minister with wider powers. 

IMPROVING HEALTH IN PRISONS 

Kindia 

Activities 

The prisoners of Kindia central prison live in 

extremely harsh conditions. Since 2001, MdM has 

supported Kindianaise d’Assistance aux Detenus 

(KAD, or Kindia Support for Prisoners) which is 

made up of volunteers who try to improve health and 

hygiene in prisons. 

There are several aspects to this work: 

• training a prisoner in nursing care and the running 

of a pharmacy within the prison; 

• partnership with the health authorities for 

treatment of the most seriously ill; 

• nutritional support; 

• refurbishing health facilities; 

• hygiene and sanitation in the prison; 

• literacy training for prisoners; 

• income generating activities enabling the prisoners 

to acquire skills as well as enabling regular outings 

from their cells. 

Outlook 

The very fragile political situation has 

prompted MdM to extend its support 

of KAD.The objective for 2007 will be 

twofold: to enable KAD to continue 

its work with prisoners, while taking 

steps to increase its financial 

autonomy. 


2000 end 2007 


>CONTENTS 

Mortality 




HDI 

> 0.445; rank: 160/177 


> 421 


Beneficiaries 

> direct: 200 prisoners (men, women and 

children) 

Staff 

> local: members of KAD 

Co-ordinators 

> programme: P. Boucourt and T. Comte 

> monitoring: Rhône-Alpes Bourgogne 

Regional Delegation (S. Bret) 

Funding 

> private partnerships, MdM 

Budget 


IVORY COAST 

Despite the consensual nomination of a Prime Minister and a cease-fire maintained by 

a considerable international military presence, the country remains divided.The north 

is controlled by the New Forces and the south is under the control of the Loyalist 

Forces. There is increasing poverty and unemployment among the population of 

Abidjan. Many health centres have had to reduce their services after many of their staff 

left and because of the falling stocks of essential medical supplies. 

PROTECTING STREET CHILDREN 

Abidjan 

Activities 

Supporting the local NGO MESAD (Movement for 

Education, Health and Development), the programme 

has two objectives: 

• the protection and re-socialisation of street 

children and minors in prison; 

• access to primary healthcare in the streets and at 

the NGO’s medical centre. 

The work involves: 

• a process of re-socialisation of street children with 

the creation of a drop-in centre, psychosocial 

monitoring, support in finding employment, reschooling 

and re-establishing family links; 

• providing primary healthcare and supporting the 

medical activities of Treichville health centre; 

• work amongst minors in Abidjan prison to improve 

their living conditions, and provide some physical, 

psychological and legal support to facilitate their 

reintegration when they leave the facility; 

• specific STI/HIV prevention activities. 

Outlook 

With financial support from MdM, 

MESAD is continuing the activities 

developed between December 1996 

and June 2003. The instability of the 

country has not helped MESAD’s 

fundraising, which is important to 

ensure the continuity of the whole 

programme. 


12/1996 31/12/2007 


>CONTENTS 

Mortality 

> infant: 117 ‰ 


> at birth: 46 

HDI 

> 0.421; rank: 164/177 

GDP/capita($) 

> 866 

Source: Human Developement Report 2006, UNDP 

UNICEF office before the conflict: CI = 175,000 street 

children/Abidjan = 35,000 street children 

Beneficiaries 

> direct: 2,500 street children 

> indirect: 25,000 street children and 

youth in great difficulty 

Staff 

> local: 15 employees and 6 volunteers 

Co-ordinators 

> programme: J.Martin 

> president of the local NGO: K.Kouassi 


Funding 

> MdM, MESAD 

Budget 



35

LIBERIA 

Almost 300,000 refugees and internally displaced people returned to their homes in 

2005, after a ferocious civil war that lasted 14 years and took 250,000 lives.The national 

elections in 2005 went smoothly but the re-establishment of the authority of the state, 

of law and order has hardly started. Social services are in a much worse state than they 

were before the war. More than one third of the Liberian population lives on less than 

one dollar a day. 

PRIMARY, COMMUNITY AND MENTAL HEALTHCARE 

Gbarnga 

Activities 

In Bong county, MdM trains and mentors the health 

staff of 10 clinics to carry out a range of activities: 

• consultations in primary and reproductive 

healthcare, including prevention of STIs; 

• epidemiological surveillance (malaria, cholera etc) 

and nutritional monitoring, particularly for under 5s; 

• vaccination programmes; 

• transferring emergency cases to referral hospitals; 

• psychological and psychiatric support for women 

who have been victims of sexual violence and 

training ‘traditional women’ to deal with psychological 

problems; 

• compilation of a teaching manual for educators on 

the positive effect of psychological treatment for 

former child soldiers; 

• development of a community health programme 

including information, education and communication 

(IEC) activities. 

Outlook 

Introduction of prevention of motherto-child 

transmission of HIV in the 10 

clinics. Supporting the medical training 

given by Phebe nursing and midwifery 

school to ensure that there is an 

ongoing supply of trained medical staff 

for the health facilities. 


09/2003 2010 


>CONTENTS 

Mortality 




HDI 

> not known 


> 130 

Source: World Bank Report 2006 

Beneficiaries 

> direct: 124,678 


Staff 

> local: 70 


Co-ordinators 

> programme: P. Hirtz 

> field:A. Devort 


Funding 

> ECHO, German Ministry of Foreign 

Affairs, MdM 

Budget 


MALI 

Landlocked Mali is heavily dependent on international aid and on an agricultural sector 

which is completely at the mercy of the climate. Because of the crisis in Ivory Coast, 

the Malian government and its partners have had to re-allocate considerable 

resources to humanitarian aid for returnees, asylum seekers and populations in transit. 

In addition,Algeria returns clandestine sub-Saharan African migrants to Mali.The health 

situation in the country remains poor. Access to healthcare is particularly difficult for 

women and there is a high maternal mortality rate linked to vesico-vaginal fistulas. 

SURGERY TO HELP COMBAT EXCLUSION 

Mopti Region 

Activities 

MdM is continuing its programme of prevention 

and treatment of vesico-vaginal fistulas. The 

programme has four aspects: 

• surgical treatment of women; 

• training local surgeons and an operating theatre 

team; 

• spreading prevention messages (on local radio, 

through theatre); 

• literacy classes for those patients who want them. 

Outlook 

In 2007, the project will continue 

without any expatriates in the field. 

The three local surgeons who have 

been trained are now autonomous 

and can continue the activities. A 

representative of MdM in Mopti will 

maintain the link with headquarters. 

The project will continue until the 

fistula work is integrated into the 

construction of the new hospital at 

Mopti. 


12/1999 2007 


>CONTENTS 

Mortality 




HDI 

> 0.338; rank: 175/177 


> 371 


> MdM Belgium 

Beneficiaries 

> direct: women affected by vesico-vaginal 

fistulas 

Staff 

> local: 7 

> expatriate: 1(until October 2006) 

Co-ordinators 

> programme: J-M.Colas 

> field: J-M.Zino 


Monitored in co-operation with the Brittany regional 

delegation 

Funding 

> MdM, Norwegian Church Association 

Budget 


37 


MADAGASCAR 

More than half of Madagascar s 18 million inhabitants live on less than a dollar per day. 

Despite annual economic growth of six percent and the cancellation of debt in June 2005 

by the G8, Madagascans continue to fight for their survival.There is still a lack of awareness 

about HIV and the number of people infected continues to rise. Respect of human rights 

is considered to be relatively satisfactory, except in prisons where the situation has been 

subject to increasing attention from the authorities and development partners. 

CHILD CARDIAC SURGERY 

Antananarivo 

Activities 

Two cardiac medical teams from Reunion, each 

composed of two cardiac surgeons, two paediatric 

cardiologists and one anaesthetist and resuscitation 

expert, carried out week-long visits.There were four 

aspects to their activities in 2006: 

> paediatric consultations; 

> closed-heart surgery in Soavinadriana hospital and 

nine other cases were transferred to F Guyon Hospital 

in St Denis, Reunion, for open-heart surgery; 

> transfer of skills by training two cardiac surgeons in 

Reunion and mentoring the local team; 

> collaboration between the MdM teams and 

Soavinadriana hospital. 

Outlook 

MdM plans to continue its activities 

with other partners so that this work 

can continue in the long-term. 


1994 ongoing 


>CONTENTS 

Mortality 




HDI 

> 0.509; rank: 143/177 


> 241 

Beneficiaries 

> direct: 12 children operated on and 45 

seen in consultation 

> indirect: skills transfer to Madagascan 

practitioners and partner NGOs 

Staff 

> local: 4 to 5 per mission 


Co-ordinators 

> programme: J-F. Delambre 

> field: N. Ramamonjisoa 

> headquarters: Indian Ocean Regional 

Delegation 

Funding 

> La Réunion Council, MdM 

Budget 


PREVENTION AND TREATMENT OF STIS AND HIV/AIDS 

Ilakaka 

Activities 

Following the training of the Salfa (Madagascan NGO) 

team and a Knowledge,Attitudes and Practices (KAP) 

survey, the focus in 2006 was on: 

• Outreach IEC (information, education and 

communication) activities amongst the groups at 

risk, and strengthening local capacity in the fight 

against STIs and HIV/AIDS; 

• Prevention activities, anonymous and free 

voluntary testing and treatment for people living 

with STIs and HIV/AIDS. 

SUPPORT FOR HEALTH IN PRISONS 

Ambanja and Antsiranana 

Activities 

In collaboration with the Ministry of Justice, MdM has 

been working in prisons since 2005 on a pilot 

programme within two central prisons in Antsiranana 

province.The programme has three dimensions: 

> health; 

> malnutrition; 

> sanitation and refurbishment. 

Outlook 

Evaluation of the programme is planned 

in 2007 in order to determine the next 

steps. 


12/2004 01/2007 


Outlook 

Extension of the activities to five 

central prisons within 24 months, 

incorporating a strong socio-legal 

dimension. 


09/2005 12/2006 


>CONTENTS 


Beneficiaries 

> direct: at risk groups (1,200 sex 

workers, mining prospectors, lorry drivers 

and travelling workers, young people and 

SALFA Centre clients) 


Staff 

> local: 6 


Co-ordinators 

> programme: C.Vichatzky 

> field: B.Aboubacar 


Funding 

> MdM, French Development Agency 

Budget 


Beneficiaries 

> direct: 800 prisoners 

Staff 

> expatriates: 1 co-ordinator 

Co-ordinators 

> programme: P. Lehoucq 

> field: O. Bouron 


Funding 

> MdM, French Embassy 

Budget 



39

MOROCCO 

Despite growing tourism, the thriving property market and the reforms which have 

started, Morocco still has insufficient growth to deal with the demographic pressures 

and poverty. Several challenges remain, particularly unemployment, access to drinking 

water and healthcare for the rural populations. Other problems include the issue of 

care for victims of the Years of Lead and for sub-Saharan migrants trapped by the 

closure of routes of passage to Europe. However, the country is involved in a 

democratic process and parliamentary elections are planned for 2007. 

SUPPORTING VICTIMS OF TORTURE 

Casablanca 

Activities 

As part of a programme of medical care for the victims 

of mass repression during the ‘Years of Lead’, MdM 

continues its support to the health centre in Casablanca 

put in place by the medical association for victims of 

torture. MdM organises training workshops on 

psychological trauma and a series of exchanges 

encouraging the creation of a network for the care of 

victims across Morocco. 

Outlook 

In partnership with our Moroccan 

partner, we will continue with training 

and exchange sessions and setting up a 

medical network for torture survivors 

who find themselves without any access 

to health services when they are freed. 


01/2005 end 2007 


ACCESS TO HEALTHCARE FOR SUB-SAHARAN MIGRANTS 

Rabat 

Activities 

MdM, in partnership with Caritas Morocco and an AIDS 

association, supports a Migrants Reception Centre in 

Rabat to implement a medical programme: 

• reception, orientation, prevention activities, health/ 

hygiene education and management of essential medicines; 

• referral and accompaniment to public health services. 

Support to ALCS, the association fighting AIDS: 

• prevention activities, support to a screening centre 

and providing medical and social care for people living 

with HIV. 

Outlook 

The reception centre for migrants will 

function independently. MdM plans to 

develop two types of activities: AIDS 

prevention and treatment, as well as a 

mother-and-child programme. 


01/07/2006 end 2007 


>CONTENTS 

Mortality 




HDI 

>0.640; rank: 123/177 


> 1,678 


Beneficiaries 

> direct, project 1: about 30 participants in 

training; 

> direct, project 2: Sub-Saharan migrants in 

Rabat, between 5,000 and 7,000 people 

> indirect, project 1: 29,000 victims of 

Moroccan jails 

Staff 


> local staff (partner organisations, Caritas 

and ALCS): 16 

> expatriates, project 1: 2 psychiatrists and 

1 doctor 


Co-ordinators 

> project 1: J. Beckouche 

> project 2: D.Guerroudj 

> field, project 2: P.Tainturier 

> headquarters, projects 1 and 2: S.Alary 

Funding 

> project 1: MdM 

> project 2: MdM, Drosos, Swiss 

Cooperation 

Budget 



NIGER 

According to the UN Development Programme, Niger is the poorest country in the 

world, with more than 63% of the population living below the poverty line.Two-thirds of 

those living in poverty are women.The health situation is characterised by a high fertility 

rate, high maternal and infant mortality rates and large gaps between men and women in 

terms of health, education and literacy. 

PRIMARY HEALTHCARE 

Keita 

Activities 

The programme includes several activities: 

• refurbishment, provision of equipment, training and 

mentoring of staff in nine integrated health centres; 

• facilitating access to primary healthcare by 

removing the financial barrier for children under five 

and pregnant women, putting in place exemptions 

from payments for healthcare; 

• supporting the implementation of the new national 

protocol for treating malaria; 

• development of a common protocol with Action 

Against Hunger Spain for screening and treating 

malnutrition. 

Outlook 

Continuing the project in Keita by 

expanding the support to Tahoua 

maternity unit to improve care for 

high-risk pregnancies. 

Start of a new ‘research-actionadvocacy’ 

project on nutrition and 

demography in Tahoua region, in 

partnership with Action Against 

Hunger Spain and with European 

Union financial support. 


01/03/2006 ongoing in 2007 


>CONTENTS 

Mortality 




HDI 

> 0.311; rank: 177/177 

GDP/capita($) 

> 228 


Beneficiaries 

> direct: 40,501 


Staff 

> local: 21 


Co-ordinators 

> programme: O. Bernard 

> field: J. F. Caremel 


Funding 

> ECHO 

Budget 



41

RWANDA 

The aim of the 1994 genocide in Rwanda was to exterminate the Tutsi population. In less 

than 100 days, nearly a million people were killed in horrible conditions.Thirteen years 

later, the country is trying to push forward its economic reconstruction.The government s 

strategy tends towards a policy of unity and reconciliation. Around 283,000 survivors of 

the genocide live in Rwanda, often in isolation and extreme deprivation. Many victims 

remain haunted by the atrocities that they experienced.The signs of trauma are more 

visible than ever, particularly during the hearings of the gachacha village tribunals in which 

the whole population is invited to participate. 

MEDICAL AND PSYCHOLOGICAL SUPPORT TO GENOCIDE SURVIVORS 

Kigali 

Activities 

The programme has three main aspects: 

• developing a joint action plan for accompaniment 

and psychological care across the country with 34 

trauma counsellors and three psychologists from 

IBUKA as well as para-legals; 

• supporting survivors going before the gachacha, 

with an analysis of the therapeutic effects linked to 

the process of these local jurisdictions (actionresearch); 

• institutional support for our partner IBUKA on 

technical, financial and institutional communication 

issues. 

Outlook 

The first phase of the project is planned 

to take place from September 2006 to 

May 2007. It includes a major element 

of experimentation, research, additional 

diagnosis with a view to more general 

support and mentoring in the longer 

term in partnership with IBUKA. The 

following phase will begin in June 2007. 


09/2006 05/2007 


>CONTENTS 

Mortality 




HDI 

> 0.450; rank: 158/177 


> 208 


Beneficiaries 

> direct: 283 000 

Staff 

> local: 90 (staff of IBUKA) 

Co-ordinators 

> programme: G. Foucaud/F. Jacquet 

> headquarters: C. Courtin 

Funding 

> MdM 

Budget 


SUDAN 

After 20 years of conflict between government forces and rebels,the population in South Sudan 

has returned home after the peace process,but the socio-political make-up of the region causes 

tensions which hinder reconstruction. In the west, the humanitarian situation has deteriorated 

in Darfur with a climate of widespread violence particularly due to the increasing number of 

parties involved in the conflict.Access to aid for the populations is diminishing, generating fears 

of an alarming deterioration in the health situation. 

IMPROVING THE QUALITY OF SURGICAL CARE AND PRIMARY 

HEALTHCARE 

Malakal, South Sudan 

Activities 

• Surgery/Hospital: completion of the project to 

renovate and equip the surgical unit, as well as 

training the staff; 

• Primary healthcare: opening five mobile clinics in 

the Tonga corridor along the White Nile; 

• Responding to a cholera epidemic by installing a 

cholera treatment centre in Kaldak in November. 

Outlook 

The fighting in Malakal at the end of 

November highlights how unstable the 

situation is and has slowed the 

reconstruction efforts.The objective is 

to develop the project, adapting it to 

the constantly changing context. 


25/11/2004 2007 


EMERGENCY MEDICAL CARE 

South Darfur – Nyala (Kalma, Dereij, Kass, Djebel Mara) 

Activities 

• The primary healthcare centre (Kalma camp) 

carried out medical consultations, care for women 

who are victims of violence, health education 

sessions and oral rehydration therapy. From June to 

October, the cholera treatment centre was active in 

response to an epidemic. 

• Between April and December, mobile clinics 

provided healthcare to the isolated populations in 

Thur, Kass and in the Djebel Mara.These clinics 

were suspended because of security reasons. 

>CONTENTS 

Outlook 

The deterioration in security conditions 

generated fears of a reduction in humanitarian 

aid and in access to the most vulnerable 

populations, leading to predictions of an 

unprecedented humanitarian crisis. 


14/07/2004 2007 


Mortality 




HDI 

> 0.516; rank: 141/177 


> 594 


International Delegations 

> project 2: MdM Greece, in El Fasher 

(West Darfur) 

Beneficiaries 

> direct, project 1:50,000 (Malakal town) + 

35,000 (neighbouring rural populations) 

> direct, project 2:80,000 

> indirect,project 1:150,000 (High Nile region) 

> indirect,project 2:120,000 

Staff 

> local, project 1:20 

> local, project 2:200 

> expatriate, project 1:5 + surgical teams 

> expatriate, project 2:17 

Co-ordinators 

> project 1:J.Larché,G.Isserlis (RT),G.Lang 

> project 2:J. Larché/G. Lang 

> field,project 1:A.Neveu/A.Rego 

> field,co-ordinator Nyala:N.Seris/P.Villedieu 

> country co-ordinator,Khartoum :F.Mawazini 

> HQ,projects 1 and 2:emergency desk/B.Contamin 

Funding 

> project 1:French Embassy in Khartoum, 

MAAIONG, Renzo Piano 

> project 2 :DFID, ECHO 

Budget 

> 2006 project 1:243,556 euros (surgery) + 

205 ,726 (primary care) + 170,043 (Cholera 

November) 

> 2006 project 2: 1,970,197 euros 


43

TANZANIA 

Considered as an island of stability in the region, Tanzania has welcomed more 

refugees than any other country in Africa following the conflicts suffered by its 

neighbours Rwanda, Burundi and Democratic Republic of Congo.The last decade has 

been notable for the introduction of reforms and relatively sustained economic 

growth.The remaining challenges are to slow the spread of HIV/AIDS and to improve 

living conditions for the most disadvantaged groups.Around seven percent of the adult 

population lives with HIV and antenatal consultations have shown prevalence rates 

ranging from five to fifteen percent in some regions, even though these rates have 

fallen in the last ten years. 

ACCESS TO EFFECTIVE ANTI-RETROVIRAL COMBINATIONS 

Bukoba 

Activities 

• MdM supports the clinic run by TADEPA, a local 

organisation, with treatment and prevention of 

opportunistic infections in people living with AIDS 

and with prevention campaigns which actively 

involve the communities. 

• Since 2004, an ambitious Highly Active 

Antiretroviral Therapy (HAART) programme has 

enabled more than 1,500 patients to access tritherapies. 

In particular, HIV-positive pregnant 

women, patients with advanced, life-threatening HIV 

infection and hospital staff and their families have 

benefited. 

Outlook 

Continuation of all these activities in 

2007 and the development of access to 

effective anti-retroviral combinations in 

rural areas by providing support to 

three district hospitals. 


02/10/2004 28/02/2010 


>CONTENTS 

Mortality 




HDI 

> 0.430; rank: 162/177 


> 288 



> MdM Spain 

Beneficiaries 

> direct: hospital personnel and their 

families, HIV-positive pregnant women and 

their families, patients presenting with 

advanced HIV infection 

> indirect: educators, nurses 

Staff 

> local: 10 

> expatriates: 2 

Co-ordinators 

> programme: P.Tattevin 

> general co-ordinator:A. Billy 

> headquarters: C. Courtin 

Funding 

> Columbia University 

Budget 


ZIMBABWE 

In 2006, a third of Zimbabwes adults were HIV positive and life expectancy was barely 

over 36 years.The health situation in Zimbabwe is one of the most disastrous in Africa. 

The controversial policies of the government have driven the country into isolation 

and have resulted in an overall reduction in international aid. On top of this, an acute 

food crisis and an economy in decline contribute to a considerable rise in infant 

mortality, the highest the country has even known. 

REDUCING THE IMPACT OF HIV/AIDS 

Chipinge 

Activities 

In partnership with MdM Canada, MdM Spain and a 

local NGO called FACT, MdM France is developing a 

comprehensive approach across Chipinge district 

combining: 

• community information and awareness-raising; 

• training community health agents; 

• running home-based care services for housebound 

HIV-positive patients; 

• psycho-social and therapeutic support to orphans 

and vulnerable children; 

• training health personnel; 

• running information and testing centres; 

• supporting prevention activities and treatment in 

four hospitals and 44 clinics in the district; 

• setting up monitoring and evaluation tools. 

Outlook 

In 2007, our teams will work on 

consolidating our activities and 

strengthening access to antiretrovirals 

in Chipinge hospital and potentially 

another hospital in the district. 


05/2004 (pilot project) – 01/2005 (overall project) 12/2010 


>CONTENTS 

Mortality 




HDI 

> 0.491; rank: 151/177 


> 363 



> MdM Spain and MdM Canada 

Beneficiaries 

> direct: 350,000 inhabitants of Chipinge 

district 

> indirect: 204 community health workers 

in Chipinge 

Staff 

> local: 33 


Co-ordinators 

> programme: C.Moncorgé 

> field: C. Garro 

> headquarters: N. Bréchet 

Funding 

> MdM France, European Union, Hivos 

Budget 


45 


LATIN 

AMERICA » 

»EMERGENCY: 

a situation where people’s lives and livelihoods are in immediate danger (natural 

disaster, armed conflict etc.). Response: substitution programme. 

»CRISIS: 

situation where people’s basic needs are not being met in the long-term (civil war, 

forgotten conflict, HIV pandemic). Response: technical assistance and 

mobilisation of local resources. 

»DEVELOPMENT: 




>CONTENTS

ARGENTINA p.52 

BOLIVIA p.53 

COLOMBIA p.54 

EL SALVADOR p.55 

GUATEMALA p.56 

MEXICO p.57 

HAITI p.58>59 

NICARAGUA p.60 

PERU p.61 

>CONTENTS 

INTERNATIONAL PROGRAMMES ¨ LATIN AMERICA ANNUAL REPORT 2006 

47

PERU 

Maria, 14 years old 

‘I live with my mother and my 

two brothers in a shanty town in 

the south of Lima. My father left 

when I was six years old. He 

was an alcoholic and used to 

beat my mother. I came to the 

teenage centre in August 2006 

with my friends and I quickly 

became a group leader.’ 

In October, Maria did not 

turn up on two Sundays in a 

row, supposedly because she 

had been in an accident and 

had been hit by a mototaxi. 

The following Sunday she 

came accompanied by her 

mother who warned that the 

girl had become sad, would 

not speak and no longer 

wanted to go to school. In 

fact, one Monday Maria woke 

up in the emergency 

department of a health 

centre with signs of having 

been cut and raped. She had 

been taken by two mototaxis 

at the school exit.They beat 

her until she lost 

consciousness, then they 

raped her. MdM helped her 

mother to press charges and 

Maria continues to be 

monitored in our centre 

where, little by little, she is 

starting to smile again. 

>CONTENTS 

MdM 

Jérôme Denni

CONTENTS 

(4) MdM 

(3) MdM 




49

CONTENTS 

(5) Wilfried Maisy

» While in Guatemala (3 and 

4) women’s health is harmed 

by globalisation, in Haiti it is 

violence which puts women 

in the position of being 

victims: in both cases, 

multidisciplinary care – both 

medical and legal – is vital. 

Migrants in Mexico (6), trying 

to emigrate clandestinely to 

the United States, are a 

population at risk, particularly 

in terms of HIV. Respecting 

their right to health is still a 

priority. In Bolivia (5), a team 

has been working since 2002 

on prevention of workrelated 

risks for child 

labourers and improving 

these children’s access to 

healthcare.The sustainability 

of this project involves 

working in partnership with 

teachers, local institutions and 

health services. In Colombia, 

the women and children of 

the indigenous Emberas 

community (7), in the midst 

of the conflict which plagues 

the country, still have difficulty 

accessing healthcare. 

>CONTENTS 

(6) Michel Redondo 

(7) Michel Redondo 


51

ARGENTINA 

Although the country is heading back to economic prosperity, the government s social 

policy initiatives have not managed to tackle the extreme poverty of the population. In 

effect, only some Argentines can access the health and welfare system. Others, including 

the indigenous communities, do not have access to healthcare because of cultural and 

economic barriers. Women and children are included in this extremely vulnerable 

category. 

IMPROVING ACCESS TO CARE FOR WOMEN AND CHILDREN 

Abra Pampa, Puna Jujena, Jujuy Province 

Activities 

MdM contributes to improving access to 

healthcare for the rural population through: 

• mother and child healthcare; 

• monitoring women to prevent cervical cancer and 

sexually transmitted infections; 

• health education and health promotion; 

• constructing a maternity unit. 

Outlook 

MdM Argentina will continue MdM- 

France’s work, through managing 

social and health activities in 

partnership with Warmi. 


01/04/2003 31/08/2006 


>CONTENTS 

Mortality 

> infant: 16 ‰ 



HDI 

> 0.863; rank: 36/177 


> 3,988 



> MdM Argentina - local projects 

Beneficiaries 

> direct: women and children 

> indirect: general population, health 

promoters and healthcare staff (hospital 

and health posts) 

Staff 

> local: 1 


Staff 

> project:T. Brigaud 

> field: H. Solis, R.Timpano 

> headquarters: E. Herrera 

Funding 

> EU, MdM France 

Budget 


BOLIVIA 

Potosi (altitude 4,000m) is a mining town employing large numbers of children.The rise in mineral prices 

on the international markets has lead to over-exploitation of these deposits.Huge quantities of water 

and numerous pollutants, needed to process the minerals, are discharged directly into the river.This 

contamination has resulted in a drop in agricultural production and worries the rural population who 

fear for their health.MdM is working on a project with the Institute for Research and Development 

which is studying the impact of mining contamination on children. 

PROMOTING ENVIRONMENTAL HEALTH 

Four communities living along the Pilcomayo river in Chuquisaca 

and Potosi provinces 

Activities 

The support provided by MdM is aimed at: 

• facilitating exchanges between communities, 

local health authorities and researchers; 

• promoting provision of healthcare, particularly 

in relation to psychological issues; 

• strengthening the capacity of the farmers’ 

organisation CODERIP (Council for the Protection 

of the Pilcomayo River). 

Outlook 

In 8 months, MdM will: carry out four 

feedback sessions on the research findings 

in each community; organise a meeting 

between researchers, local authorities and 

CODERIP; train 10 healthcare staff and 25 

community health promoters; organise six 

free discussion sessions in each community; 

carry out a community assessment in the 

river basin and will put a monthly 

information system in place. 


09/2006 12/2007 


PROTECTING THE HEALTH OF CHILD WORKERS 

Potosi, San Cristobal district 

Activities 

MdM’s activities include: 

• promoting health education and access to healthcare 

through workshops with children and educators, as well as 

providing support materials and raising awareness of traditional 

medicine and of the effects of work on children aged 

between six and eight years old; 

•activities aimed at tackling depression among adolescents 

in difficulty; 

• creation of a youth club, in partnership with an association 

from Lyon, offering recreational activities, alternatives to child 

labour; 

• training in basic life saving knowledge and treatment of those 

who are injured in mining accidents. 

Outlook 

The year 2007 will be a crucial year for the 

sustainability of the programme and the 

handover to local partners. MdM will train 

schoolteachers in health education and will 

also evaluate whether it is necessary to 

extend MdM’s presence throughout 2008 

to support the handover. 


2002 12/2007 


Mortality 

> infant, project 1: 54‰ 



HDI 

> 0.692; rank: 115/177 


> 974 




Beneficiaries 

> direct, project 1: 10 healthcare staff and 

25 community health promoters 


> indirect, project 1: 3,000 families 


Personnel 





Co-ordinators 

> project 1: S. Lagardère 

> project 2: L. Liron, D. Masson 

> field, project 1: O. Barras 

> field, project 2: I.Tapia 

> headquarters, project 1:Y. Le Corgne 

> headquarters, project 2: Rhône-Alpes 

Bourgogne Regional Delegation (S. Bret) 

Funding 


> project 2: private partnerships, Rhône- 

Alpes council, MdM 

Budget 



>CONTENTS 


53

COLOMBIA 

President Urib was re-elected in an election with a high abstention rate. Despite an 

aggressive policy towards the armed factions and the demobilisation of paramilitaries, 

the FARC has gone back onto the offensive, particularly in the south where massive 

fumigations carried out by the government have affected the population and the 

economy. In Choco, the indigenous Embera community have been doubly penalised: 

as an ethnic minority group and as victims of conflict. 

ACCESS TO HEALTHCARE FOR VULNERABLE CIVILIANS 

Meta Region 

Activities 

MdM’s objective is to ensure access to healthcare for 

civilians in the area and to respond to emergency 

situations linked to the conflict. Replacement medical 

support is provided to health posts which are lacking 

doctors because of the situation. 

Outlook 

Continue our work with victims of 

conflict in a way which improves our 

capacity to respond to humanitarian 

emergencies. At the request of local 

communities, to extend access to 

healthcare to include adults who are ill. 


01/05/2006 30/06/2008 


ACCESS TO HEALTHCARE FOR VICTIMS OF CONFLICT 

Medio Atrato Region 

Activities 

MdM facilitates access to healthcare for the 

communities when they are displaced due to the civil 

war. Our mobile medical teams provide healthcare, 

particularly to children and women who are 

especially vulnerable. These teams also train health 

promoters. With a view to improving the image of 

traditional medicine, MdM, in partnership with the 

jaibanas (traditional healers), has launched a project 

harvesting medicinal plants and based on an animist 

culture. 

Outlook 

To continue our collaboration with 

the herbal therapists and the jaibanas. 

To continue to ensure access to 

healthcare for the adult population. 


01/07/2006 30/06/2008 


>CONTENTS 

Mortality 




HDI 

> 0.790; rank: 70/177 


> 2,176 



> projects 1 and 2: MdM Spain 

Beneficiaries 

> direct, project 1: women and children 

under five 

> direct, project 2: embera population and 

afro-colombian population 

> indirect, project 1: civilian victims of 

conflict 

Staff 





Co-ordinators 

> projects 1 and 2: C. Raggioli 

> field, project 1: K. Morales 

> field, project 2:V. Gavidia 

> HQ projects 1 and 2: E. Herrera 

Funding 

> projects 1 and 2: ECHO, MdM 

Budget 



EL SALVADOR 

El Salvador is the smallest and most densely populated Central American country. 

Around a third of the population has left for the United States and the country is 

badly affected by poverty, underemployment and crime. Although one of the 

government s priorities is to tackle these social problems, the situation remains very 

critical. 

DEVELOPING A COMMUNITY HEALTH PROGRAMME 

Morazan region 

Activities 

In partnership with the Salvadorian NGO MDS, MdM 

continues its health programme working with 

vulnerable populations in the remote rural areas of 

Morazan region. Activities in Ahuachapan and 

Cuscatlan regions have been added to the 

programme. 

Our programmes involve: 

•training all the staff in management; 

•developing a communication system for the association; 

•renewing IT equipment and software training; 

• disinfection, training and prevention in 20 groups of 

houses, as part of environmental decontamination 

campaigns; 

•construction of a well and a septic tank for the staff 

accommodation beside El Tablon health centre in 

Morazan. 

Outlook 

2007 will be the final year of 

management and IT training for the 

MDS staff. This training will enable 

better management and organisation 

of the association. 

The development of a communication 

system for the association will enable 

them to improve the profile of MDS 

and its activities which, in turn, will 

help with fundraising. 


10/2004 end 2007 


>CONTENTS 

Mortality 




HDI 

> 0.729; rank: 101/177 


> 2,340 



> MdM Spain 

Beneficiaries 

> direct: 7,000 


Responsables 

> project: J.-L. Pesle 

> headquarters: Grenoble branch 

Funding 

> MdM 

Budget 

> 2006: 13,290 dollars 


55

GUATEMALA 

Maquilas are export-producing factories which are linked to foreign investment.These 

sub-contracting factories appeared throughout central America in the 1990s.They are 

exempt from some taxes and legal obligations and they create jobs. However, abuse, 

poor treatment and irregularities are common. The victims are mainly women from 

the indigenous communities, with little education and from extremely disadvantaged 

circumstances. 

HEALTH OF WOMEN WORKING IN FACTORIES 

Chimaltenango and Sacatepequez regions 

Activities 

In 2006, MdM set up easy-access medical and welfare 

consultations, enabling the recording and analysis of 

working conditions of these women. The first 

awareness-raising workshops on the Right to Health 

were organised with CEADEL, one of our local 

partners. MdM resumed its involvement in the 

organisation for preventing conflict in the maquilas in 

order to develop advocacy work on workers’ rights. 

Outlook 

In 2007, MdM plans to disseminate 

widely the findings of the analysis 

based on the medical and welfare 

consultations, to organise several 

awareness-raising workshops for 

women working in the factories and 

to identify and train leaders within this 

group. Finally, if the project is 

extended until 2009, a regional 

meeting on the rights of women 

working in maquilas will take place 

then, involving the Latin American 

Social Medicine Association (ALAMES), the 

central American network of women 

working in maquilas, our Guatemalan 

partners and the relevant ministries. 


09/2006 06/2010 


>CONTENTS 

Mortality 




HDI 

> 0.673; rank: 118/177 


> 2,233 



> MdM Spain 

Beneficiaries 

> direct: 4,800 factory workers, including 

25 leaders 

> indirect: 100,000 to 150,000 workers in 

the export industries 

Staff 

> local: 2 


Co-ordinators 

> project: P. Giraux 

> field: G. Sekhniachvili 

> headquarters:Y. Le Corgne 

Funding 

> MdM 

Budget 


MEXICO 

Mexico s economic growth in the last ten years has not reduced the inequalities or 

social exclusion which drive a large number of Mexicans to choose clandestine 

emigration to the United States.They are forced to cross the border in unsure or highrisk 

situations, particularly at Tijuana and Mexicali. With this background, the 

marginalisation of indigenous populations in southern Mexico also remains a problem. 

PROMOTING THE RIGHT TO HEALTH OF INDIGENOUS POPULATIONS 

Chiapas 

Activities 

MdM France has been working in Mexico since 1998. 

The current programme aims to improve the 

health of the indigenous populations. With the 

support of the communities, MdM is training health 

promoters and is setting up four micro-clinics to 

enable access to healthcare for these populations. 

More than 500 promoters look after their communities’ 

health and work with the three reference microclinics. 

Outlook 

The implementation of a health 

system managed by the indigenous 

community will enable them to 

become more autonomous. Real 

negotiations between the government 

and the Zapatista movement would 

enable more lasting solutions for 

managing their health to be found. 


01/07/2006 31/12/2010 


MIGRANT RIGHTS AND ACCESS TO HEALTHCARE 

Tijuana and Mexicali 

Activities 

MdM aims to improve access to healthcare and 

respecting the right to health of migrants in Tijuana 

and Mexicali.The programme’s objectives are: 

• to facilitate the provision of healthcare for migrant 

populations; 

• to prevent the transmission of HIV/AIDS and 

other sexually transmitted infections; 

• to promote and encourage the respect of the right 

to health for the migrant populations on the 

northern border. 

Outlook 

The project will continue along the 

same lines in 2007. 


04/2006 03/2008 


>CONTENTS 

Mortality 




HDI 

> 0.821; rank: 53/177 


> 6,518 



> MdM Spain, MdM Switzerland 

Beneficiaries 

> direct, project 1:Tzotzil,Tzetzal,Tojolabal 

and Chol communities 

> direct, project 2: migrants expelled from 

the US to Mexico, migrants trying to cross 

the border into the US 

Staff 




Co-ordinators 

> project 1:T. Brigaud, F. Stea 

> project 2: F. Giraux, M-D Aguillon 

> field, project 1: C. Escobar 

> field, project 2: B. Ponçon 

> HQ, projects 1 and 2: E. Herrera 

Funding 

> projects 1 and 2: French Ministry of 

Foreign Affairs, MdM 

Budget 




57

HAITI 

The poorest country in the northern hemisphere, Haiti is emerging from a long political 

crisis and trying to reconstruct a state of law, which would respect the fundamental 

rights of its citizens. 

MdM is working in disadvantaged rural areas, characterised by a weak government 

presence and a subsistence economy that is vulnerable to changing weather conditions. 

MdM is also working in poor areas of Port-au-Prince which are blighted by crime and 

violence. 

CARING FOR VICTIMS OF VIOLENCE 

Disadvantaged districts in Port-au-Prince 

Activities 

MdM organised awareness-raising sessions on 

violence in five health facilities, began a training 

programme for healthcare staff and has defined an 

outline methodology for psychological care. In 

addition, in collaboration with its partner URAMEL, 

MdM has rejoined the institutional consultation 

forums on the rights of victims. At the same time, 

MdM has lobbied for the use of a single registration 

form for cases of violence and for free medical 

certificates for victims of violence. 

Outlook 

MdM will train leaders and community 

health agents, will manage mass media 

awareness-raising activities on violence, 

will refurbish five health facilities, will 

develop a psychotherapy programme 

and will increase its involvement in multidisciplinary 

networks and in advocacy 

activities. 


01/07/2006 30/06/2009 


>CONTENTS 

Mortality 




HDI 

> 0.482; rank: 154/177 


> 420 



> MdM Canada, MdM Switzerland 

Beneficiaries 

> direct: 800 professionals: 20 community 

groups (800 people including 60 leaders) 

> indirect: 500,000 victims of violence 

(domestic, societal, state) 

Staff 

> local: 8 


Co-ordinators 

> programme:A. Urtubia, J. Boggino 

> field: C. Martin 


Funding 

> French Ministry of Foreign Affairs, MdM 

Budget 


PROMOTING ACCESS TO PRIMARY HEALTH CARE AND HYGIENE 

Grande Anse 

Activities 

Primary healthcare: 

• trials of a cost-recovery system in two health 

facilities, with exemptions for pregnant women and 

under fives; 

• a study of the social, economic and health situation 

of the population of Roseaux; 

• supporting the Communal Health Unit 2 (UCS2) 

with supervision of 15 decentralised health facilities; 

• improving the equipment and the electrical system 

at Jeremie reference hospital. 

Latrines: 

• reducing mortality and morbidity linked to faecal 

contamination in Roseaux, by increasing access to 

latrines from 0 to 28% in 18 months; 

• raising community awareness on latrine construction, use 

and maintenance; 

•carrying out home follow-up visits. 

TRAINING HOSPITAL STAFF 

Pilate 

Activities 

Programme supporting Pilate hospital which has been 

run by Canadian nuns for several decades. 

MdM’s action combines: 

•a surgical project: sending a full team for two weeks 

to carry out a hundred operations on patients selected 

by the nuns throughout the year; 

• a mother and child project: using ‘health agents’ to 

screen and treat chronic malnutrition and training health 

agents, matrons and mothers; 

• a psychiatric project: training Pilate healthcare staff 

in treatment of psychiatric illness and training Haitian 

medical personnel, with the head of the psychiatry 

department at Port-au-Prince University Hospital. 

Outlook 

MdM will demonstrate the relevance of the 

programme to the Haitian institutions as a way 

of extending it to all the facilities of UCS2.We will 

lobby the institutions concerned with access to 

primary care in Haiti. Periodic support will be 

provided to the hospital to improve the referral 

and cross-referral systems. In relation to the 

latrines, after three years, the vast majority of 

them will be in use and maintained.MdM would 

respond to requests from neighbouring 

communities if ad hoc funding were found. 


Primary healthcare 

01/07/2006 31/06/2008 



Latrines 

01/07/2004 31/01/2006 


Outlook 

In 2007, MdM will continue these 

activities. In order to adapt the 

mother and child health programme, 

there will be an emphasis on 

treatment for acute malnutrition, 

training the nuns and other staff in 

nutrition protocols developed by 

Action Against Hunger. 


1980 Ongoing 


>CONTENTS 


> MdM Canada, MdM Switzerland 

Beneficiaries 

> direct: 3,400 residents: UCS n°2 

healthcare staff (primary care) + 8,400 

(beneficiaries of the latrines) 

> indirect: 179,000 (total population of the 

UCS 2) 

Staff 

> local: 26 


Co-ordinators 

> programme: S. Lasserre 

> field: B. Deveaux / J. Pfaffmann / O. Naval 


Funding 

> UNDP, Ministry of Foreign Affairs, 

MdM, EU 

Budget 


Beneficiaries 

> direct: 60,000 

Personnel 

> local: 31 health agents 


Co-ordinators 

> project: C. Castaing 

> headquarters:Aquitaine Regional 

Delegation 

Funding 

> MdM,Amis de Sœur Madeleine 

Association, private donations 

Budget 



59

NICARAGUA 

Politically and economically unstable, Nicaragua is a country where tensions were 

exacerbated in the run up to the elections in November 2006. Poverty affects 2.3 

million people. Societal violence, alcohol and drug use are major concerns. In 2001, the 

government designated the struggle against violence, including domestic and sexual 

violence, as a public health priority. However, these issues continue to affect a large 

number of women and children. 

CARING FOR VICTIMS OF VIOLENCE 

Autonomous North-Atlantic Region (RAAN), Puerto Cabezas town 

Activities 

MdM’s activities include: 

• improving prevention and multidisciplinary care 

(health, legal and social) for victims of domestic and 

sexual violence; 

• integration into the network of the national plan 

for prevention of domestic and sexual violence 

(2001-2006); 

• refurbishment, provision of equipment, and 

management of a drop-in centre, in close 

collaboration with local partners; 

• consultations and screening for STIs, cervical and 

other cancers; 

• gynaecological and psychological treatment; 

• legal and administrative support; 

• raising awareness of all those who are potentially 

involved, including the male population. 

Outlook 

To develop the programme over a 

four year period. 


01/07/2006 30/06/2010 


>CONTENTS 

Mortality 




HDI 

> 0.698; rank: 112/177 


> 847 


Beneficiaries 

> direct: around 4,000 female victims of 

domestic or sexual violence. Children under 

15 who are victims of domestic or sexual 

violence: 20,000 children considered to be 

at risk. 3,650 men aged between 15 and 54 

years. 

> indirect: 80% of the healthcare staff of PC 

town (160 people), 45 ‘relay women’ in Bilwi 

district, 16 members of local NGOs and 

partner organisations. General population in 

PC (60,500 inhabitants) 

Staff 

> local: 1 


Co-ordinators 

> project: B.Tilmont and M-L. Deneffe 

> field: L. Muller 

> headquarters: E. Herrera 

Funding 

> French Ministry of Foreign Affairs, 

Andalusian autonomous community 

Budget 


PERU 

Each year, there are high rates of unwanted teenage pregnancies and illegal abortions 

in Peru. Pregnant teenagers are heavily stigmatised. Maternal mortality is high in this age 

group and the transmission of HIV/AIDS and sexually transmitted infections is 

increasing. However, sexual and reproductive health policy in this country is not very 

specific and lacks coherence. The government s response to the real needs of 

adolescents remains ineffective. 

PROMOTING SEXUAL AND REPRODUCTIVE HEALTH OF 

ADOLESCENTS 

Three disadvantaged districts on the outskirts of Lima 

Activities 

The project aims to improve access to prevention 

and treatment in relation to reproductive and sexual 

health for 10 to 19 year olds. It is being developed 

around nine Teenage Centres and in schools and 

colleges. In 2006, the premises of the Teenage Centres 

– places where young people can come and receive 

guidance – were identified and refurbished. Local 

psychologists have begun individual consultations and 

awareness-raising seminars. General communication 

campaigns have been carried out in the three districts 

and collaboration with the three councils has been 

established in order to create a working network 

around these Teenage Centres. 

Outlook 

In 2007, the community awarenessraising 

will be reinforced by trained 

adolescent promoters. Care for 

adolescent girls must be improved by 

stronger links between the Teenage 

Centres and local health centres. 

Training of healthcare staff is planned, 

as well as a campaign to have sexual 

and reproductive health recognised as 

a public health priority. 


10/2005 09/2008 


>CONTENTS 

Mortality 




HDI 

> 0.767; rank: 82/177 


> 2,490 



> MdM Spain 

Beneficiaries 

> direct: 47,000 vulnerable adolescents 

> indirect: 210,000 adolescents in the 3 

programme districts 

Staff 

> local: 13 

> expatriate: 1 administrator 

Co-ordinators 

> project: M. Boscaméric, C. Batard 

> field: Z. Gambirazio 


Funding 

> Annenberg Foundation (USA), French 

Ministry for Foreign Affairs,Air France 

Foundation, MdM 

Budget 



61

ASIA» 

Rép. dém. 

du Congo 

3 1 

» EMERGENCY: 



Angola 4 

» CRISIS: 


forgotten conflict, HIV pandemic). Response: technical assistance and mobilisation 

of local resources. 





>CONTENTS

AFGHANISTAN p.68>69 

BURMA p.70 

CAMBODIA p.71 

CHINA p.72 

MONGOLIA p.73 

INDONESIA p.74>76 

NEPAL p.77 

PAKISTAN p.78 

SRI LANKA p.79 

UZBEKISTAN p.80 

VIETNAM p.81 

>CONTENTS 

INTERNATIONAL PROGRAMMES ¨ ASIA ANNUAL REPORT 2006 

63

Afghanistan 

Harm reduction programme 

Said Aziz, 38, has been going to the centre 

for two months. 

‘Twenty years ago I went to live in Iran. I was a tailor 

and my boss gave me drugs so that I could work day 

and night.That’s where I became dependent on drugs. 

After the fall of the Taliban regime, I returned to Kabul. 

On the way back, however, thieves took everything from 

me. Here, I have no work and I am unhappy. On the 

radio, they said that the situation was getting better but 

if I had known that life in Afghanistan was like this, I 

would not have come back.When I lived in Iran, I was 

drug-dependent but my family did not reject me because 

I had a job and I could provide for their needs. 

Since I’ve been living here, I have no fixed job and, because 

of my drug dependence, I had to leave my family. I 

have now been living on the streets with other users 

for one year and two months. I do not want to go back 

and live with my sister, my wife and four children because 

I’m ashamed. I just heard from a friend that my 

family will be evicted because they haven’t been able to 

pay the rent for seven months. I don’t know what to do. 

Some days, I work unloading sacks of cement and bricks 

from lorries. I earn around 150 afghanis per day (2.37 

euros) and I work four days a week.With this money, or 

some that I borrow from friends, I spend 100 afghanis 

on drugs each day.That does not leave much, so I only 

eat on 20 days each month, usually bread and tea. Sometimes, 

I feel so weak that I can’t work. On the top of 

this, in the streets we are hassled and extorted by the 

police.They protect drug dealers even in the places 

where we go to buy drugs.’ 

>CONTENTS

CONTENTS 

Jacky Naegelen/Reuters 


65

CONTENTS 

(2) Isabelle Eshraghi 

(3) Franck Ferreira 

(1) Stéphane Lehr

(4) Lahcène Abib 

(6) MdM 

» Women and ethnic minorities are often the first victims of obstacles to healthcare: in Afghanistan (1) Pakistan (2) and among the Punan 

people of Indonesia (6), our teams try to remedy this situation. Elsewhere, the most disadvantaged, least educated and most excluded groups 

feel the full force of epidemics. In Cambodia (4), more than 2,000 people affected by HIV are regularly monitored and more than 500 of them 

now have access to anti-retrovirals. In Vietnam (5) and Nepal (3), the struggle against AIDS is focused on drug users and prostitutes, while in 

Mongolia (7) the focus is on stopping the spread of tuberculosis in shanty towns. 

>CONTENTS 

(5) Lahcène Abib 

(7) David Delaporte 


67

AFGHANISTAN 

Despite the democratisation process which is underway and the attempts to normalise 

and secure the situation, institutional and socio-economic reconstruction remain a 

challenge for the Afghan authorities. The return of millions of refugees from Iran and 

Pakistan, mostly to Kabul, accentuates this new impoverishment process. In addition, the 

government is not yet in a position to be able to protect public health and access to 

healthcare for the population, particularly women and children, remains poor. 


Kabul 

Activities 

MdM supports two mother and child health 

centres in Kabul.The programme involves four areas 

of work: 

• access to healthcare for women (paediatric, 

gynaecological and obstetric consultations, 

immunisation, basic health and hygiene education); 

• training of local healthcare staff; 

• refurbishment of healthcare facilities and provision 

of drugs and equipment; 

• development of a stable partnership with local 

health authorities. 

The training component of the programme has 

become particularly important since the departure of 

the Taliban, with the training of female doctors, nurses 

and midwives. 

Outlook 

Ensure handover of the two mother 

and child health centres to a local 

NGO which will maintain the level 

and quality of services. Focus again on 

the issues of mental health and harm 

reduction, so far left out of the health 

system under reconstruction. 


1995 2007 


>CONTENTS 

Mortality 


> under five mortality: 257‰ 

> maternal mortality: 1,900/100,000 



HDI 

> Not known 


> 430 

Sources: Human Development Report 2006, UNDP, 

WHO 2004 

Beneficiaries 

> direct: 36,000 


Staff 

> local: 18 


> mother and child health: 30 

Co-ordinators 

> project: G. Caussé – M-L.Tournieroux 

> field: M. Otambekova 


Funding 

> MdM, Florindon Foundation, 

State of Guernsey 

Budget 



Herat 

Activities 

In three clinics in Herat, MdM is involved in four areas 

of work: 

• working directly with the population (paediatric, 

gynaecological, obstetric, nutritional and general 

medical consultations; vaccination campaigns; medical 

follow-up; basic health and hygiene education); 

• training local healthcare staff; 

• refurbishing health facilities and supplying medicines 

and equipment; 

• establishing a partnership with local health 

authorities. 

HARM REDUCTION WITH DRUG USERS 

Kabul 

Activities 

The harm reduction pilot programme ran from 1 

April until 31 December 2006 and enabled: 

• building up and training a local team; 

• development and feasibility testing of procedures for 

working on the streets and at the drop-in centre; 

• definition of the harm reduction programme longterm 

objectives; 

• consolidation of the budget and financial framework 

of the programme; 

• registration of MdM as a local actor in the field of drug 

dependency. 

Outlook 

MdM continued to support the handover 

of its activities to the NGO Coordination 

of Humanitarian Assistance through 

technical and financial support for the 

first four months of 2006. Since May 

2006, we have seen the activities continue 

and the quality has been maintained. 


1992 05/2006 


Outlook 

Consolidate the implementation of 

the harm reduction programme in 

Kabul by strengthening the capacity of 

the target groups to reduce the risks 

associated with their drug use. 

Encourage the development of specific 

governmental responses to treating 

problems linked to drug use. 


2006 2006 


A three-year harm reduction programme (2007-2009) 

will follow on from the pilot programme, subject to 

funding. 

>CONTENTS 

Sources: Human Development Report 2006,WHO 2004 

Beneficiaries 

> direct: 415,000 

Staff 

> local: 30 

> MCH staff: 52 


Co-ordinators 

> programme: G. Caussé – ML.Tournieroux 

> field: Dr M. Otambekova 


Funding 

> MdM, SDC 

Budget 


Beneficiaries 

> direct: 14,000 injecting drug users 

(minimum) 

> indirect: 50,000 heroin users and their 

families 

Staff 

> local: 8 


Co-ordinators 

> programme: G. Caussé – O. Maguet 

> field: G. Rafatian 


Funding 

> MdM 

Budget 



69

BURMA 

The political situation in Burma is at an impasse and the economy has difficulty taking 

off. Because of the lack of progress in the democratic process, diplomatic and trade 

relations with western countries have continued to deteriorate.At the same time, crossborder 

exports of Burmese raw materials to China, India and Thailand have been 

steadily increasing since 2004. In relation to health, HIV continues to ravage this country 

where intravenous drug use and prostitution are the main modes of transmission. 

PREVENTION AND TREATMENT OF STIS AND HIV 

Myitkyina (Kachin) and Yangon 

Activities 

MdM is focusing on prevention and access to 

treatment for STIs and HIV/AIDS among people 

working in prostitution and drug users. The work 

with prostitutes includes: prevention sessions on 

HIV/AIDS, free treatment for STIs and opportunistic 

infections, recreational workshops in our day centres, 

and condom distribution. By the end of December, 

102 prostitutes were receiving anti-retroviral therapy. 

The main activities with drug users are: promotion of 

harm reduction techniques in injecting places, 

distribution of needles and syringes, educational 

sessions and recreational workshops in our day 

centres. 

Anti-retroviral therapy for eligible patients has not 

yet started.The key event has been the introduction 

of methadone substitution for seven drug users. 

Outlook 

In Yangon, MdM will continue with 

comprehensive care for the 

beneficiaries. Despite facing increasing 

operational constraints, all our efforts 

in Kachin will focus on methadone 

substitution coupled with ARV 

administration (objective: 100 users 

on the substitution programme). 


01/01/02 31/12/2010 


>CONTENTS 

Mortality 




HDI 

> 0.581; rank: 130/177 


> 498 


Beneficiaries 

> direct: 9,000 


Staff 

> local: 130 


Co-ordinators 

> project: F. Sivignon 

> field:A. Pinon 

> headquarters:V. Pardessus 

Funding 

> NOVIB, UNODC/EU, PSI/USAID, Global 

Fund, MdM 

Budget 

> 2006: 1,012,540 euros

CAMBODIA 

Despite Norodom Sihamoni s recent succession to the throne after the abdication of 

his father Norodom Sihanouk, who had been monarch since 1941, the Phnom Penh 

regime continues to be characterised by authoritarianism and corruption. The 

influence of religion and the widespread system of prebends, particularly in relation to 

natural resources, puts the economic future of the kingdom at risk. More than a third 

of the population lives below the poverty line and AIDS is endemic, with a prevalence 

rate of two percent.The government has recognised this as a public health priority. 

HIV AS A PRIORITY 

Phnom Penh 

Activities 

MdM’s project focuses on medical and psychosocial 

care for destitute people living with 

HIV/AIDS.The programme includes: 

• specialist treatment for patients infected with HIV; 

• training doctors; 

• information sessions for patients about the virus 

and the treatment; 

• hospital treatment on opportunistic infections; 

• development of a continuum of care, a network of 

help and support for people living with HIV/AIDS; 

• support for Cambodian NGOs involving people 

living with HIV/AIDS. 

In 2006, the key event was the creation of a local 

NGO called SEAD (Sharing Experience for Adapted 

Development) by MdM staff.This NGO will gradually 

take over the whole programme between 2008 and 

2009. 

Outlook 

It will be most important to 

participate in building up SEAD and 

training its members to ensure that 

the NGO will be operational and able 

to continue the activities after 

handover. 

By December 2007, 2,000 patients will 

be regularly monitored in the 

consultation centre. 


01/04/1999 30/09/2009 


>CONTENTS 

Mortality 




HDI 

> 0.583; rank: 129/177 


> 354 


Beneficiaries 

> direct: 3,000 


Staff 

> local: 59 


Co-ordinators 

> project: E. Peterman 

> field: P-R. Martin 

> country coordinator:V. Pardessus 

Funding 

> Global Fund, Elton John Aids Foundation, 

MdM 

Budget 



71

CHINA 

China s economic performance cannot mask the social inequalities within the country.Natural 

disasters and the damage caused by industry weaken those who have been overlooked by 

economic growth,particularly in the western provinces and in the countryside.Discrimination 

against people living with HIV/AIDS (almost one million people according to UNICEF) and 

the lack of awareness about the epidemic hinder the effectiveness of humanitarian 

organisations work. 

HARM REDUCTION PROGRAMME AMONGST DRUG USERS 

Chengdu (Sichuan) 

Activities 

The current project plans gradual opening of needle 

exchange drop-in centres in three districts of Chengdu. 

Users receive a warm welcome from the team,which has 

been strengthened by the involvement of volunteers,and 

are provided with training in harm reduction practices.At 

the same time, awareness-raising, prevention and 

advocacy activities are carried out amongst the medical, 

political and administrative authorities. 

Outlook 

The challenges for 2007: 

• opening two further drop-in centres in 

Chengdu; 

• working on the streets and identifying peer 

educators; 

• training medical staff, volunteers and 

disseminating information to the Public Security 

forces of the districts concerned to ensure the 

work can continue. 


01/07/2005 31/12/2008 


REINFORCING PREVENTION, IDENTIFYING AND TREATING 

PEOPLE LIVING WITH HIV 

Shanxi (Changzhi) 

Activities 

Prevention and information activities and encouraging 

testing in mines, places where prostitution takes 

place, villages where blood is sold and amongst 

private clinics which are illegally treating sexually 

transmitted infections. 

Strengthening the three screening centres of Changzhi 

council: training and introduction of rapid tests. 

Training of Changzhi health professionals. 

>CONTENTS 

Outlook 

In 2007, the following activities are planned: 

• introduction of a mobile monitoring system for 

Changzi county patients; 

• setting up a telephone helpline on AIDS and a 

volunteer association; 

• adoption of a regional policy. 


09/2006 09/2007 


Mortality 




HDI 

> 0.768; rank: 81/177 


> 1,740 

Sources: Human Development Report 2006, UNDP;World 

Bank Report, 2005 

Beneficiaries 





Staff 





Co-ordinators 

> project 1: B. Luminet- R. Baglioni 

> project 2: B. Silbermann 

> field, project 1: N. Rennes – H. Peters 

> field, project 2: N. Rennes 

> HQ, projet 1: M. Ethvignot, E. Martinon 

> HQ, projet 2 : M. Ethvignot 

Funding 



Budget 



MONGOLIA 

After seven decades of a single party regime, the process of democratisation is 

ongoing in Mongolia although one third of the population still lives below the poverty 

line.The country has been characterised by a heavy rural exodus and by the settling 

of nomadic populations. Alcoholism is one of the biggest public health problems in 

urban areas. Over half (51%) of the Mongolian population could be affected and 

mortality linked to alcohol has reached 27.5%. Sixty percent of domestic violence 

incidents take place under the influence of alcohol. 

TACKLING ALCOHOLISM AND TREATING TUBERCULOSIS 

Ulan Bator 

Activities 

To manage its activities in Mongolia effectively, MdM 

focuses on two areas of work: 

• implementing a mobile health and welfare team to 

screen for alcoholism and tuberculosis and to analyse 

the social situation in Uliastai district; 

• referring the population to existing services and 

building capacity of these services’ across Ulan Bator. 

Training on running prevention sessions, based on an 

exchange of practices between MdM and an 

employee from a local organisation. 

Outlook 

The priority for 2007 is to define an 

effective strategy for working with the 

population: 

• provision of screening and treatment 

for those affected by alcohol or TB in 

Uliastai; 

• training in alcoholism treatment at 

the national level (around 40 doctors); 

• restructuring the addiction medicine 

sector at the national level. 


10/2005 12/2007 


>CONTENTS 

Mortality 




HDI 

> 0.691; rank: 116/177 


> 690 

Source: Human Development Report 2006, UNDP;World Bank 

Report, 2005 

Beneficiaries 

> direct: 55,000 


Staff 

> local: 3 


Co-ordinators 

>project: G. Lacaze and B. Juan 

>field: O. Delclos (non-medical) & C. Durot 

(medical) 

> headquarters: M.Ethvignot 

Funding 

> MdM 

Budget 



73

INDONESIA 

With more than 15 million households living below the poverty line, the socioeconomic 

situation in Indonesia remains fragile. Access to healthcare for those living in 

shanty towns or the isolated populations of many islands in the archipelago, continues 

to be difficult. Given the growth in the AIDS epidemic and the appearance of new 

epidemics as a result of the massive displacement of populations fleeing threatened 

areas, the presence of humanitarian organisations is needed now more than ever. 

PRIMARY HEALTHCARE AND PREVENTING INFECTIOUS DISEASE 

Mulia and Sinak, Puncak Jaya district, West Papua 

Activities 

The first phase of MdM’s project, aimed at reducing 

the prevalence of STIs and the incidence of HIV/AIDS 

in Puncak Jaya district, took place between August 

2004 and February 2006. This year has seen the 

reorientation of the programme towards primary 

healthcare and prevention of infectious diseases. We 

have also extended our activities to the neighbouring 

sub-district of Sinak and introduced training 

programmes for community health workers. 

Outlook 

To develop the activities in Mulia subdistrict 

and work in Sinak sub-district 

with our local partner PRIMARI. In 

liaison with the local health 

authorities and community leaders, 

the main activities will focus on 

training medical staff in primary 

healthcare and prevention. 


01/08/2004 31/12/2009 


>CONTENTS 

Mortality 




HDI 

> 0.711; rank: 108/177 


> 1,184 


Beneficiaries 

> direct: 20,000 


Staff 

> local: 6 


Co-ordinators 

>project: P. Gaillard Olokose 

>field:A. Le Garnec/A. Ronsse/ 

F. Fombeur 

>headquarters:V. Pardessus 

Funding 

> CORDAID, MdM 

Budget 


CARING FOR PEOPLE LIVING IN URBAN SHANTY TOWNS 

Jakarta 

Activities 

MdM’s work helps the marginalised urban population 

of Jakarta.There are four areas to this work: 

• weekly medical consultations in four MdM clinics in 

shanty towns; 

• supporting the welfare activities of AULIA (local 

NGO partner); 

• setting up a referral system adaptated to this 

population’s needs; 

• helping our local NGO partner with logistics, 

fundraising and management. 

CARING FOR THE PUNAN OF TUBU FOREST 

Kalimantan 

Activities 

The Punan, an indigenous Indonesian people, are 

linked to Malinau district, whose main town has been 

experiencing major economic development with 

negative consequences for the environment, society 

and health. Because they live so far from health 

services, the Punan people do not receive any 

primary healthcare.Malaria,respiratory infections and 

high infant mortality are the main health problems 

identified. 

MdM runs several activities: 

• mobile clinics lasting a month (three times a year) in 

four sites along the Tubu river; 

• training Punan community health workers for one 

week before each clinic, with practice in the field 

during the clinic; 

• supporting the local organisation Adat Punan which 

represents the interests of the Punan of Kalimantan. 

Outlook 

In 2007, MdM will expand its activities to 

six clinics and will focus on access to 

primary healthcare, particularly for 

women and children under five, in the 

shanty towns in north Jakarta. The 

objective is to strengthen the capacity of 

AULIA, our partner NGO, so that these 

health activities can be incorporated into 

its programmes. 


05/2005 31/12/2008 


Outlook 

In addition to medical consultations 

and community health worker 

training, 2007 will see a child 

immunisation campaign and the 

distribution of insecticide impregnated 

mosquito nets. We will continue to 

support the recognition and 

protection of the Punan’s rights 

through the Adat Punan Foundation. 


05/2005 31/12/2008 


>CONTENTS 

Beneficiaries 

> direct: 8,230 medical consultation 

service users 

> indirect: 30,000 inhabitants estimated to 

be within the project area 

Staff 

> local: 12 


Co-ordinators 

> project:A.Bourdé 

> field:V. Cauche/O.Valverde 

> headquarters:V.Pardessus 

Funding 

> MdM 

Budget 


Beneficiaries 

> direct: 850 inhabitants of Tubu valley 

> indirect: 9,000 Punan in East Kalimantan 

Staff 

> local: 12 

> expatriate: 2 (based in Jakarta) + 2 

doctors (periodic missions) 

Co-ordinators 

> project: R.Garrigue 

> field: M.-L. Bry / B. Pedrique 

> headquarters:V. Pardessus 

Funding 

> MdM, Isle of Man Overseas Aid 

Committee 

Budget 



75

HELPING TSUNAMI VICTIMS 

Aceh Besar and Aceh Jaya districts (Aceh Province/Sumatra) 

Activities 

After a three-month emergency programme, the 

programme developed around four areas of work: 

• getting the public healthcare system 

working again in Aceh Besar and Aceh Jaya 

districts; 

• reconstruction of health facilities: one district 

hospital, two clinics, health centres; 

• helping to get the internal medicine 

department in Abidin Hospital, Banda Aceh 

running again; 

• providing care for psychological and 

psychiatric problems as well as dealing with the 

emergency in Sumatra. 

Activities 

The programme following the earthquake in 

Yogyakarta ran in two phases. 

An initial three-week phase: 

• intervention by MdM surgical teams providing 

human resources support and equipment to 

Indonesian teams; 

• intervention by mobile teams to enable access to 

primary healthcare for victims in rural areas. 

A second six-week phase: 

• supporting the local health authorities to ensure 

that access to primary healthcare was quickly 

restored to the area. 

Outlook 

The ‘Caring for Tsunami Victims’ programme 

finished in September 2006. 


28/12/2004 30/09/2006 


EMERGENCY AID TO EARTHQUAKE VICTIMS 

Yogyakarta (Java) / Pundong, Imogiri, Dlingo, Purwosari and 

Panggang sub-districts 

Outlook 

Since the public health services were 

reactivated relatively quickly, our 

programme was completed on 26 

August 2006. In order to be able to 

respond quickly to natural disasters in 

Indonesia, our emergency medical 

stores have been restocked in Jakarta. 


22/05/2006 28/08/2006 


>CONTENTS 


> MdM Spain, MdM Canada, MdM Greece 

Beneficiaries 

> direct: 30,000 

> indirect: n/a 

Staff 

> local: 20 


Co-ordinators 

> project: P. Foldès 

> field:V. Cauche 

> headquarters: emergency desk 

Funding 

> MdM 

Budget 



> MdM Cyprus, MdM Greece, MdM Spain 

Beneficiaries 

> direct: 10,000 


Staff 

> local: 20 


Co-ordinators 

> project: G. Pascal 

> field:V. Cauche 

> headquarters: emergency desk 

Funding 

> ECHO, MdM 

Budget 


NEPAL 

On 21 April 2006, after many months of rioting, the Nepali King Gyanendra 

announced that he was returning power to the people . The Maoist rebels agreed to 

enter a new parliament in Kathmandu and on 21 November 2006, they signed a peace 

agreement with seven coalition parties bringing the civil war to an end and limiting the 

powers of the monarch. Although 2006 has been a historic year which brought hope 

to Nepal, the country suffers from a harsh shortage of aid in relation to health. In 

particular, help is needed to tackle the AIDS and tuberculosis epidemics which are 

rapidly spreading throughout the country. 

FIGHTING TUBERCULOSIS AND HIV 

Western regions 

Activities 

The programme aims to prevent and control the 

spread of tuberculosis and AIDS in four districts 

in western Nepal through: 

• awareness-raising and information sessions 

developed using health educators in villages, health 

centres and screening centres, prisons and hotels; 

• a primary healthcare programme in prisons in 

Pokhara, which finished at the end of summer 2006. 

Outlook 

MdM is preparing a funding proposal 

for a mother and child health 

programme and a micro-credit 

mentoring programme in the same 

region from 2007. 


01/01/2002 28/02/2006 


>CONTENTS 

Mortality 




IDH 

> 0.527; rank: 138/177 


> 270 



> MdM USA; MdM Switzerland 

Beneficiaries 

> direct: 1,150 and 50% of the prostitutes 

in Syangia district 

> indirect: 1,200,000 (population of 4 

districts) 

Staff 

> local: 25 


Co-ordinators 

> project: P. Baguet and O. Lermet 

> field: M. Piasecki 

> headquarters: E. Martinon 

Funding 

> EU, ICCO, MdM 

Budget 



77

PAKISTAN 

Although the human and structural damage caused by the earthquake on 8 October 2005 meant 

that the continued presence of international organisations on the ground was essential, the 

diplomatic and regional position of Pakistan made the internal political situation very delicate.The 

government has made major commitments to improve public services. However, women 

continue to be deprived of access to their basic human rights and domestic violence remains a 

daily reality for many women. 

HELPING FEMALE VICTIMS OF DOMESTIC VIOLENCE 

Lahore, Faisalabad and Gujranwala 

Activities 

In 2004, MdM began a nine-month pilot project with 

the objective of providing medical, psychological 

and legal support to women who are victims 

of domestic violence and who have taken refuge in 

the Dar-ul-Aman in Sarghoda. This activity was then 

expanded to three new refuges: Lahore, Faisalabad 

and Gujranwala. The feasibility of this programme 

depends on the mobilisation of civil society and on 

the governmental authorities, as well as on the 

training of Dar-ul-Aman staff. 

Outlook 

In 2007, MdM will continue its 

activities in three directions: 

• access to healthcare,rights and education; 

• informing and mobilising civil society; 

• mobilising,informing and training staff.. 


2004/2005* 2008 

Project progress 

EMERGENCY HELP FOR EARTHQUAKE VICTIMS 

North West Frontier Province and Islamabad 

Activities 

The programme was rolled out in three distinct phases: 

• Phase 1: initial medical care for the victims of the 

earthquake (a surgical team and two static and mobile 

primary healthcare teams); 

• Phase 2: support for displaced homeless people 

throughout the winter (primary healthcare in Islamabad, 

clinics and mobile teams); 

• Phase 3:continuation of primary healthcare in the places 

which displaced persons returned to. 

Efforts were also focused on the protection and 

promotion of the victims’ rights, in discussion with 

Pakistani and international decision-makers. 

> 

* 2004 (Sargodha pilot project) - 2005 (project in 8 Dar-ul-Amans in Punjab) 

Outlook 

As we realised the health needs of 

mothers and children were considerable,a 

programme will be dedicated to 

improving their health during 2007. 


09/10/2005 09/12/2006 


>CONTENTS 

Mortality 

> infant, project 1: 80 ‰ 



HDI 

> 0.539; rank: 134/177 


> project 1: 632 



> project 2: MdM Greece, MdM Cyprus, 

MdM Spain 

Beneficiaries 

> direct, project 1: 4,500 women and 360 

children 


> indirect, project 1 and 2: n/a 

Staff 





Co-ordinators 

> project 1: B.Ten Kate/M. Jactat 

> project 2: B.Ten Kate 

> field, project 1: C. Jeannot/C. Lambert 

> field, project 2: D. Defrade/M. Pomarel 

/M.Van Der Mullen 

> HQ, projects 1 and 2: N. Bréchet 

Funding 

> project 1: MdM, private partners 

> project 2: Dutch Ministry of Foreign Affairs, 

MEMISA Belgium, MdM 

Budget 



SRI LANKA 

Despite the cease fire between the Colombo government and the Tamil Tigers declared 

at the beginning of 2002, the management of post-tsunami financial aid revived political 

and community tensions. Material losses have been estimated to be worth US$1 billion, 

affecting both main sectors of the economy: fishing and tourism. The population has 

suffered greatly from the repercussions of the tsunami. In addition, although the Sri 

Lankan health system is still seen as an example for developing countries, it is patchy 

across the country. 

RENOVATING HEALTH FACILITIES 

Mallavi, Tunukkai and Naadankandal – Mullaitivu District 

Activities 

The are four areas of work which take place in the 

Mallavi area: 

• renovating and equipping Mallavi hospital (opening 

a new surgical unit and an emergency centre, refitting 

the outpatient consultation department, the 

pharmacy, the inpatient department and the 

maternity unit); 

• reorganisation and training of local medical staff; 

• providing medicines and medical equipment to the 

hospital and two health centres; 

• raising awareness amongst local and national 

authorities of the problems the hospital faces in 

terms of finance, human resources and equipment. 

Outlook 

It was decided to suspend the 

programme once the renovation of 

Mallavi hospital was completed. 

Despite MdM’s desire to run a longer 

term programme, it has not been 

possible to keep a co-ordinator in 

Colombo to respond to potential 

emergencies. 


15/01/2005 30/03/2006 


>CONTENTS 

Mortality 




HDI 

> 0.755; rank: 93/177 


> 1,160 

Sources: Human Development Report, 2006 UNDP;World 

Bank, 2005 


> MdM Spain, MdM Portugal, MdM Cyprus, 

MdM Greece, MdM USA, MdM Belgium, 

MdM Argentina 

Beneficiaries 

> direct: 35,900 


Staff 

> local: 20 


Co-ordinators 

> project: C. Giboin,A. Cavey 

> field: S. Brignano 

> headquarters: emergency desk then 

V. Pardessus 

Funding 

> MdM 

Budget 



79

UZBEKISTAN 

The Republic of Uzbekistan has been independent since 31 August 1991.With 26 million 

inhabitants it is the most populated country in Central Asia.The pillar of its economy is the 

cultivation of cotton which has contributed to the shrinking of the Aral sea,one of the worst 

environmental disasters of the Twentieth Century. Despite considerable natural resources 

(eg gas, uranium), 27% of the population lives below the poverty line.Two years after the 

populist uprising in Andijan, which was bloodily suppressed by the army, Islam Karimovs 

regime is still very authoritarian. 


Bakhmal and Zamin districts, Djizzak region 

Activities 

An exploratory mission assessing the potential for a 

mother and child health programme took place in 

spring 2006. 

In the context of national health system reforms, our 

project would contribute to the implementation of 

the national Safe Motherhood Programme which 

aims to reduce maternal and neonatal mortality and 

to improve perinatal care, emergency obstetric care 

and neonatal care.The official registration of an MdM 

representative in Uzbekistan was a necessary prerequisite 

before any activities could begin. The 

application was prepared with the help of a lawyer, 

but we have not succeeded in obtaining this 

registration to date. 

Outlook 

MdM will keep a co-ordinator post in 

place until June 2007 to try to obtain 

our registration in Uzbekistan. The 

prospects for beginning our 

programme remain very uncertain. 


04/2006 31/06/2007 


>CONTENTS 

Mortality 




HDI 

> 0.696; rank: 113/177 


> 456 

Source: Human Development Report 2004, UNDP 

Beneficiaries 

> direct: 40 

> indirect: 8,500 newborns per year and as 

many pregnant women 

Personnel 

> local: 1 


Co-ordinators 

> project: L. Zamponi 

> field: E. Becquer 

> headquarters:A. Landaës 

Funding 

> MdM 

Budget 


VIETNAM 

In November 2006, Vietnam became the 150 th member of the World Trade 

Organization.With 9.5% growth in 2006, the Vietnamese economy may be thriving but 

1.4 million households live below the poverty line.Vietnam s economic development 

is deepening inequalities: the poverty rate is 18.3% in urban areas and 44.9% in rural 

areas. Drug use and prostitution, which are both criminalised by the government, 

promote the spread of HIV which, according to UNICEF, could affect around 300,000 

people. 

PREVENTING AND TREATING HIV 

Ho Chi Minh City 

Activities 

The second year of the project continued screening 

for STIs and HIV/AIDS, strengthening access to 

treatment of opportunistic infections and STIs, as well 

as continuing to train staff in HIV prevention, 

diagnosis and treatment of conditions linked to HIV 

and the administration of ARV.At the end of 2006,308 

patients were on ARV treatment. 

ACCESS TO COMMUNITY HEALTHCARE 

Hanoi 

Activities 

In 2006, the following activities were carried out: 

• providing HIV tests, consultations for primary 

healthcare, STIs, opportunistic infections and ARV 

treatment in our Day Care Centre (district clinic); 

• prevention, needle exchange, condom distribution 

and home-based care by two mobile teams; 

• promotion of income-generating activities within 

solidarity groups; 

• training for healthcare and social welfare staff. 

At the end of 2006, 78 patients were on ARV therapy. 

Outlook 

A pilot project of methadone 

substitution for intravenous drug 

users is due to start by the end of June 

2007.The number of patients on ARV 

treatment should reach 485 and the 

number of beneficiaries on the 

methadone programme should be 200 

by the end of December 2007. 


20/12/2004 31/03/2008 


Outlook 

By the end of 2007, 160 patients will be 

receiving anti-retrovirals and 25,000 

people will have been contacted by the 

mobile teams and the clubs. 


01/08/2005 31/07/2008 


Mortality 




HDI 

> project 1: 0.709; rank: 109/177 


> project 1: 550 



> projects 1 and 2: MdM Canada (withdrew 

March 2006) 

> project 2: MdM Canada 

Beneficiaries 





Staff 


> local staff allocated to the day care 

centre, project 1: 36 




Co-ordinators 

> projects 1 and 2: K.Lacombe 

> field, project 1:V.Trias 

> field, project 2: R. Jourdain 

> HQ projects 1 and 2:V. Pardessus 

Funding 

> projects 1 and 2: PACT/USAID 

Budget 



>CONTENTS 


81

EASTERN 

EUROPE 

» 

Guinée 1 

» EMERGENCY: 



» CRISIS: 








>CONTENTS

BELARUS p.88 

BULGARIA p.89 

CHECHNYA/DAGESTAN p.90 

GEORGIA p.91 

KOSOVO p.92 

MOLDOVA p.93 

ROMANIA p.94 

SERBIA p.95 

>CONTENTS 

INTERNATIONAL PROGRAMMES ¨ EASTERN EUROPE ANNUAL REPORT 2006 

83

Moldova 

Lavinia Ilie,programme co-ordinator 

‘The case which affected me most is the story 

of Oxana, a young girl who had been a victim 

of trafficking in Saudi Arabia for two years. She 

was only 20 at the time. She met a woman 

who promised her a job as a waitress but once 

she was there her papers were taken and she 

was made to work as a prostitute. She lived 

with about 10 other girls in the basement of a 

building.They were not allowed to go out or 

even to see a doctor. In the end, it was a client 

who helped her to return to Moldova. She is 

very psychologically distressed and she comes 

to the centre, but for now she only wants to 

talk to a social worker and will not see a 

psychologist… 

This victim of trafficking is one of around 700 

young men and women who come regularly to 

the health centre for young people aged 

between 14 and 25 in Balti, the second biggest 

town in the country.The team works there in 

partnership with a Moldovan organisation. 

Most NGOs are based in the capital, Chisinau. 

Therefore,this centre is very much appreciated. In 

Moldova, it is very unusual to go and see a 

psychologist and trafficking is not spoken of. By 

working in a centre which is open to all young 

people, we manage to reach victims without 

stigmatising them.Young women ask to see a 

gynaecologist and it is often a pretext to speak 

about what they have been through.’ 

>CONTENTS

CONTENTS 

Adrien Duquesnel 




85

(1) Maryvonne Arnaud 

(2) Sébastien Georges 

>CONTENTS 

» In Chechnya (1 and 2), 

the conflict continues 

and isolates the civilian 

population more with 

every day that passes. 

Tackling problems with 

access to healthcare 

remains a priority for 

MdM — we continue to 

supply several health 

facilities from our base in 

Moscow. In Bulgaria (3 

and 5) and in Georgia 

(4), M decins du Monde 

directs its work towards 

mother and child health 

or reproductive health 

programmes in order to 

improve antenatal 

monitoring, particularly 

by training healthcare 

staff.

CONTENTS 

(4) MdM 

(5) MdM 

(3) MdM 


87

BELARUS 

Alexander Lukashenkos regime does not change: individual liberties remain limited and 

structural reforms have not been carried out. The health consequences of the 

Chernobyl nuclear disaster are minimised by the government, even though the number 

of cancers and congenital malformations due to radiation continues to increase. People 

living in at-risk areas have not been evacuated and continue to suffer from chronic 

contamination because the soil affected by radioactivity is still being cultivated and food 

is grown there. 

PREVENTING RADIOACTIVE CONTAMINATION 

Chechersk district 

Activities 

MdM’s activities aim to improve the health of women 

and children living in areas contaminated by 

radioactivity.The CORE programme, supported by 

the EU, was set up to improve the living conditions of 

those living in the contaminated districts.This project, 

coordinated by MdM,is implemented by three partners: 

IRSN (Radioprotection and nuclear safety institute), 

ACRO (Western Association for Radioactivity Control) 

and MdM. 

In 2006,ACRO kept in contact with our local partners 

in order to begin the radiological quality control activities. 

Thus,radioactivity measuring laboratories were installed 

in three villages,thanks to a donation of new dosimeters 

by the Belarus Women’s Club.This will enable people 

to measure the radiological quality of their environment 

in order to adapt their diets or their homes. 

However, the entire programme has not been able to 

get off the ground because the rules governing the 

implementation of an EU-financed project are very 

difficult to comply with in the current Belarussian 

context. 

Outlook 

MdM had to abandon efforts to 

implement this programme in 

December 2006, after more than 18 

months spent trying to find a way to 

operate satisfactorily within all the 

constraints. 


13/08/2005 12/2006 


>CONTENTS 

Mortality 




HDI 

> 0.794; rank: 67/177 


> 2,330 


Beneficiaries 

> direct: 2,800 children between 3 and 15 

years/400 pregnant women and newborn 

babies 

> indirect: local health professionals, whole 

population of the district 

Staff 

> local: 1 part-time co-ordinator 

Co-ordinators 

> project: M. Costa 

> field:T. Gloukhova 

> headquarters:A. Landaës 

Funding 

> Tacis (EU), IRSN, DGSNR, MdM 

Budget 


BULGARIA 

In the period leading up to EU accession, Bulgaria has seen sizeable economic growth. 

However, despite the government s commitment to carry out reforms immediately, 

the European Union has pointed to three weaknesses: efforts to tackle corruption, the 

management of regional aid, and food security.The gradual social improvements mask 

deep regional disparities and major social inequalities, in particular for the Roma 

community whose situation remains worrying and whose health status is appalling. 


Roma district of Nadezhda, in Sliven 

Activities 

MdM continues to support the Roma population, within 

the framework of a mother and child health programme 

created by MdM’s regional delegation in Corsica. 

The programme continues to organise and provide: 

• mother and child health consultations; 

• information and health education sessions for mothers 

and children, as well as the development of a mothers’ 

school; 

• a public health survey in the ‘district of the naked’, to 

identify and accompany the most vulnerable people. 

In addition, the programme became national in 2006. 

Outlook 

To rethink this project and to define a 

partnership with private and public 

doctors in the town, we need to: 

• refocus activities on access to 

healthcare and health training; 

• strengthen the team by organising 

training and coordination meetings, to 

encourage setting up of a ‘hygiene point’ 

prior to hospital admission and to 

disseminate documents and publications. 


03/2004 12/2009 


TRAINING STAFF IN INSTITUTIONS FOR DISABLED CHILDREN 

Throughout the country (training courses in Sofia) 

Activities 

MdM is supporting a Bulgarian association called ‘Child 

and Space’ as part of the ‘Child and his symptoms’ project 

which is run in two ways: 

• training the staff of eight institutions, four disabled 

children’s centres and the social workers of the child 

protection agency; 

• a training programme for all the staff in the institutions 

and centres delivered by ‘supporters’ appointed by the 

Bulgarian project co-ordinator. 

Outlook 

• Training the staff of the majority of 

Bulgarian institutions for disabled 

children. 


01/01/2005 30/06/2009 

> 


>CONTENTS 

Mortality 




HDI 

> 0.816; rank: 54/177 


> 8,078 


Beneficiaries 

> direct, project 1: Roma mothers and 

children 

> direct, project 2: 150 professionals 

> indirect, project 1: Roma families 

> indirect, project 2: 396 education 

specialists, 360 families and 1,220 children 

Staff 




> expatriate, project 2: none 

Co-ordinators 

> project 1: P. Contois 

> project 2: F. Parrot 

> field, project 1:V. Harutyunyan 

> HQ, project 1: East European desk 

> HQ, project 2:Aquitaine Regional 

Delegation 

Funding 


> project 2: Gironde council, various 

donations, MdM 

Budget 




89

CHECHNYA/DAGESTAN 

Although there is now less fighting between the separatist forces and the federal 

forces, confrontations continue in the southern mountainous regions and in 

neighbouring republics (Dagestan, Ingushetia). Despite the reconstruction in the area 

controlled by federal forces — now handed over to R. Kadyrovs forces — the 

population still lives in poor conditions and human rights violations still occur. In 

addition, many Chechens still do not have access to primary healthcare and hospital 

facilities are sorely lacking in both resources and personnel. 

SUPPORTING VICTIMS OF CONFLICT 

Grozny, Gudermes, Urus-Martan, Argun, Kurchaloy, Nozhay-Lurt and 

Vedeno districts 

Activities 

MdM’s experienced Chechen team, managed by 

‘remote-control’, continues to focus on improving 

surgical treatment, primary and secondary care and 

has set up mental health support. The activities 

include: 

• co-ordination and supply of five urban hospitals, five 

rural hospitals and 32 medical and obstetric centres; 

• awareness-raising and training in mental health for 

Chechen healthcare staff. 

In addition, MdM has set up a primary healthcare 

assistance programme in Khassaviourt district in 

Dagestan. 

Outlook 

Expansion of the primary care 

activities in the Kurchaloy district of 

Chechnya; Collaboration with the 

republic’s centre for medical and 

psychological rehabilitation of Grozny’s 

children; Publication during 2007 of 

Chechen Voices, a collection of 

testimonies from Chechnya during the war, 

edited by Blenenn Islambard. 


1995 Ongoing 


>CONTENTS 

Mortality 

> 


> 

HDI 

> 


> 

No data for Chechnya 

Beneficiaries 

> direct: general population, 65,450 from 

11/2005 to 06/2006 

Staff 

> local: 14 


Co-ordinators 

> project: J. Dato 

> field: I. Shihab 

> headquarters:A. Landaes 

Funding 

> ECHO, MdM, Solidarité Tchétchénie, 

Adonix (for the programme in Dagestan). 

Budget 

> 2006: 1,095,090 euros

GEORGIA 

Three years after the Rose Revolution and Mikhail Saakashvili s rise to power, Georgia 

has experienced serious tensions, particularly in the secessionist territories of Abkhazia 

and Ossetia. Relations with the Russian Federation have also deteriorated. In relation to 

health, the government s new reforms of the health system have not succeeded in 

ensuring access to healthcare for the most vulnerable. 

AID FOR REPRODUCTIVE HEALTH 

Mingrelia Region 

Activities 

MdM continued its mother and child health 

programme in Mingrelia with four main areas of 

work: 

• providing medical equipment, medicines and 

supplies; 

• renovation and maintenance of health facilities; 

• training healthcare staff; 

• monitoring health services and beneficiaries. 

Outlook 

In 2007, there will be needs 

assessments on harm reduction and 

on the situation of minorities. 


09/2004 01/2007 


>CONTENTS 

Mortality 




HDI 

> 0.743; rank: 97/177 


> 2,844 


Beneficiaries 

> direct: 44,414 


Staff 

> local: 17 

> mother and child healthcare staff: 1 

> expatriate: 1.5 

Co-ordinators 

> project: H. Lepoivre/I. Hermant 

> field: S. Rogic/V. Miollany 


Funding 

> ECHO, MdM 

Budget 



91

KOSOVO 

Kosovo, which has been a Serbian province under international administration since 

1999, has experienced real inter-ethnic tensions. The Albanian majority, representing 

more than 90% of the population, is massively pro-independence while Belgrade 

remains opposed to such independence. In January 2006, the UN started negotiations 

on the long-term future of the province.Western diplomats agree on the principal of 

autonomy, conditional on respect for multi-ethnicity. In addition, the unemployment 

rate is 60% and 65% of the population lives below the poverty line. 

IMPROVING ORAL HEALTH OF THE ALBANIAN AND SERBIAN 

POPULATIONS 

Gllogovc, Hoce e Madne village (Serb enclave near Rahovec) 

Activities 

MdM’s PACA regional delegation is running a project to 

improve access to oral healthcare for people living in the 

region,irrespective of which ethnic group they belong to.For 

this reason, two health centres have been chosen, one in 

Gllogovc and one in Hoce e Madne.The programme includes: 

• installing complete, functional dental surgeries in each 

health centre; 

• training local practitioners in new dental techniques and 

setting up oral health education activities in schools. 

LISTENING TO YOUNG PEOPLE 

Pristina 

Activities 

In partnership with the Kosovan Ministry of Culture, 

Youth and Sports and with Vita Kosovo, a local NGO, 

MdM runs a prevention programme with young 

people (13 - 24 years).The activities include: 

• creating a place of welcome, listening, information, 

consultation and advice for young people; 

• direct support (individual psychological support, 

integration into a care network) and indirect support 

(ongoing training for the Listening Point team…). 

Since 2004, the programme has been sponsored by 

Salon-de-Provence’s young people’s health space 

(Espace Santé Jeunes). 

Outlook 

Continuing to implement the 

programme, in Hoce e Madne village. 


05/2004 12/2007 


Outlook 

MdM hopes to develop outreach 

activities and promote the Degjo 

Rinine centre, to develop the NGO 

Vita Kosovo in its role as programme 

manager. 


2003 12/2007 


> 

>CONTENTS 

Mortality 

> infant: 


> at birth: 

HDI 

> 


> 

No data for Kosovo 

Beneficiaries 

> direct, project 1:health professionals in two 

clinics,two Albanian dental practices in 

Gllogovc and one Serbian practice in Hoce e 

Madne. 

> direct, project 2:+/-250,000 young people 

> indirect, project 1:the Albanian and Serbian 

population in the catchment area 

> indirect, project 2:+/-1 million young 

people under 24 living in Kosovo 

Staff 

> expatriate, project 1: no permanent 

presence;regular visits by two dentists from 

the PACA region. 


Co-ordinators 

> project 1:P.Dupin 

> project 2:M.A. Chaud 

> field, project 1: regular support of the Pristina 

‘Listening Point’ team 

> field,project 2:G.Alliu 

> HQ,project 1: PACA regional delegation: 

I. Bouju Malaval 

> HQ, project 2:PACA regional delegation 

Funding 

> project 1: private partnership 

> project 2: PACA collectivity 

Budget 


MOLDOVA 

With a very high inflation rate and a very low rate of investment, Moldova remains in a 

difficult economic position. The extreme poverty encourages mass emigration and 

increases the risks linked to human trafficking, particularly for women, victims of sexual 

exploitation. Most of these victims do not have access to any healthcare and suffer from 

serious problems: sexually transmitted infections, reproductive health problems, 

psychological or nervous problems and difficulties with reintegration. 

PREVENTING HUMAN TRAFFICKING AND CARING FOR THE 

VICTIMS 

Balti region, Floresti, Folesti, Glodeni, Râscani, Sângerei 

Activities 

MdM supports the Friends of Young People Health 

Centre (ATIS), run by the NGO Young People for the 

Right to Live (TDV). This support is for prevention 

and care for victims of trafficking through access to 

healthcare, welfare and legal services. 

The programme includes: 

• encouraging the long term sustainability of the ATIS 

centre by integrating it into the national health 

system; 

• promoting coordination between those involved at 

the regional and national levels; 

• participating in the working groups on prevention 

and protection, set up by the National Committee 

Against Trafficking; 

• participating in national and international networks 

on prevention and advocacy. 

Outlook 

To integrate the ATIS centre into the 

regional health system with complete 

handover to TDV.To develop outreach 

activities among the vulnerable populations 

in the ‘raions’.To extend the MdM/TDV 

partnership into a consortium which 

includes CPTW,NPW and the medical 

and social services of Balti council. 


10/2005 07/2009 


>CONTENTS 

Mortality 




HDI 

> 0.694; rank: 114/177 


> 1,729 


Beneficiaries 

> direct: service users of the ATIS centre 

in Balti 

- young people from 14 to 25 who use the 

health centre or who are reached by 

outreach activities 

- victims of trafficking 

Staff 

> local:ATIS centre team of 8 (co-ordinator, 

doctor, gynaecologist, dermatologist, 2 

psychologists, social workers, secretary) 

> MdM staff: 3 


Co-ordinators 

> project: F. Parrot 

> field: L. Ilie, C. Ferrier 


Funding 

> French Embassy/MdM/ Adonix 

Budget 



93

ROMANIA 

In the period leading up to EU accession, Romania has seen sustained growth. Since 

1997 many reforms have been undertaken, particularly in the social and child 

protection sectors.The process specifically dealt with the role and participation of civil 

society organisations in relation to child welfare. Currently, of six million children in the 

country, 45 000 are still in institutional care. Because of the weaknesses of the Romanian 

system, de-institutionalisation has not been evaluated, particularly in relation to 

mistreatment and abuse of children. 

PROTECTING CHILDREN, SUPPORTING THE ORGANISATION COPII 

Satu Mare 

Activities 

In the absence of any Romanian child abuse 

prevention experts, MdM’s PACA regional delegation 

is monitoring the supervision of new childcare 

professionals by working with the Romanian 

organisation COPII. 

There are two parts to this work: 

• Continuing professional education for professional 

childcare assistants (AMPs) and organising support 

groups; 

• Supporting the Romanian association, COPII. 

Outlook 

• Carry on with the continuing 

professional development programme; 

• Organise specific training sessions 

for AMPs who look after abandoned 

children under one year old; 

• Work in collaboration with the 

management of child protection 

services in order to facilitate contact 

between the AMPs and birth families. 

COPII will participate in the child 

protection reforms, particuarly in 

order to obtain authorisation to be a 

training organisation. 


01/04/2006 31/03/2008 


>CONTENTS 

Mortality 




HDI 

> 0.805; rank: 60/177 


> 8,480 


Beneficiaries 

> direct: all the childcare assistants (c280) 

in the area 

> indirect: children under the care of 

childcare assistants – about 350 children 

Staff 

> local: 1 co-ordinator (part-time) and the 

volunteers of COPII 

Co-ordinators 

> project: H. Picon 

> field: M.Veres 

> PACA delegation HQ: I. Bouju Malaval 

Funding 

> private partnerships and PACA regional 

council 

Budget 


SERBIA 

After the separation from Montenegro, Serbia remains politically unstable because of the 

issue of Kosovos future and changing internal political alliances. Since the conflicts and 

disturbances of the 90s and the lack of significant international cooperation, Serbia has 

experienced economic difficulties, despite growing aid from the Serbian diaspora. 

Provision of healthcare has clearly deteriorated and the HIV epidemic is spreading, 

particularly among injecting drug users, although it is not possible to obtain a clear 

picture of the epidemiological situation. 

HARM REDUCTION PROGRAMME WITH DRUG USERS 

Belgrade 

Activities 

At the end of 2005, MdM transferred its harm 

reduction programme to Veza, a local Serbian 

association. However, the MdM team supports this 

association with fundraising, development and project 

management. MdM has also started a project towards 

the opening of a specialist addiction medicine unit 

within a primary healthcare structure. 

Outlook 

The programme started in Autumn 

2006 will lead to the opening of a 

specialist addiction medicine unit and 

the start of an opiate substitution 

programme within a primary healthcare 

centre in Belgrade in the first six 

months of 2007. 


01/12/2006 2009 


>CONTENTS 

Mortality 




HDI 

> not known 


> 2,946 


Staff 

programme transferred to Veza (needle 

exchange and information tools for 

injecting drug users): 

> direct: 823 

> indirect: 1,900; needles/year: 270,000; 

collection rate: 40% 

MdM programme (access to opiate 

substitution treatment): 

> direct: 60 by mid-2008 

> indirect: around 900 

Staff 

> local: 0.5 fte 


Co-ordinators 

> project: P. Beauverie, P. Gassmann 

> field: C. Debeaulieu 


Funding 

> French Ministry of Foreign Affairs/MdM 

/Global Fund 

Budget 

> 2006: 224,500 euros (all funding) 


95

MIDDLE 

EAST 

» EMERGENCY: 



» CRISIS: 








>CONTENTS

EGYPT p.102 

IRAQ p.103 

PALESTINIAN TERRITORIES p.104>105 

LEBANON p.106 

TURKEY p.107 

YEMEN p.108 

>CONTENTS 

INTERNATIONAL PROGRAMMES ¨ MIDDLE EAST ANNUAL REPORT 2006 

97

Elisabeth Rull/Item 

Lebanon 

Testimony recounted in South Lebanon in September 2006 

Nazek, 44 years old, lives in Khiam 

‘My car was destroyed with the first bombings. So it wasn’t possible to flee, because my mother and my brother both suffer from a 

nervous condition and can’t travel easily.We spent the whole war here.When my house was hit, we hid at my aunt’s place.There 

were also two older neighbours with us, and the woman could no longer walk.We endured bombings day and night and, each time, 

we thought we were going to die! As a nurse, I was able to care for my mother and brother while we had enough medicines. But, 

with all the fear my mother became even sicker.And I no longer had any way to treat her… Since then, her health has got even 

worse.And we all have to live crammed into my brother’s house because mine was totally destroyed…’ 

>CONTENTS

CONTENTS 


INTERNATIONAL PROGRAMMES ¨ MIDDLE EAST ANNUAL REPORT 2006 

99

CONTENTS 

(3) Bruno Fert 

(2) Bruno Fert 

(1) François Moura

» In Constantine, Algeria 

(2), treatment of asthma, 

which is neglected for 

cost reasons, is provided 

by two local health 

facilities supported and 

trained by MdM. In the 

Palestinian Territories (4 

and 5) and in Iraq (1 and 

3) problems linked to the 

conflicts severely limit 

access to healthcare for 

civilians, particularly in 

emergency cases. So, for 

example, first aid training 

for teachers, students 

and paramedics has been 

carried out in the Gaza 

strip. 

>CONTENTS 

(4) MdM 

(5) MdM 

101 

INTERNATIONAL PROGRAMMES ¨ MIDDLE EAST ANNUAL REPORT 2006

EGYPT 

Today, 60% of the urban population of Cairo lives in unhealthy conditions and, 

according to UNICEF and the Egyptian NGO Hope Village Society, the number of 

children living on the streets in Cairo varies between 15,000 and 20,000.Although the 

fact that these children are always moving around makes it difficult to have reliable 

data, one thing is sure: there are more and more of them.The sight of young mothers 

living on the streets with their babies is a recent and growing phenomenon in Cairo. 

These teenage pregnancies are most often a consequence of life on the streets. 

Particularly poorly regarded by the community, these girls wander about without any 

medical check-ups, increasing the risk of maternal and infant mortality. 

PROMOTING ACCESS TO HEALTHCARE FOR PREGNANT GIRLS 

AND YOUNG MOTHERS LIVING ON THE STREETS 

Cairo 

Activities 

MdM supports the NGO Hope Village Society in 

running a reception and re-integration centre and a 

mobile unit caring for pregnant teenagers and 

adolescent mothers living on the streets. The 

programme organises and provides: 

• psychological support for the girls coming to the 

pilot centre; 

• a care network with the public hospitals enabling 

access to healthcare for pregnant girls and young 

mothers living on the streets; 

• Information, Education and Communication (IEC) 

sessions on reproductive health, first aid, hygiene and 

nutrition for girls and boys attending the centre, 

street children leaders, educators and care staff of 

Hope Village Society as well as for staff of other 

organisations working with street children; 

• support to the network of Egyptian NGOs caring 

for street children. 

Outlook 

Continuation of the project and 

support to other NGOs working with 

young girls living on the streets. 


01/08/2005 31/12/2008 


>CONTENTS 

Mortality 




HDI 

> 0.659; rank: 119/177 


> 1,220 


Beneficiaries 

> direct: 800 adolescent girls and 3,600 

children; around 70 healthcare staff, social 

workers and psychologists 

> indirect: 10,000 adolescent girls and 

3,000 children 

Staff 

> local: 11 


Staff 

> project: R. Heimann / M.A. Silicani 

> field: I. Bruand 

> headquarters: S.Alary 

Funding 

> Drosos Foundation, EU, MdM 

Budget 


IRAQ 103 

In the grip of growing violence and insecurity, the situation in Iraq remains extremely 

worrying. Because of the great confusion between military and humanitarian 

operations, national and international NGOs are adapting to the volatile context where 

their teams are not respected. In such a situation, access to healthcare becomes very 

difficult and insecurity drives many Iraqi healthcare staff, who are particularly threatened 

by kidnappings, to abandon their work. Having closed its programme in 2004, MdM 

France is setting up maternal health and mental health activities, which will be managed 

from a distance, to get round the fact that it is impossible to have a direct presence in 

Iraq. 

IMPROVING MEDICAL EMERGENCY CARE 

Several Iraqi governorates with support from the base in Amman 

and with Iraqi medical teams in Baghdad 

Activities 

In May 2006, MdM launched a pilot programme in 

Amman with the following objectives: 

• to identify the determinants of access to healthcare 

for the Iraqi population and prioritise the problems 

identified; 

• to define the strategies, objectives and activities for 

a programme proposal; 

• to develop a network of contacts (NGO and Iraqi 

institutions) from Amman; 

• to participate in a collective NGO advocacy project 

towards European institutional funders; 

• the programme themes identified are: (i) emergency 

medical care for civilian victims of conflict, (ii) 

pregnant women and (iii) a mental health programme. 

Outlook 

From January 2007 a multi-faceted 

programme will be managed by 

‘remote-control’ from Amman in liaison 

with an Iraqi medical co-ordinator in 

the field, supporting Iraqi associations 

and partners.The activities will include 

first aid training and training on home 

births, as well as supporting the 

integration of mental health into 

primary healthcare. This will be done 

in partnership with WHO and the 

Iraqi Ministry of Health. A project 

working with Iraqi refugees in Syria is 

also planned. 


01/2007 31/12/2007 


>CONTENTS 

Mortality 




HDI 

> not known 


> not known 


Beneficiaries 

> direct: n/a 


Staff 

> local: 1 


Co-ordinators 

> project: M.A. Silicani 

> general co-ordinator: J. Lobel 

> medical co-ordinator: M. Bennour 


Funding 

> MdM 

Budget 



PALESTINIAN TERRITORIES 

Since February 2006, the occupied Palestinian Territories have been suffering the effects 

of an international economic embargo introduced by western donors following Hamas 

election victory. The destruction of infrastructure and the main transport routes by 

Operation Summer Rain has considerably hampered the distribution of essential goods 

and movement within the Gaza strip. In the West Bank, the strike of unpaid government 

workers, particularly those from the Ministry of Health, resulted in the almost total 

closure of health facilities and a deterioration in the health system. In addition, the 

construction of the Wall and the expansion of settlements continue in Jerusalem, in 

parallel with deepening intra-palestinian tensions. 

IMPROVING EMERGENCY CARE 

Gaza Strip 

Activities 

MdM aims to improve emergency medical treatment 

by: 

• first aid training, particularly schoolchildren of the 

United National Relief and Work Agency (UNRWA) 

schools; 

• a ‘training for trainers’ course for 74 paramedics from 

UNRWA health centres 

• a ‘training for trainers’ programme with the 

Palestinian Red Crescent ambulance staff in Gaza and 

Ramallah; 

• development of a reference ‘Plan for an influx of sick 

or injured patients’ with the emergency department of 

Shifa Hospital; 

• exceptional donations of medicines to Shifa Hospital 

and of hospital surgical equipment to the Ministry of 

Health. 

Outlook 

To continue the programme and 

develop primary healthcare activities, 

supporting the Ministry of Health and 

local NGOs. 


2002 2008 


>CONTENTS 

Mortality 




HDI 

> 0.736; rank: 100/177 


> 1,026 

Beneficiaries 

> direct: 1,300 trainers, teachers, 

schoolchildren and hospital staff 

> indirect: 1,400,000 

Staff 

> local: 6 

> expatriate: 1 and doctors for short 

periods 

Co-ordinators 

> project: R. Garrigue, M. Rajablat 

> field: D.Trani then R. Guzman 

> country co-ordinator:W. Dufourcq 


Funding 

> DAH, ECHO, MdM 

Budget 


MENTAL HEALTH 

Nablus district in the West Bank 

In co-operation with the Palestinian Ministry of 

Health and in partnership with several local services, 

MdM works to improve the treatment of 

psychological problems, through: 

• a de-stigmatisation campaign amongst the 

Palestinian population (leaflets, adverts,TV and radio 

programmes); 

• supervision of a programme identifying 

psychological problems in children (theatre in 

schools) which has been transferred to a local 

partner; 

• support for therapeutic activities including literary 

cafés, a ‘Listening Point’ and two psychological 

consultation services in a Nablus clinic; 

• technical support to primary healthcare staff and 

mental health professionals (training courses and 

seminars on mental health). 

ACCESS TO HEALTHCARE 

Jerusalem 

Activities 

The co-ordination team in Jerusalem ensures daily 

monitoring and running of the projects from the 

Nablus and Gaza bases. 

Outlook 

Continuing the activities and setting up 

two medical psychology community 

centres (Nablus and Jenin) in 

partnership with the Palestinian 

Ministry of Health and partially funded 

by the French Development Agency. 


mid 2003 end 2009 


Outlook 

MdM would like to develop a primary 

healthcare project to support the 

Ministry of Health and local NGOs. 

>CONTENTS 

Mortality 




HDI 

> 0.736; rank: 100/177 


> 1,026 



> project 2: MdM Switzerland, MdM 

Greece, MdM Spain 

Beneficiaries 



Staff 



> expatriate, project 1: mental health coordinator: 

C. Dugarin 


Co-ordinators 

> project 1: R. Garrigue 

> field, project 1: C.Thévenot; 

from March 2006 local team. 

> field, project 2: R. Garrigue 

> country, project 1:W. Dufourcq 

> country, project 2: R. Garrigue 

> headquarters, project 1: S.Alary 

Funding 

> projects 1 and 2: MdM 

Budget 



105 


LEBANON 

Lebanon experienced a major political crisis, exacerbated by the assassination of the former 

Prime Minister R. Hariri, and a deep socio-economic crisis aggravated by the war of July 

2006. Despite the end of hostilities and the deployment of UNIFIL forces alongside the 

Lebanese army, Israeli air incursions tend to produce tensions. In addition, Lebanon is a 

crossroads for thousands of migrants who face severe discrimination.The country is not 

party to the 1951 Geneva Convention and refuses to be a reception country. 

EMERGENCY MEDICAL ACCESS FOR CONFLICT VICTIMS 

Beirut and its suburbs, South Lebanon 

Activities 

MdM, in partnership with the Lebanese NGO Amel 

targeted displaced people in and around Beirut. Later, 

the activities were refocused on people returning to 

their towns and villages in South Lebanon. In all the 

supported areas the activities included: 

• monitoring patients suffering from chronic disease and 

epidemiological surveillance; 

• health promotion, provision of information and 

improving hygiene conditions; 

• a needs assessment and distribution of medicines and 

other medical/surgical supplies to the places people 

were returning to. 

Outlook 

The programme finished on 12 

October 2006. 


12/07/2006 12/10/2006 


ACCESS TO HEALTHCARE AND FUNDAMENTAL RIGHTS FOR 

REFUGEES, ASYLUM SEEKERS AND MIGRANTS 

Lebanon (13 prisons across the country) 

Activities 

MdM continues its activities in Roumeih central prison, in 

partnership with the Lebanese NGO Ajem, and has been 

working since mid-2006 in other prisons across Lebanon. 

In Roumieh prison:medical,social and legal follow-up for 

newly detained foreigners; 

In Roumieh prison and other prisons: 

• refurbishing and providing sanitation equipment and 

hygiene products; 

• Information,Education and Communication (IEC) sessions; 

• training in health and rights for healthcare staff, detainees, 

prison guards and voluntary organisations; 

• lobbying the prison authorities, health authorities and 

politicians; 

• creation of a network of NGOs working in prisons and/or 

with refugees,asylum seekers and migrants. 

Outlook 

Continuing the programme in 2007: 

developing activities focused on 

training and health education in other 

Lebanese prisons as well as advocacy 

activities. 


01/01/2005 31/12/2008 


>CONTENTS 

Mortality 




HDI 

> 0.774; rank: 78/177 


> 6,149 




Beneficiaries 

> direct, project 1: 62,510 people 

> direct, project 2: at least 2,000 

people/year 

> indirect, project 2: around 5,500 

Lebanese prisoners in 13 prisons including 

4 women’s prisons; prison medical and 

non-medical staff; local project partners 

Staff 





Co-ordinators 

> project 1: B. Lambert/M.A. Silicani 

> project 2: B. Lambert 

> field, project 1: N. Séris 

> field, project 2: B. Martin 

> headquarters, projects 1 and 2: S.Alary 

Funding 

> project 1: ECHO, PACA Regional 

Council 

> project 2: French Ministry of Foreign 

Affairs, EU 

Budget 



TURKEY 

The economic situation in Turkey has been positive, with a budget deficit that has been 

largely contained and ongoing liberalising structural reforms. However, this progress is still 

fragile, and social and regional inequalities are widening.With the opening of negotiations 

for membership of the EU, major questions remain: the question of Cyprus and respect 

of human rights, including those of minorities, prisoners or political opponents. Despite 

legislative efforts, people are still repressed because of their opinions. 

SUPPORTING VICTIMS OF POLITICAL VIOLENCE 

Istanbul 

Activities 

With the help of several human rights organisations, 

MdM aims to: 

• produce an expert report on the medical and 

psychological consequences of torture on former 

prisoners and the effects of solitary confinement; 

• to observe legal proceedings defending human 

rights; 

• to testify about exactions to the European Court on 

Human Rights using the ‘counter-expertise model’ 

which was used two years ago with patients whose 

health status had been wrongly judged to be 

compatible with their reincarceration. 

Outlook 

To adapt MdM’s activities to the 

changing context. 


2002 2007 


CARING FOR THE MOST DISADVANTAGED 

Disadvantaged area of Ayasma 

Activities 

As part of primary healthcare, MdM continues to 

provide medical and welfare services to people living 

in Ayasma, mainly displaced Kurds. The activities 

include: 

• healthcare and socio-educational activities for 

children, adolescents and women; 

• a local partnership and implementation of a medicosocial 

project combining healthcare, education and 

training; 

• monitoring the respect of rights, particularly the 

right to health. 

Outlook 

Set up a health observatory, continue 

the current activities, prepare the 

closure of the centre which is 

scheduled for the end of 2007. Study 

the possibility of transferring the 

project to another area of Istanbul. 


2005 2007 


>CONTENTS 

Mortality 




HDI 

> 0.757; rank: 92/177 


> 7,753 




Beneficiaries 

> direct, project 1: political prisoners, 

victims of state violence (torture, solitary 

confinement) 

> direct, project 2: pregnant women and 

young children 

> indirect, project 1: defending human 

rights and minorities 


Staff 

> local, project 2: 5 employees and 

volunteers 

> expatriate, project 1: 6 on regular visits 

> expatriate, project 2: 2 on regular visits, it 

is illegal to provide permanent assistance. 

Co-ordinators 

> project 1: B. Granjon 

> project 2: G. Couffin Guerin 

> HQ projects 1 and 2: PACA Regional 

Delegation 

Funding 

> project 1: Bouches-du-Rhône Council 

> project 2: Bouches-du-Rhône Council, 

MdM 

Budget 



107 


YEMEN 

One of the most populated and the poorest countries in the Arab world,Yemen has 

particularly alarming development indicators. In order to strengthen capacity since 

reunification in 1990, the country has sought to mobilise foreign and national 

investments. But this is proving slow to get off the ground, mainly because of the unsure 

political and legal environment.The primary healthcare system only covers 58% of the 

population s needs. Within this, 80% of the urban population s needs are covered 

compared to only 20% in rural areas. 

IMPROVING PRIMARY HEALTH CARE 

Hajjah Governorat, Beni Kays district 

Activities 

With the aim of improving medical care for 

disadvantaged populations and the Yemeni health 

system in general, MdM carried out a three-month 

needs assessment in April 2006 focusing on the 

feasibility of a structured programme.The assessment 

included: 

• building up knowledge of the general health context 

in Yemen; 

• evaluating the health needs of the population and 

their current access to healthcare; 

• determining a framework for MdM’s operations in 

Yemen. 

In December 2006, MdM started a two-year project 

intended to support primary healthcare facilities in this 

district. 

Outlook 

MdM will: 

• provide equipment to seven health 

units and the Toor health centre 

laboratory and help these units to 

become operational; 

• set up training, in collaboration with 

the Ministry of Health, for the staff of 

the units, the health centres and 

community health workers; 

• develop prevention and awarenessraising 

activities on health and hygiene 

issues, in partnership with community 

networks and Yemeni associations; 

• identify solutions to help improve 

the health system, in collaboration 

with the health and political 

authorities. 


12/2006 11/2008 


>CONTENTS 

Mortality 




HDI 

> 0.492; rank: 150 /177 


> 879 


Beneficiaries 

> for the whole project: 53,000 

Staff 

> local: 0 


Co-ordinators 

> project: F. Jeanson, J. Dato 

Funding 

> MdM 

Budget 


FUTURE PROJECTS 

NEW PROJECTS 2007 

Month Country Town / Region Theme 

FEBRUARY Ethiopia Somalia Improving access to healthcare: support to Kebri Dehar hospital and primary care in Korahe 

Indonesia Jakarta Emergency medical programme for people living in East and North Jakarta affected by flooding 

Haiti Jeremie Renovation of Saint-Antione hospital in Jeremie following flooding in November 2006 

India Jaipur Reproductive and primary healthcare programme in 10 shanty towns around Jaipur 

MARCH Madagascar Nord Madagascar, Access to healthcare in prisons 

Majunga 

Malta Promoting respect for the right to health and the dignity of migrants enclosed or living in camps 

Indonesia Sumatra Emergency medical programme for earthquake victims 

APRIL Russia Moscow Access to healthcare for migrants 

Senegal Podor, Gamadji, 

Saré Primary healthcare 

Morocco Casablanca Street children / Training social workers 

MAY Niger Tahoua Research-action-advocacy project on nutrition and family planning 

Nepal Sindhupalchowk Mother and child health programme 

district 

JUNE Ivory Coast Tenegrela, Dabakala, Improving access to healthcare and quality of care by supporting three health facilities 

Mankono districts 

Somalia 

SEPTEMBER India Kashmir Reproductive health programme 

Burma Mokens Access to healthcare 

Laos Champassak, Saravane Reproductive health programme 

China Qinghai Mother and child health programme 

Ecuador Tungurahua Intercultural health 

Madagascar Tulear HIV/Technical training 

NEEDS ASSESSMENTS 2007 

Month Country Town / Region Theme 

APRIL Somalia Bossasso Primary healthcare 

MAY Georgia Tbilissi / Zugdidi Harm reduction / Minorities 

Tajikistan/ Access to healthcare 

Kyrgyzstan 

JUNE Afghanistan Kabul Mental health 

>CONTENTS 

109 

INTERNATIONAL PROGRAMMES ANNUAL REPORT 2006

ADOPTION 

M decins du Monde is the only organisation medical humanitarian organisation in France to have incorporated 

adoption into its original statutes and created an International Adoption Programme.The status of authorised 

adoption organisation (OAA) was obtained in 1988.As an OAA, the objective is to remain faithful to the NGO s 

commitment: to defend the most vulnerable, such as children — who are often the first victims of crises or 

conflicts — and to defend their fundamental rights to healthcare, education and a family life. 

In 2006, M decins du Mondes adoption programme is the leading OAA in France.The programme prioritises 

finding families for children who have not been able to be adopted in their own country, siblings and children 

with special medical needs. In 2006, of 240 children adopted through Médecins du Monde, 109 

children (45% of all the children) met these criteria. 

CHILDREN, OUR PRIORITY 

Activities 

More than 1,800 applications were sent to MdM and 452 

applications were accepted. However, it is important to 

remember that between 27 and 30% of applicants normally 

withdraw from the process. 

In 2006, 1,259 post-adoption home visits were carried out in 

line with our commitments to do so for at least two years after the 

child arrives, and longer if needs be. 

240 children were adopted in France in 2006 by 216 families. 

2,965 children have been adopted since 1990. 

38 children from Eastern European (Albania, Bulgaria and Russia) 

136 children from Asia (China,Vietnam) 

66 children from Latin America (Brazil, Colombia) 

MdM is continuing to improve the adoption procedures in legal and 

medical terms. Four major themes have been identified: 

• adapting the number of adoptions to respond to the international 

trend for a reduction in the number of children proposed for 

adoption in the countries of origin; 

•updating procedural manuals; 

• professionalisation and training of human resources (237 people); 

• restructuring the organisation, with programme correspondents 

being placed under the authority of the MdM country co-ordinator. 

Local synergies between the programme and monitoring the 

procedures in the country are possible. 

Outlook 

Preparing requests for accreditation for 

fragile states, having carried out a geopolitical 

analysis. 

>CONTENTS 

Associated countries in 

2006 

> Albania, Brazil, Bulgaria, China, Colombia, 

Haiti, Russia,Vietnam. 

Bolivia, Ecuador and Romania were not 

operational in 2006. 

Co-ordinators 

> project: G.André-Trevennec 

> members of the Adoption Committee 

representing MdM’s Board of Directors: 

O. Bernard (MdM vice-president), P. Kempf 

(MdM deputy treasurer) 

Funding 

> adopting families, MAI, MdM 

Budget 

> 2006: 408,771 euros (provisional)

CONTENTS 

MdM 

Stéphane Lehr 

MdM 

INTERNATIONAL PROGRAMMES ¨ ADOPTION ANNUAL REPORT 2006 

111

OPERATION SOURIRE 

Operation Sourire aims to put a smile back on the faces of those who have been 

disfigured by war, illness or malnutrition.This enables people excluded because of their 

disability to find their place in society again. Reparatory surgery still does not exist in 

many countries because of a lack qualified human resources, equipment and 

infrastructure. Due to the considerable demand for plastic surgery and the complete 

lack of treatment for patients, the Operation Sourire teams are working amongst this 

forgotten population. 

PROGRAMME COUNTRIES IN 2006 

Benin/Togo, Cambodia, Eritrea, Ethiopia, Laos (needs assessment), Madagascar, 

Mali, Mongolia, Niger, Pakistan, Rwanda. 

Activities 

Operation Sourire’s long term future was confirmed in 

2006 and the programme continues to adapt to 

evolving needs and changing local circumstances in the 

10 countries involved. 

The work to create a network of partners is ongoing 

and enables better overall treatment for patients, from 

a medical point of view (operation, re-education) as 

well as from a social perspective (accompaniment 

during the integration process). 

The 25 teams who participated in Operation Sourire 

projects in 2006,operated on 670 patients.This brings 

it to more than 5,000 who have been operated on since 

1989 in 12 countries in Africa and Asia. 

In addition, the training of local teams is ongoing and 

several local surgeons, on completion of their training, 

are treating some of these specific conditions. 

This activity is developing thanks to the participation of 

more than 80 volunteer health professionals – 

surgeons,anaesthetists and nurses.The time which they 

invested on Operation Sourire programmes 

represented more than 1,500 volunteer days in 2006. 

Outlook 

Operation Sourire plans to carry out 

30 projects in 12 countries throughout 

2007. 

These projects will continue those 

already in place, including directly 

operating on patients and training 

local teams. Several local surgeons, on 

completion of their training, will be 

able to deal with these conditions. 

A new project will be developed in 

Laos and a team should also travel to 

Chad. 

>CONTENTS 

Co-ordinators 

> project: F. Foussadier 

> headquarters:A. Segard 

Funding 

> private funds, businesses, foundations 

Budget 


(1) Catherine Henriette 


>CONTENTS 

» In Chechnya, Cambodia (1), Madagascar (2), Niger (3) and Pakistan 

(4), facial disfigurement, burns whether resulting from a domestic 

accident or from honour crimes as in Pakistan, only have one solution: 

surgery.This enables faces and bodies to be repaired, but also treats 

souls destroyed by exclusion. Once treated, people can begin to 

reintegrate into their communities.This can often seem like being reborn. 


(4) Isabelle Eshraghi 

113 

INTERNATIONAL PROGRAMMES ¨ OPERATION SOURIRE ANNUAL REPORT 2006

MISSION 

FRANCE 

114/136 

>CONTENTS

CONTENTS 

Bruno Fert/Invisu 

¨ MISSION FRANCE ANNUAL REPORT 2006 

115

CONTENTS

THE HOMELESS AND POORLY HOUSED p.124 

MIGRANTS p.125 

LEAD POISONING IN CHILDREN p.126 

ROMA p.127 

TRAVELLERS p.128 

PEOPLE WORKING IN PROSTITUTION p.129 

HARM REDUCTION AND NEEDLE EXCHANGE p.130 

METHADONE BUS p.131 

RAVES p.132 

BUDDYING CHILDREN IN HOSPITAL p.133 

>CONTENTS 

117 

¨ MISSION FRANCE ANNUAL REPORT 2006

Introduction 

BRAVERY IS TO SEEK AND SPEAK THE TRUTH 

AND NOT TO FALL VICTIM OR PERPETUATE 

THE POWERFUL LIES WHICH REIGN 

TRIUMPHANT 

JEAN JAURÈS 

In order to fight discrimination in providing access to healthcare and to work daily to improve access to 

care for the most vulnerable it is essential to address common misperceptions and distorted reporting. 

That is why the team at MdM’s Mission France are committed to recording facts and figures and collecting 

case studies from everyday life across 27 French towns. 

We won’t allow the weakest to be treated as guilty, we won’t accept constant reports of fraud, crime and 

illegal activities about people who, as they try to survive, face rejection, condemnation and endless 

obstacles. Pushed out of their caravan or squat, losing their belongings, being separated from their family 

(biological or chosen), facing prejudice and not knowing where to find shelter, they live off charitable hand 

outs and stand accused of wasting their resources, they work when they can and often in dangerous jobs, 

without always being paid. 

The current trend of criminalising poverty, and in turn, the poor, is taking root in people’s minds as much 

as it is in law.The neediest are forced to comply with tortuous bureaucracy, in spite of the fact they have 

no office and often find that the authorities keep their papers. New rules that increase obstacles are issued 

and are presented to the general public as a way of having more control over the population. 

When will our society refuse to become a society based on fear? Fear of the unknown, different and 

therefore dangerous, fear of risks. The panic arising from the bird flu epidemic is a good example. The 

omnipresent sense of fear leads to a society in the grip of databases where the freedom of world citizens 

>CONTENTS

is curbed by laws. Recent action around undocumented children in their neighbourhoods and at school is 

perhaps the beginning of a wake-up call that human rights are more important than electoral speeches. 

That our society will be better off when we respect the rights of the most vulnerable and redress existing 

inequalities rather than forcing people to disappear, excluded from the few places where they found 

refuge, by chasing them underground and on to baron wastelands on the edge of town. 

How is your health? Are you well? Oh yes, its true you are sitting in front of your demolished caravan, 

with all your documents inside, alongside the toys and your children’s clothes and your medicine.You were 

granted a charitable ten minutes to retrieve your belongings before the bulldozer demolished your home. 

Tonight you will sleep in the rain with your three children...The land won’t be used but it is better without 

you.The kids were frightened, you too. But your health is ok, isn’t it? 

>CONTENTS 

Nathalie Simonnot, 20 August 2006 

Mission France Co-ordination 


119 

¨ MISSION FRANCE ANNUAL REPORT 2006

Calais 

S,22 years old,and his 20 

year old brother are originally 

from Eritrea 

‘I left Eritrea when I was 16 after a year 

in the army. I went to Libya, then three 

years later decided to come to Europe. I 

wanted to go from Italy on to Great 

Britain where one of my relatives lives. 

But I was arrested before I got there 

because I didn’t have any official 

documents. I came to Calais by train. I 

slept in the forest from the first evening, 

without any roof over my head. I tried to 

cross the Channel every day, without 

really knowing how to.After one failed 

attempt, I was detained for two or three 

days in a police station near the Gare du 

Nord in Paris where an Arabic 

interpreter told me that I had to leave 

the country within five days. One week 

after I arrived in Calais, during an 

attempt to pass through the transit zone, 

a Kurdish trafficker claimed 500 euros 

from me. Because I refused to pay him, 

he stabbed me in the thigh. I haven’t had 

any treatment for my leg. I made another 

attempt to cross at Gravelines port 

between Calais and Dunkirk but failed 

again. Since some migrants were taken 

for questioning in Calais at the end of 

October, I have not gone to the evening 

soup kitchen in case I am arrested. 

Around thirty Eritreans are in a similar 

situation here in Calais.’ 

>CONTENTS 

Martin Mazurkiewicz Martin Mazurkiewicz

CONTENTS 

(2) Sophie Brändström 

(3) Sébastien Duijndam 



121

CONTENTS 

(4) David Delaporte 

» In France, Médecins 

du Monde’s 

programmes often 

involve mobile health 

promotion and access 

to rights activities 

among Roma (4) or 

homeless people (3). 

Harm reduction linked 

to prostitution (1), 

drug use in raves (7) 

or among marginalised 

young people (5) is 

also a priority.This 

requires social, medical, 

administrative and legal 

support. Our teams 

find it unacceptable 

that 2 million children 

live below the poverty 

line. So, in addition to 

paediatric check-ups 

carried out in our 

centres, they also fight 

against lead poisoning 

(2) by identifying and 

protecting affected 

children. Finally, the 

buddying programme 

supports children who 

are in hospital and 

separated from their 

families (6).

CONTENTS 


(7) MdM (5) Stéphane Deneuville 


123

THE HOMELESS AND POORLY HOUSED 

Housing is a fundamental right. However, many people still do not have access to this right. In 

France,there are almost 3,261,600 people who are homeless or very poorly housed.In 2006, 

our distribution of more than 400 tents to people living in very precarious conditions,was one 

of the detonators of the current public debate on this issue.The large majority of patients seen 

by MdM-France are homeless or live in insecure accommodation. 

REALISING THE RIGHT TO HOUSING 

Since 1993 

Activities 

Our mobile teams go out to meet people living in the 

street or in shelters.They support this vulnerable and 

marginalised population, who have difficulty making 

contact with public services. 

There are three objectives: 

• to identify emergency cases in the street and 

take those cases to hospital; 

• to inform people of their rights to access 

healthcare, and to point them towards public 

services and accompany them if necessary; 

• in the health centres, to see those who do not 

have access to healthcare and help them to reclaim 

their rights and access healthcare. 

Each year, MdM runs programmes throughout the 

year which aim to increase access to accommodation 

and long term housing. MdM bears witness to the 

harmful health effects of homelessness or unfit 

housing. People who are already vulnerable see 

their health deteriorate because of the uncertainty 

and the unsuitability of their living conditions. 

All the teams in France work all year round watching 

the situation through outreach street patrols, medical 

consultations in shelters, and ‘nursing beds’… 

Outlook 

To continue field work amongst the 

most disadvantaged (street rounds, 

welfare and medical care, medical 

consultations and nursing care in 

accommodation hostels, work in 

partnership with health and 

homelessness services, participation in 

the ‘cold weather plan’) and political 

action (bearing witness, lobbying 

institutions to set up long term 

accommodation structures adapted to 

the needs of homeless people). 

Types of work 

Medical and welfare consultations, street patrols: 

Ajaccio,Angoulême, Le Havre, Lyons, Marseilles, Metz, Nice, 

Paris, Poitiers, Strasbourg,Toulouse,Valenciennes. 

Medical consultations for the homeless in ‘hostel 

healthcare beds’: Bordeaux, Grenoble, Lyons, Strasbourg, 

Toulouse. 

Consultations in the premises of other 

organisations: (Restos du Coeur, Salvation Army,Abbé 

Pierre Centres, Secours Catholique,Aides, Pointe Ecoute 

Sante Jeunes): Grenoble, Le Havre, Lyons, Metz, Nancy, 

Nantes, La Reunion,Toulouse,Valenciennes. 

Consultations in emergency accommodation 

centres: Lyons, Metz, Nantes, Nice,Toulouse. 

Health and welfare work in squats: Bordeaux, Calais, 

Paris. 

>CONTENTS 

Number of homeless people 

in France 

> 86,500 people (source: Insee - 2001) 

Number of poorly housed 

> 3.2 million (source: 2006 Annual report 

on poor housing in France,Abbé Pierre 

Foundation) 

Most common conditions 

> skin complaints, trauma, psychiatric 

problems, psychological difficulties, ENT 

and respiratory infections 

Number of projects 

> 18 

Number of volunteers 

> 301 

Contacts with homeless 

people 

> more than 23,000 

> 19% of people seen in CASOs are 

homeless 

> 43% live in insecure accommodation 

Characteristics of homeless 

people seen in CASOs 

> 32% are women 

> 70% are under 40 years old 

> 7% are under 18 

> 75% do not have access to healthcare 

Funding 

> local health and welfare authorities, 

town councils, regional councils 

Main partners 

> Abbé Pierre Foundation, Secours 

Catholique, Emmaüs, Red Cross, Restos du 

Cœur, Samu Social, DAL, local voluntary 

organisations (Péniche,Amis de la rue, 

Fournil, GAF, Enfants du Monde Droits de 

l’Homme)

MIGRANTS 

Migrants, particularly as the elections approached, have become scapegoats, held 

responsible for all the economic ills and social tensions. Recent legislation on immigration 

makes life on French soil harder: cancelling the right to regularisation of immigration status 

after 10 years in France, a hardening of the policy on family reunification, a dramatic drop 

in the numbers of people awarded refugee status, increasing requirements for asylum 

requests, reversal of the policy permitting regularisation for medical reasons, difficulties in 

renewing residency permits and edicts recommending questioning of irregular migrants 

even in health services or when called to the prefecture. Although the legislation on 

regularisation of families with children in school raised great hopes, it also brought arrests 

and excluded many who should have been included.Access to free healthcare in hospitals 

is still a dream: many PASS (healthcare access offices) are not working, the regulation 

enabling urgent treatment excludes a considerable number of people who cannot 

therefore access healthcare. 

FACILITATING ACCESS TO HEALTHCARE 

Since 1986 

Activities 

Healthcare centres: 90% of the people seen in the 21 

healthcare centres were migrants.The centres carried out 

39,490 medical consultations.MdM forms a bridge,linking 

people to public services. Migration pathways, generating 

physical and psychological problems, are taken into 

account and psychological support programmes are being 

developed. In 2006, following the Paris and Marseilles 

CASOs, the centres in Lyons, Rouen, Saint Denis and 

Toulouse set up specific HIV/STI prevention and screening 

programmes. 

CAFDA (Committee for Asylum-Seeking 

Families) Project: MdM has set up reception, 

healthcare and referral consultations with newly-arrived 

asylum-seeking families in the premises of our partner, 

CAFDA. In 2006, MdM saw 356 families, equivalent to 

59% of the families coming to CAFDA. 

Medical project in Calais: In order to facilitate access 

to healthcare for migrants in transit, MdM offers five 

afternoon consultation sessions per week. More than 

2,400 medical or nursing consultations were carried out 

in 2006.At the beginning of 2006,some preliminary work 

with local partners towards the creation of a PASS (health 

care access office) paid off: it was opened in December 

2006. 

Outlook 

MdM continues to work so that anyone 

can access healthcare and be referred to 

public services, irrespective of their 

status. Mission France continues to 

develop prevention, HIV, hepatitis and 

STI screening programmes as well as 

psychological services. Active in 11 

European countries,MdM has created an 

European Observatory on Access to 

Healthcare which is committed to 

improving access to healthcare for 

vulnerable migrants in Europe as well as 

bearing witness to the difficulties they 

experience. In addition, it lobbies EU 

institutions. 

Types of work 

Our programmes offer consultations, disseminate prevention 

messages and refer migrants to partners and public health 

services. Testimony on the living conditions of this population 

can help to slow down the process which sees their rights being 

taken away from them.Closely linked to the analysis of social and 

medical data recorded by each healthcare centre, these 

testimonies contribute to the project activity reports and to our 

lobbying of relevant institutions. 

>CONTENTS 

All the programmes 

(mobile and CASOs) see 

immigrant populations 

(in centres, asylum 

seekers) 

Beneficiaries 

> 90% of patients seen for the first time in 

the CASOs are migrants 

> 73% of them have irregular or uncertain 

immigration status and 20% have applied 

for asylum 

Key countries of origin 

> Algeria, Cameroon, Morocco, Romania, 

Tunisia 


> osteo-arthritis, respiratory infections, 

gastro-enterology, psychiatric, skin 

complaints, obstetric-gynaecological and 

psychological problems 

> 88% of migrants seen do not have 

access to healthcare when they come 

to an MdM CASO for the first time 


> all programmes 



Funding 


Regional councils,Town councils, Regional 

and national health insurances (CRAM, 

CPAM) 

Partners 

> CASP, Cimade, Gisti, LDH,Anafé, CFDA, 

Comede, involvement in ODSE 

(Observatory on Migrants’ Right to 

Health), local and regional voluntary 

sector organisations 

125 

ANNUAL REPORT 2006 

¨ MISSION FRANCE

LEAD POISONING IN CHILDREN 

Children are more vulnerable when faced with exclusion, poverty and illness.According to 

the report by the Council on Employment, Revenue and Social Cohesion (CERC), two 

million children live below the poverty line. The number of children affected by lead 

poisoning in France is estimated at around 85,000. On top of the lead poisoning 

programmes, paediatric monitoring is carried out in the healthcare centres. Since 1993, 

M decins du Monde has been running programmes to tackle lead poisoning, which aim to 

identify and protect children.The lead poisoning project has been working in Hauts-de- 

Seine since 2003 as part of the mission banlieue. In Poitiers, the team has been working 

since 1997, in cooperation with the hospital, to initiate screening and awareness-raising 

amongst families. 

IDENTIFYING AND CARING FOR EXPOSED CHILDREN 

Child lead poisoning programme since 1993 

Activities 

Lead Poisoning results from ingestion of lead from the 

paint on the walls of buildings built before 1948.When a 

building is very run down the paint flakes and its dust can be 

ingested by children, causing poisoning which affects the 

central nervous system.The effects are irreversible and there 

is no treatment.The only solution for child lead poisoning is 

prevention. 

MdM’s project involves three areas of work: 

• identifying unsafe housing and informing families to increase 

take-up of screening; 

• following up with affected families to ensure protection of 

the children,whether by improvements in the building or by 

re-housing; 

• mobilising all those involved in local health, housing, and 

rights to develop a more effective network. 

These activities are done in collaboration with the public 

services, including health authorities and medical 

professionals,mother and child health services,paediatricians, 

school doctors and town environmental health services. 

The mission banlieue organised a conference at the Ministry 

of Health on 7 November 2006, in partnership with the 

Abbé Pierre Foundation.The aim was for all those working 

in health,housing,and social policy to work together to tackle 

lead poisoning more effectively. 

Outlook 

Lead poisoning: MdM’s mission 

banlieu wants to consolidate the 

network set up in Hauts-de-Seine to 

ensure a long-term approach to 

tackling child lead poisoning, and in 

order to take action in the other 

departments of the Parisian suburbs. 

The Poitiers programme continues its 

activities in co-operation with the 

town hospital services. 

Types of work 

Lead poisoning programme: identification of unsafe 

buildings, informing families, screening children, following up 

families of affected children, mobilisation of those working 

locally in health, housing and rights. 

CASO: paediatric consultations, referral to mother and 

child health services.All healthcare centres see children. 

>CONTENTS 

Beneficiaries 

> 1,756 children under 18 years (8% of 

patients seen in CASOs) were seen in 

CASOs in 2006 


> ENT, respiratory conditions... 

Funding 

> local health authorities, health insurance 

offices (CPAM), regional councils 

Number of children 

potentially affected by lead 

poisoning 

> 85,000 (source: INSERM study 1999) 


> 2 


> 9 

Main partners 

> Association of families who are victims 

of lead poisoning, local health and social 

authorities,Abbé Pierre Foundation, Pact 

Arim 92,ADIL, Mother and Child Health 

Protection service,ASDES, Poitiers 

environmental health service, Poitiers 

medical and social services

ROMA 

Roma leave their country of origin to flee racial discrimination and poverty. In France, 

however, they still face extreme living conditions, surviving in shanty towns or in squats. 

The increase in expulsions weakens them and makes their lives even more insecure. 

These expulsions often lead to a break in continuity of care, a fundamental principle 

for medical practice. Often forced into living clandestinely, many Roma are refused 

access to healthcare and, more generally, to their fundamental rights. 

SUPPORTING EXPELLED FAMILIES 

1992, mission banlieue in Ile de France: first project with Roma migrants 

1994, opening of a Roma project in Strasbourg 

2001, opening of a Roma project in squats and shanty towns in Lyons 

2002, Roma project in Nantes opens 

Activities 

MdM teams visit places where Roma live to help 

them get access to healthcare and their rights. This 

health monitoring is aimed particularly at health 

education and promotion, schooling for children, 

access to drinking water and mother and child health. 

The Ile de France Roma project carried out 65 visits, 

88 paediatric and 57 obstetric-gynaecological 

consultations and 25 information campaigns on 

reproductive health. Thirty-nine children were 

enrolled at school and, of these, 23 stayed. 

The mobile Roma project in Lyons went to eight 

places and saw almost 900 people, of which 58.8% 

were women. Despite a major partnership with the 

mother and child health services and the 

Departmental social hygiene service, several 

expulsions took place and both the inhabitants and 

the people working in the field felt the effects: 

belongings destroyed, links with health services and 

schools broken… 

The Lyons programme participated in the CLASSES 

collective to promote child schooling. Collaboration 

with midwives for the CASO improved the care for 

pregnant women. 

A partnership with the Vinci Foundation enabled 

improvement works to be carried out on a site 

occupied by Roma in Villeurbanne. 

Outlook 

Continue our activities, focusing 

attention on children, monitoring for 

tuberculosis, improving access to 

immunisation, defending the right to 

health. Develop mother and child 

health activities. Strengthen our 

testimony on the health consequences 

of expulsions and raise awareness 

among those working locally. As part 

of the Romeurope collective, MdM 

will continue to mobilise against the 

discrimination which Roma face in 

France and to promote access to their 

rights. 

Types of work 

• Health monitoring: primary care and referral to public 

health services; 

• Facilitating child schooling: raising awareness, administrative 

procedures and vaccination; 

• Sanitation: lobbying local councils for improvements to 

hygiene conditions on sites; 

• Partnership with the Vinci Foundation to improve a site in 

Villeurbanne; 

• Perinatal health: preventing terminations, monitoring 

pregnancies, providing information on contraception, child 

immunisation, accompaniment to mother and child health 

services and family planning centres; 

• Bearing witness to living conditions, repeated expulsions, 

obstacles impeding access to healthcare and other rights; 

• Mobilising Roma family support committees, and those 

working in health services, councils and other government 

services. 

Main conditions 

> illness linked to living conditions, delays 

in accessing healthcare in France and in 

country of origin, and to psychological 

trauma due to repeated expulsions 

Epidemiological 

characteristics 

> early neonatal mortality (0–1month): 9 

times higher 

> infant mortality (0–1 year): 5 times 

higher 

> life expectancy: 15 to 20 years lower 

than for the French population in general 

(Romeurope data, 2000) 


> 4 

Number of project 

beneficiaries 

>more than 3,500, including 2,700 in Ile de 

France 


> 39 

Funding 


Regional councils, town councils 

Partners 

> Alpil,ASAV,ATD Quart Monde LDH, 

MRAP, support networks for Roma 

families, Romeurope, municipal mother and 

child health protection services, healthcare 

access offices (PASS), CLASSES collective 

>CONTENTS 

127 


¨ MISSION FRANCE

TRAVELLERS 

The rights of travellers are under threat.These violations have physical and psychological 

repercussions. The Besson law on travellers is ignored, because only 15% of town 

councils of more than 5,000 inhabitants really comply with their obligation to provide 

reception sites reserved for travellers. In addition, the 2006 finance law introduced a plan 

to tax mobile homes (several tens of euros per square metre) even though they are not 

recognised as accommodation. 

FACILITATING ACCESS TO FUNDAMENTAL RIGHTS 

Since 1997 

Activities 

MdM’s mobile teams have two aims: to meet 

travellers where they live and to help them to have 

their rights recognised. 

In fact, there are few reception sites and when they 

do exist, the living conditions on these sites are very 

insecure: no sewage system, poor access to running 

water and electricity, rats, a lack of toilets. These 

regular site visits also enable the team to establish 

contacts and to encourage dialogue and listening. 

MdM is carrying out the following activities: 

• support, counselling and referral activities; 

• facilitating access to healthcare, to rights and to 

school for children; 

• lobbying the public authorities to create reception 

sites for travellers. Organisations defending travellers’ 

rights, are calling for this illegitimate and unfair tax to 

be dropped. Their priority is the recognition of 

caravans as accommodation and the associated social 

rights. In addition, they want to participate in the 

institutions dealing with travellers’ issues, such as the 

National Consultative Commission and the HALDE 

(High Authority Fighting Discrimination and 

Promoting Equality) for discrimination cases and to 

promote equality. 

Outlook 

Continue activities aimed at improving 

hygiene, living conditions and health of 

travellers and at facilitating their 

access to public health and welfare 

services and, more generally, to 

citizenship. MdM’s teams are 

represented on several authorities, 

including the Departmental Consultative 

Commissions on the reception plans 

for travellers. The stigmatisation that 

they are subjected to is hard to bear. 

Identifying delicate psychological 

situations and cases which are likely to 

get worse is also a priority when 

supporting travellers. 

Types of work 

Listening, psychological support, prevention and information 

messages. 

Primary healthcare, help with access to schooling and to 

housing, referral to other public welfare and health services 

Lobbying town councils, health institutions and health 

professionals to improve hygiene, living and health 

conditions; promoting the recognition of citizenship. 

Participation in the departmental consultative commissions 

on the reception plan for travellers. 

>CONTENTS 

Beneficiaries 

> in 2005: approximately 100 

Main conditions 

> depression, cardiovascular disease, drug 

or alcohol dependency 

Social characteristics 

> isolation, poor education, social 

exclusion 


> 2 


> 4 

Funding 


URCAM (Union of Regional Health 

Insurance Offices) 

Partners 

> Relais Accueil Gens du Voyage, coordinating 

body for travellers,Alliers Social 

Centre, LDH, CCAS, schools, town 

councils

PEOPLE WORKING IN PROSTITUTION 129 

Since the Internal Security Law was implemented in 2003, life has generally become 

harder for people working in prostitution. In addition to the criminalisation of passive 

soliciting which is largely arbritary, the majority, who have irregular immigration status, 

have also experienced the current repressive context for foreigners. People working in 

prostitution, who are particularly at risk of sexually transmitted infections, encounter 

many obstacles to healthcare and their other rights. For example, they are subjected to 

violence and abusive arrests, and often have housing problems. The need to remain 

invisible, since the Internal Security Law came into force, drives people to work in 

hidden areas, distancing them from support organisations. In addition, clients take 

advantage of the criminalisation of passive soliciting and threaten to report people 

working in prostitution and robbery, rape and other forms of violence are becoming 

more common. 

SUPPORT THROUGH PREVENTION AND INFORMATION 

Since 1999 

Activities 

Promoting the health and the rights of people 

working in prostitution. Mobile units do night 

rounds of prostitution sites, and they distribute 

prevention materials and provide an 

environment for listening and answering 

questions from the women.There are also sessions 

inside premises to allow more detailed individual 

check-ups (consultations, screening, listening…) and 

health workshops. The teams offer physical 

accompaniment when necessary, to go with the 

women to the public services they have been referred 

to and facilitate communication if they do not speak 

French. Working groups adapt and translate, if 

necessary, information on risks linked to 

HIV/STIs/hepatitis and on rights. Our regular visits to 

prostitution sites, enable us to build up relationships 

of trust with people working in prostitution, allowing 

us to take steps together to address medical and 

social issues. 

Outlook 

The Internal Security Law has displaced 

prostitution sites. Today, the teams know 

that they can’t reach all the people working 

in prostitution.It is important,therefore,to 

be able to map the current situation so that 

we can reach people who are not working 

in street prostitution, but have the same 

needs in terms of access to prevention, to 

healthcare and to their rights. The 

programmes want to continue to improve 

their advocacy work, particularly on the 

health and social consequences of this law. 

Beneficiaries’ 

characteristics 

> often from Eastern Europe, sub-Saharan 

Africa and rural China. Either holding 

tourist visas, applying for asylum or staying 

illegally, sometimes the victims of 

trafficking 

> Main conditions 

gynaecological conditions; illness linked to 

conditions on the street, psychological 

problems linked to stress, isolation and 

abuse; drug or alcohol dependency 


> 6 mobile street teams, closely linked to 

CASOs and to harm reduction projects 

working with drug users 

Number of beneficiaries 

> data is very hard to obtain, more than 

800 individuals 


> 98 

Partners 

> Arcat, Cabiria, Friends of the Women’s 

Bus,AIDES, Gasprom,Anti Human 

Trafficking Platform, anonymous screening 

centres (CDAG), town councils, Moulin 

Joly, family planning 

Types of work 

Metz: creation of a mobile service with the organisation Aides. The programme finished in the last quarter. 

Montpellier: on top of its evening activities in the town centre,the programme set up a weekly day-time session on the 

main national roads. 

Nantes: the bus goes round the town two or three nights per week. Physical accompaniment to the hospital and to 

access healthcare, rights, registering complaints and at hearings on soliciting. Help to enrol in literacy courses. Running 

themed health workshops. 

Paris: three sessions per week on the streets. Adapted and translated information in Chinese, referrals and 

accompaniment with interpreters if needed. Running themed health workshops. 

Poitiers: two sessions per week; day and night patrols once a week with the L’Abri collective. 

Rouen:bus visits once a fortnight,alternating with the Aides association,and an infectious diseases screening programme. 

>CONTENTS 


¨ MISSION FRANCE

HARM REDUCTION AND NEEDLE EXCHANGE 

Since 2006, the needle exchange programmes have been recognised as medical-social 

establishments and are financed by health insurance,as CAARUDs (Centres for support and 

harm reduction among drug users) on condition that they carry out specific work (reception, 

referral, accompaniment...).As part of the move to becoming CAARUDs, the Paris, Bordeaux 

and Marseilles programmes left MdM at the end of 2006 and Bordeaux left at the very 

beginning of 2007.They have now become autonomous associations set up by the field teams, 

supported by MdM.Negotiations with the government and health insurance on the transition 

of these programmes to medical-social establishments were a key part of the work in 2006. 

SUPPORTING A MARGINALISED POPULATION 

Activities 

Providing sterile equipment reduces the risks 

associated with drug use. This also allows 

direct contact with a population which is often 

pushed to the margins and facilitates access 

to information and to existing public services 

for this population.Once the link is established,the 

teams can also spread prevention messages, listen to 

drug users and give guidance on medical, social or 

legal issues. These include accommodation, rights, 

resolving legal issues, withdrawal, post-treatment care 

and substitution treatment. 

Hepatitis C screening takes place in Paris and 

Bordeaux (saliva tests in Paris and blood testing in 

Bordeaux). If the results are positive, drug users are 

then offered treatment. The harm reduction 

programmes are implemented depending on the 

context: inhalation straws for ‘sniffers’, crack pipe 

mouthpieces to avoid burns and hepatitis C 

transmission, sterifilts which enable filtration of noninjectable 

substances at the end of the syringe…The 

field teams are continually involved in research and 

survey work to improve the quality of their activities. 

Street work often complements the work carried out 

in the mobile units. 

Outlook 

Improving prevention and access to treatment 

for hepatitis C for drug users is a priority. The 

increase in polydrug use and the new users we 

meet show that we need to update our tools 

and skills to adapt our prevention work to the 

changing context. 

As part of the transition to CAARUDs,three of 

our five needle exchange programmes were 

autonomous by the end of 2006: 

• The Paris programme transferred to the GAIA 

Paris association; 

• The Bordeaux programme transferred to the 

La Case association; 

• The Marseilles programme transferred to the 

Bus 31-32 association. 

The Angoulême programme also became a 

CAARUD supported administratively and 

financially by the organisation Aides which has a 

signed partnership with MdM. 

The teams stay in contact with MdM and are 

involved in the Harm Reduction Collective 

which brings together the harm reduction 

programmes which have been transferred from 

MdM as well as the ongoing MdM harm 

reduction programmes. 

Types of work 

Five mobile units:bus,vans and outreach teams visit drug users on the 

streets or in squats. 

Three day-centres in Bordeaux,Paris and Marseilles for needle exchange. 

Provision of sterile injecting equipment in all the CASOs. 

229,319 needles distributed,41.5% of used needles were returned in 2006. 

>CONTENTS 

Common conditions 

> infections linked to drug use (Hep C, 

HIV, Hep B), abscesses, psychiatric 

problems, dental problems, psychological 

difficulties linked to social exclusion. 

Marginalisation, 

discrimination and social 

damage: our findings 

> poly drug use and new consumption 

habits (injection, sniffing, ingestion etc) 

> high prevalence of hepatitis C in drug 

users 

> increasing numbers of young users seen 

(under 25), with a high proportion of 

young women 


> dossier of almost 3,700 drug users for 

more than 12,000 contacts at the mobile 

units and centres. More than 15,000 other 

visits (provision of information, signposting 

and other needs) 


> 84 within mulit-disciplinary teams 

Funding 

> mainly government funding through local 

health and welfare services, territorial 

collectives, health insurance offices 

(CPAM),the National Fund for Health 

Prevention, Education and Information 

(FNPEIS), town councils, regional health 

insurance offices (CRAM) 

Partners 

> Ministry of Health, Inter-ministerial task 

force on drug use and addiction (MILDT), 

French Observatory on Drugs and Drug 

Dependence (OFDT) and all the harm 

reduction services of the towns where we 

work

METHADONE BUSES 

Methadone is an opiate substitution treatment. It relieves withdrawal sensations and 

reduces the risks linked to drug use. Within a substitution programme, we can also 

accompany drug users towards social re-integration and monitor their health.This is 

extremely important for this population who are extremely vulnerable and often 

marginalised and who have very often lost all links with health and social services. 

DAILY OUTREACH WORK 

Since 1998 

Activities 

We aim to treat opiate dependency by 

introducing and monitoring substitution 

treatment with methadone. Set up in drug use 

sites, our buses create a space to welcome 

drug users and provide guidance on medical, 

social and psychological issues. All drug users can 

benefit, although the programmes particularly focus 

on the most marginalised people who will not 

approach mainstream services. Our teams offer 

personalised services, depending on each user’s needs 

and deliver a daily dose of methadone to each patient. 

Patients are included from the day they request it, 

with treatment provided in a healthcare centre after 

a medical interview. Supporting the most problematic 

users is a integral part of our activities.We refer them 

to other services and the bus becomes a bridge 

between the users and mainstream medical services. 

To date, these are the only methadone buses in 

France: by going to users and having a very low 

threshold to access the programme, they are able to 

treat a very vulnerable group of users. 

Outlook 

In Paris, the methadone bus has been 

a medical-social establishment since 

September 2003. This programme, 

combined with the needle exchange 

programme which became a 

CAARUD in September 2006, was 

transferred to the association GAIA 

Paris on 1 December 2006. 

In Marseilles, the methadone bus 

transferred its activities to the 

association Bus 31-32 on 1 December 

2006. 

These programmes are still linked to 

MdM and are involved in the Harm 

Reduction Collective which brings 

together all the harm reduction 

programmes which have been 

transferred from MdM as well as the 

ongoing MdM harm reduction 

programmes. 

Types of work 

Mobile healthcare units on duty seven days a week. 

Local outreach teams. 

Reception in centres. 

>CONTENTS 

Drug users 

> more than 100,000 estimated injecting 

drug users (source: OFDT – BEH N° 33 

september 2006) 


> HIV, hepatitis B and hepatitis C infection 

in injecting drug users, psychiatric 

problems (dual diagnosis), psychological 

problems linked to social exclusion 


> 213 in Marseilles and 484 in Paris, 

equivalent to a total of 697 individuals 


> 28 

Number of contacts 

>nearly 40,000 

Funding 

> health insurance offices (CPAM),local 

health and welfare authorities (DDASS), 

Solidarité Sida, Sidaction, local and regional 

authorities 

Partners 

> ASUD (Drug users’ self-help group), Le 

Tipi, Sleep’ in, drug addiction treatment 

centres (CSST) in Marseilles and Paris, 

hospitals, treatment and post-treatment 

services etc 

131 


¨ MISSION FRANCE

RAVES 

The policy towards raves has lead to a fall in the number of medium-sized free parties . 

Now parties with a maximum of 500 people are more common. However, because of 

the legislation around these events and the media hype, a massive increase has been 

seen in the number of participants at Teknivals. 

During these festival days, we have faced co-ordination difficulties with the public 

authorities, whose approach is more oppressive than health oriented. Testing or RPP 

(presumptive identification of products) is still banned (Decree of 14 April 2005) and 

this restricts the preventive approach. 

PROVIDING INFORMATION ABOUT RISKS 

Since 1997 

Activities 

Harm reduction activities linked to use of psychoactive 

substances. We have had to change our 

activities to respond to the changing context. 

At Teknival, our programme includes five activities: 

• welcome (prevention table, making harm reduction 

documents and equipment available, injection kits,‘roll 

your straw’…); 

• healthcare (doctor and nursing care); 

• reassurance (supervised chill-out area, coming down 

from bad trips, space for receiving and diagnosing 

breakdowns); 

• analysis of drugs using TLC (thin layer 

chromatography - the only analysis legally permitted) 

At the Teknival on 1 May, RPP (presumptive 

identification of products) was also carried out in 

order to raise public awareness and convince 

legislators on the legitimacy of this tool. 

In free parties and cross-border clubs. 

In squats, during parties but also, importantly, on 

other days. The Rave programme in Paris has 

redirected some of its activities towards squats.The 

team sets up harm reduction stands each Friday 

evening, and visits around three squats each week and 

carries out TLC analysis. 

Outlook 

To adapt the programmes’ working 

methods (in squats for example). 

To maintain our lobbying for the 

authorisation of RPP as a relevant 

tool. 

To develop prevention tools and 

flyers, adapted to the polydrug use 

culture which is evolving. 

To adapt our working methods to the 

public needs (reduced-risk injection 

spaces). 

In squats: to ensure sustainability of 

the project and to strengthen the 

current approach, particularly in terms 

of medical-psychological-social sessions. 

Types of work 

All the programmes practise first aid, provide information 

and product analysis to reduce the risks linked with drug 

use. 

Activities in places where young people get together: free 

parties,Teknivals, discotheques, clubs, squats… 

In 2006, 12 samples (all drugs) were collected, documented 

and analysed under the SINTES programme co-ordinated by 

OFDT (French monitoring centre for drugs and drug 

addiction). 

>CONTENTS 

Beneficiaries 


Sex, age 

> mainly young men (average age, 25) 

Substances 

> alcohol, cannabis, ecstasy, cocaine, LSD 

and other halucinogens, amphetamines, 

heroin, anaesthetic substances (GHB, 

ketamine) 


> HIV/hepatitis C, withdrawal, psychiatric 

problems, anxiety, bad trip, dependency, 

different physical conditions, headaches, 

vomiting 

Most common risks 

> HIV/hepatitis C, bad trips, dehydration, 

hypothermia/overheating, hypoglycaemia 

Number of interventions 

> 92 including 3 joint projects at Teknivals 


> 172 

Funding 

> Ministry of Health, local health 

authorities (DDASS), Inter-ministerial task 

force on drug use and addiction (MILDT), 

French Observatory and Drugs and Drug 

Dependence (OFDT), local and regional 

authorities 

Partners 

> Techno Plus,Aides, Blue Orange, drug 

users self help group (ASUD),Tipi,Act Up, 

Acothé, Nantes daycentre, Espace 

Indépendance, Sida Paroles,Association 

Liberté, Bizia, La Fratrie

BUDDYING CHILDREN IN HOSPITAL 

The psychological balance of a sick child is important,or rather essential,for his or her recovery. 

From babies to teenagers,all paediatricians confirm that emotional support is fundamental for 

the process of fighting illness. 

Many children, often from disadvantaged areas, are regularly hospitalised in or near Paris to 

receive treatment for illnesses which are very difficult or impossible to treat near their home. 

They come from sub-Saharan Africa, North Africa, La Reunion, Mayotte and Guiana and also 

from the regions in France.Many of them arrive alone in the unknown and hostile universe of 

the hospital.Their parents are unable to accompany them for financial or practical reasons. 

ACCOMPANYING SICK AND ISOLATED CHILDREN 

Since 1988, the buddying programme has supported 1,400 isolated children 

during their hospital stay 

Activities 

Buddying is launched like an emergency programme.To ease 

the emotional pain of separation, to help the child to deal 

with his or her illness and to promote recovery, the 

relationship has to be created quickly. It is like an energy 

transfusion for the children in psychological distress,who are 

sometimes at risk of severe depression or institutionalisation. 

Three visits per week are essential to establish this bonding 

with the child which,according to the neuropsychiatrist Boris 

Cyrulnik,will help the child to draw on its own resources to 

survive. 

Sadly, in 10 percent of cases the volunteers accompany the 

child to the end of his or her life.These children will also have 

experienced a solidarity that goes beyond race and culture. 

The volunteers always try to maintain, or even restore, 

contact with the parents.It is vital to completely respect the 

child’s identity. 

In French Guiana,half of the buddying begins in the neo-natal 

department where premature children benefit from the daily 

presence of MdM volunteers. 

The partnerships developed with the hospital teams goes 

from strength to strength. 

The buddying programme is now actively involved,alongside 

care staff, in the project to humanise hospitals by creating 

social links with this group of isolated, and usually very 

disadvantaged,children. 

Perspectives 

Propose the implementation of a 

programme in regional delegations: 

Lyons, Marseilles… 

Recruit and train new volunteers in 

French Guiana so that we can respond 

better to the needs. 

Training in listening and providing 

support to improve the quality of the 

support given to children. 

Types of work 

Paris and the Paris area 

French Guiana 

At least three visits per week to children, including one at 

the weekend (the rhythm and length of the visits depends on 

the age of the child and his or her illness). 

Possible outings from hospital, health status permitting. 

Repatriation of children according to the medical team’s 

requests. 

MdM undertakes to carry out the recruitment and training 

of volunteers, to organise discussion groups and ongoing 

training.Volunteer co-ordinators supervise the buddies. 

>CONTENTS 

Number of children: 

> 187 

> In the Parisian region: 146 

Country of origin: France (La Reunion, 

Mayotte,Antilles),Africa, north Africa 

> In French Guiana in 2006: 41 


> 104 

> Parisian region: 91 

> In French Guiana: 13 

Partners 

Paris: 

> Paediatric services in AP-HP hospitals: 

Necker Enfants Malades,Trousseau, Robert 

Debré, Saint-Louis 

> Paul Parquet creche 

> 3 long stay Centres: Margency Red 

Cross Centre, Côtes à Jouy-en-Josas 

Centre, Paediatric Re-education Centre in 

Bullion 

French Guiana: 

> Cayenne paediatric hospital 

133 


¨ MISSION FRANCE

Health and deprivation 

Reforming medical education 

Bordeaux 

University Degree, 3 rd cycle 

Optional module, 2 rd cycle 

Paris Nancy 

Clermont Ferrand 

Montpellier 

Grenoble 

Lobbying and ministerial meetings / training curriculum 

Lille 

Strasbourg 

The part of the medical curriculum dedicated to the physical, social 

and psychological aspects of health and deprivation has been 

reduced.The medical profession, especially general practitioners 

because of their close knowledge of families and the environments 

they live in, have a vitally important role to play in prevention, 

screening and early treatment of disease. However, initial medical 

training has very little content relating to public health or, more 

specifically, relating to poverty and exclusion. 

In several regional delegations, new initiatives have been launched. 

Activities at the national level have been set up in order to reform 

national programmes.To date, six University Degrees dealing with 

issues relating to health and deprivation have been introduced. 

Nice 

>CONTENTS 

Contacts (harm reduction) 

NEEDLE EXCHANGE 

BUS 

ANGOULEME 

Valérie PATRIER 

Health listening bus - ANGOULEME 

Marie-Laure FERRARI 

Médecins du Monde 

22,Allée du Champ Brun 

16000 ANGOULEME 

Tel: 05 45 65 11 82 ou 05 45 65 07 47 

Fax: 05 45 61 18 85 

Mobile: 06 25 64 63 14 

mdm-angouleme-rdr16@aliceadsl.fr 

METHADONE BUS/ 

HARM REDUCTION, 

SQUATS, 

RAVES 

MARSEILLES 

Béatrice STAMBUL 


4 avenue Rostand 

13 003 MARSEILLES 

Tel: 04 95 04 56 06/08 

Fax: 04 95 04 56 07 

Rdr.marseille@medecinsdumonde.net 

PPMU / 

METHADONE BUS 

PARIS 

Jean-Pierre LHOMME 


62 bis avenue Parmentier 

75011 PARIS 

Tel: 01 43 14 81 61 

Fax: 01 47 00 80 70 

Tel methadone bus: 06 15 45 46 71 

Tel van: 06 15 02 65 12 

Bus.methadone@medecinsdumonde.net 

ppmu@medecinsdumonde.net 

HARM REDUCTION 

BORDEAUX 

Jean-Pierre DAULOUEDE 

Guy MAYER 


2 rue des Etables 

33800 BORDEAUX 

Tel: 05 56 92 51 89 

Fax: 05 56 92 03 59 

rdr.mdm.bx@wanadoo.fr 

RAVES 

BAYONNE 

Jean-Pierre DAULOUEDE / 

Jean-Luc PRADEILLE 

Médecins du Monde/BIZIA (methadone 

centre) 

Centre Hospitalier Côte Basque – Bât. 

Zabal 

BP 8 - 64108 BAYONNE Cedex 

Rave port 06 03 21 21 57 

Tel: 05 59 44 31 05 

Fax: 05 59 44 31 03 

missionrave.bayonne@wanadoo.fr 

NICE 

Philippe de BOTTON 


34, rue Rossini 

06000 NICE 

Tel: 04 93 28 80 08 

mdmnice@numericable.fr 

TOULOUSE 

Olivier DROUAULT 

Julien SANCHEZ 


5, boulevard de Bonrepos 

31000 TOULOUSE 

Tel: 05 61 63 78 78 

Fax: 05 61 62 04 15 

mdmmidipy.raves@laposte.net 

RAVES / SQUATS PROGRAMME 

PARIS 

Benoit DELAVAULT 

Alexandre PEYRE 



75011 PARIS 

Tel: 01 43 14 81 68 / 81 54 

Fax: 01 47 00 80 70 

rave.paris@medecinsdumonde.net 

XBT PROGRAMME/ 

DRUG ANALYSIS 

PARIS 

Stéphane LE VU 



75011 PARIS 

Tel/Fax: 01 43 14 81 69 

s.levu@laposte.net

Contacts (mobile projects) – medical outreach 

MOBILE PROJECTS 

STREET ACTIVITIES 

LYONS 

Françoise MICHAUD 


1, place du Grffon 

69001 LYONS 

Tel: 04 78 29 59 14 

Fax: 04 78 29 55 91 

mflyon@free.fr 

METZ 

René MOUTIER 


11 rue Saint Pierre 

57000 METZ 

Tel: 03 87 63 55 91 

Fax : 03 87 66 60 93 

medmond.metz@free.fr 

POITIERS 

LA CARAVANE 

Marie-Thérèse RAYMOND 


21 rue Boncenne 

86000 POITIERS 

Tel: 05.49.01.77.77 

Fax: 05.49 60 28 93 

SAINT-DENIS IN REUNION 


250 bis, rue Général-Rolland – bât. K 

SHLMR Bouvet – BP 964 

97479 Saint-Denis de la Réunion Cedex 

Tel: 02 62 21 71 66 

Fax: 02 62 41 19 46 

Medecinsdumonde.reunion@wanadoo.fr 

STRASBOURG 

Catherine FRAPPARD 


24 rue du Maréchal Foch 

67000 STRASBOURG 

Tel: 03 88 14 01 01 

Fax: 03 88 14 01 02 

mdmalsac@club-internet.fr 

PREVENTION WITH 

PEOPLE WORKING IN 

PROSTITUTION 

LE HAVRE 

Arlette SEIFFERT 


28, rue J-B Eyriès 

76000 Le Havre 

Tel: 02 35 21 68 66 

Fax: 02 35 22 67 33 

Mdm.lehavre@wanadoo.fr 

METZ 

René MOUTIER, Frédérique CARRIE 


11, rue Saint-Pierre 

57000 METZ 

Tel: 03 87 63 55 91 

Fax: 03 87 66 60 93 

medmond.metz@free.fr 

MONTPELLIER 

Frédérique CARRIE 


18, rue Henri Dunant 

34090 MONTPELLIER 

Tel: 04 99 23 27 17 

Fax: 04 99 23 27 18 

mdmcaso34@wanadoo.fr 

NANTES 

FUNAMBUS 

Paul BOLO 


33, rue Fouré 

44000 NANTES 

Tel: 02 40 47 36 99 

Fax: 02 51 82 38 09 

mdmfunambus@free.fr 

PARIS 

LOTUS BUS 

Marie DEBRUS 


62 bis, avenue Parmentier 

75011 PARIS 

Tel: 01 43 14 81 61 

Fax: 01 47 00 80 70 

lotusbus@medecinsdumonde.net 

POITIERS 

Magali CATHALIFAUD 


21 rue Boncenne 

86000 POITIERS 

Tel: 05 45 65 07 47 

Fax: 05 45 61 18 85 

mdm-poitoucharentes@aliceadsl.fr 

ROUEN 

Jean-Jacques PREY 


5, rue d’Elbeuf 

76000 ROUEN 

Tel: 02 35 72 56 66 

Fax: 02 35 73 05 64 

mdmrouen@wanadoo.fr 

TRAVELLERS 

PROGRAMME 

STRASBOURG 

Catherine FRAPARD 


24, rue du Maréchal FOCH 


Tel: 03 88 14 01 01 

Fax: 03 88 14 01 02 


CHILDREN 

Child lead poisoning 

BANLIEUE 

Claude CHAUDIERES 

Mission Banlieue 


8-10, rue des Blés 

93210 La Plaine Saint Denis 

Tel: 01 55 93 19 37 

Fax: 01 55 93 19 30 

mdm.mission.saturnisme@wanadoo.fr 

BUDDYING 

>CONTENTS 

Catherine PETERMAN 


62, rue Marcadet 

75018 PARIS 

Tel: 01 44 92 13 10 

Fax: 01 44 92 99 92 

parrainage@medecinsdumonde.net 

ROMA/TZIGANES 

BANLIEUE 

Bernard MORIAU 




Tel: 01 55 93 19 38 

Fax: 01 55 93 19 30 

mdm.mission.banlieue@wanadoo.fr 

Squats project 

LYONS 

Monique Ardiet 

Thérèse Nandagobalou, 

Maïeule Nouvellet 

le bus – LYONS 


13 rue Sainte Catherine 

69001 LYONS 

Tel: 04 78 29 59 14 

Fax: 04 78 29 55 91 

missions.france@mdmlyon.net 

HOMELESS AND 

POORLY HOUSED 

PARIS 

Graciela ROBERT 

Paul ZYLBERBERG 


62 bis Avenue Parmentier 

75011 PARIS 

Tel (from 9-11pm): 01 43 14 81 74 

Fax: 01 43 14 81 51 

mfsdf@medecinsdumonde.net 

Squats project 

BORDEAUX 

Guy and Liane MAYER 


2 rue Charlevoix de Villers 


Tel: 05 56 48 52 52 

Fax: 05 56 52 77 69 

mfbordeaux@wanadoo.fr 

TOULOUSE 

Marie-Pierre BUTTIGIEG 




Tel: 05 61 63 78 78 / 

Fax: 05 61 62 04 15 

mdmmidipy.delegation@laposte.net 

CAFDA PROGRAMME 

PARIS 

Fabrice GIRAUX 

Marc LERICHE 

44, rue Planchat – 75020 Paris 

Tel / Fax: 01 45 49 03 80 

Mobile: 06 09 68 02 33 

mdmcafda2@yahoo.fr 

HEALTHCARE FOR 

MIGRANTS 

CALAIS 

Philippe PLUVINAGE 

Guy DEHAUT 

Martine DEVRIES 

Médecins du Monde c/o Dr Martine 

DEVRIES 

12 rue des Soupirants 

62100 CALAIS 

Contact: Martine DEVRIES 06 88 75 18 85 

martine.devries@wanadoo.fr 

Contact: Philippe PLUVINAGE 06 75 54 96 14 

phpluv@club-internet.fr 

135 


¨ MISSION FRANCE

Contacts (CASOs - Healthcare and Guidance Centres) 

AIX EN PROVENCE 

Philippe ROQUEJEOFFRE 


Maison de la Solidarité 

Rue Philippe Solari 

13100 AIX EN PROVENCE 

Tel: 04 42 21 45 84 

Fax: 04 42 21 62 48 

medmondaix@wanadoo.fr 

AJACCIO 

François PERNIN 


c/o Sec.Cath. 6 bd Casanova 

Tel: 04 95 51 28 93 

fax: 04 95 21 17 13 

postal address: F. Pernin 

La Gravona 

20000 AJACCIO 

Tel: 04 95 29 90 75 

fax: 04 95 29 94 24 

mdmcorse@wanadoo.fr 

ANGERS 

Isabelle SALAUN / Frédéric VIE 


62 boulevard Saint-Michel 

49100 ANGERS 

Tel: 02 41 43 65 66 

Fax: 02 41 43 01 49 

mdm.mdm-angers@wanadoo.fr 

BANLIEUE 

Jeanine ROCHEFORT 




Tel: 01 55 93 19 29 / 

Fax: 01 55 93 19 30 

Michael: 01 55 93 19 32 

mdm.mission.banlieue@wanadoo.fr 

BESANCON 

Violaine LLORCA 


Appartement 168003 

7 rue du Languedoc 

25000 BESANCON 

Tel: 03 81 51 26 47 

Fax: 03 81 52 70 28 

mdm.fc@wanadoo.fr 

BORDEAUX 

Christophe ADAM 


2 rue Charlevoix de Villers 


Tel: 05 56 79 13 82 / 

Fax: 05 56 52 77 69 

mfbordeaux@wanadoo.fr 

CAYENNE 

Sylvie CREGUT 

Stéphane GARNIER 


32 rue Vermont Polycarpe 

97300 CAYENNE 

Tel/Fax: 05 94 28 36 77 

mdmmfcayenne@yahoo.fr 

GRENOBLE 

Patrick BAGUET 


19, rue René Thomas 

38000 GRENOBLE 

Tel: 04 76 84 17 21 

Fax: 04 76 84 17 58 

mfgrenoble@free.fr 

LE HAVRE 

Arlette SEIFFERT 


28, rue J.B Eyriès 

76000 LE HAVRE 

Tel: 02 35 21 68 66 

Fax: 02 35 22 67 33 

mdm.lehavre@wanadoo.fr 

LYONS 

Karen FINSTERLE 

Marc CUCHE 


13, rue Sainte-Catherine 

69001 LYONS 

Tel: 04 78 89 99 99 

Fax: 04 78 71 75 72 

missions.france@mdmlyon.net 

MARSEILLES 

Georgia COUFFIN GUERIN 

Michel GLASS 


4 avenue Rostand 

13003 MARSEILLES 

Tel: 04 95 04 56 00 ou 03 

Fax: 04 95 04 56 04 

mf.marseille@medecinsdumonde.net 

MONTPELLIER 

Fabien BEZEL 

Marie Bernadette CADILHAC 

Margarita GONZALEZ 

Eve MOINEAU-QUENT 



34090 MONTPELLIER 

Tel: 04 99 23 27 10 

Fax: 04 99 23 27 18 

mdmcaso34@wanadoo.fr 

NANCY 

Jean-François LE CORVOISIER 


5, rue de l’Armée Patton 

54000 NANCY 

Tel: 03 83 27 87 84 

Fax: 03 83 28 42 55 

medmond.nancy@free.fr 

NANTES 

Anne LIBEAU 



44000 NANTES 

Tel: 02 40 47 36 99 

Fax: 02 51 82 38 09 

mdm.nantes@free.fr 

>CONTENTS 

NICE 

Michel de SWARTE 


34 rue Rossini 

06000 NICE 

Tel: 04 93 16 59 60 

Fax: 04 93 16 59 61 

mdmnice@numericable.fr 

PARIS 

Claude MARTINE 



75011 PARIS 

Tel: 01 43 14 81 81 

Fax: 01 47 00 75 53 

mfparis@medecinsdumonde.net 

PAU 

Robert LAFOURCADE 


12 bis Place de la Monnaie 

64000 PAU 

Tel: 05 59 83 74 28 

Fax: 05 59 27 22 32 

mdmpau@wanadoo.fr 

ROUEN 

Agathe BONMARCHAND 



76100 ROUEN 

Tel: 02 35 72 56 66 

Fax: 02 35 73 05 64 


STRASBOURG 

Jean-Maurice SALEN 


24 rue du Maréchal Foch 


Tel: 03 88 14 01 00/01 

Fax: 03 88 14 01 02 


TOULOUSE 

Geneviève MOLINA 


5, Boulevard de Bonrepos 


Tel: 05 61 63 78 78 

Fax: 05 61 62 04 15 

mdmmidipy.delegation@laposte.net 

VALENCIENNES 

Eliane LAMORISSE 


10-12, rue du Grand Fossart 

59300 VALENCIENNES 

Tel: 03 27 47 40 08 

Fax: 03 27 30 19 16 

mdmvalenciennes@free.fr

» MOBILISATION 

137/146 

>CONTENTS

CONTENTS 

Wilfried Maisy 


Robert Mulder 

MdM 

Isabelle Eshraghi 

David Delaporte Meura 

Nicolas Lainez

Andrew Aitchison 

Project: London Palestinian territories 

JANUARY 

Key Events 

16 January: Project: London, Médecins 

du Monde UK’s first project on access 

to healthcare in East London was 

launched. Nine doctors, 12 nurses and 15 

other volunteers, work in partnership with 

three local organisations (Praxis, Providence 

Row and U-Turn).The teams provide advice 

and primary healthcare to vulnerable people 

and help them to access mainstream 

services. 

Bruno Fert 

FEBRUARY 

Key Events 

MdM criticised the international 

economic embargo of the occupied 

Palestinian Territories introduced by the 

main Western donors after Hamas’ 

election victory. Severely affected and 

weakened since 2000,the Palestinian population 

will have to experience the suspension of all 

direct aid from the European Union and the 

United States.This measure,on top of existing 

poverty and unemployment,hastens the 

deterioration in the health system.Having 

supported the health services in the Territories 

for 10 years,MdM warned of an emergency and 

the direct and immediate humanitarian 

consequences of this sanction on health 

services.Although we decided to ensure 

continuity of care by donating medicines to 

Gaza and Nablus hospitals,we are conscious 

that humanitarian action should not hide the 

responsibilities of international donors who 

should respond to the fundamental needs of the 

civilian population. 

>CONTENTS 

139 

» MOBILISATION ANNUAL REPORT 2006

Isabelle Eshraghi 

MARCH 

Key events 

28 March: Called for a repeal of the 

Circular of 21 February on the 

conditions for questioning migrants 

and holding them in police custody. 

This regulation, which listed exhaustively the 

reception or healthcare premises, even 

operating theatres, which could be seen as 

places where people without residency 

permits could be questioned, violates the 

fundamental principles of medical ethics and 

infringes the right to health. The petition 

launched by MdM reiterates that the right to 

healthcare should never by used for other 

purposes apart from protecting health and 

that all patients must be welcomed and 

cared for. MdM, supported by health 

professionals, confirmed its refusal to let law 

enforcement officers enter its health centres 

to prevent these centres from becoming 

immigration control places. 

8 March: International Women’s Day. 

MdM highlighted the situation of women 

victims of domestic violence in Pakistan and 

the support it has been providing to the 

governmental refuges in Punjab since 2004. 

In 80% of Pakistani households women suffer 

from daily domestic violence, are victims of 

honour crimes and continue, despite the 

D.R 

Dar-ul-Aman, in Pakistan Seminar on humanitarian surgery Healthcare and guidance centre (CASO) 

commitments of the Pakistani government, 

to be deprived of their most basic rights.The 

only NGO working with local actors, MdM 

supports, in partnership with the Ministry of 

Social Affairs, several Dar-ul-Aman ‘safe 

houses’. Provision of medical, psychological 

and legal support enables us to help these 

women in distress and to mobilise all the 

institutional and voluntary sector actors to 

take action. 

And also... 

8 March: MdM welcomed the Liberian 

President, Ellen Johnson-Sirleaf’s visit 

to France, and solemnly called on the 

international community to support the 

reconstruction of the health sector in this 

country where MdM has been working since 

1992. 

14 March: Two expatriate volunteers in 

the Gaza Strip programme were 

kidnapped then released the same 

evening. Despite the deterioration in the 

humanitarian and security situation in Gaza, 

MdM resumed activities on 22 March,because 

of the worsening humanitarian crisis. 

22 March: Humanitarian Review No 13. 

Humanitarian work in disasters. In this 

issue, the contributors reflect on the role 

which humanitarian NGOs can, or should, 

>CONTENTS 

Véronique Burger/Phanie 

play in the context of natural disasters. 

25 March: MdM’s second surgery 

seminar. This second meeting on 

humanitarian surgery, was the opportunity 

to share experience and to capitalise on the 

different experiences of the various hospital 

practitioners in the programmes in differing 

contexts and with extremely complex needs.

DR 

Campaign on the shortage of health professionals in 

southern countries 

APRIL 

Key events 

7 April: Launch of a campaign ‘Health 

professionals in southern countries: a 

fatal shortage’. On World Health Day, 

MdM, Agir Ici, Aide Medicale Internationale 

and Secours-Catholique-Caritas France 

called on WHO member states to take 

action to address the gap of almost 4.3 

million healthcare personnel, affecting the 

health systems of more than 57 countries, 36 

of which are in sub-Saharan Africa. With no 

solution having been proposed, the 

organisations involved in this campaign called 

on the French government to focus on this 

issue during the World Health Assembly and 

on WHO member states to support national 

policies to reinforce human resources. 

And also... 

4 April: MdM joined with the Overseas 

Collective to highlight the exceptional 

situation in Mayotte. In effect, migration 

law applicable in French overseas 

departments legalises an action plan against 

immigration. This is turning Mayotte into an 

experiment in the fight against clandestine 

immigration and restriction of access to 

citizenship. As a result, migrants have very 

limited access to state medical help, support 

for re-settlement, health insurance or even 

work. The collective also issued a report 

highlighting the difficulties of access to 

healthcare in the overseas departments. 

12 April: MdM denounced the daily 

violence in Gaza and in Nablus on top 

of the international economic 

embargo. 

>CONTENTS 

141 


MdM 

MAY 

Key events 

1May: During the Teknival, MdM 

decided to restart the testing which 

has been banned since April 2005. This 

‘presumptive recognition of products’ is a means 

of prevention which enables a discussion 

with drug users to be started.There are now 

major threats to the harm reduction 

approach that MdM has adopted for 17 

years, which involves close contact and is 

both caring and pragmatic. MdM calls for an 

open debate on harm reduction and the use 

of testing, in order to increase understanding 

of the public health impact of this nonrepressive 

approach. 

27 May: Earthquake on Java. MdM sent 

an emergency team of 30 professionals 

from its programme in Indonesia and 

from headquarters in Paris, Madrid 

and Athens. The earthquake, which 

registered 6.2 on the Richter scale, killed 

5,100 people, injured 20,000 and made 

nearly 200,000 people homeless. Two first 

teams identified the needs which had not 

been met and provided initial medical care, 

before expanding their activities to surgical 

emergencies. 


Teknival on 1 May Emergency programme: earthquake on Java Humanitarian Review 

And also... 

15 May: Change of Presidency at MdM. 

During the Annual General Meeting, MdM 

elected a new Board of Directors. Dr Pierre 

Micheletti was elected President. As a 

doctor, qualified at ENSP, Dr Micheletti 

joined the Board of Directors in 2002. He is 

director of the public and environmental 

health service in Grenoble. 

22 May: National education campaign 

on development and international 

solidarity. Within the framework of 

‘Tomorrow the world…migration in order to live 

together’ the LDH, MdM and secular 

Solidarité organised a press conference 

followed by the presentation of the 

exhibition, ‘Opre Roma! Tomorrow the 

world…our Roma citizens’. This campaign 

brought together 35 organisations whose 

objective is to tackle prejudice and promote 

the recognition of the rights of migrants as 

citizens and operators in their own right in 

the development process of southern 

countries. As part of this, the Opre Roma! 

exhibition retraced the specific routes which 

several thousand Roma were forced to take. 

>CONTENTS 

May: Humanitarian Review No 14, 

‘Emergencies and Sustainable Action’. 

This issue took a clear and impartial look at 

what remains for humanitarian action when 

the emergency has passed. The issue also 

considered the importance of focusing 

attention on the populations who received 

aid and the fragile and complex contexts in 

which humanitarian organisations work.

Elisabeter Rull/item 

JUNE 

Key events 

2 June: Inauguration of MdM’s Mission 

France in Guiana. The French department 

of Guiana is experiencing a difficult time with 

demographic, economic, migratory and 

health problems. Difficulties with access to 

healthcare, particularly for migrants, have 

prompted MdM to set up activities in this 

Department. The programme will include 

consultations in the MdM centre as well as a 

programme of ‘buddying’ for isolated children 

in hospital. 

27 June: Internal Security Law, two 

years on. MdM called for the repeal of 

measures which criminalise people working 

in prostitution because of the harmful effects 

of such measures, particularly on migrants. 

Namely, a deterioration in their living 

conditions in terms of violence, abusive 

arrests, distancing from prevention services, 

use of condoms as proof of soliciting… An 

exhibition of photos and testimonies 

illustrated the difficulties seen in six French 

towns. 

David Delaporte 

Project with women working in prostitution 8 th Solidays festival Poster for the 20 th anniversary of MdM Grenoble 

And also... 

8 June to 7 July: Exhibition ‘Missions, 

Medecins [jusqu’au bout] du Monde’ of 

Gerard Rondeau photographs. On the 

occasion of MdM’s 25 th Anniversary, the 

Paris City Hall hosted this exhibition of 100 

photographs along with extracts from the 

book of the same title, edited for the 

occasion. Gerard Rondeau, loyal companion 

to the ‘French Doctors’ movement, helped us 

to discover the places and the people of 

MdM’s work and tell the story of our 

ongoing commitment. 

8 June to 7 July: MdM participated in 

the 8 th Solidays festival. MdM had a 40m 2 

stand with the objective of raising awareness 

of two issues. The first related to harm 

reduction through the needle exchange and 

methadone bus and an interactive game 

called ‘Risk or no risk?’. The other issue was 

the campaign on ‘Health professionals in the 

south: a fatal shortage’. 

>CONTENTS 

16 June – 2 July: MdM’s Grenoble 

branch commemorated its 20 th 

anniversary, by organising a large 

exhibition and an information day for 

donors on Saturday 24 June. 

Since 1986, this branch has developed many 

programmes in the town with more than 

2,800 medical and social consultations. It has 

also developed overseas programmes in 

Algeria, Afghanistan, Nepal, Salvador and 

Chechnya as well as participating in the 

international adoption programme. 

143 


Elisabeter Rull/item 

Emergency programme: humanitarian crisis in Lebanon Poster for Médecins du Monde 

atVisa pour l’image, Perpignan 

JULY/AUGUST 

Key events 

12 July /12 August: From the beginning 

of the Israeli offensive,and given the scale 

of the humanitarian crisis that Lebanon 

faced, MdM launched an emergency 

programme.Five mobile clinics were set up in 

Beirut among the populations fleeing south 

Lebanon.The MdM teams,along with the NGO 

Amel, ran consultations in 12 centres for 

displaced people and distributed essential 

medicines. In South Lebanon, MdM distributed 

medicines and medical equipment in clinics.Like 

many other NGOs, MdM denounced the nearimpossibility 

of reaching the civilian populations 

and violations of international humanitarian law. 

After the ceasefire on 14 August,MdM redeployed 

its programme to support displaced people 

returning to their villages. 

SEPTEMBER 

Key events 

2 – 17 September: MdM participated in 

the 18th film festival,‘Visa pour l’image’ in 

Perpignan. For more than a year, MdM 

strengthened its commitment to so-called 

‘forgotten’ populations and to fight for more 

media attention for serious humanitarian 

disasters which currently have a low public 

profile.As part of this struggle, MdM members 

distributed a pamphlet with a collection of 

opinion pieces on this issue from those working 

in the media or in humanitarian affairs. 

4 September: Publication of the 3 rd 

special edition of the Humanitarian 

Review dedicated to ‘Media and Advocacy: 

how NGO voices can be heard’, a debate 

extended to MdM’s blog. This special 

edition dealt with the relationship between the 

media and humanitarian organisations, who 

both need each other in order to inform, exist 

or bear witness. More generally, the issue 

focused on methods of communication for 

NGOs,particularly for advocacy,a new tool for 

influencing opinions and putting pressure on 

leaders. MdM put this debate on its blog under 

the theme ‘The media and humanitarian 

organisations: enemies or brothers?’. 

OCTOBER 

Key events 

5 October: In Pakistan,one year after the 

earthquake which killed 80,000 people 

and injured more than 70,000 people, 

MdM carried out a survey aimed at 

preventing another medical emergency. 

On 8 October 2005,MdM set up an emergency 

medical programme, helping the earthquake 

victims and six months later we denounced the 

>CONTENTS 

Humanitarian Review (special issue) 

pressures put on the displaced persons to 

return home prematurely.The camps in which 

they were living were effectively closed before 

the end of the winter,forcing refugees to return 

to their devastated villages, deprived of the 

most basic essential services. Data collection 

(statistics and testimonies) carried out in areas 

where populations are returning to enabled us 

to alert the authorities to the difficulties facing 

the Pakistani population and to prevent the 

consequences. 

6 October: Conference on ‘Post-conflict 

reconstruction of health systems: DRC as 

a case study’. People from all the different 

sectors involved in this reconstruction 

(government, public institutions, international 

institutions, private sector, diaspora, NGOs and 

Congolese civil society) participated in this day 

entitled ‘Reconstruction after war: hope in DRC’, 

initiated by MdM a year before. Having come 

through a very serious humanitarian crisis, 

which killed 4 million Congolese through 

different recent armed conflicts, DRC is a 

country emerging from conflict. The debate 

throughout this day was complementary to the 

field work of MdM and other humanitarian 

organisations. The Congolese health director 

presented the ‘Strategy for strengthening the 

health system’, to be put in place after the 

elections. This strategy was applauded for its 

relevance, overall approach to health problems, 

and decentralised implementation.The themes

MdM 

One year after the earthquake Health centre in Goma, DRC 

tackled were: the political challenges after the 

transition, an overview of the health situation 

after the conflict, the challenges of 

reconstructing the health system. 

17 October: International day for the 

eradication of poverty. MdM aims to enable 

the voices of the most disadvantaged patients 

encountered in its 120 programmes in France 

to be heard. To do this, MdM relies on the 

statistical information collected by the 

Observatory on access to healthcare in France, and 

also on a survey of 725 doctors in 10 cities,and 

focusing on the refusal of healthcare for people 

entitled to the CMU (Universal healthcare 

insurance) and the AME (state medical aid).The 

evidence of a worrying rate of refusals by health 

professionals to provide treatment resulted in 

the publication of a report ‘I won’t deal with these 

patients’ aiming to alert policy makers, 

institutions and health professionals to this legal 

and medical responsibility. MdM also called for 

the AME to be merged with the CMU so that 

anyone in a vulnerable situation would be able 

to access healthcare. 

Bruno Fert 

And also... 

27 October: MdM is a member of the 

European network on Global Health is a 

coalition of NGOs. This advocacy network 

aims to improve health in developing countries 

in line with the Millennium Development Goals 

(MDGs).The network, set up at the same time 

in Germany, Belgium, Spain, France and the UK, 

brings together 15 organisations to call on 

NGOs, the private sector and governments to 

improve health in developing countries. The 

MDGs anticipate that child mortality rates 

should fall by two-thirds and that deaths linked 

to pregnancy and childbirth should fall by threequarters 

by 2015. Yet, 10.6 million children 

under five die each year and in some countries 

one women in six dies as a result of pregnancy 

or childbirth.A reduction in the number of new 

cases of HIV infection, malaria and tuberculosis 

is also far from being a reality.MdM and Avocats 

pour la Santé dans le Monde (Global Health 

Advocates) will work together in France as 

members of the European network for global 

health. 

>CONTENTS 

DR 

Poster for the conference on unfit housing and health 

NOVEMBER 

Key events 

7 November: MdM and the Abbé Pierre 

Foundation organised a conference ‘Unfit 

housing and health: ending child lead 

poisoning’. Through their field activities and 

testimony, the two organisations witness the 

real risks health posed by unfit housing every 

day. Although the importance of child lead 

poisoning in France has now been recognised 

for 20 years, further progress is needed in the 

struggle against this and other health problems 

linked to housing. The conference brought 

together the key players in health, housing and 

rights in Ile-de-France, in order to develop a 

dialogue and a network in order to take more 

effective action and capitalise on existing 

experience. 

DECEMBER 

Key events 

1 December: World AIDS Day. MdM called 

for action and highlighted our work on 

prevention, screening and access to antiretroviral 

therapy.We are lobbying for an overall approach 

to the illness, and also emphasise the control of 

this pandemic through the defense of individuals’ 

rights as well as by tackling stigmatisation and 

exclusion. Since 1987, MdM’s approach in 

145 


Lancène Abib 

Vietnam: access to anti-retroviral therapy for people 

living with HIV programme 

fighting against HIV/AIDS has been innovative 

and forward-thinking, with the opening of the 

first anonymous, free testing programme in 

Paris. Since 1989, MdM has positioned itself in 

France as a major player in the field of harm 

reduction and prevention of HIV and hepatitis 

transmission linked to intravenous drug use. 

Since 1992, MdM has built on this experience 

and expertise to extend our harm reduction 

programmes internationally, particularly to 

Eastern Europe and to Asia (six programmes in 

Afghanistan, Burma, China and Vietnam). 

21 December: One year of activism with 

‘For lack of a roof,a tent’. Last year,MdM gave 

tents to homeless people in Paris who would 

not go to emergency shelters. Since then, more 

than 400 tents have been distributed. MdM has 

continued with this activity,despite the summer 

polemic and threats that the tents would be 

taken down.This activism was accompanied by 

positive government measures: the Winter Plan 

presented in November by the Ministry for 

Social Cohesion proposed creation of 1,100 24hour, 

unlimited stay ‘stabilisation accommodation’ 

places in the Ile-de-France area. Nonetheless, 

MdM highlighted the lack of transparency in the 

how these places are run and their insufficient 

number to be able to respond to the needs on 

a national scale. Despite these measures, the 

occupants of the tents were asked to move to 

the city’s periphery without any alternative 

options or support.MdM therefore called for an 

Martin Mazurkiewicz 

Migrants programme in Calais Tents given to homeless people in Paris 

immediate stop to the dismantling of the tents 

and repeated its position. 

8 December:Four years after the closure 

of Sangatte, migrants are in a vulnerable 

situation. In its report entitled,‘After Sangatte, 

daily inhumanity’, MdM highlighted the worrying 

humanitarian situation of migrants since the 

closure of the Calais centre. These homeless 

migrants, including pregnant women, children 

and people who are ill,are largely dependent on 

help from humanitarian organisations and are 

subject to permanent pressure from the police. 

Since the centre was closed, MdM has carried 

out occasional medical consultations amongst 

this group, but the fact that this situation is 

ongoing has lead us to set up a long-term 

project.Thus, in March 2005 the Ile-de-France 

delegation and the Nord-Pas-de-Calais delegation 

started a programme to facilitate access to 

healthcare for these people in transit. Despite 

MdM’s advocacy and action to improve the living 

conditions of these migrants, their situation is 

worsening in light of the repressive approach of 

the national authorities, who refuse to hear the 

arguments and remain intransigent. 

>CONTENTS 

Bruno Fert 

And also... 

8 December: As part of humanitarian 

meetings, MdM participated in the 

conference ‘Humanitarian organisations in 

danger’ organised at the political studies 

institute in Paris. Eric Chevallier, Director of 

International Operations,spoke on the question 

of ‘What risks do humanitarian workers face in the 

field?’’ and Michel Brugière, MdM’s Director 

General spoke on the theme ‘Sri Lanka,DRC and 

Afghanistan: the shrinking humanitarian space’. 

5 December: Publication of the new issue 

of Humanitarian Review dedicated to the 

relationship between humanitarian 

organisations and the anti-globalisation 

movement. With the World Social Forum 

taking place in Nairobi from 20 to 25 January, 

the Review focused on relationships between 

the two movements. A round table discussion 

summarised the differences, the common 

points, the objectives and the respective 

cultures.

» THE REPRESENTATION 

NETWORK 

147/156 

>CONTENTS

» ALSACE 

Contact details 

> Delegation: 

24, rue du Maréchal Foch 

67000 Strasbourg 

Tel: 03 88 14 01 00 

Fax: 03 88 14 01 02 

Mission France: 

03 88 14 01 01 


Board Members 

> Representative: 

Dr Maryvonne Le Gac 

> Secretary: 

Aloyse Kriegel 

> Treasurer: 

Sophie Py 

> Other members: 

Catherine Frapard 

Marie-Luce Arbogast 

Dr Paul-André Befort 

Dr Jean-Maurice Salen 

> Secretary of the delegation: 

Brigitte Fanteguzzi 

> Adoption: 

Colette Minard-Rosenstiel 

> Number of members: 

72 

>CONTENTS 

Key Events 

Publicity events and activities 

• Provision of information to medical 

students – participation in the optional 

module on Health and Deprivation; 

• Information days in colleges and high 

schools,the IFSI (the national nursing 

training institute),at ESTES (education and 

social work college); 

•A Soroptimist concert for donations 

(hygiene products); 

• Participation in the ‘African Week-end’ in 

Illkirch (partnership with Senegal); 

• Dissemination of an internal newsletter. 

Partnerships 

• Alerte group,a local network; 

• Participation in the European Social Forum 

(Council of Europe); 

• Participation in the National Congress of 

FNARS (National federation of reception 

and social integration organisations); 

• Regional health conference; 

• GPs and psychiatrists group,think-tank on 

exclusion,testimony on the restrictions on 

access to CMU and AME; 

• Collective working with people working in 

prostitution (one meeting a month); 

• Meetings with the partners of 115. 

Other activities 

Regionally-managed international 

project: 

• Health programme in Gamadju Saré region 

of Senegal with recruitment of an expatriate 

for three months and a set-up mission by 

the delegation from Alsace. 

Adoption 

Contact:Colette Minard-Rosenstiel 

•The group of eight people is still involved; 

• A 10% increase in the number of 

applications received and in couples 

interviewed; 

•With the opening of Haiti: more 

proposals to offer couples for older 

children; 

• Four special needs children this year; 

• Improving the meetings to help couples 

prepare for parenthood (in preparation of 

the agreement). 

» AQUITAINE 


> Delegation: 

2, rue Charlevoix-de-Villers 

33300 Bordeaux 

Tel. 05 56 79 13 82 

Fax: 05 56 52 77 69 

medecinsdumonde.bx 

@wanadoo.fr 

Board Members 


François Cougoul 

> Secretary: 

Philippe Gavout 

> Treasurer: 

Christine Suraud 


Pierre Beze-Beyrie 

Jean-Pierre Daulouede 

Fabienne Favarel-Garrigues 

Anne-Marie Jouves 


Marie-Christine Chauveau 


133 

> Pau branch: 

Co-ordinator: Robert Lafourcade 

Tel. 05 59 83 74 28 

Key Events 


• Commitment to set up ‘health rest 

beds’ in Leydet hostel; 

• Campaign ‘Health professionals in the 

south: a fatal shortage’ – stand and 

petitions; 

• Global action against poverty. Stand 

in partnership with Promofemmes, 

ATD Fourth World and Secours 

Catholique; 

• For the 20 th Anniversary of Mission 

France: exhibition – conference 

Rondeau organised in partnership 

with the Regional Council, 

debate–Round-Table–Citizens cafés; 

• Partnership with the training centre 

of Bordeaux University Hospital for 

four days of volunteer training; 

• 2007 presidential election campaign: 

two-day visit of the MdM campaign 

bus in Bordeaux; 

• Participation in the local Social 

Forum ‘Health, a right for everyone’; 

• Partnership with Acquitaine Image 

Cinema in conjunction with the 

Regional Council; 

• Open day with families who have 

adopted or are in the process of 

adopting in the region; 

• Opre Roma: exhibition in a hall in 

Bordeaux and in schools. Organisation 

of a round table. 


Proposal for a regionally-managed 

international programme in Nicaragua.

» BRITTANY 


> Delegation: 

19, rue Balzac 

56270 Ploemeur 

Tel. 02 97 86 27 50 

kerduellic.hochet@wanadoo.fr 

Board Members 


Marie-Elizabeth Hochet 

> Secretary: 

Valérie Bergeron 

>Treasurer: 

Christophe Perron 


Jean Godefroy 


37 

Key Events 


• Presentation of MdM in information 

centres in Lorient and Vannes; 

• MdM presentations in colleges, high 

schools and to groups of young 

people; 

• Participation in association forums; 

• Mobilisation for the International 

Day for the Eradication of Poverty; 

• Participation in the network of 

associations in Ile,Vilaine and 

Morbihan. 


Adoption: three teams in Ile,Vilaine 

and Morbihan; 

International: handover of the Mali 

programme to become a regionallymanaged 

programme; 

France: needs assessment on 

vulnerability in Lorient and Vannes 

during 2006.At the end of this 

assessment in December a project 

proposal is being developed for 

approval. 

>CONTENTS 

» CORSICA 


> Delegation: 

Résidence «La Gravona» bât.A 

Rue des Romarins 

20090 Ajaccio 

Tel: 08 75 33 18 99 

Tel./Fax: 04 95 10 25 49 

mdmcorse@wanadoo.fr 

http://perso.wanadoo.fr/ 

mdmcorse 

Board Members 

Catherine Contois 

Corinne Girardin 

Michèle Iborra 

Jean-Pierre Lucciani 

François Pernin 

Isabelle Serain 

Myrtha de Tollenaere 


Jean-Pierre Lucciani 

> Secretary: 

Catherine Contois 

>Treasurer: 

Corinne Girardin 


Anne Galeani 

Denise Giacomoni 


34 

Key Events 


• Meeting with partner 

organisations in order to identify 

new activities to reflect changing 

public needs; 

• Participation in the associations 

forum; 

• Publication of a newsletter; 

• Sale of Regis Arrighi’s book 

‘Smile of Saigon’ whose profits will 

go to MdM, Presence Bis, Mekong 

and Corse Vietnam. 

Partnerships 

• Founding member of interassocation 

Collective Fighting 

against Exclusion (CLE); 

• With the CLE and other 

partner organisations: setting up 

of a winter night shelter, 

improvised in 2004, but from 

now on an activity managed by 

professionals and volunteers; 

• Weekly medical and nursing 

consultations in the premises of 

Stella Maris day centre; 

• Restoring links with 

pharmacies; 

• Collecting food for Aiutu Corsu 

(fighting AIDS). 

149 

» REPRESENTATION NETWORK ANNUAL REPORT 2006

» FRANCHE-COMTE 


> Delegation: 

7, rue du Languedoc 

Appt 168 003 

25000 Besançon 

Tel. 03 81 51 26 47 

Fax: 03 81 52 70 28 

mdm.fc@wanadoo.fr 

Board Members 


Jacques Guitard 

> Secretary: 

Violaine Llorca 

>Treasurer: 

Bernard Badey 


Marie-Claire Tisserand 

M.Thérèse Vernier 

Key Events 


• Participation in health days in 

colleges and high schools; 

• Participation in the associations’ 

forum; 

• Participation in the International Day 

for the Eradication of Poverty. 

Partnerships 

• Red Cross; 

• PASS (Access to Healthcare Office); 

• CCAS (Central Social Activities 

Desk). 

>CONTENTS 

» ILE-DE-FRANCE 


> Delegation: 

62 bis, avenue Parmentier 

75011 Paris 

Tel. 01 43 14 81 99 

Fax: 01 48 06 68 54 

mdm.idf@medecinsdumonde.net 

Board Members 


Graciela Robert 

> Secretary: 

Dominique Kunst 

>Treasurer: 

Marc Leriche 


Philippe Pluvinage 

Benoit Hénaut 

Alexandre Peyré 

Maria Melchior 

> Contact: 

Johanna Boucher 


400 

Key Events 


• Nine presentations to schools and 

IFSIs (Nursing Training Institutions); 

• Three presentations to the CRESIF 

(Regional Health Education 

Committee for Ile-de-France); 

• Round table ‘How do we welcome 

migrants today in Ile-de-France 

programmes?’; 

• Participation in the press conference 

on ‘Calais, daily inhumanity’; 

• Participation in the Solidays festival. 

Publications 

• Three issues of the newsletter ‘Le Fil’ 

(700 copies). 

Partnerships 

• MdM’s Nord-Pas-de-Calais 

delegation for the Calais programme. 


• Running the recruitment of new 

volunteers for Ile-de-France 

programmes; 

• Regionally-managed international 

programme: Exploratory mission in 

Morocco. Project proposal under 

development; 

• IdF elections, new Board in June 

2006; 

• Meetings of the Heads of Projects 

and co-ordinators for Ile-de-France 

programmes.

» LANGUEDOC-ROUSSILLON 


> Delegation: 


34090 Montpellier 

Tel. 04 99 23 27 17 

Fax: 04 99 23 27 18 

mdmlr34@wanadoo.fr 

Board Members 


Mady Mercier 

> Secretary: 

Claude Aiguesvives 

>Treasurer: 

Françoise Jourdan 


Marie Bernadette Cadilhac 

Robert Chaluleau 

Valérie Vandermesch 

Mansoureh Yaghmaie-Astruc 

> Secretary: 

Magali Ibanez 


87 

Key Events 


• Presentations in high schools and 

training colleges for nurses and other 

health professions; 

• Stand at an Associations’ fair in 

Montpellier; 

• Participation in the ‘Visa pour l’Image’ 

festival at Perpignan; 


for the Eradication of Poverty at 

Montpellier. 

Partnerships 

• PHI 34; 

• Herault food bank; 

• La Babotte; 

• Harm reduction organisations 

(Passerelles – Axes); 

• Cimade; 

• Halte Solidarité; 

• Global Health collective. 


• Recruitment of new volunteers for 

the delegation’s programmes; 

• Start of an outreach programme, 

linked to the CASO, with a mobile 

unit which goes out two evenings a 

week and works with homeless 

people; 

• Set-up of a training programme for 

members; 

• Harm reduction: Participation at the 

Teknivals with other MdM harm 

reduction teams (Angouleme, Larzac 

and Vannes); 

• Participation in NGO Council 

training: presentation of our work on 

street fundraising in Montpellier. 

>CONTENTS 

» LORRAINE 


> Delegation: 

5, rue de l’Armée Patton 

54000 Nancy 

Tel. 03 83 27 87 84 

Fax: 03 83 28 42 55 

del.lorraine1@free.fr 

Board Members 


Anne-Marie Worms 

> Secretary: 

Monique Ulrich 

> Treasurer: 

Anne-Marie Marchetto 


Lucien Gbetro 

Véronique Gorsic 

Marie-Pascale Verdenal 

Jean-Marie Gilgenkrantz 

> Lorraine regional 

programmes: 

Nancy Head of Project (HP): 

Jean-Marie Gilgenkrantz 

Metz HP: 

René Moutier 

Adoption HP: 

René Moutier 

Key Events 


Regional assembly in January to 

renew the Board. Regional 

Representative, Secretary and 

Treasurer remain in post. 

Organisation of a roundtable 

on ‘Forgotten Crises’ with 

presentations by J.M. 

Gilgenkrantz on those who are 

forgotten in France, J. Larché on 

Darfur and J. Dato on Chechnya. 

Displaying the MdM Roma 

exhibition in Longwy during a 

week of solidarity with Eastern 

countries, supported by the town 

council. 

Contacts with Amities tsiganes and 

the urban community of greater 

Nancy around travellers. Several 

meetings with the Council and 

other organisations about a 

group of Roma. 

Meetings on the theme of 

decentralisation, in liaison with 

Christian Carter. 

Participation in ‘Market of the 

World’ and meetings with several 

partners on ‘Healthcare 

professionals in the south:A fatal 

shortage’. 

Informal meeting with 

MdM’s Alsace delegation in 

Strasbourg. 

Continued efforts to set up a 

regionally-managed 

international project in 

Burkina-Faso: Support for 

the improvement of 

maternal healthcare in 

Gnanga province.Veronique, 

Marc and Carlos carried out an 

exploratory mission in June. 

Approval from the Africa Group, 

then the Management 

Committee in September. Budget 

update, partnership with 

ICODEV, our partner British 

NGO, remains outstanding. 

Veronique and Carlos went to 

the field in December. 

151 


» MIDI-PYRENEES 


> Delegation: 


31000 Toulouse 

Tel: 05 61 63 78 78 

Fax: 05 61 62 04 15 

mdmmidipy.delegation 

@laposte.net 

Board Members 


Dr Florence Rigal 

> Secretary: 

Marie-Pierre Buttigieg 

>Treasurer: 

Luis Garcia 


Dr Hélène Bonnet 

Dr Geneviève Molina 

Christine Remiot 

> Programme Officer: 

Tom Wingefeld 


Isabelle Malet 

> Albi branch: 

Contact: Nicole Cany 

Tel. 05 63 45 08 15 

Key Events 


• Various presentations in colleges, 

high schools, IFSI (Nurse Training 

Institute), schools, welcoming IFSI 

students to the delegation; 

• Meeting with several members of 

parliament for ‘An overhaul of the 

accommodation system’; 

• Stands at the associations’ open day 

and on 1 December at Paul Sabatier 

University; 


for the Eradication of Poverty; 

• Participation in the presentation of 

the prizes – bronze medal – the 

‘Affichades’ at the ESC (business 

school); 

• Public conference on the 20 th 

Anniversary of ‘La Foulé pour la Vie’ 

• Internal meetings: Lebanon; working 

meeting on ‘improving practice at the 

CASO’; 

• Supporting families whose 

accommodation is no longer provide 

by the government (removals help, 

one night stay at Capitole, and moving 

in); 

• Co-ordinating the monitoring of a 

hunger strike by 89 people for 26 

days. 

Publications 

• Quarterly newsletter ‘Lettre et debats’. 

>CONTENTS 

Exhibitions 

• Exhibition of photos from Chad at 

Communauté Municipal de Santé de 

Toulouse, at Cepiere training; 

• Roma exhibition from 30/10 to 

22/11 in St Orens college. 


• Various events organised for MdM 

(with Foulée pour la Vie, Solidarity en 

pays de Save); 

• Presentation during the street 

fundraising training; 

• Adoption, sessions on Mondays from 

2-6pm: 1-2 public information 

meetings per month; 

• Tri-therapies: 14 tonnes unused 

medicines collected. 

Financial partners 

• General Council,Toulouse City 

Council; 

• CPAM Haute Garonne, Ddass Haute 

Garonne, Drass Midi Pyrenees.

» NORD-PAS-DE-CALAIS 


> Delegation: 

10-12, rue du Grand Fossart 

59300 Valenciennes 

Tel. 03 27 47 40 08 

Fax: 03 27 30 19 16 

mdmvalenciennes@free.fr 

Board Members 


Guy Dehaut 

> Head of Programme: 

Eliane Lamorisse 

> Secretary: 

Fabienne Ducatez 

> Treasurer: 

Christiane Ficheroulle 


Elisabeth Dusart 

Charles Lejeune 

Claudine Leleu 


33 

Key Events 


• 17 October: International Day for 

the Eradication of Poverty with local 

associations; 

• Participation in regional health 

programme. 

Partnerships 

• Emergency shelter associations, the 

CHRSs (Accommodation and Social 

Reintegration Centres) in Valenciennes 

district, drop-in day centres including 

AJAR,APE, Midi-Partage, La Pose; 

• Rimbaud mobile team; 

• PASS (Healthcare access centre) – 

Espace Baudelaire; 

• Boutique Solidarité; 

• Social services CCAS, CPAM; 

• SOS Bébé (assistance to families in 

financial difficulty); 

• Avenir et Cooperation Logistique – 

humanitarian logistics. 


• Supporting refugees in Calais 

(medicines, sleeping bags, Dr Dehaut’s 

involvement in the Calais programme); 

• Participation in the mobile team’s 

activities (accompaniment twice a 

month in their sessions); 

• Distributing blankets, sleeping bags 

and other help to homeless people 

(gloves, socks, hats, shoes, Christmas 

presents at the Boutique Solidarité); 

• Outreach consultations twice a 

week at the Boutique Solidarité; 

• Flu vaccination sessions in 

accommodation centres and in our 

clinics (more than 100 vaccinations); 

• Collecting and sorting medicines as 

part of Cyclamed (eight tonnes 

sorted, two tonnes validated for our 

own programmes, the surplus sent to 

Africa through Avenir et Cooperation, 

according to demand); 

• Collecting glasses which have been 

refurbished by an optician. 

>CONTENTS 

» NORMANDY 


> Delegation: 


76100 Rouen 

Tel. 02 35 72 56 66 

Fax: 02 35 73 05 64 


Board Members 


Christian Cartier 

> Secretary: 

Valérie Scetbon 

>Treasurer: 

Michel Joly 


Agathe Bonmarchand 

Arlette Seiffert 

Mireille Vache-Picat 


Claudie Hauduc 

Rouen branch: 

Contact:Agathe Bonmarchand 

Tel. 02.35.72.56.66 


Le Havre branch: 

Contact:Arlette Seiffert 

Tel. 02.35.21.68.66 

mdmlehavre@wanadoo.fr 

Key Events 


• Opening of the PASS 

(Healthcare access centre) at the 

hospital in October 2006 (this 

resulted in the closure of the Le 

Havre branch of Mission France); 

• Regional day at Rouen-Le Havre 

on 11 November 2006. 

153 


» INDIAN OCEAN 


> Delegation: 

250 bis, rue du Général Rolland 

Bât. K - SHLMR Bouvet 

BP 964 

97479 Saint-Denis Cedex Réunion 

Tel. 02 62 21 71 66 

Fax: 02 62 41 19 46 

medecinsdumonde.reunion 

@wanadoo.fr 

Board Members 


Gilbert Potier 

> Secretary: 

Mireille Beaufils 

>Treasurer: 

Agnès Jean-Marie 


Blandine Megroian 

Gilles Bourdiol 

Christophe Ottenwaelder (Head of 

Programme:Tuléar) 


Claudie Pante 

> Other active members: 

Arnaud Bourde (Tsunami) 

Jean-François Delambre (Children’s 

projects) 

Philippe Jeu (Indonesia) 

Sophie Louys (Mission France, 

Mayotte) 

Jean-Luc Michel (vascular surgery) 

Jean Aribaud 

Philippe Benaich 

Gilles Bourdiol 

Marie-Claude Castex 

Philippe de Chazournes 

Raymonde Grosse 

King Soon Cynthia 

Frédéric Le Bot 

Dominique Rabouille 

Martine Rajzman 

Dominique Rivas 

Corine Sayag 

Claudia Vichatzky (Ilakaka) 


39 

Key Events 


• Fundraising mailing for Action 

Enfance; 

• Mission France - organisation of a 

Christmas meal for homeless people. 

Training 

• The medical co-ordinator of the 

‘Action Enfance’ project; 

• Dr Ramamonjisoa Nivohanta 

received fast-track training in 

paediatric cardiology, from 29 May to 

1 June 2006 in Paris. 


• Mission France: medical and welfare 

consultations at the Boutique 

Solidarité (Abbé Pierre Foundation at 

St Denis and St Pierre); 

• Mission France: medical 

consultations at EDSI for people in 

Saint-Denis who have difficulty 

accessing healthcare; 

• Mission France:‘Mayotte – supporting 

irregular migrants to access healthcare’, 

proposal submitted to the 

Management Committee for approval 

in May 2006, having already been 

reviewed positively by the France 

Group. Start date for project, January 

2007. 

>CONTENTS 

» PACA (Provence-Alpes-Côte d’Azur) 


> Delegation: 

4, avenue Rostand 

13003 Marseilles 

Tel. 04 95 04 59 60 

Fax: 04 95 04 59 61 

mdmpaca@medecinsdumonde.net 

Board Members 

> Representative 

Xavier Carrard 

> General Secretary: 

Denise Clément 

> Treasurer: 

Serge Rumin 


Olivier Bernard 

Vincent Girard, 

Philippe Dupin, 

Philippe de Botton 

> Programme officer: 

Isabelle Malaval 

> Accounts: 

Ghislaine Vincenti 


Anne-Marie Combe 

Martine Semat 

Daniel Imbert 


167 

Key Events 


• 18 and 19 May exhibition:‘100 families, 

children placed, displaced, adopted and migrants’ 

in the Salon-des-Provence as part of the 9th 

International Conference on Resilience; 

• 8 June debate: programmes in Pakistan; 

• 29 June, private view: Francois Moura 

photography on ‘Reconstruction: testimony from 

the MdM programme in Algeria after the 

earthquake in Boumerdes’ at the new Gare 

Maritime de la Major; 

• 1 July, demonstration: at the old harbour 

with the Marseillais collective Logement- 

Santé; 

• 17 October: International Day for the 

Eradication of Poverty – press conference 

with the management of the public hospital 

in Marseilles.Aim: to remind this institution 

of its obligation to set up a medical/welfare 

PASS (healthcare access centre); 

• 22 October: Provence Philharmonic 

Orchestra held a concert at Marseilles 

Opera House in aid of MdM; 

• 23 October: opening of the Opre Roma! 

exhibition in the migrants’ centre with 

screening of a film,‘Who is afraid of Romanian 

tsiganes?’; 

• 16 November: private view of the ‘Tijuana 

– Wall of Shame’ exhibition in the migrants’ 

centre; 

• 16 November: Provencale day for 

humanitarian health,‘Between desire and 

power’; 

• 22 November: visit to Marseilles of the 

‘Humanitarian organisations meet young people’ 

Tour de France with Bioforce in partnership 

with MdM; 

• 26 November: discussion day with the 

Mediterranean Ethnic Forum,Timone 

hospital; 

• 21 December: homeless people 

demonstrate and question politicians at the 

old harbour.

» PAYS DE LA LOIRE 


> Delegation: 


44000 Nantes 

Tel. 02 40 47 36 99 

Fax: 02 51 82 38 09 

mdm.nantes@free.fr 

Board Members 


Paul Bolo 

> Secretary: 

Anne-Lise Guéguen 

>Treasurer: 

Nicole Neyrat 


Philippe Jarrousse 

Hélène Lepoivre 

Jean-Pierre Clauzel 

Marion Gassiot 


Corinne Lepert 


70 

Key Events 


• Presentations in schools, colleges 

and nursing schools in and around 

Nantes; 

• Participation in a Franco-German- 

Romanian seminar on health and 

exclusion; 

• Participation in a careers forum; 

• Participation in the humanitarian 

Tour de France organised in 

partnership with Bioforce; 

• Organisation of open days for our 

mobile clinics at medical and 

pharmacy schools on the International 

Day for the Eradication of Poverty; 

• Organisation of the Autumn 

University at Clisson; 

• Organisation of a press conference 

on the Sarkozy law; 

• Participation in a seminar organised 

by TAMPEP (European Network for 

HIV and STI Prevention among 

Migrant Sex Workers); 

• Participation in seminars on human 

trafficking. 


• Several presentations on the 

prostitution programme to partners or 

to other MdM programmes; 

• Numerous presentations and 

meetings with voluntary sector 

partners on issues relating to women, 

health and deprivation. 

>CONTENTS 

» POITOU-CHARENTES 


> Delegation: 

22, allée du Champ Brun 

16000 Angoulême 

Tel. 05 45 65 07 47 

Fax: 05 45 61 18 85 

desede@tiscali.fr 

Board Members 


Marie-Laure Ferrari 

>Treasurer: 

Hubert Lacombe 

> Deputy treasurer: 

Philippe Boulanger 

> International programmes 

officer + CCN: 

Patrick Bouet 


Myriam Massé 

Daniel Reiss 

Fabienne Drieu 

> Secretary of the 

delegation: 

Paule de Sède 

Angoulême branch 

(mobile project): 

> Contact: 

Marie Laure Ferrari 

Tel. 05 45 65 11 82 

Co-ordinator of needle exchange 

programme: 

Marie-Laure Ferrari 

Valérie Patrier 

Poitiers branch: 

> Contact: 

Patrick Bouet 

Tel. 05 49 01 77 77 

Key Events 


Angoulême centre 

• Successful partnership with Jean 

Rostand secondary school; 

• Tea party for the most destitute 

on 31 December; 

• Creation of a voluntary sector 

collective (AFUS 16 – Emergency 

Platform); 

• Setting up the CAARUD (harm 

reduction centre) – an enormous 

task; 

• Beginnings of a partnership with 

the Bellevue de Saintes secondary 

school (17000); 

• Winter outreach patrols with 

media coverage (in partnership 

with OMEGA). 

Poitiers centre 

• Thematic workshop en 

partnership with Toit du Monde, 

Secours Catholique, CADA, Relais 

Charbonnier; 

• Mother and child health 

programme; 

• Prostitution outreach sessions in 

partnership with the DDASS, 

CCAS, town hospital network, 

International Red Cross; 

• Sessions at the caravan: increase 

in social vulnerability. 

Partnerships: 

Angoulême 

Angoulême PASS (healthcare 

access centre), OMEGA, 

International Red Cross, local 

social work centre,Aides, 

Eclaircie. 

Poitiers 

Toit du Monde, Secours 

Catholique, Red Cross, CADA, 

Relais Charbonnier, Mother and 

Child Health Protection, DDASS, 

CCAS, town hospital network. 

155 


» RHONE-ALPES–BOURGOGNE 


> Delegation: 

13, rue Sainte Catherine 

69001 Lyons 

Tel. 04 78 29 59 14 

Fax: 04 26 84 78 08 

delegation.regionale@mdmlyon.net 

Board Members 


Michèle Roelens 

> Secretary: 

Lionel Liron 

>Treasurer: 

Gilbert Faizant 


Patricia Le Goff 

Gérard Collombel 

Robert Allemand 

Roland Filopon 

>Secretary of the delegation: 

Clothilde Guillerm 

> Programme officer: 

Sophie Bret 


approximately 160 

Grenoble branch: 

> Co-ordinators: 

Guy Caussé and Robert Allemand 

Tel. 04 76 84 17 31 

mdm.grenoble@free.fr 

> Secretary 

Angélique Giannini 

Key events 


• Participation in conferences and 

round-table discussions on 

humanitarian activities, access to 

healthcare for vulnerable groups, 

emergency and long-term 

programmes; 

• Three weeks of events to mark the 

20 th anniversary of MdM in Grenoble: 

exhibition, debates, film screenings, 

meal, concerts; 

• In Grenoble and Lyons, participation 

in the International Day for the 

Eradication of Poverty. 

Partnerships 

• Golf competitions, plays and 

partnerships with local businesses to 

support the regional activities; 

• Concert with Andean musical and 

Trail des Cabornis in aid of the 

programme in Bolivia; 

• Concert as part of a humanitarian 

festival in aid of the programme in El 

Salvador. 

Exhibitions 

• Photo exhibition on the health of 

migrants; 

• Mobile photo exhibition on child 

workers in Potosi (Bolivia). 

>CONTENTS

» OUR ORGANISATION 

157/178 

>CONTENTS

Médecins du Monde and its 

management 

Médecins du Monde is dependent on member professionals with field experience, volunteers in France, 

voluntary workers for international operations and a permanent paid staff. The support of hundreds of 

thousands on donors ensures Médecins du Monde’s financial independence. Thanks to this diversity, MdM 

always operates on the basis of debate, the views of civil society and the operational efficiency of its 

programmes for beneficiaries. As a result MdM has an original organisational structure which is strong and 

distinctive amongst large NGOs. 

DECISION-MAKING AUTHORITIES 

Once a year, MdM members (1,269 in 2006) come together at the 

General Assembly (GA), the highest decision-making body and the 

only one with the authority to modify the organisation’s statutes.The 

GA elects 12 members of the Board of Directors, and three 

substitute Directors. 

From amongst its members, the Board elects the President and the 

organisation’s Officers for one year: the Vice-Presidents,Treasurer, 

Deputy Treasurer, General Secretary and Deputy General Secretary 

and a Representative. The Board, the organisation’s executive body, 

meets monthly and takes any decisions concerning the organisation’s 

management. 

To carry out its tasks properly the Board relies on: 

• an advisory structure of MdM members; 

• a permanent operational structure; 

• joint decision-making bodies bringing together the staff and MdM 

members; 

• the regional offices. 

THE ADVISORY STRUCTURE 

This includes the continental groups and thematic groups. Each of 

these groups, made up of volunteer members with project 

experience or involved in projects, advises on the continent or 

theme for which it is responsible. Their role is vital in terms of 

analysing contexts, working methods and drawing on the experience 

>CONTENTS 

of projects. MdM has five continental groups, eight thematic groups 

and a France group which includes the Mission France and Harm 

Reduction steering committees.The members of the advisory groups 

are elected according to the internal regulations. 

THE PERMANENT OPERATIONAL STRUCTURE 

This is led by two Directorates. The Humanitarian Aid Directorate 

includes the international operations department, the Mission France 

co-ordinating office, project logistics, the adoption department and 

the communications department. 

The Management Directorate includes the human resources 

department, the development department, the finance and IT 

department and the legal department. Non-strategic operational 

decisions are made each week during a ‘project meeting’ for projectrelated 

decisions and at a ‘management meeting’ for other aspects. 

International programmes are managed by the programme’s medical 

co-ordinator, reporting to the Head of Project who, in turn, deals 

with aspects of policy or specific expertise and is in operational 

contact with the desk officer at Head Office or the project officer in 

some regional offices. Heads of Projects are nominated by the 

different internal bodies and ratified by the Board.

THE JOINT DECISION-MAKING BODIES 

These include the Management Committee, which brings 

together the staff members involved in management each week and 

examines strategic decisions concerning projects and takes a close 

look at decisions about bearing witness, political lobbying and 

publicity. 

Other joint decision-making bodies are the human resources 

group which meets monthly to define human resources and 

management policies which are then finalised and ratified by the 

Board. 

THE REGIONAL DELEGATIONS 

Across France, Médecins du Monde has set up regional 

delegations. Elected every two years, the regional colleges 

represent the regions within MdM. The delegations carry out 

international or regional projects, within the overall framework 

defined by the Board. 

All of the Board members, Heads of Project, group co-ordinators, 

regional and board representatives meet three times a year for a 

National Advisory Council meeting. 

>CONTENTS 

THE DONOR COMMITTEE 

The Donor Committee is made up of 12 co-opted members and 

it provides constructive criticism and consensual analysis of MdM’s 

projects, ratios or communication strategy. It is given funding to go 

and evaluate projects in France and abroad.Through its Chair, it can 

express its views to the Board and to the General Assembly. 

This specific set-up encourages debate at all levels. It allows MdM to 

be an active association which is both politically and financially 

independent.It encourages voluntary commitment by health workers 

in the service of the most destitute and vulnerable people, and has a 

constant concern for the quality and effectiveness of its international 

or local projects. 

159 


» OUR ORGANISATION

Departmental News 

The departments of the MdM France headquarters have three main aims. Firstly, to support programmes 

run by the organisation amongst the most vulnerable people in France and abroad. Secondly, to provide 

institutional, human resources, logistic and financial support to the programmes.The final objective is to 

account for, and report on, the programmes to our funders and donors. 

HUMANITARIAN ACTION 

At the international level, the year was marked by the end of the 

programmes in Indonesia and the continued development of 

international programmes. Our programmes budget has increased by 

60% in three years. Our presence in post-conflict areas intensified, 

such as in Democratic Republic of Congo, which is the country with 

our largest programmes. 

In France, the key event was the fact that our main harm reduction 

programmes became autonomous. With the changes in the 

legislation, and the fact that health insurance now pays for these 

activities, the two methadone buses (in Paris and Marseille) and the 

two main needle exchange programmes (in Paris and Bordeaux) 

were transferred to independent organisations.These organisations, 

based on the programme staff and volunteer teams, will still be linked 

to Médecins du Monde via a collective created for that purpose. 

HUMAN RESOURCES 

The creation of a Human Resources Directorate, whose remit 

covers all human resources – both staff and volunteers – is the key 

element of 2006. One of the key areas of work for this new 

directorate is to explore what innovation is required for 

recruitment, retention and development of MdM’s international field 

personnel. 

MANAGEMENT 

In relation to private donations, which are essential for the financial 

independence of the organisation, several areas of work have been 

carried out: 

• For private individual donors, a step reduction in requests to loyal 

donors (-15% in one year) and emphasis on standing orders as a 

>CONTENTS 

form of donation. These are the most regular and least costly to 

manage; 

• Introduction of street fundraising, with immediate sign-up to 

standing orders, with satisfactory results; 

• Development of resources from major donors, individual donors, 

businesses and foundations; 

• Development of funding from the Médecins du Monde 

international network, through the Representative Offices in 

Germany, Japan, Netherlands and the UK.Also, through some 

international delegations such as Canada, Spain or Switzerland. 

MANAGEMENT (UNTIL 31 DECEMBER 2006) 

Director General of Humanitarian Action: Dr Michel Brugière 

Director General of Management and Human Resources:François Dupré 

International Operations Directorate: Dr Eric Chevallier 

Finance and IT systems Directorate: Catherine Duffau 

Administration and Legal Directorate: François Rubio 

Human Resources Directorate:Thomas Durieux 

Communications and Development Directorate: Isabelle Finkelstein 

until April 2006, Juliette Chevalier since December 2006 

Adoption Directorate: Dr Geneviève André-Trévennec.

MdM’s International Network 

The Médecins du Monde international network was created in 1989 and is today comprised of 16 associations. 

MdM makes a distinction between international delegations (11) and representative offices (5). All the 

members of the network, are committed to respecting the MdM international associative model, which 

confirms the values and fundamental principles of the network. 

Since December 1996, Médecins du Monde has had consultative status with the Economic and Social 

Council of the United Nations. 

INTERNATIONAL DELEGATIONS AND 

REPRESENTATIVE OFFICES 

An international delegation is an autonomous organisation, based on 

the associative model of MdM: 

• which implements international and national projects; 

• which has its own independent communication policy; 

• which participates in the International Board of MdM. 

A representative bureau is an organisation based on the associative 

model of MdM: 

• which has a partnership agreement with one specific delegation; 

• whose operation is directly supervised by the partner delegation; 

• which benefits from financial support from the partner delegation; 

• which carries out fundraising and overseas volunteer recruitment 

for the partner delegation; 

• which runs national programmes after validation by the partner 

delegation. 

But, which does not implement international programmes and does 

not participate in the International Board. 

NETWORK INSTITUTIONS 

The International Board 

The presidents of the 11 delegations meet at least twice a year in the 

International Board.This deals with political and ethical issues, is the 

authority on ethics for the network, decides on measures to take in 

the event of serious misdemeanours by one of the international 

delegations, determines the general policy approaches of the 

network, elects non-permanent members of the International 

Executive Committee, approves the accounts and provisional budget 

>CONTENTS 

of the International Secretariat and appoints the director of the 

International Secretariat. 

The International Executive Committee 

This meets at least four times a year, bringing together the presidents 

of MdM France and MdM Spain (members by right) and the 

presidents of two other delegations elected for two years. The 

Committee monitors the implementation of the annual action plan, 

developed with the International Secretariat on the basis of the 

decisions taken by the International Board. It also monitors 

compliance with the ethics and principles of the network, advises on 

membership or sanctions, acts a mediator when there are problems 

between delegations, and ensuring the institutional representation of 

the network. 

The International Secretariat 

Implements the political decisions of the International Board and the 

International Executive Committee. The six areas of work of the 

International Secretariat include: 

• leading, administrating and organising the network; 

• co-ordinating delegations’ international programmes (emergency 

or development programmes); 

• supporting institutional fundraising; 

• developing co-ordinated network communication activities; 

• representing Médecins du Monde at international organisations; 

• monitoring and evaluation visits to delegations under the 

Executive Committee’s mandate. 

The International Secretariat has its own budget, based on pro-rata 

contributions from the various delegations, based on their 

penultimate financial results. 

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» OUR ORGANISATION

PRIORITIES FOR 2006 

Operational Co-ordination 

The International Secretariat continued to centralise and disseminate 

information on activities carried out by the different delegations, 

emphasising those areas where several delegations are working 

(Haiti, Palestine, Sri Lanka, Sudan etc) and information relating to 

security issues. 

The International Secretariat acted as the interdelegation coordinating 

mechanism during the emergency programmes in 

Lebanon. 

The Directors of Operations of the international delegations had 

their annual meeting in November 2006.This meeting enabled them 

to draw some lessons from their experience and to improve coordination 

and operational synergy. 

Supporting fundraising 

Throughout the year, the International Secretariat has disseminated 

information on donors grant application processes to the 

international network. The Secretariat supported some delegations 

in their fundraising and clarified the rules and procedures relating to 

fundraising through the Representative Offices. 

Thematic groups 

The International Secretariat continued to promote information 

exchange between the international delegations by running some 

thematic groups. 

AIDS group 

The international network participated in the 26 th international AIDS 

conference in Toronto in August 2006. The delegations developed 

joint communication materials which were displayed on the 

international network’s stand at the conference. 

Health and Migration group 

Work has continued on this theme, including the work of the 

European Observatory, the development of the Averroes project and 

>CONTENTS 

efforts towards creating a network of European organisations 

working for access to healthcare for migrants. 

Communication group 

The International Secretariat has been developing a new website 

which is due to go live in the first half of 2007.The site, a portal for 

the websites of the delegations and offices, will give an overview of 

activities across the whole network. 

In addition, a communications steering committee has been set-up. 

This will work on harmonisation of key communication tools across 

the network. 

THE MdM INTERNATIONAL NETWORK 

THE 11 DELEGATIONS & THEIR PRESIDENTS 

Médecins du Monde-Argentina / Médicos del Mundo-Argentina 

President: Dr Alicia Luna then M. Gonzalo Basile 

Médecins du Monde-Belgium / Dokters van de Wereld-Belgie 

President: Dr Michel Degueldre 

Médecins du Monde-Canada 

President: Dr Réjean Thomas then Dr Nicolas Bergeron 

Médecins du Monde-Cyprus/Giatri Tou Kosmou-Cyprus 

President: Dr Elias Papadopoulos 

Médecins du Monde-France 

President: Dr Françoise Jeanson then Dr Pierre Micheletti 

Médecins du Monde-Greece / Giatri Tou Kosmou- Greece 

President: Dr Elefteria Parthenopoulos 

Médecins du Monde-Portugal / Médicos do Mundo-Portugal 

President: Dr Rui de Portugal

Médecins du Monde-Spain / Médicos del Mundo-España 

President: Dr Teresa Gonzales 

Médecins du Monde-Sweden/Läkare i Världen-Sverige 

President: Pr Anders Bjorkman 

Médecins du Monde-Switzerland 

President: Dr Nago Humbert 

Médecins du Monde- United States/Doctors of the World-USA 

President: Dr Vicky Sharp 

THE 5 REPRESENTATIVE OFFICES 

MdM-Germany (Representative office of MdM-France) 

MdM-Italy (Representative office of MdM-Spain) 

MdM-Japan (Representative office of MdM-France) 

MdM-Netherlands (Representative office of MdM-France) 

MdM-United Kingdom (Representative office of MdM-France) 

>CONTENTS 

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» OUR ORGANISATION

INTERNATIONAL OFFICES 

GERMANY 


> International Office 

Ärzte der Welt 

Thalkirchner Str 81/Kontorhaus 1 

81371 Munich 

Germany 

Tel. 0049 89 62 42 09 55 

Fax: 0049 89 65 30 99 72 

info@aerztederwelt.org 

www.aerztederwelt.org 

Contacts 

Dr Lecia Feszczak, Gertrud 

Wimmer, Dr Monika Kleck 

Association under German law, 

constituted 19 March 1999 

Board of Directors 

> President: 

Pr Wilfried Schilli 

> Vice-President : 

Dr Pierre Rosenstiel 

>Treasurer: 

Rolf-Michael Schlegtendal 


Dr Klaus Wieners 

Dr Béatrice Stambul 

Dr Francois Scheffer 

Pr Albrecht Pfleiderer 

Pr Norbert Schwenzer 

Andreas Jungk 

Key events 

Financial support for projects: 

• Angola: mother and child health programme in North 

Huambo region; 

• Liberia: primary healthcare, community and mental 

healthcare; 

• Pakistan: supporting government refuges for women 

who are victims of domestic violence and emergency aid 

to the victims of the earthquake; 

• Indonesia: supporting victims of the earthquake in 

Yogyakarta; 

• Lebanon: supporting victims of conflict; 

• Sri Lanka: preparing to refurbish the operating theatre 

at Batticaloa hospital. 

Human resources support for projects: 

• 12 participants in Operation Sourire; 

• 1 expatriate in Sudan. 

Events: 

• Newspaper articles on Operation Sourire and the 

programmes in Liberia, Sri Lanka, Pakistan, Mexico and 

Lebanon as well as other coverage; 

• Four email newsletters; 

• Radio Lora broadcast on the Liberia project, the local 

project and Arzte der Welt; 

• MDR – Leipzig TV invited Dr Lauer and Dr Pinzer to 

speak about Operation Sourire on the ‘4 to 4’ show. 

• RTL broadcast a film on Operation Sourire. 

Events: 

• Four conferences on Operation Sourire; 

• Screening a film on child soldiers; 

• Participation at the Volunteers Fair and the ‘Out in the 

World’ day in Munich; 

• Presentation of Arzte der Welt with the children of 

Pinocchio circus in Aachen; 

• Participation in the Munich council photography 

exhibition on Batticaloa, Sri Lanka; 

• Humanitarian conference in Berlin in October 2006; 

• ’23 artists for Médecins du Monde’ auction of prints in 

aid of MdM by the Neumeister auction house 

Supporting the European lobbying campaign for an 

amendment to the new EU Directives. 

>CONTENTS 

Projects: 

• Three Operation Sourire missions to Cambodia 

(Kampong Cham, O Reang Ov and Phnom Penh); 

• Launch of a local project in Munich on ‘Access to 

healthcare for people without health insurance’; 

• In partnership with Munich council and the 

organisation Help from Germany, we worked on the 

refurbishment of Batticaloa hospital in Sri Lanka. 

Acknowledgements: 

German Ministry of Foreign Affairs, the City of Munich, 

Süeddeutsche Zeitung, Eine-Welt-Haus de Munich, 

Munich North-South Forum, Stadtsparkasse Munich, 

Kulturreferat der Landeshauptstadt Munich, Bayerischer 

Rundfunk, Sternstunden e.V., M-Net Munich, Sofa-lxsystems, 

Sonja Schultes & Hersberger, 

www.helpdirect.org, www.malinet.de, 

www.zdf.de/zdfde/inhalt,ARD, MDR-Leipzig, RTL - 

Explosiv, SWR Freiburg, Radio Lora, Cafe 104, 

Bayerischer Flüchtlingsrat, Neumeister – 

Kunstauktionshaus Munich; Munich, Charity Label, 

Aachen Children Circus ‘Pinocchio’, Excognito Agentur 

für Public Realtions, Euro RSCG LIFE Munich, D 8 - 

DigitalLab, Barbara Harmann Fotografie, 

Communications and Design - Nikolaus Teixera, Bar-M- 

Fabian Hickethier, AstraZenesa GmbH,Athos- 

Unternehmensberatung, Bausch, Lomb & Dr Mann 

Pharma, DekaBank Deutsche Girozentrale, Dornier 

E.U.C., Zug, Firma Schwemmhuber, Fresenius KABI, 

Munidpharma Vertriebs-GmbH & Co. KG, Pfizer Pharma 

GmbH, Rath-Schwind Verwaltungsgesellschaft mbH, 

Steigerwald Arzneimittelwerk GmbH,WIT-Stiftung für 

sozial Zwecke,Widder-Apotheke Warngau; Grünental 

GmbH, Firma Paul Hartmann AG

JAPAN 



Médecins du Monde-Japan 

PMC Building 

1-23-5 Higashi-Azabu, 

Minato-ku,Tokyo 106-0044, Japan 

Tel. 0081 3 3585 6436 

Fax: 0081 3 3586 7746 

info@mdm.or.jp 

http://www.mdm.or.jp 

Contacts 

Prune Helfter 

Yu Kumano 

Nao Kuroyanagi 

Tatsuya Kishi (employees) 

Association under Japanese law, 

constituted 10 October 2000 


> President: 

Gaël Austin 


Dr Arnaud Bourde 

Dr Patrick David 

Dr Francois Foussadier 

Masako Harada 

Akitane Kiuchi 

Dr Norihiko Oura 

Dr Satoshi Yoza 

Key events 


• Operation Sourire programmes; 

• Angola: mother and child health; 

• China:AIDS prevention in Chengdu; 

• Ethiopia: prevention of mother to child transmission of 

HIV; 

• Haiti: caring for victims of violence and revitalising the 

health service; 

• Indonesia: healthcare for the Punan people; 

• Indonesia: emergency programme after earthquake in 

Java; 

• Niger: malnutrition emergency; 

• DRC: supporting street children; 

• Sudan: emergency programme in Darfur. 


Seventeen Japanese volunteers went to the field with 

Operation Sourire to three different countries: Niger, 

Cambodia, Ethiopia. 

Publicity events and activities: 

Events 

• Gala evening in aid of MdM organised in the Residence 

de France: more than 260 participants; 

• French Blue meeting: collecting donations from more 

than 6,000 visitors; 

• Global Festa: MdM stand at this general public event 

(66,700 visitors over two days); 

• Presentations on MdM’s work to several hundred 

students; 

• Link to three gala evenings which gave a proportion of 

the profits to MdM; 

• Photo exhibitions in the Tokyo Metro. 

Advocacy: Speeches at conferences on tuberculosis, 

innovative development finance mechanisms and 

homelessness. 

Recruitment: Organising five information meetings on 

volunteering. Stand at two recruitment fairs and during 

the general assembly of the Tropical Medicine 

Association. 

>CONTENTS 

Press: 30 minute TV programme on Operation Sourire 

in Niger. Several long articles on MdM’s activities in high 

circulation daily and weekly newspapers. 

Commercial partnerships: Sales of greeting cards, 

decorative plates, patisserie and designer clothes in aid 

of MdM. 

Other communication tools: Presentation of MdM’s 

activities to donors, volunteers and partners through 

the new website, blog, a printed newsletter and an enewsletter. 


Air France,Akebono Brake,Alsok, French Embassy in 

Japan, Asahi Pretec, Céline, Chanel, Châteaux & Hôtels 

de France, Christofle, Oiso College, Creator’s Next, 

Daboo, Dominique Doucet, Expert Alliance, Exprime, 

Fund Creation (FC Reit Advisors), Felissimo 

Corporation, French Blue Meeting, French Food Culture 

Center, Givenchy, Ginza Gallery (Circle Club), Grand 

Hyatt Tokyo, Greeting life, Impresario,French Institute in 

Tokyo, Johnson & Johnson, LVMH, Mainichi Social 

Welfare Foundation, Marijoli, Mitsui Sumitomo 

Insurance, Oka Tetsuya, Osaka Suminoe Rotary Club, 

Patrick Nugier, Seiyu Shoji, Sompo Japan Insurance, 

Tokyo University of Agriculture, Daiichi Junior High 

School. 

165 

» OUR ORGANISATION ANNUAL REPORT 2006

THE NETHERLANDS 



Dokters van de Wereld 

Rijswijkstraat 141 A 

1062 ES Amsterdam 

The Netherlands 

Tel. 0031 20 465 2866 

Fax: 0031 20 463 1775 

info@doktersvandewereld.org 

Internet: 

http://www.doktersvandewereld.org 

Contacts 

José Utrera 

Nadjehda Brouwer-Richardson 

Sacha Godschalk 

Monica Reulink 

Letteke Swartjes 

Anna Miranda Scholten 

Sabrina Langerak 

Arianne de Jong (employees) 

Marian van Keuk 

Gerd Beckers (co-ordinators) 

Association under Dutch law, 

constituted 28 April 1997 


> President: 

Dr Barbara ten Kate 

> Secretary: 

Dr Dirk Jan Pot 

>Treasurer: 

Casper van Rijn 


Dr Howard Teunisse 

Bernard Juan 

Dr Françoise Sivignon 

Key events 

Financial support for projects (through direct marketing 

and grants): 

• Benin: fighting epidemics – HIV/AIDS; 

• Burma: harm reduction programmes linked to drug 

use; 

• Colombia (Meta): access to healthcare for civilian 

populations; 

• Guatemala: right to health for women working in the 

maquilas in Chimaltenango; 

• Indonesia: Central Aceh; 

• Indonesia,Western papua: access to healthcare for 

minorities; 

• Liberia: primary healthcare, community and mental 

healthcare; 

• Operation Sourire; 

• Pakistan: earthquake emergency programme; 

• DRC (Goma): fighting HIV/AIDS; 

• Sudan: emergency medical care; 

• Zimbabwe:AIDS programme; 

• China, Chengdu (Sichuan): HIV/AIDS prevention and 

harm reduction among drug users; 

• West Bank, Palestinian Territories: mental health. 

Human resources support to programmes: 

20 expatriate volunteers in the field (1 General Coordinator, 

3 Medical Co-ordinators, 5 doctors, 4 

midwives, 1 psychologist and 1 trainer) for the following 

missions: Papua New Guinea, China, Banda Aceh, Sudan, 

Liberia, Zimbabwe, Pakistan and Java. 


• Media interviews with Dutch volunteers; 

• Launch of a new publicity campaign on forgotten 

populations for Dokters van de Wereld; 

• Press trip to Pakistan and publication of articles; 

• Three newsletters (on Dokters van de Wereld’s 

international programmes) for donors and volunteers; 

• Exhibition on Papua in the Arena Hotel in Amsterdam 

and media interviews with Dutch volunteers (radio, 

newspapers). 

>CONTENTS 

National projects 

• Roma and Sinti populations: health programme, 

focusing on women. Health education among the Roma 

and Sinti communities in the Netherlands; 

• Irregular migrants: pilot programme to improve access 

to healthcare for irregular migrants in Amsterdam; 

• Distribution of medical documents (MEDOC) to 

irregular migrants and information campaign amongst 

health professionals about access to healthcare. 

International projects: 

• Curacao: pilot programme on improving access to 

reproductive health, and HIV/AIDS; 

• Indonesia, Central Aceh: pilot programme to improve 

access to healthcare for mothers and children. 


Aids Fund, Cordaid, ICCO, Oxfam Novib, Dutch 

Ministry of Co-operation and Development, NCDO, 

Nora Tol Virtual Publishing, Stichting Lions, STOP AIDS 

NOW, Zicht nieuwe media ontwerpers, Sandra van 

Noord - Bureau voor tekst en redactie, Ordina, Haute 

Finance, Paradiso,Tom van der Leij, Capi Lux Vak, EURO 

RSCG, MEMISA Belgium, PIN, SKAN Foundation, 

Ministry of Social Affairs and Science, Hotel ArenA, 

Jeroen van Loon, and all our volunteers, interns and 

thousands of individual donors.

UNITED KINGDOM 



Médecins du Monde UK 

14 Heron Quays 

London E14 4JB 

Tel. +44(0)20 7517 7534 

Fax: +44(0)20 7515 7560 

info@medecinsdumonde.org.uk 

www.medecinsdumonde.org.uk 

Contacts 

Susan Wright (new Director), 

Karen McColl (Director until end of 

2006) 

Frank Dixon, Michelle Hawkins, 

Elinor Middleton, Dorothy Muthuri, 

Fizza Qureshi, Isabelle Raymond, 

Macarena Yarza (employees) 

Association under English law, 

constituted 13 January 1998 


Dr David Barnes 

Dr Laurence Bioteau 

Ms Janice Hughes 

Mr Robert Lion 

Dr Sarah Pickworth 

Lord Rogers of Riverside 

Mr Roo Rogers 

Key events 


• Cambodia:Antiretroviral therapy programme in Phnom 

Penh; 

• Sudan (Darfur): Medical aid for the displaced 

population; 

• Afghanistan: Mother and child healthcare programme in 

Kabul; 

• Indonesia: Caring for the Punan population. 


UK volunteers sent to international projects. 


• Advocacy: preparation of first year report on Project: 

London; 

• Charity Challenge: MdM UK’s London to Paris Bike 

Ride 2006 – An event to raise funds for MdM UK, 

cyclists travelled to Paris (293km) from Tower Bridge to 

the Eiffel Tower.Then they visited MdM headquarters; 

• MdM UK volunteers gave interviews to British press 

and articles on Médecins du Monde were published 

(Internet, magazines, newspapers, radio,TV); 

• Publication of NEWS, newsletter detailing MdM UK’s 

activities, for volunteers and donors; 

• Raising awareness: 24 forums to engage doctors, 

nurses, midwives, psychologists, surgeons, logisticians, 

administrators and students who may wish to volunteer 

in the future; 

• Nine presentations to the general public for potential 

volunteers and donors; 

• Fundraising evening: music event ‘Musique du Monde’ at 

SOAS featuring five international groups; 

• Bearing witness:10 th Luis Valtuena Humanitarian 

Photography Exhibition was launched at the Scottish 

French Institute in Edinburgh. The exhibition will tour 

throughout 2007. 

Projects: 

• Launch of Project: London, national project to facilitate 

access to healthcare for the most vulnerable (migrants, 

homeless people, street sex workers); 

• Twice weekly sessions offering medical consultations 

and advice on accessing healthcare; 

• Recruitment and training of a team of 80 volunteers; 

>CONTENTS 

• Participation in the European survey on Access to 

Healthcare for Undocumented Migrants in Europe. 


Action for Bow;Alliance Pharmacy; Cabot Hall; Canary 

Wharf Group; Clifford Chance; Coutts; Department For 

International Development (DfID); Elton John AIDS 

Foundation; French Huguenot Church of London 

Charitable Trust; GLA; Grazia; Guernsey Overseas Aid 

Commission; Hewlett Packard Computers; Isle of Man 

Overseas Aid Committee; Jeune Chambre de 

Commerce Franco-Brittanique; London to Paris Bike 

Riders 2006; Lonely Planet Foundation; MEDSIN; 

Microsoft; MVM Charitable Trust; Pauffley; Paul & Joe; 

staff of the Prisons & Probations Ombudsman office; 

Quire;The Rawhides; Rayne Foundation; Richard Rogers 

Settlement;Thames Wharf Charity; SOAS;Tudor Trust; 

London Catalyst. 

Thanks to all our donors and particularly to Michael 

Watt for his generosity and support. Special thanks, as 

always, to all our volunteers. 

167 

» OUR ORGANISATION ANNUAL REPORT 2006

Sister organisations and 

local partners 

Médecins du Monde bases its work around local partners to provide links that will ensure the work will 

continue. If no partners exist, MdM supports the setting up of sister organisations, which are often 

formed on the initiative of, and based around, MdM’s local team.They gradually become autonomous and 

are supported for, on average, one to two years.The structures created in this way remain MdM’s natural 

partners in the region. 

> IN EUROPE 

• Bosnia-Herzegovina, Sarajevo 

DUGA (Reception and Psychological 

Support Centre for Children and 

Adolescents) 

Established 1994, independent since 2002. 

info_duga@yahoo.com 

Activities: supporting children, preventing 

HIV/AIDS. 

• Poland,Warsaw 

Nobody’s Children 


www.fdn.pl 

Activities: supporting children. 

• Romania, Bucharest 

FICF (International Foundation for 

Children and Families). 

Established 1993, 

independent since 2003. 

Fax: + 40 21 311 19 15 / 23 05 


Activities: fighting AIDS, harm reduction. 

> IN AFRICA 

• Mozambique, Maputo 

Meninos de Moçambique 

(Children of Mozambique) 


Fax: + 258 30 41 16 


• Madagascar,Tuléar 

Association Sisal (Doctors for the 

Right to Health). 


• Uganda, Kyotera 

CIPA (Community Initiative for 

the Prevention of HIV/AIDS/STIs). 

Established October 2003, 

independent since December 2005. 

cipacp@yahoo.com 

Activities: fighting HIV/AIDS. 

> IN LATIN AMERICA 

• El Salvador 

MDS (Doctors for the Right to 

Health). 

Established in1998. 

www.mds.org.sv 

Activities: promoting the right to health. 

>CONTENTS 

ORGANISATIONS REQUIRING 

SUPPORT FROM MDM 

> IN AFRICA 

• Tanzania, Bukoba 

Tadepa (Tanzania Development 

and Prevention of Aids). 

Established 2001. 


• Ivory Coast,Abidjan 

Mesad (Movement for Education, 

Health and Development). 


mesad_ci@yahoo.fr 

Activities: supporting children, fighting 

HIV/AIDS. 

> IN EUROPE 

• Bulgaria, Sofia 

Child and Space Association. 

Established July 2005. 


def@bulinfo.net

• Serbia, Belgrade 

VEZA. Established June 2005. 

vezango@gmail.com 

Activities: fighting HIV/AIDS, harm 

reduction. 

SOUTHERN PARTNER 

ORGANISATIONS 

> AFRICA 

• Guinea, Kindia 

KAD (Kindianese Assistance to 

Prisoners). 


Activities: supporting prisoners. 

• Rwanda, Kigali 

Ibuka (Memory and Justice). 


Activities: defending the rights of genocide 

victims. 

• DRC, Kinshasa 

AED (Aid to Disadvantaged Children). 


Activities: assisting children. 

• Zimbabwe, Chipinge 

FACT (Family aids caring trust). 

Established in 1987. 


• Madagascar,Antananarivo, Ilakaka 

Salfa (Madagascan lutheran church). 

Established July1987. 

Activities: primary health care. 

> LATIN AMERICA 

• Haiti, Port-au-Prince 

Uramel (Medico-legal Research and 

Action Unit). 

Established July 2002. 

www.uramel.net 

Activities: promoting justice in partnership 

with health professionals. 

> MIDDLE EAST 

• Egypt, Cairo 

Hope Village. 


www.egyhopevillage.com 

info@egyhopevillage.com 


• Lebanon, Antelias 

Ajem (Justice and Mercy Association). 

Established January 1998. 

ajem@intracom.net.lb 

Activities: aid to refugees, asylum seekers 

and imprisoned migrants. 

• Morocco, Casablanca 

Medical Association for the 

Rehabilitation of Victims of Torture. 

Established January 2001. 

caovt@menara.ma 

Activities: supporting victims of torture. 

>CONTENTS 

> EUROPE 

• Moldova, Balti 

TDV (Tinerii Pentru Dreptul la Viata). 

btdv@mtc-bl.md 


• Bulgaria, Sliven 

Foundation for Roma Health. 


mngrf-sl@mbox.digsys.bg 

Activities: primary healthcare. 

> ASIA 

• Indonesia, Jakarta 

Yayasan Aulia. 


ypmaulia@cbn.net.id 

Activities: right to health and education 

and community organisation. 

169 


» OUR ORGANISATION


and civil society in France 

MdM 

Co-ordination groups 

> SUD co-ordinating body – CCD 

> CNVA 

> Fonjep 

> Charter committee 

> Unogep 

> VOICE 

> CO-ORDINATION GROUPS 

SUD (Solidarity Emergency 

Development) Co-ordinating body 

A co-ordinating body for French 

humanitarian and development NGOs 

which it represents in France and 

internationally.As a Board Member, MdM 

represents the group in: 

• the CCD (Development Co-operation 

Commission), a joint body informing NGOs 

of the public authorities’ co-operation 

Thematic platforms 

> Health and Welfare 

• Uniopss - Alerte collective 

• CNLE 

• ODSE (Observatory on Migrants’ 

Right to Health) 

• Platform for the Fight Against Human 

Trafficking 

• French Co-ordinating body for the 

right to asylum 

• Romeurope 

• International Harm Reduction 

Association 

> Funding 

• Afta 

> Human Rights 

• CNCDH 

> International Action 

• URD 

• Clong Volontariat 

policy. 

CNVA (National Council of Voluntary 

Organisations) 

An independent authority attached to the 

Prime Minister’s office, through which all 

French associations relate to the Prime 

Minister. MdM monitors issues related to 

humanitarian activities. 

• FONJEP (Youth and popular education cooperation 

fund).A jointly-managed 

organisation bringing together public 

>CONTENTS 

Geographical platforms 

> Mixed Commissions 

> Palestine Platform (observer) 

authorities and voluntary organisations to 

facilitate voluntary work. MdM monitors 

volunteering issues. 

• Comité de la Charte (Charter 

Committee).A committee bringing together 

organisations which fundraise from the 

general public, in accordance with the 

Charter and previous recommendations. 

• UNOGEP (National Union of Fundraising 

Organisations)

THEMATIC PLATFORMS 

Health and Welfare 

• UNIOPSS (National Inter-federal Union of 

Private Health and Welfare organisations). 

It works with institutions promoting the 

recognition of the voluntary sector in 

health and welfare in European social policy. 

MdM belongs to the poverty and exclusion 

commission of the health and europe 

groups. Link with the Alerte group. 

• CNLE (The National Council for Anti- 

Exclusion Policy). It checks that the 

government is enforcing all measures in the 

fight against exclusion. MdM has set up a 

group to monitor the CMU (universal 

health insurance), investigating issues 

relating to asylum seekers and refugees. 

• ODSE (Observatory on Migrants’ Right to 

Health) 

• Platform for the Fight Against Human 

Trafficking 

• French Co-ordinating body for the Right 

to Asylum 

• Romeurope 

• International Harm Reduction Association 

Funding 

• AFTA (French Association of Voluntary 

Organisation Treasurers) 

Human rights 

• CNCDH (National Advisory Committee 

on Human Rights). It delivers opinions and 

recommendations on human rights to the 

Prime Minister. 

International Action 

• URD (Emergency Rehabilitation 

Development Group): group of relief 

organisations working on quality assurance 

in humanitarian activities 

• Volunteering NGO liaison committee 

(effective from 2004). 

> GEOGRAPHICAL PLATFORMS 

• Mixed commissions: Joint body of NGOs 

and public authorities. Exchanges on 

working methods in a country. 

• The Palestine platform: Group of 

voluntary organisations. MdM has observer 

status. 

>CONTENTS 

171 


» OUR ORGANISATION

Médecins du Monde and 

international institutions 

NGOs that are active in the humanitarian field cannot ignore international institutions, which are both 

major funders and front-line political authorities. Many decisions these days go beyond the national context 

and relate to European or global decisions. In order to fully understand this complex situation, Médecins du 

Monde is involved in different groups which facilitate access to the international decision-making authorities. 

At the same time, MdM is developing partnerships with other international organisations and has kept 

specific status which allows it to intervene immediately. 

> EUROPEAN UNION (EU) 

• The task of ECHO (the European 

Commission’s Humanitarian Aid Office) is 

to provide aid and emergency relief to 

populations affected by natural disasters or 

conflicts outside the EU. ECHO has 

intervened in more than 85 countries since 

1982 and has an annual budget or more 

than 500 million euros. 

EuropeAid (Co-operation Office) is 

charged with implementing the European 

Commission’s external aid mechanisms.The 

EU is one of the main institutional donors 

for development. More than 150 countries, 

territories or organisations receive this aid 

which is managed by the EuropeAid office. 

MdM relates to EuropeAid through 

Concord (the Confederation of European 

Relief and Development NGOs), which 

carries out collective lobbying of the 

European Union’s institutions and facilitates 

development of common positions on 

European development policy and the 

major issues in north-south relations. 

For several years, MdM has been 

particularly active in VOICE, the interface 

between aid organisations and ECHO, 

which brings together 90 European 

emergency relief NGOs. MdM France is a 

member of the Task Force which negotiates 

with ECHO on behalf of VOICE’s NGO 

members.Thus, during the last few years, 

MdM has played a large part in the revision 

of ECHO’s framework partnership 

agreement through the group set up by 

VOICE to monitor the partnership 

agreement. 

MdM France and other MdM delegations 

participate in ECHO’s strategic planning 

meetings. 

> COUNCIL OF EUROPE (COE) 

• The Council of Europe brings together 46 

European states. Set up in 1949 to defend 

human rights, its particular focus since 1989 

has been to help the Central and Eastern 

European countries to implement and 

consolidate political reforms. 

MdM’s international network has 

consultative status with the CoE and is part 

of OING Service, a liaison group for NGOs 

with this status. 

>CONTENTS 

> UNITED NATIONS (UN) 

• The Economic and Social Council 

(ECOSOC) is the main co-ordinating 

body for the economic and social activities 

of the UN and its specialist bodies and 

institutions. MdM’s international network 

has special consultative status which 

means that it can carry out lobbying 

activities, especially of the Human Rights 

Commission. It has observer status in this 

subsidiary body of ECOSOC and is one of 

the few medical NGOs present in this 

public arena addressing human rights 

violations.At the Commission’s annual 

meeting, MdM can intervene on each 

agenda item and submit texts. 

• MdM’s international network has 

representation at the World Health 

Organization (WHO) and the Office 

for the Co-ordination of 

Humanitarian Affairs (OCHA) in the 

High Commission for Refugees 

(UNHCR).This political representation is 

supplemented by an operational 

agreement which MdM has with UNHCR. 

There is an information exchange 

partnership between OCHA and MdM and 

operational monitoring through Reliefweb.

• Some MdM programmes are in contact 

with the United Nations Development 

Programme (UNDP) through 

operational collaboration and a policy, 

notably on the theme of children in 

conflicts. 

The same occurs with the United 

Nations Children’s Fund (UNICEF) 

with which MdM works on several projects. 

• MdM is a member of the International 

Council of Voluntary Organisations 

(ICVA), a network of NGOs involved in 

human rights, which concentrates on 

humanitarian issues relating to refugees. 

ICVA brings together over 80 international 

NGOs.The Council relates to the UN 

authorities, especially as an interface with 

UNHCR by tackling different themes such 

as the relationship between humanitarian 

workers and the military, or the protection 

of civilians in armed conflicts. 

>CONTENTS 

173 


» OUR ORGANISATION

The Board of Directors and Executive 

Committee of Médecins du Monde 

General Assembly and Board Meeting on 13 May 2006 

PRÉSIDENT 

Dr Pierre Micheletti 

Public health doctor 

GA 2007 

VICE-PRESIDENTS 

Dr Olivier Bernard 

Paediatric 

GA 2007 

Dr Patrick David 

Anaesthetist-resuscitation specialist 

GA 2008 

TREASURER 

Catherine Giboin 

University Lecturer 

GA 2009 

DEPUTY TREASURER 

Pierre Kempf 

Hospital deputy director 

GA 2009 

GENERAL SECRETARY 

Dr Fabrice Giraux 

General Practitioner 

GA 2008 

DEPUTY GENERAL SECRETARY 

Dr Thierry Brigaud 


GA 2009 

INTERNATIONAL PROJECTS 

REPRESENTATIVE 

Joseph Dato 

Associate Professor at Grenoble University 

GA 2007 

BOARD MEMBERS 

Dr Pascale Estecahandy 

Hospital doctor 

GA 2008 

Dr Françoise Jeanson 


GA 2007 

Dr Jérôme Larché 

Resuscitation doctor 

GA 2009 

Dr Françoise Sivignon 

Radiologist 

GA 2008 

>CONTENTS 

DEPUTY BOARD MEMBERS 

Dr Arnaud Bourdé 

Anaesthetist-resuscitation specialist 

GA 2007 

Dr Didier Cannet 


AG 2009 

Dr Régis Garrigue 

Emergency care doctor 

GA 2008

OUR THANKS TO: 

Our private partners: 

A 13,A2P and associates,Adonix application and services,A Novo,Abbaye de Pradines,ACB Xerox,ADCS,Affival,Aladin,AMCM,Amicale cardiologue de Paris,Amicale des sapeurs-pompiers 

de Poitiers,Amitiés loisirs Gouvernes,Antin résidences,Arasim,Arche promotion groupe Arcade,Assurances médicales Ales,Arrfliv,Aubry artistepeintre,Axalto international SAS, Beat SA, 

Beaulieu sports, Begon Bonneau, Herbert Bouchard SCP, BHV, bibliothèque scolaire Peep Ass, Bretagne Enchères, Brossard - Saveurs de France, Camif solidarité, Capa television, Carrefour 

DMG,Carte et Services,CGMI,chambre départementale des huissiers de la Nièvre,Champion,Charpentier travaux publics,Chercheminippes,chorale Risle-Gospel,Club Méditerranée,Club 

Soroptimist, CMP, Codara SA, Cofiroute, Comanaging SAS, Comité des oeuvres sociales de Meyzieu, Comptoir des voyages, Consort Netcom, Construction mécanique de l’Isère, Crédit 

coopératif,Decobat SARL,Desmarez SA,Diager SA,Divers et Imprévus,Eberle SA,Echanges & Solidarités,En apparence,Entraide majolane,Equus SA,Eric Bompard SA,Euro Assurance,Euro 

information service, Eurofeu SA, Factum finance, Fermod, Finaler Friedrich, Football breton solidaire, Heilbronn Fiszer FHF, Geste, GFS SA, Go Voyages, Goéland productions, Grands Moulins 

de Strasbourg, groupe SNPE, Hammerson France, Hilti France, Hydrosystem, ING fixations, Ifcic, Impact Immo, Intermed exportation, Iveco France, JP Chaussures, Kahn et associés, Keyrus, 

la Baguetterie, la Boutik, la Mimetaine, la Ronde des âges, le Canard enchaîné, Leclerc Siplec, Leo Pharma, l’Esprit de sel, librairie le Coin du feu, Logicacmg SAS, Lowendal Group, Marc Orian, 

Marie Marchand multimédia SARL, MBP France, Mc Racing, Medi-Science, Mohn Media, Mondial Assistance, Mr and Mrs Peters, Munch Sa, Nec, New Deal HBC, New Deal Sarl, Oddo, Olives 

Arnaud Sa,Opera Paris,Orange Réunion,Optimege,Ouest Affiche,Peugeot Citroën Automobile,Pierson Meunier export SA,Polypore Europe SA,Prima Solutions,Production La Prade SARL, 

Renzo Piano Building Workshop, Readers Digest Selection, Reuters, Rotary Club de Gordes, de Toulouse Ouest, de Papeete-Tahiti, Rousseau, RS Com SA, SACD, SAFI, SA IFB, Sagone SA, 

SANOFI- Aventis, Saulnier Blache SARL, See Velado, Sers, SFR, Sham, Smith And Nephew SAS, Sodang, Sofisol, Solutys, Sonia Rykiel SA, Sopag Maine Parking, Stade rennais FC, Stratégie 

investissement,Suzuki France,TAP Services,Taxi Jocelyne Perree,TBWA,Techmo Systems SA,Techni Alarme,Tele2 France,Temex,Croissy-sur-Seine tennis club,TF1,Théâtre de La Michaudière, 

Théâtre de la Tête noire,Top Famille,TV5 Monde, UFG, ULIF, UNIM,Vialtis Fournisseurs,Vivendi,Voyageurs du Monde,Wargny Katz (SCP),Wegener DM. 

Foundations: Annenberg Foundation, Florindon Stiftung,Air France Foundation,Arradon Foundation, Bois Brillou Foundation, Caisse d’Epargne Foundation, Club Méditerranée Foundation, 

Drosos Foundation,Fondation de France,Lille Foundation,Deniber Foundation,GlaxoSmithKline Foundation,Johaniter Foundation,Mantegna Stiftung Foundation,Niarchos Foundation,Sancta 

Devota Foundation, Seviajer Foundation, Sternstunden Foundation,Vinci Foundation, Union des blessés de la face et de la tête. 

Staff committees and employees of:Agefi,Banque de France,Caisse d’épargne Ile-de-France Paris,CCSO social,Cetim Senlis,Georges Dumas clinic,CPAM Sélestat,CPR,Crédit agricole 

Centre France, Crédit coopératif, Crédit foncier de France, Galeries Lafayette, GlaxoSmithKline, IBM Eurocoordination, Marsh, Natexis Banques populaires, Nestlé Waters,Vosges Prolabo, 

PTC Nestlé, Réel,Thalès, UES LCF, UFG, Screg Sud-Ouest,Wyeth Pharmaceuticals. 

Public partners: 

For our international projects: académie de Lille, Administration des biens et des majeurs protégés, Canadian Agency for International Development (ACDI), Canadian embassy, 

Association des régions de France, World Bank,Centers for Disease Control And Prevention,Chaîne du bonheur (Switzerland),Rouen chambre of commerce,Columbia University,Cordaid, 

communauté d’agglomération du bassin d’Aurillac, Department for International Development, the Swiss Directorate for Development and Cooperation, ECHO, Europeaid, Global Fund to 

fight AIDS,Tuberculosis and Malaria, Institut de radioprotection et de sûreté nucléaire, Joint United Nations Programme on HIV/AIDS, German, French and Japanese Ministries of Foreign 

Affairs,Dutch Ministry for Cooperation and Development,IOM,PACT,UNDP, Population Services International,PACA region,Rhône-Alpes region,Safer de l’Ile-de-France,UNHCR,UNFPA, 

UNICEF, UNOCHA, United Nations Office on Drugs and Crime, USAID,Villes unies contre la pauvreté. 

Town councils: Aigremont,Audincourt, Bassens, Behren-lès-Forbach, Bonnelles, Bourg-lès-Valence, Brioux-sur-Boutonne, Chilly-Mazarin, Drancy, Garlin, Goussainville, Lacroix-Falgarde, Le 

Croisty, Le Crouesty, Lormont, Paray-Vieille-Poste, Paris, Paris 17e, Petrosella, Saint-Estève, Saint-Jean-de-Gonville, Saint-Sylvestre-sur-Lot, Sucy-en-Brie,Toulouse,Le Tréport,Val-d’Isère. 

For our regionally managed international projects:Department councils – Bouches-du-Rhône,Alpes-de-Haute-Provence,Gironde,Charente-Maritime,Vosges,Doubs,La Réunion,Midi- 

Pyrénées ; regional councils – Provence-Alpes-Côte d’Azur and Rhône-Alpes; presidency of the regions, Guadeloupe region prefecture. 

For Mission France: CNAM (National Health Insurance Office), CAF (Family Allowance Fund), CMR (Regional Health Offices), CPAM (Local Health Insurances Office), CRAM (Regional 

Health Insurance Offices), CCAS (Communal Social Action Centres), district councils, regional councils, town inter-ministerial delegations (DIV), General Department of Health, General 

Department of Social Affairs,regional and district health and welfare services (Drass and Ddass),prefectures,Healthcare acccess offices (PASS), Armée de terre,DASES (Department of Social 

Action,Children and Health), Abbé Pierre Foundation,MILDT (Interministerial platform against drugs and drug dependency),la DSS (Health and Society Department) ,CTC (Corsican regional 

collective), URCAM (Union of Regional Health insurance offices), Mutualité agricole de Normandie,Valenciennes Hospital, CGSS (Guiana social security office), COMAGA (Communauté 

d’agglomération du Grand Angoulême), MSA (Mutualité Sociale Agricole), OFDT (French Observatory on Drugs and Drug Dependence). 

Our partner associations: 

Aides,ALC Nice,Amnesty International,ANEF, Association of communication and action for access to treatment,Association of French Regions, AFR, Association of Families Victims of Child 

Lead Poisoning,Self-help association and harm reduction for drug users,Travellers association,Health without borders association,Association les Mondes solidaires,Association des Inadaptés 

des Po, Pays de Retz doctors’ association, le Foyer, Setton Association, Sanatatea Association,ATD Fourth World, Avenir et Coopération, Banque humanitaire, Bus 31-32, Pays de la Loire 

planning centre, CFDA,Alsace collective of organisations working with sex workers,Alerte Collective, Collective supporting victims of Bam, Friends of Emmaüs Committee, Communauté 

mariste, Congrégation des soeurs augustines, Red Cross, CSF, French Co-ordinating Body for the Right to Asylum, CNR (National Coordinating Body for Networks), Cyclamed, Droit Au 

Logement (Right to Housing), D’une rive à l’autre, DHL Liens, Emmaüs, Ensemble contre le Sida, Entraide majolane, Equipe mobile Rimbaud, FAPIL (Federation of Associations for the 

Promotion and Integration through Housing), FIDH, FNARS (National Federation of Associations for Reception and Social Reintegration), Sonacotra foyer, St-Benoît foyer, GAIA Paris, Gisti, 

International Harm Reduction Association (IHRA), the Order of Malta, LA CASE, Friends of the Women’s Bus, Mondes solidaires, Restos du Coeur, Stade rennais FC, Brittany Football League 

and the clubs in Brittany, Ligue des Droits de l’Homme, Max Havelaar, Mouvement du Nid, ODSE (Observatory on the Right to Health for Foreigners), OIP (International Observatory on 

Prisons), Passerelle la santé sans frontières, PHI, Platform against human trafficking, Secours catholique, Sid’espoir, Solidarité Sida, SOS Drogue internationale (SOS DI), SOS Femmes, Rasko, 

Techno Plus, Uniopss,Veille sociale,Vialtis.* 

And all our partners who have supported our work in France and abroad during 2006, as well as our individual donors. 

>CONTENTS 

175 


» OUR ORGANISATION

GLOSSARY 

A 

ACF: Action Contre la Faim (Action against 

Hunger) 

ACRO: Association pour le Contrôle de la 

Radioactivité de l’Ouest (Western Association for 

Radioactivity Control) 

ADIL: Agence Départementale d’Information sur le 

Logement (District Office on Housing Information) 

ADS: Agence du Développement Social (Social 

Development Agency) 

AED: Aide à l ‘Enfance Défavorisée (Aid for 

Disadvantaged Children) 

AFD: Agence Française de Développement (French 

Development Agency) 

AFR: Association Française de Réduction des 

Risques (French Harm Reduction Association) 

AFTA: Association Française des Trésoriers et 

responsables d’Associations (French Association of 

Treasurers and Managers of Voluntary Organisations) 

AFUS: Association of former staff members 

(UNESCO) 

AFVS: Association des Familles Victimes du 

Saturnisme (Association of Families Victims of Lead 

Poisoning) 

AIDES: Association fighting AIDS 

AJAR: Association of Young Anaesthetists and 

Resuscitation Specialists 

AJEM: Association for Justice and Mercy 

ALPIL: Action Lyonnaise pour l’Insertion par le 

Logement (Lyons Action for Inclusion through 

Housing) 

ALS: Association fighting aids 

AME: Aide Médicale de l’Etat (State Medical 

Assistance) 

AMP: Childcare assistants 

ANIT: Association Nationale des Intervenants en 

Toxicomanie (National Assocation of People 

Working on Drug Dependency) 

ANPAA: Association Nationale de Prévention en 

Alcoologie et Addictologie (National Association for 

the Prevention and Addictions) 

APE: Agence des Participations de l’État (State 

participation agency) 

APHP: Assistance Public - Hopitaux de Paris (Social 

services – Paris Hospitals) 

ARV: Antiretroviral 

ASAV: Association pour l’accueil des gens du 

voyage (Association for Welcoming Travellers) 

ASC: Agent de Santé Communautaire (Community 

Health Workers) 

ASDES: Accès aux Soins, aux Droits et Education à 

la Santé (Access to Healthcare, Rights and Health 

Education) 

ASUD: Auto-Support des Usagers de Drogues 

(Drug Users Self-help Group) 

ATD-Quart Monde: Aide à Toute Détresse (Help 

to All Distressed- Fourth World) 

ATIS: Centre de Santé Ami des Jeunes (Friend of 

Young People - health centre) 

AULIA: Indonesian foundation for street children 

B 

BCZ: Bureau Central de la Zone (Central Area 

Office) 

BEI: Bureau Exécutif International (International 

Executive Committee) 

C 

CA: Conseil d’Administration (Board of Directors) 

CAARUD: Centre d’Accueil et d’Accompagnement 

de Réduction des Risques pour les Usagers de 

Drogues (Harm Reduction Centre for Drug Users) 

CADA: Centre d’Accueil des Demandeurs d’Asile 

(Asylum Seekers Centre) 

CAFDA: Coordination d’Accueil des Familles 

Demandeuses d’Asile (Coordinating body for 

Asylum Seeking Families) 

CAI: International Board of Directors 

CAM: Centre for Migrants in Rabat 

CASO: Centre d’Accueil, de Soins et d’Orientation 

(Healthcare and Guidance Centre) 

CASP: Centre d’Action Sociale Protestant 

(Protestant Social Action Centre) 

CCAS: Caisse Centrale d’Activités Sociales (Social 

Activties Central Office) 

CCD: Commission Coopération Développement 

(Development and Cooperation Commission) 

CCN: Convention Collective Nationale (National 

Collective Convention) 

>CONTENTS 

CDC: Centers for Disease Control 

CEADEL: Centro de Apoyo al Desarrollo Local 

(Centre Supporting Local Development) 

CENHOSOA: Soavinandriana Hospital 

CERC: Conseil de l’Emploi, des Revenus et de la 

Cohésion sociale (Council for Employment, Income 

and Social Cohesion) 

CFDA: Coordination Française pour le Droit d’Asile 

(French Co-ordinating Body for the Right to Asylum) 

CHRS: Centre d’Hébergement et de Réinsertion 

Sociale (Accommodation and Social Re-integration 

Centre) 

CIMADE: Service oecuménique d’entraide 

(Ecumenical Mutual Aid Service) 

CIPA: Community Initiative for the Prevention of 

HIV/AIDS/STIs 

CLE: Collectif inter-associatif de Lutte contre les 

Exclusions (Inter-association Group Tackling 

Exclusion) 

CMU: Couverture Maladie Universelle (Universal 

Health Insurance) 

CNCDH: Commission Nationale Consultative des 

Droits de l’Homme (National Consultative 

Commission on Human Rights) 

CNLE: Conseil National des politiques de Lutte 

contre l’Exclusion (National Council on Social 

Exclusion) 

CNVA: Conseil National de la Vie Associative 

(National Council of Voluntary Organisations) 

COE: Council of Europe 

COMEDE: Comité Médical pour les Exilés 

(Medical Committee for Exiles) 

CONCORD: European Confederation of Relief 

and Development NGOs 

CORE: Co-operation for Rehabilitation 

CORDAID: Catholic Organisation for Relief and 

Development Aid 

CPAM: Caisse Primaire d’Assurance Maladie (Local 

Health Insurance Office) 

CRAM: Caisse Régionale d’Assurance Maladie 

(Regional Health Insurance Office) 

CRAMIF: Caisse Régionale d’Assurance Maladie 

d’Ile-de-France (Ile de France Regional Health 

Insurance Office) 

CRESIF: Comité Régional d’Education pour la 

Santé d’Ile de France (Ile de France Regional Health

Education Committee) 

CRIPS: Centre Régionaux d’Information et de 

Prévention du Sida (Regional Centre for Prevention 

and Information on AIDS) 

CSCAD: Chambre Syndicale des Cabarets 

Artistiques et Discothèques (Union of Cabarets and 

NightClubs) 

CSST: Centre Spécialisé de Soin aux Toxicomanes 

(Specialist Drug Treatment Centre) 

D 

DAL: Droit Au Logement (Right to Housing) 

DDASS: Direction Départementale des Affaires 

Sanitaires et Sociales (District Department of Health 

and Social Affairs) 

DG: Direction Générale (Department of Health and 

Social Services) 

DGS: Direction Générale de la Santé (Ministry of 

Health) 

DGSNR: Direction Générale de la Sûreté 

Nucléaire et de la Radioprotection (Department of 

Nuclear Security and Radioprotection) 

DRASS: Direction Régionale des Affaires Sanitaires 

et Sociales (Regional Department of Health and 

Social Affairs) 

DRC: Democratic Republic of Congo 

DRDJS: Direction Régionale et Départementale de 

la Jeunesse et des Sports (Regional and District 

Office for Youth and Sports) 

DUGA: Children and Young People’s Psychological 

Support Centre 

E 

ECHO: European Commission Humanitarian Office 

ECOSOC: UN Economic and Social Council 

EDSI: Espace Dionysien de Solidarité et d’Insertion 

(Dyionesien Space for Solidarity and Integration) 

EGO: Association Espoir Goutte d’Or (Goutte 

d’Or Hope Association) 

ENSP: Ecole Nationale de la Santé Publique 

(National Public Health School) 

ENT: Ear, Nose and Throat 

ESC: École Supérieure de Commerce (Business 

School) 

ESTES: Ecole Supérieure en Travail Educatif et 

Social (Educational and Social Work College) 

EU: European Union 

EuropeAid: European Commission Development 

Office 

F 

FACT: Family Aids Caring Trust. 

FAP: Fondation Abbé Pierre (Abbé Pierre 

Foundation) 

FARC: Armed Revolutionary Forces in Colombia 

FED : Fonds Européen de Développement 

(European Development Fund) 

FICF: Fondation Internationale pour l’Enfant et la 

Famille (International Foundation for the Child and 

the Family) 

FNARS: Fédération Nationale des Associations 

d’Accueil et de Réinsertion Sociale (National 

Federation of Reception and Social Reintegration 

Organisations) 

FNPEIS: Fonds National de Prévention, d’Education 

et d’Information en Santé (National Prevention, 

Education, Health Education and Information Fund) 

FONJEP: Fonds de Coopération de la Jeunesse et 

de l’Education Populaire (Youth and Popular 

Education Co-operation Fund) 

FTE: Full time equivalent 

G 

GAF: Groupe Amitié Fraternité (Friendship and 

Brotherhood Group) 

GHB: Gamma-Hydroxybutyrate acid (rape drug) 

GISTI: Groupe d’Information et de Soutien des 

Immigrés (Immigrants Information and Support 

Group) 

H 

HALDE: Haute Autorité de Lutte contre les 

Discriminations et pour l’Egalité (High Authority 

Fighting Against Discrimination and Promoting 

Equality) 

HDI: Human Development Index 

HIV: Human Immunodeficiency Virus 

>CONTENTS 

HJRA: Joseph Ravoahangy Andrianavalona Hospital 

(Madagascar) 

HMU: Hanoi Medical University 

HSSEP: Sous Département des affaires sociales 

pour la prévention des maux sociaux (Sub- 

Department of Social Affairs for the Prevention of 

Social Problems) 

I 

IBUKA: Memory and Justice (literally, Remember!) 

ICODEV: Community Initiatives for Development 

IdF: Ile de France 

IDU: Injecting drug user 

IEC: Information, Education and Communication 

IFSI: Institut de Formation aux Soins Infirmiers 

(Nurse Training Institute) 

INSEE: Institut National de la Statistiques et des 

Etudes Economique (National Institute for Statistics 

and Economic Studies) 

INSERM: Institut National de la Santé et de la 

Recherche Médicale (National Institute for Health 

and Medical Research) 

IRD: Institute for Research and Development 

IRSN: Institut de Radioprotection et de Sûreté 

Nucléaire (Institute for Radioprotection and 

Nuclear Security) 

ITS: Swiss Tropical Institute 

IVDU: Intravenous drug users 

K 

KAD: Kindianaise d’Assistance aux Détenus (Kindi 

anese Support for Prisoners) 

KAP: Knowledge,Attitudes and Practices survey 

L 

LDH: Ligue des Droits de l’Homme (Human Rights 

League) 

LSD: Lysergic Acid Diethylamide 

LSI: Internal Security Law 

177 


» OUR ORGANISATION

M 

MAAIONG: Mission d’Appui à l’Action 

Internationale des ONG (International Support for 

NGOs International Programmes) 

MAE: Ministère des Affaires Etrangères (Ministry of 

Foreign Affairs) 

MAI: Mission Adoption Internationale (International 

Adoption Programme) 

MCH: Mother and Child Health 

MdM: Médecins du Monde 

MDGs: Millennium Development Goals 

MDS: Doctors for the Right to Health 

MESAD: Movement for Education, Health and 

Development 

MF: Mission France 

MILDT: Mission Interministérielle de Lutte contre 

la Drogue et la Toxicomanie (Inter-Ministerial Task 

Force on Drugs and Addictions) 

MTCT: Mother To Child Transmission 

MRAP: Mouvement contre le Racisme et pour 

l’Amitié entre les Peuples (Movement against racism 

and for friendship between people) 

N 

NOVIB: Oxfam Novib 

O 

OAA: Organisme Autorisé pour 

l’Adoption(Authorised Adoption Agency) 

OCHA: UN Office for Co-ordination of 

Humanitarian Affairs 

ODSE: Observatoire du Droit à la Santé des 

Etrangers (Observatory on the Right to Health of 

Migrants) 

OFDT: Observatoire Français des Drogues et des 

Toxicomanies (French Observatory on Drugs and 

Drug Dependence 

OS: Opération Sourire 

OXFAM: Oxford Commitee for Famine Relief 

P 

PACA: Provence- Alpes-Côte d’Azur 

PACT: American consortium of NGOs and private 

voluntary organisations 

PASS: Permanence d’Accès aux Soins de Santé 

(Healthcare Access Office) 

PEKABO: Perma Kanisa pe Bongwana 

PPMU: Programme de Proximité en Milieu Urbain 

(Urban outreach programme) 

PROSES: Programme Science, Environnement et 

Société (Science, Environment and Society 

Programme) 

PMTCT: Prevention of Mother to Child 

Transmission 

S 

SALFA: Sampanasa Loterana momban’ny 

Fahasalamana (Health Department of the Lutheran 

Church in Madagascar) 

SDC: Swiss Development Cooperation 

SEAD: Sharing Experience for Adapted 

Development 

SNEG: Syndicat National des Entreprises Gaies 

(National Union of Gay Businesses) 

SRH: Sexual and Reproductive Health 

STI: Sexually Transmitted Infections 

STEP: Network and Fair Trade label 

T 

TADEPA:Tanzania Development and Prevention of 

Aids 

TAMPEP: European Network for HIV Prevention 

of HIV and STIs and for Health Promotion amongst 

Migrant Sex Workers 

TB:Tuberculosis 

TDV: Tinerii Pentru Dreptul la Viata (Young People 

for the Right to Live) 

TLC:Thin Layer Chromotography 

U 

UCS: Unité Communale de Santé (Communal 

Health Unit) 

UK: United Kingdom 

UNDP: United Nations Development Programme 

UNFPA: United Nations Population Fund 

UNHCR: UN High Commissioner for Refugees 

UNICEF: UN Children’s Fund 

>CONTENTS 

UNIOPSS: Union Nationale Interfédérale des 

Oeuvres et des Organismes Privés Sanitaires et 

Sociaux (National Inter-Federal Union of Private 

Health and Social Organisations) 

UNOGEP: Union Nationale des Organismes 

faisant appel à la Générosité du Public (National 

Union of Fundraising Organisations) 

UNRWA: United Nations Relief and Work Agency 

URAMEL: Unité de Recherche et d’Action 

Médico-légale (Medico-legal Research and Action 

Unit) 

URCAM: Regional Union of Health Insurance 

Offices 

URD: Groupe Urgence Réhabilitation 

Développement (Emergency Rehabilitation 

Development Group) 

USA: United States of America 

USAID: United States Agency for International 

Development 

UTC: Unité de Traitement du Choléra (Cholera 

Treatment Centre) 

V 

VOICE: NGO Collective 

W 

WFP: World Food Program 

WHO:World Health Organization

Publication Director: Dr Pierre Micheletti - Editor in Chief: Giselda Gargano - 

Editorial Committee: Dr Michel Brugière, Martine Mikolajczyk, Hélène Valls - Editorial Staff: Samira Clady, 

Daouda Dia, Cyril Gouiffes, Céline Marvie - Editorial Secretary: Emmanuelle Weiss Picture Editor: 

Aurore Voet - Acknowledgements: thanks to all those who participated in the 2006 edition 

Design: François Despas

ANNUAL REPORT 2006

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