Activity Report 1994-2011

EMERGENCY

Every year war and poverty destroy the lives of millions of people around the world. In todays conflicts, 90% of the victims are civilians. EMERGENCY is an independent Italian organization founded in 1994. EMERGENCY provides free, high quality medical and surgical treatment to the victims of war, landmines and poverty. EMERGENCY promotes a culture of peace, solidarity and respect for human rights.

2011 was a hard year, marked by the four long months when our colleague Francesco Azzar was held hostage after being kidnapped in South Darfur while working with his usual enthusiasm and professionalism at the Paediatric Centre in Nyala. Along with his family and friends, and the EMERGENCY volunteers, we spent 124 anxious days before we were able to set eyes once again on his smile the smile that all the children in the Centre had learnt to recognise. In 2011 we carried on working to spread a culture of peace. EMERGENCY has always met up with students and teachers in schools of every type and for every age group. Weve always organised conferences and discussions to explain the reason for our work, the daily reiteration of the right to healthcare, the horror of war, and the many reasons (four and a half million reasons equal to the number of people weve treated) why wed like to think the world no longer needed EMERGENCY. We want these words to reach as many people as possible, so weve set up a new project: a monthly magazine called E like EMERGENCY. Its available in all newsagents, speaking about rights and wrongs, denouncing what doesnt work but also leaving room for the multitude of big or little stories about things that do work, experiences of peace and solidarity that cost far less than a bomb and, unlike bombs, really do build peace. And weve worked increasingly around the world, where every day were called on to deal with ever greater and more widespread needs. Weve extended our regional paediatrics and cardiac surgery network in Africa, opening the Paediatric Centre of Port Sudan: the Centre has been treating the regions children (free of charge) since December 2011, but it also looks after the screening of heart patients both children and adults wholl undergo operations in the Salam Centre for Cardiac Surgery in Khartoum. Unfortunately, weve also had to extend the assistance we offer to those wounded in the war in Afghanistan a country where it seems theres no end to war. In order to help the civilians most affected by the conflict, we opened four new First Aid Posts in the regions of Helmand, Logar and Wardak. All the Surgical Centres worked at full stretch throughout 2011 to assist the injured; one bed in three is always occupied by a child, who has nothing to do with the war and who shouldnt be there. In 2011 war showed up in the Mediterranean, and we did our best to help these victims too: sending a war surgery team to Libya during the siege of the city of Misurata, but also aiding the refugees that escaped from northern Africa and came to Italy. And here, in Italy, we assisted the victims of another type of war as well the war against foreigners. In April 2011, EMERGENCYs two mobile clinics began making the rounds of the southern Italian countryside, offering medical treatment to thousands of invisibles: men and women who work and live in inhumane conditions, sometimes without water, sometimes without a roof over their heads, often without hope, always without rights. Come to think of it, weve also been helping the victims of yet another war the one against the poor: in 2011, in our Outpatient Clinic in Marghera (that we actually opened for immigrants), we saw an ever increasing number of Italian citizens approaching EMERGENCY for free medical treatment. There are those whove lost their jobs, those without a fixed abode, those who can no longer afford to spend even just a few euros for their health, and so they turn to us for help. We try to do our best for them, as we do with all our patients around the world. Not without difficulties though, because the recession has hit us too. The Italian people have always been the real strength behind EMERGENCY; its thanks to them that weve been able to treat millions of people over the world. When the Italians suffer the effects of the economic crisis (when we even reach the point where they become our patients), its inevitable that resources become ever harder to find. But well keep on asking for the support of those whore still able and willing to give attention to solidarity. To lend a hand to all those in need, whether African children or the Italian jobless, Afghan women, or the invisible men who work in the fields, just a stones throw from our homes. Only with the support of everyone we can go on helping all these people. And therell be more and more need here in Italy as well. Help us not to stop.

Cecilia Strada President of EMERGENCY

We have been treating a person every 2 minutes. For 17 years.

HOW WE WORK
In order to assert the right to healthcare for everyone, EMERGENCY:
provides assistance totally free of charge; guarantees treatment to anyone in need of assistance, without any sort of discrimination; practices high quality medicine and employs standardized therapeutic and working protocols already tested in emergency situations; trains local staff thoroughly until complete operational independence is achieved.

EMERGENCY designs, builds and manages through its international staff:

hospitals for victims of war and surgical emergencies; rehabilitation and social reintegration centres; first aid posts for emergency treatment; basic health centres for primary healthcare; paediatric and maternity centres; outpatient and mobile clinics for migrants and destitute people; a centre for cardiac surgery.

EMERGENCYs international staff is also committed to the training of national staff.

AREAS OF INTERVENTION
SURGERY
Paediatric and adult cardiac surgery Surgery for victims of war and landmines Emergency and trauma surgery General surgery Orthopaedic surgery Plastic and reconstructive surgery Ophthalmic surgery First aid

MEDICINE
Cardiology Primary health care Internal medicine Neonatology Ophthalmology Obstetrics and gynaecology Paediatrics

REHABILITATION
Physiotherapy Production of prostheses and orthosis Vocational training and setting up of small business cooperatives for the physically disabled.

Between 1994 and 2011, in the hospitals, clinics and rehabilitation centres run by EMERGENCY, 4,668,900 people received high quality medical care free of charge.
03

CULTURE OF PEACE

1995 Campaign against landmines

In 1995, one year after its foundation, EMERGENCY reactivated the hospital of Choman, a village in Iraqi Kurdistan near the border with Iran. The surrounding area had been polluted with landmines, mainly of Italian production: one of the most common ones being the Valmara 69, a fragmentation mine produced in Brescia, which can kill within a 25 meters radius and seriously injure in a radius of 200 meters from its explosion. EMERGENCYs doctors treated landmine victims in the hospital in Choman at first, and then also in the other two set up in Erbil and Sulaimaniya. The victims were men, women and children who had stepped on a mine while leading animals to pasture, as they went to fetch water, or while playing. They were not fighters, but people trying to lead their own lives. In Iraqi Kurdistan, EMERGENCYs doctors faced up to one of the worst heritages of war: 100 million unexploded mines are estimated to be scattered around some seventy countries. EMERGENCYs surgeons started to tell what they saw on the operating tables of their hospitals. Their work gained great attention on the television programme called the Maurizio Costanzo Show, where Gino Strada, the founder of EMERGENCY, talked to the general public about the devastating effects of landmines for the first time. For many people this was a totally new issue: few media outlets had dealt with this topic in a country that was one of the largest producers and exporters of landmines at the time. Thanks to an intensive information campaign consisting of newspaper articles, meetings in schools, debates and exhibitions, mines became a subject of public interest. EMERGENCY publicly asked the Minister of Defence to take concrete action against landmines. On August 2, 1994 the Italian Parliament approved a moratorium on the production and export of landmines.

Keakaws Amin Ahmed , 30 years old, hunting, left leg amputated; Karim Wahid, 32, collecting metal, right leg amputated; Saeed Majeed, 43, collecting metal, multiple wounds ...: an extract from the admission book of EMERGENCYs hospital in Sulaimaniya became a postcard to be sent to the Italian President Oscar Luigi Scalfaro to ask for the prompt discussion and approval of a bill prohibiting Italy from producing, trading and using landmines, as well as a commitment in the international arena for their total ban and the launch of humanitarian initiatives of mine clearing and aid to victims. More than a million postcards were sent to the Quirinal Palace, the official residence of the President of the Italian

Republic, in the summer of 1996. In December of the same year the international call for the ban on landmines was also signed by ten Nobel laureates: Rita Levi Montalcini, Adolfo Perez Esquivel, Joseph Rotblat, Elie Wiesel, Jean Dausset, Christian de Duve, Frank Sherwood Rowlands, Steven Weinberg, Kenneth J. Arrow, James M. Buchanan. Finally, under the pressure of an increasingly public awarness, the Italian Parliament approved the Law n. 374 on October 29, 1997. This law forbids - in Italy - the manufacture, storage, sale, export and possession of mines, components, technologies and patents. Moreover, the law forbids the economic

participation in foreign companies dealing with mine production and trade. On December 3, 1997 in Ottawa, Italy signed the Anti-Personnel Mine Ban Convention, which prohibits the use of these weapons, mandates the dismantlement of arsenals and makes provisions for de-mining and victim assistance an innovation in the Italian regulations. The Ottawa treaty came into force on March 1, 1999, but many countries had not yet signed it at the end of 2011. Among them there were China, Russia and the United States of America.

2001 A shred of peace

War broke out, is in progress, has killed and keeps on killing. It will last even when military strategists decide to affirm that it is over, from their point of view. It will last in the mourning of the survivors, in the mutilated bodies of many of them. It will last in the bursts of unexploded devices still on the ground. We know that many are in favour of this war. We also want the voice of those who are against it to be heard. And we will use a piece of white cloth to say this: hanging from a purse or a briefcase, tied to front doors or balconies, to dog leashes, car antennas, baby strollers, school bags ... A shred of peace. And if many of us show it, it will not be possible to say that Italy as a whole has chosen war as an instrument of conflict resolution. EMERGENCY calls for the participation of individual citizens, and also of municipalities, parishes, associations, schools and of anyone sharing this position. Spreading this message is a way to start. On September 11, 2001 the attacks in the United States shocked the international public. The reaction was swift: not even a month after the attacks, on October 7th, U.S. bombers attacked Afghanistan. It was the Operation Enduring Freedom, the first act of the global war on terror: the Taliban regime that ruled Afghanistan was accused of supporting the terrorist group Al-Qaeda, held responsible for the attack on the Twin Towers. The military attack on Afghanistan was largely supported by the international community. Italy also fell in line: on November 7, 2001 the Italian Parliament approved the participation in the international military operation with the favourable pronouncement of 92% of its members, in evident disregard of Article 11 of the Constitution stating that Italy repudiates war. Eleven days later, thanks to the most bipartisan vote in the history of the Republic - as it was defined by Gino Strada - 600 Italian soldiers left for Afghanistan aboard warships from the port of Taranto. The war was propagandized as the inevitable self-defence measure of a country under attack. EMERGENCY knew that war would not bring justice to the victims of the attack, nor it would eliminate the terroristic threat, but it would just be the umpteenth act of violence on a country battered by decades of conflict, causing the deaths of further thousands of innocent people. Many showed the same conviction supporting the work of EMERGENCY, the only NGO present in Kabul at the time of the attack of the international coalition. EMERGENCY asked people to show their disagreement through the symbolic use of a shred of peace, in order to manifest public dissent against the war and the decisions of the Italian Parliament. The small white strip of fabric tied to the wrist, hanging on bags or cars would become a symbol of recognition among those who want to find new ways of being together, new ways to solve problems other than violence, terrorism, or war .

2002 Italy Out of the War

It was the autumn of 2002. Once again, war seemed to be an unavoidable choice: Iraq was the number 1 enemy, the nonexistent weapons of mass destruction were presented as a threat to the safety of the West and the West was preparing another military campaign in the area. Italy out of the War: EMERGENCY put forward this request to the Italian government and to the citizens with a massive mobilization that reached its peak on December 10, 2002. On the anniversary of the Universal Declaration of Human Rights, more than 250 torchlight processions and 500,000 people poured into the streets throughout Italy, while rainbow flags and white shreds of peace waved from the windows. Moreover, hundreds of meetings were organized in schools; scores of municipalities, provinces and regions adhered to the call, and 500 thousand signatures were collected in favour of the appeal Italy out of the War on EMERGENCYs website. We want a world based on justice and solidarity. We reject violence, terrorism and war as means of conflict solving between people and nations. We ask that Italy, facing the threat of a military attack against Iraq, does not participate in any act of war, in observance of its Constitution. We do not want to be jointly responsible for new grief, nor want to feed the spiral of terror. Stop wars, stop killings, stop victims. EMERGENCY handed the text of the appeal and the signatures collected to the presidents of the Republic, the Government, the Chamber of Deputies, the Senate, and of the parliamentary groups. Against the will of a great part of the country, on April 15, 2003, the government won the vote of the Parliament in favour of the emergency humanitarian mission, even before the UN Security Council adopted resolution n. 1483. Stop war, sign for peace. Repudiation of war is a fundamental principle of the Italian Constitution and it is declared in article n. 11. In the same period, to give strength to its call for peace, EMERGENCY proposed to three jurists - Luigi Ferrajoli, Domenico Gallo, Danilo Zolo - to draft a bill of popular initiative Rules for the execution of the principle of repudiation of war, as declared in article n. 11 of the Italian Constitution and in the UN Charter. The draft bill calls for a series of guarantees that would put article n. 11 into operation, allowing its actual application and providing strict penalties in case of violation. EMERGENCY collected 137,319 signatures (far beyond the 50,000 required by law) and submitted them to the Normative Texts office of the Chamber of Deputies on June 17, 2003. The draft bill has not yet been assigned to any parliamentary committee.

2003 - Cease fire

Citizens of the world can no longer grieve over the tragedies of terror: a bomb is followed by a car bomb, every death leads to a revenge that generates other deaths and other revenges. Different names - war, terrorism, violence - but the results are always human bodies torn into pieces and pieces of humanity lost forever. We no longer want to see atrocities: it is inhuman that human beings keep on killing each other. Lets stop this spiral, or in the end there will be nothing left, no one will be right or wrong, there will only be an endless chain of grief and destruction. We ask all those who are carrying out and planning attacks and wars to stop. We ask for time to reflect, we cannot helplessly witness the spreading of murderous madness. To all those who promote violence, clandestine organizers of massacres or extremely visible dictators or presidents, we, the people, implore: cease fire!. In autumn 2003, the intensification of the war in Iraq and Afghanistan and bombings in Turkey, Palestine and Chechnya followed one another in a spiral of violence that seemed destined to expand endlessly. EMERGENCY became the promoter of an appeal to ask governments and armed groups to cease fire before hatred and violence became the only language used by human beings. The appeal was immediately signed by Noam Chomsky, professor of Massachusetts Institute of Technology; Ignacio Ramonet, director of Le Monde Diplomatique; Oscar Luigi Scalfaro, President of the Italian Republic 1992-1999; Rigoberta Mench, Nobel Peace Prize in 1992; Rita Levi Montalcini, Nobel Prize in Medicine in 1986; Dario Fo, Nobel Prize in Literature in 1997; Jack Steinberger, Nobel Prize in Physics in 1988; Leonard Boff, philosopher and theologian; Tavola Valdese, Union of the Methodist and Waldensian churches in Italy; Inge Schoental Feltrinelli, publisher; Ermanno Olmi, director; Riccardo Muti, conductor; Pietro Ingrao, politician and writer; Carlo Ossola, professor of the Collge de France; Father Alex Zanotelli, Comboni missionary; Rabbi Michael Lerner, director of Tikkun magazine; Sari Hanafi, director of the Palestinian Diaspora and Refugee Centre; Peretz Kidron, journalist and writer; Yesh Gvul, Movement of Israeli soldiers against occupation; Sylvie Coyaud, journalist; Farid Adly, journalist; Hebe de Bonafini, President of the association Madri de Plaza de Mayo; Father Luigi Ciotti, president of the association Libera; Carlyle Vilarinho, Head of Cabinet of the Brazilian Government; Jos Graziano da Silva, Minister of the programme Fame Zero of the Brazilian Government; Amos Oz, writer; Andrea Camilleri, writer; Monsignor Raffaele Nogaro, Bishop of Caserta; Tiziano Terzani, writer. Among the first signatories there was also Hans von Sponeck, former director of the UN humanitarian programme in Iraq, who had resigned as a gesture of protest against the sanctions required by the United States. Many municipalities, as well as Italian and international associations also adhered, along with family members of September 11th victims. Over 76,000 of citizens signed the appeal on EMERGENCYs website.

2010 - The world we want

We believe in the equality of all human beings, regardless of their opinions, sex, race; of their ethnic, political, religious background and belonging; of their social status and financial condition. We repudiate the use of violence, terrorism and war as instruments to resolve the disputes between individuals, peoples, nations. We want a world based on social justice, on solidarity, on reciprocal respect, on dialogue, on an equal distribution of resources. We want a world in which governments guarantee the basic equality of all members of society and the right to medical treatment that is both of a high standard and free; the right to a public education system that develops each person, each human being, enriching their knowledge and intellect; the right to free information media. In our own Country, instead, for many years now weve witnessed the progressive and systematic destruction of any and all principles of social, human cohabitation. A most severe and savage drift is before our eyes. In the name of international alliances, the Italian political class has chosen war and aggression against other Countries. In the name of freedom, the Italian political class has chosen war against its own citizens, building a system of privileges based upon exclusion and discrimination, a system of arrogant prevarication, of ordinary, daily corruption. In the name of security, the Italian political class has chosen war against those who come to Italy to survive, instigating hatred and racism against them. Is this a democracy? Simply because it involves electoral processes of representativeness? Is the act of voting enough for a Country to be defined as democratic? To us, a political system is democratic only if it works for the common well-being, favouring in its actions the needs of the underprivileged, the needs of the weakest social groups, to better their living conditions, so that we may all be a society of citizens. This is the world we want. For ourselves, for all of us. A world of equality. The world we want is the title of the Manifesto presented by EMERGENCY at the ninth National meeting of its volunteers in September 2010. Discussed by Gino Strada, along with authors and personalities, the Manifesto calls for a world without war, where the basic rights of every human being are guaranteed - health, education, information ... - and fundamental values such as peace, democracy, rights and equality are shared. The Manifesto is not a revolutionary document: it was written having in mind both the Italian Constitution and the Declaration of Human Rights, which date back to more than sixty years ago, when the world was coming out of two wars that had subverted each and every principle and human ideal. EMERGENCY felt the urge to put these words back at the centre of public discussion so that basic rights of all do not become privileges of a few. The Manifesto was written tracing EMERGENCYs history: from its very first mission, in Rwanda, to the Outpatient clinic in Marghera, EMERGENCY has given assistance to anyone in need because we have always believed in peace, democracy, rights and equality as the only possible forms of coexistence between human beings.

2011 - It can only be abolished, against the war in Libya

In February 2011, the international community and, subsequently, Italy, declared war against Libya. EMERGENCY sided once again against the war: to strike a dictator, whod been sustained by many western governments until just a few months before, it was decided to attack a whole country and infringe the Italian Constitution. EMERGENCY promoted an appeal inspired by the famous words of Einstein: War cant be humanised. It can only be abolished. Within a few days, the appeal had been undersigned by more than 50,000 people. Amongst the first of these were Gino Strada, Carlo Rubbia, Renzo Piano. The peak of the mobilisation was on 2nd April in Piazza Navona, in Rome. A few days later, EMERGENCY sent a war surgery team to Misurata, the city most badly hit by the war. Once again the statesmen have chosen the way of war. Gaddafi has chosen the war against his own citizens and the immigrants that are crossing through Libya. And our country has chosen the war against Gaddafi: its presented to us, yet again, as humanitarian, inevitable, necessary. No war can be humanitarian. War has always been the destruction of fragments of humanity, the killing of our fellow men. Every humanitarian war is actually a crime against humanity. If we want to defend human rights, the only way is for all the parties to undertake to cease fire and stop the war, the violence and the repression. No war is inevitable. Wars only seem inevitable at a certain point when nothing has been done to avoid them. They seem inevitable to those who for years have ignored the infringement of rights, got rich by trafficking in arms, or denied peoples dignity and social justice. They appear inevitable to those whove prepared them. No war is necessary. War is always a choice, not a need. The preposterous choice to kill, that glorifies violence and spreads it, is what generates a culture of war. Here, then, is the problem which we present to you, stark and dreadful and inescapable: shall we put an end to the human race; or shall mankind renounce war? (from the Russell-Einstein Manifesto, 1955). For this utopia to become real, we must first of all learn to think in a different way, removing war from our cultural and political horizon. Together with all the citizens whore victims of war, violence and repression, who struggle for their rights and for democracy. War cant be humanised. It can only be abolished. Albert Einstein

2011 - The first issue of E the monthly magazine

In April 2011, the first issue of E EMERGENCYs new monthly magazine arrived in all the Italian newsagents. With the aid of photoreports, investigations, travel tales, interviews, stories and inserts, E brings to light small and big stories about an Italy and a world different from those described by the other media. With an unconventional look at school, work, health, environment, but also cinema, books, theatre and music, the magazine speaks about the world we want a world thats more open, more united, more fair. E is a further example of EMERGENCYs commitment to the promotion of values of peace and solidarity (as laid down in its statute), alongside the treatment of victims of war and poverty. Edited by Gianni Mura and Maso Notarianni, its permanent contributors include Gino Strada.

HUMANITARIAN PROGRAMMES

Afghanistan
In over 40 years, war in Afghanistan has led to one and a half million deaths, hundreds of thousands of people wounded and mutilated, more than four million refugees. The most recent war, begun in October 2001, continues to wound, kill and destroy. And the ground still contains the legacy of the previous wars: landmines and unexploded devices continue to maim children and adults, primarily civilians. Since 1999, EMERGENCY has built and managed a Surgical and Medical Centre and a Maternity Centre in the Panjshir Valley, a Surgical Centre in Kabul, and another one in Lashkar-gah (in Helmand province). EMERGENCY also runs a medical assistance programme for the inmates of the countrys largest prisons, and has set up a network of 30 First Aid Posts and Health Centres. Four First Aid Posts were opened during 2011: two in Helmand province, one in Logar province, and one in Wardak province. In 2011, Afghanistan became part of EMERGENCYs Paediatrics and Cardiac Surgery Programme. International cardiologists selected the heart patients who were to be operated on at the Salam Centre for Cardiac Surgery in Khartoum. EMERGENCY looked after the journey of the patients and their relatives to Sudan, and their stay there until the end of the convalescence. 211 cardiology examinations have so far taken place at the EMERGENCY hospitals in Afghanistan.

Since 1999, EMERGENCY has treated 3,188,325 people in Afghanistan.

Uzbekistan Tajikistan Turkmenistan

China

Anabah Kabul

AFGHANISTAN
Lashkar-gah Iran Pakistan

EMERGENCY - Activity Report 2011

Anabah, Panjshir Valley

Surgical and Medical Centre

In 1999 EMERGENCYs intervention began in the Panjshir Valley, in northern Afghanistan. A former military compound in the village of Anabah was renovated and turned into a Surgical Centre for War Victims. In order to meet the needs of the local population, the Centre progressively expanded its activities to include emergency surgery, general surgery, trauma care, internal medicine and paediatrics. A programme for the surgical and medical treatment of the most prevalent ophthalmic diseases is also active within the Centre, where periodical missions of international specialized staff are organized. An ambulance service connects the Surgical and Medical Centre in Anabah to a network of 17 First Aid Posts and Health Centres, opened by EMERGENCY in the Panjshir Valley and in the neighbouring provinces of Kapisa, Parwan and Badakhshan and on the Salang pass.

Opened: December 1999 Activities: Surgery for war and landmine victims Emergency Surgery General Surgery Trauma Surgery Internal Medicine Paediatrics Facilities: Emergency Department, Outpatient Department, 2 Operating Theatres, Sterilization Room, Intensive Care Unit, Surgical-Medical Wards, Physiotherapy, Radiology, Laboratory and Blood Bank, Pharmacy, Classrooms, Playroom, Auxiliary Facilities, Maintenance Department. Number of beds: 56 Local staff: 214 As of December 31, 2011 Admissions: 26,267 Outpatient consultations: 172,396 Surgical operations: 17,181

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Anabah, Panjshir Valley

Maternity Centre
In 2003 EMERGENCY opened a Maternity Centre in Anabah to provide antenatal, gynaecological, obstetric and neonatal care to the population of the Valley and the surrounding provinces. More than 300 babies are born every month at EMERGENCYs Maternity Centre, which is the only specialized and free facility in the area. EMERGENCY has also activated a prenatal care programme for women living in remote areas, who are assisted through the network of EMERGENCYs First Aid Posts and Health Centres spread over the Panjshir Valley and the surrounding provinces. International and national midwives carry out periodical monitoring missions of pregnancies. Patients who need further checkups are referred to the Maternity Centre by EMERGENCYs ambulances. The staff working in the Maternity Centre are entirely female. The international personnel also look after the training of local midwives, with classroom and practical lessons. The summer of 2011 saw the beginning of a four-year specialisation course for gynaecologists at the Maternity Centre, recognised by the Afghan Ministry of Health.

Opened: June 2003 Activities: Obstetrics Gynaecology Neonatology Facilities: Emergency Department, Outpatient Department, 1 Operating Theatre, Intensive Care Unit, Wards, Nursery, Ultrasound Room, Delivery Room, Diagnostics. Technical and Auxiliary Facilities shared with the Surgical and Medical Centre. Number of beds: 39 Local staff: 44 As of December 31, 2011 Admissions: 21,051 Outpatient consultations: 82,090 Surgical operations: 4,573 Babies born: 14,080

EMERGENCY - Activity Report 2011

Kabul

Surgical Centre for War Victims

EMERGENCY started working in Kabul in 2000, renovating and expanding a former nursery school in the centre of the capital. The structure, which had previously been hit by a rocket that killed five children, was then turned into a Surgical Centre for war victims, and started its clinical activities in April 2001. In August 2003, a 6-bed intensive care unit was set up. In 2005, a device for computerized tomography (CT) was installed; it is still the only free one in Afghanistan. Since July 2010 the admission criteria have been restricted to war surgery only, in order to meet the needs of the increased number of injured patients. In August 2011 the Centre registered the highest number of war victims admitted since the opening. The Kabul Surgical Centre is linked to 10 of EMERGENCYs First Aid Posts and Health Centres in the provinces of Kabul, Parwan, Logar, Ghazni and Wardak.

Opened: April 2001 Activities: Surgery for war and landmine victims Facilities: Emergency Department, Outpatient Department, 2 Operating Theatres, Sterilization, Intensive Care Unit, Sub-intensive Care Unit, Surgical Wards, Physiotherapy, CT Scan, Radiology, Laboratory and Blood Bank, Pharmacy, Classrooms, Playroom, Auxiliary Facilities, Maintenance Department. Number of beds: 95 Local staff: 252 As of December 31, 2011 Admissions: 25,268 Outpatient consultations: 76,928 Surgical operations: 31,167

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Lashkar-gah

Surgical Centre for War Victims

In 2004, EMERGENCY opened a Surgical Centre for war victims in Lashkar-gah. The Centre is the only free, specialised one in an area Helmand province which in recent years has been at the heart of the Afghan conflict. The fighting between the Afghan army and the Taliban, the bombing by the allied forces, the kamikaze attacks and the landmines all continue to be a constant threat for those who live in this region. In 2011, 6 out of 10 patients at the Lashkar-gah hospital were war victims, and 1 in 3 was a child. The Lashkar-gah Surgical Centre has a 24/7 ambulance service link with EMERGENCYs First Aid Posts in the villages of Grishk, Sangin and Gamsir.

Opened: September 2004 Activities: Surgery for war and landmine victims Trauma Surgery Facilities: Emergency Department, Outpatient Department, 2 Operating Theatres, Intensive Care Unit, Surgical Wards, Physiotherapy, Radiology, Laboratory and Blood Bank, Pharmacy, Classrooms, Playroom, Auxiliary Facilities, Maintenance Department. Number of beds: 70 Local staff: 215 As of December 31, 2011 Admissions: 13,935 Outpatient consultations: 71,786 Surgical operations: 16,925
EMERGENCY - Activity Report 2011

First Aid Posts (FAPs) and Primary Health Clinics

Since 1999, EMERGENCY established a network of 30 First Aid Posts (FAPs) and Primary Health Clinics in Afghanistan, in order to provide prompt treatment also to the population of the most remote areas or to zones lacking healthcare facilities, such as the Panjshir Valley and the Salang pass, together with some areas around Kabul and in the provinces of Kapisa, Logar, Ghazni, Wardak, Parwan, Badakhshan and Helmand. In 2011 four First Aid Posts were opened: two in Helmand province, one in Logar province, one in Wardak province. The local staff trained by EMERGENCY provides basic healthcare, first aid and the referral of patients in serious conditions to EMERGENCYs hospitals by an ambulance service available 24/7.
Number: 30 Locations: Anabah, Abdara, Ahangaran, Anjuman, Changaram, Dara, Darband, Dasht-e-Rewat, Gulbahar, Kapisa, Khinch, Koklamy, Oraty, Paryan, Rokha, Sangi Khan, Shutul, Mirbachakot, Said Khil, Poli Sayad, Maydan Shahr, Ghazni, Azra, Chark, Grishk, Sangin, Garmsir. EMERGENCY also offers health care at the Juvenile Rehabilitation Centre and the Tahi Mashkan orphanage in Kabul. Local staff: 217 As of December 31, 2011 Outpatient consultations: 2,273,253 Patients referred to EMERGENCYs hospitals: 31,430

Prison Programme
Since 2000, EMERGENCY has been running a programme of medical assistance to prisoners by setting up outpatient clinics within prisons. EMERGENCYs nurses provide basic medical treatment and guarantee the referral of surgical cases to the hospitals of the NGO.
Duab Prison: 694 patients examined and treated from 2001 to 2003 Shebergan Prison: 13,338 patients examined and treated from May 2002 to June 2004 Lashkar-gah Prison: 1,880 patients examined and treated from February 2006 to December 2007 Prisons in Kabul (Governmental Jail, Investigation Department, Pol-e-Charki): 363,718 patients examined and treated as of December 2011 Local staff: 28

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Cambodia
In 1998 EMERGENCY built a Surgical Centre addressing the victims of war and landmines in Battambang, one of the most heavily mined areas of the country. Through the years, the hospital was turned into a Surgical and Trauma Centre. In the Samlot district, EMERGENCY opened five First Aid Posts in order to provide emergency treatment and basic healthcare in a heavily mined area with no other healthcare facilities. Management of the FAPs was definitively handed over to the local government in 2009. In view of the improvement in the general conditions of the country and the level of autonomy acquired by local staff, in 2011 EMERGENCY began to pave the way for the gradual handover of the hospital management to the Cambodian Ministry of Health. Since 1998, EMERGENCY has treated 390,008 people in Cambodia.

Thailand

Laos

Battambang

CAMBODIA
Phnom Penh Vietnam

Gulf of Thailand

EMERGENCY - Activity Report 2011

Battambang

Surgical Centre
The Surgical Centre in Battambang was opened in 1998 to provide surgical assistance to war and landmine victims. Through the years, the activities of the Centre have been expanded to include emergency and trauma surgery, as well as plastic and reconstructive surgery for the correction of congenital malformations and of the effects of polio. The Centre also hosts specialized periodical missions for the medical and surgical treatment of ophthalmic diseases. EMERGENCYs international staff is also engaged in the professional training of local personnel, including specific workshops for physiotherapists, nurses and anaesthetists.

Opened: July 1998 Activities: Surgery for war and landmine victims Emergency Surgery Trauma Surgery Facilities: Emergency Department, Outpatient Department, 3 Operating Theatres, Sterilization Room, Intensive Care Unit, Surgical Wards, Physiotherapy, Radiology, Laboratory and Blood Bank, Pharmacy, Classrooms, Playroom, Auxiliary Facilities, Maintenance Department. Number of beds: 109 Local staff: 185 As of December 31, 2011 Admissions: 29,225 Outpatient consultations: 111,749 Surgical operations: 32,806

21

Iraq
The Iraqi Kurdistan is infested with millions of landmines, many of which were manufactured in Italy. In order to bring assistance to landmine victims, in 1995 EMERGENCY restored and reactivated the hospital of Choman, a village in Iraqi Kurdistan on the Iranian border. In 1996 and 1998 EMERGENCY opened two Surgical Centres for war victims in Sulaimaniya and Erbil, two cities which were under the control of opposing factions at the time. Both Centres were expanded later on, to include specialized units for the treatment of burn and spinal injuries. EMERGENCY also opened 22 First Aid Posts to guarantee prompt assistance to the injured and to refer them to the hospitals when indicated. In 2005, EMERGENCY entrusted the local authorities with the management and running of the two Surgical Centres and of the network of First Aid Posts, now integrated into the national health system. In 1998, EMERGENCY opened a Rehabilitation and Social Reintegration Centre in Sulaimaniya. Since 1995, EMERGENCY has treated 390,103 people in Iraq.

Turkey

Syria

Sulaimaniya

IRAQ
Baghdad Jordan

Iran

Saudi Arabia

Kuwait

EMERGENCY - Activity Report 2011

Sulaimaniya

Rehabilitation and Social Reintegration Centre

In 1998, EMERGENCY opened a Rehabilitation and Social Reintegration Centre in Sulaimaniya, specialized in physiotherapy and in the production of prostheses, orthoses and walking aids / orthopaedic devices for disabled and amputee patients. A project to address and correct architectural barriers is in place to assist the homecoming of patients. The Centre offers professional training courses in metal work, carpentry, tailoring, leather-work and shoe-making to encourage the occupational reintegration of former patients. At the end of the courses, EMERGENCY guarantees financial and management assistance for the setting up of small business co-operatives and artisan workshops. By December 2011, 275 co-operatives had been established. The Centre is the only free, specialised facility of its kind in the area and has become a point of reference for the whole of Iraq. At the request of the local authorities, EMERGENCYs cardiologists came to the centre again in 2011 to screen heart patients who were then transferred free of charge to the Salam Centre for Cardiac Surgery in Sudan. The Rehabilitation Centre guarantees a follow-up for patients after their operations.
Opened: February 1998 Activities: Physical Rehabilitation Prostheses and Orthoses Production Cardiac screening and follow-up Facilities: Patient Wards, Physiotherapy, Indoor Swimming Pool, Orthopaedic and Prosthetic Workshops, Auxiliary Facilities. Number of beds: 41 Local staff: 86 As of December 31, 2011 Admissions: 6,174 Sessions of Physiotherapy: 39,859 Upper Limb Prostheses: 804 Lower Limb Prostheses: 5,821 Orthoses: 774 Trainee class graduates: 459 Cooperatives set up: 275 Cardiological examinations: 385

23

Italy
The right to medical care is recognized by law in Italy, and it is actually often denied to immigrants, foreigners, poor people who do not have access to treatment because of their scarce knowledge of their rights, as well as the linguistic barriers and the difficulty in finding their way within a complex health system. In a climate of widespread fear and growing racism, migrants often do not turn to public facilities as they are afraid of being reported to the police or the authorities. For these reasons EMERGENCY began to work in Italy, operating within prisons (2005-2007), treating immigrants, and situations of social distress. In 2006 EMERGENCY opened an Outpatient Clinic in Palermo, Sicily, to guarantee free healthcare to migrants with or without residence permits and to any person in need. In December 2010 EMERGENCY opened a second Outpatient Clinic in Marghera, near Venice. In 2011, two buses turned into mobile clinics brought assistance directly where it is needed. Other than a few professionals needed to guarantee continuity and smooth running of the Clinics, the staff are unpaid professional volunteers.

Valle dAosta

Switzerland Marghera

Austria Slovenia

Hungary Croazia Bosnia and Herzegovina

Piemonte Liguria

Serbia Montenegro Kosovo

ITALY
Rome Adriatic Sea

Macedonia Albania Greece

Sardeg

Tyrrhenian Sea

Palermo Mediterranean Sea

EMERGENCY - Activity Report 2011

Ionian Sea

Palermo

Outpatient Clinic
In April 2006 EMERGENCY opened an Outpatient Clinic in Palermo, Sicily, to guarantee free healthcare to migrants, with or without residence permit. The clinic is open to anyone in need. Other than a few professionals that are necessary to organize and give continuity to the services, both the medical and non medical staff of the Outpatient Clinic are unpaid professional volunteers. The Outpatient Clinic guarantees the presence of cultural mediators, who support the patients in the administrative procedures for the issuing of the Stp code (Straniero Temporaneamente Presente, which stands for temporarily present foreign citizen, which guarantees access to the public health service to undocumented foreigners). Cultural mediators also assist patients needing examinations or tests within public health facilities. The project has been realized in cooperation with the health authorities of Palermo, who took care of the renovation of the facility and assigned it to EMERGENCY. All services provided at EMERGENCYs Outpatient Clinic in Palermo are free of charge.

Opened: April 2006 Activities: Basic healthcare Cardiology Dentistry Dermatology Infectious diseases Obstetrics and gynaecology Otorhinolaryngology Paediatrics Psychiatrics and psychology Senology Social-medical assistance and counselling

Facilities: 5 Outpatient departments, Waiting room, Offices and Auxiliary services. Employees: 7 Volunteer staff: 73 (68 medical, 5 non-medical staff) As of December 31, 2011 Outpatient consultations: 51,919

25

Marghera

Outpatient Clinic
EMERGENCY opened an Outpatient Clinic in Marghera on December 2010 to offer primary and specialized care to migrants and to people in need. Other than a few staff members that are necessary to organize and give continuity to the services, both the medical and non medical staff of the outpatient clinic are unpaid professional volunteers. Cultural mediators assist patients who need support in approaching public facilities for medical treatment: the Outpatient Clinic aims at cooperating and integrating its services with the ones provided by the National Health Service. All services provided at the EMERGENCYs Outpatient Clinic in Marghera are free of charge.

Opened: December 2010 Activities: Basic healthcare Cardiology Dentistry Obstetrics and gynaecology Ophthalmology Social-medical assistance and counselling Facilities: 6 Outpatient departments, Waiting room, Consulting room, Offices and Auxiliary services. Employees: 6 Volunteer staff: 87 (80 medical, 7 non-medical) As of December 31, 2011 Outpatient consultations: 5,171
EMERGENCY - Activity Report 2011

Mobile Clinics
In 2010, two buses were equipped as mobile clinics to bring assistance wherever its needed. The EMERGENCY doctors provide free medical treatment in Gypsy camps, agricultural areas and refugee camps. Cultural-linguistic mediators assist those requiring the services of the public health facilities for specialist medical examinations. Most of the immigrants turn to EMERGENCY for problems linked to their extremely hard living and working conditions: musculo-skeletal pain, gastrointestinal infections and respiratory infections. Each bus contains two consulting rooms, plus a room set aside for meetings with the cultural-linguistic mediators. In 2011, EMERGENCYs mobile clinics worked in the southern Italian regions of Apulia, Sicily, Calabria and Basilicata, bringing assistance to temporary farm labourers in particular.

Opened: April 2011 Places of intervention: provinces of Foggia and Lecce, province of Potenza, province of Reggio Calabria, provinces of Ragusa and Syracuse. Activities: General medicine Social-medical assistance and counselling Facilities: 2 Consulting rooms, Consulting room for cultural mediators, Waiting room and auxiliary services. Employees: 10 As of December 31, 2011 Outpatient consultations: 2,471

27

Sierra Leone
In 2001, EMERGENCY opened a Surgical Centre in Goderich, on the outskirts of Freetown, the countrys capital. The Centre provides free high quality treatment in orthopaedics, trauma and emergency surgery. In 2002, EMERGENCY opened a Paediatric Centre next to the Surgical Centre in order to guarantee treatment to children under 14. The child mortality rate in Sierra Leone is one of the highest in the world: malaria, malnutrition, respiratory and gastrointestinal infections are the main causes of death among children up to 5 years of age. The International staff is also committed to training local personnel: EMERGENCYs Surgical Centre has been recognized as a training institution for anaesthetist nurses by the Ministry of Health of Sierra Leone. Construction in order to expand the Surgical Centre in Goderich started in October 2010 in order to meet the needs of an increasing population.

This hospital is also part of the Regional Programme for Paediatrics and Cardiac Surgery: the EMERGENCY cardiologists regularly carry out screening sessions to identify patients needing to be operated at the Salam Centre for Cardiac Surgery in Khartoum, Sudan, and subsequently perform all the necessary post-op checks.
Since 2001, EMERGENCY has treated 373,657 people in Sierra Leone.

Guinea

SIERRA LEONE
Freetown Goderich

Gulf of Guinea

Liberia

EMERGENCY - Activity Report 2011

Goderich

Surgical Centre
EMERGENCYs Surgical Centre is located in Goderich, on the outskirts of Freetown, the countrys capital, which is populated by one and a half million inhabitants, 50% of whom are under 15 years of age. Admission criteria include emergency surgery, especially abdominal, trauma surgery and elective surgery for the treatment of congenital or acquired malformations, such as club foot or conseguences of poliomyelitis. The hospital also offers a programme for the treatment of oesophageal burns caused by accidental ingestion of lye by children. It is a very common phenomenon among children in a country where lye is widely used for the home-making of soap. Work continued throughout 2011 on the expanding the new Surgical Centre with operating theatres, wards and guesthouse for the relatives of patients arriving from the more distant provinces. Once again in 2011, the EMERGENCY cardiologists carried out screening sessions to identify the patients who would undergo operations at the Salam Centre for Cardiac Surgery in Khartoum, in Sudan, and they also provided all the post-op follow-ups needed.

Opened: November 2001 Activities: Emergency and General Surgery Orthopaedic and Reconstructive Surgery Trauma Surgery Cardiac Screening and Follow-up Facilities: Emergency Department, Outpatient Department, 2 Operating Theatres, Sterilization, Intensive Care Unit, Patient Wards, Physiotherapy, Radiology, Laboratory and Blood Bank, Pharmacy, Classrooms, Playroom, Auxiliary Facilities. Number of beds: 85 Local staff: 257 As of December 31, 2011 Admissions: 23,535 Outpatient consultations: 212,605 Surgical operations: 23,981 Cardiological examinations: 495

29

Goderich

Paediatric Centre
In 2002 the Goderich Surgical Centre was extended to include a paediatric clinic. Two new wards were opened in 2003, one of them entirely for paediatric patients. The Centres main work includes the programme to prevent and treat malnutrition: as well as treating the children, EMERGENCYs staff also teach mothers the basic principles of good nourishment and hygiene. At least 50 children are examined every day at the Paediatric Centre. Malnutrition, malaria, gastrointestinal infections and respiratory infections are the most common problems.

Opened: April 2002 Activities: Paediatrics Facilities: 2 Outpatient Departments, Medical Ward, Waiting Area, Technical and Auxiliary Facilities shared with the Goderich Surgical Centre. Number of beds: 14 Local staff: 56 As of December 31, 2011 Admissions: 10,291 Outpatient consultations: 126,731
EMERGENCY - Activity Report 2011

EMERGENCY IN AFRICA:
THE REGIONAL PROGRAMME FOR PAEDIATRICS AND CARDIAC SURGERY
In 2007, EMERGENCY opened the Salam Centre for Cardiac Surgery in Khartoum, Sudan. This is the only free and specialized facility in the whole African continent. The Salam Centre is the hub of the Programme for Paediatrics and Cardiac surgery that EMERGENCY is implementing in Africa. EMERGENCYs Paediatric Centres provide free high quality medical treatment to children up to 14 years of age. These Centres are equipped with a cardiologic outpatient unit where our international cardiologists carry out the screening of children and adults suffering from heart diseases to be referred to the Salam Centre for surgery. In March 2009, the first Paediatric Centre of the Regional Network for Paediatrics and Cardiac surgery was inaugurated in Bangui, the capital of the Central African Republic. The second Paediatric Centre was opened in Nyala, South Darfur, in July 2010 and the third was opened in Port Sudan, Red Sea State, in December 2011. In areas where EMERGENCY does not have its own facilities, our cardiologists carry out screening missions in local hospitals, in collaboration with the health authorities of the host countries. In little less than five years, the staff of the Centre has operated on patients from 24 countries: Afghanistan, Burkina Faso, Burundi, Central African Republic, Chad, Democratic Republic of Congo, Djibouti, Eritrea, Ethiopia, Jordan, Iraq, Italy, Kenya, Nigeria, Rwanda, Senegal, Sierra Leone, Somalia, Sudan, South Sudan, Tanzania, Uganda, Zambia, Zimbabwe. MANIFESTO FOR A HUMAN RIGHTS BASED MEDICINE The Salam Centre for Cardiac Surgery in Khartoum is a truly innovative model of humanitarian intervention. The aim of the project is to bring healthcare of excellence to Africa as well, putting into practice the belief in the unquestionable right of every human being to receive free high quality medical treatment. On the strength of the results achieved by the Salam Centre, in May 2008 EMERGENCY gathered the delegations of the Ministries of Health of eight African countries for the international workshop Building Medicine in Africa. Principles and Strategies, hosted on San Servolo Island, Venice, Italy. EMERGENCY and the representatives of the Central African Republic, the Democratic Republic of Congo, Egypt, Eritrea, Rwanda, Sierra Leone, Sudan and Uganda discussed on how to ensure the right to free high quality healthcare to African citizens. The conclusions of the workshop were formalized in the document Manifesto for a Human Rights Based Medicine in which the signatories recognize the right to be treated as a basic and inalienable right belonging to each and every member of the human community and ask for a health system based on equality, quality and social responsibility.

Lebanon

Syria Iraq
Jordan Kuwait

Afghanistan

Morocco

Tunisia

Israel

Libya Algeria

Egypt Saudi Arabia

United Arab Emirates

Oman Mauritania Mali The Gambia Senegal Guinea Sierra Leone Liberia
Cte dIvoire Burkina Faso

Niger Chad
DARFUR

SUDAN

Eritrea

Yemen Djibouti

Nigeria
Ghana Central African Republic Cameroon Equatorial Guinea Gabon Congo Democratic Republic of Congo
Rwanda Burundi

Somalia South Sudan Ethiopia

Togo Benin

Uganda

Kenya

Tanzania

Angola
Zambia

Malawi

Mozambique

Zimbabwe

Madagascar

Namibia

Home countries of the patients of the Salam Centre EMERGENCY is present with health facilities

Botswana Swaziland Lesotho South Africa

31

On the sixtieth anniversary of the Universal Declaration of Human Rights Manifesto for a Human Rights Based Medicine After the International Workshop Building Medicine in Africa. Principles and Strategies hosted at San Servolo Island, Venice, Italy, on May 14 -15, 2008 and in accordance with the spirit and the principles of the Universal Declaration of Human Rights, stating that All human beings are born free and equal in dignity and rights ( art.1 ) Everyone has the rightto medical care ( art.25 ) The recognition of the inherent dignity and of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world ( Preamble ) WE HEREBY DECLARE the Right to be Treated as a basic and inalienable right belonging to each and every member of the human community. WE THEREFORE ADVOCATE the implementation of health systems and projects solely devoted to preserve, extend and improve the life of the people in need and based on the following principles: Equality Every human being has the right to be cured regardless his economic and social condition, gender, race, language, religion and opinions. Standards of health care, set by the progress of medical knowledge, must be delivered equally and without discrimination to all patients. Quality High quality health systems must be based on communitys needs, up to date with the achievements of medical science, and not oriented, shaped or determined by lobbies and corporations involved in the health industry. Social Responsibility Governments must have the health and well being of their citizens as their priority, and allocate adequate human and financial resources. The services provided by health systems and humanitarian projects in the health sector must be accessible to and free of charge for all. As Health Authorities and Humanitarian Organizations WE RECOGNIZE EQS (Equality, Quality, Social responsibility) based health systems and projects as respectful of human rights, appropriate to develop medical science and effective in promoting health by strengthening and generating human, scientific and material resources. WE COMMIT To plan and develop EQS based policies, health systems and projects. To cooperate among us to identify common needs in the health sector and design joint programmes. WE APPEAL To other Health Authorities and Humanitarian Organisations to sign this Manifesto and to join in promoting an EQS based medicine. To donors and to the international aid community to support, fund and participate in designing and implementing EQS based programmes.

THE AFRICAN NETWORK OF MEDICAL EXCELLENCE - ANME

In 2009, on the Island of San Servolo, the ANME (African Network of Medical Excellence) was born. The aim of the ANME is to promote the construction of medical centres of excellence on the African continent, following the model of the Salam Centre for Cardiac Surgery. Absence of charge and excellence of treatment are the foundations of the model of healthcare that the members of the ANME intend to build within their countries. Absence of charge is a fundamental prerequisite so that everyone can have prompt access to the treatment they need. Excellence guarantees high clinical standards of each intervention and promotes the training of qualified medical personnel, together with the development of scientific research and local health systems. In February 2010 EMERGENCY and the Federal Ministry of Health of Sudan organized a Regional Meeting of the representatives of the countries composing the ANME in Khartoum. On that occasion they launched a joint appeal to the international community: We, Ministers of Health and representatives of the Health Authorities of: Central African Republic, Chad, Democratic Republic of Congo, Djibouti, Egypt, Eritrea, Ethiopia, Rwanda, Somalia, Sudan, Uganda, attending the first Annual Conference of the African Network of Medical Excellence, jointly organized in Khartoum, Sudan, by the National Ministry of Health of Sudan and the international NGO EMERGENCY,

Acknowledging the urgent need of establishing centres of excellence in Africa to provide high standards of medical treatment through secondary and tertiary facilities, thus strengthening disease prevention and primary health care delivery; Considering the Salam Centre for Cardiac Surgery, established by EMERGENCY in cooperation with MOH of Sudan in Khartoum, as a replicable model in all our countries to provide qualified care to our citizens and proper training to medical and non medical professionals; We commit to improve regional cooperation by establishing the African Network of Medical Excellence (ANME) in different medical specialities in order to strengthen our Health Systems at national and regional level. We jointly appeal to the international donors community to support us and contribute to the successful implementation of this innovative multi-disciplinary project by providing human and financial resources.
Thursday, February 11, 2010 - Khartoum, Sudan On behalf of the Ministries of Health of: Central African Republic H.E. Nalke Dorogo Andr, Chad H.E. Hissein Djidda Khours, Democratic Republic of Congo Dr. Lokadi Opeda Pierre, Djibouti H.E. Abdallah Abdillahi Miguil, Egypt Dr. Mamdouh Ali Mohammed, Eritrea Dr. Ghirmay Tesfasellasie, Ethiopia H.E. Kebede Worku, Somalia H.E. Mohammed Haga, Sudan H.E. Tabita Botros Shokai, South Sudan Dr. Majok Yak Majok, Uganda H.E. Stephen O. Malinga. In October 2010, the third workshop of the series Building Medicine in Africa was held on the Island of San Servolo, where the implementing strategies for the development of the project were defined.

Reaffirming the principle that health care is a basic right of every individual, as stated in the Universal Declaration of Human Rights; Recalling the principles of Equality, Quality and Social responsibility stated in the Manifesto for a Human Rights Based Medicine, calling for the delivery of high quality and free of charge health care for all;

Sudan
In 2004 EMERGENCY intervened in Sudan to support the hospitals in Mellit and Al Fashir, in Northern Darfur, by renovating and equipping the emergency surgical block and ward. In 2005 EMERGENCY opened a Paediatric Centre in Mayo Internally Displaced People (IDP) camp, a few kilometres from the capital Khartoum. The Centre provides free of charge primary healthcare to children up to 14 years of age. In the same year, again nearby the capital, EMERGENCY started to build a Centre for Cardiac Surgery in order to provide highly specialized free medical and surgical assistance to patients from Sudan and its neighbouring countries. The Salam Centre for cardiac surgery started its activities in 2007. It is linked to a network of Paediatric Centres where EMERGENCYs international cardiologists carry out the screening and follow-up of children and adult heart patients that are transferred to Khartoum for surgery. The staff of the Centre has operated patients from 24 countries. In July 2010 EMERGENCY opened in Nyala, Darfur, its second Paediatric Centre in the country. A third Paediatric Centre was opened in Port Sudan, Red Sea State, in December 2011. Since 2007, EMERGENCY has treated 201,161 people in Sudan.

Egypt Libya Port Sudan Chad Khartoum Mayo Eritrea

DARFUR

Nyala

SUDAN
Ethiopia South Sudan

Central African Republic

Democratic Repubblic of Congo

Uganda Kenya

33

Khartoum

The Salam Centre for Cardiac Surgery

The Salam Centre for Cardiac Surgery, opened by EMERGENCY in Khartoum, provides free high standard surgical care to children and adults suffering from acquired or congenital heart diseases. Valvular diseases of rheumatic origin have a particular prominence; their development is often related to poverty and lack of basic healthcare. The incidence of these diseases is particularly high among young people. 61% of patients admitted to the Salam Centre are under the age of 26. The Salam Centre is the only Centre of excellence providing completely free cardiac surgery in Africa. The Centre was meant to respond to the needs of Sudan and its neighbouring countries, but in more than four years of activity it has already treated patients from 24 countries. EMERGENCY has built a guesthouse within the compound in order to facilitate access to services by providing free accommodations to foreign patients. Opened: April 2007 Activities: Paediatric Cardiac Surgery Adult Cardiac Surgery Interventional Cardiology Facilities: 3 Operating Theatres, Sterilization, 15 beds Intensive Care Unit, Sub-intensive Care Unit, 3 Surgical Wards, Outpatient Department, Catheterization Laboratory, Radiology, Ultra Sound, TC, Laboratory and Blood Bank, Physiotherapy, Pharmacy, Technical and Auxiliary Facilities, Guesthouse for foreign patients. Number of beds: 63 Local staff: 312 As of December 31, 2011 Admissions: 4,894 Outpatient consultations: 36,359 Cardiological examinations: 28,092 Surgical interventions: 4,167 Cath Lab diagnostic and surgical procedures: 1,031 Home countries of patients (except Sudan): Afghanistan (21), Burkina Faso (2), Burundi (10), Central African Republic (73), Chad (26), Democratic Republic of Congo (30), Djibouti (16), Eritrea (114), Ethiopia (128), Jordan (1), Iraq (71), Italy (2), Kenya (46), Nigeria (35), Rwanda (7), Senegal (2), Sierra Leone (46), Somalia (39), South Sudan (84), Tanzania (4), Uganda (30), Zambia (8), Zimbabwe (4).

EMERGENCY - Activity Report 2011

Mayo, Khartoum

Paediatric Centre
In 2005 EMERGENCY opened a Paediatric Centre to provide primary healthcare to children in the IDP (Internally Displaced People) camp of Mayo, near Khartoum. There are no other free health facilities in the camp, which hosts about 250,000 people. The Centre has a 6-bed paediatric ward for daily observation; an ambulance ensures immediate referral of urgent cases to city hospitals. Local doctors and nurses work side by side with an international paediatrician and nurses. A midwife provides antenatal care to the pregnant women 5 days a week. In collaboration with the Ministry of Health a vaccination programme is held at the Centre. Six community health promoters go around the camp on their bikes to find sick children, to give hygiene advice to the patients families and to check up on the proper use of the prescribed therapies. The outreach programme started in 2010 is still ongoing in different areas of the IDP camp: the staff of the Paediatric Centre organizes health education sessions, screening for malnutrition and antenatal care for pregnant women, as well as vaccination programmes in collaboration with the local Ministry of Health. 50 children are examined every day by nurses and doctors in the Paediatric Centre in Mayo.

The Paediatric Centre of Mayo is co-financed by European Union

European Union

Opened: December 2005 Activities: Paediatrics Facilities: 2 Outpatient Departments, Patient Observation Ward, Pharmacy, Laboratory, Auxiliary Services, Reception, Outdoors play area. Number of beds: 6 (day hospital) Local staff: 34 As of December 31, 2011 Patients admitted for observation: 5,295 Outpatient consultations: 111,709 Patients referred to hospital: 2,930 Recipients of the prevention programme: 12,540

35

Nyala

Paediatric Centre
Nyala, capital of South Darfur, is home to more than one and a half million people mainly refugees whove fled from the war and are living in camps on the outskirts of the city. In July 2010, EMERGENCY opened a Paediatric Centre offering healthcare to children up to the age of 14. The facility is open 24/7 and has an 18-bed ward for the hospitalisation of the most serious cases. On 14th August 2011, the logistician working in the Nyala Centre was kidnapped by a gang of armed men. The work of the Centre was subsequently suspended as basic safety conditions for personnel could no longer be guaranteed. EMERGENCY staff worked unceasingly for 4 months in Nyala and Khartoum for the release of their colleague, with the full support of the Sudan authorities. The logistician was finally released on 16th December 2011.

Opened: July 2010 Suspension of activities: September 2011 Activities: Paediatrics Paediatric First Aid Cardiac screening and follow-up Facilities: 2 Outpatient Departments, Cardiology Outpatient Department, Radiology, Laboratory, Pharmacy, Ward, Warehouse, Offices, Staff services, Reception and outdoors play area, Auxiliary Services. Number of beds: 18 Local staff: 86 As of December 31, 2011 Patients admitted: 1,458 Outpatient consultations: 29,530 Cardiological examinations: 368
EMERGENCY - Activity Report 2011

Port Sudan

Paediatric Centre
EMERGENCY opened its third Paediatric Centre in Sudan in the city of Port Sudan, capital of Red Sea State. The clinic opened its doors on 26th December 2011, offering free treatment to the children of Port Sudan and the surrounding area. Over the past 10 years, hundreds of thousands of refugees have come to the city, attempting to escape the numerous local conflicts and droughts in the countryside. The Centre has 3 outpatient departments, a 14-bed ward and a 4-bed sub-intensive care unit. The building of the Centre was supported by the contribution of the MAXXI 2per100 competition, set up by MAXXI (the National Museum of XXI Century Arts) in Rome.

Opened: December 2011 Activities: Paediatrics Paediatric First Aid Cardiac screening and follow-up Facilities: 2 Outpatient Departments, Cardiology outpatient department, Sub-intensive care unit, Ward, Radiology, Ultra sound, Warehouse, Offices, Pharmacy, Laboratory, Auxiliary Services, Reception, Outdoors play area. Number of beds: 18 Local staff: 85 As of December 31, 2011 Outpatient consultations: 211 Cardiological examinations: 46 The Centre started admissions in January 2012.

37

Central African Republic

The Central African Republic ranks 179st (out of 187 countries) on the Human Development Index compiled by the UNDP (United Nations Development Programme), with a life expectancy of only 48 years. Infant mortality rate is of 112 deaths every 1,000 live births. In March 2009 EMERGENCY opened a Paediatric Centre in the capital city Bangui in order to provide healthcare to children up to 14 years of age. The Centre also organizes activities of health promotion for families, focusing on the fundamentals of hygiene and nutrition that are essential for childrens health. An antenatal care programme was launched in 2011: an EMERGENCY midwife examines pregnant women, prescribes the necessary tests and offers advice about basic hygiene.

Since 2009, EMERGENCY has treated 57,326 children in the Central African Republic.

Sudan Nigeria Chad

Cameroon

Bangui

CENTRAL AFRICAN REPUBLIC

South Sudan

Democratic Republic of Congo Uganda

Congo

EMERGENCY - Activity Report 2011

Bangui

Paediatric Centre
EMERGENCYs Paediatric Centre is located in front of the Parliament of the Central African Republic, in a compound made available by local authorities. EMERGENCYs paediatricians and nurses provide free high quality outpatient services to children up to 14 years of age, while the most serious cases are admitted in the 8-bed inpatient ward. An antenatal assistance programme was launched in 2011: an EMERGENCY midwife examines pregnant women, prescribes the necessary tests and offers advice about basic hygiene. About 70 children and 20 pregnant women are examined every day by the staff of EMERGENCY. The Paediatric Centre of Bangui is part of the Regional programme for Paediatrics and Cardiac Surgery that EMERGENCY is promoting in Africa. The programme involves a network of facilities where our international cardiologists carry out the screening of children and adult heart patients for the Salam Centre for cardiac surgery in Sudan and provide the needed postoperative treatment to those who already underwent surgery.
Opened: March 2009 Activities: Paediatrics Paediatric Emergency Unit Cardiac screening and follow-up Antenatal care Facilities: 2 Paediatric Outpatient Departments, Cardiology Outpatient Department, Ultra Sound, Radiology, Laboratory, Pharmacy, Ward, Warehouse, Offices, External Waiting Area and Playground, Auxiliary Facilities. Number of beds: 8 Local staff: 77 As of December 31, 2011 Admissions: 2,973 Outpatient visits: 51,064 Antenatal care: 2,580 outpatient consultations Cardiological examinations: 709

39

COMPLETED PROGRAMMES
1994 - Renovation and reopening of the surgical department of Kigalis hospital, Rwanda. During a 4 month mission, a surgical team operated on 600 war victims. Within the same facility, EMERGENCY reopened the Ob-Gyn ward, which offered medical and surgical assistance to over 2,500 women. 1996/2005 - Building of a Surgical Centre in Sulaimaniya, Northern Iraq, to treat landmine victims. The facilities include a burn unit, and one for the treatment of spinal cord injuries. In 2005, the Centre and the network of 22 First Aid Posts were handed over to the local health authorities. 1998/2005 - Building of a Surgical Centre in Erbil, Northern Iraq, to treat landmine victims. The facilities include a burn unit and one for the treatment of spinal cord injuries. In 2005, the Centre was handed over to the local health authorities. 1999 - Supported the Jova Jovanovic Zmaj orphanage in Belgrade, Serbia. 1999/2003 - Establishment of 5 First Aid Posts (FAP) in Samlot district, Cambodia, to assist landmine victims. In 2003, the FAPs in ORotkroh, Chamlong Kouy, Tasanh and OChom were handed over to the local health authorities. 2000 - Upon request by the Italian Cooperation, a surgical team was sent to Eritrea. EMERGENCYs personnel worked for two months at the Mekane Hiwet hospital, in Asmara, treating victims of the conflict between Ethiopia and Eritrea. 2001 - Building of a Rehabilitation and Prosthetics Centre in Diana, North Iraq. The Centre was handed over to the local health authorities. 2001 - Establishment of a social programme to help war widows with the distribution of farming cattle to 400 families in the Panjshir Valley, Afghanistan. 2003 - Supply of pharmaceuticals, consumables and fuel for the generators
EMERGENCY - Activity Report 2011

to the Al-Kindi hospital in Baghdad and to the Karbala hospital, Iraq. 2003 - Established a Rehabilitation and Prostheses Centre in Medea, Algeria. EMERGENCY refurbished and equipped a building inside the local public hospital, undertaking the training of the local personnel, as well. The management of the Centre, called Amal (hope in Arabic) was handed over to the local health authorities in 2004. 2003 - Building of a Rehabilitation and Prosthetics Production Centre in Dohuk, Northern Iraq. The Centre is now run by local health authorities. 2003/04 - Established two Health Centres in the Benguela province, Angola. EMERGENCY equipped and managed the centres and trained the local staff for over a year before handing it over to a congregation of local nuns. 2003/04 - EMERGENCY sent a surgical team to work at the Orthopedic Unit of the Jenin public hospital, in Palestine. In addition to the supervision of clinical activities and training of the local medical staff, EMERGENCY opened a new physiotherapy unit and a new orthopaedic ward. 2003/04 - Supply of medicines to the Casa de la Mujer, a community network giving assistance to women affected by cancer and diabetes in Nicaragua.

Sudan. The facilities include a surgical block and a 20 bed ward. The unit was transferred to the Ministry of Health in August 2005. 2005 - EMERGENCY donated surgical equipment and consumables to the general hospital in Kalutara, Sri-Lanka, to enhance its clinical activities after the tsunami. 2005 - EMERGENCY completed the Back to the Sea project, which called for the distribution of engine-powered boats, canoes and fishing nets to the fishermen in the village of Punochchimunai, in Sri-Lanka. To further encourage the resumption of daily activities, school kits were donated to the students in the village. 2005/07 - EMERGENCY organised courses in hygiene, prevention and first aid for the inmates of the Rebibbia New Complex prison in Rome. In the same prison, EMERGENCY organized a TB screening. Furthermore, EMERGENCY guaranteed the assistance of medical specialists in other jails in the Lazio region, Italy. 2005/08 - EMERGENCY completed the construction of 91 brick houses for the families in the village of Punochchimunai, in Sri-Lanka, destroyed by the tsunami in 2004. The delivery of the houses could only be completed in September 2008, due to the resuming hostilities between government troops and local rebels, which halted all work for months.

2003/2007 - Opening of a workshop for the production of rugs aimed at promoting the economic independence of 2009 - Transfer of the management of women in the Panjshir Valley, Afghanistan. the First Aid Post of OTatiak, Cambodia to local health authorities. 2004 - EMERGENCY supported the population of Fallujah, in Iraq, during the 2011 - War surgery programme in Libya, siege of the city, in May. Relief items, in the under-siege city of Misurata (read water and medicines were distributed to the following page). representatives of the local community and to the local hospital. 2004/2005 - Renovation and equipment of the emergency surgery ward of the Al Fashir Teaching hospital, in North Darfur,

Libya
In April 2011, EMERGENCY sent a war surgery team to Misurata to offer health treatment to the people of the city, under siege for two months. Thousands of people were being injured as a result of the air raids, snipers and armed combat, but they had no chance of receiving adequate care because there were no personnel specialised in war surgery. EMERGENCY was the only western humanitarian organisation in the city at that time. The team had to leave the country on 25th April, when the hospital found itself at the heart of the fighting: even minimum safety conditions for the patients and humanitarian workers could no longer be guaranteed. A second team set off for Misurata on 12th May to offer medical assistance and set up a field hospital in the area of Zarroch, organising the facilities and training local staff in basic nursing care. The EMERGENCY team wound up its second mission to Misurata on 21st June 2011, after completing the programme agreed with the local health authorities.

Tyrrhenian Sea Italy Malta Tunisia

Ionian Sea

Greece

Turkey

Mediterranean Sea
Tripoli Misurata Benghazi

Algeria

LIBYA
Egypt

Niger

Chad

Sudan

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VOLUNTEERING
Volunteering is a fundamental and necessary component of EMERGENCYs work. Volunteers work to inform the general public and promote a culture of peace through participation in conferences, meetings and workshops. Volunteers are key to fundraising by hosting dedicated events and presenting projects to local donors both in the public and private sector. To become a volunteer and suport EMERGENCYs projects around the world, please contact us: EMERGENCY info@emergency.it EMERGENCY UK info@emergencyuk.org EMERGENCY USA info@emergencyusa.org EMERGENCY JAPAN info@emergency-japan.org EMERGENCY CH info@emergencych.org

EMERGENCY - Activity Report 2011

EMERGENCY
via Gerolamo Vida 11 - 20127, Milan ITALY T +39 02 863161 F +39 02 86316336 info@emergency.it - www.emergency.it via dellArco del Monte 99/A - 00186, Rome ITALY T +39 06 688151 F +39 06 68815230 roma@emergency.it - www.emergency.it

EMERGENCY USA
1016 Lincoln Blvd, Suite 211, San Francisco - CA 94129 T 1-888-501-3872 info@emergencyusa.org - www.emergencyusa.org

EMERGENCY UK
Can Mezzanine, 49-51 East Road, Old Street, N16AH London T +44(0)333 340 6411 / +44(0)207 250 8302 F +44 (0)333 340 6499 info@emergencyuk.org - www.emergencyuk.org

EMERGENCY CH
CP 1435 6501 - Bellinzona CH T +41(0) 787 333 159 info@emergencych.org - www.emergencych.org

EMERGENCY JAPAN
669-2702, Hyogo-ken, Sasayama-shi Hongo 499-15 T / F +81 79 506 0932 info@emergency-japan.org - www.emergency-japan.org

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WORK WITH US
EMERGENCY is recruiting medical staff for its hospitals in AFGHANISTAN, CENTRAL AFRICAN REPUBLIC, SIERRA LEONE and SUDAN
For projects in AFGHANISTAN, CENTRAL AFRICAN REPUBLIC, SIERRA LEONE and SUDAN we are recruiting: - GENERAL AND ORTHOPAEDIC SURGEONS - GYNAECOLOGISTS (female only) - MIDWIVES - ANAESTHESIOLOGISTS - PAEDIATRICIANS - X-RAY TECHNICIANS - DOCTORS OF INTERNAL MEDICINE - PAEDIATRIC AND NEONATAL NURSES - GENERAL SURGERY, ORTHOPAEDICS, EMERGENCY ROOM NURSES - ICU NURSES - OT NURSES - PHYSIOTHERAPISTS For the CARDIAC SURGERY Centre in KHARTOUM, SUDAN, we are recruiting: - SURGEONS - ANAESTHESIOLOGISTS - CARDIOLOGISTS - PERFUSIONISTS - SPECIALISTS IN ECHOCARDIOGRAPHY - SPECIALISTS IN CATH LAB - NURSES (OT, ICU, ward, Cath Lab) - PHYSIOTHERAPISTS - LABORATORY TECHNICIANS - X-RAY TECHNICIANS

We require advanced professional experience in the area of reference; 6 months availability; knowledge of written and spoken English; aptitude for teaching and training local staff. The knowledge of written and spoken French is required for the programme in the Central African Republic. For further details and to submit your application browse: www.emergency.it (section work with us) or send your CV to: curriculum@emergency.it.

To support EMERGENCY:
DONATIONS - Bank wire in favour of EMERGENCY: - Banca Etica, Filiale di Milano IBAN IT 02 X 05018 01600 000000130130 - BIC CCRTIT2T84A - Banca Popolare dellEmilia Romagna IBAN IT 41 V 05387 01600 000000713558 - BIC BPMOIT22 XXX - Banca Monte dei Paschi di Siena IBAN IT 76 D 01030 01600 000007362036 - BIC PASCITMMMIL - Banca Popolare di Milano IBAN IT 35 T 05584 01600 000000067000 - BIC BPMIITMMXXX - Banca Popolare di Sondrio IBAN IT 89 M 05696 01600 000006710X50 - BIC POSOIT22 - PayPal toll-free number 800-667788 to donate through PayPal, Visa and MasterCard (this number is toll-free only if called from Italy) - Credit card on-line (on Secure Server) at www.emergency.it (Euros). SUPPORT EMERGENCY THROUGH A REGULAR DONATION Be directly involved in EMERGENCYs work through an automatic donation. With direct debit you can donate an amount of your choice automatically and on a regular basis - even monthly - allowing EMERGENCY to better plan its interventions and the management of its hospitals around the world. Donations by direct debit do not imply additional costs to the donor in the majority of Italian banks. For further information: www.emergency.it (section "Help us Individual") - Tel. (+39) 02 863161. DONATE THE 5/1,000 OF YOUR INCOME-TAX RETURN TO EMERGENCY If you live in Italy, you can contribute to EMERGENCYs activities in favour of the victims of war and poverty for free: donating the 5/1,000 of your income-tax return wont cost you anything. Donors submitting the 730 or CUD models for their income-tax can fill in the file for the destination of 5/1,000 of their income-tax return with EMERGENCYs data and fiscal code: 971 471 101 55. EMERGENCYS MEMBERSHIP CARD EMERGENCYs membership card is dedicated to the first article of the Universal Declaration of Humans Rights. The membership card is valid from January 1, 2012 to December 31, 2012. Along with EMERGENCYs card, members receive the quarterly magazine and are entitled to discounts and special terms in libraries, theatres and art galleries in Italy. For further information and for membership registrations browse: tessera.emergency.it or e-mail: tesseramento@emergency.it. GADGETS AND BOMBONNIRES FOR SOLIDARITY T-shirts, sweatshirts, key rings... are for sale online or in our stalls. EMERGENCYs gadgets represent a simple and direct way to support the activities of the association. The bombonnires for solidarity are a different way to provide a souvenir for a special day to friends and family by giving a concrete sign of commitment towards the victims of war and poverty. For further information browse: shop.emergency.it and lietieventi.emergency.it.

All human beings are born free and equal in dignity and rights. The acknowledgment of this principle is the foundation of freedom, justice and peace in the world.
Universal Declaration of Human Rights Paris, December 10, 1948, Article 1 and Preamble

EMERGENCY

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