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 Report - Monthly Report (UMCOR)

 Report date: 30.04.1999

30 Bul-Bul Avenue, Apt. #45Telephone: (994-12) 93-43-11; 98-05-38
Baku, Republic of AzerbaijanFax: (994-12) 98-28-70
E-Mail: mhuet@amadou.baku.az

EXECUTIVE SUMMARY

UMCOR's clinics and medical points maintained regular schedules during the month of May, with primary health care clinics in Baku serving 8,476 IDP patients. These facilities serve IDPs residing in ten districts of the city. A total of 6,245 IDPs received primary health care through eight UMCOR medical points in Sabirabad, Imishli, Saatii, Fizuli and Agjabedi.

In May, the MCI clinic doctors continued to distribute health education leaflets pertaining to Acute Lower Respiratory Infections (ALRI) of Children; Immunization; and Micro- Nutrients/Vitamin Deficiency; Tuberculosis; Scabies; Worms; and Poliomyelitis. The goal of this initiative is to raise awareness and improve the knowledge of die target population (IDP/RP mothers of reproductive age) in relation to these health concerns.

During the month, one meeting was conducted for UMCOR's MCI- and DOS-funded medical staff. Work-related issues were discussed during die meetings, hi May training sessions were also conducted for the medical staff on the topic of Malnutrition. Training materials were developed and distributed to the medical staff. Pre- and post-test were administered to training session participants.

PROJECT UPDATES

1. Department of State Emergency Medical Assistance Project

Five Department of State-funded clinics continued providing primary health care services to the target population.

The following are statistics pertaining to IDP/RP patient visits to the DoS clinics in May 1999:

Districts:AzizbekovSurakhaniBinagadiSabunchiKaradagTOTAL:
#of IDP/RP13,44718,22336,26823,62110,971102,530
#of patients:6596515729717253,578

In die month of May die most prevalent, diseases among die ID/RP population were die following:

1. Worms-10.6%;
2. Headache/Joint Pain - 9.8%
3. Hypertension - 5.3%;
4. Tonsillitis - 4.6%
5. Vitamin Deficiency - 4.6%

During the month of May, a mobile clinic consisting of a Pediatrician, a Nurse and a Driver continued their outreach activities, which enable primary healdi care, medicines and medical supplies be delivered to institutionalized/handicapped children residing in 33 Children Institutions in Baku and the Absheron area. In May, the UMCOR Pediatrician served 257 institutionalized/handicapped children in the targeted Children Institutions.

40 state health facilities continue to receive medicines and medical supplies available from five UMCOR medicine dispensaries. A total of 555 patients received medicines and medical supplies in the five UMCOR medicine dispensaries during the month of May.

In May medicines and medical supplies were received from Interchurch Medical Assistance (IMA), the US based partner of UMCOR. The total value of commodities received on the shipment was $112,937.05. The shipment was delivered to UMCOR warehouse in Baku, and the process of inventorying the shipment has been initiated.

During the month, UMCOR medicine dispensary #3 continued providing all the registered Diabetic children and youths of the Republican and Baku Endocrinology Clinics with syringes for Insulin.

Medicines and medical materials were delivered to local NGOs working in collaboration with UMCOR. Health workers of the following organizations filled patient prescription forms using UMCOR medicines and medical supplies: Azerbaijan Charity Society HAWA^ The Association of Parents of the Children with Talassemia, Hemophilic Patients Association and the Jewish Women's Organization of Azerbaijan.

In May UMCOR continued collaborating with Mercy and Health Foundation, a local NGO, that provides dental care for IDP children residing in the former ECHO camps in Imishli, Saatii, and Sabirabad regions of Azerbaijan, where UMCOR medical points are providing primary health care to IDP and refugees. According to a predetermined arrangement, UMCOR supported Mercy and Health Foundation dentists with medical supplies and allowed them to work at UMCOR medical points functioning in IDP camps.

Prescription and consumption forms written by DoS clinics doctors and local state doctors were analyzed in May. The quantity of the three medicines randomly selected from each clinic, the mobile pediatric team and the medicine dispensaries was compared with the quantity presented in the consumption forms. No divergence was detected between the prescription and consumption forms.

The monitoring of all 4,354 (100%) prescription forms was conducted during May, which had been filled by UMCOR clinic doctors in April, were in accordance with WHO protocols and MSF guidelines. Results of the monitoring indicated that 4,346 (99.8%) of the prescriptions had been correct.

Community Health Provider Transition Model for DOS:

During the month of May the identification of all the public buildings where DOS targeted IDP population reside completed. These public building are located in the following six districts; Azizbayev, Surakhani, Binagadi, Sabunchi, Garadagh, and Nasimi. In each area, both the IDP Committees and the District Executive Committees were contacted for the most recent list ofIDP-occupied public buildings in their areas. In addition, other buildings were identified by UMCOR staff which had not been included in the list provided by the Executive Committees.

The process in identifying key IDP physicians continues, and final list of all IDP health providers will be completed during the month of June. Identification criteria was established to determine which medical professionals would participate in activities to be implemented by UMCOR, and be the designated Community Health Providers for this transition. This criteria includes the following:

Identification Criteria:

a. Would be an IDP;
b. Would already be providing primary health services in their community;
c. Would be willing to attend all the UMCOR-organized training sessions;
d. Would be willing to coordinate their work to include the following UMCOR requirements:

• Prescription forms
• Growth monitoring forms
• Patient health card
• Morbidity surveillance report;

e. Would also be willing to serve patients from neighboring buildings;
f. Would be a Doctor. If no doctor resides in the area, then a Felcher could be selected

2. USAID/MCI 1 Primary Health Care Support/Five Clinics in Baku/Absheron Region

The table presented on the following page shows statistics ofIDP/RP patients who received primary health care from the five clinics supported by the project during the month of May.

Districts:YasamalNarimanovKhataiNizamiSabailTOTAL:
#of IDP/RP12,25725,74721,83618,44910,81489,103
#of patients:889105012197709664,894

The most prevalent diseases among the ID/RP visiting MCI clinics were the followings:

1. Worms - 7.6%
2. Headache/joint pain - 7.6%
3. Hypertension - 6.3%;
4. Vitamin Deficiency - 5.8%
5. Trauma/bums/wounds -4.5%

On 19 May, Mr. James Smith and Dr. Arsen Kubatayev, the representatives of American International Health Alliance (AIHA) together with UMCOR senior personnel visited the Narimanov clinic. The Alliance became acquainted with the work of UMCOR's clinic and attached medical dispensary. Future collaboration in Baku between UMCOR and AIHA was discussed during the visit.

In May, an end-use survey was conducted among the project beneficiaries in Khatai district of Baku. The monitoring was based on random selection of prescription forms, prescribed by the UMCOR clinic doctors. Out of 2,717 (100%) prescription forms 323 (9%) forms were selected and 187 (7%) of the beneficiaries were surveyed. The survey revealed the following information: 1) all (100%) of the surveyed population had access to free medical consultations and medicines; 2) as a result of the treatment, there was a considerable improvement in the health status of the beneficiaries; 3) the surveyed population stated that they would continue to visit UMCOR clinics; and 4) 71% of the surveyed population were aware of the country providing them with this type of assistance. Prescription and consumption forms written by USAID/MCI clinic doctors and local state doctors were analyzed in May. The quantity of the three medicines randomly selected from each clinic, the mobile pediatric team and the medicine dispensaries was compared with the quantity presented in the consumption forms. No divergence was detected between the prescription and consumption forms.

In May, the monitoring of all 4,304 (100%) prescription forms filled out by clinic doctors during the month of April was conducted in accordance with WHO protocols and MSF guidelines. Results of the monitoring indicated that 4,293 (99.7 %) of the prescriptions had been completed correctly.

USAID/MCI Primary Health Care Support/Seven ECHO Camps and Two IDP Settlements

All the eight medical points continued to serve IDP/RP patients, residing in die seven former ECHO camps and the two collective centers in Imishli, Saatii, Sabirabad, Fizuli and Agjabedi regions of Azerbaijan.

The table below presents statistics on the number of IDP/RP patients that received primary health care at UMCOR's eight medical points during the month of May:

Medical PointRegion#ofIDPs/RPs# of patients
Sabirabad 1 (Ahtachi)Sabirabad2,311591
Sabirabad 2 (Shahriyar)Sabirabad2,069362
Saatii (Alisoltanii)Saatii2,145625
BahramtepeImishli3,900820
Fizuli (Bahmanii)Fizuli2,650563
Agjabedi (Khojavand)Agjabedi2,0001,720
BoztepeImishli2,790872
GarabagFizuli12,326692
TOTAL:  30,1916,245

The most prevalent diseases among the ID/RP visiting MCI medical points were the followings:

1. Headache/joint pain - 9.2%
2. Trauma - 7.0%
3. Bronchitis - 5.8%
4. Vitamin Deficiency - 5.7%
5. Tonsillitis-4.3%

Prescription and consumption forms written by medical point doctors were analyzed in May. The quantity of the five most commonly used medicines and two medicines randomly selected from the prescription forms was compared with the quantity presented in the consumption forms. In total, 4,161 prescription forms were checked and 56 denominations of medicines were selected. The monitoring indicated that there was no divergence between the prescription and consumption forms of the medical points.

The May monitoring of all 4,161 (100%) prescription forms, prescribed by the medical point doctors in March was conducted in accordance with WHO protocols and MSF guidelines. The results of the monitoring indicated that 99.8% of prescription forms had been correct.

3. USAID/MCI 1 Health Partnership Program

Pursuant to a request by the MCI Baku office, documentation pertaining to the current status of the Health Partnership was submitted. Information presented included the number of training sessions delivered, a list of translated documentation and physician reports.

A questionnaire was developed to evaluate the effectiveness and relevance of training programs from program participants' perspective. A draft of the questionnaire was shared with the representatives from the Baylor College of Medicine, and feedback was promised.

On 12 May, the Medical Program Officer had a meeting with the Israeli Ambassador in Azerbaijan. UMCOR's overall activity was introduced with special emphasis being placed on the Health Partnership project. The Ambassador expressed his interest in the program, and willingness to discuss the possibilities of initiating similar programs for Israeli physicians. A follow-up meeting concerning this issue was held later in the month with Israeli Ambassador, with the participation of UMCOR Head of Mission and two Medical Program Officers.

On 20 May, meetings were organized with the Executive Director for Caucasus Office of American International Health Alliance (AIHA) Mr. James P. Smith and AIHA's Regional Director Dr. Arsen Kubataev and representatives of the two hospitals targeted by the UMCOR/Baylor Health Partnership project.

The Chief Physician of Republican Clinic Hospital Dr. VagifJafarov welcomed the idea of involving AIHA in partnership project in the fields of Women's Reproductive Health, Primary Health Care and Infection Control. Dr. Jafarov and two physicians from the Republican Clinic Hospital were invited to Tashkent in order to get acquainted with the ongoing partnership activities of AIHA in Uzbekistan. The trip to Uzbekistan is planned to occur during the month of June.

The Director of the Republican Center of Surgery Dr. Farman Jeyranov received similar proposal for partnership concerning Infection Control, but he stated that without technical support the program would be difficult to implement.

Information gathering for the creation of the Web Pages for the Mir-Kasimov Republican Clinic Hospital is ongoing.

4. UNHCR/Meskhetian Turk Project

Non-Food Distribution

A total of 69 quilts were distributed during die month of May in the Northwest region.

Agriculture

California worms: The farmer from Velvala, Guba district continues maintaining the worms. He is satisfied with the progress of project and looks forward to using the fertilizer this coming summer.

Family Greenhouse: The farmers removed the plastic sheeting from the steel-bar frame of the greenhouses and transplanted the seedlings to their fields.

Health and Nutrition

Health Education: The 146 leaders of the women's groups continue to assist UMCOR health educators in the dissemination of health education lesson plans for women and children.

UMCOR's four part-time Health Education teams completed the dissemination of the third lesson plan on Diarrhea and Dehydration in settlements targeted in the 1999 project. Dissemination of the same lesson plan is ongoing in settlements targeted in the 1998 project. The preparation for the fourth lesson on Sexually Transmitted Diseases in the 1999 program settlements is underway. The fourth lesson plan had already been conducted in settlements targeted during 1998 health education program activities.

A total of 1,721 women (784 in the Northeast region and 937 in the Southeast region) attended the third lesson plan. A total of 6,632 condoms (3,920 in the Southeast and 2,712 in the Northeast) and 312 layette kits (193 in the Southeast and 119 in the Northeast) were distributed during the month of May.

Reproductive Health Care (RHC) Services: The UMCOR's gynecologists continued to work conjointly with the local MoH employees (mid wives, felchers or nurses) in the settlements where UMCOR has established its clinics.

Preparations are underway to conduct training on Anemia during pregnancy for MoH personnel in the Northeast regions. Training materials have already been distributed among the trainees.

A total of 458 MT/IDP women were examined; 58 cases of which were referrals to women's consultation centers and 560 diseases were diagnosed by UMCOR gynecologist. UMCOR Gynecologists distributed a total of 72 contraceptives (47 per oral, 6 injections and 19 intrauterine) in the Northeast and Southeast regions.

Community Services - Children's activities

UMCOR supported Community Committees (CC) to organize sports groups in the targeted settlements. hi the Southeast region six more sport groups have been established in addition to currently functioning groups, thus raising its number to ten. Sports groups are classified according to the age groups: 10 to 13 years and 14 to 17 years old. UMCOR provided them with sports supplies to conduct the proposed activities.

Education

Teachers' Training: Open Society Institute (OSI) conducted the step-by-step training for UMCOR's teachers in children's centers and for MoE kindergarten teachers. The training was organized in Sabirabad district. The OSI and UMCOR issued joint certificates at the conclusion of the five-week training program.

Pre-school Children's Centers: UMCOR hired additional community-selected teachers/volunteers to conduct pre-school children's activities. A total of 19 Children's Centers (7 in the Southeast region and 11 in the Northeast region) were organized based on the proposals developed by CCs. UMCOR provided them with- classroom supplies, cognitive games and locally manufactured seesaws, swings, benches and blackboards to conduct the proposed activities.

Vatan Society Capacity Building

Starting from May 1999, the Vatan Society commenced preparing their monthly activities report in English.

The various group leaders identified the needs related to the segment of community they represent, and presented them to their community committee to develop the proposals. These committees work closely with UMCOR field staff while developing the proposals. They have already prepared and submitted 11 proposals on water supply, road repair, shelter, vocational training and children's activities.

Miscellaneous

  1. In May UMCOR Khachmaz office welcomed Mr. William Brady and Ms. Maureen McBrien from UNHCR. Project Director, Medical Coordinator and other staff escorted them in the field trip. Mr. Brady also visited UMCOR's Baku warehouse the next day after the field trip.
  2. UMCOR Project Manager together with Vatan Project Manager visited Shamakhi district to collect information about socio-economic situation ofMeskhetian Turks residing in this district. They met with the local authority representatives in the settlements and also with the MT community representatives.
  3. UMCOR Project Manager visited Agjabedi district to leam from IRC's experience of implementing Children's activities.


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