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 Report - Monthly Report (UMCOR)

 Report date: 31.05.1999

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

UMCORs clinics and medical points maintained regular schedules during the month of June, with primary health care clinics in Baku serving 8,179 IDP patients. These facilities serve IDPs residing in ten districts of the city. A total of 6,638 IDPs received primary health care through eight UMCOR medical points in Sabirabad, Imishli, Saatli, Fizuli and Agjabedi.

In June, 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 the target population (IDP/RP mothers of reproductive age) in relation to these health concerns.

During the month, one meeting was conducted for UMCORs Baku-based MCI- and DOS-funded medical staff. Work-related issues were discussed during the meetings. Training sessions were also conducted for the medical staff on the topic of Diarrhea during the month. Training materials were developed and distributed to the medical staff. Pre- and post-test were administered to training session participants.

The creation of the Web Pages for the Mir-Kasimov Republican Clinic Hospital and Republican Scientific Center of Surgery was completed.

Under the auspices of our UNHCR project, 56 layette kits were distributed to pregnant Meskhetian Turk refugee women during the month of June and to those women with infants. 528 Meskhetian Turk IDP women were examined by UMCOR Gynecologists during the month.

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 June 1999:

Districts:AzizbekovSurakhaniBinagadiSabunchiKaradagTOTAL:
# of IDP/RP

13,447

18,223

36,268

23,621

10,971

102,530

# of patients:

814

767

569

788

731

3,669

During the month of June, the most prevalent diseases among the ID/R population of DoS clinics were the following:

  1. Headache/Joint Pain - 9.8%;
  2. Worms - 9.3%
  3. Hypertension - 6.3%;
  4. Common cold- 3.9%
  5. Stenocardia/Arrhythmia 3.3%

A mobile clinic consisting of a Pediatrician, a Nurse and a Driver continued their outreach activities, which enable primary health care, medicines and medical supplies be delivered to institutionalized/handicapped children residing in 33 Children Institutions in Baku and the Absheron area. In June, the UMCOR Pediatrician served 267 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 703 patients received medicines and medical supplies in the five UMCOR medicine dispensaries. Also during the month, UMCOR medicine dispensary #3 continued providing all 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 HAVVA and INSAN, The Association of Parents of the Children with Talassemia, Hemophilic Patients Association and the Jewish Womens Organization of Azerbaijan.

Prescription and consumption forms written by DoS clinic doctors and local state doctors were analyzed in June. 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 3,476 (100%) prescription forms was conducted during June, which had been filled by UMCOR clinic doctors in May, were in accordance with WHO protocols and MSF guidelines. Results of the monitoring indicated that 3,461 (99.6%) of the prescriptions had been correct.

At the end of June UMCOR medical monitors left for Lerik and Yardimli districts to conduct the monitoring pertaining to the distribution of medicines and medical supplies provided by UMCOR to these earthquake affected regions in September 1998. Monitors visited UMCOR targeted local health facilities to review the current balance of donated medical consumables, internal distribution process and the distribution registration forms on their correct completion. Local medical personnel of these facilities were provided with pertinent recommendations and survey was carried out to determine the needs for further medical provision.

DOS Community Health Provider Transition Activities:

During the month of June the final list of all IDP Community Health Providers (CHPs) identified for training was completed. All these health providers reside in the public buildings where IDPs live. They provide primary health advise to the inhabitants of the building. UMCOR selected health providers are mostly physicians, however in the areas where physicians were not available, felchers were selected. In total 76 health provider (physician and felcher) was identified.

In addition during the month of June preparation for the training of the Community Health Providers was initiated. Training schedule as well as a training curriculum was developed. The training is scheduled to start on July 5, 1999 and continue for 12 consecutive weeks. All the CHPs are divided into 8 groups depending upon the region they live in, and each group is assigned to a nearby UMCOR training center. The curriculum will focus on both curative and health information. Initial training will cover health topics identified as important health problems by the Azerbaijani MOH and WHO, and provide the trainees with sufficient information to enable them to write UMCOR prescription forms. In this regard, UMCORs previous training materials will be updated as well as translated into Azerbaijani.

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

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

Districts:

Yasamal

Narimanov

Khatai

Nizami

Sabail

TOTAL:

# of IDP/RP

12,257

25,747

21,836

18,449

10,814

89,103

# of patients:

933

864

1,103

708

902

4,510

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

  1. Headache/joint pain - 8.2%
  2. Worms - 6.6%
  3. Hypertension - 6.2%;
  4. Vitamin Deficiency - 6.0%
  5. Tonsillitis - 4.1%

Prescription and consumption forms written by USAID/MCI clinic doctors and local state doctors were analyzed in June. 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 June, the monitoring of all 4,116 (100%) prescription forms filled out by clinic doctors during the month of May was conducted in accordance with WHO protocols and MSF guidelines. Results of the monitoring indicated that 4,103 (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 the seven former ECHO camps and the two collective centers in Imishli, Saatli, 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 UMCORs eight medical points during the month of June

Medical Point

Region

#of IDPs/RPs

# of patients

Sabirabad 1 (Ahtachi)

Sabirabad

2,311

644

Sabirabad 2 (Shahriyar)

Sabirabad

2,069

508

Saatli (Alisoltanli)

Saatli

2,145

607

Bahramtepe

Imishli

3,900

872

Fizuli (Bahmanli)

Fizuli

2,650

639

Agjabedi (Khojavand)

Agjabedi

2,000

1,831

Boztepe

Imishli

2,790

819

Garabag

Fizuli

12,326

718

TOTAL:

 

30,191

6,638

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

  1. Headache/joint pain - 11.6%
  2. Trauma - 8.1%
  3. Worms - 4.8%
  4. Bronchitis - 4.2%
  5. Hypertension - 3.8%

In June training session was organized in Imishli office. Eight doctors of UMCOR medical points, one substitute doctor and two camp project doctors participated in the training session dedicated to Heart Failure. Training materials were developed and distributed to the medical staff.

Prescription and consumption forms written by medical point doctors were analyzed in June. 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, 4,128 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 June monitoring of all 4,128 (100%) prescription forms, prescribed by the medical point doctors in May was conducted in accordance with WHO protocols and MSF guidelines. The results of the monitoring indicated that 99.7% of prescription forms had been correct.

In June, an end-use survey was conducted among the project beneficiaries of the targeted regions. The monitoring was based on random selection of prescription forms, prescribed by the UMCOR medical point doctors. 1,172 (9%) prescription forms were selected and 1,052 (8%) of the beneficiaries were surveyed. The survey revealed the following information: 1) 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; and 3) the surveyed population stated that they would continue to visit UMCOR clinics.

Simultaneously survey was carried out among the 179 project beneficiaries (IDP/RP mothers of reproductive age) to reveal their knowledge of Acute Lower Respiratory Infections of Children. The survey was conducted based on the questionnaire. The results of the survey unveiled that 51% of the surveyed population have sufficient understanding of the presented topic.

3. USAID/MCI 1 Health Partnership Program

In June, the Program Officer received the approved version of questionnaire from the Baylor College of Medicine. This questionnaire was developed to evaluate the efficacy and pertinence of training programs from program participants' perspective.

The Program Officer met with the Chief Physician of Republican Clinic Hospital Dr. Vagif Jafarov and the Director of the Republican Center of Surgery Dr. Farman Jeyranov. The questionnaire was discussed and approved by these two Head Doctors.

The creation of the Web Pages for the Mir-Kasimov Republican Clinic Hospital and Republican Scientific Center of Surgery (both English and Russian versions) was completed. The created Web Pages were placed in Internet. These WebPages are presented in the AZMedNet server, and the URLs are:

For Republican Center of Surgery

http://www.azmednet.az/azmed/medinstitut/surcenter/index-en.html

For Republican Clinical Hospital

http://www.azmednet.az/azmed/medinstitut/republic/index-en.htm

The WebPages were employed in Texas Medical Center and the Baylor College of Medicine. UMCOR's partners made some comments and recommendations from the Baylor College of Medicine, which would be eliminated during the next upgrades of the sites.

In June four physicians of the selected hospitals visited U.S. Embassy to receive American visas in order to participate in the training sessions in Houston. All the applicants received their visas.

4. UNHCR/Meskhetian Turk Project

Non-Food Distribution

No distribution was carried out during the month of June.

Agriculture

California worms: The farmer from Velvala, Guba district continues maintaining the worms.

Family Greenhouse: The greenhouses are not employed during summer. Currently, UMCOR is negotiating with Diakonie for their surplus greenhouse plastic sheeting to use in Meskhetian Turks program. Diakonie had purchased this commodity from Spain for their own use.

Health and Nutrition

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

UMCORs four part-time Health Education teams completed the dissemination of the second lesson plan on Diarrhea and Dehydration in settlements targeted in the 1998 project and dissemination of the fourth lesson plan on Sexually Transmitted Diseases in settlements targeted in the 1999 project.

A total of 998 women (609 in the Southeast region and 389 in the Northeast region) attended the second lesson plan on Diarrhea and Dehydration and 797 women (348 in the Southeast region and 449 in the Northeast region) attended thefourth lesson plan on Sexually Transmitted Diseases . The preparation for the fifth lesson on Scabies in both 1999 and 1998 project settlements is underway.

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

UMCOR discontinued the work of one clinical point in Siyazan hospital due to unsatisfactory number of patients recorded during the past three months of clinical activities. In view of communitys request, UMCOR established one reproductive health care clinic in Gudajuhur, Sabirabad district.

Training session on Anemia during pregnancy was conducted for MoH personnel in the Northeast region.

A total of 528 MT/IDP women were examined; 61 cases of which were referrals to womens consultation centers and 519 diseases were diagnosed by UMCOR gynecologist. UMCOR Gynecologists distributed a total of 145 contraceptives (104 per oral, 7 injections and 34 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. Nine more sport groups (1 in the Southeast region and 8 in Northeast region) have been established during the month of June. A total of nineteen sport groups are conducting sport activities (football, volleyball, badminton, chess) for adolescent children in both regions. Sports groups are classified according to the age groups: 12 to 14 years and 15 to 20 years old. UMCOR provided them with sports supplies to conduct the proposed activities.

Education

Teachers Training: The preparation for conducting training sessions for volunteers of UMCOR organized Children Centers is underway. These teachers participated in the step-by-step training carried out by Open Society Institute. The purpose of the training is to provide volunteers with new teaching methods.

Pre-school Childrens Centers: The educational monitors continue monitoring of the children centers on a weekly basis. They observe the knowledge level of the teachers, schedule and discipline of the classrooms, and determine needs of the centers. A total of 19 Childrens Centers (7 in the Southeast region and 12 in the Northeast region) were organized based on the proposals developed by CCs. UMCOR provided them with necessary supplies to conduct the proposed activities.

Capacity building - Vatan Society and Meskhetian Turk Community

The various group leaders participate in identifying the needs related to the segment of community they represent, and present them to their community committee to develop the proposals. These committees work closely with UMCOR field staff while developing the proposals. The proposals are mainly focused on water supply, road repair, shelter, vocational training and childrens activities.

Miscellaneous

The first budget realignment and revised narrative for 1999 was submitted to UNHCR.



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