CCM Mission report 2019 by Comitato Collaborazione Medica

Archive CCM ÂŠ Angel Ballesteros - Kenya (2019)

Mission 2

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Mission

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summary 1.The Central Role of the Healthcare System and the Importance of Communities, the True Guardians of Health Letter from the President and Executive Director

pag. 4

2. Identity The History of CCM Mission and Values The Organisation

pag. 5 pag. 6 pag. 8

3. Goals and Results Goals and Results in Africa and Italy CCM and the SDGs (Sustainable Development Goals) Results

pag. 13 pag. 14 pag. 18

4. Indicators

pag. 20

5. Fields of Activity Mother, Child and Adolescent Health The Fight Against the Great Pandemics Surgery, Emergency Medicine and Trauma Care Inclusion of Vulnerable Groups

pag. 22 pag. 23 pag. 24 pag. 25

6. Projects In Africa and in Italy

pag. 26

7. Smiles of African Mothers

pag. 35

8. Fundraising and Communication

Fundraising and local activity Communication

pag. 37 pag. 38

9. Financial Statement

pag. 39

Contacts

pag. 41

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The Central Role of the Healthcare Letter from the President System and the Importance of Communities, the Guardians of Health And Executive Director

Throughout 2019 CCM’s commitment to carry out its mission has not faltered nor deviated from its founding ideals. Our modus operandi in all ongoing projects is still collaboration with the institutions of African countries where we operate and with the civil society organisations that have arisen and developed within local communities. The local communities, with their own distinctive characteristics, values and aspirations, are the real guardians of public health. The national healthcare facilities, operating within the unique communities of each country, are an integral part of that public health; our projects should not run parallel to them or replace them, but rather strengthen them through qualifications. In this spirit, we have quickly embraced our new intervention philosophy, which encompasses health, its social determinants, and the environment. We have continued to actively support these ideas for years, specifically with the WaSH method (Water, Sanitation and Hygiene) and One Health (the health of the people, of the animals and of the environment addressed as a coherent whole). The direction we have taken is extremely exciting and it has been acknowledged not only by respected international institutions and various partners involved in cooperation, but also among schools of thought that are more concerned with environmental protection and human advancement, from the Greens to Pope Francis. Nevertheless, following this direction is not easy for those who, like us, have to run the “last mile” of cooperation in the field. We need to bring various ministries, bureaucracy systems and command chains into step, and we must align, or at least manage, numerous and often conflicting interests as well as we must act on various fronts in a harmonious and balanced manner...We’re giving our full commitment, body and soul. A concrete example of an initiative embodying these ideals has been “Acqua per l’ospedale di Tonj”, or “Water for Tonj Ugo Marchisio President

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Hospital”, created and led in the spirit of true volunteerism. A great success in the field was created in memory of Marco Sicuro, who had launched the idea just before passing away. Rallying friends and supporters, the promoter group quickly collected the necessary funds and it made its own professional skills available free of charge. It overcame rather significant technical and logistical difficulties and, at the end, it made its dream come true. Now the entire hospital in Tonj, including all outbuildings, is supplied with running drinkable water that is drawn from a quality aquifer by pumps powered by solar generators; this is a sustainable technology that respects the environment and represents a real leap forward in the level of collective hygiene and quality of hospital service. While we all can take satisfaction in the accomplishments, we have seen during 2019, we cannot hide our great concern for the future of CCM as it moves Archive CCM © Angel Ballesteros - Kenya (2019) forward into 2020 and for the future of the same international cooperation in Italy and Europe. The Governing Council of CCM has decided to close the 2019 budget with a heavy deficit so it can set aside a contingency fund in 2020 to effectively meet extraordinary expenses that had arisen or could no longer be deferred during the previous year, such as the reconstruction of buildings either damaged or even destroyed by natural disasters, vehicle fleet renewal and dependable safety equipment for our staff. Unfortunately, 2020 has shocked us with the tragic COVID-19 epidemic, against which we have tried our best to face both in Italy and in Africa, endeavouring to help first those who had borne the brunt of the disease and ensuring the safety of our staff before thinking about budgets and fundraising. We are proud of the work our collective effort has accomplished and we learnt a lot from this experience. However, our budget was certainly dealt a hard financial blow and 2020 will be a crucial year for CCM’s survival. Filippo Spagnuolo Executive Director

2 Identity

2.1 Our History

For over 50 years, we have been providing healthcare skills in areas where local health workers need further training. We support and train community health workers, to provide adequate treatment and assistance, even in areas of abject poverty and need. We take care of the most vulnerable groups in society, particularly women and children, who have always had, and continue to have, a high mortality rate. Our first international cooperation programme took place in 1970 in Kenya, at the rural Eldama Ravine hospital. This means that we have been in Kenya for almost 50 years, and we are now in Nairobi and Isiolo County. In 1983, we launched the first training course for local personnel in Wau in South Sudan. Despite war, violence, and logistical difficulties, we are still there supporting the Turalei, Tonj, and Maria Lou hospitals, as well as the health centres in the local area. Our first project in Ethiopia dates back to 1983, where our work in the Bale Zone, Tigray Region and Somali Region continues to this day. Since 1992 we have been in Burundi, particularly in Cibitoke, where we built a blood bank, improved the hospital and set up a neonatal wing; that equates to 25 years of commitment to mother and child health. In 1997, we launched a rehabilitation and physiotherapy programme at Lacor Hospital in Uganda, while in 2004 we launched a programme in Somalia to counteract the great pandemics, with a special focus on tuberculosis. The countries where we work are particularly difficult to operate in, and improvements are slow; we remain there nonetheless, providing the best possible healthcare services in the poorest areas. Since 1978, CCM has been working in Italy to train doctors who want to join missions in Africa, and this training continues today through our Global Health course and scientific conferences. We have also turned our efforts to the poorest and most vulnerable residents of the Piedmont area. With the help of the knowledge and skills we developed in Africa, we have created multicultural training sessions for healthcare workers in collaboration with numerous local health authorities in the area. We also train workers involved in the reception and management of migrants. The current economic climate has increased the range of vulnerable people. With this in mind, today in Turin we assist in the management of two clinics for those most in need, where we offer preliminary screening and we direct patients to the Italian National Health Service. Since 2005, we have been working with pupils and teachers in schools to tackle important issues such as discrimination and bullying.

In 1968, a group of young doctors and medical students from Turin decided to take a step towards guaranteeing the right to health for all.

Therefore, CCM - the Medical Collaboration Committee - was born. 1970

1980

1970

1982

The first private cooperation project takes place at the rural Eldama Ravine Hospital in Kenya.

First health programmes commence in Sololo, Kenya, and in Bushulo, Ethiopia.

1972

1983

CCM is recognised as a non-governmental organisation (NGO) by the Ministry of Foreign Affairs.

1975 Our first two-year cooperation programme to be approved by the Ministry of Foreign Affairs is the ‘Health Aid Project for the Residents of the South Baringo District’ (Mercy Hospital, Eldama Ravine, Kenya), which was implemented with the volunteer services of resident physician Dr Filippo Gallo.

1978

Launch in Italy of training courses for doctors who want to join missions in Africa. Publication of Practical Surgery, by G. Meo, F. Gallo, edited by Minerva Medica.

Launch of training courses for local staff at the Health Training Institute in Wau and Wad Medani in South Sudan.

1985 Collaboration with the magazine VPS (Volunteers for Development) and the publication of 28 monographic issues on health, information and education for global citizenship.

1986

CCM heads the Coordinamento Formazione Sanitaria (CFS), an initiative composed of 7 NGOs and created to consolidate training for volunteers bound for developing nations.

1990 1992

Launch of mother and child health projects and construction of blood bank in Cibitoke, Burundi. First NGO to participate in the United Nations Operation Lifeline Sudan.

1993 Publication of “A Colour Atlas of Surgical Cases in the Tropics” by S. Galvagno.

1994 Prevention of sexually transmitted diseases in the slums of Nairobi in conjunction with Nazareth Hospital.

1994

Foundation and management of a clinic for migrants in Turin, in collaboration with the non-profit organisation Camminare Insieme.

1997

Launch of rehabilitation and physiotherapy programme at Lacor Hospital in Uganda.

2000 2003

Launch of the National and International Volunteer Civil Service.

2004

Launch of the ‘Global Fund to Fight AIDS, Tuberculosis and Malaria’ in Somalia.

2005

Launch of our awareness campaigns and global citizenship education in Piedmont schools.

2006

First edition of our Tropical Medicine course (now our Global Health course).

2008

CCM’s organisation is updated; professionalization and restructuring in Italy and its partner countries result in a stable operating structure and the appointment of an Executive Director.

2009

In response to a proposed law requiring health workers to report illegal migrants, CCM launches ‘Did You Know That...’, a healthcare information project aimed at migrants.

2010 2011

Work with refugees begins with the ‘Not Just Asylum’ project. Launch of ‘Smiles of African Mothers’, a campaign dedicated to reducing maternal and child mortality in Ethiopia, Kenya, Burundi, Somalia and South Sudan.

2014

Our activities in Italy expand training, global citizenship education and inclusion projects for vulnerable groups.

2015

In the four years since its foundation, Smiles of African Mothers has trained 1902 healthcare workers, treated and vaccinated 611,000 children and cared for 127,000 mothers with 16 projects in Africa.

2016

Second phase of ‘Smiles of African Mothers’ begins with new goals for 2020.

2018

Our project One Health starts in Ethiopia and Kenya first.

2019

Expansion of healthcare support in the counties of Kepoeta in South Sudan.

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2 Identity

2.2 Mission and Values

Mission We support development processes that take a global approach to defending and promoting the right to health, working on healthcare needs, influencing socio-economic factors and recognising poverty as the chief cause of health problems. We focus our efforts on the poorest segments of society and we operate in the worldâ&#x20AC;&#x2122;s most disadvantaged areas by meeting and collaborating with people and communities both in Italy and in low-income countries. Our interventions take the form of international cooperation projects in the healthcare field; educational programmes on global citizenship and healthcare training; campaigning for fair policies; and activities to protect the health of migrant and nomadic communities.

Our Values

1 2 3 4 5 6

7 8 9 10 11 12

Volunteering and professionalism

Respect for human dignity Secularism, pluralism and the acceptance of others, working towards peace Participation and establishment in the areas in which we operate

Testimony Appropriate technology

Honesty and transparency

Development of local professional standards

Solidarity as an act of justice

Impartiality, neutrality and independence

Earnestness

Accountability: responsibility for our actions

Itâ&#x20AC;&#x2122;s in our DNA CAPACITY BUILDING

TRAINING ON THE JOB

VOLUNTEERING

TASK SHIFTING

GLOBAL HEALTH

APPROPRIATE TECHNOLOGY COMMUNITY PARTICIPATION

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CAPACITY BUILDING We equip African healthcare workers with the skills they need to provide care to their communities. The primary goal of our efforts is to improve their ability to respond to community needs as well as to individual emergencies. Capacity building in our programmes includes both formal and informal training courses. The trainer combines theory-based lessons with practical exercises and he involves healthcare workers in hospitals and health centres as well as the community workers who are responsible for healthcare awareness and education in the villages. Informal training mainly takes place on the job through real-life experience, side by side with doctors and nurses, international volunteers and local personnel.

TRAINING ON THE JOB This is one of the simplest and most effective ways of passing on knowledge and skills: training in the field, pairing expert staff with those less experienced. Hands-on learning in hospitals, operating rooms, on ward rounds, or during checks in the mobile clinic that reaches the most remote villages. Those skilled in a task teach their less experienced colleagues. This is one of the most essential aspects of our volunteer doctors’ missions and something that our healthcare workers make a point of doing with new recruits. The results have been extremely positive.

TASK SHIFTING It is essential to ensure that the few on-site workers in a given territory are qualified and capable of responding to the greatest possible number of healthcare needs. The redistribution of tasks and responsibilities among various workers, also known as task shifting, is an effective strategy for achieving this goal. We train ‘non-doctors’ to provide life-saving surgery (caesarean sections, for example) even in the smallest clinics.

APPROPRIATE TECHNOLOGY Appropriate technology is available and usable even in remote and poverty-stricken areas and can address important healthcare issues. In practice, this means low-cost technical equipment that is easy to use and maintain. A notable example is kangaroo mother care, used for premature or underweight newborns. Simple wraps allow skin-to-skin contact and the transfer of heat from mother to baby. This method has achieved excellent outcomes in terms of lives saved, particularly in clinics that cannot afford a sufficient number of incubators or where lack of funding or skills would make maintenance impossible. Furthermore, in our experience, the use of this technology allows healthcare to become integrated within the social context, helping to break down cultural barriers and encourage communities to use the healthcare services available to them.

COMMUNITY PARTICIPATION Working with communities is a fundamental aspect of what we do. Knowing their real needs and sharing project design and implementation with them increase the effectiveness of our programmes. Facilities in good working condition and appropriate expertise must go hand in hand with community awareness of how important it is to prevent and treat illness. We benefit from our many years of experience in the countries in which we work, as the people now know and trust us. Furthermore, choosing to strengthen national healthcare systems rather than establishing parallel services allows us to work in conjunction with local communities, so that in time they will be able to continue the work without our help.

GLOBAL HEALTH Global Health is an action research approach with a broad outlook that analyses interdependencies between local and global phenomena. It makes use of contributions from a wide range of disciplines in addition to those typically associated with healthcare, such as social and human sciences, economics and law. We have enthusiastically adopted this approach since the 1990s, with increasing focus on the various determinants of health. Our activities aim at establishing useful partnerships in order to pair healthcare service improvements with integrated community system strengthening; this can be done, for example, through income-generating activities and the improvement of infrastructures necessary for better hygiene.

VOLUNTEERING A highly motivated group of volunteers set up CCM in 1968. This same strong sense of motivation still allows today’s volunteers to overcome the numerous physical and psychological challenges that our missions entail. Without this strong motivation, our volunteers would likely struggle to carry on with more missions (which often happens) or remain committed at the end of a mission by raising awareness, sharing experiences and encouraging involvement, as they currently do. Over the years, we have structured the organisation to increase the impact of our work. Consequently, CCM is no longer composed strictly of volunteers. A staff of highly motivated professionals can be found in our offices and in the field but volunteers are still one of our most precious resources, increasingly important even in Italy.

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2 Identity

2.3 The Organisation

The Organisation and its composition

208

members

volunteers

CCM - Comitato Collaborazione Medica (The Medical Collaboration Committee) - is a CSO (Civil Society Organisation) recognised as a non-governmental organisation by the Ministry of Foreign Affairs since 19 June 1972 (Law no. 125/2014) and registered on the List of Civil Society Organisations with the Italian Agency for Development Cooperation (Law no. 125/2014, Decree 2016/337/000148/5), and pursuant to Law no. 49/1987, it is qualified to conduct activities both in low-income nations and in Italy. The association gained legal status in 2010. Its registered office is in Turin, where part- and full-time staff work together with volunteers to implement policy and strategy recommendations from associate bodies, as well as to ensure the coordination and overall control of its activities. A stable organisational structure, supervised by a Country Representative, is in place in all of our affiliated countries, except Uganda and Somalia.

Countries:

Ethiopia TURIN

Governance The main governance assets are set out in the By-laws (Article 3). The Members’ Assembly determines the guidelines of the association; it ratifies the admission of members upon proposal by the Executive Board; it nominates the members of the governing bodies; and it approves the balance sheet and the social report. Periodic meetings allow us to look at the annual business plan in detail, to learn about the organisation’s progress and to share and guide the strategic choices made. Those of us who work for the right to health must pursue our company mission by ensuring that our activity keeps pace with our international agenda and the changing realities where we operate. The Executive Board is composed of seven members with one term lasting four years and it elects the Chairperson, Vice-Chairperson and Treasurer. In addition to encouraging active participation among its members, it executes the decisions of the Assembly and submits the strategic and project management guidelines of CCM to this Assembly. It also draws up the annual plan, budget, balance sheet, mission report and social balance sheet. It periodically assesses project status, makes decisions on new project proposals and authorises the drawing up of staff contracts and third-party agreements. The Board of Auditors has the duty to monitor compliance with laws and by-laws as well as observance of management accounting principles. It also closely checks if the organisational, administrative and accounting structures are suitable and how they operate in practice. Finally, it oversees adherence to civic aims and certifies that the social balance sheet is compiled in accordance with established guidelines. The duty of the Supervisory Body is to evaluate if the entire organisation and its thirdparty partners are in compliance with the prescribed rules of conduct contained in the Code of Ethics and the Organisation and Control Model. It also recommends possible measures to prevent misconduct, where this is deemed necessary.

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AFRICA

South Sudan

Kenya

Members’ Assembly 2 March 2019 Action plan and budget for 2019. 15 June 2019 Chair’s report, amendments to the association by-laws, approval of 2018 balance sheet, reappointment of Governing Bodies positions. CCM Board Members Marilena Bertini • Chairperson Ugo Marchisio • Vice-Chairperson Francesco Torta Anna Valesano • Treasurer Franco Ponzio Matteo Bolla Maresa Perenchio Auditors Mario Paolo Moiso Antonio Mainardi Michele Romano Supervisory Board Membersa Paolo Piana Antonio Mainardi

Human Resources Both our paid staff and volunteers have always been our most valuable resource, vital to our efforts in bringing projects to fruition. They are skilled and motivated individuals, Italian and African, who carry out their work with passion every day.

Italia Africa

2019

2018

Paid 29 285

Volunteer 195 13

Paid 33 479

Volunteer 195 17

Burundi

Ethiopia

Kenya/Somalia

South Sudan

213

404

Uganda

Regional Health Advisor

513

212

315

Subtotal Total (Paid & Vol.)

523

Employees

213 men

101

women

In Italy: 29 employees: 22 women - 7 men In Countries Where We Work: 285 employees: 78 women - 207 men 10 expatriate staff members (European): 8 women - 2 men 9 regional staff members (neighbouring African countries): 3 women - 6 men 276 local staff members (African personnel): 75 women - 201 men

725

Volunteers

315 total

208

208 total 77

men

131

women

In Italy: 195 volunteers: 123 women - 72 men In Africa: 13 volunteers: 8 women - 5 men

The work donated by volunteers in 2019 has an estimated value of EUR 276,275.

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Volunteers and Support Teams In 2019, volunteer involvement once again proved to be an integral part of CCM’s mission. Our volunteers are the best testimony to our work in the field. Their commitment, professionalism, passion and responsibility continue to make all the difference. Volunteering at CCM means being part of a remarkable project, putting the ideal of universal healthcare into practice. This is why over 200 people have decided to get involved and do their part. They have provided service in the two clinics directed at vulnerable groups in Turin; they have trained healthcare professionals; they have supported staff in health promotion courses aimed at the young and vulnerable; they have embarked on missions to care for local healthcare systems in the countries where CCM operates; they have helped the organisation in fundraising initiatives; and they have become a living testimonial to our commitment in the field. Volunteering also means meeting, training and exchanging ideas. For this reason, there is no shortage of events dedicated to the friends of CCM throughout the year: training opportunities, detailed analysis of our projects and focus on the countries where we work, sharing of experiences, time for informal meetings and reflection on topics that are dear to us, and finishing with a special volunteer weekend that reinforces our sense of identity and belonging. In 2019, we had 13 volunteers in Africa, including Ethiopia, Kenya, Burundi, Uganda and South Sudan. Of those who attended our Global Health Course, 1 doctor had the opportunity to embark on a volunteering and training mission at Filtu Hospital in Ethiopia. 13 people have collaborated on an ongoing basis to support the hospital’s various activities by making a wide variety of skills available. In Italy, 65 volunteers have participated in training and global citizenship education, as well as projects to promote the inclusion of vulnerable groups. Approximately 115 people have been involved in fundraising and awareness-raising activities. The dedicated work of our support teams in coordinating awareness and fundraising initiatives has continued, contributing to the economic sustainability of the organisation. Among these, we would like to acknowledge: Gruppo Volontari Torino, Volpiano per il CCM (Turin), Associazione Needle di Caluso (Turin), Amici CCM Ivrea (Turin), Amici di Nanni (Cuneo), Gruppo Pulia di Moretta (Cuneo), Amici CCM Arenzano (Genoa), Comitato ‘Per Terre Remote Onlus’ di Tirano (Sondrio), Amici di CCM Bergamo – Monte Marenzo, and Associazione Mondo Domani di Bitonto (Bari).

Organisational Structure (revised 31 May 2020)

MEMBERS’ MEETING Supervisory Body Executive Board Executive

International Projects

Italian Projects

Desk Officers

Area Officers

Country Representative

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Administration, Finance and Control

Human Resources and General Services

Fundraising and Communications

Administrative Desk Officers

Area Officers

Project Managers Country Administrators Technical Officers 2

The Sounding Board The Sounding Board was created out of the desire to open ourselves up to the outside world, to people who live and work in situations different to our own and international cooperation in general, and to people who can give us a different perspective and new ideas to consider. Established in the first half of 2017, CCM’s Sounding Board meets approximately twice a year. CCM’s Sounding Board:

LORENZA BRAVETTA Visual arts specialist and advisor

GIUSEPPE COSTA Epidemiologist and health inequalities expert

EGIDIO DANSERO Professor of economic and political geography and international cooperation expert

GUIDO GIUSTETTO Medical Practitioner and President of the Turin Medical Association

MARTINO GRINDATTO Expert in corporate business and social activities

STEFANIA LALLAI Sustainability & External Relations and Director of Costa Crociere (Costa Cruises)

SIMONE MIATTON President, CEO and Director of Personnel, Michelin, Italy

EDUARDO MISSONI Medical Practitioner, expert on global health, development and international cooperation

ROBERTO PAGELLA Senior Managing Director of Accenture

RENZO ROSSO Diplomat

DANIELE ROSSI Marketing and communications expert, CEO of social enterprise Trame d’Italia s.r.l.

CHIARA SARACENO Sociologist

ANDREA SILVESTRI Director General of Cassa di Risparmio di Cuneo (Cuneo Savings Bank)

FLAVIANO ZANDONAI Euricse (European Research Institute on Cooperative and Social Enterprise) researcher and secretary of the Iris Network

We lovingly remember RAFFAELE MASTO our friend and member of the Sounding Board, who passed away this year from COVID-19.

Our Network: INTERNATIONAL Europa Asilo, White Ribbon Alliance, WHO - GIEESC Global Initiative for Emergency and Essential Surgical Care. NATIONAL ASviS (Italian Alliance for Sustainable Development through Link2007), AOI (Italian Association of NGOs and Tertiary Sector Forum through COP [Piedmont NGO Consortium]), CSR Manager Network, FNOMCEO (National Federation of Medical, Surgical and Dental Associations), Link2007, Italian Watchdog for Global AIDS Action, RIISG (Italian Network for Global Health Education), SIN (Italian Society for Neonatology, Working Group for Limited-Resource Countries), UNAR (National Anti-Racial Discrimination Office). LOCAL COP (NGO Consortium of Piedmont), CCVD (Committee Against Violence Towards Women), GRIS (Regional Immigration and Health Group), part of SIMM (The Italian Society for Migrant Medicine), OMCEO (Turin Medical, Surgical and Dental Association), Not Just Asylum Network, Paediatric Network, Planet Africa.

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Stakeholders’ Map CCM has always acted, primarily, in the interest of its beneficiaries. Our programmes focus on local workers, the most vulnerable communities, and mothers and children in particular. However, we do operate under a multi-stakeholder system. In our work, we collaborate, share and interact with many different key figures. Our stakeholder map provides a summary of this collaboration, which is explained in full in the different sections of our Mission Report and by the list of individual projects. • Supplier Organisations and Private Foundations • National Bodies and Institutions • Governments • Religious Organisations • European Union

• Members • Volunteers • Staff in Africa • Staff in Italy • Individual Donors

• Italian and International Networks and Consortia • Media • Local Bodies and Institutions • Local Health Authorities • NGOs • Training and Research Institutes and Universities

BENEFICIARIES • Schools • Suppliers • Civil Society • Local Communities • United Nations

How to Read the 2019 Mission Report The Mission Report is an in-depth guide to CCM’s projects in Africa and Italy. These projects are grouped under the organisation’s four main areas of interest: mother, child and adolescent health; the fight against the great pandemics; surgery, emergency medicine and trauma care; and the inclusion of vulnerable groups. For each area, we have identified a few specific indicators that allow us to closely monitor various activities and the number of beneficiaries reached. Our monitoring tools for individual projects enable us to collect data about both training and awareness-raising activities and the supply of healthcare services. The indicators for healthcare services were taken from those already provided for by the national healthcare information systems and are monitored through the daily compilation of records in healthcare facilities. Each indicator reports the number of services provided, not the number of individuals treated. For example, a child who receives nutritional treatment and subsequently has a possible diagnosis of malaria at one of our paediatric clinics is counted twice. However, if protocol dictates multiple visits for a certain service, as in the case of prenatal visits and vaccinations, then this is counted as accessing the healthcare facility only one time. Services that fall under more than one area of intervention are reported separately under each area, but counted only once in the table of total beneficiaries. Therefore, a mother who takes an HIV test during a prenatal visit is counted under Mother, Child and Adolescent Health as well as in the Fight against the Great Pandemics, but only once under total beneficiaries. The 2019 Mission Report sets out CCM’s objectives in relation to the Sustainable Development Goals (SDGs). The first part contains CCM’s strategies and activities, taking into account the SDGs and the relevant indicators to which the various projects contribute. The report then continues with a description of each country’s intervention programme.

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Goals and Results

The goals and results in Africa and Italy

Archive CCM © Angel Ballesteros - Kenya (2019)

In 2019 CCM worked to intensify the implementation of redefined strategic guidelines from the previous year. In Africa actions were focussed on 1) mother and child health with a special focus on the development of health services for young people; 2) health activities in aid of particularly vulnerable groups within the population; 3) One Health (OH). Our working approach is always looking to be increasingly multi-sectoral where the health component is part of operations carried out on non-health determinants such as food safety, access to income, water and hygiene services. Mother and child health actions were concentrated in Ethiopia and South Sudan. In Ethiopia, many emergency multi-sectoral projects connected to the prevention of irregular emigration were launched. The focus was on the development of services for young people. In South Sudan, CCM took on the management of the health system in a new state, Kapoeta, which joins the actions we have been carrying out for years in Tonj and Twic. The beneficiary of the interventions is the population as a whole, within which mothers and children represent the most significant parts. Vulnerable groups saw an intensification of actions with programmes in support of internally displaced people in Ethiopia and street children in Kenya. One Health finally passed its initial experimental stage and projects in the south of Ethiopia and the north of Kenya became fully operational. The OH approach is, and hopefully always will be, a distinctive element of our organisation’s strategy, with the intention to respond in an integrated and coordinated way to the determinants

of health and to promote the continuous involvement of experts of various disciplines, institutional parties and local communities in participative work. The appropriateness of this approach can be confirmed yet again, given the current COVID-19 situation which originated from animal to man transmission of a virus. The beneficiaries in Africa decreased from 946,205 in 2018 to 913,266. The increases registered in Kenya and Ethiopia were compensated by the decrease in South Sudan due to strikes by health staff in the second trimester of the year which halted the activities of the facilities. In Italy, interventions were focussed on only 3 areas following the decisions to resize, which were implemented in 2018: healthcare for vulnerable groups, with a reinforcement of collaboration with non-profit clinics; training and professional development and global citizenship education with a focus on health both in CCM’s usual areas of intervention (e.g., schools, migrant reception) and within businesses. The number of beneficiaries decreased overall with respect to 2018 due to the reduction of activities carried out in schools and to the failure to obtain approval for large projects. From an economic point of view, 2019 saw an overall increase in the volume of income (+1.8 million mainly in Kenya and Ethiopia); it represents a sign of quality, of how much planning has been carried out and how CCM’s proposals have been welcomed. This improvement in volume did not translate into an operating profit, which was extremely negative due to the difficulty in making necessary co-financing arrangements and to the unforeseeable cost and risk accounting in South Sudan linked to staff management.

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Goals and Results

3.1 CCM and the SDGs

GLOBAL GOALS FOR SUSTAINABLE DEVELOPMENT NO POVERTY

ZERO HUNGER

AFFORDABLE AND CLEAN ENERGY

DECENT WORK AND ECONOMIC GROWTH

CLIMATE ACTION

LIFE BELOW WATER

GOOD HEALTH AND WELL-BEING

INDUSTRY, INNOVATION AND INFRASTRUCTURE

LIFE ON LAND

QUALITY EDUCATION

GENDER QUALITY

CLEAN WATER AND SANITATION

REDUCED INEQUALITIES

SUSTAINABLE CITIES AND COMMUNITIES

RESPONSIBLE CONSUMPTION AND PRODUCTION

PEACE, JUSTICE AND STRONG INSTITUTION

PARTNERSHIPS FOR THE GOALS

An overview of the goals and sub-goals we are working towards. Reference numbers match those of the 2030 agenda.

GOAL 3 Ensure the health and well-being of everyone of all ages. 3.1 By 2030, reduce the global maternal mortality rate. 3.2 By 2030, reduce the mortality of newborns and children below the age of 5, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births. The health of mothers and children is one of CCM’s most important areas of interest and the theme of the Smiles of African Mothers campaign. Amongst the many projects aimed at reducing mother and child mortality, CCM in 2019 continued its battle against starvation in South Sudan through the treatment and prevention of acute malnutrition, the distribution of food to children, pregnant and breastfeeding women, and through awareness-raising and community training. 3.3 By 2030, put an end to the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, waterborne diseases and other communicable diseases. The fight against great pandemics is an integral part of our projects, both when we act to strengthen the healthcare system and when we meet with communities. In Ethiopia, we promote awareness-raising and the distribution of information on sexual and reproductive health, with particular attention to the youth demographic; we support services that prevent and treat communicable diseases, and AIDs in particular as it is the leading cause of death among adolescents in Africa and the second most common in the world. 3.4 By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being. Teaching the importance of prevention and promoting health education and awareness-raising activities are the focal points of our outreach and distribution of information with communities, across all our projects in Africa and Italy. 3.5 Strengthen the prevention and treatment for substance abuse, including drug and alcohol abuse. Our support and prevention activities, particularly those aimed at young people, always focus on the forms of addiction and substance abuse. This aspect is highly relevant to the Boresha Maisha project in Kenya. As a community reintegration programme to support the street children and youth, it has chosen sport as an essential tool to improve health, promote better lifestyle choices and to foster relationships. 3.7 In 2030, guarantee universal access to sexual and reproductive healthcare services, including family planning, information and education, and the integration of reproductive health in strategies and national programmes. All CCM projects pay particular attention to universal access to sexual and reproductive healthcare services. In Ethiopia we are committed to improving the availability, quality and access to healthcare services intended for young people through the training of healthcare workers, and we have arranged areas for “Youth Friendly Services” which are entirely dedicated to listening to young people and their needs.

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3.8 Achieve universal health coverage, including financial risk protection, access to essential quality healthcare services and access to safe, effective, quality and affordable essential medicines and vaccines for all. It is written in our DNA: CCM works for the right to health, defining this as a possibility for everyone, even the most vulnerable, to access health services and essential care. An example is the One Health project in Kenya, where, as a result of the collaboration with our project partners, we can continue operations to address economic determinants of health in an integrated and coordinated manner. VICOBA (Village Community Banks) are models of community micro-credit which facilitate access to credit and saving services and allow families to access healthcare services when necessary. 3.b Support the research and development of vaccines and medicines for communicable and non-communicable diseases which especially affect developing countries, provide access to essential medicines and vaccines at affordable prices, in accordance with the Doha Declaration on the TRIPS agreement. We work hard to improve the accessibility and availability of essential medicines, supporting local transport authorities and supplementing purchases when necessary. This is particularly important in more remote, rural areas, especially during the critical rainy season, when timely pre-positioning of essential medicines is necessary to guarantee the management of common illnesses, such as diarrhoea and malaria. 3.c Considerably increase healthcare funding and the recruitment, development, training and retention of healthcare personnel in developing countries, especially in the less developed countries and small, developing island states. Enhancing the skills of local healthcare workers has epitomised our work for 50 years, through formal and non-formal training courses, on-thejob training and task shifting. 3.d Strengthen the capacity of all countries, in particular developing countries, through early warning, risk reduction and national and global health risk management. In 2019, in Kenya and Ethiopia, the One Health project supported local authorities and communities in strengthening early warning and response systems for public health events and in reducing health risks, especially those from animal-borne diseases. The action calls for the integration of traditional knowledge about the environment with innovative technologies and the involvement of all key players in a community to guarantee a multi-sectoral, integrated and coordinated response to threats of infection typical of pastoral areas.

GOAL 2 End hunger, achieve food security and improved nutrition, and promote sustainable agriculture. 2.2 By 2030, put an end to all forms of malnutrition, achieving, by 2025, the agreed international goals on the nutrition of children under 5 years and satisfying the nutritional needs of adolescents, pregnant and breastfeeding women and elderly people. In South Sudan we supported the healthcare facilities that offer an integrated health-nutrition service and, through the active involvement of Mother-to-Mother Support Groups (MtMSG), we strengthened the community nutrition activities to guarantee continuous support to mothers and children during the difficult weeks of malnutrition treatment.

GOAL 4 Ensure inclusive and equitable quality education and promote learning opportunities for all. 4.7 By 2030, ensure that all students acquire the knowledge and skills necessary to promote sustainable development, through education on sustainable development and sustainable lifestyles, human rights, gender equality, the promotion of a culture of peace and non-violence, global citizenship and the appreciation of cultural diversity and cultureâ&#x20AC;&#x2122;s contribution to sustainable development. In Addis Ababa, Ethiopia, we contribute to the improvement of sanitary conditions in 6 schools. The active involvement of the teaching staff and parents is essential for the development of a health education course aimed at young students. We maintain great commitment in Italy, among young people and in schools, to deliver education and knowledge, to promote global citizenship and foster meetings and respect for differences.

Mission

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GOAL 5 Achieve gender equality and to empower all women and girls. 5.6 Guarantee universal access to sexual and reproductive health and to reproductive rights, as agreed under the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action. This concerns a central aspect of the Smiles of African Mothers campaign which bases its action on an integrated approach of sexual, reproductive, mother, neonatal, child and adolescent health. CCM is particularly committed to improving the availability, quality and access to healthcare services for young people by training health workers and launching dedicated services, known as Youth Friendly Services. Emotional and sexual education is also a fundamental aspect of this goal in Italy, especially with vulnerable adolescents.

GOAL 6 Ensure the availability and sustainable management of water and sanitation services for all. 6.2 By 2030, guarantee adequate and equitable access to sanitary services and hygiene for all and put an end to open defecation, with particular attention to the needs of women and girls and those in vulnerable situations. Attention to personal hygiene and the environment is essential for health. In Ethiopia we improved community hygiene conditions, guaranteeing the delivery of basic healthcare service to displaced people and host communities, through the start up of mobile clinics, the construction of new toilets and the distribution of soap and water purifiers. We also deal with topics that are still taboo, such as menstrual hygiene, which in some places still cause disease and isolation.

GOAL 9 Resilient infrastructures, sustainable industrialisation and innovation. 9.a Facilitate the development of sustainable infrastructures in developing countries through greater financial, technological and technical support in African countries and those less developed. The construction and restoration projects carried out every year remain constant and numerous. Especially in South Sudan and Ethiopia, collaboration with local communities allowed healthcare facilities to reinstate the use of some rooms suitable for accommodating the sexual and reproductive health clinics aimed at young people.

GOAL 10 Reduce inequality. 10.2 By 2030, enhance and promote social, economic and political inclusion of all, regardless of age, sex, disability, race, ethnicity, origin, religion, economic or other status. Inclusion of vulnerable groups is a central field of activity for CCM. In Nairobi, Kenya, rehabilitation and community reintegration programmes are important both for contributing to the improvement of psychosocial well-being and health of children, street children and refugees and for promoting better lifestyles and social integration. Furthermore, we operate in Ethiopia with other organisations which promote activities to generate income in order to strengthen economic inclusion. In Italy, we work to remove cultural and information barriers which hinder a real inclusion of the more vulnerable population, especially migrants. 10.7 Facilitate the safe, orderly, legal and responsible migration and movement of people, including through the implementation of wellmanaged and planned migratory policies. The right to migration is inviolable. However, it is also right to know the risks connected to illegal migration and to have the choice of staying in oneâ&#x20AC;&#x2122;s own country. Some of our projects in Ethiopia are developed on these fundamentals. These projects operate in the areas particularly hit by the migratory phenomenon and they try to strengthen the opportunities for socio-economic development and access to health services for young potential migrants and returnees.

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10.b Encourage public aid for development and cash flow, including direct foreign investments, in states where the need is greater, especially in less developed countries, African countries, and developing countries, in accordance with their national programmes. Together with our network of partners, we maintain that government investment in international cooperation is essential to support low-income countries.

GOAL 11 Make cities and human settlements inclusive, safe, adaptive and sustainable. 11.6 By 2030, reduce the adverse per capita environmental impact of cities, paying particular attention to air quality and urban and other waste management. Waste management involves the correct disposal of hazardous medical waste, which is also a threat to the health of humans, animals and the environment. Minimising waste production, ensuring its proper separation and treatment according to national and international regulations, searching for innovative strategies which concern the environment is a commitment across all our projects.

GOAL 12 Guarantee sustainable consumption and production patterns. 12.8 By 2030, ensure that all people in the world receive relevant information and are made aware of sustainable development and lifestyles in harmony with nature. CCM embraces the One Health approach as an ideal means to achieve sustainable development and the health of mothers, children and the general population. The strategy recognises the close interaction between the health of humans, animals and the environment, and promotes an intersectorial collaboration to face the grave problems which characterise the twenty-first century, such as global overpopulation, climate change and the loss of biodiversity, the onset of new infectious diseases and the risk of global pandemics.

GOAL 13 Promote action at all levels to combat climate change. 13.1 Strengthen resistance and adaptability to risks linked to climate and natural disasters. The correlation between human, animal and environmental health is behind the One Health approach, which CCM has adopted and is looking into further with structured research. We started and developed the One Health project to advance the integrated health of the nomadic pastoral population in northern Kenya and in the Somali region of Ethiopia, who are particularly vulnerable to extreme weather events and climate change.

GOAL 17 Strengthen the means of implementing goals and modernise world partnership. Finance - Technology - Capacity building - Business - Political and institutional consistency - Multilateral partnerships - Data monitoring and responsibility. Institutional reinforcement, construction of multi-stakeholder partnerships, involvement of various parties within our projects, from communities and local authorities to policymakers, civil society and the private sector. These are essential elements of our approach to promoting the right to health. Facing the different economic and social health determinants means setting up a multi-disciplinary and intersectoral work.

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Goals and Results

3.2 Results

In Africa

In 2019 CCM consolidated its intervention in the Horn of Africa through 24 cooperation projects. The organisationâ&#x20AC;&#x2122;s work was concentrated in 19 health districts that serve almost 1.5 million people. The interventions benefited the most vulnerable groups of the population: children, young people, and women who live in remote and difficult to reach areas, such as the agro-pastoral zones of Kenya, Ethiopia and South Sudan, and densely populated urban areas where particularly disadvantaged groups are concentrated, such as the slums of Mlango Kubwa in the centre of Nairobi. Training remains at the centre of CCMâ&#x20AC;&#x2122;s interventions and during the year it was able to reach 1,268 authorities and social and healthcare workers. The training courses were carried out with local authorities, with respect to the priorities of each area of intervention and to ministerial guidelines. Various topics were covered, among which were paediatric care, sexual and reproductive health, and the planning and management of healthcare services. Training and technical supervision enabled the support of 142 healthcare facilities, among which were hospitals that guarantee the management of obstetric-neonatal emergencies and basic surgery services. Around 404,000 children and adults benefited from preventive health services (vaccinations and antenatal visits) and healthcare (clinic visits, in-patient services, skilled-birth attended deliveries and surgical operations) and around 425,000 people were reached by health education and awareness-raising activities. To improve the quality of the health system, CCM worked with local authorities and communities to identify the problems behind the delivery and use of services and to plan effective and sustainable strategies to resolve them. Prompt solutions allowed us to increase support to healthcare social services dedicated to young people, with particular focus on the zones most hit by the migratory phenomenon in Bale in the region of Oromia, in the Eastern Zone of the Tigray region and in South Wollo in the Amhara region, in Ethiopia. We consolidated the institutional and community welfare project in the slum of Mlango Kubwa in Nairobi and pastoral communities in the south of Ethiopia and the north of Kenya, through the implementation of the One Health approach that promotes multi-sectoral collaboration to ensure the health of people, animals and the environment. Regarding the global strategy of the Sustainable Development Goals, One Health is the ideal instrument to achieve global health and sustainable development. Recognising the close interaction among animals, people and the environment, One Health promotes a multi-sectoral collaboration to face the serious problems which characterise the twenty-first century, such as the overpopulation in the world, the climate change, the occurrence of new infectious diseases and the risk of global pandemics. CCM

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has adopted One Health as a distinctive feature of its organisational strategy, with the intent to respond in an integrated and coordinated way to health determinants and to promote the continuous involvement of experts from various disciplines, institutional parties and local communities in participative work, which favours the integration of scientific knowledge with traditional knowledge and practices.

913,266 trained workers and assisted people

Ethiopia

19,63% 179,358

Kenya

3,06% 27,973

South Sudan

77,29% 705,935

2019

2018

Implemented projects

Supervised facilities

142

Trained health workers

1.268

535

People examined and/or treated People with access to water and toilets People benefitting from raised awareness

487,017

629,750

13,800

424,981

302,120

913,266

946,205

In Africa

TOTAL BENEFICIARIES

Archive CCM ÂŠ Angel Ballesteros - Kenya (2019)

In Italy In 2019, the efforts of CCM in Italy were concentrated on three traditional areas of intervention, namely the right to health for vulnerable groups, training and professional development of healthcare social workers, and global citizenship education (GCED) with a particular focus on health. We created 14 initiatives, reaching more than 3000 beneficiaries. With migrants and homeless people, activities of empowerment were carried out with the aim of enabling them to take a greater control over their health. Through the management of two areas of listening and health guidance, health education sessions and networking activities, CCM worked to improve the programmes of treating both vulnerable Italians and foreigners. In schools and meeting places in Turin, and in the surrounding area, we worked with adolescents to fight discrimination and promote healthy relationships with each other and with diversity. Through the Global Health Course, scientific conventions, training in universities and the professional development of workers, CCM contributed to spreading the principles of the right to healthcare for everyone and to advocating against inequalities in healthcare.

2019

2018

Implemented projects

Trained healthcare ocial workers

850

499

People educated about Global Citizenship and made aware of health

416

1,805

Vulnerable people assisted

1,176

1,774

TOTAL BENEFICIARIES

3,042

4,078

In Italy

The drop in the number of beneficiaries reached is attributed mainly to the reduction of the citizenship education activities, in particular to the cancellation of some street events which took place in May 2019 that usually allows us to reach a great number of students in a few days.

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4 Indicators

Our work in 2019 is summarised in both words and figures. This helps us describe in more detail what we do, how we operate and our future directions.

TOTAL PROJECTS

TOTAL BENEFICIARIES

913,266

532,932

Maternal and Child Health The Fight Against the Great Pandemics

442,669

BENEFICIARIES IN STRATEGIC AREAS

The number of beneficiaries in our various areas of activity demonstrates the general trend of our decisions. We always focus on the most serious conditions and illnesses, as well as those we can most efficiently help, with the aim of saving as many lives as possible.

Surgery, Emergency Medicine and Trauma Care Inclusion of Vulnerable Groups

2,893 570

CCM holds third place among national NGOs in the classification drawn up by Open Cooperazione (Open Cooperation).

TRANSPARENCY In the NGO transparency index, we are committed to providing prompt and INDICATOR

95%

accurate accountability to all our stakeholders.

AREA ACCEPTANCE INDICATOR

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The relationship between expatriate and local staff is an indicator of our impact and local acceptance.

expatriate staff

0,82%

local staff

99,18% 2

OUR COMMITMENT IN THE COUNTRIES WE WORK IN

USE OF FUNDS

SOURCE DIFFERENTIATION

The organisation concentrates most of its activities in South Sudan. It is increasing its work in Ethiopia and in Kenya. The volume of activities in Italy is lower than the previous year.

CCM maintains its decision to allocate the majority of its funds to the fulfilment of its activities in the field. 90% of economic resources are used for everyday activities in Africa and in Italy. General support costs amount to 5.85%, of which 0.35% for running offices in Africa and 5.50% for running the central office. The office running costs are shown net of the fixed administrative costs acknowledged by institutional projects.

The organisation remains committed to seeking a wider differentiation of sources of finance in order to improve the response to new emerging community needs and make the organisationâ&#x20AC;&#x2122;s work more solid and stable.

EUR

7,430,146.60 South Sudan

51,20% 3,804,875

12,40% 920,922

Kenya

91,43% 8,169,628

Activities in Italy

0,9 % 70,312

Intercountry projects

0,0% 2,754

8,484,177

Cooperazione italiana (Italian Cooperation)

40,56% 3,441,477

Local Administrations

0,34% 29,048

Foreign public administrations Promotional and fundraising costs

2,23% 199,384

UN agencies and other international bodies Prime Ministerâ&#x20AC;&#x2122;s Office

0,1% 5,000

Burundi

Typical activity costs

35,30% 2,626,284

Ethiopia

8,935,529

Asset and financial costs

General support costs

0,49% 43,957

5,85% 522,560

36,92% 3,132,057 6,63% 562,356 0,72% 60,754

Private and business

10,72% 909,822

Financial and asset income

1,34% 113,578

Other income

0,35% 29,711

Other

2,42% 205,374

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5 Activity Areas of

5.1 Maternal, Child and Adolescent Health

The health of mothers and children has always been one of the ticide-treated mosquito nets and intermittent anti-malaria priorities of CCM. In the first 1000 days in the mother-child re- treatment during pregnancy. We informed the local commulationship, encompassing pregnancy and the child’s first year, nities about nutrition, prevention of common diseases, family health inequalities are great whereas simple and cheap inter- planning and sexually transmitted diseases, and we organized teaching courses to improve the knowledge of health workers. ventions of prevention and treatment can make a difference. Every year women die during or within few days of deliv- Our stay in the same area for years has increased the trust of ery due to complications. In 2018, 295000 women died from local communities and authorities. Our activities contributed to a significant drop of mortality for causes related to pregnancy and mothers and children. delivery. Most deaths (94%) ocIn Italy and in particular in Piedmont curred in low-income countries the national health system is accesand many could be prevented: 462 sible to everybody but there are indeaths/100000 live births in low-inequalities in the access to reproduccome countries versus 11/100000 in tive and obstetric/pediatric health the Western world. services. Scarce social inclusion, The same happens to children educational poverty and cultural younger than one year of age. In difficulties often cause underweight 2018 5.3 million children younger babies, unwanted pregnancies, Archive CCM © Angel Ballesteros Kenya (2019) than 5 died, half of them in the first abortions; this happens because month. In sub Saharan Africa a child has 15 more chances to die than in Europe. Most of those deaths are preventable through foreign women ignore the presence of the available services. vaccination, a healthy diet, clean water, treatment of common Teenagers grown in marginalized and degraded environments face health risks such as unwanted pregnancies and sexual disdiseases and prevention of malaria. In 2019 we kept on fighting mothers’ and children’s mortali- eases because of lack of information, both about behaviours ty. Together with local health authorities and communities we and about health services. CCM has continued its educational tried to reach out the remotest villages. We provided assistance activity among migrants and students, promoting information to delivery, prenatal surveillance, vaccination for mothers and about current health facilities and their use. children, supplementation of vitamin A, B12 and iron, insec-

2019

2018

10,773 131,916 43,091 25,133 12,878 33,521 277,960 767 5,366

9,461 151,068 51,955 27,064 5,599 15,614 141,184 381 4,424

25,048

93,896

532,932

479,963

Trained healthcare social workers People benefitting from raised awareness/educated

206 248

18 115

TOTAL BENEFICIARIES

454

133

In Africa Births and obstetric care emergencies Children under 5 visited / treated Women of childbearing age and children vaccinated Women assisted during pregnancy Women who use family planning Adolescents and young people accessing dedicated services People made aware of maternal and child health People trained in maternal and child health Malnourished children treated in clinic Children and pregnant women involved in acute malnutrition prevention programmes

TOTAL BENEFICIARIES

In Italy

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5 Activity Areas of

5.2 The fight against the Great Pandemics

228 million cases of malaria were diagnosed worldwide in 2018, causing the deaths of 405,000 people, 93% of whom were in Africa. Between 2010 and 2018, the incidence of malaria has fallen from 71 to 57 cases per 1000 population. However, over the last 3 years this decrease in the number of cases has slowed. Children under 5 are most vulnerable, and have a mortality rate of 67% as a demographic (272,000). Malaria contracted in pregnancy caused 872,000 infants (16%) to be born with low birth weight, many of whom later become anaemic - this is because few countries provide intermittent preventive therapy for malaria. Even seasonal preventive therapy is only carried out in a small number of African countries. In addition to being deadly, malaria causes a state of exhaustion in adult sufferers, leading families to fall into poverty when one or more members are affected by the disease, and yet it is easy to treat and easy to prevent. Mosquito nets, treated with long-lasting natural insecticide, are the best means for preventing the transmission of the parasite, but access to medicine and the availability of Rapid Diagnostic Tests are also fundamental to reducing the number of deaths. With its projects, carried out in collaboration with local health services, CCM has continued to provide information, train health workers, and distribute preventive measures, medicine and rapid tests. Deaths from AIDS amounted to 37.3 million people in 2018, 25.7m of whom were in Africa. Treatment with antiretroviral therapy was performed in just 62% of patients, well below the 90% recommended by the WHO. However, compared to 2010, when only 7.7m patients were treated, 23.3 million patients were treated in 2018. With respect to HIV/AIDS, our strategy focuses mainly on prevention: the prevention of HIV infection in women of childbearing age, increasing their awareness of the disease, facilitating the availability and use of condoms and promoting gender equality; the use of safe family

planning methods for the prevention of unwanted pregnancies; the prevention of vertical transmission of the virus from an infected woman to her child at the moment of birth; and the provision of treatment and support to women and children during birth and the first few days of life. Deaths from tuberculosis numbered 1.5 million people in 2018 (215,000 of whom had HIV) and have decreased by 2% per year. However, to reach sustainable development goals by 2030 (to eradicate the tuberculosis epidemic), this decrease must double to 4-5% per year. Cases of multi-drug-resistant tuberculosis (MDR TB) are a major public health issue which require more complicated treatment with higher levels of toxicity. Convincing patients to take their prescribed medication for as long as necessary is vital for this reason. In treating tuberculosis, we use medicines and management methods recommended by the WHO - always in cooperation with local authorities - above all to ensure patients regularly take their medication. This is overseen by a trustworthy individual within the patientâ&#x20AC;&#x2122;s community. In Africa it is particularly difficult to accept continuous therapy for at least 6 months - social control has proven itself the best tool available for this, and is effective even in rural areas. Archive CCM ÂŠ Ethiopia (2019) In Italy, infectious disease has garnered some media attention and has taken an important role within the broader theme of public health. The increase of migration flow is erroneously connected to the return of diseases such as tuberculosis and HIV. In 2019 we have continued to debunk fake news and spread reliable information and knowledge on how to prevent/hinder pandemics and emerging diseases. There has been some interest in animal-borne diseases and antibiotic resistance; we have continued to work on these issues, discussing the One Health strategy with veterinarians and environmental experts.

2019

2018

11 24,872 263,149 137,842 389 16,418

11 19,987 336,331 167,541 73 18,504

442,669

524,436

In Africa Disease surveillance laboratories HIV tests carried out Cases of infectious diseases diagnosed and treated People educated about infectious diseases People trained in infectious diseases Mosquito nets distributed Zanzariere distribuite

TOTAL BENEFICIARIES

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5 Activity Areas of

5.3 Surgery, Emergency Medicine and Trauma Care

Upon his election in 2017, the Director-General of the WHO, Dr. Tedros Adhanom Ghebreyesus, highlighted that surgery must be considered a fundamental component of adequate universal health coverage (UHC). In fact, 28-32% of all illnesses can be resolved with surgical treatment. Emergency surgery is performed in rural hospitals of Sub-Saharan Africa and includes all interventions without which patients may die or become permanently disabled. The WHO recommends that all rural hospitals should be equipped with persons capable of carrying out life-saving interventions in a safe, accessible and affordable way. In 2014 the president of the World Bank, Dr. Jim Yong Kim, also highlighted surgery as an essential part of the healthcare system in reaching the objective of UHC, one of the objectives of the Sustainable Development Goals (SDGs). The Lancet Commission on Global Surgery notes that surgery and anaesthesiology improve not only the health of individuals but also countries’ productivity by reducing the number of deaths and disabilities. In the early years of the new century, efforts to improve the state of global health were focused on specific diseases, concentrating on so-called vertical programmes (TB, Malaria, AIDS). However, it has become evident that such a strategy has not reduced mortality and morbidity as hypothesised. In the second decade of the 2000s, health policy has changed strategy. Every state must strive to achieve health and wellbeing for all of its citizens; in order to reach this objective, strengthening the National Health System is necessary. This involves building facilities throughout the territory, including healthcare centres, rural hospitals, and secondary and tertiary services, such that the network of services is well-distributed and accessible to all.

Rural hospitals must be able to guarantee emergency surgery services and be capable of treating clinical situations that if not treated in a timely manner may cause the patient’s death (e.g., complicated birth, acute abdomen), or traumas that if left untreated may evolve into permanent disabilities. Secondary and tertiary hospitals must provide access to surgical services to be carried out on patients with cancer, complicated trauma and debilitating deformities. The task of the international community is to ensure that, by 2030, 80% of hospitals are equipped with surgical and anaesthesiology services, that they are adequately distributed throughout each country’s territory, and that surgical interventions are lowcost and accessible to all. In the countries where CCM operates, the difficulties encountered by rural hospitals overlap with one another: poor training and organization, limited surgical specialization and inadequate operating and emergency rooms, often without a continuous supply of medicines. For years CCM has been working to provide highquality surgery to patients who would not otherwise be able to receive it. Our model promotes Archive CCM © South Sudan (2019) free healthcare capable of guaranteeing high clinical standards for individual operations as well as promoting the training of qualified health workers to ensure proper management of obstetric emergencies and general surgery. In 2019, CCM’s projects have allowed three rural hospitals in South Sudan to strengthen their surgical services, guaranteeing the constant presence of qualified personnel and essential medical supplies and medicines to deal with elective and emergency surgeries. In Italy, the subject of essential surgery was addressed via elective training courses aimed at students of the Faculty of Medicine and Surgery of Turin.

2019

2018

3 2,893 -

3 2,852 3

2,893

2,855

In Africa Supported surgical facilities/services Surgical procedures and emergency operations carried out People referred for urgent surgery Staff trained in surgery and emergency medicine

TOTAL BENEFICIARIES

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5 Activity Areas of

5.4 Inclusion of Vulnerable Groups

According to the WHO, health is a state of complete physical, mental and social well-being. The international agenda for Sustainable Development Goals (SDGs) - to be reached by 2030 - has underlined the fact that many of its 17 goals are involved in achieving a state of good health. Only the 3rd goal is directly dedicated to health (ensuring health and wellbeing for all at all ages), while the others are indirectly linked (reduction of poverty, malnutrition, provision of education, achieving gender equality, the right to clean and public water, the reduction of inequalities within countries). These goals apply not only to lowincome countries but to all countries as major social and healthcare inequalities are present even in nations in the northern hemisphere. CCM has always considered health in all its complexity, putting people at its heart and paying particular attention to the most fragile fringes of the population. In order to reduce the inequalities present within nations as well as between nations (that is, between high-income and low-income countries), it is important to promote inclusive and sustainable social and healthcare services that value every single individual and allow them to become, at least in part, the creator of their own well-being. To this end, we work in rural areas of Africa where preventive and curative healthcare services are less present. When we work in capital cities, we turn to the weakest sections of the population, such as the inhabitants of slums, the disabled and victims of violence. We carry out information campaigns, provide health training and bring healthcare services to areas lacking them, adapting them to the local culture and infrastructure. We work with communities to facilitate their well-being, their capacity to request high-quality social healthcare services from local authorities, and

encourage their leadership. Informing local populations of possible treatments and prevention strategies triggers a positive mechanism of requests for services and informed management of these services, improving community well-being. We work in a network with national and international organizations specializing in areas that influence/determine good health, such as those providing clean water, educating children, assisting people in finding work, improving agri-food production and improving animal health. In Italy we work with the weakest segments of the population (the homeless, irregular migrants and asylum seekers), promoting the use of national healthcare services within these marginalized populations, who at times are unaware of the possibilities offered by these services. We provide training in schools to support the right to public water and to combat discrimination based on race, gender, and differing religious beliefs. We train university students on topics in global health and cultural competence, material not present in the training curriculums of health personnel. We work in a network with public structures (Regions, Communes, Local Health Units, Universities, districts, neighborhoods), the tertiary sector (SERMIG, Gruppo Abele, Ufficio Pastorale Migranti, Camminare insieme, some NGOs in the Piedmont NGO Consortium...), cooperatives managing asylum seekers, and private organizations (Michelin...) We aim to develop community healthcare projects, encouraging citizens to take an active role in the management of their own health. We insist upon the importance of primary prevention (proper diet, regular physical exercise, social skills) and secondary prevention (regular metabolic testing, examinations for the prevention of tumors), as well as the use of available social assistance services to request help with the daily management of oneâ&#x20AC;&#x2122;s needs.

2019

2018

People made aware of sexual violence Staff trained to deal with victims of violence Victims of violence given healthcare, social and legal support Staff trained in social inclusion techniques Vulnerable people involved in social inclusion pathways

54 120 396

2 41 222

TOTAL BENEFICIARIES

570

265

201 120 1,385

723 2,059 800

1,706

3,582

In Africa

In Italy Trained healthcare social workers People benefitting from raised awareness/educated Vulnerable people assisted

TOTAL BENEFICIARIES

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report 25

6 Projects

In Africa. In Italy

Key to areas of interest and activities:

MATERNAL AND CHILD HEALTH

THE FIGHT AGAINST THE GREAT PANDEMICS

SURGERY, EMERGENCY MEDICINE AND TRAUMA CARE

INCLUSION OF VULNERABLE GROUPS

WATER AND HYGIENE

IN AFRICA NO POVERTY

ZERO HUNGER

GOOD HEALTH AND WELL-BEING

GENDER QUALITY

CLEAN WATER AND SANITATION

REDUCED INEQUALITIES

ETHIOPIA In 2019, CCM continued its efforts to strengthen the Ethiopian healthcare system by increasing and improving the available primary and secondary healthcare services, particularly for youth and young people, by promoting awareness campaigns and by providing information at the community level. It also encouraged capacity building for healthcare professionals and authorities and continued its operation to support mother and child health in the Liben Zone of the Somali Region. CCM also increased its support to healthcare social services for young people, focusing specifically on the areas most affected by the migratory phenomenon: the Bale Zone of the Oromia Region, the Eastern Zone of the Tigray Region and South Wollo in the Amhara Region. CCM and its partners have contributed to strengthening the resilience of the pastoral farming communities in the Somali Region with integrated and multidisciplinary operations based on One Health. Furthermore, CCM has worked with the international community in order to respond to humanitarian emergencies in the country, providing health assistance to internally displaced people, implementing health services dedicated to the most vulnerable populations of Oromia, and participating in the united response to the needs of Eritrean refugees in Tigray.

• Universal and fair access to quality health services in order to meet the health needs of women and children in the Filtu and Dekasuftu districts. • The intervention aims to improve the health of mothers and children in two districts of the Liben Zone by increasing access to the prevention and treatment services at Filtu Hospital, 5 health centers and 14 dispensaries. Services are strengthened not only in infrastructure and availability of medical equipment but also through the continuous training and supervision of health professionals. It is expected that the provision of training courses and technical assistance for health authorities will strengthen their capacity to plan, manage, and monitor healthcare services. Furthermore, activation of protocols, communication systems and the transfer of urgent cases to qualified facilities will enhance the referral system to first-level hospitals for patients within these communities. CCM supports the ‘House for a Safe Delivery’ at Filtu Hospital where women close to childbirth with symptoms of possible complications are assisted in order to guarantee quick and direct access to urgent care if necessary. Thanks to the involvement of traditional

Mission

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leaders and the use of community theatre techniques, the local community is provided with information on the best practices in mother and child health. Partners: The Somali Region, Filtu and Dekasuftu Districts Health Department, Filtu Hospital Health Management. Sponsors: Italian Agency for Development and Cooperation (AICS), 8x1000 CEI, National Federation of Medical, Surgical and Dental Associations (FNOMCEO). Timeframe: January 2016 - October 2019.

• Health workers and local communities cooperating to improve mother and child health in the Liben Zone (Somali Region - Ethiopia) • The project aims to contribute to the improvement of community health in the Liben Zone (Filtu and Dekasuftu districts), with a particular focus on improving access to mother and child and reproductive health for women and children. This intervention is partially in support of the aforementioned project. However, an additional component of the intervention provides

training on patient and personnel safety for the prevention of infection as well as community awareness-raising efforts through theatrical performance on the theme of mother and child health, featuring high-impact content that is easily comprehended even by individuals with minimal education. Partners: The Somali Region, Filtu and Dekasuftu Districts Health Department, Filtu Hospital Health Management. Sponsors: 8x1000 CEI. Timeframe: July 2019 - May 2020.

and identifying any weakness in the proposed strategy. The results of this research, which are in the process of being finalized, will allow the planning of future projects and will provide information on how to best respond to the needs of young people in Ethiopia. Partners: CIAI Ong (NGO), University of Turin, University of Rome, Tigray Region Health Department, Institute of Health and Research in Tigray, University of Mekelle, The Letwomen Association. Sponsor: Italian Agency for Development and Cooperation AICS, Vismara Foundation. Timeframe: April 2017 - June 2020.

• One Health: improving the health conditions of nomadic herders in the Filtu District. Phase 2 • #Lemieradici (#myroots): A socio-economic and healthcare social support intervention • for potential migrants in Ethiopia’s South 80% of the population in the Somali region are nomadic herders. Due to Wollo Zone. their constantly roaming lifestyle and their cultural and behavioral dynamics, pastoral communities are rarely inclined to access conventional health services, which are particularly scarce and ill-equipped within the region. This contributes to indicators of poor health in the area, characterized by high infant mortality rates and high incidence of infectious diseases, especially zoonosis (diseases transmitted from animals to humans). Recognizing the close connection and interaction among pastoral communities, the environment and animals, the project intends to use the One Health approach. This promotes an integrated model of human, animal and environmental health, which is well adapted to the customs and needs of nomadic pastoral communities. Action is focused on the Filtu and Dekasuftu districts in the Liben Zone of the Somali region. The current project is a continuation of a project previously financed by funds from the 8x1000 Council Presidency and implemented between 2016 and 2018. Partners: CISP Ong (NGO), local health departments and the Departments of Farming, Livestock and Fishing in the Filtu and Dekasuftu districts in the Liben Zone. Sponsor: Overseas office of the Italian Agency for Development and Cooperation - The Council Presidency of AICS in Addis Ababa, through funding from 8x1000. Timeframe: November 2018 - October 2019.

•

The project, carried out by CIFA and CCM in the woredas of Ambassel, Tehuledere and Worebabo in the South Wollo Zone, is intended to contribute to the improvement of the socio-economic and healthcare social conditions of potential migrants and to inform them of the risks of irregular migration. CCM is particularly concerned with improving the availability, quality and accessibility of healthcare services for young people, through the education of healthcare workers and the opening up of spaces dedicated to both their physical and psychological needs- Youth Friendly Services. In collaboration with professionals at the Social and Community Theatre Centre of Turin (TSC), the project includes the organization of training and mentoring initiatives on various healthcare social topics for groups of young people, adding to other initiatives by TSC and CIFA that place greater emphasis on raising awareness of the risks of irregular migration. Partners: CIFA, Health Departments in the South Wollo Zone and in the Ambassel, Tehuledere and Worebabo districts, Social and Community Theatre Centre of Turin (TSC). Sponsor: Italian Agency for Development and Cooperation AICS, Tavola Valdese (Waldensian Round Table). Timeframe: April 2017 - June 2020.

• PROJECT YOUNG PEOPLE! The promotion of health and research to give a voice to Tigray’s • A socio-economic, health and psychosocial support intervention to mitigate the principal young people. causes of illegal migration in South Wollo, in the Amhara region • • This project has built on the results achieved in its first year, growing into an integrated program to improve the health and social conditions of young people in the area of intervention. At the heart of the operation is the promotion of good sexual and reproductive health among youth and young people, through the creation of dedicated spaces for young people in 20 health centers and their direct involvement in awareness-raising activities within the community. Development of the project involves a research element that requires an epidemiological and anthropological multidisciplinary approach, with the aim of both gaining a deeper understanding of the basic themes

•

This intervention complements the #myroots project, expanding the project’s geographic coverage and focusing particularly on urban and semi-urban areas of the South Wollo zone in the Amhara region, namely the Dessie and Dessie Zurie districts. It takes into consideration the lessons learned and the good practices developed during the #myroots project. In particular, the project team is intent on strengthening socio-economic development opportunities and healthcare services available to young potential migrants.

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It also works closely with local partners to create and provide an integrated social inclusion program for returnees, including a pilot project that offers psychological support. Partners: CIFA, Health Departments in the South Wollo zone and in the Dessie and Dessie Zurie districts. Sponsor: Overseas office of the Italian Agency for Development and Cooperation - AICS in Addis Ababa. Timeframe: July 2018 - October 2019.

• Emergency initiative for the defence of vulnerable repatriated groups and potential migrants to mitigate the causes of irregular migration in Bale, Arsi and West Arsi zones. •

•

This project, carried out by CCM in partnership with COOPI (Cooperazione Internazionale) and LVIA (Lay Volunteers International Association), aims to mitigate the causes of irregular migration in the Oromia Region, and in particular in the Bale and Arsi zones, areas with the highest levels of irregular migration in the country. The project plans to reach its goal through by improving the provision of, and access to, sexual and reproductive health services for youth and young people, potential migrants and returnees; by increasing employment among young potential migrants and returnees within the agriculture and service sectors; and by studying healthcare social problems that affect returnees to identify sustainable and efficient ways to provide psychological support and encourage social reintegration. Within the consortium, CCM focuses its work on the strengthening of healthcare services for young people, awareness-raising campaigns within the community and the study of healthcare social problems affecting young returnees following a difficult migratory experience. Partners: COOPI, LVIA, the Health Departments of the Oromia Region and the Bale and Arsi districts. Sponsors: Overseas office of the Italian Agency for Development and Cooperation - AICS in Addis Ababa. Timeframe: July 2018 - October 2019.

• Improving access to water, healthcare and hygiene in 6 schools within the sub-city of Silk-Lafto in Addis Ababa. The project aims to contribute to the improvement of health and hygiene conditions in 6 schools in the Mekanisa area of Addis Ababa, by means of an integrated approach based on the experiences and longterm collaboration of three Italian non-governmental organizations: CISP, CCM and CIAI. More specifically, the project aims to improve: access to water through the reconstruction of water supply systems within schools; awareness of good personal hygiene practices through soap-making workshops, focusing specifically on menstrual hygiene;

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awareness of environmental health through the involvement and training of student groups; family and student nutrition through the creation of school kitchen gardens. In addition, young students will be shown how to make recyclable sanitary towels and will learn how to manage their periods. The active involvement of teaching staff and groups of parents will allow the project to become sustainable over time. Partners: CISP, CIAI, the Letwomen Association, the management of the 6 schools involved. Sponsor: Overseas office of the Italian Agency for Development and Cooperation - AICS in Addis Ababa. Timeframe: August 2018 - November 2019.

• An integrated approach to improving living conditions and strengthening the resilience of the pastoral and agro-pastoral communities affected by the drought in the Somali region • This project is working to help improve the living conditions of pastoral and agro-pastoral communities in the Somali region by reducing the effects of drought. More specifically, the project aims to strengthen the resilience of communities in the Liben Zone, adopting the integrated and multidisciplinary One Health approach. At the heart of this work is the multi-party platform, composed of the leading community representatives – including healthcare workers and veterinarians, traditional leaders, women, young people and teachers – who work together to identify a village’s main priorities and to develop sustainable joint strategies to face these problems and encourage rural development. The project is carried out in partnership with CISP in three districts (Filtu, Dekasuftu and Kersadula) in the Liben Zone. Partners: CISP, the Health Department and Departments of Agriculture and Fishing in the Filtu, Dekasuftu and Kersadula districts, the administrative offices in the Liben Zone. Sponsor: Overseas office of the Italian Agency for Development and Cooperation - AICS in Addis Ababa. Timeframe: September 2018 - March 2020.

of the fight against gender-based violence and taking responsibility at the community level. The intervention is being carried out in the Oromo Region, West Hararghe Zone, with particular reference to Chiro hospital. Partners: CISP (leader), CIAI, CIFA, CEFA, Live Addis, ALMATERRA. Sponsor: Overseas office of the Italian Agency for Development and Cooperation - AICS in Addis Ababa. Timeline: April 2019 - January 2021.

Archive CCM © Ethiopia (2019)

• Strengthening and integration for Eritrean refugees and host communities in the Shire area • This intervention seeks to promote the improvement of asylum and protection services in the Eritrean refugee communities of Ethiopia’s Tigray region. It proposes an integrated intervention founded on the experience and collaboration of four Italian non-governmental organizations: VIS, CIAI, CISP and CCM. The project aims to improve basic services within refugee camps, focusing on health services, education and the diversification of means of livelihood. Women will especially benefit through their involvement in female empowerment activities. The project will take place in 3 refugee camps (Mai-Ayni, Adi Harush and Itsas) and within the host populations in the surrounding districts of Selemti and Asegede Tsmbla and in the city of Shire. Partners: VIS, CIAI, CISP, ARRA the National Agency for the Management of Refugees and Repatriates, Health Departments in the Tigray region. Sponsor: Overseas office of the Italian Agency for Development and Cooperation - AICS in Addis Ababa. Timeframe: October 2018 - August 2020.

• Strengthening of social cohesion in Ethiopia: opportunity, protection and employment for minors and potential migrants (HOPE) •

•

This intervention seeks to strengthen social cohesion and raise awareness among local authorities and civil society of migration management. It aims to improve the health and living conditions of those most vulnerable to the risks of irregular migration (particularly young people and adolescents). The project also contributes to the fight against migrant exploitation, offering them increased protection and economic opportunity at home and discouraging irregular emigration by making them aware of the risks and supporting local authorities to improve management of migratory issues. Concentrating above all on the improvement of the sanitary conditions of potential migrants, CCM emphasizes the importance of raising awareness

• Focus on internally displaced persons: basic services, resilience and social inclusion on the border between the Somali Region and Oromo • This intervention aims to strengthen the resilience of internally displaced persons living in refugee camps on the border between the Somali and Oromia Regions and the host communities of the Liben, Bale and Guji zones and seeks to reduce their socio-economic vulnerability. CCM’s primary focus is on the training of health workers at Filtu (Somali Region) and Negelle (Oromia), the creation of mobile clinics to service refugee camps, and on training and psychological support for community health workers and teachers. Partners: COOPI. Sponsor: Overseas office of the Italian Agency for Development and Cooperation - AICS in Addis Ababa. Timeframe: July 2019 - April 2021.

• HEAL - One Health Mobile Units for People, Animals and the Environment • This is the initial phase (15 months) of a long-term (12 years in total) One Health Program of regional significance - Ethiopia, Kenya, and Somalia. The consortium is comprised of CCM, Vétérinaires Sans Frontières (Veterinarians Without Borders) Suisse, and ILRI (International Livestock Research Institute), and aims to improve the well-being of drought- and conflict-affected nomadic and semi-nomadic pastoral communities within the region. It aims to ensure that these communities sustainably maintain both their own health and the health of the livestock upon which their livelihoods depend. More specifically, this intervention seeks to ensure greater access to high-quality human and animal healthcare services, allowing pastoral communities to better manage grazing. This project includes the One Health Kenya project. Partners: VSF - Vétérinaires Sans Frontières Suisse and ILRI - International Livestock Research Institute. Sponsor: Swiss Agency for Development and Cooperation. Timeframe: January 2018 - May 2020.

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GOOD HEALTH AND WELL-BEING

REDUCED INEQUALITIES

CLIMATE ACTION

KENYA National and regional volatility remains high in Kenya, and tensions and conflicts often jeopardise and complicate our work there. In 2019, in partnership with GRT and RefuShe Kenya (formerly Heshima), we continued and consolidated our institutional and community welfare project (psychosocial and health-related), which was launched in February 2017 in the Mlango Kubwa and Eistleigh slums of Nairobi. In these areas, street children and underage refugees live in deplorable conditions and they require medical care and social reintegration. We became fully involved with the One Health project supporting integrated health services for the nomadic shepherd population in Northern Kenya, their livestock and the environment in which they live.

• Boresha Maisha! An alternative life for • ONE HEALTH: A multi-disciplinary approach to street children and underage refugees in promote the health and resilience of pastoral Nairobi communities in Northern Kenya •

•

CCM, along with the NGO GRT, cooperates with local authorities in Nairobi to help improve the physical and psychosocial well-being of street children and youth in the Mlango Kubya slum and young refugees in the Eistleigh slum. The project strategy includes rehabilitation and reintegration within the community and the improvement of health and social care services for beneficiaries. In particular, this project helps improve health with regards to the area of intervention by bolstering 2 facilities and 12 community health units. The project’s innovative approach is using sport as an essential tool for maintaining health. Girls and boys are involved in individual and group sports activities in order to promote improved lifestyles and social integration, fighting the stigma and prejudices which are often widespread in these areas. Partners: ONG Group for Transcultural Relations (GRT), Heshima Kenya, the Starehe Sub-county Health Board. Sponsors: the Italian Agency for Development Cooperation (AICS), Catholic Church 8x1000, Italian Episcopal Conference, Quaresima di Fraternità, Prima Spes. Time frame: February 2017 - March 2020.

• CCM, along with VSF Germany, TriM and DIST, cooperates with local authorities in Marsabit County (sub-county of North Horr) to improve access to and the coordination of human and animal health services and to reinforce the warning and response system during events posing health risks in the pastoral community of the sub-county. This project uses the multi-disciplinary and integrated approach of One Health. The strategy focuses particularly on involving community volunteers in training activities, setting up mobile clinics for integrated human and animal health, raising community awareness about the prevention of animal-borne diseases and the health risks linked to food conservation methods and food processing. It also includes diversifying access to credit for households in the event of human and animal medical expenses and strengthening the decision-making process and prompt action in response to climate change by combining traditional knowledge about the environment with sustainable scientific and technological tools. Partners: Veterinarians Without Borders, VSF Germany, Translate into Meaning (TriM), the Interuniversity Department of Regional and Urban Studies and Planning (DIST) and the North Horr Sub-county Health Board. Sponsor: the Italian Agency for Development Cooperation (AICS). Time frame: May 2018 - April 2021.

Archive CCM © Angel Ballesteros - Kenya (2019)

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NO POVERTY

ZERO HUNGER

GOOD HEALTH AND WELL-BEING

GENDER QUALITY

REDUCED INEQUALITIES

SOUTH SUDAN

South Sudan continues to suffer a serious humanitarian crisis due to the cumulative effect of years of conflict and violence against civilians, which have destroyed half of the population’s livelihoods and has forced 4.2 million people to flee their own homes - 2 million people internally and almost 2.2 million people outside of the country. Estimates from the United Nations Office for the Coordination of Humanitarian Affairs suggests that the number of people in need of humanitarian aid to survive is still very high (more than 7 million, an increase from 2018). Women and children continue to be the most affected group of the population (2.2 million children cannot go to school and around 600,000 pregnant and breastfeeding women need nutritional and health assistance). In 2019, there were 183 humanitarian organizations involved in the humanitarian response (67 international NGOs, 105 local NGOs and 11 United Nation Agencies). CCM remains committed to mothers and children, through ante and postnatal care, vaccinations, childbirth assistance and the prevention and treatment for malnutrition and infectious diseases.

• Strengthening the primary healthcare • Support for the primary healthcare system system for the county population to improve the nutritional status of mothers and children in Greater Tonj and Twic State •

In 2019, CCM’s main objective was once again reinforcing the provision of primary healthcare assistance, in particular for mothers and newborns, and supporting the health system in the two states of Greater Tonj (in Tonj South and Tonj East counties) and Eastern Equatoria (in the counties of Kapoeta North, Kapoeta East and Kapoeta South) by bolstering 12 health centres and 45 dispensaries. Although the healthcare systems are suffering from very limited resources, the core strategy is still in the training of healthcare staff (via training courses, on-the-job training and supervised tasks), supplying medication and medical equipment, the active participation of rural communities through activities which promote health and hygiene and working to strengthen local health authorities. Partners: The Ministry of Health of the State of Greater Tonj; The Department of Health of the Tonj East and Tonj South Counties; The Ministry of Health of Eastern Equatoria State; The Department of Health of Kapoeta East, Kapoeta South and Kapoeta North counties; local communities. Sponsors: Health Pooled Fund, UNICEF, Tavola Valdese (Waldensian Round Table), Presidency of the Council through funding from the Catholic Church 8x1000. Time frame: October 2013 - December 2019.

In a country where it is estimated that one out of two children are severely malnourished, CCM continues its fight to reduce the under-5 mortality rate in Greater Tonj and Twic State through the treatment and prevention of acute malnutrition (severe and moderate). In 2019, CCM continued to ensure food distribution to the most vulnerable groups of the population (children, pregnant women and breastfeeding mothers) and the administration of food supplements for children and mothers. Efforts were made using an integrated health and nutrition approach through awareness campaigns and community training to encourage a change in habits in order to fight malnutrition, since early identification of malnutrition reduces the risks associated with it. Partners: The Ministry of Health, the Department of Health of Tonj East and Tonj South counties, Hospital Management in Tonj, Marial Lou and Turalei hospitals, local communities. Sponsors: UNICEF, World Food Programme, Fratelli Dimenticati, Italian Buddhist Union. Time frame: October 2013 - December 2019.

• Support to reduce mother and child mortality • In Tonj with Marco. by improving secondary healthcare services Let’s bring water to South Sudan •

•

In 2019, much work was done to reinforce secondary healthcare in hospitals in Tonj and Marial Lou (state of Greater Tonj), in Turalei hospital (Twic State) and in Kapoeta hospital (Eastern Equatoria State). Reinforcing hospital services was ensured through the presence and continual training of qualified personnel (nurses, midwives and clinical officers), who, along with the supply of medication and medical material, enabled the 24/7 management of obstetric emergencies and the development of neonatal services. Partners: The Ministry of Health of the State of Greater Tonj and Twic State; The Ministry of Health of Eastern Equatoria State: Hospital management at Tonj, Marial Lou and Turalei hospitals, the Diocese of El Obeid and Kapoeta; local communities. Sponsor: Health Pooled Fund. Time frame: October 2013 - December 2019.

During the mission carried on in December 2019 CCM brought water to Tonj hospital and to the compound hosting staff and volunteers. We installed 45 water taps, 15 showers, 1700 meters of pipes and we built two 6.5 m high towers for two 5000 l reservoirs. Today water is present in every ward of Tonj hospital and in the bathrooms and kitchen of the compound. Fondi: From September 2018 up to date we collected the money needed to set up the water supply system in Tonj hospital thanks to the generosity of friends and relatives of Marco Sicuro. Marco was member and volunteer of CCM, he died between 21st and 22nd November 2018 leaving us his legacy of commitment, solidarity and love for justice. Time frame: Project for Marco “Water system in Tonj hospital and compound” - 2019.

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IN ITALY GLOBAL CITIZENSHIP EDUCATION

• Discrimination, relationships, and water in • Cerco, provo, tento… Perché io cambio. (Try, try and try again…because I’m changing). A schools getting-to-know-yourself workshop •

•

This initiative consists of various educational micro-plans created in collaboration with local schools and organizations. During the 20192020 school year, we worked on three issues: combatting discrimination, relationships and sex education and the conscious use of water. The courses were aimed at children between the ages of 11 and 14 years old. Alongside traditional workshops, we organized and led educational activities, afterschool activities and meetings to promote health within the scope of the “Barrier in Transition”project in partnership with the NGOs RETE and MAIS. We worked with a group of underage foreigners, as always in the Barriera di Milano area, around the theme of relationships and sexuality in partnership with the Passo Social Point of the Diaconia Valdese organization. Sponsors: CRT Foundation, Circoscrizione 6 (District 6, Turin) and educational establishments.

Developed at the Istituto Comprensivo Antonelli, the project enabled us to work with 2 groups of students between the ages of 11 and 14. Over three months, various activities were carried out outside of school hours with the aim of supporting children in developing their identity by building healthy relationships with others. Topics related to relationships, emotional affectivity and sexuality were tackled. Sponsors: PON MIUR Fund, Global Citizenship Skills.

THE INCLUSION OF VULNERABLE GROUPS

• Clinic Article 32: build networks for the right to health The most vulnerable groups in Turin, homeless people and irregular migrants, are those who are suffering the most from mental and physical distress. For these people, finding treatment is difficult, disjointed and not sufficient. The project supports the operation of two healthcare counselling desks for homeless people at two centers in Turin dedicated to this marginalized group and managed by the organizations La Carità di Santa Luisa and the Servizi Vincenziani per Senza Fissa Dimora, and it also reinforces the referral system to general practitioners and the Emergency and Admission Departments of the main hospitals. Partner: World Friends Onlus (non-profit organisation for social utility). Sponsor: Tavola Valdese (Waldensian Round Table).

• The right to health: a network to support the most vulnerable

Thanks to the supervision of around 20 voluntary healthcare workers, CCM and World Friends ensured the running of the counselling clinic, basic medical and nursing care and referrals to local specialist organizations for people who contacted them. Partners: World Friends Onlus, the Vincenziano Centre for the Homeless. Sponsor: The Intesa San Paolo Charity Fund.

• Pluralistic Healthcare 6 • Launched in 2014, pluralistic healthcare has become a long-standing program that aims to promote access to social and healthcare services for migrants and their families, with a particular focus on mental health. Within this framework, CCM organizes and leads health education courses for migrants about different subjects (communicable and sexually transmitted diseases, mother and child health, good hygiene practices) and a referral service. The project was managed in partnership with, and held at, the Camminare Insieme, Associazione La Tenda e Coop. Altri Modi. Partners: The Frantz Fanon Centre Association (leader), Marco Cavallo Migrant Centre, Cooperativa Esserci, Mamre Association Onlus. Sponsor: San Paolo Company.

The project aims to help improve health conditions for the most vulnerable people who visit the Vincenziano Centre for the Homeless (Via Saccarelli 21), strengthening the referral system from and for the public health service.

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• Mediato 6

• Healthcare advice •

The initiative aims to improve the quality and accessibility of information for foreign citizens and workers who work with foreign users, with a particular focus on the technical legal area. Within the context of this project, CCM developed and led two refresher workshops for social and healthcare workers in 2019 using the therapeutic alliance model which brings together interdisciplinary skills in order to improve the management of foreign patients and their adherence to their course of treatment. Partners: IRES Piedmont (leader); ASGI (The Association for Juridical Studies on Immigration) and A.M.M.I. (Associazione Multietnica Mediatori Interculturali). Sponsor: San Paolo Company.

• New migrations, new generations: reinforcing the Drop-in Service of the local health authority in the city of Turin The phenomenon of drug addiction of both Italians and foreigners is deeply rooted in the city of Turin. The project is aimed at contributing to policies on harm reduction and the promotion of the rights and dignity of addicts by reinforcing the DROP-IN service of the local health authority in the city of Turin. In particular, training initiatives for workers were implemented in order to deepen their knowledge and teach them about tools that are helpful in their work with foreign users of the service. Partners: The Department for Addiction, Local Health Authority of the City of Turin. Sponsor: CRT Foundation.

In 2019, training and health education activities continued for groups of foreigners in response to requests made by local cooperatives and associations which are more directly involved with receiving and managing refugees and asylum seekers. Many meetings were held for men and women from reception centers and unaccompanied foreign minors on various health issues, such as good hygiene practices, nutrition, infectious diseases and sexually transmitted diseases, contraception, the referral service and the right to health. In partnership with / sponsors: Progetto Corridoi umanitari from the Diaconia Valdese Organisation, Casa della Difesa del Fanciullo, Civico Zero.

• Non solo pane (‘not just bread’) The aim of the project is to try to create an innovative community welfare model that combines educational courses and job placement for disadvantaged people with social and cultural activities which are open and inclusive for all citizens. Within the scope of this project, CMM is a kind of healthcare antenna available to the community and to the people involved in the training and job placement programme. Partner: Panacea Social Farm. Sponsor: PON Metro Fund.

• WellFARE in Azienda (WellFARE at work) Encourage staff health by promoting healthy lifestyles In 2018, CCM offered to support the company welfare policies of Michelin by investigating the health needs of their employees. Through this process of listening and needs analysis the “WellFARE at work” project was born, which in 2019 involved promoting the theme of healthy eating at the Alessandria factory. A nutrition workshop was held with 5 groups of employees. Each workshop was organized into four 2-hour meetings, each led by two experts, one in educational techniques and health promotion and the other in nutrition and dietary education. Partner and sponsor: Michelin.

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Archive CCM © Italy (2019)

HEALTHCARE TRAINING

• Global Health Course 2019 • For over 15 years, CCM has upheld its proposal of education through the Global Health Course. The aim of this course is to train and update healthcare workers on health rights and justice. The course is directed at workers who are interested in carrying out clinical activities in low-income countries or acquiring a better understanding of the backgrounds of migrant patients in Italy. The course, accredited by the CME (continuing medical education) and provided in partnership with the University of Eastern Piedmont, is carried out partly through distance learning and partly through traditional lessons held in Novara. It is organized into three modules: the right to health, globalization and development; infectious diseases; and mental health. Sponsor: Self-financed (enrolments in the CSG).

• Scientific conference “La salute e lo stato della donna nel mondo” (Health and the condition of women in the world) This conference continued the tradition of CCM scientific conferences, which in 2019 focused on women’s health from a multi-disciplinary view (health, legal,

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work) and considered throughout their lifetime (childhood, teenage years and old age). The events, accredited for all healthcare professions, took place in Turin, Ivrea and Savigliano, and social and healthcare workers, students, researchers and contacts from companies and associations attended. During the round table discussions, CCM reported its work experience in international cooperation with a focus on reproductive health in Ethiopia. Sponsors: own funds and the Piedmont Region Grant.

• Elective Educational educational training

Activities

and

• 2019 was also a witness to our partnership with the Department of Medicine and Surgery and the Department of Nursing Sciences at the University of Turin and with the Department of Medicine and Surgery at the San Luigi University in Orbassano. We organized co-teaching in the framework of curricular courses and elective educational activities for university students. Specifically, two courses were held: healthcare organization in low-income countries (2nd year - bachelor’s degree in Medicine); Medical Humanities (1st year bachelor’s degree in Nursing Sciences). CCM led a two-day training module at the Umbrian School of Public Administration titled ‘Taking Care of Migrant Patients’. Sponsors: University departments, CERSAL and private donors.

Smiles of African Mothers

Training healthcare workers. Treating mothers and children.

2019 saw the Smiles of African Mothers campaign finish its 4th year. CCM has worked for over 50 years with communities and health authorities; their ongoing partnership continues to grow stronger and is reflected in the campaignâ&#x20AC;&#x2122;s achievements. During the year, 795 healthcare workers were trained, bringing the total number to almost 3500. Thanks to them, 35,906 women were helped during pregnancy and childbirth, enabling us to reach 82% of our final goal. However, the more than 175,000 children vaccinated and treated enabled us to hit our goal of 780,000, which had been set for 2020. Finally, more than 400,000 people participated in community awareness activities on treatment and prevention. In 2020, CCM will continue its commitment to promote the health of mothers and children in the wider context of global health. In line with the Sustainable Development Goals, the aim of the campaign is to help ensure healthy lives and promote well-being for all at all ages by adopting the multisectoral approach of One Health, to act on the determinants of health. Training healthcare workers remains at the heart of the organizationâ&#x20AC;&#x2122;s pledge, with the end goal of improving the quality of service aimed mainly at mothers and children.

Archive CCM ÂŠ Eyrara Niyominungere - Burundi (2014)

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Healthcare workers - Capacity building programs

201

JEC OB T

IVE

2015-2020

278,014 20 225 170.000 women to be helped NEW 416,187 3.900 103.817 during pregnancy 2.697 workers 3.492 women childbirth trained 20 toand be trained helped trained workers workers E V

202

82% 100% 39% 2020 1129% 919 Mothers - Assistance during pregnancy and childbirth JEC OB T

61%

210.098 36.392 children women 20 helped helped

27% 21%

2020 11

432.092 67.755 children women 20 helped helped

55% 40%

625.170 103.817 children women 20 helped helped

80% 61%

2020 11

CHILDREN - Treatment and vaccinations 2015-2020

201

2015-2020

201

432.092 children helped

625.170 children helped

27%

55%

80%

210.098 children 20 helped

432.092 children 20 helped

625.170 children 20 helped

27%

55%

80%

201

202

170.000

women helped

1 2020 182%

800.176 139.723 children helped women helped

2020 22

103% 82%

780.000

IVE

201 IVE

children to be helped

202

780.000

800.176 children helped REACH

OBJECTIVES

210.098 children helped

170.000

women780.000 to be helped during children pregnancy 139.723 andtochildbirth be helped IVE

REACH

OBJECTIVES

201 JEC OB T

40%

JEC OB T

2020 11

21%

JEC OB T

2015-2020

103.817 women helped

OBJECTIVES OBJECTIVES 2015-2020

67.755 women helped

REACH

201

36.392 women helped

2020 22

women to be helped during pregnancy and childbirth

2015-2020

82% 129%

IVE

REACH

OBJECTIVES

2020 11

139.723 3.492 women helped trained workers

2020 11

40%

REACH

2020 11

21%

NEW

67.755 2.203 women trained 20 helped worker

workers to be trained

Maternal, sexual and reproductive health 82% 100% 39% Production of personal hygiene products TOTAL

36.392 1.044 women trained 20 helped workers

3.900

COMMUNITY AWARENESS 2.203 2.697 1.044 trained trained trained Infectious disease prevention worker workers 137,948 workers

OBJECTIVES OBJECTIVES 2015-2020

129%

201

202

2015-2020

3.492 trained workers

REACH

OBJECTIVES

201

100%

NEW

JECTI

201

82%

3.900

workers to be trained

JECTI

201

39%

2.697 trained workers

JECTI

2015-2020

2.203 trained worker

OBJECTIVES

1.044 trained workers

103% 201

800.176 children helped

children to be helped

202

103%

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Fundraising and Communication

In 2019, the fundraising sector worked hard to obtain funding in order to help launch projects in Africa and in Italy, hosting activities aimed at donors, companies, foundations and institutions. Throughout the year, CCM participated, and was a promoter, at numerous local events in partnership with other companies. The organization was the beneficiary at the 31st International Hot-Air Balloon Festival in Mondovì. There the colourful aerostats captured the gaze of our volunteers for an entire weekend and the organization was incorporated into the Charity Programme during the city track event La Mezza di Torino (Turin Half Marathon). Many of the fundraiser runners got involved in this initiative to support the health of mothers and children in Filtu, Ethiopia. A special mention goes to the company FitMomInAction and its owner Giovanna Ventura, a psychologist and fitness coach; she managed to mobilize many people which not only led to a fantastic result, but it was also a wonderful occasion for her runners to come together and meet. Several initiatives were launched throughout the year, including an Easter Egg Sale with delicious chocolate by Ziccat, an artisanal chocolatier from Turin (for which we would like to thank the Associazione Needle and the Michelin plant in Cuneo for their valuable contribution), the raffle to support projects in South Sudan and the traditional summer event Cineforum where the documentary film “Al di qua” was shown, presenting the social issues of homeless people in Turin. On this occasion, director Corrado Franco was CCM’s guest, along with publicist Don Giampaolo Pauletto and the lead actors from the film. During the Christmas season, the staff, friends and volunteers of CCM got involved with the Christmas campaign “Ogni pacco un sorriso” (a smile for every gift) at the Libreria della Torre and the Christmas dinner at the Osteria Andirivieni in Turin. We would like to thank our network of businesses and parishes which supported CCM in 2019 during the launch of the 5x1000 campaign and our project on health for mothers and children in Filtu on the occasion of the Quaresima di Fraternità. As is the case every year, fundraising by local groups and networks is vital and is based on word of mouth and the strength of sharing experiences. Many events were promoted by local groups, in particular the annual meeting with the friends of the Mondodomani Association in Bitonto and the Rebel Bit concert, the stars of the Christmas meet with the Amici di Nanni from Cuneo. Once again, the Associazione Needle organized the “Corsa dell’Uva”, a renowned running event in their hometown of Caluso, as they do every year. A big thank you as well to our volunteers who took the initiative to organize fundraising events, such as the concert by the Settignano Music School (Florence) and the event in memory of Fabrizio de André in Sant’Albano Stura (Cuneo). Major donors were the champions of a fundraising introductory event dedicated to our projects in South Sudan at the Blue Note, a historic Milanese jazz and blues concert venue. On this very occasion, more than 70 people attended as our guests to support the community of the Greater Tonj state and listened to “Noi duri… in Pink”, a band which pays homage to female soul singers who sang about activism, pain and redemption. All of our donors were invited to donate to CCM projects and were informed about the current challenges in the context of international cooperation via two emails and many targeted communications.

8.1 fundraising and local activities

Five voluntary doctors provided their skills in support of our projects in Filtu, Ethiopia, and in “Boresha Maisha – An alternative life in Nairobi” in Kenya. There was intense planning work with foundations and organizations through meetings, customised proposals and participation in tenders, for seeking co-funding and for new projects. We received support from the following organisations: Fondazione Cassa di Risparmio, Fondazione Creonti, Fondazione Ferrero, Fondazione Fratelli Dimenticati Onlus, Fondazione per la Cultura Torino, Fondazione Peppino Vismara, San Paolo Company and the Santander Consumer Bank. Companies were presented with personalized proposals of support, and in this way contributed to the success of our projects and to some fundraising events. We received support from the following organizations: AB&S Avvito, Bricco Dolce, Bubot, Cascina Fontanacervo, CDP, CM, Costa Crociere, Diatech Lab Line Service, Equilibria, EPS- Elvi Energy, Esi.it, Ettore Germano, Forestello, Fratelli Vergnano, G.D. Vajra, Ged Shop, GROM, Giacometto, Giuliano Caffè, Gruppo Maurizi, IFly, Il Tucano Viaggi e Ricerca, Intrappola.TO, La Spinetta, Latham Watkins London, Lyving Ecodesign, Macron, Michelin, Nostromo, One Way Out, Palestra Body&Soul, Parco della Fantasia, Peraga, Relab, Regali24, Soimar Group, Shop Piemonte, Teaciok.

909.822

Fundraising Total

Local events

6% 51.723

Individual donors

30% 268.854

Foundations, organisations and companies

48% 432.746

Groups and networks

10% 87.803

5x1000

8% 68.697

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Fundraising and Communication

8.2 communication

The way in which CCM communicates reflects the values at the heart of the organization. Our communication steers clear of the stereotypical image of Africa and its migrants and respects people’s dignity and sensitivity, whether they are the receiver or subject of the message. CCM provides accurate communication about the progress of projects and planned initiatives. At the same time, it aims to become a point of reference for news about the countries in which it works and about the various areas of intervention and their related issues. Our communication is direct and is aimed at valuing the accounts of workers and volunteers who work in the field, paying particular attention to the stories and events described by the people our staff meet every day.

Journalist missions • 1 journalist mission in North Horr, Kenya.

Publications • Note A Margine. 2 issues with an average print run of 4,500 copies. • Mission Report. One annual issue in Italian and English. • Smiles of African Mothers - Projects and results. Strategies and goals for 2020. Campaign report in Italian and English.

Events • Round table “Apriamo alla salute globale, fermiamo l’Aids” (“Let’s start global health and stop AIDS”) - 4th December 2019, at Camera, the Italian Centre for Photography, in partnership with the Global Health Italian Network. An analysis of the global situation in the fight against AIDS, examining the shared guidelines and projects, with a focus on Italy and Africa. • Supporting the promotion of the scientific conference “Vulnerabilità Sanitaria del Migrante. Le Dipendenze” (Migrant Health Vulnerability. Addiction) - 28th November 2019, promoted by CCM with the support and participation of the Dipartimento Dipendenze (Department of Addiction) of the local health authority in the City of Turin. The conference introduced participants to the complex phenomenon of substance use by the foreign population from epidemiological, anthropological and legal points of view. • Supporting the promotion of the scientific conference “La salute e lo stato delle donne nel mondo” (Health and the Condition of Women in the World), at the offices of Ivrea, Turin (Multimedia Room in the Piedmont Region) and Savigliano. A global view of the health situation and increasing economic and social poverty of women in the world and the opportunities for intervention to ensure their full recognition.

Online • www.ccm-italia.org: 17,300 registered users in 2019 • Institutional Newsletter: 12 editions sent to an average of 9,000 recipients • Facebook: 4,348 fans • Twitter: 849 followers • YouTube: 1,400 total views • Instagram: 500 followers • LinkedIn: 452 followers

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Financial Statement

The 2019 financial statement consolidates financial reports related to activities carried out in Italy, Ethiopia, Kenya, Somalia, South Sudan and Burundi. The following countries’ financial reports were locally audited and certified: • in E thiopia by Soliyana Kiros Chartered Certified Accountant & Authorised Auditor • in K enya by Crowe Erastus & Co., Certified Public Accountants (K) • in S outh Sudan by TMK & Co.o. The financial report for Burundi was consolidated and verified in Italy. The consolidated financial statement was externally audited by Dr Michele Matteo Romano, who verified and certified the truthfulness and clarity of the financial and economic information and assets contained within it, as well as the consistency and soundness of the underlying administrative processes. The financial statement has been prepared in accordance with Legislative Decree 139/2015. It contains the balance sheet, the final balance sheet and the cash flow statement, and is attached to the Mission Report.

2019

2018

16,215

17,652

998

Tangible

2,710

3,149

Financial

13,505

4,198,138

4,552,626

Receivables

2,827,155

2,934,372

For completed projects

1,220,179

1,382,002

To entities

1,052,292

951,475

554,684

600,895

1,370,983

1,618,254

15,080

71,456

4,229,433

4,641,734

Balance Sheet - ASSETS 1 FIXED ASSETS Intangible

2 CURRENT ASSETS

Other receivables Cash and cash equivalents

3 PREPAYMENTS AND ACCRUED INCOME TOTAL ASSETS

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2019

2018

142,857

800,838

100,000

Restricted capital assets

255,823

Restricted funds

76,349

Free assets

42,857

445,015

Disposable assets

494,209

80,000

424,730

- 451,352

- 59,715

2 PROVISIONS FOR LIABILITIES AND CHARGES

358,321

155,640

3 TFR (REDUNDANCY PAY) FOR EMPLOYEES

279,702

126,232

2,634,085

2,829,411

5 DEBTS

706,467

723,331

Banks

Suppliers

92,435

62,712

Taxes

32,574

14,065

Social security institutions

38,999

29,978

Other debts

542,459

616,520

8,982 4,229,434

6,283 4,641,734

Balance Sheet - LIABILITIES 1 NET ASSETS Organisational endowment fund

Projects' fund Current operating result

4 DEBT OWED TO LENDERS

6 PREPAYMENTS AND ACCRUED INCOME TOTAL LIABILITIES

2019

2018

Final balance sheet INCOME 1 2 3 4

8,484,177

6,618,496

7,459,858

71,83

6,093,831

92,07

Proceeds from fundraising

909,822

5,38

456,852

6,90

Financial and property income

113,578

0,46

38,969

0,59

919

0,34

28,844

0,44

8,935,529

6,678,211

8,169,628

89,43

5,972,615

89,43

Promotional and fundraising expenses

199,384

3,39

226,110

3,39

Financial and capital expenses

43,957

1,78

118,956

1,78

General support expenses

522,560

5,40

360,531

5,40

Operating income and revenue

Other income

EXPENSES 1 2 3 4

Operating expenses

FINAL BALANCE: EUR -451,352. Please refer to the financial statement and explanatory notes for remarks and comments.

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contacts

CCM Support Groups in Italy

CCM Italy Via Ciriè, 32/E 10152 Turin Italy

CCM Headquarters in Africa CCM Burundi Avenue de la Plage 01 BP 198, Bujumbura

Turin Voluntary Groups Contact: Erika Larcher, erika.larcher@ccm-italia.org – 011 6602793 Associazione Needle (Caluso, Turin) Contact: Luca Cacciotella, luca.cacciotella@gmail.com – 340 0053617 Volpiano for CCM (Turin) Contact: Aldo Bordigoni, aldo.bordigoni@tiscali.it – 339 6438610 Sandro Foglia, fogliasandro@yahoo.it – 339 4751056 Amici CCM Ivrea (Turin) Contact: Maresa Perenchio, maresaperenchio@yahoo.it – 335 5432407

CCM Ethiopia Kirkos Sub city - Kebele 01 - House Number 714 - Code 1110 P.O. Box 712 Addis Abeba CCM Kenya - Somalia Rhapta Road Westland - PLOT no 47 P.O. Box 12027 Sarit 00606 Nairobi CCM South Sudan Plot no 45A, Block no. BV

CCM Group ‘Pulia’, Manta, Saluzzo and Moretta (Cuneo) Contact: Matteo Bolla, matteoandreina@gmail.com – 348 7075433 CCM Group ‘Amici di Nanni’, Cuneo Contact: Cristiana Lo Nigro, lonigro.c@ospedale.cuneo.it – 347 6219417 Amici CCM Arenzano (Genoa) Contact: Fabia Binci, fabia.binci@fastwebnet.it – 336 916125

Hai Cinema, Juba CCM Group Bergamo – Monte Marenzo (Lecco) Contact: Parrocchia di San Paolo Apostolo (Parish of St Paul the Apostle) Committee “Per Terre Remote Onlus”, Tirano (Sondrio) Contact: Peter Taliente, taliente@tiscali.it – 339 8573013 Associazione Mondodomani Bitonto (Bari) Contact: mondo.domani@gmail.com

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The 2019 Mission Report was created in collaboration with all the staff of CCM. Contributions in particular from: Mara Nuzzi, CCM Head of International Project Department Daniela Rana, CCM Desk Officer Burundi, Ethiopia, Kenya, Somalia, Uganda Sabina Tangerini, CCM Italian Project Department Officer Marilena Bertini, MD and CCM Volunteer

This English translation has been possible thanks to the PerMondo project: Free translation of website and documents for non-profit organisations.

A project managed by Mondo Agit. Translators: Pasquale di Matteo, Carla Milkins, Ruth Collins and Clara Barufatti. Proofreader: Pasquale di Matteo. Revision: Francesca Fontanelli. Project design: Tipolitografia Graph Art, Manta (CN) - www.graph-art.it Turin, June 2020.

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Via Ciriè, 32/E • 10152 Turin • Italy • Tel. 011 6602793 • Fax 011 3839455 • ccm@ccm-italia.org CF 97504230018 C/C POSTALE N. 13404108 IBAN IT 94 AØ5Ø 18Ø1 ØØØØ ØØØ1 1998 481

Comitato Collaborazione Medica

@CCM_ItaliaONG

www.ccm-italia.org 44

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