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Medicus Mundi Italy

2010 Report


Medicus Mundi Italy Via Martinengo da Barco 6/a 25121 Brescia (Italy)

Tel. +39 0303752517窶認ax +39 030 43266

www.medicusmundi.it info@medicusmundi.it progetti@medicusmundi.it promozione@medicusmundi.it amministrazione@pec.medicusmundi.it


Table of Contents Presentation

p. 5

Our mission

p. 6

Who we are

p. 9

Partnerships

p. 13

Projects

p. 16

Activities in Italy

p. 43

2010 Balance Sheet

p. 44


MEDICUS MUNDI ITALY

4


2010 REPORT

Presentation

2010 has been a very special and successful year for our Organization. Medicus Mundi Italy has grown considerably thanks to all those who, with passion and commitment, have shared our ideals and have helped fulfilling them. It is therefore, as usual, a pleasure and an honor for me to present, on behalf of all members, friends and supporters of Medicus Mundi Italy, these few pages which summarize strenuous and important efforts. As for last year, the Report presents the mission of the Association, the Organization Chart and the Commissionings, as well as the most important component: the under way projects with the sources of their fundings, and how these are employed. Our on-going projects are giving satisfactory results in Africa (Burkina Faso, Mozambique and South Sudan), and Latin America (Bolivia, Brazil and Ecuador). These projects are very important, as they have been demanded by the local populations with whom we effectively work hand-in-hand for a better future. In order to succeed in our projects, our philosophy is always to cooperate with as many subjects as possible, as we firmly believe that this is the only way the projects become sustainable. We are extremely grateful to all our partners. In spite of some economical difficulties, our Organization’s finances are steady and transparent, and, until now, we have always been able to rely on many friends’ support. Furthermore, we have developed our educational mission by promoting, once again, an Updating Course on Tropical Diseases and by reinforcing our collaboration with academic, scientific and health institutions in Italy, especially with the University of Brescia and the Spedali Civili Hospital of Brescia. It is with great pleasure that I mention the fact than in 2010 Medicus Mundi Italy has given important contributions to research. Our results have become the subject of several studies which have been published in major scientific reviews, as well as presented at national and international conventions on Tropical Diseases and Global Health. I would also like to remind that in 2010 we undertook a particularly difficult path – the demand to be accredited at the Italian Institute for Donation, an institution certifying the correctness of the conduct of nonprofit organizations. We took this decision with a certain amount of concern, but also with the strong wish to confront ourselves with national standards. We are also aware that, despite our limitations and the frailty of our structure, we are proud of having always been honest and of having tried to do our best. The verifying procedure is bound to end in 2011. I would really like to thank everyone who has contributed to creating this Report. You will find their names in their respective projects and in the section dedicated to the Organization Chart - the biggest thank you goes to them. We will certainly be very grateful to all those who will be so patient as to read the Report and to those who will kindly point out the improvements that could be made for future editions, which I hope are soon to follow. Francesco Castelli President, Medicus Mundi Italy

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MEDICUS MUNDI ITALY

Our Mission

Medicus Mundi Italy is a Non-Governmental Organization (NGO), a non-profit making association, at international level and specialized in healthcare cooperation. Founded in 1968 in Brescia, it is part of Medicus Mundi International which is present in over 50 Countries with more than 1000 projects carried out and is officially recognized by the World Health Organization (WHO resolution EB 63 R 27) with which it regularly cooperates. The objective of Medicus Mundi Italy is to contribute to the integrated promotion of the human being through the creation of structural healthcare development and emergency programs (these last ones within specific situations). Medicus Mundi Italy, in cooperation with public institutions (Italian Ministry of Foreign Affairs, European Union, United Nations Agencies, Regions, Provinces, Cities, etc.) and private non-profit ones, is committed to improving quality and efficiency of local healthcare services and promoting primary and community healthcare, by creating adequate infrastructures and by training medical, nursing and technical personnel. The projects of Medicus Mundi Italy are always spurred by precise requests of the communities in question and local partners participate from the earliest stages to strategic and operational choices. Medicus Mundi Italy is independent from political or religious sidings and acts in total respect of local cultures in a selfdevelopment and self-determination philosophy. Since the beginning, the vision of Medicus Mundi Italy has been directed towards professional cooperation for development, in strict relation with the principles outlined by the WHO and without ever renouncing the strong humanitarian motivation underlying its actions. One of the fundamental choices which have always characterized Medicus Mundi Italy, is the focusing on the need to promote and support adequate healthcare human resources, without failing to grant financial and material aid. The main objective is to share, with the poorest communities in the South of the world, the abundance of healthcare technology and medical-scientific know-how in the most underdeveloped countries. The option for poor people and our non-profit service has always distinguished and still distinguishes to this day the actions performed by Medicus Mundi Italy. Traditionally, the role of doctors was often linked to charity and concentrated on the sick. Medicus Mundi Italy has tried to integrate the approach based purely on the disease, taking an interest in healthcare prevention and treatment in terms of community health, with particular focus on mothers and children. This understanding and mission needed the healthcare cooperation world to open its views towards a new approach: not only curing individuals was important, but also promoting healthcare and the improvement of healthcare systems. The traditional question ―for who?‖, typical of the charitable approach, has slowly been substituted by the question ―with whom?‖. The main task has changed from paternalistically assisting the weaker people, to involving them directly and making them also directly responsible. The concept of partnership has become the slogan of international cooperation, thanks to the training of doctors and local medical attendants. One of the objectives of Medicus Mundi Italy is to promote the creation of local competent and professional pools, in order to avoid massive emigration of such human resources towards Western countries, which represents one of the main problems of Countries in the Southern hemisphere of the globe. Internal discussions and dialogues with the partners, has enabled Medicus Mundi Italy to keep in touch with the constant changes of foreign politics and development strategies in the various Countries.

6


2010 REPORT In planning future commitment, Medicus Mundi Italy has closely followed the so-called Millennium Development Goals in its fight against poverty, inequality, violence and injustice. These strategies allow to maintain competence and motivation of medical personnel at all levels and must be intensified to protect the ideal of a not-profit service. In this respect, the Alma Ata declaration in 1978, to which 150 countries adhered, has pointed out principles which, being based on human rights, make an appeal to everyone’s right to being healthy and they also represent a fundamental reference for all the organizations working in this field. At the basis of the Alma Ata declaration was the rule that healthcare programs ―have to be accessible to everyone, they have to fit in the socio-cultural situation of each Country, they have to be governed by the local National Health Service and supervised by independent technical committees. The declaration prophetically presented a global approach to health meant as something not strictly linked to the medical aspects but in its broader sense as something aimed at developing socio-cultural situations. Over 30 years later, the approach is not only that of curing diseases but also of promoting healthcare prevention. The right to health is perceived as an element of social justice and democratic involvement of each individual as well as of communities, in providing for healthcare for everyone. The Alma Ata conference, dedicated to Primary Health Care (PHC), highlighted that in basic communities there was a social unity to guarantee health for everyone, as it is only by offering necessary medical treatments close to where people live and work that it is possible to concretely meet the project objective. The principles and the approach introduced by the Alma Ata Conference are still at the basis of international cooperation healthcare projects and they inspire Medicus Mundi International and Medicus Mundi Italy. The projects which Medicus Mundi Italy has carried out in Africa, Latin America and Asia focus on fighting AIDS and supporting infantile and maternal health.

Children playing in Ecuador

7


MEDICUS MUNDI ITALY

Daily life in Burkina Faso

8


2010 REPORT

Who we are

Operational Structure Medicus Mundi Italy is ruled by a mandate which provides for: Board of Directors’ Meeting to organize the NGO’s activities, to approve balance sheets and to elect the Directive Committee Directive Committee in charge of managing the NGO by following the protocols outlined by the Board of Directors’ Meeting A National Secretary responsible for organizing the operational structure. Proposals and requests coming from partners in the South, from our own volunteers or from collaborators which operate or have operated in developing countries, or from other partner organizations; they are evaluated by our managers and by the personnel in charge of the planning stage sorted by geographical area. The criteria adopted to select project proposals, aside from the criteria qualifying the quality of the proposal and the credibility of the proposer, are those defined by the guidelines of the Board of Directors and the Directive Committee. Positively evaluated proposals, normally approved after having verified the feasibility of the project on site, are later elaborated with the partners, Italian ones and also from the South, and presented for approval to the Directive Committee. In case of consortium projects, Medicus Mundi Italy takes part in decisional and coordination meetings attended by representatives of each partner organization.

Activities In over 40 years of activity, Medicus Mundi Italy has operated in Africa, Latin America, Asia and Eastern Europe by realizing the following: Hospitals, urban and rural dispensaries, labs and multi-purpose diagnostic stations co-operating with the local National Health Services (Albania, Bolivia, Brazil, Burkina Faso, Burundi, Ecuador, Ethiopia, Ghana, Guinea Bissau, India, Lithuania, Rwanda, D. R. Congo); Primary Healthcare projects and integrated initiatives for community development, environmental hygiene, healthcare education and training for medical operators (Chad, Madagascar, Mozambique, Somalia, Sudan, Thailand); Medical-health care schools to contribute to the training of local specialists (Ethiopia, D. R. Congo); Specialized and emergency actions (D.R. Congo, Rwanda, Burundi, Thailand, Tanzania).

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MEDICUS MUNDI ITALY In Italy, Medicus Mundi Italy is engaged in education development. In this view, it organizes training meetings and periodically publishes its own information paper, the ―Bulletin‖ of Medicus Mundi Italy). In the training field, Medicus Mundi Italy has been organizing a Course in Tropical Disease over the past 20 years, of the duration of 3 weeks, with the objective of offering an opportunity of professional and cultural expertise targeted to both prospective social workers in developing countries and medical assistants working in Italian hospitals, structures which are more and more involved in diagnosis and therapy of tropical and sub-tropical pathologies. The course is organized in cooperation with the Infectious and Tropical Disease Clinic in the University of Brescia, the Medical Association of Surgeons and Dentists of the Province of Brescia and the Italian Ministry of Foreign Affairs – General Division for Development Cooperation. Medicus Mundi Italy actively works with the Infectious and Tropical Disease Clinic in the University of Brescia to organize the European Master of Tropical Medicine and International Health (TROPED), inserted in the European network of Tropical Medicine Schools. The activities of Medicus Mundi Italy are made possible by recurring to self-financing, to conspicuous support offered by private individuals, associations and support groups, not to mention contributions received for specific projects by public and private Institutions: European Commission, Ministry of Foreign Affairs, Regions, Local Authorities, Bank Establishments, Italian Bishops’ Conference, etc.

Human Resources Personnel in Italy 1 part-time employee (secretary/administration) 1 part-time employee (project administration) 1 project consultant for project organization and management 1 project employee for “Stop Malaria Now!” Doctors, remunerated and volunteers, for short-time missions in Southern Countries 1 part-time voluntary (secretary) Around 20 people (doctors and not) who act as volunteers for the association in various chores: communication and fund raising, training, organization, management and project realization.

Personnel involved in Southern Countries 2 co-operators 2 on-site project coordinators/cooperators

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2010 REPORT Recruiting Members

During 2010, Medicus Mundi Italy has received more than 20 application requests, many of which are from young doctors and specialized doctors in the School of Medicine of the University of Brescia. This turn -over is more than ever necessary in order to promote a constant circulation of ideas and the potential growth of activities. On 31st December 2010 our members were 55, as established by Art. N째5 of the Association Mandate, whereas our regularly enrolled subscribers were 413.

Mozambique: Morrumbene Project

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MEDICUS MUNDI ITALY

Operating mandate

GENERAL ASSEMBLY

BOARD OF DIRECTORS

GOVERNMENTAL RELATIONSHIPS

GENERAL SECRETARIAT AND ACCOUNTING

PROJECTS

TRAINING

BOARD OF DIRECTORS FOR 2009-2011

12

President Vice President National Secretary

Francesco Castelli Silvio Caligaris Giuseppe Andreis

Advisor Advisor Advisor

Monica Franchi Mariarosa Inzoli Roberto Marzollo

Advisor Advisor Advisor

Alessandro Pini Fausta Prandini Paola Maria Rossini

Advisor

Richard Fabian Schumacher

Advisor

Lina Rachele Tomasoni

COMMUNICATION AND FUND RASING


2010 REPORT

Partnerships

In a more and more globalized context, and in view of reinforcing and sharing commitments in the international cooperation world and in developing education targeted to creating a fair and equal society, Medicus Mundi Italy firmly believes that teamwork with other associations and the participation of different Northern and Southern networks is more and more pressing and necessary. In this perspective, Medicus Mundi is part of: Medicus Mundi International - http://www.medicusmundi.org Medicus Mundi Attrezzature—MeMuA - http://www.memua.it/ Volontari nel mondo FOCSIV (Federazione Organismi Cristiani di Servizio Internazionale Volontario Federation of Christian Orgnizations and International Voluntary Service) http://www.focsiv.it. Medicus Mundi Italy is a member of the Federation since 1996. NGO Italian Association- http://www.ongitaliane.it CoLomba - Lombardy NGO Association- http://www.onglombardia.org ―Brescia for Mozambique‖ – coordination of Brescia NGOs in Mozambique. Bakhita Consortium‖ NGO consortium and associations for South Sudan Consultation on peace and solidarity among populations in the town of Brescia.

Moreover it cooperates with: University of Brescia School of Medicine and Surgery Infectious and Tropical Diseases Clinic Pediatrics Clinic Pathology Chair School of Engineering CeTamb (Centre for Documentation and Research on Appropriate Technologies for Environmental Management in Developing Countries). Spedali Civili Hospital of Brescia Infectious Diseases Department Pediatrics Department National network of NGOs fighting AIDS, information service, analysis and monitoring of initiatives in fighting AIDS in developing countries. STOP MALARIA NOW! Campaign. European network to fight malaria CLIA – International Fight against AIDS Connection International Civil Service

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MEDICUS MUNDI ITALY Medicus Mundi International www.medicusmundi.org Medicus Mundi International is a network of organizations which operate in the international healthcare sensitivity and cooperation field. The Medicus Mundi Electronic Platform enables to access programs, events and news regarding the network itself to share knowledge, know-how and direct all efforts towards the common goal of granting health to everyone. In 2010, the Medicus Mundi International network was composed by 15 members in 8 Countries (Benin, Germany, Italy, Kenya, the Netherlands, Poland, Spain and Switzerland). The multi-plural healthcare approach of the Medicus Mundi International members is based on the experience matured on site and is a fundamental element of the network. Together, they can examine all aspects of medical policies and cooperation, from primary medical assistance to emergency interventions. The 15 Members of MMInternational are: Africa CHA Platform

http://www.africachap.org/

Action Medeor, Germania

http://www.medeor.org/

AGEH, Germania

http://www.ageh.de/

AMCES, Benin

http://membres.multimania.fr/cotonou/amces/

CUAMM, Italia

http://www.cuamm.org/

CORDAID

http://www.cordaid.nl/nl/%28728%29-Cordaid.html

EPN

http://www.epnetwork.org/

Fatebenefratelli, Italia

http://www.oh-fbf.it/

Medicus Mundi Svizzera

http://www.medicusmundi.ch/

Medicus Mundi Spagna

http://www.medicusmundi.es/

Medicus Mundi Italia

http://www.medicusmundi.it/

MISEREOR

http://www.misereor.org/

Redemptoris Missio

http://www.medicus.amp.edu.pl/

Smile Train Italia

http://www.smiletrain.it

WEMOS

http://www.wemos.nl/

Medicus Mundi Attrezzature (MeMuA) www.memua.it Medicus Mundi Equipment is a Type B Social Co-operation which collects the unused equipment in Italian hospitals and makes it available – after testing and revision – to non-profit medical activities in Countries with few resources. The collection of the equipment started in 1996 with a small group of volunteers of Medicus Mundi Italy and in 2004 it adopted the jurisdictional title of Type B Social Co-operation to guarantee the continuity and the independent development of the initiative. Medicus Mundi Equipment, as a type B social cooperation, is also dedicated to supporting and directing people in need of jobs.

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2010 REPORT

15


16

Child Malnutritionâ&#x20AC;&#x201D;Children aged <5 years underweight

Deaths due to malaria (per 100 000 population per year)

Prevalence of HIV among adults aged 15 to 49 (%)

Nursing and midwifery personnel density (per 1 000 population)

Physicians density (per 1 000 population)

Number of environment and public health workers

Number of laboratory health workers

Number of nursing and midwifery personnel in the country

Number of medical doctors (physicians) in the country

OMS/WHO Data

4,5

0

0,2

N.G.

1,22

1.579

540

18.091

10.329

BOLIVIA

2,20

0,10

N.D.

6,50

1,72

N.G.

N.G.

1.243.804

329.041

BRAZIL

26

221

1,2

0,729

0,064

1.239

510

10.539

921

BURKINA FASO

6,2

0

0,4

1,48

N.G.

N.G.

20.586

18.335

ECUADOR

21,2

N.G.

11,5

0,308

0,027

N.G.

800

6.214

548

MOZAMBIQUE

31,7

23

1,1

0,84

0,28

5.797

N.G.

32.439

10.813

SUDAN

0

0

0,3

6,52

0

N.G.

379.213

246.834

ITALY

MEDICUS MUNDI ITALY


2010 REPORT

Medicus Mundi Italy’s Projects

AFRICA Burkina Faso

Fighting AIDS - Adults

Italian Ministry for Foreign Affairs and Private Donors

Burkina Faso

Fighting AIDS - Children

Burkina Faso

Providing Drinkable Water

A2A Foundation

Mozambique

City of Brescia

South Sudan

Maternal - Infant Medical Assistance/ Training Medical Assistance/Training

South Sudan

Pediatric Assistance

Italian Bishops’ Conference Fondi 5 x Mille Brescian Community Foundation

LATIN AMERICA Private Donors

Brazil

Maternal - Infant Medical Prevention/ Training Socio/Healthcare Assistance

Brazil

Dialysis Service

Region of Lombardy - City of Brescia - City of Marone - Brescian Community Foundation ―Cuore Amico‖ Association Leno Missionary Group

Ecuador

Test Lab and promotion of Primary Healthcare

Brescian Community Foundation - ―Comunità De Angeli‖ Association, Milan

Bolivia

City of Brescia

EUROPE Germany/Poland/ Spain/Italy

Stop Malaria Now!

European Commission

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MEDICUS MUNDI ITALY

BURKINA

FOCUS

18

Surface area

274.000 Kmq

Total population

14.800.000

Gros National Income per capita (US$)

1.215

Population below $1 per day - %

27,2

Human Development Index (1-169)

161

Life expectancy at birth (years)

53,7

Mortality rate of children under 5 years old (per 1,000 live births)

204

Maternal mortality ratio (per 100,000 births)

700

FASO


2010 REPORT

Burkina Faso – Fighting AIDS affecting Adults in the District of Sector 30 of Ouagadougou and in the rural District of Nanoro

Place Ouagadogou and Nanoro (Burkina Faso) Local Partners Camillian Vice Province in Burkina Faso Centre Médical Saint Camille (CMSC ), Ouagadougou Centre d’Accueil Notre Dame de Fatima (CANDAF), Ouagadougou Centro di Ricerca Biomolecolare Pietro Annigoni (CERBA ), Ouagadougou Centre Médical avec Antenne Chirurgicale - St. Camille (CMA-SC), Nanoro The project is carried out jointly by Medicus Mundi Italy (head of group) and the International Lay Volunteering Association (LVIA) from Cuneo, Italy. Co-financers Italian Ministry for Foreign Affairs Private Donors Duration of Project 30 months (2008-2011) Project Goal Develop performances offered to HIV/AIDS patients in the 4 structures of the Camillian delegation in Burkina Faso. This objective will be met mainly by using antiretroviral therapy, in accordance with WHO protocols for countries with limited financial resources and to dispositions of the local Ministry of Health. Therefore, the project provides for requalification of diagnostic and first-aid structures (laboratory and radiology) in the four Health Centers of the Camillian Vice Province in Burkina Faso, in partnership with the local health service.

Activities 1.

Reinforce the integration between Reproductive Healthcare measures, in particular by screening the spread of HIV infection during the inter-pregnancy interval.

2.

Supply 15 medical structures of the District of Nanoro (the CMA-SC Hospital and 14 healthcare centers) with reactants and essential goods.

3.

Screen and diagnose children with HIV-infected mothers.

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MEDICUS MUNDI ITALY 4.

Monitor the supply of ARV medicines in the medical structures of the District.

5.

Ensure protocols are correctly enacted by the district team.

6.

Supply the medical structures with substitutes of maternal milk.

7.

Supply the new ambulatories and the Day Hospital at CANDAF/CERBA Center with new furniture and medical equipment.

8.

Supply the pharmacies of CANDAF/CERBA Center, of CMSC Center and ―Ospedale San Camillo‖ Hospital in Nanoro with medicines for the prevention and treatment of infections.

9.

Supply the laboratories of CANDAF/CERBA Center, of CMSC Center and ―Ospedale San Camillo‖ Hospital in Nanoro with reactants and essential goods.

10.

Train local staff so as to provide them with clinical and diagnostic skills.

11.

Train 30 agents to an integrated syndrome approach to HIV/AIDS cases.

12.

Organize a calendar of domestic medical examinations.

13.

Ensure monitoring of activities.

The project is conducted in partnership with ―Esther Italia‖, an intra-hospital program fighting AIDS, and is supported by the University and the Spedali Civili Hospital of Brescia. In 2010 the project has been monitored by two co-operators: Dr. Virginio Pietra (physician and head of project) and Mario Civettini (administration-logistics).

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2010 REPORT Results In the following sections, some data on the results obtained in the project by the 1st semester 2010. Percentage of deaths and patients who were lost of sight among those treated in the 3 Camillian structures. These figures refer to a 26-month period, starting from the beginning of the project (April 2008).

Structure

N° Patients

N° Deaths (%)

N° Lost of Sight (%)

adults

750

13 (1,7%)

21 (2,8%)

children

184

14 (7,6%)

4 (2,2%)

408

20 (4,9%)

17 (4,2%)

-

-

-

306

37 (12,1%)

25 (8,2%)

14

1 (7,1%)

0

1.464

70 (4,8%)

63 (4,3%)

198

15 (7,6%)

4 (2,0%)

CMSC

CANDAF/CERBA adults children S. Camillo Hosp. Nanoro adults children Total adults children

Percentage of therapeutic failures (clinical, immunological and virological) among patients under tritherapy. These figures refers to a 26-month period, starting from the beginning of the project (April 2008).

N° Pazients under tritherapy

N° therapeutic failures (%)

adults

579

33 (5,7%)

children

111

8 (7,4%)

346

33 (9,5%)

-

-

160

2 (1,3%)

7

0

1085

68 (6,3%)

119

8 (6,7%)

Structure CMSC

CANDAF/CERBA adults children San Camillo Hosp. Nanoro adults children Total adults children

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MEDICUS MUNDI ITALY These variables refer to the period between July and December 2008, during the first phases of the project, (training and planning), and it refers to the periods between January and December 2009 and between January and December 2010, when the project became an effective support to the medical assistance provided in the District. A comparison between figures shows that: i) the number of test takers has tripled, ii) pregnant women affected by HIV and lost of sight have considerably reduced and iii) an adequate number of births by HIV+ affected mothers take place under ARV prophylaxis (>80%). Throughout the project, the amount of medical centers has increased from 15 to 17, as two new Medical centers have been created. July – December 2008

January – December 2009

January – May 2010

6/15

14/17

17/17

% of patients submitting to CDV

697/2.747 natal counselling (25,4%)

2.747/5.913 natal counselling (46,5%)

1.508/2.150 natal counselling (70,1%)

% women affected by HIV lost of sight

10/12 HIV+ (83,3%)

7/41 HIV+ (17,0%)

4/28 VIH+

% deliverys under ARV prophylaxis

2/12 (16,7%)

34/41 (82,9%)

(14,3%) 13/15

Variables Number of Centers offering CDV during pregnancy

(86,7%)

Number of patients who have received day-hospital assistance: 1,662 patients VS 1,328 at the beginning of the Project (+ 20.2%); Number of patients under ARV therapy: 1,204 patients, VS 931 at the beginning of the Project (+ 29.3%); % of patients under co-infection screening; All patients have undergone hepatitis B and C screening. 176/1,662 (10.6%) patients were found positive with Hepatitis B, while 16/1,662 (0,96%) were found positive with Hepatitis C. All patients found positive with Hepatitis B and/or C are treated accordingly to diagnostic and therapeutic protocols advised by WHO. All 106 patients with TBC-like symptoms have undergone medical examinations in search of MTB, which was found in 17 cases. Cervical cancer screening was introduced during the second year of the project in all three centers, and it is available also to HIV-negative women. All HIV+ female patients have undergone an annual screening by checking dubious injuries with acetic acid and Lugol’s iodine. This screening has given positive outcome in 16 patients who, according to their respective results, have been treated with cryotherapy, biopsy or conization and, only in one case, with hysterectomy. In 250 patients, HPV infection has been found thanks to RTPCR and genotyping tests, performed in the CERBA laboratories. Results showed that about 60% of patients were infected by HPV genotypes, more than 90% of whom oncogenic. The definition of the oncogenic HPV genotypes present in the country is a major element in MMI’s/MMI personnel’s choice of antigenic targets. For the future, it is envisaged to vaccinate the female population of Burkina Faso against HPV. Monitoring therapeutic failures in patients - 196 patients were suspected of being under therapeutic failure, according to clinical and immunological criteria. The viral load of HIV on their plasma has been tested in the CERBA laboratories. In 25 cases, the test proved therapeutic failure. This lead to changes in the current therapeutic procedures, towards the second therapeutic strategy. Number of trained counselors - 82 counselors have been trained, out of the 90 which had been foreseen throughout the project. Training focused on counseling about sexuality and procreation, response to treatment, personal hygienic and nourishing habits and less dangerous breastfeeding for children born from HIV+ mothers. Number of domiciliary counseling sessions per patient - Throughout the second year of the project, 1,260/1,662 patients have requested and obtained 1,774 medical examinations at home.

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2010 REPORT

Burkina Faso – Fighting AIDS affecting Children in the District of Sector 30 of Ouagadougou and in the rural district of Nanoro.

Place Ouagadougou

Local Partners Camilian Vice Province in Burkina Faso Centre Médical Saint Camille (CMSC ), Ouagadougou AEM ―Aide moi à être mère‖ CREN Suore di St. Marie de Torfou e Suore Apostole del Sacro Cuore di Gesù

Co-Financers Italian Ministry of Foreign Affairs Private Donors

Duration of the Project 2010-2012 Project Goal The project aims at reinforcing the services of medical assistance given to children affected by HIV/AIDS in the CMSC Hospital, Ouagadougou, by providing: Support to the model medical assistance given to HIV+ children in the medical centers in charge of the Camillian Vice Province (assistance goal). This includes also treatment of malnutrition, in cooperation with several local Recreational and Nutritional Centers (CREN); Training local medical staff in technical skills on antiretroviral therapy and on actions against malnutrition; Support to research activities aiming at defining pilot modes of intervention; Facilitating access and administration of antiretroviral medications and drugs treating malnutrition. This involves the creation of a specific database, the acquisition of medical-diagnostic devices, aiming at treating patients affected by HIV/AIDS and by diseases linked to HIV (logistic aim). Activities Train nurses and the local doctor of the CMSC in treating HIV+ children; Train nurses working in the Pediatrics ward and the CREN of the CMSC, as well as of further CRENs in treating malnourished children; Screen (by examining RT-PCR at 2 months of age and serology from the 18th month) children with HIV infected mothers, both participants and non-participants to the Prevention of mother-child infection program-PTME

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MEDICUS MUNDI ITALY Supply the medical center with ARV medications (antiretroviral) and with medications for the prevention and treatment of opportunistic infections. Train a person in charge of the distribution of ARV medications and of the adherence supervision. Identify and collaborate with specific personnel (psychologists, educators, social workers) who aim at supporting and improving children with HIVâ&#x20AC;&#x2122;s interior lives, as well as their familiesâ&#x20AC;&#x2122;. This measure intends to reinforce compliance and adherence, and to establish a communication program. Establish a communication program which informs adolescent patients about the diagnosis, in order to facilitate the passage to adult day-hospitalization. Supply the CSMC and the other CRENs participating to the project with the necessary products for treating malnourished children, according to the latest WHO/UNICEF guidelines. Ensure that the enactment of protocols concerning both malnutrition and coping with HIV is supervised. Ensure pediatrical patients that the integrated syndrome approach is supervised. Develop training contents so as to make them available not only to the medical staff of St Camille Hospital and the CRENs, but also to DIU (Diplome Inter-Universitaire) students. Identify families who have priority for domestic counseling and organize a calendar of domestic medical examinations. Ensure monitoring over a further medical center using pediatric ARV.

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2010 REPORT

Burkina Faso – Providing Drinkable Water for the Natenga, Boura and Gogma communities (District of Garango)

Place Natenga, Boura and Gogma communities (District of Garango, Province of Boulgou – Burkina Faso).

Local Partner DAKUPA Association, Garango

Co-Financer A2A Foundation – ―It’s raining on dry land‖ campaign, promoted by several NGOs from Brescia Duration of the Project 6 months (June - November 2010)

Project Goal Facilitating the population from the Natenga, Boura and Gogma communities in Burkina Faso accede to drinkable water. Activities The areas of Natenga, Boura and Gogma had their own wells for drinking water, which were, however, out of use because immersion pumps were irreparably damaged. Substituting the damaged pumps would have been financially unaffordable for the local population, who could benefit only from a limited budget. Therefore, the population was forced to use water from traditional wells or from forages (in-deep, with manual pumps drilled wells ) in surrounding areas. During the dry season, from February to June, traditional and modern wells dry up and the only alternative source of water are distant forages. During those months, these wells are usually extremely crowded, since they are used by a high number of persons. So, collecting one’s daily water supply becomes very exhausting and stressful, in particular for women and children who have to walk kilometers-long distances and wait for hours for their turn at the well. So, the three forages which had served the beneficiary communities for many years before being damaged by the wearing effect of time, have been repaired. This initiative led to a decrease in crowding around the other forages, brought the water closer to the three communities in question and contributed to improving the population’s health conditions. Results The three wells were dug and set up according to the schedule. Beneficiaries of the intervention were the inhabitants of the communities of Boura (approximately 700 people), Natenga (approximately 1,800 people) and Gogma (700 people): as a whole, 3,200 people. The project ended in November 2010.

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MEDICUS MUNDI ITALY

MOZAMBIQUE

FOCUS

26

Surface area

801.590

Total population

21.400.000

Gross National Income per capita (US$)

854

Population below $ 1 per day - %

36,2

Human Development Index (1-169)

165

Life expectancy at birth (years)

48,4

Mortality rate of children under 5 years old (per 1,000live births)

138

Maternal mortality ratio (per 100,000 births)

520


2010 REPORT

Mozambique – Improving Healthcare Assistance in the District of Morrumbene (Mozambique), by Supporting Maternal - Infant Healthcare and Prevention of Vertical HIV Transmission Program.

Place District of Morrumbene - Province of Inhambane - Mozambique Local Partners Missão Santa Maria de Mocodoene Serviço Distrital de Saúde, Mulher e Acção Social de Morrumbene Co-Financers City of Brescia Duration 22 months (2008-2010) Project Goal Reinforcing the maternal-infant healthcare network and the Prevention of Vertical HIV Transmission Program in the District of Morrumbene. Activities The project is part of the ―Brescia for Mozambique‖ program, which is promoted by 5 NGOs from Brescia (Tovini Foundation, SCAIP, Medicus Mundi Italy, SVI, SIPEC Foundation) and by the Missionary Diocesan Center, and aims at creating cooperation projects for agricultural, educational and healthcare development in the District of Inhambane. This project was a pilot action set up in the Medical District of Morrumbene. The Maternal-infant healthcare project and Prevention of Vertical HIV Transmission has been reinforced, especially in rural areas, by providing technical assistance, basic training and socio-healthcare prevention. In particular, the project enabled the 9 healthcare centers present in the area and the ―Brigadas moveis‖ (mobile medical units) to improve their services, also thanks to the on site training program set up by MM Italy, in collaboration with the Department of Infectious Diseases of the Spedali Civili Hospital of Brescia. This was the right starting-point of a more relevant coordination with the medical actions and programs of the District of Morrumbene. The project worked jointly with the Healthcare Strategic Plan of the Provincial Healthcare Department of Inhambane and the National Strategic Plan of the Fight against AIDS. Results The project ended in the first 3 months of 2010 and produced the following results: Physical examinations of maternal-infant health conditions have been performed in rural areas, in between 2008 and 2010: Vaccinated children: 10,300 Pre-natal counseling: 8,800 Cured children: 23,300 Children under growth monitoring: 28,800 Dr. Anna Cristina Carvalho, MM Italy, has given two short technical training courses for local healthcare teams, on the following issues: Prevention of vertical transmission of HIV (may 2009, 14 participants) Updating course on TBC prevention and treatment (January 2010, 16 participants).

27


MEDICUS MUNDI ITALY

SOUTH SUDAN

PS: South Sudan became independent from Sudan on 9th July 2011. In 2010, the year this Report is about, therefore, it was still part of Sudan.

FOCUS

28

Surface area

n.g.

Total population

n.g.

Gross National Income per capita (US$)

n.g.

Population below$1 per day - %

n.g.

Human Development Index (1-169)

n.g.

Life expectancy at birth (years)

n.g.

Mortality rate of children under 5 years old (per 1,000 live births)

n.g.

Maternal mortality ratio (per 100,000 births)

n.g.


2010 REPORT

South Sudan - Reinforcement of healthcare and socio-health care training in Mapourdit, Yirol and Tonj.

Place Districts of Mapourdit, Yirol and Tonj, in the Lakes Region and Bahr El Ghazal area, South Sudan. Local Partners AAA Arkangelo Ali Association (NGO recognized by the Government of South Sudan) Other Partners AIFO—Italian Association of Friends of Raoul Follerau Cesar Association—Coordination of Solitarity Corporations in Rumbek Co-financers Italian Bishops’ Conference (CEI) Duration of the Project 36 months (2008-2010) Project Goal The project aims at developing primary health care and socio-healthcare training in the Mapourdit, Yirol and Tonj Districts and in their respective surrounding territories. Activities To diminish the mortality rate in children under 5 because of ―killer‖ diseases (diarrhea, severe respiratory infections, malaria…) in the Districts of Mapourdit, Yirol and Tonj, the following actions have been undertaken: Basic Training for community agents (Village Volunteers) and for Traditional Birth Assistants; supervision of their activities; Healthcare prevention activities and a long-term vaccinating program for children; Assistance and counseling for pregnant women and young mothers; Purchasing of medical equipment and pediatric medications. Results In 2010, the following results have been achieved: Children cured of malaria: 4,300 Children cured of respiratory infections: 2,900 Children cured of diarrhea: 1,600 Children cured of various diseases (pneumonia, cough, dehydration etc): 700 N° of distributed Nutrition kits: 1,550 N° of distributed medicaments in bars (amoxicillin, zinc, amodiaquine, artesunate): 12,500 Mothers having received assistance in proper care of children’s growth: 7,800.

29


MEDICUS MUNDI ITALY Basic Healthcare Training Courses organized during the project: Village Volunteers: 18 courses for new Village Volunteers 22 updating courses Traditional Birth Assistants: 38 courses for beginners 30 updating courses Thanks to the fundings MM Italy received from 5 X 1000 Donation, it has been possible to continue supporting the work of Village Volunteers and Traditional Birth Assistants throughout 2010.

30


2010 REPORT South Sudan – Supporting the Pediatric Assistance Program at the Marial Lou Hospital (Tonj County, South Sudan)

Place Marial Lou, Tonj County, South Sudan Local Partner AAA Arkangelo Ali Association (NGO recognized by the Government of South Sudan) Co-financers Brescian Community Foundation Durata del progetto 18 months (2009- 2010)

Project Goal The project’s objective is to improve pediatrics, nursing and nutritional assistance to children, between 0 and 5 years of age, who are underfed and affected by local diseases common in the Marial Lou area. Activities The project contributed to improving pediatric assistance and professional skills of medical personnel in hospitals and dispensaries in Marial Lou. A training program has provided the personnel with the necessary skills to respond effectively and efficiently to local medical emergencies. The most relevant examples of these are fighting infectious diseases and the mortality rate in children under the age of 5 by ―killer‖ diseases (diarrhea, severe respiratory infections, malaria), not to mention providing nutritional awareness campaigns targeted to young mothers. During the project, voluntary nurse Luciana Resconi from Brescia has supervised, in particular, a specific training course for medical personnel and has been working at the ―Saint Francis‖ Hospital, Marial Lou.

Results The project ended in April 2010 and produced the following results: Children cured at the local Hospital of Marial Lou: 3,450 N° of Distributed Nutrition kits: 180 Professional Training Course, aimed at improving basic nursing and nutritional skills of medical personnel, provided by a voluntary nurse from Brescia sent to South Sudan by MMI.

31


MEDICUS MUNDI ITALY

BOLIVIA

FOCUS

32

Surface area

1.098.581 kmq

Total population

9.500.000

Gross Nationa Income per capita (US$)

4.357

Population below $ 1 per day - %

23,2

Human Development Index (1-169)

95

Life expectancy at birth (years)

66,3

Mortality rate of children under 5 years old (per 1,000 live births)

61

Maternal mortality ratio (per 100,000 births)

290


2010 REPORT

Bolivia - "Educación para la salud": Integral Attention for Prevalent Childhood Diseases (AIEPI/IMCI) Project in the outskirts of La Paz

Place Areas of Munaypata and Cotahuma, District n° 1, La Paz (Bolivia) Local Partners: Dr. Cynthia Aparicio Gutierrez (Pediatrician, Hospital Juan XXIII, La Paz) Dr. Jorge Aquize Rendón (Internist, Hospital Juan XXIII, La Paz) Co-Financers Private donors Duration of Project: 3 years (2009-2011) Project Goal Improving maternal-childhood healthcare skills in local population: prevention and treatment of Prevalent Diseases in children between 0 and 5 years old, providing assistance to pregnant women and providing nutritional assistance. Activities The educational and medical awareness program supporting voluntary health promoters such as mothers and fathers, which had started in 2009, ended in 2010. In addition, a new educational, involvement and awareness campaign for teachers and students was set up, focusing on: education and prevention of major sexually transmitted diseases; Nutritional and hygienic useful training; prevention of basic health problems (diarrhea, fever, cough, etc…). Results In 2009 and 2010, the project produced the following results: 80 voluntary health promoters, mothers and fathers (8 groups of 10 persons each) completed a theoretical and practical 60-hour course 37 teachers and 80 students completed a 120-hour course in the schools of Munaypata and Cotahuma. Indirect beneficiaries of the activities promoted by the AIEPI program are over 700 students and more or less 1,000 families.

33


MEDICUS MUNDI ITALY

BRAZIL

FOCUS

34

Surface area

8.514.877 kmq

Total population

191.800.000

Gross National Income per capita (US$)

10.847

Population below $ 1 per day - %

7,5

Human Development Index (1-169)

69

Life expectancy at birth (years)

71

Mortality rate of children under 5 years old (per 1,000 live births)

20

Maternal mortality (per 100,000 births)

110


2010 REPORT

Brazil – Permanent Socio-Healthcare Training for Young People and Adults in Cidade Olimpica Place Cidade Olimpica, São Luis (Maranhao) – Brazil Duration of Project: 24 months (started in November 2007) Local Partners: Archdiocese of Sao Luis Paroquia Santissima Trinidade – Santissima Trinidade Parish Secretaria de Saude e Secretaria de Educação da Prefeitura de São Luis Conselho Tutelar São Luis Centre Direitos Humanos Marcos Passerini Co-Financers City of Brescia Project Goal 1.

Supporting socio-healthcare training targeted to the male population of the six communities of Cidade Olimpica in order to restore the role of men in families and society;

2.

Reinforcing medical prevention by increasing knowledge of major infectious diseases, sexually transmitted diseases and malnutrition diseases

3.

Reducing the abuse of alcohol and drugs

Activities In collaboration with the City Health Office, educational and socio-healthcare training courses were created for the men of Cidade Olimpica. Special focus has been given to psychological aspects, the claim for one’s dignity, the quest for one’s role within the family and the community and an analysis of Brazilian average families and society. Activities have centered on specific education and training concerning community life. These have included: basic socio-healthcare prevention and training; men’s and fathers’ responsibilities within the family and the community; training to couple life and family life; providing awareness on hygienic and medical habits, on infectious diseases, sexually transmitted diseases and diseases connected to abuse of alcohol and drugs. Results The project ended in January 2010 and produced the following results: 80 men and their respective families of the 6 communities of the area of Cidade Olimpica were involved in socio-healthcare prevention and assistance activities 52 course participants took a diploma Reinforcement of collaborations and professional exchange with the Secretaria de Saude e Secretaria de Educação da Prefeitura de São Luis, il Conselho Tutelar di São Luis e il Centro Direitos Humanos Marcos Passerini. Start-up of permanent basic socio-healthcare education program in the rural area of Cidade Olimpica. Beneficiaries of this project are all families of Cidade Olimpica, thanks to the enhancing effect of sociohealthcare prevention, of the awareness action on men’s and fathers’ responsibilities within the family and the community, and on children’s intellectual growth.

35


MEDICUS MUNDI ITALY

Brazil - Requalifying the “Vale do Jequitinhonha” Hospital, by activating the Dialysis Service and Kidney disease prevention in the Region of Itaobim (Minas Gerais) Place Itaobim – Minas Gerais – Brazil Local Partner Prefeitura di Itaobim (Mg) Hospital "Vale do Jequitinhonha" Hospital "Do Rim di Montes Claros" and Kidney Therapy Unit Pro-Rim of Brasilia de Minas Dioceses of Araçuai Partnership Spedali Civili Hospital of Brescia, Department of Nephrology and Urology University of Brescia, School of Medicine and Surgery, School of Specialization in Nephrology Co-financers Region of Lombardy City of Brescia City of Marone (Brescia) ―Associazione Cuore Amico‖ NGO ―Fondazione Comunità Bresciana‖ Foundation Leno Missionary Group Duration of Project 24 months (2009-2011) Project Goal Supporting the redevelopment of the Hospital ―Vale do Jequitinhonha‖, through the activation of dialysis services and kidney disease prevention, for the benefit of the region of Itaobim. HVJ Hospital lacks the needed resources to purchase equipment for treating patients. Due to the gradual increase of secondary pathologies, local healthcare authorities give primary importance to intervention in kidney disease prevention; the request that the HVJ created a new haemodialysis center in the area has come directly from the Ministry of Health of the State of Minas Gerais. The city of Itaobim, financed by the State of Minas Gerais, has seen to the creation of the necessary structure for setting up the service. In addition, the city council is also committed to covering the charges of medical and healthcare staff (nurses), and the supply in medicaments and other materials in order to guarantee continuity to the service in future.

Activities Completing the structure used for the haemodialysis service Training of nurses and technicians on the dialysis service Providing for an updating course for the haemodialysis service staff (nurses and technicians with nursing skills) Creation of a water-treating system for haemodialysis Supplying furniture for the haemodialysis ward and day-hospital Purchasing, installing and launching 14 haemodialysis machines and accessories (14 chairs, a computer, a ECG, a defibrillator and further more) Having the haemodialysis ward of HVJ Hospital work in full activity Monitoring, consulting and medical-scientific supervision activities.

36


2010 REPORT Results The first year of the project ended giving the following results: Creation of the new haemodialysis ward Purchase of furniture for reception desk, hospitalization and waiting rooms Purchase of 7 haemodialysis machines and correspondent chairs Purchase of a reverse osmosis system Purchase of a haemodialysis computer Specific training courses for nurses and technicians.

37


MEDICUS MUNDI ITALY

ECUADOR

FOCUS

38

Surface area

283.561 kmq

Total population

13.300.000

Gross National Income per capita (US$)

7931

Population below $ 1 per day - %

17,7

Human Development Index (1-169)

77

Life expectancy at birth (years)

75,4

Mortality rate of children under 5 years old (per 1,000 live births)

24

Maternal mortality ratio (per 100,000 births)

210


2010 REPORT

Ecuador – Creation of an Analysis laboratory in the area of the "Manga del Cura" Place Manga del Cura (Ecuador) Local Partners Archdiocese of Portoviejo Universidad Técnica de Manabì - Facultad de Ciencias de la Salud Direccion Provincial de Salud de Manabì Paduan Sisters of Saint Francis de Sales Co-financers ―Fondazione Comunità Bresciana‖ Foundation Private donors ―De Angeli‖ Community, Milan Duration of Project 3 years (2010-2012) Project Goal Increasing diagnosis and disease prevention skills in the area of Manga del Cura. The project began with a group of friends who have known and supported the social and human campaign promoted by missionary Father Alberto Ferri, who died in 2009 of a serious disease. During his last years, he had been working in the area of Manga del Cura, one of the most isolated and underdeveloped rural regions of Ecuador. The area is inhabited by 60,000 people who still live mainly in wooden and cane huts and have serious difficulties acceding to primary healthcare services, which are often very distant or scarce. Among the health priorities pointed out by the local health authorities and by the local population the necessity to create a Bio-Chemical Analysis Laboratory to survey infectious diseases and monitor chronic ones emerged. On the other hand, the greatest lack in healthcare assistance is the difficulty to diagnose properly and in proper time symptoms of diseases which could easily be cured in their initial phase. The spread of HIV, of sexually transmitted diseases and TBC is the major cause of the paramount necessity to identify infected individuals, in order to take adequate preventive measures for the whole community. Activities (2010) Preliminary analysis for the creation of a clinical analysis laboratory and for the promotion of family and community healthcare. Targets are the 54 rural communities of the Manga del Cura area Training of an emigrated laboratory technician The project was set up in the last 3 months of 2010. It constitutes the first phase of a three-year program aimed at contributing to improve the quality of medical assistance and to reinforce healthcare services in Manga del Cura.

39


MEDICUS MUNDI ITALY

40


2010 REPORT

Development Education STOP MALARIA NOW! Co-Financer European Commission Place Europe and Africa Partners Deutsches Medikamentenhilfswerk Action Medeor e.V. – Germany (leader) Stowarzyszenie Polska Misja Medyczna – Poland Federación de Asociaciones Medicus Mundi España – Spain Fundacja Pomocy Humanitarnej, ―Redemptoris Missio‖ Medicus Mundi Poland – Poland Eine Welt Netz NRW e. V. – Germany CUAMM Doctors with Africa Kenya NGO/Private Sector Alliance against Malaria – Kenya Duration of Project 4 years (1st phase 2008-2009 / 2nd phase 2010- 2011) Project Goal Improving sensitivity on malaria in Europe by activating public support campaigns in order to increase political, financial and strategic commitment, on behalf of European governments, in fighting malaria. A further aim is reaching the Millennium Development Goal concerning malaria. STOP MALARIA NOW! is a program conducted jointly by several NGOs from Germany, Italy, Kenya, Poland, Spain and Switzerland committed to healthcare and development. The ―Stop Malaria Now!‖ project promotes awareness and advocacy campaigns in Europe, in order to share knowledge and experience on fighting malaria. This disease is strictly linked to poverty and one of the main causes of death in the African South-Sahara region. Healthcare coordinator for Italy: Dr. Fabio Buelli Administration and Logistics coordinator: Dr. Sabrina De Nardi. The target groups of the initiative are: European representatives for healthcare and development NGOs; Private donors of European NGOs; Local, regional and national administrators in charge of healthcare and development in the European Union; Local and national press.

41


MEDICUS MUNDI ITALY In 2010, activities have concerned: Internet campaign ―Show Your Face Against Malaria!‖ Distribution of ―lobbying letters‖ to local and national politicians to demand greater efforts in fighting malaria Articles about malaria on local newspapers and national magazines Distribution of gadgets and informative material in schools, local events and conventions Awareness campaign on local radios (Radio Number One) In October 2010, Medicus Mundi Italy hosted the annual meeting of the NGOs collaborating to this project.

42


2010 REPORT

Further Activities in Italy

Brescia Medicus Mundi Italy – ―Bulletin‖ The Medicus Mundi Italy ―Bulletin‖ continues to be published regularly. In its simple form, it represents a useful tool to spread the news about our activities. A copy of our ―Bulletins‖ can be downloaded from our website (www.medicusmundi.it).

Brescia 1.

Collaboration with the art exhibition ―Inca in Brescia. Origins and mysteries of the Golden Civilization‖, shown in Brescia in the ―Santa Giulia‖ Museum, from 4 December 2009 to 27 June 2010.

2.

Collaboration with ―LeXGiornate‖ Festival, organized by ―Soldano‖ Association, Brescia – September 2010.

3.

Participation to the ―Tenda della Solidarietà – Tent of Solidarity‖ – event organized by the Board for Peace of the City of Brescia. This is a traditional initiative taking place in December and in which various cooperation and international charity associations gather for a common goal – December 2010.

Brescia 23rd Updating Course on Tropical Diseases

Dr. Myriam Brunelli, supported by Dr. Silvio Caligaris, Dr. Paola Rossini, accountant Ms. Cinzia Ferrante, laboratory technician Osvaldo Martelli and volunteer Mario Bina set up the Updating Course on Tropical Diseases, now at its 23rd edition. The course has been recognized by the Italian Ministry of Health as a formative activity authorized to release credits in the ―Continuing Education Program in Medicine‖ (ECM) – Italy, November 2010.

43


MEDICUS MUNDI ITALY

Dati dal bilancio 2010

2010 Positive Operating Result: â&#x201A;Ź 36.174 44


2010 REPORT

Data from the 2010 Balance Sheet

Note -The total sum of â&#x201A;Ź738,476 derives from summing â&#x201A;Ź479,667 (relating to expenditure of fundings received in 2010 on projects) with â&#x201A;Ź 258,809 (relating to fundings saved up from projects in 2009 and used in 2010).

Since 2008, Medicus Mundi Italy has decided to have its financial statements formally audited by the Studio Nassini&Associati in Brescia, as MMI believes that it is fundamental to have an independent evaluation of its work. To guarantee the future of such transparency with all its supporters and beneficiaries, MMI has decided to publish its balance sheets and notes on its website.

45


Medicus Mundi Italy 2010 Report