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 Report - Monthly Report (UMCOR)

 Report date: 31.08.1999

UMCOR AZERBAIJAN
30 Bul-Bul Avenue, Apt. #62Telephone: (994-12) 93-01-10; 98-05-38
Baku, Republic of AzerbaijanFax: (994-12) 98-28-70
E-Mail: mhuet@amadou.baku.az

EXECUTIVE SUMMARY

UMCORs clinics and medical points maintained regular schedules during the month of September, with primary health care clinics in Baku serving 7,910 IDP patients. These facilities serve IDPs residing in ten districts of the city. A total of 10,608 IDPs received primary health care through eight UMCOR medical points in Sabirabad, Imishli, Saatli, Fizuli and Agjabedi.

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

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

Threephysicians from the Health Partnership-targeted hospitals left for Houston to take part in the training to be conducted at the Baylor College of Medicine.

Under the auspices of our UNHCR project, UMCOR continued supporting sport, cultural and skill development activity circles for adolescent girls and boys. UMCOR initiated the distribution of textbooks, UNHCR-donated school kits and UMCOR-procured oral hygiene kits for the children. A total of 7,461 condoms, 112 bars of toilet soap and 224 bars oflaundry soap were distributed during the month of September to Meskhetian Turk communities under the health education component of the program. 707 Meskhetian Turk IDP women were examined by UMCOR Gynecologists in the month of September. UMCOR and Vatan initiated the process of establishing a Community Seed Bank in the Northeast region.

UMCOR/Azerbaijan received funding from the U.S. State Departments Bureau for Population Refugees and Migration (BPRM) for to initiate a new project. This project will target Meskhetian Turk refugees residing in in Northeast, Southeast and Shamakhi regions, and include interventions in the following sectors: Community Development, Participation and Contribution; Local Institutional Capacity Building; Community Infrastructure; Health and Nutrition; and Economic Opportunities

PROJECT UPDATES

1. Department of State Emergency Medical Assistance Project

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

Statistics pertaining to IDP/RP patient visits to the DoS clinics during the month of September 1999 are provided below:

Districts:AzizbekovSurakhaniBinagadiSabunchiKaradagTOTAL:
# of IDPs/RPs

13,447

18,223

36,268

23,621

10,971

102,530

# of patients:

732

694

796

798

596

3,616

The most prevalent diseases among the ID/RP population frequenting the DoS clinics in September were the following:

  1. Worms - 10.1%
  2. Common cold - 6.3%
  3. Hypertension - 4.7%
  4. Vitamin Deficiency - 4.6%;
  5. Tonsillitis - 3.9%;

During the month of September, a mobile clinic consisting of a Pediatrician, a Nurse and a Driver continued their outreach activities, which enable primary health care, medicines and medical supplies be delivered to institutionalized/handicapped children residing in 33 Children Institutions in Baku and the Absheron area. In September, the UMCOR Pediatrician served 284 institutionalized/handicapped children in the targeted Children Institutions.

51 state health facilities continue received medicines and medical supplies available from five UMCOR medicine dispensaries in September. A total of 855 patients received medicines and medical supplies in the five UMCOR medicine dispensaries during the month.

During the month of September UMCOR Medical Monitors implemented monitoring in ten state health facilities. These state health facilities included the following:

  1. Polyclinic #5
  2. Polyclinic #8
  3. Polyclinic #31
  4. Republican Center of Surgery
  5. Childrens Polyclinic #14
  6. Hospital #1
  7. Hospital #5
  8. Childrens Infection Hospital #5
  9. Caspian Shipping Hospital
  10. United Hospital #6

The current balance of UMCOR donated medicines and medical supplies was assessed during monitoring. In addition, UMCORs internal distribution methodologies and distribution forms were also reviewed. This monitoring also assessed the needs of these health facilities for receiving further medical provision by UMCOR.

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

In September UMCOR continued to support NGOs including Azerbaijan Charity Society HAVVA and INSAN, The Association of Parents of the Children with Talassemia, Hemophilic Patients Association and the Jewish Womens Organization of Azerbaijan, a Jewish charity organization Hesed Gershon, working in collaboration with UMCOR. Health workers of these organizations filled patient prescription forms using UMCOR medicines and medical supplies.

In September, new contracts for collaboration were signed with Khachmaz, Davachi and Siyazan district Central Hospitals. According to the contracts signed, the vulnerable patients of these health facilities will be provided with UMCOR donated medicines and medical supplies.

In addition, UMCOR delivered large shipments of medicines and medical supplies to the Central Hospitals of Sabirabad, Yardimli, Khachmaz, Davachi, and Siyazan districts. A new order for medicines and medical supplies was prepared according to IMAs Bi-Weekly inventory lists.

In September, UMCOR established two pharmacies in Kurdamir and Ali-Bayramli districts. As a result, vulnerable patients of these districts will have access to prescriptions written by state physicians, which will provide them access to UMCOR donated medicines. Prior to the opening of the pharmacies, training sessions were conducted based on WHO protocols and UMCORs guidelines for the state physicians of Ali-Bayramli and Kurdamir Central Hospitals.

Prescription and consumption forms written by DoS clinic doctors and local state doctors were analyzed in September. The quantity of the three medicines randomly selected from each clinic, the mobile pediatric team and the medicine dispensaries was compared with the quantity presented in the consumption forms. A few discrepancies were detected between the prescription and consumption forms this month due to replacement of permanent staff by substitute doctors as the result of staff members taking vacation.

The monitoring of all 2,636 (100%) prescription forms was conducted during September, which had been filled by UMCOR clinic doctors in August, were in accordance with WHO protocols and MSF guidelines. Results of the monitoring indicated that 2,590 (98%) of the prescriptions had been correct. This discrepancy is associated with the work of substitute physicians.

DOS Community Health Provider Transition Activities:

During the month of September training program for IDP Community Health Providers (CHP) continued. Activities implemented included the delivery of training sessions, and updating and translating training materials.

Training:Selected CHPs were divided into eight groups depending on the region of their residence, and each group was assigned to the closest UMCOR training center. Training will last 12 weeks with each week being dedicated to a different health topic.
Training materials:The curriculum focuses on both curative, as well as public health information. The initial training sessions covered those health topics that emphasize important health problems as identified UNICEF, the MOH and WHO. The sessions will provide the trainees with sufficient information to enable them to write UMCOR prescription forms. UMCORs previous training materials were updated, and translated into Azerbaijani.

The following topics were covered during the month of September:

Week of September 6:-Family Planning and Contraceptives.
Week of September 13:-Goiter; Review of the previous lessons.
Week of September 20:-Final Test.
Week of September 27:-Training on UMCOR protocols: Prescription Forms, Growth Charts, Patient Cards, etc.
-Announcement of Test results and distribution of Certificates.
-Video-film associated with Acute Respiratory Infection and Diarrhea.

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

The table below presents statistics of IDP/RP patients who received primary health care from the five clinics supported by the project during the month of September.

Districts:

Yasamal

Narimanov

Khatai

Nizami

Sabail

TOTAL:

# of IDPs/RPs

12,257

25,747

21,836

18,449

10,814

89,103

# of patients:

667

721

1187

818

901

4,294

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

  1. Headache/joint pain - 7.3 %
  2. Trauma/burns /wounds- 7.0%
  3. Common cold- 6.8%
  4. Worms- 6.3%
  5. Hypertension- 6.1%

Prescription and consumption forms written by USAID/MCI clinic doctors and local state doctors were analyzed in September. The quantity of the three medicines randomly selected from each clinic, the mobile Pediatric team and the medicine dispensaries were compared with the quantity presented in the consumption forms. Four cases of divergence were detected between the prescription and consumption forms.

In September, the monitoring of all 2,896 (100%) prescription forms filled out by clinic doctors during the month of August was conducted in accordance with WHO protocols and MSF guidelines. Results of the monitoring indicated that 2,884 (99.6%) of the prescriptions had been completed correctly.

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

Settlements

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

The table below presents statistics on the number of IDP/RP patients that received primary health care at UMCORs eight medical points during the month of September.

Medical Point

Region

#of IDPs/RPs

# of patients

Sabirabad 1 (Ahtachi)

Sabirabad

2,311

978

Sabirabad 2 (Shahriyar)

Sabirabad

2,069

822

Saatli (Alisoltanli)

Saatli

2,145

1,046

Bahramtepe

Imishli

3,900

1,154

Fizuli (Bahmanli)

Fizuli

2,650

1,251

Agjabedi (Khojavand)

Agjabedi

2,000

2,491

Boztepe

Imishli

2,790

1,585

Garabag

Fizuli

12,326

1,281

TOTAL:

 

30,191

10,608

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

  1. Headache/joint pain- 11.8%
  2. Trauma- 6.5%;
  3. Hypertension - 4.9%
  4. Vitamin Deficiency- 4.1%
  5. Tonsillitis- 4.1%;

In September, the Baku-based Medical Manager visited all the medical points and reviewed their activities. He also assisted Imishli office staff in preparing monthly report for September.

On 30 September, two MCI Board Members, Mr. Frank Dobyn and Ms. Phylis Dobyn visited the Hojavand medical point in Agjabedi district. They became acquainted with the activities of the medical points including registration of patients (health cards), growth monitoring (growth cards), referral system (referral form), immunization (immunization passport) and also medicine tracking system.

Prescription and consumption forms written by medical point doctors were analyzed in September. The quantity of the five most commonly used medicines and two medicines randomly selected from the prescription forms were compared with the quantity presented in the consumption forms. In total, 5,003 prescription forms were checked and 56 denominations of medicines were selected. The monitoring indicated that there was no divergence between the prescription and consumption forms of the medical points.

The September monitoring of all 5,003 (100%) prescription forms, prescribed by the medical point doctors in August, was conducted in accordance with WHO protocols and MSF guidelines. The results of the monitoring indicated that 4,994 (99.8%) prescription forms had been correct.

3. USAID/MCI 1 Health Partnership Program

On 12 September, next group of physicians (Dr. Nizami Muradov, Dr. Agabala Agayev from the Republican Center of Surgery and Dr. Sevinj Abdoullayeva from the Republican Clinic Hospital) from the partnership hospitals left Baku to participate in the training sessions to be conducted at the Texas Medical Center.

The Program Officer finished the preliminary analysis of 132 completed Questionnaire Forms (out of distributed 200 forms) collected from the physicians of the selected hospitals, who participated in training activities in Baku.

The Questionnaire Form included the following items:

  • Personal information including the position and medical background.
  • Evaluation of the Health Partnership Program activities (in general)
  • Evaluation of lectures delivered by American physicians in Baku.

The second part of the Questionnaire Form concerns the physicians who have participated in Partnership training at the Texas Medical Center in Houston. 10 completed Questionnaire Forms were received in this regard. Analysis of these questionnaires revealed that:

  • All the physicians (100%) improved their professional knowledge in the selected areas.
  • Most of them (60%) practiced the knowledge acquired in the Texas Medical Center in their daily activities and the rest (40%) is planning to apply this knowledge in future when the needed equipment will be available.
  • All the physicians were contented with the organization of the training.

Currently, Health Partnership Program Officer is working on organization of Dr. Zurawin and Dr.Scotts visits (creation of schedules, set up of the conference room etc.) which will take place on 2 October.

4. UNHCR/Meskhetian Turk Project

A. Non-Food Distribution

No food distribution was carried out during the month of September.

B. Agriculture

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

Family Greenhouse: Greenhouses were not employed during the month of September.

Community Seed Bank: Most of the Meskhetian Turk refugee families are engaged in wheat and vegetable production. Poor quality of traditional seeds resulted in decrease of harvest. Thus, UMCOR and Vatan initiated organization of Meskhetian Turk farmers groups and would provide them with the improved quality of wheat seed for a seed generation program. Vatan Society will monitor the program and follow up the first harvest to be distributed among the other groups of farmers. For this purpose seven metric tons of wheat seed was locally procured in the Northeast region. UMCOR and Vatan will also provide fertilizer and pesticides required for the wheat seed generation program.

Agriculture Extension Project: The Agricultural Extension Project has expanded to the Southeast region. Initially, UMCOR focused on the Northeast region. A team of eight community agronomists and farmers (four from each region) attended a four-day training seminar on agriculture extension methodologies in Agcabedi. Diakonies Agriculture Extension Trainers provided training on various topics including theoretical input on extension and extension methodologies; communication behavior for extension purposes; field testing; and developing a work plan for an extension agent. In collaboration with Diakonie, the second set of similar training for eight more agronomists and farmers is scheduled for 19 October to be held in UMCOR-Sabirabad.

C. Health and Nutrition

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

UMCORs four part-time Health Education teams completed the dissemination of the lesson plan on General Nutrition in settlements targeted in the 1999. Dissemination of the same lesson plan is ongoing in 1998 project settlements.

A total of 2,646 women (1,339 in the Southeast region and 1,307 in the Northeast region) attended these lesson plans. The preparation for the seventh lesson plan on Pregnancy for 1999 project settlements is underway.

Health education teams distributed the following items during the month of August: 7,461 condoms (3,618 in the Northeast region and 3,843 in the Southeast region); 224 bars of laundry soaps and 112 bars of toilet soaps in the Northeast region.

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

A total of 707 MT/IDP women were examined; 3 cases of which were referrals to womens consultation centers and 518 diseases were diagnosed by UMCOR gynecologists. UMCOR Gynecologists distributed a total of 87 contraceptives (29 per oral, 11 injections and 47 intrauterine) in the Northeast and Southeast regions.

Pharmaceutical Distribution for Primary Health Care: UMCOR initiated pharmaceutical distribution activities to support Meskhetian Turk refugees and other vulnerable population with basic pharmaceuticals. UMCORs gynecological teams operating within the framework of UNHCR-funded MT project were employed to conduct this activity. A total of 388 beneficiaries received various medicines prescribed by UMCOR gynecologists during the month of September.

D. Community Services

Sports Groups: UMCOR continues supporting Community Committees (CC) to organize sports groups and circles in the targeted settlements. Three more sport groups were established during the month of September. A total of 27 sports groups are conducting sport activities (football, volleyball, badminton, and chess) for adolescent children in both regions. Sports groups are classified according to the age groups: 12 to 14 years and 15 to 20 years old. UMCOR provided sports groups with additional equipment and supplies to conduct the proposed activities.

Recreational/Cultural Groups: A total of seven circles including cookery, art, drama, dancing were organized in Southeast region. UMCOR provided the circles with equipment and supplies to conduct the proposed activities.

E. Education

Pre-school Childrens Centers: UMCOR continued the distribution of school and hygiene kits to the primary school children in Southeast and Northeast regions. A total of 788 school and hygiene kits were distributed as of 30 September.

Due to inadequate number of children attending the centers, only four children centers continued functioning during September. By the same reason three of these centers will also stop its activities as of 30 September. However, one children center in Akhiskha-Sabirabad will continue its work as a full-time kindergarten. UMCOR reached a verbal understanding with Sabirabad department of MoE. According to this understanding, MoE-Sabirabad will provide the kindergarten with childrens food and teachers salaries, and UMCOR will keep supporting this center with classroom supplies. If the agreement is respected by MoE-Sabirabad, UMCOR will support the rehabilitation of this center under the auspices of BPRM funding.

Vocational Training: Two more sewing circles were organized during September.Currently, a total of five sewing circles are functioning with 95 adolescent girls in attendance. UMCOR provided these circles with necessary equipment and materials. UMCOR provided these circles with necessary equipment and adequate materials/supplies to function according to their proposed plan. Five community instructors are employed for conducting the training sessions.

In view of existing interest among youth for acquiring skills, UMCOR plans to organize vocational training courses in the vocational schools of Saatli, Sabirabad and Davachi districts. UMCOR achieved a verbal agreement with Davachi vocational school to conduct a six-month tractor mechanic/driver course in Melikler-Davechi. The Community Committee of the settlement formed a group of 12 adolescent boys and identified a community instructor with tractor for the envisioned training. As per agreement with the vocational school the practical classes will be conducted in the settlement and theory classes will be conducted at the school. UMCOR will cover the expenses of the training course. At the end of the training course, the vocational school will award diplomas and issue driving license to all children who will pass final examination.

Textbooks Fund:Textbooks for Secondary Education -UMCOR initiated the distribution of textbooks for the adolescent children, and also to invalid/disabled children who do not attend school but can read and write. Community Groups in various settlements carried out the distribution. UMCOR facilitated the distribution process, and will conduct monitoring next month to ensure the proper use of resources. Textbooks for Primary Education - The printing of the primary education textbooks is underway. The textbooks will be transported to the regions in the beginning of October.

D. Capacity building

Meskhetian Turk Community: Many members of various farmers groups welcomed UMCORs idea of conducting training sessions on agriculture extension. Thus, eight farmers and agronomists attended a four - days training session organized in Diakonie-Agcabedi. The community groups actively participated in the distribution of educational materials to their children. The initial report revealed that the rate of childrens school attendance increased.



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