„Our motivation is to alleviate human suffering.“

(Code of Conduct: The humanitarian imperative comes first)

www.malteser-international.org English edition PREFACE

Dear friends and supporters of Malteser International,

For more than 900 years the Order of Malta has been helping those in need. Now I am pleased to announce the launch of Malteser International, which brings together the existing forces of the Order, further reinforcing our network of 46 Order organisations all over the world and 13 Malteser relief services in Eastern , with the aim of enhancing the synergy of all partners in the worldwide service to people in need. Malteser International is based on the experiences of the Emergency Corps Order of Malta (ECOM), which was founded in 1992 to unite the strengths, resources and activities of the Order’s various agencies for emergency relief more effectively and on the existing global structures of Malteser . Although humanitarian aid often has a special focus on people in emergencies, the boundaries between emergency relief, rehabilitation and development are becoming increasingly blurred. As more and more crises become on-going and chronic, efficient aid no longer means simply being on the spot in the immediate emergency phase with human resources and material, but standing alongside those afflicted until they can take control of their own lives again. ECOM focussed on acute emergencies, whilst other organisations of the Order, such as the German Malteser Foreign Aid Division and the French Hopitaller Service of the Order of Malta, have a long tradition in linking relief, rehabilitation and development. Drawing on the benefits of this solid background, and our cooperation with our partners all over the world, as well as with our international donors, Malteser International will carry on the humanitarian traditions set up over 900 years ago and still needed today. , June 2005

Nicolas de Cock de Rameyen President Malteser International

PREFACE 3 THE ORGANISATION THE PROGRAMME

Malteser International, the Order of Malta’s Malteser International’s mission is to: worldwide relief service, was created in 2005 ● Provide relief to major emergencies in the world, to combine its relief activities with over 50 especially in the health sector years experience in specialised humanitarian ● Implement rehabilitation measures and link aid. It provides humanitarian aid in all parts relief, rehabilitation and development (LRRD) of the world without distinction of , ● Establish and promote primary health care race or political persuasion. services in developing countries ● Reduce the vulnerability and poverty of those Malteser International has the status of a afflicted Non-Governmental Organisation (NGO). ● Care for refugees and returnees To carry out its mission to help the needy, ● Support partner Non-Governmental it brings together the human, material and Organisations (NGOs). financial resources of the Order of Malta´s 46 In addition, Malteser International has a special national associations. Christian values and ongoing programme of supporting the development the humanitarian principles of impartiality of partner organisations and their social services in and independence are the foundation of Eastern Europe. its work. The organisation’s policy is to continue its relief efforts in afflicted areas COMMITMENT TO QUALITY Child health is Malteser International is committed to quality in the basis for for as long as they are necessary. future growth and humanitarian aid. It adheres to and promotes the stability. Health International Humanitarian Charter, the Code of care in . With its headquarters in Cologne, Germany, and its local and international staff on the Conduct for Non-Governmental Organisations ground, Malteser International covers hu- (NGOs) in Disaster Relief, the Sphere Project and manitarian projects worldwide. the People in Aid Code. Accountability and transparency, both towards do- nors and target groups, are priorities of Malteser International’s agenda.

Local helpers focus on care for the most vulnerable in the Relief and psychological community. Emergency assistance for those who lost aid and medical care almost everything. Tsunami in Angola. projects in ...

Health prevention measures are the first step towards the reduction of infections. Installation of a ... and in Sri Lanka. Medical treatment of water tank. tuberculosis and HIV/AIDS Tsunami project in in . Indonesia.

4 THE ORGANISATION THE PROGRAMME 5 WORKING WITH PARTNERS SPOTLIGHT ON ACTION IN THE FIELD

Providing relief to major emergencies in the world

People in need throughout the world benefit substantially from The majority of Malteser International’s projects arise out of conflicts and natural a community of helpers and supporters who, working together, disasters. Malteser International targets basic and life-saving aid such as provision of food, water, shelter and basic health care services. Once these needs are covered, can achieve efficient, coordinated results. Malteser International Malteser International develops rehabilitation projects to reduce vulnerability and actively encourages these partnerships. poverty, helping the affected community develop its own survival means for the future.

HELP FOR BODY AND SOUL LOCAL PARTNERS To strengthen civil societies, safeguard cultural sensitivity and ensure ‘We work together’ local participation, Malteser International works whenever possible Following the tsunami disaster in South East , through local partners such as local Non-Governmental Organisations Malteser International and its partner organisations (NGOs) and church structures – valued partners in humanitarian continue to work side by side in many affected relief. areas. One of many Malteser International projects is their work with Sahayi, an Indian NGO, and a group of voluntary helpers. Together, they are NON-GOVERNMENTAL ORGANISATIONS ( NG O s ) reconstructing houses in a coastal village north Whenever the coverage of humanitarian activities can be improved of Kollam. Totally devastated by the quake, the by working together with other national and international Non- village is now back to life. A mother and her baby thankfully return to their rebuilt dwelling – but of Governmental Organisations (NGOs), Malteser International seeks the father, after that terrible day no news has ever ways for cooperation and partnership, at a strategic level or on a day- come. to-day basis. ‘We cry together’ Malteser International has set up psychological PUBLIC DONORS counselling for stricken inhabitants of three Through the Order of Malta’s associations and relief agencies, fishing villages near Peryar Nagai, Kanjakumari District, southern India. Hagawaty, a mother of Malteser International has longstanding partnerships. Among them three, is in charge of a group of 14 volunteers. The are the European Commission/ECHO, national governments, the Tsunami victims and crisis has made them one big family. She says: emergency expert in United Nations (UN) and the United Nations High Commissioner for ‘Many people cannot sleep and often cry. So we refugee camp in India. Refugees (UNHCR). cry together. In the evenings we all sing and pray which gives us strength.’

PRIVATE DONORS With Malteser International’s help, damaged fishing boats are now repaired. The fisherman can The support of private donors worldwide is also essential. Without once again take up their livelihood. A programme them, Malteser International’s humanitarian work could not be carried for the reconstruction of 350 houses in the villages forward. is planned. Provision of food and shelter for children who lost their parents. Child care in India.

Through partnerships with local Non- Governmental Organisations (NGOs) Malteser International is funding the relief reaches those who need it most. Rehabilitation of subterrestrial engagement of local partner organisations water channels in Afghanistan. in this and other regions to help the Top: Mother-child-health programmes afflicted rebuild their lives, and giving Many fishermen have lost form a central part of our relief work. their boats and thus their Health centre in Angola. After the tsunami the provision advice on planning, organisation and of drinking water was a high livelihood after the tsunami. priority. Delivery of a water tank implementation of support projects. India. in Sri Lanka. The tsunami claimed well over a quarter of a million lives. Rebuilding homes, hearts and businesses will take a long time and a great deal of continuing help from humanitarian organisations.

6 WORKING WITH PARTNERS SPOTLIGHT ON ACTION IN THE FIELD 7 Linking relief, rehabilitation and Establishing and promoting primary health development (LRRD) care services in developing countries

An example of our approach to linking relief, rehabilitation and Health care is a vital part of Malteser International’s programmes. In addition to the provision development was a programme established in Kosovo during the recent of medical services, we provide training and counselling for community health, to develop the war: carpenters were assisted with a loan to restart their businesses. The capacities of individuals. benefit to their local communities was that they would re-pay in kind, by providing the much-needed carpentry to their destroyed villages. PREVENTING DISEASE IN SUDAN

REBUILDING HOMES AND LIVES ‘All we had is lost’ I N KO S OVO In Darfur, Western Sudan, civil war has been ‘A sign of hope’ raging since February 2003. ‘In spite of the terrible events which have occurred The voice of Samira Adam, 22, falters: ‘They in our country, we have still found hope,’ said came at night, killed our men, raped us, burned Basri Dervisha, 35. everything. All we had is lost.’ Escaping with her At the start of the 1990s, Basri owned a successful two small children, she has been on the road for carpentry shop in a small village close to Ferizaj, four months. a city of 115,000 inhabitants. Then came the war. He lost his wife and eldest son, and was left to ‘Without help they have no chance’ care for Miriam, six, and four year-old Sadik. He The wet season comes. ‘Without our help tens of and his community lost heart and hope. thousands of people will die during this season,’ Through Malteser International’s rehabilitation fears emergency aid expert Birke Herzbruch, project, Basri was provided with carpentry tools who is coordinating Malteser International’s aid and wood to reconstruct his home, and many in Darfur. ‘They will die of infectious diseases or others too. Optimism has returned. ‘The project malaria. Their emaciated bodies have no chance.’ was more than relief. It was a sign of hope,’ says Basri.

Carpentry shop in Kosovo. Malteser International runs rehabilitation Malteser International is in action in the Children in a refugee camp in Darfur, Sudan. programmes in devastated communities, villages of Shingil Tobaya, Abu Zeriga helping to put those affected back on their and Thabit, with health centres caring feet by providing survival packages and for more than 40,000 people. Children, then long-term business development and nursing and pregnant mothers need urgent income-generating projects. help: antibiotics, anti-malaria medication, vaccines and sugar-salt solutions against loss of fluid during diarrhoea. Carpentry is an income- generating project of Malteser International in Kosovo.

In the Balkans, Malteser International concentrates on assisting displaced persons and refugees returning home. Through income-generating measures Polio vaccination in Darfur, for returnees from ethnic minority groups, Malteser International promotes Sudan. sustainable self-sufficiency and personal responsibility, using local structures and the cooperation partners’ capability for self-help. 1.2 million people are fleeing Darfur. There are thousands in emergency camps, most Birke Herzbruch, emergency expert sleeping outdoors on bare ground. The route to the next waterhole is often long and in Darfur, Sudan. dangerous. There is hardly anything to eat. During wet season torrential rain makes the ground sodden, malaria flies breed in the mud holes.

8 SPOTLIGHT ON ACTION IN THE FIELD SPOTLIGHT ON ACTION IN THE FIELD 9 Reducing the vulnerability and poverty of those afflicted Caring for refugees and returnees

The HIV/AIDS epidemic is now a social as well as a medical problem. 95% of HIV/AIDS sufferers Malteser International cares for refugees and internally displaced persons (IDPs). Besides the live in poor, often highly indebted countries. The illness destroys structures in family and society basic health care services in the refugee camps, the most essential parts of the programme are and leaves older people looking after small children and orphans. The middle generation is missing. the training of local health workers and the development of income-generating measures to facilitate future repatriation. ON THE WAY TO A BETTER FUTURE: GENERATION AIDS HEALTH AND NEW LIVELIHOOD

At the end of the day in the small village school in the hills between ‘A new feeling of community’ Thailand and Myanmar, children in colourful school uniforms Afghanistan has suffered over 20 years of run out. Among them are seven year-old twin boys Somchai and occupation and civil war. Surachai, heading for the simple bamboo hut where they live with ‘Our towns and villages have been destroyed their grandparents. Grandmother Sumalee and grandfather Uthai during the fighting. Nothing works any more. The are just over 70 and earn their daily rice as day labourers. The boys water is so dirty it makes us ill,’ says refugee Sadar have lived there since they were three months old. Their mother Habibi. He has only recently been able to bring died from AIDS at the age of 28, their father disappeared without his family home. Sadar is taking part in Malteser trace. International’s self-help ‘village renewal’ project, ‘Who is going to look after them?’ where the villagers are reconstructing their streets, houses and irrigation systems themselves and are ‘The boys need clothes and books, and medicine if they are ill. being paid for their work. If we have enough rice for every day, we’re satisfied.’ Sumalee worries for her small grandchildren. ‘I just hope I live until they In another area, the Badghis province, West are 18 and can look after themselves. Who else is going to look Afghanistan, Malteser International is training after them?’ midwives to look after pregnant mothers before, during and after childbirth. Malteser International ‘Grants and loans for a better future’ reaches 500,000 people through its ten health care The twins are among the lucky ones: they have a small Malteser centres there. International grant, so that their grandmother can buy milk, fruit ‘Malteser International is achieving several targets and vegetables for them. Provisional tent school in at once.’ Programme coordinator Wolfgang Herdt Afghanistan. In addition to the grants, Malteser International introduced a small explains their tasks: ‘We are able to improve not loan programme in autumn 2003. Grandfather Uthai used the loan only the primary health care but also the infra- to buy six pigs and two hens. Others buy seeds and cultivate rice, structure. The families have some income. At the garlic or soy beans to sell at market; or they set up small businesses. same time, a quite new feeling of community is Within 12 months they must repay from the yield. being created in the villages.’

In the Mae Sariang district Malteser International is In Afghanistan, Malteser International supporting 75 orphans aged between three and 18; their has implemented a comprehensive Somchai and Surachai with their grandparents… parents have died of AIDS and they are being brought rehabilitation programme for schools

… and among their up by grandparents or foster parents. Also in Kenya and health care facilities as well as a classmates. and many other countries, Malteser International helps consolidation programme for communities Malteser International is training midwives to look numerous families affected by HIV/AIDS to improve with a high number of returnees. Through after mothers during and after pregnancy. Current estimates: 16 million children worldwide under the their income long term. income generating and occupational age of 15 have lost one or both parents to HIV/AIDS, with training measures Malteser International the largest growth rates of the epidemic in Asia and Eastern Europe. 25% of those infected – 40 million people globally assists numerous returnees in building up a The mother and infant death rate in Afghanistan is the second – live in Asia. 50% are 15 to 24-year-olds. highest in the world. Three out of four children die before their new livelihood for themselves. fifth birthday. 25,000 mothers die every year giving birth or shortly afterwards. Life expectancy is 42 years.

10 SPOTLIGHT ON ACTION IN THE FIELD SPOTLIGHT ON ACTION IN THE FIELD 11 Supporting local partners Malteser International needs your help

To strengthen civil societies, to safeguard cultural sensitivity and to ensure participation, to continue its work Malteser International works whenever possible through local partners.

OPENING A WINDOW IN NAIROBI’S SLUMS

The hut in Kangemi, Nairobi, with walls of them. Then Diana grew ill. Mary sought help corrugated tin and cardboard, had little light or air. from George Ratenu, health volunteer at Kangemi Diana Nafungu, aged six, has lived there in semi Health Centre, where he works for the Malteser darkness with her three-year-old brother Francis, International team. He went with Mary and Diana Mary her 18 year-old aunt and her 12-year-old for tuberculosis and HIV tests; both tests were cousin Janet, in eight square metres. Such living positive. conditions threatened their health. ‘We explain how to avoid TB’ At weekends, Diana’s grandmother, a maid in Today, it is hard to believe Diana has had TB. rich downtown Nairobi, can sometimes bring ‘She has recovered so well,’ beams Mary. Diana food and money. Mary explains: Diana’s father survived thanks to the antibiotics she took for died of AIDS and her mother, a drug addict, left eight months. ‘We tell patients they must not stop treatment after a few weeks,’ says nurse Margaret Meruga at the Health Centre, ‘because they will become resistant to the antibiotics.’ The Malteser International team is made up of nurses, a clinical officer and a doctor. It also includes six local health care workers who live in the slums themselves. They tell their neighbours, families and friends about the Health Centre’s tests and explain how to avoid tuberculosis. ‘Fresh air is important for TB patients,’ George advised Diana’s family. Since The bikes enable the then, windows have been put in Diana’s hut for Community Health Workers to reach patients in remote air and light. areas. Health project in Myanmar. Malteser International has been supporting urban health services in Kenya for three years. Health and sexual education campaigns in cooperation with

Little Diana has suffered local self-help organisations contribute from tuberculosis. to containing the spread of the infectious Malteser International Donation Account 120 120 120 diseases. Malteser International puts Bank für Sozialwirtschaft, Sort Code 370 205 00 special emphasis on continuous training (IBAN: DE 49 3702 0500 0001 0258 01, BIC: BFSWDE31XXX) Malteser laboratory in and retraining for both government- Nairobi, Kenia. Reference: Malteser International employed and community-employed In Kenya three quarters of all TB patients are infected with HIV. health care personnel. In Kangemi, one of the largest slum areas in Nairobi, 78,000 people live in tiny spaces, without sewage, power or water. In the dry season, the paths are full of refuse. In the rainy season they are full of mud which seeps indoors.

12 SPOTLIGHT ON ACTION IN THE FIELD 13 Psychological support for tsunami victims in Thailand.

Publisher: Malteser International, Kalker Hauptstr. 22-24, D- 51103 Cologne Germany, Phone +49 (0)221 9822-151, Fax +49 (0)221 9822-179, [email protected] Responsible for content: Ingo Radtke Editorial team: Petra Ipp (resp.), Dr. Claudia Kaminski, Philippa Leslie, Michael Lülsdorff, Stefanie Mosch, Sid Johann Peruvemba Layout/Design: Alexander von Lengerke Photography: Malteser Archives, Hermann Bredehorst, Kurt Oxenius, Thilo Schmülgen, Sven Torfinn, Stefan Trappe Title image: Darfur/Sudan: vaccination campaign against polio

14 Malteser International Headquarters Kalker Hauptstr. 22-24 D- 51103 Cologne Germany Phone +49 (0)221 9822-151 Fax +49 (0)221 9822-179 [email protected] www.malteser-international.org