Medair Annual Report, 2018

ANNUAL REPORT 2018

For more stories and videos from 2018, click the .

The heart of We believe every person Bangladesh Medair is not is a unique individual created by God. Medair health services, seeks to listen to people’s DR Congo water, or shelter— stories, spend time in their it is people. presence, and treat them

with the compassion and Mghames © Medair/George — David Verboom, Medair CEO dignity they deserve. © Medair/Tamara Berger © Medair/Tamara

Nepal Lebanon

2 | MEDAIR 2017 MESSAGE FROM

DAVID VERBOOM, CEO © Medair / Diana Gorter

David (left) in South Sudan

Being a humanitarian aid worker is one of the most rewarding People and their dignity are at the core of our work. As we carry out jobs in the world. It’s not always easy; the best jobs never are. In our mission, we want people to know we care about them, that their recent years, relief agencies and aid workers have needed to adapt to a lives matter, that they have not been forgotten. rapidly changing humanitarian context. In a remote part of South Sudan, my colleague John said, “Some Close to 132 million people worldwide need assistance today. Natural organisations might fear to go somewhere because of the danger, but disasters have become more frequent and more severe. Prolonged it doesn’t stop Medair from reaching out to people in need. Because of crises in some countries have stretched people’s capacity to cope, and Medair, a lot of people are still alive.” As I listened to John, I thought, taxed the generosity of donors. The sheer scale of needs is staggering, ‘We can go to these difficult-to-reach places because of you, our while the resources available to respond to them are falling short of committed, brave colleagues.’ the demand. Each life matters, and each contribution to saving lives matters. Despite these challenges, I’m pleased to report that, with your Medair is made up of people like John, just as it is made up of people support, Medair was able to reach more people with direct assistance like you: people who pray for us, who give us financial support, who in 2018 than ever before. We adopted several measures to become work with us every day. You are lifting people up in their time of need. more cost-efficient and scaled up our innovation approach through It’s not always easy, but what could be more worthwhile? excellent partnerships. Thank you for joining us on the journey in 2018. When I visited our teams in the Middle East, Asia, and Africa, I was moved by the humanity of the people I met, the stories shared with me by people in crisis, and the commitment of our staff to deliver the highest quality of aid possible.

MEDAIR 2018 | 3 0 500.000 1.000.000 1.500.000 2.000.000 2.500.000 2018 MEDAIR 2017 2,585,964 2016 2015 in 2018 PEOPLE DIRECTLY ASSISTED 2014 2013

HEALTH & NUTRITION WATER, SANITATION, & HYGIENE SHELTER & INFRASTRUCTURE 1,217,838 554,165 105,233 254,051 535,347 262,910 295,113 444,741 14,343 consultations people taught malnourished gained gained people taught received people benefited received at Medair- life-saving patients improved improved life-saving shelter from new or training in supported health and treated access to access to hygiene assistance rehabilitated disaster risk clinics nutrition safe water sanitation practices infrastructure reduction practices SHELTER & INFRASTRUCTURE HEALTH & NUTRITION WASH SHELTER & INFRASTRUCTURE HEALTH & NUTRITION SHELTER & INFRASTRUCTURE SHELTER & INFRASTRUCTURE Free primary health care Safe drinking water Essential household supplies Vaccinations Sanitation facilities Emergency shelters Treatment of common diseases Teaching communities about hygiene Shelter supplies Malnutrition screening/treatment Hygiene items Transitional shelters constructed / rehabilitated Infant and young children feeding support Training people to maintain WASH infrastructure Permanent houses constructed / rehabilitated Disease outbreak detection/response Bridges Training local health workers Health facilities constructed / rehabilitated Community-based teaching/support groups to CASH ASSISTANCE Schools constructed / rehabilitated prevent illness Communal shelters Care for pregnant and breastfeeding women 63,130 received cash or voucher assistance CASH ASSISTANCE Site improvements Mental health/psychosocial support Cash-for-work projects Mapping Support to survivors of sexual assault Training on safe reconstruction Unconditional cash assistance Livelihood support Cash for health services Disaster Risk Reduction (DRR) activities

4 | MEDAIR 2018 13 25 1 DR Congo 647,942 Jordan 50,305 countries past countries international South Sudan 362,298 Afghanistan 346,517 of operation of operation headquarters in ( 2018) Switzerland, 135 staff Somalia 258,492 Bangladesh 132,494 (119 full-time equivalents) 2,585,964 Madagascar 13,946 Philippines 2,230 people Syria 247,389 Nepal 177,551 Iraq 203,188 Indonesia 16,093 6 1,182 196 Lebanon 127,519 affiliate offices nationally internationally in Europe and recruited recruited staff North America staff in the field

SYRIA AFGHANISTAN LEBANON IRAQ JORDAN NEPAL BANGLADESH

PHILIPPINES SOUTH SUDAN SOMALIA

DR CONGO INDONESIA

MADAGASCAR 0 2,000 mi

0 2,000 km N

MEDAIR 2018 | 5

0 If we do not go, who will? Medair How did you is the only organisation working in ever find us?

these faraway places. It is not the first Itin © Medair/Eric — A young student

time I’ve worked in dangerous areas; in the disaster-struck Anne Cadd © Medair/Lu this is Afghanistan and security is village of Camunayan in the dense always a problem. But if I say I will not mountains of go, then who does the responsibility the Philippines. get passed on to? When I see the children I am helping, I know it is the right thing to do.

— Latifa, Medair nurse, southern Afghanistan

Afghanistan Philippines

No matter who they are, no matter where they live. We go the extra mile because each life matters.

South Sudan South Sudan © Medair/Faith Atyang © Medair/Faith © Medair/Annegreet Ottow © Medair/Annegreet

In 2018, Medair responded to 23 emergencies in some of the hardest-to-reach places in South Sudan.

6 | MEDAIR 2018 © Medair 258,492 PEOPLE SOMALIA DIRECTLY ASSISTED

Halima gave birth to a healthy boy Severe drought Conflict Mass displacement Acute malnutrition at a Medair-supported health facility.

“Alhamdulahi! My baby boy and I are in Medair partnered with four local NGOs HEALTH AND NUTRITION good health!” said Halima, hours after giving to provide health care, nutrition, and • 233,450 patient consultations at 12 Medair- birth. She had good reason to be thrilled. Just safe drinking water in four states and eight supported clinics; 62 health staff trained 25 years old, she had already lost three children: districts in 2018. One of those districts was so • 1,154 community health workers trained; “I prefer delivering in the health centres rather remote that no other INGOs worked there. 14,769 consultations by community than at home because home deliveries are Our community-based approach focused on health workers not safe.” putting people first. A network of over 1,100 trained • 34,620 people reached with health and In 2018, Medair supported 12 health facilities in volunteers visited households to promote health, nutrition promotion Somalia that provided 24/7 maternity services. nutrition, and hygiene, and refer people to clinics. • 16,012 people treated for acute malnutrition Halima was one of 9,911 women who safely gave Outreach teams carried out biweekly visits to • 9,911 women gave birth in Medair- birth under our care. remote communities to deliver much-needed aid. supported facilities “I have never seen such a kind midwife in my After a near-famine in 2017, Medair continued WATER, SANITATION, & HYGIENE life,” said Halima. “I will never forget the way she delivering aid at a heightened level in 2018, even supported me.” as better rains improved conditions and access. • 7,533 people gained improved access to As a result, we reached over 100,000 more safe drinking water via 1,395 water filters people with aid than we did in 2017. “There is much to admire about Medair’s SHELTER AND INFRASTRUCTURE © Medair work in Somalia,” said Matthew Maury, CEO • 13,063 people benefited from construction of TEAR Australia. “The work is saving lives and support for 2 new health facilities helping build healthier communities in one of the more complex settings in the world. It is incredible how much they are able to accomplish amidst the many challenges.” Mothers taught mothers about health, nutrition, and hygiene.

MEDAIR 2018 | 7 362,298 PEOPLE SOUTH SUDAN DIRECTLY ASSISTED

© Medair/Annegreet Ottow © Medair/Annegreet million Chronic 7 Our ERT delivered essential supplies and improved access underdevelopment Acute malnutrition Conflict need humanitarian aid to safe water for displaced people in Ulang.

Linda walked for three hours in the people were treated and cured of malnutrition. HEALTH AND NUTRITION scorching sun to reach the Medair Medair midwives also provided safe deliveries for • 116,317 patient consultations at Medair- emergency nutrition site, carrying her more than 1,000 women. supported clinics listless 22-month-old daughter Bakita in her Our emergency response team (ERT) provided • 104,405 people vaccinated arms. Over six million people in South Sudan aid during 23 different crises: mass displacements, are suffering due to food insecurity, sometimes • 59,892 people reached with health/nutrition disease outbreaks, and emergency levels of promotion; 870 community promoters trained resorting to eating water lilies or leaves. malnutrition. “We go to very remote places, • 42,318 people treated for acute To reach more children like Bakita, Medair added beyond where all the emergency relief is malnutrition; 144,436 children screened 12 new sites where more than 42,000 vulnerable clustered,” said Kim Heidekamp, Health Project Manager. “We just try to go further.” WATER, SANITATION, & HYGIENE

• 44,227 people gained improved access to In remote areas, an inspirational workforce safe water of Medair-trained volunteers promoted • 66,408 people gained improved access good practices for health, hygiene, and nutrition, to sanitation provided basic medical treatment, screened • 75,821 people reached with hygiene © Medair/Jemma Bristow © Medair/Jemma for malnutrition, and offered grass-roots level promotion; 1,110 hygiene promoters trained; psychosocial support. 36,585 people received hygiene kits

“We are just housewives and mothers here. SHELTER AND INFRASTRUCTURE We’ve never been to school because of the war,” said a Care Group volunteer. “When Medair gave • 38,868 people received essential me training, I realised that I had a real value to my household items household. I never knew before that I could make Volunteers diagnosed and managed common illnesses such a difference.” and acute malnutrition. 8 | MEDAIR 2018 647,942 PEOPLE DR CONGO DIRECTLY ASSISTED © Medair/Kate Holt © Medair/Kate

Marie and her children fled from home to escape the conflict Complex conflict Ebola crisis Mass displacement Disease outbreaks that had killed her husband.

Marie’s daughter fell seriously ill, but she In 2018, Medair provided nearly HEALTH AND NUTRITION hesitated to bring her to a health centre, 648,000 people with emergency • 485,209 patient consultations at Medair- fearing exposure to Ebola. Sadly, the Ebola health, nutrition, and WASH services in Ituri, supported clinics; 34,787 people vaccinated outbreak was just one of many threats people Nord Kivu, Sud Kivu, and Kasaï provinces. • 178,248 people reached with health or faced this past year. Thankfully, Marie did bring To reach displaced people, our teams overcame nutrition promotion her daughter to a Medair-supported clinic, and insecurity and arduous journeys to reach remote • 15,111 people treated for acute malnutrition she safely received free treatment. villages. “Medair is the first NGO to support us. • 320 people received psychosocial support Our teams responded with courage to the second When we had the influx of displaced people last year, we didn’t know how we would manage,” said • 33,926 people reached with Ebola largest Ebola outbreak in history, supporting prevention messaging infection prevention and control and reaching nearly Catherine, Iga Barrière Health Centre. “But the Division Provinciale told us not to worry, because • 1,924 local health workers trained; 34,000 people with Ebola prevention messages. 1,300 trained for Ebola response Trusted by communities, we were among the first Medair was coming!” NGOs to equip and train traditional practitioners. Our main project provided long-term support to WATER, SANITATION, & HYGIENE vulnerable health centres while also responding • 118,630 people gained improved access flexibly to new emergencies. That flexibility was to safe water crucial in 2018, as the number of people in need • 404,238 people gained improved access rose sharply. to sanitation Béatrice, “It’s amazing to see the expansion of areas • 51,617 people reached with hygiene promotion Medair Health © Medair/Pete Harrison © Medair/Pete Supervisor, where we work, and the development of staff SHELTER AND INFRASTRUCTURE trained hospital members,” said Esther Mourick, Base Manager. staff to work with “We find ways to be present despite the security • 11 health facilities rehabilitated, benefiting Ebola patients. situation and to show that someone cares.” 140,816 people • 8 bridges constructed, benefiting 62,123 people • 400 people received cash for work

MEDAIR 2018 | 9 13,946 PEOPLE MADAGASCAR DIRECTLY ASSISTED © Medair/Sandra Raherison © Medair/Sandra

Severe poverty Severe weather Remote communities Women and children gathering water during the drought.

Severe drought has devastated build community resilience. We trained nearly WATER, SANITATION, & HYGIENE southern Madagascar, leaving the 600 volunteers and 200 community leaders • 45 water points rehabilitated after region in a state of emergency. After 12 years of to encourage behaviour-changing health and cyclone Enawo, benefiting 8,100 people life-saving work in the northeast, Medair opened a hygiene practices. “We are thankful for the health • 597 village volunteers and 211 local leaders field base in Beloha town, one of the south’s most education as well as for giving us access to clean trained on good hygiene practices vulnerable and remote areas. Reaching Beloha water,” said Nirina, a woman in Marolinta town. • 4,752 people reached with hygiene requires an eight-hour car ride from Fort Dauphin To prepare for severe weather events, we promotion messaging via 5 street over badly damaged roads with deep potholes. assembled a national emergency response theatre performances “Dedicating yourself to saving lives means being team in partnership with the government and • 33 people trained in first-aid interventions ready to go where no one wants to go,” said Klaas local community. The emergency responders for emergency responses Overlade, Country Director. received training in first aid and the use of • 286 people received training on In September, Medair launched the Rano drones in post-disaster evaluations, and they are project accountability Velo project in Beloha to improve access to now ready to take action when needed. safe drinking water for 10,000 people and

Street theatre is a great way to teach people about health and hygiene practices. Our entertaining performances attracted large crowds, with some children climbing trees to Rakotomavo © Medair/Chrystelle Rakotomavo © Medair/Chrystelle watch the public health presentations. Drilling of a water point underway in Marolinta.

10 | MEDAIR 2018 Thanks to It feels Medair’s cash like they are support, we were able celebrating my

baby with me. O’Connor © Medair/Sue to pay the hospital Abdallah © Medair/Deema bill and give the It is a very nice money back to our surprise. neighbour. Without — Hannah (left) that support, we received a free would have been in baby kit with trouble now. her postnatal check-up in Iraq — Azeez, father of premature twins, Jordan Jordan Iraq

In 2018, Medair’s Middle East Regional Programme effectively oversaw humanitarian relief activities for over 625,000 people whose lives had been touched by conflict and displacement in Jordan, Iraq, Lebanon, and Syria.

When I see Medair © Medair families trying to is the only find safety, I feel organisation motivated to help that has reached © Medair/George Mghames © Medair/George them, because this area and refugees are provided just like me life-saving and you. assistance to us. — Ali, Medair relief worker, Lebanon — Displaced person from Afrin, Syria Lebanon Syria

MEDAIR 2018 | 11 50,305 PEOPLE JORDAN DIRECTLY ASSISTED

Less than a week into his life, Khaled was and support pregnant women with deliveries. HEALTH AND NUTRITION dangerously ill. He had an intestinal obstruction Our community teams also visited families to • 49,508 people reached with health and needed surgery right away, a surgery his deliver vital health messages about exclusive and nutrition promotion by community parents could not afford. “I sat in front of the breastfeeding, nutrition, and vaccinations. health workers (CHWs) hospital and cried,” said his mother Nasra. “It was Nasra and her husband borrowed money for the • 85 CHWs trained in delivering health the worst day of my life.” surgery to save Khaled’s life, but they couldn’t pay messages and case finding; 6 CHWs trained In 2018, Medair provided 4,400 people like Nasra the debt until Medair came to their door. “This was in supporting psychosocial sessions with cash to pay for urgent health procedures the first time we’ve been helped. Thank you!” • 272 people received psychosocial support • 4,400 people received cash assistance to pay for health services It’s important In 2018, we began providing cash for • 633 people benefited from cash assistance to spend time with 300 vulnerable families to pay for for basic needs the people we serve. urgent expenses like rent and food. We • 114 people were referred to different adopted a new “case management” approach social services; 82 people attended legal

© Medair/Lucy Bamforth © Medair/Lucy Some of them are to help families access different services and awareness sessions here alone, they improve their overall well-being. don’t have anybody, Our psychosocial sessions gathered people to and they have share their experiences, address their traumas, suffered through and learn strategies to cope with life as refugees. “I don’t know what I would horrible situations. Lifting the burden of a hospital “I had no idea there were programmes to help have done if traumatised people like me,” said Haleema. “I was Medair hadn’t

debt is a huge benefit. Taking the time to listen to Abdallah © Medair/Deema able to open my heart in front of a lot of women, helped us.” people can be even more important. and I felt safe. Medair has given me a chance to — Mohammad — Elsa (left), Medair Health Project Manager be a different woman.”

12 | MEDAIR 2018 247,389 PEOPLE SYRIA DIRECTLY ASSISTED © Medair/Zain Albadeen © Medair/Zain 7 13 Devastated Million need Medair and Syrian Arab Red Crescent staff registered Years of crisis Mass displacement families receiving shelter kits in Aleppo. infrastructure assistance

The Syrian crisis experienced dramatic Medair is registered in Syria and provided HEALTH AND NUTRITION shifts in 2018, with the government health, nutrition, WASH, and shelter for over • 160,879 patient consultations at 12 Medair- regaining control over much of the country. 247,000 people in Rural Damascus, Homs, Aleppo, supported clinics; 4,683 children vaccinated; Through turbulent times, Medair used creative and Dar’a. Some of our work involved repairing 1,229 people received psychosocial support solutions to reach and respond to people in need. services that had suffered extensive damage • 8,022 people reached with health/ In October, we were one of the few INGOs such as health care facilities, water networks, and nutrition promotion granted access to Dar’a, where emergency shelters. We also provided help to seniors and needs were high with winter approaching. We people with disabilities by making health clinics, WATER, SANITATION, & HYGIENE responded in a remote area where others had services, and homes more accessible. avoided travelling because extreme caution was • 46,861 people gained improved access to “What is great about Medair, which I admire, safe water needed to reach it safely. Our team went from is that they look at the beneficiaries as human • 12,000 people gained improved sanitation house to house to assess needs, then distributed beings, not numbers as others do,” said Bassel, blankets, stoves, and related items that helped Medair Finance Manager. 7,883 people stay warm and survive the winter. SHELTER AND INFRASTRUCTURE • 32,467 people received essential household items • 526 people benefited from rehabilitation Ali, 4, is examined by a doctor in a Medair- © Medair of damaged homes supported clinic in Rural Damascus. • 7 primary health care centres and 1 physiotherapy centre repaired and equipped Medair supported 12 clinics in 2018, providing consultations to over 160,000 people, repairing and upgrading damaged clinics, and training and supporting clinic staff.

MEDAIR 2018 | 13 127,519 PEOPLE LEBANON DIRECTLY ASSISTED

In 2018, Medair continued bringing In December 2018, a fire devastated an HEALTH AND NUTRITION aid to Syrian refugees in the Bekaa informal settlement. Our emergency response • 63,789 patient consultations at Medair- Valley and expanded activities into Mount team helped families rebuild the settlement in one supported clinics; 13,949 children vaccinated Lebanon and Saida. We helped refugees and week, including shelters, latrines, water tanks, and • 13,916 people reached with health and vulnerable Lebanese cope with the ongoing crisis fire extinguishers. “We lost everything, but not our nutrition promotion with dignity, providing health services, shelter, hope,” said Karima. “Your presence motivated us to • 6,961 women received antenatal/postnatal sanitation, access to safe water, and mapping move on. Despite the pouring rain, you were here care via home visits from Medair midwives of informal settlements. every day beside us to help us recover.” Medair was the lead agency for shelter WATER, SANITATION, & HYGIENE assistance in the Bekaa Valley, providing shelter • 4,346 people gained improved access Majed has kits and assistance to over 90,000 people. Our to safe water visited this team mapped over 8,000 refugee settlements • 5,083 people gained improved access in Lebanon, and shared our data with the UN centre five times, to sanitation and has already and aid agencies to ensure that no one would © Medair/George Mghames © Medair/George be forgotten. changed in ways SHELTER AND INFRASTRUCTURE no one could Medair supported seven health clinics that offered families affordable medical care, free vaccinations, • 93,446 people received shelter support; 6,092 people trained in fire safety imagine. He was like a shy flower and now he health promotion, psychosocial support, and has bloomed. Thank you for making this centre reproductive health care for women. “If it weren’t • 5,087 people benefited from cash assistance easily accessible for my son! — Majed’s father for the support I am getting from the clinic and the doctors here, I wouldn’t know what to do,” said • 8,089 informal settlements mapped, home to 294,192 Syrian refugees In 2018, Medair improved accessibility and mobility Fatima, mother of 10. for over 1,200 people with disabilities like Majed, using custom solutions like ramps, grab bars, and widened doors.

14 | MEDAIR 2018 203,188 PEOPLE Mobile DIRECTLY ASSISTED medical teams IRAQ travelled each day to O’Connor © Medair/Sue deliver free health care. Destruction Conflict recovery Mass displacement Loss of savings of villages

Iraqi families began returning home Medair adapted rapidly to a changing HEALTH AND NUTRITION in 2018, but they found extensive environment in Iraq. We worked in Hawiga, • 94,780 patients treated at Medair- damage and the loss of essential services. In Sinjar, Telkaif, Telefar, and Mosul and provided supported clinics Riyadh, Medair rehabilitated a once-robust health health and WASH services, psychosocial • 36,014 people reached with health/nutrition clinic, including its water and sanitation facilities. support, household items, cash assistance, messages; 138 community promoters trained We worked to strengthen Iraq’s health care and emergency shelter. “We were in need of • 67 children treated for acute malnutrition system, repairing damaged clinics and providing everything,” said Khalil. “You listened to our high-quality training for local health workers. concerns and you came to help. There was no • 726 people reached with psychosocial support “Since I have been working with Medair, my skill one else here to help.” WATER, SANITATION, & HYGIENE as a doctor has improved,” said Dr Ali. We restored vital services like safe water and school latrines, and we gave cash assistance to • 10,759 people gained access to safe water over 4,600 vulnerable people. “My house was • 39,743 people gained improved access burned but we must live in it anyway,” said Yusra, a to sanitation widowed mother of nine. “I will spend some of the • 42,969 people reached with money on fixing our house. I want my children to hygiene promotion © Medair/Sue O’Connor © Medair/Sue be safe most of all.” SHELTER AND INFRASTRUCTURE To help people deal with the mental trauma of conflict and displacement, we provided over • 94,910 received essential household items 700 people with psychosocial support. “This is so • 10,666 people received emergency Medair provided nearly 95,000 people good for us to get together and talk about what shelter kits with essential household supplies. “We lost is in our hearts,” said Raqqan. “We talk about our • 11,954 people benefited from rehabilitation everything and very much need the things you are losses and share our feelings together. It helps us of 4 health clinics giving us,” said Jassim. “We stay hopeful that things come together as a community.” • 4,621 people benefited from cash assistance will get better and we can rebuild our lives.”

MEDAIR 2018 | 15 16 Traditional scale in South Sudan. South in scale Traditional | The Airbusengineers rose to thechallenge and them for malnutritioninremote locations. field weigh young children, making itharder to treat projects. to Itiscurrently precisely very difficult precise infant-weighing scalefor nutrition created AirbusHumanity Lab to develop a In 2018, Medairpartnered withthenewly saving aidtothepeoplewhoneeditmost. and vulnerable wherecreative communities, theonlyway solutionsareoften tobring life- Medair isuniquelypositionedtodrive innovations forward becausewe targetthemost remote INNOVATIONS IN AID MEDAIR 2018 Scaling UpInnovation

© Medair/Faith Atyang Designing a more accurate prototype. accurate amore Designing measure.” Engineer. “Inreal life, without itisanimpact Enrique Maldonado, AirbusHumanity Lab a measurement of one ortwo grams,” said 2019. “From thetechnical side, itcouldbejust weighing scale which we are field-testing in aprototypedesigned for animproved infant-

© Airbus, Humanity Lab meets with refugees in Lebanon. Lebanon. in refugees with meets (IM) Management Manager, Information Reine, way of working intheaid sector. 2018 to anditcontinues inspire anew Corporate Engagement Awards in Most Innovative Collaboration atthe The Qlik-Medair project won the timethanthat.”less takes even oneweek, andsometimes used to take around three weeks now said Reine Hannah,IMManager. “What needs of refugees muchmore quickly,” now, we have managed to the meet we have thedataandanalytics “With in Lebanon. withSyrianwider impact refugees to scale resources andmake amuch Their softwareanalytics. enabledus intelligenceleader inbusiness and partnering withQlik,anindustry In 2018, MedairLebanon continued Innovative Collaboration

Earthquake Tsunami Loss of homes Over 16,000 people received emergency assistance.

On 28 September 2018, a 7.5-magnitude “Almost every family has been affected and WATER, SANITATION, & HYGIENE earthquake triggered a deadly tsunami most of the houses are uninhabitable now,” • 14,242 people received hygiene items that struck Sulawesi island at a speed of 800 kph said Irman, Soulowe village. “Even if some houses with six-metre waves. Over 4,300 people were seem to be standing, they are cracked inside and killed and more than 100,000 homes were people don’t feel safe living there anymore.” SHELTER AND INFRASTRUCTURE severely damaged or destroyed. Medair deployed a team of experienced staff and • 1,851 people received emergency was one of the first international organisations to shelter kits (tarpaulin, tools, rope, wire, pegs) and essential household items reach the affected area. We partnered with World (blanket, mosquito net, sleeping mat, Renew and local NGOs to initiate a rapid emergency cooking set) response that reached over 16,000 people with aid. Families in remote, underserved communities © Medair/Paola Barioli © Medair/Paola received emergency shelter, hygiene kits, and household supplies to help them survive and get back on their feet.

“What we appreciate the most is Medair’s Barioli © Medair/Paola approach,” said Fondi, 36. “You don’t just come and drop emergency items. You ask what we It all happened so fast. I saw the water coming need and make sure we know how to use it. You towards us, washing people away and dragging follow up days after the distribution, and you them into the sea. In a second, everyone was gone, always listen to us and to our concerns. I think just gone. We lost our houses, we lost everything we this is the most important form of help you give had. Will we ever be able to rebuild our lives? us: you make us feel like we are active actors in our own reconstruction.” — Kiki, 20, Silae district Our team assessed the extensive damage.

MEDAIR 2018 | 17 132,494 PEOPLE “When we BANGLADESH DIRECTLY ASSISTED arrived in Cox’s Bazar, we had nothing,” Berger © Medair/Tamara said Amina, 18. 700,000 Rohingya refugees Mass displacement in Kutupalong Camp Severe weather Living in limbo

Amina lives in Kutupalong, the world’s Our team travelled for hours each day through HEALTH AND NUTRITION largest refugee camp, home to over muddy conditions, by car and on foot, to reach • 20,283 patient consultations at Medair- 700,000 Rohingya who fled Myanmar. In the health posts. “The people have been through supported clinics; 34,094 people reached 2018, Medair and World Concern expanded relief a lot and there are so many stories that they tell us,” with health and nutrition promotion assistance for displaced Rohingya families. said Jesmin, a midwife. “I am happy they can share • 2,777 children and pregnant/breastfeeding Fears were high that the monsoon season would their often difficult experiences with us.” women treated for acute malnutrition devastate the camp. Medair supported In June, we opened our first of three nutrition • 229 infants under 6 months screened 5,000 households with upgraded shelter kits and sites, providing food, malnutrition screening, for malnutrition (C-MAMI) tie-downs to help strengthen their shelters before and treatment. We recruited Rohingya people • 20,735 received blanket supplementary food the monsoons. We also improved schools, clinics, to provide outreach services, registration, and • 134 people reached with psychosocial support nutrition sites, pathways, and drainage. Lives were counselling, which built local relationships and spared thanks to many NGOs uniting to improve provided people with much-needed income. SHELTER AND INFRASTRUCTURE the camp, and a mild monsoon season. “I love this job,” said Amina. “I’ve seen mothers • 22,373 people received shelter assistance Medair opened three health posts in a remote part and children getting stronger and this makes me • 11,228 people received cash for work of the camp, providing free health care, maternal happy and makes me feel useful. I am proud to and newborn care, and psychosocial support. help my family and bring in some money.” • 82,134 people benefited from construction/repairs to infrastructure • 5,016 people trained in disaster-risk- “This is addressing a huge gap for families,” reduction (DRR) construction methods said Astrid, Nutrition Manager C-MAMI. In 2018, we launched innovative nutrition programming for vulnerable mother-infant pairs. Mothers and infants © Medair/Tamara Berger © Medair/Tamara received weekly support via breastfeeding counselling and health check-ups.

18 | MEDAIR 2018 346,517 PEOPLE AFGHANISTAN DIRECTLY ASSISTED © Medair/Joern Escher © Medair/Joern

We distributed fruit trees and seeds to families Severe drought Decades of conflict Acute malnutrition Remote communities in the remote Central Highlands.

Drought gripped the country in 2018. Nadia and Musa are parents to seven childen HEALTH AND NUTRITION Our dedicated team responded by who don’t have enough to eat. Like most families • 7,066 patient consultations reaching twice as many people as the year in the Central Highlands, they lost their harvest and before. While widespread insecurity remained have been struggling to survive. • 137,937 people reached with health and nutrition promotion a major challenge, our work took us to southern Medair travelled on steep mountain roads to Afghanistan, three provinces in the remote • 209,875 children and pregnant/ reach remote communities and provide families breastfeeding women screened for acute Central Highlands, and Kabul city. with cash to buy food. We also promoted healthy malnutrition; 28,113 treated nutrition and hygiene practices. “We were so happy to receive the help from Medair and we WATER, SANITATION, & HYGIENE now pray for you daily,” said Nadia. • 13,595 people gained improved access to I see my future In the Central Highlands and southern Afghanistan, safe water much brighter, now Medair treated malnourished children while • 53,766 people reached with that I have learned addressing the underlying causes. We encouraged hygiene promotion so much. We learned thousands of people to adopt life-changing nutrition

© Medair/Wendy van Amerongen van © Medair/Wendy and hygiene practices, and our WASH team built or SHELTER AND INFRASTRUCTURE how to get a good restored sources of safe water for over 13,000 people. • people benefited from harvest from our 35,216 When a Medair mobile nutrition team arrived cash assistance kitchen garden. in Anoosha’s village, her baby Fatima’s life • 2,700 women grew kitchen gardens — Zahra, Central Highlands was in jeopardy. We treated Fatima for severe and received relevant training, malnutrion and helped Anoosha with her benefiting 21,600 people Medair provided 2,700 women with seeds and breastfeeding. “My family is impressed at how training to grow vegetable gardens and improve quickly Fatima has recovered. It is as though a dietary diversity. miracle is happening to my child!”

MEDAIR 2018 | 19 177,551 PEOPLE NEPAL DIRECTLY ASSISTED © Medair/Tamara Berger © Medair/Tamara

2015 earthquakes Loss of homes Severe poverty Remote communities Nepali families rebuilt safer, stronger homes.

Rasmita was only six when the To build back better, we trained hundreds of WATER, SANITATION, & HYGIENE earthquake destroyed her house. “For masons in earthquake-resilient construction • 967 earthquake-resilient latrines methods and supervised their work. “There more than two years, we slept outside under the constructed, benefiting 4,835 people shelter we use for the animals,” said her mother, is a great sense of ownership,” said Carl Adams, • 981 people reached with hygiene Country Director. “Seeing the sense of Lok. They dreamed of building a new place to promotion through trainings, video call home. achievement that homeowners have when presentations, and special event days they finish rebuilding makes it all worth it.” Medair and our local partner CDS helped support SHELTER AND INFRASTRUCTURE people like Lok and Rasmita to rebuild safer, In 2018, 780 homes were completed and over stronger homes in the remote mountain locality of 950 household latrines were built. We trained • 780 permanent earthquake-resilient Bijulikot in Ramechhap district. Using an owner- people in safe sanitation and hygiene, and homes constructed, providing safe shelter driven approach, we encouraged groups of eight the entire community was declared “Open- to 3,900 people to 10 families to work together in clusters and help Defecation Free.” Challenges included scarce • 1,545 people benefited from cash build each other’s homes. building materials, rising market prices, and a assistance to rebuild their homes long monsoon season, but so many families saw • 2,110 people received training on their hopes fulfilled with a safe new home. “I am earthquake-resilient reconstruction and/or happy because my house is ramro,” said Rasmita, earthquake safety which means both beautiful and good/right. • 177,551 people reached with safe shelter “Medair is the Usain Bolt of housing promotion via radio broadcasts

© Medair/Tamara Berger © Medair/Tamara reconstruction in Nepal, and a model for other agencies to follow,” said Parikshit Kadariya, DLPIU Building Chief, Ramechhap. “The houses being constructed are better than in other areas I have visited, in terms of quality.” Lok and her daughter Rasmita love their new home.

20 | MEDAIR 2018 Isolated 2,230 PEOPLE families PHILIPPINES DIRECTLY ASSISTED received emergency © Medair/Lu Anne Cadd © Medair/Lu shelter and rice 117,000 provisions. Super Typhoon Widespread Mangkhut devastation Homes damaged Loss of harvest

On 15 September 2018, a category-5 Using a helicopter, Medair identified some SHELTER AND INFRASTRUCTURE “super typhoon” devastated the east of the hardest-hit and hardest-to-access • 505 families and 27 teachers in coast of Luzon in northern Philippines. Over communities in Luzon. Over the next few 6 communities received emergency 500,000 people were affected; houses, crops, weeks, Medair reached six isolated communities shelter kits, benefiting 2,230 people and fishing boats were destroyed. A Medair accessible only by air, boat, or on foot. We provided • 3 schools/storm shelters rehabilitated in team arrived within 24 hours to begin an over 2,200 people with emergency shelter support Bolos Point, Linawan, and Valley Cove emergency response. and provisions of rice. “Thank you so much for • 1,657 people received disaster-risk- “Nothing really prepares you for that moment coming here,” said Sorina, in Bolos Point. “We have reduction training on how to build back when you meet families who are standing by lost our trees, our rice crops, and the closest market better after a disaster their flattened homes and no longer have a way is five hours by boat.” • 505 families received rice and rice sacks of feeding their children or earning an income,” We repaired and strengthened the roofs of three for harvesting salvageable crops said Medair’s Jonathan Genet. schools that served as storm shelters, and trained people in disaster-resilient building techniques. “My favourite part was learning about the foundations and the braces,” said Manni. “We will use them to make our buildings and our school stronger.” “When we found out that Medair was going to © Medair/Nath Fauveau © Medair/Nath rebuild the school, after having distributed rice Anne Cadd © Medair/Lu and shelter kits to all homes, most of us school teachers cried,” said Elpido, a teacher in Valley Cove. “This was an answer to our prayers. We don’t know what we would have done without Medair’s help.” People shared their stories and needs with us. We delivered urgent aid to remote villages.

MEDAIR 2018 | 21 FUNDING PARTNERS Organisational partners listed alphabetically ≥ USD 20,000

United Nations, US Department of State TEAR Australia Globus Foundation (DE) Intergovernmental, World Food Programme Tearfund (NZ) Humanitas Foundation (CH) and Governmental Partners World Health Organization Tearfund (UK) Lancaster Foundation (UK) German Federal Foreign Office (AA) Transform Aid (AU) Maiores Foundation (LI) Afghanistan Humanitarian Fund Other Institutional Woord en Daad (NL) Medair Invest in Aid Foundation (CH) Australian Department of Foreign Affairs and Public Partners and Trade World Concern (US) Medicor Foundation (LI) Agence de l’eau Rhône Méditerranée World Relief (US) Migros (CH) Democratic Republic of Congo Corse (FR) Humanitarian Fund World Relief Canada Morgan Hill Bible Church (US) Canton of Aargau (CH) Dutch Ministry of Foreign Affairs ZOA (NL) Qlik Canton of Basel-Stadt (CH) EU Civil Protection and Humanitarian Aid Fondation Philanthropique Famille Canton of Zürich (CH) Sandoz (CH) EU Regional Trust Fund in Response Corporate, Foundation, to the Syrian Crisis Elrha’s Research for Health in Souter Charitable Trust (UK) Humanitarian Crisis Programme (UK) and Private Organisational Global Affairs Canada Partners Stanley Thomas Johnson Johns Hopkins University (US) International Organization for Migration Alfred und Anneliese Sutter-Stöttner Foundation (CH) Republic and State of Geneva (CH) Iraq Humanitarian Fund Foundation (CH) Teamco Foundation (CH) Swiss Solidarity Jordan Humanitarian Fund Aligro (CH) Wellcome Trust (UK) Ville de Carouge (CH) Lebanon Humanitarian Fund Basel gegen Hunger campaign (CH) Ville de Lausanne (CH) Principality of Liechtenstein Campus for Christ (CH) Gift-in-Kind Partners Ville de Meyrin (CH) Slovak Agency for International Caritatis Foundation (LI) ADRA (US) Development Cooperation CGK Christian Reformed Churches (NL) Bain and Company (CH) South Sudan Humanitarian Fund Non-Governmental Evangelische Landeskirche in Lebanon Ministry of Public Health and Network Partners Swiss Agency for Development Württemberg (DE) Mondial de l’Auto - Paris (FR) All We Can (UK) and Cooperation Ferster Foundation (CH) Qlik EO Metterdaad (NL) Syria Humanitarian Fund Fondation de bienfaisance du groupe South Sudan Ministry of Health Fonds StopPauvreté d’Interaction (CH) Pictet (CH) UK Government UN Children’s Fund Integra (SK) Fondation Demaurex Frères (CH) UN Children’s Fund UN High Commissioner for Refugees Läkarmissionen (SE) Fondation du Protestantisme (FR) UN Development Programme World Food Programme Mennonite Central Committee (CA) Fondation Ernest Matthey (CH) UN High Commissioner for Refugees World Health Organization UN Office for the Coordination of Mercy Corps (US) Fondation Pierre Demaurex (CH) Humanitarian Affairs Mission Aviation Fellowship (SE) Fresh Leaf Charitable Foundation (UK) US Agency for International Development Red een Kind (NL) Gebauer Foundation (CH)

22 | MEDAIR 2018 Medair is on the front lines in tough places delivering life- © Medair/Sarah Davis © Medair/Sarah

saving assistance with Manson © Medair/Helen empathy, commitment to principles, and high levels of professionalism. Highly admired by all humanitarians.

— Kate Farnsworth, South Sudan Office, US Agency for International Development South Sudan

We decided to work with you because you are really focused on the

deliver quality. We see Bangladesh it when we go with you to the field. You know I have huge regard and respect for the way people... you know the Medair does its work, serving people impartially local people, and you and based only on assisting those most in need.

know your local staff. — Andrew Robinson, Bangladesh Programme, Tearfund New Zealand — Rudolf Gsell, Swiss Agency for Development and Cooperation, on a field visit to Visit www.medair.org/2018_info to download a list of Medair Jordan Jordan Medair’s accreditations and affiliations in 2018.

MEDAIR 2018 | 23 FINANCIAL REVIEW

PROGRAMME INCOME AND EXPENSE 2018 (USD)

32,000,000 30,000,000 28,000,000 26,000,000 24,000,000 22,000,000 20,000,000 18,000,000 16,000,000 14,000,000 12,000,000 10,000,000 8,000,000 6,000,000 4,000,000 2,000,000 0 Afghanistan Bangladesh DR Congo Indonesia Madagascar Middle East Myanmar Nepal Philippines Somalia South Sudan Closed country programmes INCOME 7,220,131 2,522,828 12,843,195 761,780 935,975 32,264,762 91,858 1,304,890 247,801 4,602,072 16,503,465 4,551 EXPENSE 7,234,987 2,486,477 12,795,669 305,245 958,429 32,656,891 91,866 1,313,684 107,914 4,686,601 16,912,256 10,135

OPERATING EXPENSE 2018 OPERATING INCOME 2018 BENEFICIARY EXPENSE BY SECTOR 2018

2 % CASH ASSISTANCE 1 % 12.3 % 14.8 % 5.4 % OTHER 86 % CORPORATE, OTHER GIFTS- HUMANITARIAN EXPENSE FOUNDATION, INSTITUTIONS IN-KIND (DIRECT) AND OTHER AND NGOS 14 % 1 % FOOD AND PRIVATE WATER, SANITATION, LIVELIHOODS DONATIONS AND HYGIENE 0.3 % OTHER INCOME

43 % 23 % HEALTH SHELTER AND INFRASTRUCTURE 3 % 5% 16 % FUNDRAISING HUMANITARIAN 67.1 % GOVERNMENTS, EU, UN NUTRITION 6% EXPENSE (INDIRECT) GENERAL MANAGEMENT

MEDAIR 2018 | 25 CONSOLIDATED All figures shown are in USD 31.12.2018 31.12.2017 ASSETS STATEMENT CURRENT ASSETS Cash and bank accounts 13,829,813 9,902,751 OF FINANCIAL Donor receivables 10,350,344 7,725,684 Other receivables 514,364 880,408 POSITION AS AT Inventory 66,814 70,240 Prepayments 1,061,711 1,234,283 31 DECEMBER 25,823,046 19,813,366 LONG-TERM ASSETS 2018 Financial assets 170,595 141,927 Capital assets 908,813 1,068,038 1,079,408 1,209,965 TOTAL ASSETS 26,902,454 21,023,331

LIABILITIES, FUNDS, AND CAPITAL

CURRENT LIABILITIES Accounts payable 1,396,245 1,239,624 Donor payables 116,776 569,710 Short-term debt 1,994,695 − Accrued liabilities 2,044,793 1,172,913 Deferred revenue 10,074,256 9,155,674 Provisions 931,000 216,750 End-of-contract benefits 188,090 499,615 16,745,855 12,854,286

LONG-TERM LIABILITIES End-of-contract benefits 438,877 1,165,768 438,877 1,165,768 TOTAL LIABILITIES 17,184,732 14,020,054

RESTRICTED FUNDS Restricted income funds 662,183 578,764 Restricted programme funds 384,927 557,744 1,047,110 1,136,508

CAPITAL/UNRESTRICTED FUNDS Unrestricted capital − − Allocated capital 8,670,612 5,866,769 8,670,612 5,866,769 TOTAL FUNDS AND CAPITAL 9,717,722 7,003,277

TOTAL LIABILITIES, FUNDS, AND CAPITAL 26,902,454 21,023,331

26 | MEDAIR 2018 CONSOLIDATED All figures shown are in USD 2018 2017 INCOME Total Total OPERATING INCOME Grants (restricted) 66,650,558 57,301,831 STATEMENT Private Donations 9,378,829 10,569,041 Unrestricted 4,720,393 5,353,268 Restricted 4,658,436 5,215,773 Gifts-in-kind 4,352,205 4,321,316 Other income 281,713 330,426 2018 80,663,305 72,522,614

OPERATING EXPENSE Humanitarian expense -73,914,162 -65,509,044 Administrative expense -6,899,339 -6,262,131 -80,813,501 -71,771,175

OPERATING RESULT -150,196 751,439

FINANCIAL RESULT Financial income 9 338 Financial expense -46,687 -10,499 Realised gain/(loss) on exchange -65,738 433,730 Unrealised gain/(loss) on exchange 678,971 -419,008 566,554 4,561

RESULT BEFORE EXTRAORDINARY INCOME 416,358 756,000

Extraordinary income 2,298,083

RESULT BEFORE CHANGE IN FUNDS 2,714,441 756,000

FUND ALLOCATIONS Withdrawal from/(allocated to) restricted funds 89,399 -931,558

ANNUAL RESULT BEFORE ALLOCATION TO CAPITAL 2,803,840 -175,558

Allocated to/(withdrawal from) unrestricted funds -2,803,840 175,558

RESULT AFTER ALLOCATION − −

Visit www.medair.org/2018_finances to download the 2018 Audited Consolidated Financial Statements.

MEDAIR 2018 | 27 ARA52018

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