September-October, Issue #9-10 (29) USAID IN SIGHT LINC CRIMEAN INITIATIVE: OFF TO A QUICK START mprovement in the well-being of citizens – the aspiration of Scholkine, as well as Bakhchysaray and Bilohirsk raions – to assist them any economic development activity – is the paramount goal of with the development and implementation of economic development USAID’s new project, the Local Investment and National Com- strategies. The goal of these efforts is to make the cities and raions petitiveness project (LINC). LINC will assist Ukrainian cities and more competitive and appealing for investment, and thereby to ensure regions to shape a strategic vision and move down the path to their sustainable economic development. Icommunity sustainability by enhancing their economic competitive- Based on a trilateral protocol signed in July 2009 between by ness and thus creating more jobs and investment opportunities. USAID, Ukraine’s State Land Cadastre Centre and Crimea’s Land The LINC project kicked off in mid-April, and since then it has Resources Committee, the project began developing a pilot unifi ed established itself in Crimea. The property registry in Crimea’s LINC Initiative consists of two Bilohirsk raion. The registry is a components: improving the busi- "The project will help to build communities single system of ownership rights ness enabling environment; and whose economies possess competitive jobs and registration that will provide a enhancing enterprise competitive- opportunities for years to come. That will mean that complete and accurate database ness. In Crimea the project aims of land plots and buildings, as well to improve economic governance, Crimea’s young people will stay where they were as their owners and users. When pilot the development of a unifi ed raised, cities will thrive, and Crimea will be a place developed and implemented, the property registry, and undertake a registry will strengthen not only competitiveness enterprise devel- with communities as rich as the culture and history the transparency of the Crimean opment program. of the peninsula itself.” property market, but also the According to Howard Ockman, Republic’s business-enabling envi- LINC’s Chief of Party, "the project Howard Ockman, LINC Director ronment, making it more attractive will help to build communities to investors. whose economies possess competitive potential, and will create jobs A streamlined permitting system, in the form of one-stop shops, is and opportunities for years to come. That will mean that Crimea’s also currently in process. LINC is lending a hand to Crimean raions in young people will stay where they were raised, cities will thrive, and rendering their one-stop shops into effective units, where entrepre- Crimea will be a place with communities as rich as the culture and neurs will be able to obtain building permits effi ciently and in a timely history of the peninsula itself.” manner. LINC also plans to help Crimea increase competitiveness Since April, LINC has signed protocols of intention with six of its industries and individual enterprises, and with a focus on the Crimean cities – Bakhchysaray, Bilohirsk, Feodosia, Kerch, Saky and tourism and agriculture sectors. Æ4 UUSAID-TrainedSAID-Trained DDoctoroctor HHelpselps INSIDE CCombatombat TTBB iinn FFeodosiaeodosia THIS ISSUE Irina Alekseenko, a bacteriologist and an exem- plary laboratory specialist, has been working as the head of the TB lab in Feodosia, Crimea, for 10 years. LINC Crimea Initiative: She vividly remembers the time when chest X-ray Off to a Quick Start page 1 was the primary method for diagnosing tuberculosis (TB). Candidly sharing her opinion on the practice, she notes: “This method had questionable effi cacy USAID-Trained Doctor for TB case detection. In addition, resources associ- Helps Combat TB in ated with mass photo-fl uorography were far from Feodosia page 1 cost-effective.” TB is one of the major public health problems in Ukraine today. With an estimated TB case rate Simferopol Maternity Spreads Modern Birth of 106 cases per 100,000 people, Ukraine has the Practices in Crimea eighth highest rate of new TB cases in Europe and page 2 Eurasia. TB mortality in Ukraine is high too, with 10,000 Ukrainians dying of TB each year. Crimea is among the regions with the highest mortality rates, Pushkino Residents with alarming growth in TB-related mortality during Learn to Solve Local recent years, at 24.5 TB deaths per 100,000 people Issues though Public in 2007, up from 14.4 deaths per 100,000 people in Hearing page 2 1997. There has also been high growth in the number Irina Alekseenko examines a smear simple of new cases of TB during the past decade – from for mycobacterium tuberculosis (Photo by V. 38.2 new cases per 100,000 people in 1997, to Fauna NGO Helps Æ4 Save Birds from Avian Matyukhin) 85.2 cases per 100,000 people in 2007. Infl uenza page 3 USAID Insight 2 September-October, Issue #9-10 (29) SIMFEROPOL MATERNITY HELPS SPREAD MODERN BIRTH PRACTICES IN CRIMEA Dr. Oleh Tikholaz, the Head Physician of the Kerch Maternity USAID’s Maternal and Infant Health Project, which has been working on Hospital, had always strongly believed in traditional Soviet birthing reducing maternal and infant morbidity and mortality rates in Ukraine practices and so did not favor Ministry of Health adoption of maternal since 2003. Simferopol Maternity Hospital # 2 was the fi rst Crimean and child care protocols recommended by the World Health Organi- Maternity to participate in project activities. Today, fi ve years later, the zation (WHO). “I was convinced that traditional maternity practices, Simferopol facility successfully provides high quality perinatal care, serv- including Rakhmanov beds, a husband-free environment in a delivery ing as a training site to educate Crimean health professionals in new room and separate nurseries for newborns were the most correct clinical guidelines. Since 2004, 650 health care providers (ob/gyns, neo- practices to implement, and natologists, midwives and I was positive that this is the nurses) have participated in way it should be in every training courses organized Ukrainian maternity. When by the maternity. I was invited to Simferopol After fi ve years of col- Maternity Hospital #2 for a laboration with the USAID USAID-supported training project, the Simferopol Ma- course in evidence-based ternity has achieved measur- perinatal practices, I was able results in reducing un- dumbfounded by what I saw. necessary medical interven- Husbands and relatives were tions during delivery. 89% in delivery rooms while wom- of deliveries at Simferopol en were in labor; infants and Maternity Hospital #2 are mothers were together in the now classified as normal, postpartum department; and compared to 32% in 2004. there were no Rakhmanov In addition, the use of post- beds; instead, women were partum anesthesia dropped choosing positions in which from 9% in 2004 to 0.9% in to deliver!” 2008; the rate of episiotomy During the training declined from 22% in 2004 course, however, Dr. Tikholaz to 1.5% in 2008; and the gradually began to realize that practice of companion de- the ideas that had seemed Happy Together. A woman is warming her baby on her chest after the deliv- liveries increased from 17% outrageous at first were ery with her husband (Photo: Oleksandr Golubov) in 2004 to 61% at the end starting to make sense. He of 2008. The maternity also found especially interesting the story of a trainer from the hospital successfully reduced the rate of mother-to-child HIV transmission who had experienced a 180-degree shift in attitude, changing from a to less than 2% by making elective Caesarean section (C-Section) an “non-believer” to a strong supporter of modern birthing technolo- option for HIV-positive women. (A scheduled C-Section, which takes gies. By the end of the course, Dr. Tikholaz’s attitude had changed place before labor and before the rupture of membranes, reduces completely, too. “Thanks to my colleagues in Simferopol, I understand exposure of the newborn to maternal blood as it moves through the the importance of these new practices. Now I’m certain that upon my birth canal). return from training I will do my best to introduce these technologies Results have been seen, in fact, in all project supported facilities in in my maternity, and I will establish individual delivery rooms and throw Crimea. For example, effective implementation of warm chain technol- away Rakhmanov beds.” ogy, in which a baby is kept warm through either the mother’s body Æ4 Evidence-based perinatal care training is an important component of heat or warm clothing covering the infant, helped to reduce Pushkino Residents Learn to Solve Local Issues though Public Hearing rimea often suffers from For approximately 2,000 Pushkino council. When councils are not responsive droughts, but in the case of the residents, the river is the source for life and to the needs of local citizens, public hearings Vostochnyi Bulganak River, the well-being. “Can you imagine life in the village are a way that people can force the local drought is man-made. Local without water?” asked Muzafar Karauseinov, government to consider an issue. residents claim that the river the head of the village council, in an inter- After learning how to conduct such hear- Cdidn’t dry up naturally - businessmen from a view with STB, a national television channel. ing, 155 citizens of Pushkino came together nearby raion (district) built canals from the “People here live from cattle-breeding and and forced the local council to place this river to fi ll artifi cial lakes in order to service gardening, neither of which is possible with- item on their agenda. The council has since their private fi sh breeding business.