Malteser Germany – Relief Worldwide

Our mission Malteser Germany is a German Catholic relief agency of the Order of Malta (www.orderofmalta.org). Founded in 1953 and based in Cologne, it is one of the major relief organisations in Germany and exclusively pursues charitable purposes for the well-being of people. In Germany over 37,000 volunteers and approximately 13,000 full-time employees are committed to social issues such as promotion of health and social services, youth work, first aid Malteser Germany training, disaster control and migration, supported by almost 900,000 donors. On international level, Malteser Germany’s Foreign Aid Division Foreign Aid Division (www.malteser-international.org) has provided humanitarian relief since 1956. Around 35 employees in Cologne and 100 expatriates as well as several hundred local staff care for the projects Annual report 2004 worldwide. We are active in Asia, Africa, the Balkans and in Central and Eastern Europe in the sectors of emergency relief and rehabilitation. Over the last year, with a project turnover of EUR 18.6 million, we have carried out 80 projects and programmes in 34 countries. Malteser Germany was formed with the purpose to practice the Order’s basic principles and Christian charity in contemporary ways. Relief for people in need irrespective of race, creed, or political persuasion lies at the heart of our international work. Our objectives We are especially committed to people whose lives are endangered by disasters and conflicts. The objectives of our programmes are:

● Emergency and disaster relief ● Basic medical care and setting up basic health care services ● Rehabilitation programmes following crises and disasters ● Social programmes and reduction of vulnerability and poverty ● Supporting local partner organisations ● Medical care in the context of peacekeeping missions of the United Nations

Our principles We commit ourselves to the following:

● To assist and help regardless creed, gender, race or nationality ● To respect religious and cultural tradition ● To involve all parties concerned in the planning, implementation and coordination process ● To enhance a participatory approach ● To hand over responsibilities to local partners at the earliest possible stage ● To be accountable towards all our stake-holders ● To manage financial resources cost-effectively In order to realise effectiveness, sustainability, and accountability in humanitarian assistance, we adhere to and promote the

● International Humanitarian Charter ● Code of Conduct for NGOs in Disaster Relief ● Sphere Project ● People in Aid Code

www.malteser-international.org English edition Contents Editorial Editorial 2 New challenges in emergency and rehabilitation aid 3 Dear Readers, Emergency aid and disaster relief Dear Friends and Supporters of the Malteser Foreign Aid Division, Tsunami flood relief in South and South-East Asia 6 At the beginning of 2004 Malteser Germany provided emergency relief for thousands of earthquake victims in the Africa southern Iranian town of Bam. 2004 ended with one of the greatest natural disasters we have ever known. According Our projects in Africa 9 to provisional estimates, the tsunami not only killed over 260,000 people but deprived at least as many of their On the spot - Sudan and Kenya 10 livelihood. In many cases Malteser staff were there on the spot, putting programmes into operation to guarantee the Asia provision of care to the survivors. On behalf of Malteser Germany there were soon more than 500 local aid workers Our projects in Asia 12 in India and Thailand, making it possible for the homeless to get through the first few days after the flood with On the spot - Iran and Thailand 14 medicines, blankets, food, cooking utensils and human care. It was only a short while later that the first Malteser Project overview 2004 16 teams began relief operations in Sri Lanka and Indonesia. Johannes Freiherr Heereman Executive President Europe Another sphere of operation for Malteser Germany’s emergency aid and disaster relief in 2004 was aid to refugees Malteser Germany Our projects in Europe 18 and displaced people in Darfur/Sudan. Malteser personnel have been working since last summer in the north of the On the spot - Albania 19 crisis region, where they are assisting health care centres with medicines, carrying out vaccination campaigns and Central and Eastern Europe/ encouraging the continuing education of midwives. Partnership work abroad 20 In its new-look format, the 2004 Annual Report you have before you also gives details of the large number of On the spot - DR Congo: Water for Ariwara 21 other worldwide projects of Malteser Germany in Africa, Asia and Europe and gives account of the careful, rapid United Nations and efficient use of the funds entrusted to us. Around 35 staff in Cologne manage our projects on which, in 2004, Peacekeeping missions 22 around 100 expatriates and over 800 local employees were working. In 2004, project turnover compared with the On the spot - Afghanistan 23 previous year increased again by approximately EUR 600,000 to EUR 18.6 million. The 230 partnerships of our 130 German Malteser groups operating voluntarily on projects abroad also extend to Africa, Asia and Latin America as Facts and Figures well as Europe; altogether, more than 2,400 German Malteser volunteers are collaborating with 27 countries on four Experts abroad 24 continents. Theodor Wallau Incoming donations and project expenditure 26 Commissioner Project expenditure by countries 28 Our operations in Eastern Europe, the continuously growing commitment in Africa and Asia and in particular the Malteser Foreign Aid Division Profit and loss account 29 relief efforts for the tsunami victims have contributed to the expansion and strengthening of Malteser Germany’s foreign aid work and also brought together more closely the associations and relief services of the Order of Malta on a worldwide level. In future, therefore, with Malteser International we want to utilise the international resources of the worldwide Malteser network even more intensively, form synergies and create a joint international relief service. Working with partners In this way we can consolidate the manpower in humanitarian aid, safeguard the high quality of our project work and strengthen the communication and the exchange of experience among the members. Malteser International is based People in need throughout the world benefit substantially from a on the experiences and structures of Malteser Germany and its Foreign Aid Division and of ECOM (Emergency community of helpers and supporters who, working together, can Corps Order of Malta), which was founded in 1992 as a network of the Order for worldwide emergency and disaster achieve efficient, coordinated results. Malteser Germany actively relief. encourages these partnerships. We thank all our public and private donors and cooperation partners as well as all volunteers and full-time employees Local partners for their loyal support which ultimately makes our work possible. Please continue with us on our journey so that, with To strengthen civil societies, safeguard cultural sensitivity and Malteser International, we can pursue our commission established over 900 years ago which is just as relevant today ensure local participation, Malteser Germany works whenever as it was then, namely to provide relief for people in need throughout the world. possible through local partners such as local Non-Governmental Organisations (NGOs) and church structures - valued partners in Malteser - help that reaches its destination. humanitarian aid. Worldwide. - Thanks to your support!

Non-Governmental organisations (NGOs) Whenever the coverage of humanitarian activities can be improved by working together with other national and international Non- Governmental Organisations (NGOs), Malteser Germany seeks ways for cooperation and partnership, at a strategic level or on a Johannes Freiherr Heereman Theodor Wallau day-to-day basis.

Public donors Cologne, October 2005 Through the Order of Malta’s associations and relief agencies, Malteser Germany has longstanding partnerships. Among them are the European Commission/ECHO, national governments, development banks and the organisations of the United Nations (UN).

2 New challenges in emergency and rehabilitation aid

Current developments and experiences using the examples of the seaquake in South and South-East Asia and chronic crises in East Africa

The events following the seaquake of 26 December 2004 prompt us to examine the topic of health provision in humanitarian emergency and rehabilitation aid. Let it be said in advance that beyond the unprecedented willingness to donate and aid the victims of the natural disaster in Asia, the poverty and suffering of large numbers of people, for example in Africa, should not be allowed to fade into oblivion. Kurt Oxenius Kurt

Disaster phases – emergency aid of drinking water are among the priorities. Sri Lanka: It will take years before normal everyday life returns to the regions affected and rehabilitation In this context it is often forgotten that by the tidal wave and the many fishermen The worldwide aid measures as a result those affected themselves, their neighbours who have lost their boats can go out to sea of the seaquake in December 2004 showed and fellow countrymen do a tremendous again. how important it is to become aware of the amount of relief spontaneously, before phases, methods and contents of the aid. the arrival of the international aid. This During such acute events, in natural disasters also proved to be the case in the countries or flight movements the first objective affected by the seaquake. is to secure survival and to provide those Depending on the type of disaster, the affected as quickly as possible with the bare emergency relief phase lasts from a number essentials. In the first phase of emergency of weeks up to two months. Right from relief, saving and rescuing, emergency the phase of emergency aid, aspects of medical provision, preventive measures to rehabilitation under local responsibility contain epidemics, hygiene and the supply must be incorporated into planning. Despite

LEADING ARTICLE 3 the fact that the situation during emergency relief and the early phase of rehabilitation is marked by infrastructural deficiencies, chaos and planning uncertainty, the relief organisations must act in the interests of the transition to the rehabilitation of local structures, i.e. link emergency relief with rehabilitation and development measures (“linking, relief, rehabilitation and development”, LRRD). This presupposes that, alongside skills and experience in emergency relief, they are also familiar with and apply methods and objectives of rehabilitation geared to development. Particularly important is the willingness to include local structures in the planning and implementation of the measures. It is about putting the local players and partners back in a position to exercise their responsible role in rehabilitation and reconstruction themselves. We must recognise and respect this role. Only in this way can we prevent of motives – relief items and medical Indonesia: Whole sections of towns and unsuited parallel structures from being set emergency teams are sent randomly into villages were wiped out. Large expanses of rubble testify to the unimaginable energy up which may even be in competition with the region. In many places this has made and violence of the tidal wave. the local supply structures. coordination considerably more difficult. No government in the world, not even the Coordination and communication United Nations, would be in a position to Especially in the first few days and prevent this humanitarian “circus” during weeks after major disasters the question such disasters, placed as they are in the Thailand: The supply of water tanks is an important measure of emergency relief. always arises regarding the coordination media spotlight. We must adjust to the fact of relief measures. We should not succumb that this chaos, this lack of coordination to the mistaken belief that at the level of and communication is the norm in such a the United Nations or elsewhere there is situation. As an organisation we must be a supranational institution which would prepared for it and be in a position to move take on this important task. Managing and act in a focussed manner within this this task lies clearly within the sphere of chaotic environment. Coordination, joint responsibility of the affected states that planning and action by all participants is have to be assisted by the international essential. In addition, all those involved organisations. The relief organisations have – relief organisations, media, governments

a duty to help to do the coordination work. and politicians everywhere – must be clear Voigt Jochen Complaints about lack of coordination in about the fact that despite all the joint the early phase are therefore addressed efforts there will always be an overtone of directly at them and are an invitation to competition for media presence, the exertion provide this support. The aim is to provide of influence, recognition, donations and assistance according to need, to prevent public funds. We must learn how to deal with duplications on the one hand and neglect this competitive situation appropriately in on the other. Information not only on the the interests of those affected. It is evident need but also on the offers of help must be that work in the context of humanitarian available to all involved. assistance today constitutes an enormous The reality – particularly current challenge to the aid organisations, not experience in Indonesia –, however, only from a professional but also from an Voigt Jochen also proves that in the early phase of organisational and structural point of view. Thailand: In view of the large extent of the humanitarian relief – from the best destruction, the psychosocial care of the survivors by local staff was and still is a considerable help in coping with what they have experienced.

4 LEADING ARTICLE Standards and guidelines provide sufficient drinking water. Thanks describe and define the disaster situation in humanitarian aid – to the internationally accepted guidelines – and not the reporting in the news which experiences from the flood disaster we speak a common language. At regular then “triggers” publicity and the flow of Despite the perennial question, namely meetings in Banda Aceh/Indonesia, donations (CNN effect). how the relief measures could have been which were organised by the local health better coordinated, current experience authorities and supported by WHO and Forgotten disasters – following the seaquake has shown that UNICEF, requisitions were produced and “silent emergencies” the existing standards and guidelines (e.g. compared with available resources and Accepted standards are also suitable Sphere Project, Humanitarian Charter offers of aid. The decisions are based on for analysing and describing those crises and Minimum Standards in Humanitarian the collection of epidemiological data on and disasters that lack media attention Assistance) are of considerable support the incidence of diseases and causes of and publicity. Most projects of Malteser in reconnaissance, demand analysis and death. This information helps us to decide Germany and other organisations take planning of relief measures. Malteser what assistance has to be given, where, to place in this context of so-called “silent personnel were able to react promptly what extent and how urgently. It is these emergencies”. Examples we should to the current crises and, in accordance well-known indicators that ultimately mention include the Malteser projects supported by the Federal Government of Germany in southern Sudan and in the slums of Nairobi. By the end of 2004 alone Malteser staff in the south of Sudan had tested more than 100,000 people in remote villages for sleeping sickness, which is fatal without treatment, and in the process diagnosed and treated 1,500 cases. In the slums of Nairobi the infection rates for HIV/AIDS and tuberculosis Kenya: Patients and have assumed proportions which, based a Malteser doctor in front of a centre for on disease and treatment figures, can voluntary counselling be labelled “disastrous”. This is why it

and testing. Torfinn Sven is the goal of the project to improve the opportunities for diagnosis and treatment in with these guidelines, initiate emergency eight slum areas. The project successfully relief programmes in terms of health integrates and supports local structures. For care provision, supply of drinking water, Sri Lanka: Clean water is vitally this Malteser Germany has been honoured accommodation and providing people necessary to prevent the spread of diseases. by the Kenyan Ministry of Health. affected with the bare essentials. At an early These examples show that especially in stage, however, also rehabilitation projects politically unstable countries, in forgotten were planned, in close cooperation with crises and in the context of poverty, the local population and the responsible infectious diseases are spreading quickly authorities. The aim is not only to secure – and this is why, there too, humanitarian survival but to make it possible for people action is of the utmost importance. to live in dignity quickly again following Dr. Peter Schmitz the disaster. The current events in Asia, not to mention a variety of experiences elsewhere, make

it clear that the existing references and Oxenius Kurt guidelines, in so far as they are realistically applied, are achieving their ends and proving their worth in practice. With reference to each target group we can estimate how many patients will come into a health care centre each day. We can plan how many assistants, how many staff, how many medicines, what equipment we need, Southern Sudan: Due to more how many latrines have to be built and than 20 years of civil war, sleeping

how many water points have to be set up to Torfinn Sven sickness spreads like an epidemic.

LEADING ARTICLE 5 EMERGENCY AID AND DISASTER RELIEF Tsunami – flood relief in South and South-East Asia

The seaquake and tidal wave on 26 December 2004 ravaged the coastal stretches of many countries bordering on the Indian Ocean. There were more than 200,000 fatalities. Millions of people lost their relatives, their houses and their livelihoods. Indonesia, Sri Lanka, India, Thailand and Myanmar were the most severely affected areas. Malteser Germany immediately made available an emergency relief budget of EUR 250,000 for the crisis region and concentrated the aid first on the regions and countries in which they have been active and had excellent contacts for many years.

India

In South India, Malteser Germany collaborated with four local partner organisations which were immediately in a position to help the people affected. Father Maria Arputham, head of the forces penetrated up to two kilometres into severely affected. There Malteser Germany Christian organisation HOM (Health for the interior, reported Binoy Acharya, who and its partners distributed food, medicines, One Million), reported on the day of the led the Unnati assessment team. “Among clothing and cooking utensils to over 1,000 seaquake from his diocese Marthandam on the fatalities are a large number of children, families. the southern tip of India: “We have pulled women and elderly people. More than Working with CHAI, the Catholic Health bodies from the sand. The destruction here 7,000 houses have been destroyed”, said the Association of India, proved to be a wise is unimaginable.” Together with over 100 expert. Those affected were mostly simple choice. Here, too, contacts have existed voluntary helpers from congregations, youth fishermen who were only able to finance since the earthquake in Gujarat in 2001. groups and women’s networks, Arputham their boats and equipment with loans, and CHAI consists of a network of over 3,000 provided emergency relief on behalf of now they had lost any means of earning Catholic health institutions and therefore Malteser Germany: he distributed food a living. Acharya is certain: the survivors has considerable social influence. It is and clothing, cooking utensils, blankets will definitely need psychosocial support in important to know because shortly after the and mats to people who had fled from their the longer term. seaquake the Indian government refused destroyed fishing villages into the hinterland Surprisingly, part of the west coast of every offer of international aid. Thanks and accommodated them in schools and Kerala in the Kollam District was also to its dense network CHAI was also in a church buildings. The day after the quake Arputham faxed a cry for help to Germany and asked for further assistance: “We need medicines due to the imminent threat of epidemic.” The committed priest also took care of emergency accommodation: the camps were set up near the destroyed villages so that the reconstruction would be easier. Altogether HOM and its helpers looked after approximately 10,000 refugees. All of them in the Kanyakumari District. The Indian partner organisation Unnati (Development Education Organisation from Ahmedabad, Gujarat) with which Malteser Germany had been collaborating successfully since the earthquake in Gujarat in the north of India in 2001, sent an assessment team into the crisis region. It came across catastrophic devastation on the 35 kilometre-long coastal strip between Kurt Oxenius Kurt Thangapatnam and Colachel, Kanyakumari Sri Lanka: The strong cohesion in families and villages District. The tidal wave with its destructive helps to overcome the horror and despair and to jointly build a new future.

6 EMERGENCY AID AND DISASTER RELIEF position to send well-trained staff quickly of Trivandrum and for over ten years has and efficiently into crisis regions. On been Malteser Germany’s project partner, 28 December the Malteser Foreign Aid especially in health education for women. Division received a request for assistance The Director of MSSS, Father Joze from the Director, Father Ousepparampil, Kizhakkedath, recognised the needs of the which was promptly answered positively. people and very soon initiated steps to offer On behalf of Malteser Germany, CHAI set psychosocial support to the population: up on the east coast not only permanent “After the initial shock the children above medical facilities but, with mobile medical all are totally apathetic. Many are only teams - consisting of nurses and doctors - now after the chaos of the first few days also visited remote areas to look after the realising that their parents are never coming injured there. At the same time food and back.” At the same time MSSS provided drinking water were distributed. emergency relief on the coast of Kerala, In Trivandrum, Malteser Germany where the southern sections were severely collaborated with MSSS, the Malankara affected: emergency shelter was set up, Social Service Society. MSSS is the cooking utensils and clothing obtained and Crisis regions in southern India where Caritas organisation of the archbishopric medical care ensured for 1,000 families. Malteser Germany is working.

This “family kit” contains the necessary equipment, materials and food to enable a family India: Emergency expert in a refugee camp to make a new start. in Tamil Nadu.

Very early, Malteser Germany learnt from its Indian partners how much the tidal wave had damaged the fishing industry, the tourism and the agriculture of the affected regions. It also became clear how much the tsunami had affected the people in India psychologically. The lethargy of the surviving fishermen became evident at an early stage.

Thailand

On the day the seaquake occurred, staff from the Malteser projects in the north of Thailand set out for the holiday island of Phuket in the south to begin relief work there. Furthermore, inland, at the request of “The hospitals are completely overflowing the Federal Foreign Office of Germany, and local resources are utterly inadequate”, 34 Malteser personnel took care of the reported the 50 year-old country coordinator psychosocial support of those returning for Myanmar. “Not only is the number of home. Altogether, they looked after more dead being recovered each day huge, so is than 150 people affected and their relatives. the number of injured, too.“ North of Phuket After their mission, the helpers received and Khao Lak a scene of horror was being acknowledgement for their work from revealed: “We came upon around 2,000 the highest quarters and were invited to a families whose village had been completely reception with German President Horst washed away. They still had absolutely no Köhler. aid”, said a female staff member. Voigt Jochen André Stülz together with the Thai André Stülz reported from Khao Lak: Thailand: With games and handicrafts staff help children in the day care centre Malteser staff quickly arrived in the crisis “A robust fisherman told me with tears in in Ban Muang to overcome their terrible area in Thailand to provide assistance: his eyes that out of his family of ten only experiences.

EMERGENCY AID AND DISASTER RELIEF 7 two had survived and four had so far been Westerwald, who has been living in Thailand recovered dead, scattered over 1,000 square for nine years. Rehabilitation projects kilometres. He still had to look for the other and income generating programmes are four and - standing beside a working shovel designed to improve the lives of the people dredger - he reckoned he would have great affected by the tsunami in the long-term. difficulty in recovering the rest of his family At New Year, four surgeons and four alive.” According to Stülz, the search for paramedics from Malteser Germany arrived the missing was the very first desire of the in Thailand to assist the medical team of the survivors. Many people would go into one Federal Foreign Office of Germany. In their of the four Buddhist temples which were luggage they had 400 kgs of medical drugs, used as collection points for the dead. New infusion and dressing materials. They were bodies were continually being transported flown by helicopter mainly to German and laid out there. patients in hospitals. On 30 December, Marie-Theres Benner, While Foreign Secretary Joschka Fischer country coordinator for Thailand, arrived exhorted the Germans to spend their money in Phuket. Her mission: to plan the relief not on New Year’s Eve firecrackers but rather measures and rehabilitation work of in the form of donations for the tsunami Malteser Germany in Thailand on a long- victims, Dr. Constantin von Brandenstein, term basis. She was assisted by local staff and President of Malteser Germany, made Jon Freeman. “The people are very afraid an initial interim assessment of the aid: of epidemics”, said Benner, describing her “The wave of death on 26 December was Areas where Malteser staff are first impressions. To prevent their spread, followed by a wave of global willingness deployed in southern Thailand. clean water, hygiene, personal protection to help. I am pleased that we were able to and vaccinations were necessary. be part of this wave quickly, effectively and Malteser personnel were working for the in varied ways. We will continue to provide people in the region of Khao Lak, Phang assistance. So that the necessary support - Nga and Phuket: “We are distributing physical, psychological and social - reaches medicines, food, blankets, drinking water, the people who have survived the terrible pans and crockery, so that immediate needs tragedy.” are covered”, said the coordinator from

Thailand: Jon Freeman coordinates the emergency aid in a refugee camp in the Khao Lak region.

Thanks to generous donations, Malteser Germany was able to provide around one million euros immediately for emergency relief measures in South and South-East Asia. For rehabilitation, in 2005 alone projects and relief measures with a combined turnover of a further six to seven million euros are sche- duled or are already being implemented. To finance all medium and longer-term rehabili- tation measures in the interests of guarante- eing lasting help for the region, Malteser Ger- many has launched a rehabilitation fund. This includes funds which benefit all activities in the regions affected by the seaquake and will thus facilitate structured rehabilitation in the five most severely affected regions (Indonesia, Sri Lanka, India, Thailand and Myanmar).

8 EMERGENCY AID AND DISASTER RELIEF Africa

Building up and strengthening health care structures, training local personnel and combating epidemics are the main focus of attention for Malteser Germany in seven African countries at the present time. An important concern in all projects is the fight against HIV/AIDS, a disease with dramatic effects on the population.

Angola time. Our work is exemplary in nature, Sudan Following the end of the 27-year as there are only a few projects around In civil war-torn Sudan, Malteser civil war the refugees have returned and the world in which tuberculosis is being Germany is working in the south and reconstruction has begun. In the deep south- successfully stemmed and AIDS combated north of the country. In Rumbek and Yei east, Malteser Germany is assisting not at the same time in slum conditions. The in the south, mainly tuberculosis, leprosy, only in the renewal and equipping of health Kenyan government honoured this work in sleeping sickness and malaria are being care centres but is also setting up a nutrition 2004. combated. Patients are identified in the centre for children and pregnant women. health care centres and through outreach The training of health personnel, education Mozambique teams who travel into remote villages. In about HIV/AIDS, the construction of In the province of Sofala, Malteser addition, in Rumbek, local lab technicians latrines and the distribution of household Germany is using monthly health days and are being trained. In northern Darfur, since items are other major tasks. vaccination programmes to care especially the middle of 2004 Malteser Germany has for mothers and children. Staff are travelling been providing emergency aid, supporting Democratic Republic of Congo into the villages to treat the population and health care centres with medicines and Malteser Germany is helping the educate them about HIV/AIDS. equipment, carrying out vaccination population to take over basic health care campaigns and promoting the further itself on a long-term basis. In the provinces education of midwives. DR Congo: Doctors and nurses of South Kivu and Ituri, as in past years, in the hospital in the province Dr. Père Simarro, World Health the local health care systems are being of Kivu. Organisation (WHO): supported in over 240 health facilities. “In the treatment of sleeping sickness It is particularly important to train local Malteser Germany has achieved a personnel. Vaccinations as well as the care remarkable success. It is the first time such of women and men infected with HIV/ good results have been achieved. Thanks AIDS supplement the work in Ituri. In to Malteser Germany we have been able Bukavu, the focus is on additional food to bring the problem of sleeping sickness security programmes and the psychological in Yei effectively under control. The most support of women who became victims of outstanding result of the Malteser sleeping sexual violence during the war. The local sickness project in Yei is a death rate among personnel are made more aware of the treated patients of zero.” problem via special training sessions. Uganda Ethiopia In Maracha hospital, Malteser Germany In Gilgel Beles in the north-west, Malteser has been for many years supporting a Germany is involved in communal water therapeutic nutrition centre for mal- supply for 30,000 people. nourished children. In order to reduce the number of relapses and to monitor the state Kenya of health of the children on a continuous In eight Nairobi slums Malteser Germany basis, staff also carry out regular house is improving the health care of 700,000 visits. slum dwellers: thanks to new laboratories and the training of personnel, the spread of tuberculosis and HIV/AIDS is being combated. In the slums tuberculosis can now be recognised and treated in time. In Angola: Mothers with their Nairobi, approximately 50% of tuberculosis children in front of a health care patients are infected with HIV at the same centre.

AFRICA 9 Sudan: Health for the people in Galab/Darfur

Since the summer of 2004 Birke Herzbruch has been working for Malteser Germany in the north of the crisis region. She is coordinating vaccination campaigns against polio, distributing medicines, assisting in the reconstruction of destroyed health care centres and organising further education programmes for midwives. Here she tells of her everyday life and the small and bigger successes of her work:

Galab - a refugee camp along the main us from Malteser Germany together with road between El Fasher and Nyala. From the refugees selected a place in the camp the road it can barely be seen, it lies in the where we offer health care with local health interior to the west, idyllically situated personnel. Together, a tent was set up for before a range of mountains. On closer the treatment of large and small patients, inspection though, the camp turns out to pits dug out for toilets which were then be less idyllic. The terrain is barren, the fenced round and provided with plastic wind blows incessantly over the plain, and canopies and a shaded area built for the it is dusty. Excrement and refuse attract people waiting. swarms of flies. The plague of flies leaves Today is the first day we have been able to the children in the camp unmoved. I wave give the people in Galab and the surrounding my hands in front of my face to get at least Training for local midwives. a moment’s respite from the plague. The approximately 6,000 people who have fled the surrounding areas from the attacks of the militias have built themselves small round huts from branches and grasses, in order not to have to spend the nights in the open air. A relief organisation has distributed plastic canopies that are pulled over the small dwellings to give some protection from the wind and a little privacy. There is no clean drinking water. The only hand pump in the neighbouring village is broken. A good number of people walk miles to reach water. Others dig holes in the ground to get to it. Everyone in the camp is sick: diarrhoea because of the dirty water, eye infections because of the dust swirled up by the wind, respiratory diseases and fever because of the cold time of year. The children especially are affected. Their swollen stomachs suggest worms and malnutrition, Ralf Pahlmann their snotty noses and gummed-up eyes area a little aid in their hardship. And it will Oral vaccination for a colds or conjunctivitis. be a long time yet before the camp can no refugee child in the open country. Following talks with the community, longer be seen from the road because it is the village elders and the sheikhs, the no longer needed. leaders of the expelled people, those of Birke Herzbruch

Thilo Schmülgen Thilo Birke Herzbruch.

10 AFRICA A window into the darkness - Combating tuberculosis and HIV/AIDS in the slums of Nairobi

The hut in Kangemi, Nairobi, has Nevertheless, the disease has left traces them.” Together with the head of the clinic, windows that let in a little light and air. behind. Diana is very small for her age. six other nurses and a doctor, Margaret is In the semi-darkness stands Mary with a Thanks to the antibiotics, though, she has working on the prevention, diagnosis and small girl in a red dress on her arm. The survived the tuberculosis. treatment of tuberculosis and HIV. little girl’s name is Diana Nfungu, she’s six “It’s very important that the patients Their work is supported by six health years old and lives with her three year-old don’t stop the treatment after a couple of workers who live in the slum themselves brother Francis, her 18 year-old aunt Mary weeks”, says nurse Margaret Meruga, and receive from Malteser Germany a and her 12 year-old cousin Janet in an eight who works in the Kangemi Health Centre. small wage of 800 Kenyan shillings, square metres small room. “Otherwise, the patients develop resistances around 8 euros, a month. They inform their At weekends grandma, who works as a to the antibiotics and we can no longer help neighbours, families and friends about the housemaid in Nairobi’s rich city centre, voluntary tests in the health care centre and comes home to the slum. She is the only explain how tuberculosis can be prevented. one in the family who now and then brings “Fresh air is important for tuberculosis something to eat and some money. During patients”, George advised Diana’s family. the week 18 year-old Mary looks after her Since then, windows have been put in six year-old niece Diana on her own. Mary Diana’s hut for air and light. tells us briefly: Diana’s father had died of Claudia Leipner AIDS, the mother was a drug addict and had abandoned the family. Due to new labs and the training of staff, the “Little by little, Diana became so thin, spread of tuberculosis and HIV/AIDS in the slums so weak”, says Mary. When Diana was of Nairobi is being combated and the rate of new

Sven Torfinn Sven infections significantly reduced. barely eating, Mary sought help from George Ratenu, a 25 year-old from the neighbourhood who has been working for three years as a health volunteer for Malteser Germany in Kangemi. He accompanied Mary with her niece Diana to the health centre, where the little girl was tested for tuberculosis and HIV. Both tests proved positive. If you see Diana playing outside today, you wouldn’t believe she had tuberculosis. “She has come on so much”, says Mary.

Tuberculosis (TB) and HIV are often connected: in Kenya, half of all TB patients are also infected with HIV, because immunodeficiency makes people more susceptible to the tuberculosis pathogens. Advice from Malteser staff is bearing fruit:

patient numbers are growing, because more Torfinn Sven and more people are getting themselves In eight Nairobi slums Malteser staff are tested and treated in the labs for tuberculosis improving the health care of 700,000 slum and HIV. Many slum dwellers are dealing dwellers. more openly with these diseases, previously endured in silence. The medicines are prolonging the lives of the patients and also improving their quality of life. This enables them to continue to go to work and feed their families. And: children like Diana don’t have Thanks to the commitment of Kenyan health to grow up without parents. volunteer George, Diana was able to be

Sven Torfinn Sven cured of her tuberculosis.

AFRICA 11 Asia

Over the last few years Asia has been shaken by conflicts and natural disasters. After the wars in Afghanistan and Iraq there followed - both at Christmas time - the earthquake in Bam/Iran in 2003 and the tsunami in 2004. Helping people overcome the consequences of these wars and disasters was the focal point of Malteser Germany’s work in 2004. In countries such as India, Myanmar, Thailand, Cambodia and Vietnam the rehabilitation and development projects were successfully pursued.

Afghanistan Iran For the population and Malteser staff, At Christmas 2003 the southern Iranian 2004 was a year of terror. Besides several town of Bam was almost completely Myanmar: kidnappings, 30 staff members belonging to destroyed. Following the deployment of On their bicycles, the local health relief organisations were the victims of fatal the Mainz rescue dog unit to recover the workers can also reach patients in remote areas. attacks, among them two from Malteser earthquake victims, Malteser Germany Germany. Considerable efforts were erected 20 prefabricated school containers therefore devoted to safeguarding staff. We for 700 children as part of its emergency either had to withdraw completely from the relief effort. Since then a permanent school most dangerous areas or, as in the case of building has been constructed. Local the province of Badghis, shift parts of the organisations give advice on the planning programme into the neighbouring province. and execution of relief and rehabilitation Schools are therefore now being built in projects. the environs of Herat. Malteser Germany Siegfried Helias, a member of the is continuing to maintain health care for German Bundestag, visited the town of 500,000 inhabitants in four districts and in Bam in October 2004 with a delegation of the provincial hospital of Badghis. Great the Committee for Economic Cooperation importance is attached to peace-building and Development. measures designed to integrate refugees “I wanted to get a picture on the spot of the back into their home villages. current state of rehabilitation. In the process I also had an opportunity to look closely at Cambodia some of Malteser Germany’s projects. In With the introduction of a quality Bam, Malteser Germany is backing close management system for health care centres cooperation with local relief organisations in rural areas, Malteser Germany was able that are familiar with the language and the to conclude the programme for improving conditions of the country and in this respect health care successfully after a period can provide targeted help. From a fund, on of five years. Follow-up projects will the one hand support is being given to encourage self-help among communities relief projects of the local organisations, and strengthen patients’ rights. such as care for traumatised women and children. On the other, Malteser Germany India is sponsoring the further education of Even in the fourth year after the severe staff from Iranian organisations, for earthquake in Gujarat, Malteser Germany instance in the form of seminars on the is continuing to assist its Indian partner subject of project management. With organisations in reconstruction work. these programmes, Malteser Germany is Afghanistan: Inspection of A further 600 houses for people in need providing exemplary help for people to reconstruction progress in the provincial hospital in Qala-i-Nau. have been completed. Altogether, over help themselves and guaranteeing that 1,000 houses in Gujarat have been rebuilt. long-term support will be given to the Necessary knowledge about disaster people in Bam. Because the earthquake prevention and disaster management is victims must under no circumstances be given in training sessions. left with a feeling of helplessness when the international organisations one day withdraw from Bam”.

12 ASIA Iraq Owing to the critical security situation, since IN MEMORIAM February 2004 no further German Malteser staff have been working in northern Iraq. Emal Abdul Samad (19) The health care centre in Karmless, however, continues to be equipped with Mohammed Idrees Sadiq (38) medicines via local partners. Malteser Germany mourns its two Afghan staff members, Emal Abdul Samad and Mohammed Idrees Sadiq, who were murdered on 3 August 2004 during an attack Myanmar in the south-east of Afghanistan. They were just returning from their project area 2004 was a year of new challenges. An when, at around 5 p.m. local time, well-aimed shots were fired at their car from agreement between the Health Ministry a passing vehicle. The 19 year-old driver of the car, Emal Abdul Samad, could and Malteser Germany safeguards access to still be flown to the hospital in Bagram but there succumbed to his severe bullet Rakhine State and to the Yangon Division wounds. 38 year-old Mohammed Idrees Sadiq died at the scene of the accident; for a further three years. On this basis, in he leaves a wife, three daughters and two sons. As driver and project supervisor, Rakhine State the basic health care activities Emal and Mohammed assisted numerous families who were returning to their were expanded and a new project started in destroyed home areas and facing an apparently hopeless future. They had to pay the slum areas of Yangon: together with with their lives for supporting the cause of people in need. Our deep sympathy and German Agro Action (Welthungerhilfe) our prayers go to their families, friends and colleagues. Malteser Germany is improving the health and nutritional situation of the people and giving them access to drinking water and infected by HIV through income generating sanitary facilities. measures. In addition, support is given to orphans whose parents have died of AIDS. Thailand Ever since 1993 Malteser Germany has Vietnam been responsible for the health care of In a programme especially aimed at reducing 27,000 refugees in two camps at the border poverty, 450 families in particularly poor Cambodia: Health education for with Myanmar. Besides medical treatment, areas of central Vietnam learned to improve schoolchildren in the province of Oddar Meanchey. we provide the refugees with drinking their health and nutritional situation and water, build toilet facilities, offer health to increase their income by finding new education and train health workers. In order sources of earnings. In cooperation with to avoid tensions between refugees and the the women’s union of this region, the population, since 2002 a basic health care programme is to be extended to further project has also been undertaken in the districts in 2005. villages of the district. The focus here is on the prevention of diseases and health education as well as the support of those

Myanmar: Basic health care in remote villages in Northern Rakhine State.

Vietnam: Improving the health and nutritional

Jochen Voigt Voigt Jochen situation of 450 families.

ASIA 13 Bam in December 2004 – One year after the earthquake

Impressions of Dr. Peter Staudacher, country coordinator Iran

Life in Bam is visibly getting back to play on the playgrounds between the school however. In order to help them, international normal. Gone are the times when dozens containers. and also Iranian NGOs offer special of yellow wheel loaders fought their way Hard to believe that some of these support programmes. In the public arena, through the building rubble and turned children lost their mother, their father and however, it is rather the technical aspects of everything into a dusty hell. The government some of them both parents in the earthquake reconstruction that are discussed. has already erected a large number of of 2003. The number of traumatised people “Bam lives on after the earthquake”, a emergency dwellings in the form of camps - particularly among the children - is high, young tourist guide who once used to escort of prefabricated shelters; the rebuilding international tourists through the ancient of houses has so far been tackled mainly castle complex of Bam told me in January by the international relief organisations. Dr. Peter Staudacher with project 2004. The quake turned the old castle of partners in Barawat in front of Until now, the reconstruction of residential the premises on which a new Bam, a masterpiece of oriental architecture, buildings has only been taking place in the school is to be built. into a pile of rubble. When I asked after villages around Bam, as initially a “master young Mohammed on my return to Bam I plan” for the rebuilding of the city was was told that he had left for England two drawn up by the government which has months ago. He was now studying English only now been presented - almost a year literature there. The earthquake left him after the earthquake. This is why not a great without his castle and without his job. deal of reconstruction has taken place to Bam has been living on for a year after date in the urban area of Bam itself. the terrible earthquake but it still needs Along the former main streets, shop- international assistance. For a long time now keepers have taken the initiative of re- there has been no satisfactory solution for opening their businesses in provisional the numerous people who still have to live buildings that look like garages. New in the prefabs. Lessons in most schools still buildings sprang up before long and take place in containers. Hospitals operate now televisions, DVD players, washing in emergency accommodation. Hardly any machines and bicycles are on sale again playing grounds and sports fields exist. in Bam. In addition, a number of cheap Traumatised children continue to wait for restaurants have already set up their tables psychosocial support, the unemployed again on the roadside and are serving kebabs hope for work, women who have lost their - spicy meat skewers - with rice. Fruit and husbands and now have to look after their vegetable sellers are offering the entire range families feel abandoned. necessary for traditional Iranian cuisine: One year after the earthquake Bam has dates, aubergines, cucumbers, pistachios, recovered a little. Whether the city will oranges, kakis and pomegranates. really get back on its feet depends on the Life in Bam goes on, as people say. It’s commitment of everyone: on the Iranian true that they’re not happy with life in government, the relief organisations and School containers for a girls’ the temporary shelter, but the children are class in Bam. the inhabitants of Bam. laughing again. One can see their cheerful Dr. Peter Staudacher

In the past year, the Malteser Foreign Aid Division in cooperation with Diakonie Emergency Aid and with support from Malteser groups and the University of Regensburg, has begun building a school in Bam in the suburb of Barawat. Three schools were equipped with school containers where lessons are now taking place until permanent school buildings can be re-erected. Malteser Germany is committed to the strengthening of local self-help organisations in order to promote sustainable structures of civil society in Bam. By means of training and financial support they are being put in a position to pursue their important responsibilities in the social sphere, e.g. organising holiday camps and programmes for traumatised children, freeing widows from their isolation with discussion groups or supporting small income generating activities. With this form of help to self-help, Malteser Germany is shaping the rehabilitation process on a sustainable basis.

14 ASIA The stream, the flight and new life

Visiting a midwife in the Thai jungle

Rainy season in the Thai jungle: the and extensive educational work for young water’s streaming, the air’s steaming, and people and mothers also play an important the red earth has turned into soft soap. The role in the camp. “The subject of HIV/ jeep is barely making progress - despite AIDS is really off-limits among refugees”, snow chains. After a four-hour journey to explains country coordinator Marie-Theres get 80 kilometres, hundreds of bamboo Benner, who has already been working in huts appear; we have finally arrived at the Thailand for nine years. “However, the “Mae La U” refugee camp. offer of voluntary counselling and testing Almost 15,000 people live here: “Mae plays an important role in the advice we Midwife Sunny examining a girl in the refugee camp. La U” is one of two large refugee camps in give, as it removes anxieties and the subject the north-west of Thailand looked after by of AIDS is not hushed up.” Malteser Germany. In the course of the last Sunny has no desire to hush up her 25 years, together with refugees from Laos sadness at the fact that she sees her two and Cambodia around one million people eldest children so rarely. Both are attending have come to Thailand. secondary schools in another refugee camp 41 year-old midwife Sunny has been and can only visit once a year. However, living in this new camp since spring 2004 Sunny consoles herself with a vision: “I together with her husband Jonathan, her 79 really hope that at last our children will year-old aunt and two of her four children. be able to return again one day to their Sunny herself was twelve years old when homeland when we really have peace and soldiers of the military government attacked democracy there. That’s also why their her village in Myanmar and killed her training here is so important to us. We’ll father. The mother entrusted Sunny to the use the opportunity we have to raise a new aunt who fled with her over the border to generation for our country”. Thailand. Since then Sunny has not seen her Then Sunny goes back into the hospital mother and her seven brothers and sisters. to the two children who came into the world In 1988 she married Jonathan, who had also the night before. The rain has stopped. fled from Myanmar. When military conflict Petra Ipp erupted again in 1994, both of them fled to the “Mae Kong Kha” refugee camp where Sunny was trained by Malteser Germany to become a midwife. Since 1993 Malteser Germany has been operating at the Thai- Myanmar border, supporting the refugees to set up their own health system. Sunny’s husband Jonathan was also trained by Malteser Germany. As a medical supervisor he directs - supported by doctors from Germany - the work of a total of 110 health workers operating in the camp. It’s not just about mother and child health care; vaccination and nutrition programmes

The hospital in the “Mae La U” refugee camp at the border with Myanmar.

ASIA 15 2 2 1 3 1 1 2 1 2 1 2 1 1 1 1 1 1 1 1 1 1 3 2 1 1 2 2 2 2 1 1 1 1 1 1 2 1 1 1 4 2 2 4 1 3 2 8 1 No. of No. Projects Local Partner Organisations Local Partner Kubango Kuando Caritas Menongue, provincial health delegation NCC AMREF Kenya, Authority Sofala Provincial Health Yei Dioceses of Rumbek and Yei Diocese of Torit Rumbek and Yei, Dioceses of Diocese of Rumbek Municipal health centres Local and national health school authority Local and national health school authority District councils and NGOs District councils and NGOs village Local health authority, communities Education Society/ Non Formal Xavier’s St. BSC with Ekklavia Foundation Unnati Organisation for Development Education Sisters of Destitude Health for One Million Marthandam Association of India, CHAI Catholic Health HOM Marthandam Trivandrum, MSSS THW NGO House Kerman Katastrophenhilfe Diakonie Disaster Relief) Welfare (Social NGO House und Hamyaran Kerman Local health authorities village Local health authorities, communities village Local health authorities, communities of inhabitants and authorities health Local the urban district Local authorities Karen Refugee Committee Local authorities unions at village and district Women’s level Nien newspaper Thanh International Blue Crescent International Blue Crescent International Blue Crescent Vafki BHWI and local Local social institutions, NGOs Local NGOs Local authorities Local NGOs local Local Public Health Department, NGO Novi Sad administration, Dom Zdravlja, welfare medical and senior citizen’s Novi Sad authorities, Catholic parish of Boka Local Malteser organisations AA - EUR 60,000 EUR 67,000 EUR 17,000 EUR 40,000 EUR 16,156 EUR 30,000 EUR 46,000 EUR 90,000 EUR 35,000 EUR 55,000 EUR 35,000 EUR 15,000 EUR 75,000 EUR 21,500 EUR 27,150 EUR 37,800 EUR 91,000 EUR 87,000 EUR 230,000 EUR 710,000 EUR 191,000 EUR 359,000 EUR 808,200 EUR 141,000 EUR 155,000 EUR 478,800 EUR 588,500 EUR 355,000 EUR 373,500 EUR 305,000 EUR 390,000 EUR 110,000 EUR 175,000 EUR 100,000 EUR 632,000 EUR 212,000 EUR 253,000 EUR 299,500 EUR 900,000 EUR 150,000 EUR 103,500 EUR 680,000 EUR 279,500 EUR 504,000 EUR 469,500 EUR 979,158 EUR 1,330,000 EUR 2,915,000 EUR 1,017,000 EUR 5,800,000 EUR 1,001,000 nations/Grants Amount of Do - - - - - Donors/Cooperation Partners* ADH ECHO, UNICEF ECHO, ECHO EuropeAid BMZ BMZ donations Private PMK Caritas Spain, donations Private ECHO, BMZ, Caritas Spain DAHW, ECHO, DAHW ECHO, Aktion Deutsch UNICEF, AA, land Hilft (Action Campaign Stiftung Germany Helps), „Nachbarn in Not“ (Neigh bours in Need) Foundation PMK BMZ (KfW and CIM) UNICEF UNHCR UNHCR donations private ECHO, donations Private donations Private donations Private donations Private donations Private donations Private THW donations Private donations Private donations Private do private UNAIDS, ECHO, nations private WFP, UNHCR, ECHO, donations funding providers, private BMZ, embassy, Japanese UNICEF, donations private do private BMZ emergency aid, Action) Agro (German nations, European Commission/ EuropeAid donations private ECHO, donations Private Child Foundation, World donations private Office of Foreign Federal Germany donations Private donations Private donations Private donations Private AA UNHCR, Association of the Order British of Malta AA UNHCR, archdiocese of AA, UNHCR, Cologne Aktion Mensch (Action for Humanity) AA Associa British Renovabis, tion of the Order Malta, foundation donations Private AA GF 07 n.a. n.a. n.a. EUR 60,000 EUR 90,000 EUR 56,000 EUR 16,156 EUR 30,000 EUR 51,000 EUR 90,000 EUR 45,000 EUR 82,000 EUR 50,000 EUR 27,150 EUR 41,300 EUR 500,000 EUR 710,000 EUR 270,000 EUR 600,000 EUR 900,000 EUR 300,000 EUR 220,000 EUR 531,500 EUR 647,400 EUR 425,000 EUR 373,500 EUR 305,000 EUR 390,000 EUR 110,000 EUR 175,000 EUR 100,000 EUR 652,000 EUR 260,000 EUR 280,000 EUR 315,000 EUR 900,000 EUR 150,000 EUR 107,000 EUR 872,000 EUR 279,500 EUR 580,000 EUR 251,000 EUR 107,000 EUR 469,500 EUR 979,158 (spread over (spread Project Costs Project EUR 1,370,000 EUR 2,915,000 EUR 1,200,000 EUR 6,000,000 EUR 1,100,000 several years) several

- al and Eastern Relief worldwide – Our projects in 2004 (extract) in 2004 (extract) Relief worldwide – Our projects Brief Description Emergency relief and health care for displaced persons the population distribution of nutrition, medical provision and training, Kubango, in Kuando and hygiene measures water relief items, Rehabilitation of health care structures in South Kivu Supporting over 20 nutrition centres in Bukavu/South Kivu with medicines and Ariwara/Mahagi in Providing the local health workers training support of basic occupational training, Mandura, for Gilgel Beles, Water group women’s Improving the possibilities of diagnosis and treatment tuberculosis support of nursing and education in eight slum areas Nairobi HIV/AIDS; programme vaccination days, Monthly health awareness Archangelo-Ali clinic in Rumbek and the Saint Bakhita Health Supporting the Yei Care Center in County Yei in Sleeping sickness control programme and Rumbek Yei in and leprosy control programmes Tuberculosis of lab assistants school in the training Supporting the Rumbek laboratory campaigns in Darfur Basic health care and vaccination Maracha Nutrition centre, Badghis province Rehabilitation of schools and basic health care, Badghis Supporting the obstetrics department in Qala-I-Nau Hospital, province Afghanistan south-east for returnees, programmes Income generating central for returnees, and peace-building programmes Income generating Afghanistan Oddar Meanchey province Basic health care, Reconstruction of 500 houses in Bachau development of disaster Reconstruction of 100 and equipping 250 houses; prevention measures in 20 villages Pre-school education for children of the socially disadvantaged of female health workers training Basic health care in slums, measures for women Setting up a loan fund for income generating Nadu Tamil medical help in clothing, Providing tsunami victims with food, and Kerala provision of three emer Deployment of rescue dog unit and medical team, gency health kits chool containers with cooling units and toilets for three schools Reconstruction of the school in Khadije for local relief organisations and establishment of a small project Training fund region, Wa diagnosis and treatment, Malaria and HIV/AIDS prevention, Shan State Improving the health and nutritional situation of returnees with focus on northern Rakhine State TB control, basic health care and diagnosis prevention, Improving health care and supply of drinking water, Township Thongwa TB, and treatment of HIV/AIDS in the urban area Improving health care and supply of drinking water Yangon of Improving health care and HIV/AIDS prevention border Thai-Myanmar for refugees along the Basic health care programme medical help clothing, Providing tsunami victims with food, new business for women and children, Nutrition and health care programme set-up courses Vietnam Flood relief – central Setting-up/equipping a centre for 250 mentally-impaired children in Izmit, for parents programmes awareness centre for first aid Training Yatzik Health care centre for 5,000 people in bus Day care centre for children including transport returnees, measures for among others minorities, Income generating programme women’s integrated first aid training Domestic nursing, Care of individuals willing to return measures income generating Support in setting up new businesses, Supporting people with disabilities assistants nurse of training aid, infrastructural people, Romany for care Health equipping and providing financial assistance for Boka senior Extending, citizens’ home Medical care for UNAMA and the police academy - Programme Focus Programme Emergency relief Emergency relief Emergency relief Rehabilitation/health care aid Structural aid/health care Structural aid Structural Health care Health care Rehabilitation/health care aid Structural Emergency relief security Food Rehabilitation/health care Rehabilitation/health care Rehabilitation/aid to returnees Rehabilitation/aid to returnees Health care Rehabilitation – Gujarat earthquake Rehabilitation/disaster pre earthquake vention - Gujurat Rehabilitation/development earthquake – Gujurat Health care aid Structural Emergency relief – tsunami Emergency relief – Bam earthquake Emergency relief – Bam earthquake Emergency relief – Bam earthquake Emergency relief – Bam earthquake Emergency relief Health care Health care Health care Health care Health care Emergency relief - tsunami aid Health care/structural Emergency relief Rehabilitation Health care Health care aid Structural aid Structural Health care Repatriation and protection for refugees aid Structural aid/health care Structural Health care aid Structural Health care Country Angola DR Congo DR Congo DR Congo Ethiopia Kenya Mozambique Sudan Sudan Sudan Sudan Sudan Uganda Afghanistan Afghanistan Afghanistan Afghanistan Cambodia India India India India India India Iran Iran Iran Iran Myanmar (Burma) Myanmar (Burma) Myanmar (Burma) Myanmar (Burma) Thailand Thailand Thailand Vietnam Vietnam Turkey Turkey Turkey Turkey Bosnia- Herzegovina Bosnia- Herzegovina Kosovo/ Macedonia Kosovo Kosovo Serbia Serbia Setting up Malteser (organizational) structures and supporting activities in 13 countries of Centr Serbia and Russia, Romania, Poland, Lithuania, Latvia, Albania, financial assistance for the Malteser organisations in Europe; the Ukraine Afghanistan Asia Africa United Europe Europe Europe Eastern Nations Balkans Central-/ Central-/ Region

16 PROJECT OVERVIEW - 2 2 1 3 1 1 2 1 2 1 2 1 1 1 1 1 1 1 1 1 1 3 2 1 1 2 2 2 2 1 1 1 1 1 1 2 1 1 1 4 2 2 4 1 3 2 8 1 No. of No. Projects N.B.: N.B.: difference between the amount of The provided by the donor/ donations/grants partner and actual project cooperation donations ear costs is covered by private for Malteser foreign aid work. marked Local Partner Organisations Local Partner Kubango Kuando Caritas Menongue, provincial health delegation NCC AMREF Kenya, Authority Sofala Provincial Health Yei Dioceses of Rumbek and Yei Diocese of Torit Rumbek and Yei, Dioceses of Diocese of Rumbek Municipal health centres Local and national health school authority Local and national health school authority District councils and NGOs District councils and NGOs village Local health authority, communities Education Society/ Non Formal Xavier’s St. BSC with Ekklavia Foundation Unnati Organisation for Development Education Sisters of Destitude Health for One Million Marthandam Association of India, CHAI Catholic Health HOM Marthandam Trivandrum, MSSS THW NGO House Kerman Katastrophenhilfe Diakonie Disaster Relief) Welfare (Social NGO House und Hamyaran Kerman Local health authorities village Local health authorities, communities village Local health authorities, communities of inhabitants and authorities health Local the urban district Local authorities Karen Refugee Committee Local authorities unions at village and district Women’s level Nien newspaper Thanh International Blue Crescent International Blue Crescent International Blue Crescent Vafki BHWI and local Local social institutions, NGOs Local NGOs Local authorities Local NGOs local Local Public Health Department, NGO Novi Sad administration, Dom Zdravlja, welfare medical and senior citizen’s Novi Sad authorities, Catholic parish of Boka Local Malteser organisations AA - EUR 60,000 EUR 67,000 EUR 17,000 EUR 40,000 EUR 16,156 EUR 30,000 EUR 46,000 EUR 90,000 EUR 35,000 EUR 55,000 EUR 35,000 EUR 15,000 EUR 75,000 EUR 21,500 EUR 27,150 EUR 37,800 EUR 91,000 EUR 87,000 EUR 230,000 EUR 710,000 EUR 191,000 EUR 359,000 EUR 808,200 EUR 141,000 EUR 155,000 EUR 478,800 EUR 588,500 EUR 355,000 EUR 373,500 EUR 305,000 EUR 390,000 EUR 110,000 EUR 175,000 EUR 100,000 EUR 632,000 EUR 212,000 EUR 253,000 EUR 299,500 EUR 900,000 EUR 150,000 EUR 103,500 EUR 680,000 EUR 279,500 EUR 504,000 EUR 469,500 EUR 979,158 EUR 1,330,000 EUR 2,915,000 EUR 1,017,000 EUR 5,800,000 EUR 1,001,000 nations/Grants Amount of Do - - - - - United Nations AIDS Programme United Nations Fund United Nations Children’s United Nations High Commissioner for Refugees Relief Organisation Technical German Programme Food World THW UNAIDS UNHCR UNICEF WFP Donors/Cooperation Partners* ADH ECHO, UNICEF ECHO, ECHO EuropeAid BMZ BMZ donations Private PMK Caritas Spain, donations Private ECHO, BMZ, Caritas Spain DAHW, ECHO, DAHW ECHO, Aktion Deutsch UNICEF, AA, land Hilft (Action Campaign Stiftung Germany Helps), „Nachbarn in Not“ (Neigh bours in Need) Foundation PMK BMZ (KfW and CIM) UNICEF UNHCR UNHCR donations private ECHO, donations Private donations Private donations Private donations Private donations Private donations Private THW donations Private donations Private donations Private do private UNAIDS, ECHO, nations private WFP, UNHCR, ECHO, donations funding providers, private BMZ, embassy, Japanese UNICEF, donations private do private BMZ emergency aid, Action) Agro (German nations, European Commission/ EuropeAid donations private ECHO, donations Private Child Foundation, World donations private Office of Foreign Federal Germany donations Private donations Private donations Private donations Private AA UNHCR, Association of the Order British of Malta AA UNHCR, archdiocese of AA, UNHCR, Cologne Aktion Mensch (Action for Humanity) AA Associa British Renovabis, tion of the Order Malta, foundation donations Private AA GF 07 n.a. n.a. n.a. EUR 60,000 EUR 90,000 EUR 56,000 EUR 16,156 EUR 30,000 EUR 51,000 EUR 90,000 EUR 45,000 EUR 82,000 EUR 50,000 EUR 27,150 EUR 41,300 EUR 500,000 EUR 710,000 EUR 270,000 EUR 600,000 EUR 900,000 EUR 300,000 EUR 220,000 EUR 531,500 EUR 647,400 EUR 425,000 EUR 373,500 EUR 305,000 EUR 390,000 EUR 110,000 EUR 175,000 EUR 100,000 EUR 652,000 EUR 260,000 EUR 280,000 EUR 315,000 EUR 900,000 EUR 150,000 EUR 107,000 EUR 872,000 EUR 279,500 EUR 580,000 EUR 251,000 EUR 107,000 EUR 469,500 EUR 979,158 (spread over (spread Project Costs Project EUR 1,370,000 EUR 2,915,000 EUR 1,200,000 EUR 6,000,000 EUR 1,100,000 several years) several

- al and Eastern Association Relief Tuberculosis German Leprosy and European Commission – Humanitarian Office Mission Organisation for Children Papal Nairobi City Council Development Bank - KfW Banking Group and Development Centre for International Migration CIM DAHW ECHO PMK KfW NCC Brief Description Emergency relief and health care for displaced persons the population distribution of nutrition, medical provision and training, Kubango, in Kuando and hygiene measures water relief items, Rehabilitation of health care structures in South Kivu Supporting over 20 nutrition centres in Bukavu/South Kivu with medicines and Ariwara/Mahagi in Providing the local health workers training support of basic occupational training, Mandura, for Gilgel Beles, Water group women’s Improving the possibilities of diagnosis and treatment tuberculosis support of nursing and education in eight slum areas Nairobi HIV/AIDS; programme vaccination days, Monthly health awareness Archangelo-Ali clinic in Rumbek and the Saint Bakhita Health Supporting the Yei Care Center in County Yei in Sleeping sickness control programme and Rumbek Yei in and leprosy control programmes Tuberculosis of lab assistants school in the training Supporting the Rumbek laboratory campaigns in Darfur Basic health care and vaccination Maracha Nutrition centre, Badghis province Rehabilitation of schools and basic health care, Badghis Supporting the obstetrics department in Qala-I-Nau Hospital, province Afghanistan south-east for returnees, programmes Income generating central for returnees, and peace-building programmes Income generating Afghanistan Oddar Meanchey province Basic health care, Reconstruction of 500 houses in Bachau development of disaster Reconstruction of 100 and equipping 250 houses; prevention measures in 20 villages Pre-school education for children of the socially disadvantaged of female health workers training Basic health care in slums, measures for women Setting up a loan fund for income generating Nadu Tamil medical help in clothing, Providing tsunami victims with food, and Kerala provision of three emer Deployment of rescue dog unit and medical team, gency health kits chool containers with cooling units and toilets for three schools Reconstruction of the school in Khadije for local relief organisations and establishment of a small project Training fund region, Wa diagnosis and treatment, Malaria and HIV/AIDS prevention, Shan State Improving the health and nutritional situation of returnees with focus on northern Rakhine State TB control, basic health care and diagnosis prevention, Improving health care and supply of drinking water, Township Thongwa TB, and treatment of HIV/AIDS in the urban area Improving health care and supply of drinking water Yangon of Improving health care and HIV/AIDS prevention border Thai-Myanmar for refugees along the Basic health care programme medical help clothing, Providing tsunami victims with food, new business for women and children, Nutrition and health care programme set-up courses Vietnam Flood relief – central Setting-up/equipping a centre for 250 mentally-impaired children in Izmit, for parents programmes awareness centre for first aid Training Yatzik Health care centre for 5,000 people in bus Day care centre for children including transport returnees, measures for among others minorities, Income generating programme women’s integrated first aid training Domestic nursing, Care of individuals willing to return measures income generating Support in setting up new businesses, Supporting people with disabilities assistants nurse of training aid, infrastructural people, Romany for care Health equipping and providing financial assistance for Boka senior Extending, citizens’ home Medical care for UNAMA and the police academy - Programme Focus Programme Emergency relief Emergency relief Emergency relief Rehabilitation/health care aid Structural aid/health care Structural aid Structural Health care Health care Rehabilitation/health care aid Structural Emergency relief security Food Rehabilitation/health care Rehabilitation/health care Rehabilitation/aid to returnees Rehabilitation/aid to returnees Health care Rehabilitation – Gujarat earthquake Rehabilitation/disaster pre earthquake vention - Gujurat Rehabilitation/development earthquake – Gujurat Health care aid Structural Emergency relief – tsunami Emergency relief – Bam earthquake Emergency relief – Bam earthquake Emergency relief – Bam earthquake Emergency relief – Bam earthquake Emergency relief Health care Health care Health care Health care Health care Emergency relief - tsunami aid Health care/structural Emergency relief Rehabilitation Health care Health care aid Structural aid Structural Health care Repatriation and protection for refugees aid Structural aid/health care Structural Health care aid Structural Health care Country Angola DR Congo DR Congo DR Congo Ethiopia Kenya Mozambique Sudan Sudan Sudan Sudan Sudan Uganda Afghanistan Afghanistan Afghanistan Afghanistan Cambodia India India India India India India Iran Iran Iran Iran Myanmar (Burma) Myanmar (Burma) Myanmar (Burma) Myanmar (Burma) Thailand Thailand Thailand Vietnam Vietnam Turkey Turkey Turkey Turkey Bosnia- Herzegovina Bosnia- Herzegovina Kosovo/ Macedonia Kosovo Kosovo Serbia Serbia Setting up Malteser (organizational) structures and supporting activities in 13 countries of Centr Serbia and Russia, Romania, Poland, Lithuania, Latvia, Albania, financial assistance for the Malteser organisations in Europe; the Ukraine Afghanistan African Medical Research Foundation Office of Germany Foreign Federal Aid, on Humanitarian Force Task and Development Department of Economic Cooperation German Federal Action Campaign Germany Helps Office of Germany Foreign Federal Asia Africa United * Donors/Cooperation partners: * Donors/Cooperation AA ADH AMREF ASHH BMZ Europe Europe Europe Eastern Nations Balkans Central-/ Central-/ Region

PROJECT OVERVIEW 17 Europe

Balkans Turkey

Even ten years after Dayton and five years after the end In Izmit and the surrounding area, the centre of the 1999 of the Kosovo war, by no means all the war refugees have earthquake, Malteser Germany is working with its Turkish returned to their native regions. Malteser Germany is partner International Blue Crescent. helping returnees to make a new life for themselves. The programmes for a centre in Izmit, in which 240 mentally Bosnia-Herzegovina handicapped children live, are a main focus of Malteser Germany’s The “Bosnia-Herzegovina Women’s Initiative” advises and aid efforts in Turkey. Therapeutic procedures, the acquisition of supports unemployed women in setting up new businesses. a transport bus and a training programme that gives the parents Ethnic minorities and returning displaced persons receive similar support in dealing with the children and their environment, alleviate assistance. In Mostar, a domestic nursing service began its work; in the children’s situation. In addition, Malteser Germany has set up a Grahovo a first aid training course for nurses was run. health care centre and a training centre for first aid in Izmit.

Kosovo and Macedonia Turkey: Handicapped children from the day Malteser Germany assists displaced persons, mostly relatives of care centre in Izmit were the proud winners of ethnic minorities returning to their homeland, by means of income a nationwide sporting competition. generating measures with repayment components as well as through direct financial assistance and winterised accommodation. The often difficult situation of handicapped people is improved by offers of advice for families and measures designed to create awareness.

Serbia Malteser Germany is especially committed to improving infrastructure in health care services. To this end we equipped five dental practices with modern instruments, developed a training programme for nursing auxiliaries and took on the financing of a mobile medical team for the preventive and diagnostic care of Romany families. The extension of the senior citizens’ home in Boka was successfully completed.

Kosovo: By supporting carpentry Serbia: Mobile medical team in one businesses, Malteser Germany is of the Romany camps. helping returnees to make a new life for themselves.

18 EUROPE MD Marku – an example of emergency aid without red tape

You couldn’t imagine health care in Albania without Malteser Germany

On Wednesday morning, in a small village in the mountains of northern Albania, a number of inhabitants are awaiting the arrival of the doctor. A small boy has severe stomach pains, a peasant woman has injured herself while working in the fields, an elderly woman has a high fever. MD Maranaj Marku from the Albanian Malteser Relief Service “Malteser - Ndihmon ne Shqiperi” (Malteser - Aid in Albania) knows most of them, because for years he has been holding consultation hours every One of the eight week on the same day in the village and mountain villages where “Malteser sorting out those seeking help. - Ndihmon ne Malteser doctor MD Maranaj Marku, Shquiperi” is together with a physician colleague, a providing health care. handful of full-time and a large number of voluntary co-workers, helps to maintain Every year the Albanian Malteser Relief “Malteser – Ndihmon ne Shquiperi” is basic health care in the archdiocese of Service runs summer camps with Albanian putting a lot of energy into youth work. Shkoder. They hold consultation hours in girls and boys and Romany children on the They are training volunteers and offering individual villages and look after the sick coast near Velipoja. These holiday activities challenging leisure activities to young and injured. are now finding a high level of acceptance in people who in view of the high level of With financial assistance from Renovabis, northern Albania and a further unexpected unemployment often simply “live for the the Albanian Malteser Relief Service also success is the fact that some Romany youths moment”. This makes questions about provides information on natural family are now becoming involved as volunteers the future, which offers the youths few planning in order to make a contribution for the relief service. prospects, easier to bear. towards reducing the high number of Ludwig Unger (Renovabis) abortions. For the patients, treatment in the health care centres by Malteser staff is In Albania – as the example of the Albanian free, just like the medicines distributed to Malteser Relief Service shows – the Catholic the sick. The Albanian Malteser personnel Church is taking on certain public tasks, for are mainly dependent on donations and the most part of necessity. Almost two-thirds support from outside, “on every euro, in of the roughly 3.15 million-strong population fact”, according to MD Maranaj Marku. of the country are Muslims; approximately The chairman of the Malteser Relief 13 per cent of the people are Catholic. Organisation in Albania is especially Without the involvement of priests, members grateful for the support from Germany, of religious orders and lay people, many for example by the Malteser groups of the would have to wait for assistance in vain. archdiocese of Cologne and Renovabis. In the south-east European country, around 40 small health care centres are being looked after jointly by Malteser and/or Caritas staff. In the “poorhouse” of Europe, Top: Delivery of medicines and as Albania is rightly called, cars are a scarce medical equipment. commodity, and transporting sick people to the “hospital” in the nearest town is not always without its problems. MD Maranaj Marku en route with Renovabis visitors.

EUROPE 19 Central and Eastern Europe/Partnership work abroad

Despite the fact that some Central and Eastern European states are members of the European Union, neither there nor in other countries of the east has life actually become any easier. The aid of Malteser Germany continues to be necessary and is readily provided. The Malteser relief services in Central and Eastern Europe, however, are also increasingly taking their fate into their own hands and preparing themselves for the future. In 2003 and 2004, with “Water for Ariwara”, many German Malteser groups made an important contribution to the success of the health project in the Democratic Republic of Congo through committed fundraising.

“Relief for Ariwara” - Qualification donation funds are still available ● On the 15th anniversary of the “Day – “CEE network” for rehabilitation aid for the Eastern of Reception” on 14 August 1989, the On World Water Day on 22 March 2004 European Malteser partner organisations, Hungarian Malteser organisation invited the anniversary project “Water for Ariwara” the latter have been trained since 2003 to guests from home and abroad to Budapest- was officially ended, with donations be able to finance themselves to a greater Zugliget. On that date the site had been totalling almost EUR 88,000. Three extent. opened for the reception of East German representatives of the dioceses of Cologne, ● Through his foundation, Udo Jürgens refugees. In the ceremony the Hungarian Berlin and Aachen travelled in spring to the also supports two of the children’s President paid tribute to the remarkable Congolese project region. The aid will also homes near Lemberg looked after by the commitment of Hungarian and German continue in 2005 under the slogan “Relief Ukrainian Malteser organisation. At the Malteser staff. A short time later, during for Ariwara”. TV gala broadcast on the occasion of his his trip to Hungary, German Chancellor In January 2004, at a pilot seminar for 70th birthday, two children from these Schröder also thanked Malteser staff for voluntary leaders and decision-makers in homes as well as Paul Titko, Director of the fact that, 15 years before, they “had the foreign aid and partnership work sector, the Ukrainian Relief Service, took the helped to overcome the painful division participants were given details of the opportunity to wish him many happy of Europe with courage and drive”. fundamental principles of foreign aid and returns. information on operational practice. A first regular seminar programme will follow at the end of 2005. At a conference in Prague in November 2004, the responsibles of nine Central and Eastern European Malteser relief services and representatives of the Malteser Foreign Aid Division agreed on concrete steps to consolidate the “Central and Eastern European Malteser Network”. Birthday gala on TV: Surprise guests from the Malteser Highlights from our children’s homes in partner organisations: Ukraine congratulate ● At the beginning of 2004, the Albanian Udo Jürgens on his

Andreas Friese 70th birthday. Malteser Relief Service guaranteed accommodation and food for families Hungary: On the affected by a severe earthquake in the occasion of the 15th anniversary, south of Albania. This was possible Chancellor Schröder thanks to an emergency aid fund of the thanks Father Imre Malteser diocesan office of Cologne Kozma, Director of the and the Malteser Foreign Aid Division. Hungarian Malteser organisation, for their Alongside this, staff from the Albanian commitment. Malteser organisation were in action during the flood disaster in the northern Albanian district of Shkoder. ● The Romanian Malteser Relief Service has been taking part in the counselling process offered since October by the Foreign Aid Division. As only limited

20 CENTRAL AND EASTERN EUROPE / PARTNERSHIP WORK ABROAD “Water for Ariwara” – Travelling with Malteser Germany in the Congo

Impressions of a newcomer to Africa

What a country! Green and lush. bicycle dealer, one of them recently let off Spring enclosure in Ariwara, Everywhere friendly, open, happy people. a hand grenade in the market. There were donated by Malteser groups of I find it quite impossible to escape the a number of dead and many injured. These the diocese of Münster. children’s charm. Curiously but cautiously characters worry me. they approach with friends, brothers and But I do enjoy the good atmosphere in the sisters, registering amazement and disbelief Malteser team. Alain, the logistics specialist at our strange appearance and splitting their from France, confessed to me how glad he is sides with laughter. The women set out for that because of our visit there’s Nutella for market first thing, on foot, often for hours. breakfast. Yes, food in Africa! I set off with On their heads they carry brushwood or a thousand warnings ringing in my ears but charcoal, cassava or other vegetables. In nothing’s quite as bad. We eat well, but a the tall grass they seem to float - despite the lot here is still somewhat more immediate. 20-litre water cans on their heads. The goat lying grilled on the buffet table Water - what a subject in this country. It’s this evening I saw just this morning still full the rainy season. On the bumpy roads, large of life - then heard its pitiful screams. reddish brown puddles linger in the rutted After four days with the Malteser team potholes. At the sources, newly walled- I even know some of the many local staff. round by Malteser Germany, there’s a lively At the beginning I had great difficulty crush. Clear water flows into bowls, kettles in distinguishing the black faces. Steffi and cans. A woman with her child on her Heil from Cologne, only there for barely back fills the can with water, pauses for a half a year, sympathises. Things hadn’t moment, then lifts it high over her head been any different for her, she says. Steffi and lets it down gently. It stays secure; she accompanies us to the health care centres, doesn’t have to hold on to it. interprets and fixes everything on the What a life, here “in the bush”! By the spot so we can film - and is glad of the way, that term should be taken literally. diversion. She loves this country and its Ingo Radtke, Head of the Malteser people. I watch how the nurses press their Foreign Aid Department, has told how stethoscopes onto the swollen stomachs of people even experience something like the pregnant women to eavesdrop on the a “bushification effect”. If they’re far unborn. Seven children per woman. That’s away from our civilisation for too long the average in the Congo. they begin, for example, to stop assessing After ten days I return home healthy. dangers correctly. - Does the project Thankful. My head is full of images. And I coordinator, Dr. Alfred Kinzelbach, still am several valuable experiences richer. assess dangers realistically? This appalling Anne Balzer (Hessian Radio, rebel leader, for example, and his warlike Co-author of the report boys with their machine guns and reflecting “Water for Ariwara”/May 2004) Dr. Constantin von Brandenstein sunglasses. Out of sheer frustration with a (2nd from left) and Ingo Radtke (right) with project coordinator Dr. Alfred Kinzelbach (left) and local staff on the project.

Anne Balzer in conversation with Dr. Alfred Kinzelbach, project coordinator in Ariwara.

CENTRAL AND EASTERN EUROPE / PARTNERSHIP WORK ABROAD 21 United Nations – Peacekeeping missions

For 14 years now Malteser Germany has been charged with the medical and first aid care of peacekeeping missions of the United Nations.

UNAMA - United Nations Assistance Treatments and medical examinations Mission for Afghanistan In June 2004 our mission to provide Patients/recruits 2004 2003 medical care for the UN organisations in Treatment of patients 7,326 5,799 Kabul ended. Malteser Germany had taken Physicals 1,260 873 charge of this task for two years on behalf Laboratory analysis 17,399 22,092 of the German Federal Foreign Office. In X-rays 3,654 4,874 the second half of the year the team with its Dentist treatments 1,128 ./. seven staff members concentrated on setting up medical structures at the police academy in Kabul and in the police headquarters in Trainings the provinces. 2004 was very much a year of Participants 2004 2003 consolidation. From its temporary be- First aid course 43 138 ginnings in the summer of 2002, the First aid course “Train the trainer” 65 83 German Malteser Hospital has developed into a well-functioning general medical institution. Through training and further education, the Malteser team had been preparing the specialist Afghan staff to assume direct control of the hospital. In the middle of December the official handover took place to the commander of the police academy; Malteser Germany stood by in an advisory capacity until 30 June 2005. Support work in the provinces also got under way: Malteser Germany set up a police medical testing laboratory in Herat in the west and trained police and border police in first aid there.

Ceremonial handover of the German Malteser Hospital to the commander of the police academy.

Taking blood under the supervision of the Head of Mission.

22 UNITED NATIONS For the others – Interview with MD Kai Stietenroth, Head of Mission of the Malteser German Medical Team in Kabul

Kai Stietenroth, born in 1970 in Wolfenbüttel, has been a doctor since 1999. He spent a practical year in Trinidad and wrote his doctoral thesis about a leprosy project in India. Since February 2004 he has been working as a doctor for Malteser Germany in the German Medical Team in Kabul/Afghanistan.

Why did you become a doctor? How are you handling the aggravated What is your experience of the The medical profession has fascinated security situation? rehabilitation and how do you assess the me right from my early childhood. Albert The murder of the two local Malteser staff future of the country? Schweizer especially appealed to me. in south-eastern Afghanistan last August Kabul especially is a very dynamic city Interest in the old jungle doctor was shocked the entire team. However, the at the moment; construction work is taking perhaps the first indication of my current incident won’t stop us from continuing the place and work going on everywhere. occupation. work. The people at whose expense these Things look different in the province, so far conflicts are being pursued are here, as only a small amount of international aid has How did the contact with Malteser elsewhere in the world, always the children arrived. That’s why, in addition to the project Germany come about? and women, the old, the sick and the weak. in Kabul, Malteser Germany is active in the I had already known about Malteser west, in the south-east and in the central Germany’s projects for a fairly long time. A region. The Afghans are expecting stability year before my deployment in Afghanistan from the outcome of the latest elections. I had applied for a project on the border Nevertheless, there’s no doubt that years between Iraq and Kuwait that was called of effort by the international community off because of the political changes. Then, are necessary to bring health, education, at Christmas 2003, my telephone rang: a the infrastructure and democracy up to an job in Kabul had become vacant at short acceptable level again. The people here are notice. trusting that the world won’t forget them What are your tasks during this operation again. in Afghanistan? Heike Otto and Petra Ipp conducted the As the Malteser German Medical Team interview with MD Kai Stietenroth. Re- we are helping to build up the Afghan police MD Kai Stietenroth, printed by kind permission of the Nie- Head of Mission of and thus contribute to greater security in the Malteser German dersächsisches Ärzteblatt (Lower Saxony the country. We assist them, for example, in Medical Team in Kabul. Medical Journal). the general medical care for police recruits and policemen. To this end we’ve set up a small hospital in the police academy. Until the middle of the year, in addition to this activity we were also responsible for the general medical care of the staff of the UNAMA mission and involvement in emergency operations for the United Nations.

What is your everyday working life like in Kabul? One important task is our first aid courses for policemen and courses for paramedics and nursing assistants. We are improving organisational procedures in further and advanced vocational training and giving our Afghan colleagues the necessary knowledge to enable them to manage the hospital soon on their own account.

Blood test in the lab of the German Malteser Hospital on the site of the police academy.

UNITED NATIONS 23 Facts and Figures Experts abroad

Expatriate employments per region

Special projects - 15

Africa - 37

Balkans - 3

Asia - 37

Expatriates by education and occupation

trainees/ project assistants - 11 physicians - 20

paramedics - 5

nurses and orderlies - 8

others - 6

logistics specialists/ administrators - 15

project managers - 27

24 EXPERTS ABROAD Local staff employment Malteser volunteers and per region their activities abroad

Countries 2004 2003 2004 2003 2002 Africa 346 359 Number of activities abroad 506 529 531 Angola 24 12 of which transports of relief items 352 385 388 DR Congo 98 80 Tonnage 4,265 4,404 3,504 Ethiopia 12 22 Journeys without tonnage 154 143 143 Kenya 23 20 Number of kilometres driven 1,298,460 1,351,050 1,337,701 Mozambique 0 8 Number of volunteers 2,430 1,727 2,019 Sudan 170 198 Total number of volunteers (honorary/paid) 2,538 1,832 2,086 Uganda 19 13

Zimbabwe 0 6 The 130 German Malteser subdivisions, which in 2004 were linked by a total of 230 partnerships with organisations and projects in 27 countries, Asia 414 312 have shown an undiminished level of activity. Afghanistan 251 190 Cambodia 20 40 Iran 2 0 Myanmar 110 52 Thailand 27 27 Vietnam 4 3

Balkans 34 39

Bosnia-Herzegovina 19 20 The areas of responsibility and activities of our local Kosovo 11 13 staff are characterized by Macedonia 1 3 a large variety. They work, Serbia 3 3 for example, as project supervisors, logistics specialists, secretaries, administrative Special projects 28 34 staff, nurses and orderlies, physicians, lab technicians Afghanistan/Kabul 28 34 and lab assistants, translators, drivers, cleaning staff, gardeners, security personnel, Total 822 744 engineers or mechanics. Figures correct at: 31 December 2004

EXPERTS ABROAD 25 Incoming donation and project expenditure

Development of incoming donations

This table includes donations for longer-term 3,234,585.00 € 3,045,408.00 € and regular programmes/projects as well as 3,000,000.00 € receipts following appeals for donations at the € time of disasters. 2,500,000.00 € 2,466,175.00 The tsunami donations will only be recorded in 2005 and are therefore not contained in this 2,000,000.00 € table. Donations received for the tsunami disaster 1,500,000.00 € currently amount to approximately EUR 28 millions, of which approximately EUR 15 mil- 1,000,000.00 € lions were received via the “Action Campaign Germany Helps” appeal. 500,000.00 €

0 2002 2003 2004

Project expenditure by source of funding

Caritas, PMK, WFP and other UN organisations 1,43% ADH Aktion Deutschland Hilft (Action Renovabis and others 1,54% Campaign Germany Helps) Miscellaneous (GTZ, DAHW, ADH BMZ Bundesministerium für wirtschaftliche UNHCR 7,59% and others) 2,33% Zusammenarbeit und Entwicklung (German Federal Department of Donations and Economic Cooperation and EuropeAid own resources Development) and other EU MHD 35, 04% DAHW Deutsche Lepra- und Tuberkulosehilfe departments (German Leprosy and Tuberculosis 8,18% Relief Association) ECHO Europäische Kommission – European Commission ECOM Emergency Corps of the Order of Malta GTZ Gemeinschaft für Technische Zusammenarbeit (Community for Technical Cooperation) ECOM/ KfW KfW Entwicklungsbank (Development Order of Malta Bank - KfW Banking Group) 0,13% MHD Malteser Hilfsdienst (Malteser ECHO 23,02% Germany) PMK Päpstliches Missionswerk der Kinder Federal Foreign Office (Papal Mission Organisation for of Germany 11,03% Children) UNHCR United Nations High Commissioner KfW 6,0% BMZ 3,69% for Refugees

26 INCOMING DONATIONS AND PROJECT EXPENDITURE Project expenditure by relief sectors

Special projects 4,95%

Miscellaneous (combined relief sectors and indirect project costs) 20,36%

Emergency and disaster relief 36,17%

Structural aid 5,72% Rehabilitation 32,8%

Direct project expenditure (rounded up) by regions/areas

Special projects Special projects EUR 925,000.00 EUR 705,000.00 Latin America EUR 20,000.00 Balkans EUR 2,465,000.00 Africa EUR 6,165,000.00

Asia EUR 6,160,000.00

INCOMING DONATIONS AND PROJECT EXPENDITURE 27 Project expenditure by countries

Project turnover Region Country (EUR) rounded Region total

Africa Angola 365,000.00 DR Congo 3,515,000.00 Ethiopia 315,000.00 Kenia 485,000.00 Mozambique 60,000.00 South Afrika 25,000.00 Sudan 1,320,000.00 Uganda 75,000.00 Multi-country project expenditure 5,000.00 6,165,000.00 �

Asia Afghanistan 2,210,000.00 Cambodia 350,000.00 India 1,040,000.00 Iran 460,000.00 Iraq 40,000.00 Myanmar 1,020,000.00 Sri Lanka 10,000.00 Thailand 895,000.00 Vietnam 130,000.00 Multi-country project expenditure 5,000.00 6,160,000.00 �

Balkans Bosnia-Hercegovina 925,000.00 FYROM (Macedonia) 280,000.00 Kosovo 790,000.00 Serbia 320,000.00 Turkey 150,000.00 2,465,000.00 �

Central and Albania 5,000.00 Eastern Europe Latvia 35,000.00 Lithuania 100,000.00 Poland 25,000.00 Romania 140,000.00 Russia 100,000.00 Ukraine 220,000.00 Multi-country project expenditure 80,000.00 705,000.00 � *“Miscellaneous expenditure” is made up as follows:

Special Afghanistan 920,000.00 Indirect project expenditure: projects Kuwait 5,000.00 925,000.00 � - expenditure on project management and supervision - pro rata expenditure on recruitment, development Latin America Dominican Republic 20,000.00 20,000.00 � and support of project personnel - pro rata expenditure on media and public relations activity Direct project expenditure 16,440,000.00 � Head office, general administrative costs: Miscellaneous expenditure* 2,140,000.00 � - non project-specific costs for personnel, IT, Total 18,580,000.00 � accounting, rents and similar items

28 PROJECT EXPENDITURE BY COUNTRIES Profit and Loss Account for the period from 1 January to 31 December 2004

2004 2003 € € € €

1. Sales 90,969.51 59,156.37 2. Other operating income 12,658,712.48 12,749,681.99 18,625,859.17 18,685,015.54 3. Cost of materials a) Cost of raw materials, consumables and supplies 4,285,733.21 4,385,258.77 b) Cost of purchased services 777,922.22 3,655,692.34 4. Personnel expenses a) Wages and salaries 2,618,615.09 3,136,633.84 b) Social security and other pension costs 647,163.66 752,378.38 - of which in respect of old age pensions 122,538.59 (prior year 146,502.07) 8,329.434.18 11,929,963.33 Interim result 4,420.247.81 6,755,052.21 5. Income from release of payables to earmarked allocations 10,739,340.79 8,734,743.35 6. Income from release of special items including allocations for financing fixed assets 21,485. 00 26,229.00 7. Expenses for transfers to payables to earmarked allocations 4,592,868.07 6,167,957.72 9,835,986.94 -1,075,014.59 8. Depreciation on intangible fixed assets and tangible assets 221,217.85 205,651.15 9. Other operating expenses 9,999,318.02 10,220,535,87 5,487,931.78 5,693,582.93 Interim result 367,669.66 -13,545.31 10. Other interest and similar income 168,080.74 247,096.42 11. Interest and similar expenses 2,006.85 166,073.89 10,088.84 237,007.58 12. Results from ordinary activities 533,743.55 223,462.27 13. Other taxes 29,190.74 -56,073.10 14. Net income for the year 504,552.81 279,535.37

Certificate

Audit opinion to Malteser Hilfsdienst e.V. We have audited the annual financial statements of the such that inaccuracies and violations materially affecting the Our audit has not led to any reservations. Division Generalsekretariat, Abteilung Auslandsdienst, Köln, presentation of the financial statements are revealed with Cologne, 15 June 2005 of Malteser Hilfsdienst e.V., Cologne, for the financial year reasonable accurance. Knowledge of the business activities KPMG Deutsche Treuhand-Gesellschaft from 1 January to 31 December 2004 taking ino account and the economic and legal environment of the Association Aktiengesellschaft the accounting records. The accounting and the preparation and the Auslandsdienst and expectations of possible Wirtschaftsprüfungsgesellschaft of the financial statements in accordance with the German misstatements are taken into account in determining the (Auditors) generally accepted accounting principles are the responsibility audit procedures. The effectiveness of the accounting related of the Association’s management board. Our responsibility is internal control system and the evidence supporting the to express an opinion on the financial statements, including disclosure in the books and records as well as the annual the accounting records, on the audit performed by us. financial statements are mainly examined on a sample We carried out the audit of the financial statements basis within the framework of the audit. The audit includes according to § 317 HGB [Handelsgesetzbuch: German assessing the accounting principles applied and significant Commercial Code] in conformity with the generally estimates made by the Association’s management board as accepted auditing standards stipulated by the Institut der well as evaluating the overall presentation of the financial Wirtschaftsprüfer [Institute of Auditors - IDW].According to statements. We believe that our audit provides a reasonable these standards the audit has to be planned and performed basis for our opinion.

PROFIT AND LOSS ACCOUNT 29 Notes to the Profit and Loss Account

For consolidation reasons, the Profit and UNHCR of EUR 856,068.26 are contained Expenditure Loss Account of the Malteser Foreign Aid in Contributions by third parties, as are The items Cost of materials and Department is prepared according to the the project funds of Caritas International, Personnel expenses include a part of system of accounts established by Malteser UNICEF, the German Leprosy and the project costs (e.g. costs of medicines Hilfsdienst e.V. (Malteser Germany). The Tuberculosis Relief Association (DAHW) and relief items of a combined total of structure of the Profit and Loss Account (but and the Order of Malta. Income from EUR 4,285,733.21; payments to building not the audited contents) therefore differs donations and internal Malteser organisation contractors in rehabilitation projects; in some respects from the presentation of contributions amounting to a combined costs of international and local project data elsewhere in this Annual Report and is total of EUR 3,419,098.68 is shown under personnel), but also parts of the indirect briefly explained in the following notes. Other operating income. project costs and administrative costs (non Grants from fund providers which cannot project-specific personnel costs). Income be used in the current financial year (e.g. The item Other operating expenses Sales revenues include all income for projects that last for several years or also includes direct project costs (e.g. from supplies and services provided. are carried over into the next year) as well structural aid and direct project support for Allocations and grants from the public as donations which cannot be used fully local partners in Eastern Europe of EUR sector include project funds provided by in the current financial year (since a large 417,111.06; freight and transport charges) the German Federal Foreign Office and the proportion of donations is received at the as well as indirect project costs (pro rata German Federal Department of Economic end of the year) are carried over to the next costs of media and public relations, costs Cooperation and Development (BMZ) year and then used. The use of these funds of personnel recruitment and support) and of EUR 2,552,108.14 (of which EUR is shown under Income from the release administrative costs (rent, IT). 925,893.36 was Foreign Office funding for of payables from investment allocations/ In 2004, administrative costs amounted special projects, formerly UN missions), donations and grants not yet used (the to less than 6% of our total expenditure. and by the European Union of EUR carry-over of such funds to the following 3,265,446.86). Church contributions year is shown under Expenses from the include project resources of EUR transfer of payables from donations and 73,321.14. The project funds provided by grants not yet used).

30 PROFIT AND LOSS ACCOUNT affix stamp Our assistance in 2004 at a glance Please

We carried out more than 80 projects and programmes in 34 countries with a total turnover of EUR 18.6 millions… Around 100 experts were sent on assignment around the world…

Over 800 local staff take care of our projects… International Malteser Kalker Hauptstraße 22-24 Köln D- 51103 GERMANY Around 6 million people worldwide benefit from our programmes worldwide… More than 110,000 donors support our work financially… 2,430 male and female volunteers of Malteser Germany foster 230 partnerships with projects and groups in Central and Eastern Europe… In 506 missions, they have distributed over 4,200 tons of relief items… Sender Family name, Christian name Street, house number Post code, town eMail address Malteser Archiv Malteser

Published by: Malteser International, Kalker Hauptstr. 22-24, D- 51103 Cologne,Telephone +49 (0)221 9822-151, Fax +49 (0)221 9822-179, [email protected] Responsible for content: Ingo Radtke Editor: Petra Ipp (editor-in-chief), Janine Hammans Layout/Setting: Alexander von Lengerke Translation: Puretrans (Glees & Purer OEG) Photographs: Malteser archive, Birgit Betzelt, Andreas Friese, Claudia Leipner, Kurt Oxenius, Ralf Pahlmann, Thilo Schmülgen, Sven Torfinn, Jochen Voigt

Graphics/production: Malteser graphic designer team, Jörg Röhrig (director) Banking Group) - KfW municipal entities of Malteser Germany for Children) Mission Organisation for Refugees) plus countless other local, national and international partner organisations. We also thank all our cooperation partners We European Commission – Humanitarian Office Entwicklungsbank (Development Bank KfW and Malteser Hilfsdienst e.V./diocesan Päpstliches Missionswerk der Kinder (Papal Renovabis UNHCR (United Nations High Commissioner Fund) UNICEF (United Nations Children’s Child Foundation World ● ● ● ● ● ● ● ● Germany) Zusammenarbeit und Entwicklung (German Federal Department of Economic Cooperation and Development) Entwicklung (Centre for International Migration and Development) Association) Relief Tuberculosis Leprosy and Archbishopric of Cologne Aktion Mensch (Action for Humanity) of Amt (Federal Foreign Office Auswärtiges Wirtschaftliche Bundesministerium für Centrum für Internationale Migration und (German V. e. Tuberkulosehilfe Deutsche Lepra- und Thank you! For their support in 2004 we want to say “thank you” all companies, foundations, societies, schools, as well all our members, donors and sponsors that with their donations have parishes and organisations made it possible for us to help people in need around the world. for their generous support of our work, especially: ● ● ● ● ● ● customers, whether the staff of a company collect the cents of their salaries as a donation, whether a parish wants to get Germany, Malteser via that, sure be can you people: needy involved of behalf on your help will arrive where it is needed most. Questions? Any questions about our projects? you like to know more about our work? Would to us or call: Write +49 (0)2 21 / 98 22-151. Telephone Or visit our website: www.malteser-international.org Individual donations Individual Use the payment form and state the name reference so of that the donation the can be country used for the as project area you the select. Regular contributations debit direct a issue or society, bank your with order standing a up Set can cancel both at any time. mandate - naturally you and anniversaries celebrations Family There are many occasions on which you might want to share your happiness with others: birthdays, weddings, company anniversaries a donation for a Malteser project. Ask your guests for etc. Legacies and foundations people to estate your of part dedicate can you Germany, Malteser Via or even set up your own foundation. who live in need and poverty, Imagination There are no limits to your imagination. Whether a company wants to donate to a project instead of sending Christmas presents to its There are many ways to help us get our job done. job our us get to help ways many are There

Please send me further Malteser Germany is a member in the following networks and associations, among others: information on ● Aktion Deutschland Hilft (ADH) (Action Campaign Germany Helps) ● Aktionsbündnis gegen AIDS (Action Against AIDS Alliance) ● Arbeitskreis Medizinische Entwicklungshilfe (AKME) ) (Working Group on Medical p Malteser International Development Aid) p Sponsor membership ● Koordinierungsausschuss Humanitäre Hilfe (KAHH) (Coordinating Committee for p Donation opportunity Humanitarian Relief) ● Katholischer Arbeitskreis Not- und Katastrophenhilfe (KANK) (Catholic Working Group p Will donation on Emergency and Disaster Relief) p Setting up a foundation ● People in Aid p Active membership ● Verband Entwicklungspolitik Deutscher Nicht-Regierungs-Organisationen (VENRO) (National Association of German Non-Governmental Organisations for Development Policy) ● Voluntary Organisations in Cooperation in Emergencies (VOICE) I like the Annual Report… We have committed ourselves to observe, inter alia, the following national and international p very much p quite a lot p not so much p not at all codes and standards: ● The Sphere Project: Humanitarian Charter and Minimum Standards in Disaster Response The Annual Report should contain more… ● The Code of Conduct: Principles of Conduct for the International Red Cross and Red information p Yes p No Crescent Movement and photos p Yes p No ● NGOs in Disaster Response Programmes ● Principles for the International Work of the German Caritas Association figures p Yes p No ● Code of Conduct to protect children and young people from abuse and sexual exploitation Ideas/comments:______(Caritas Internationalis)