Health Action − in the North Caucasus NEWSLETTER ON EMERGENCY PREPAREDNESS AND RESPONSE APRIL-MAY 2005 Make every mother and child WHO missions to Chechnya count Nozhai-Yurt and Vedeno Districts In 2005, as every year, the World Health Day (WHD) was marked on 7 April. The In April and May 2005, WHO visited health facili- theme of this year is mother and child ties in Nozhai-yurt and Vedeno districts. Facili- health with the slogan: "Make every ties in both districts incurred significant damage mother and child count". during military activities in 1999-2000. The cen- tral district hospital in Vedeno was fully de- In the North Caucasus, recognition of the World stroyed and the majority of ambulatories and Health Day is particularly vital, as Ingushetia FAP are seriously damaged. and Chechnya are among the regions of the Russian Federation with the highest rate of ma- ternal and infant morbidity and mortality and birthrate. On 7 April WHO facilitated and organized in three republics of the North Caucasus a number of activities, including: • distribution of WHO World Health Day toolkits to interested health organizations and informa- tion material on mother and child healthcare to the MoH of Chechnya and Ingushetia; • lectures on legal aspects of protecting human life by representatives of state health facilities Ambulatory in Khatunni, Vedeno dictrict and school teachers; • round table discussions with participation of Health facilities in Nozhai-Yurt are supported by MoH officials, WHO representatives and leading MDM. Three district hospitals, two ambulatories MCH specialists, focusing on strengthening the and nine FAPs receive regular drugs, consum- provision of mother and child healthcare in the ables and selected medical equipment. region; WFP carries out school-feeding programme in 53 • airing TV episodes, recognizing the main schools and 3 kindergartens as well as some theme of 2005 World Health Day, etc. food-for-work projects. On the same day, the newly reconstructed sur- gery unit of the Republican clinical hospital in Vedeno district is supported by MSF-Holland North Ossetia-Alania and a new Republican cen- providing essential drugs and medical consum- tre for adolescents' rehabilitation "Kind Heart", ables to the central district hospital in Vedeno were opened, and a conference on first aid as- and district hospital in Mahkety villages. sistance in emergency situations facilitated by WHO assessed the central district hospital (CDH) the Ministry of Health and State medical acad- in Vedeno village, the FAP in Tsa-Vedeno village, emy, was held in Vladikavkaz. the ambulatories in Elistanzhi, Khattuni, Tevzini villages and the district hospital in Mahkety vil- Information about WHD can be found on the lage. WHO website www.who.int/world-health-day. Full report is available from WHO Moscow. 1 Humanitarian assistance in In- gushetia and Chechnya 2002-2005 WHO compared information on health services Seven (in 2003 ten) humanitarian organisations provided by humanitarian organisations in In- deliver medical equipment to Chechen facilities gushetia and Chechnya between 2002 and 2005 and five deliver to Ingushetia. years. The number of organisations providing individual In 2002 there were 30 organisations operating medical assistance as well as reference for out- in the health sector and in 2005 still 24. Main of-town treatment has changed from six in 2002 humanitarian activities were focused on support to two in 2005 for Ingushetia and seven to four of state and non-state health posts, operation of for Chechnya. mobile medical teams, drugs and medical Psychosocial rehabilitation projects have been equipment distribution, individual medical assis- traditionally popular and equally represented in tance, psychosocial rehabilitation and capacity both Republics with their reduction in Ingushetia building components, including various training (from 10 in 2002 to 7 in 2005) and 12 organisa- courses. tions running such activities in Chechnya. The In 2002 all health posts supported by humani- main difference is that Chechen projects were tarian organisations (10) were located in In- initially implemented mainly by local Chechen gushetia, with only one organisation maintaining NGOs, while at present they are run alsoy by its health post in Chechnya. In 2005, six organi- international humanitarian organisations. sations support health posts in Chechnya and Capacity building projects including various five in Ingushetia. training courses for health and non-health ex- Three organisations operate mobile medical perts have been growing and expanding in both teams in Chechnya; in Ingushetia seven organi- republics. There is a definite prioritisation by sations in 2002 and four in 2005. humanitarian organisations to couple aid deliv- The number of organisations involved in drug ery with strengthening local capacity building. In distribution in Ingushetia reduced as well (from 2002 there were four organisations involved in 12 in 2002 to 9 in 2005). In Chechnya drugs are capacity building programmes; 12 in 2005 for distributed by ten organisations in 2005 as in Ingushetia and six in 2002 and 15 in 2005 for 2002. Chechnya. INGUSHETIA AND CHECHNYA TB WHO continues distribution of WFP food com- Federal AIDS Centre, Federal TB/HIV Centre in modities to the Republican TB service in In- cooperation with international organizations and gushetia. In April-May a total of 200 people re- with support from Open Health Institute and ceived food assistance. World Health Organization. WHO funded participation of four Chechen and IMC carries out educational learning sessions on Ingush TB and HIV state experts in the scientific TB issues in Ingushetia. The programme covers and practical conference “TB in HIV infected pa- 30 settlements in Nazran and Sunzha districts tients” taking place in Moscow, on 25-26 May, where IDPs are tested for TB and also receive TB 2005. The conference was organised by the Rus- information material. sian Ministry of Health and Social Development, 2 Health situation MDM continued monthly assistance programme within its “rural medicine” project in Nozhai-Yurt MoH of Chechnya reports serious problems in district of Chechnya. Each of the assisted district implementation of the latest federal law N122 on health facilities (14) received required instru- payment of monetary compensation (“Benefits ments and equipment (scales, fridges, growth law”) in the Republic. An assortment of some measures, etc.) Three district hospitals received 350 various drugs is available in Chechnya with generators, dentist equipment and other instru- 250 of them distributed to assigned 7 state ments. pharmacies in Grozny and 14 in rural areas. Lack of computers and computerised network 18-25 May IMC organized a training course on required for drugs distribution registration is one first aid assistance for 24 doctors from Grozny- of the main constraints. Another problem is the Selsky and Achkhoi-Martan districts of Chechnya absence a complete list of people in need of fed- in Nazran. eral and republican drugs assistance. World Vision published 1000 booklets on acute Grozny city administration reports numerous respiratory infections treatment for distribution sites in Chechnya containing radioactive waste in Chechnya. with possible long-term health implications for the general population. Epidemiology and immunization Emercom requests equipment for detection and training courses on diseases related to radioac- SES of Russia issued a decree to carry out an tive environment. additional polio and measles immunisation in Chechnya and Ingushetia in April-May 2005. Health assistance UNICEF procured and distributed to 17 district and city hospitals in Chechnya and eight hospi- tals in Ingushetia 153,000 disposable syringes to IRC supplements 550 children in 10 IRC- facilitate the implementation of routine vaccina- supported schools in Ingushetia and 1377 chil- tion activities. As well, UNICEF initiated pro- dren in 5 schools in Chechnya with iron tablets curement of cold chain equipment for primary and carried out follow-up haemoglobin testing and secondary health care facilities in both re- on all children taking iron-supplements. publics. IRC conducted awareness trainings on nutrition and hygiene in relation to helminthes and anae- mia prevention in all their schools. HIV/AIDS In addition to regular supply of medicines and Chechnya medical consumables to ten hospitals in Chech- The Republican AIDS centre in Chechnya reports nya, one in Ingushetia and one in Dagestan, 116 new cases registered in 2004. According to ICRC provided in April a wide range of medical the latest information, there are 493 HIV cases (Kurchaloi and Urus-Martan regional hospitals) reported in Chechnya, including 78 women and and laboratory (Gudermes and Nadterechny re- 27 children, registered in the period from 1989 gional hospitals) equipment. As well, ICRC do- to 2005. The majority of registered HIV infected nated over 900 vials of insulin to ten policlinics patients is drug-users. of ICRC-assisted hospitals. The Republican Blood Out of 27 children, 17 were born from HIV- nd Bank in Grozny received the 2 quarter supply positive mothers. of medical donations. ICRC made a special do- There were 31 mortality cases, including one nation of emergency assistance for the flood vic- woman and seven children since 1989. The tims in Dagestan to two ambulatories in the main mortality causes among HIV/AIDS infected Khasavyurt region of the republic. people are tuberculosis and cardiovascular dis- eases.