Medair

International Humanitarian Aid Organisation

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Health Services

Health Services

Why Health Services?

 

The world’s most vulnerable areas are often places that have been struck by natural disasters or conflicts. However, the most serious threat to the health of affected people in these areas usually has more to do with illnesses and outbreaks rather than with actual violence or injury. A 2006 mortality study in the Democratic Republic of Congo showed that most of the 3.9 million deaths attributable to the conflict from 1998-2004, were, in fact, illness-related:

 

“Most deaths were from easily preventable and treatable illnesses rather than violence… Improving food security and increasing access to essential health services such as immunizations, clean water, insecticide-treated bednets, and case management of common diseases, have the potential to contribute greatly to reductions in excess mortality.”[1]

 

When there is war or major displacement because of a natural disaster, there are two levels of medical help required. The first is immediate treatment for a variety of injuries such as wounds from guns, bombs, and landmines, or crush injuries in earthquakes. The second is to provide the population with access to primary health care, with particular emphasis on prevention and treatment of infectious diseases. In many situations of massive displacement, the major killers are diarrhoea, respiratory infections, measles, malaria, and malnutrition.  These are preventable diseases which can usually be easily prevented or treated within the context of primary health care.

 

Medair’s Health Services Sector
Therapeutic feeding in Southern Sudan

Therapeutic feeding (Southern Sudan)

 

Medair’s involvement in Health Services began in our inaugural year, with our first project in Soroti, Uganda, in 1988. The Medair team assisted the general population with vaccination projects and medical evacuations, and also provided nutritional support for tuberculosis patients.  Since that time, our Health Services sector has continued to grow, and has become one of our three key sectors of expertise.

Medair’s main focus is on Primary Health Care, which includes both preventative and curative services. We are committed to working alongside communities as we implement and conduct our Health Services programmes.

Preventative Services:

These services include routine vaccinations of children and women, antenatal clinics, health education, de-worming campaigns, and the distribution of long-lasting insecticide-treated mosquito nets.

Curative Services:

Curative services include basic care for the most common diseases and, where possible, referral to the nearest hospital for more complicated cases. Curative services may also include emergency obstetric care, and specific disease control programmes for diseases such as tuberculosis, trachoma, and guinea worm.

Both preventive and curative services are usually delivered through fixed clinics, or mobile clinics when access or security is difficult.  Some preventive services are delivered at the village level by trained community health workers.

Emergency Response

We maintain a capacity to respond to outbreaks of diseases such as cholera or meningitis in countries where these are significant problems. 

In some countries, Medair includes nutritional programmes for children and mothers, ensuring they are screened and appropriately treated for malnutrition. Elsewhere, in countries such as D.R. Congo and Uganda, Medair provides psychosocial support to conflict-traumatised people, particularly children.

 

Secondary Health Care

Medair sometimes focuses on secondary health issues, such as maternal health. If no other agency with this expertise is available, Medair very occasionally supports local health personnel in emergency surgeries.

 

Core Strengths of Medair’s Health Services Sector
Medair doctor examining patient

Medair doctor examining patient


Experience

Medair has been delivering Health Services since our first programme in 1988. Now, almost twenty years later, we have gained invaluable experience and are at the forefront of the field, bringing life-saving care to beneficiaries in remote and insecure areas around the globe.

Needs Assessment

Medair’s emphasis on accountability includes conducting operational research to ensure an understanding of the health problems of beneficiary populations.  We conduct baseline household surveys and malaria studies; KAP (knowledge, attitude, practice) studies to explore attitudes and behaviours in seeking health care or general illness prevention; studies which explore the specific outcome of mosquito-net distributions; and mortality studies to examine the impact of our interventions.

Beneficiary Feedback

Medair seeks feedback from beneficiaries regarding the health care they receive, which helps us to monitor the quality of care and whether it is really accessible for the populations most at-risk.  This has helped us to remove cultural or language barriers that might prevent patients from seeking help, for example, ensuring that we find female health staff so that women are able to go to clinics in conservative societies.

Flexible Approach

Health Services includes everything from urgent emergency response to longer-lasting rehabilitation with preventative and curative health care. As such, it is imperative that Medair’s Health Services teams be able to respond instantly to a variety of health needs. Our flexible approach and our dedicated staff enable us to respond efficiently and effectively to challenging and sometimes dangerous situations.

Capacity Building

Medair focuses on strengthening local systems wherever they exist, rather than setting up separate clinics which are entirely dependent on Medair and not the government system. We emphasise the training of health care staff in the use of standardised treatment protocols and rational prescribing, in order to improve the level of service provided, and as an investment in the long-term future of health care in a region. Working alongside communities not only ensures the independence and dignity of beneficiaries, but also the stability and longevity of Health Services programmes.

 

Maintaining Consistent Standards and Quality of Care

We ensure that our health projects receive strong supervision, which includes regular monitoring of the quality of care provided. We use standard protocols and essential drugs in line with national and international recommendations.

Coordination with Other Agencies

Medair works in close cooperation – not competition – with other actors in the humanitarian sector. This allows us to provide the best and most useful support possible. The same applies when we are coordinating efforts to achieve synergies with other Medair sectors, such as WatSan or Shelter & Infrastructure.

 

Passionate About Serving the Vulnerable

Medair looks for areas that are not receiving assistance from other agencies. Often this means that we are working in remote, difficult-to-access areas, or isolated sub-sets of the community. This leads to many logistical challenges regarding the transportation of personnel and medical supplies. Medair’s experienced logisticians are an immeasurable asset, allowing Health Services to be provided where they otherwise would not.  

Case Study: Sudan (Northern and Southern States)

After maintaining a longstanding primary health care support project in Darfur, Medair was forced to rapidly change to an emergency relief mode after attacks on villages in 2003. Medair continues to support Primary Health Care, but the teams still have to address emergency outbreaks of malaria, bloody diarrhoea, meningitis, and measles in displaced populations throughout Sudan.

Case Study: Afghanistan

In Afghanistan, approximately one in nine women dies during or shortly after pregnancy, and in remote areas, this figure is even worse.  The northeastern province of Badakhshan has the highest recorded maternal mortality rate in the world.[2]  It is an area that subscribes to strict Islamic tradition. For this reason, one of Medair’s priorities was to establish female health workers, so that women would be able to come to clinics. In addition, as the nearest hospital was out of reach of most of the population, Medair trained and supported emergency obstetric care in the central clinic.

Case Study: Democratic Republic of Congo

Medair supports the provision of drugs and training to over 600 health facilities in northeastern D.R. Congo. Two areas of special emphasis are malaria prevention and treatment, and the deployment of the effective Artemisin combination therapy (ACT) drugs. Teams also regularly respond to outbreaks of disease such as cholera, measles, and plague.

  


[1] Coghlan, B., Brennan, R., Ngoy, P., Dofiara, D., Otto, B., & Stewart, T. (2006). Republic of Congo: A nationwide survey.

[2] Maternal Mortality in Afghanistan: Magnitude, Causes, Risk Factors and Preventability.

Summary Findings. Linda Bartlett, MD, MHSc, UNICEF. 2002

Other Sectors of Expertise

Water & Sanitation
Shelter & Infrastructure