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The most frequently reported causes of ill health are malaria, respiratory infections, diarrhoea and intestinal parasites . The Under-5 mortality rate for Angola in 2003 was 260/1,000 live births and life expectancy at birth is only 40 years . Coverage of immunisations is poor; only 46% of one-year-olds were fully immunised against DPT in 2003, and only 62% against measles.
In Angola, 10% of under-fives are reported as sleeping under a bed net, and only 2% under an insecticide-treated net.
The adjusted maternal mortality ratio in 2000 for Angola was 1,700 / 100,000 live births, with the lifetime risk of maternal death at 1 in 7 . Medair has given technical support to the provincial maternity hospital in Luena since mid-2002 until the end of 2005. But even though the standards of care in this hospital have improved, many women have little chance of getting to Luena due to long travelling distances, broken bridges and mined roads. Although we do not have formal statistics on obstetric complications and maternal deaths in Bundas municipio, the Medair medical team has definitely seen increasing numbers of obstetric complications presenting to the health centre over the past year as the population has increased .
How is Medair addressing the problem?
By:
- Rehabilitation, equipping and supplying 4 new Health facilities
- Support & supervision of existing Health Centre (1) and Health Posts in communal centres(6)
- Support to first referral level hospital in Lumbala N’guimbo
- Implementation of National Malaria Control Programme.
- Traditional Birth Attendant (TBA) training and support.
- Community Health promotion campaign.
- Logistical Support to National Essential Medicines Programme (PNME) for Moxico province
Who is Medair assisting ?
Returnees constitute the vast majority of the 40,000 people in Bundas Municipality. However, some of these people live in very remote villages, still one to two days’ walk from a communal centre. Thus, it is not expected that all communities will have a health centre within 5 hours travelling distance, even with 4 new centres built and staffed in 2006. By the end of this project phase it is expected that around 70-75% (28-30,000 people) of the population will live within ‘acceptable’ reach of health facilities. Most of the remote bairros have small populations.
- 2,500 consultations are expected to take place in Health Posts each month
- Up to 30 government nurses will receive training and support
- Up to 150 local Traditional Birth Attendants will receive training and support
The target population is composed of families that have almost all been displaced at some time during the war, some as IDPs and many as official or unofficial refugees in Zambia. Most of the former IDPs returned to settle in the area two or three years ago. The majority of the former refugees have returned to the area within the past two years. They are living in areas where the infrastructure is non-existent or limited especially with regard to health, clean water and education. Many of the refugees had access to a higher quality of health care in the refugee camps in Zambia.
2. Water and Sanitation
What are the core issues that Medair is aiming to address?
Since the end of the war in 2002, over 26,000 former refugees have returned to Bundas Municipality, the vast majority of these since August 2004. These people have returned to an area totally devastated by the deprivations of the war and without access to the most basic health or social services. In particular, the majority of returnees do not have access to safe water and sanitation facilities with all its attendant health issues. Water related diseases are consistently the major cause of illness amongst the population.
How is Medair addressing the problem?
By:
- Improving access to clean water for the populations living within the Bundas Municipality through the construction of 15 new community dug wells and the installation of pumps on 22 existing wells
- Improving the health and sanitation of the populations in Bundas Municipality through the construction of a minimum of 1,000 new latrines and the distribution of basic hygiene kits
- Strengthening cooperation with water-related government and community institutions at provincial and municipal levels
Who is Medair assisting?
- 18,500 people served by new or improved wells
- 6,000 people served by 1,000 new latrines
Presence of Medair in Angola
Medair has been operational in Angola since February 2002. The first Medair programme, an Integrated Medical Programme for the War Affected and IDP Populations was established in Luena, Moxico. With an increasing focus on Mother and Child Health and particular support to the Provincial Maternity Hospital and a TBA programme based in and around Luena town, as well as initial PHC support, this programme finally came to an end in December 2005.
In August 2002, Medair participated in two interagency rapid assessments of critical needs along with African Humanitarian Action, Lutheran World Federation, OCHA, UNHCR, UNICEF, UNSECOORD, WHO, and others. These surveys visited Cangamba and Lumbala N’Guimbo. This was the first time that international humanitarian partners had been to either town in many years.
During 2003, Medair built up an operational base in Lumbala N’guimbo, and gained experience and expertise in Southern Moxico, running successful Health, Water and Sanitation, Construction and Agriculture projects. Medair is also the implementing partners for WFP and UNHCR.
During 2004 and 2005, Medair consolidated the Health, Water and Sanitation and Education projects implemented during 2003 providing essential services to vulnerable returnee populations, as well as continuing in partnership with UNHCR and food distribution for WFP.
Notes:
- Returnee Population – GIS Unit, UNHCR Angola, December 2005
- Patterson L, 2005, ‘An examination of the influences on health development post-conflict: Angola – in the transition’. MPhil thesis, Massey University, New Zealand
- Anecdotal evidence from discussions between these communities and Medair staff
- Government of Angola, 2003: “Strategy to Combat Poverty: Social Reinsertion, Rehabilitation, Reconstruction and Economic Stabilisation.”
- WHO Global Atlas website www.who.int/globalatlas, accessed on 14-10-05
- Monthly statistics from Lumbala health centre & Mobile Medical Team
- http://www.unicef.org/infobycountry/angola_statistics.html, accessed on 14-10-05
- ibid.
- ibid.
- http://www.unicef.org/infobycountry/angola_statistics.html, accessed on 14-10-05
- Reported by medical team in Lumbala-N’guimbo
- Patterson L, 2005, ‘An examination of the influences on health development post-conflict: Angola – in the transition’. MPhil thesis, Massey University, New Zealand
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