Annual Report Dokters van de Wereld (Médecins du Monde Netherlands) 2011

Transcription

1 Annual Report Dokters van de Wereld (Médecins du Monde Netherlands) 2011 Dokters van de Wereld is the Dutch branch of the international medical development organisation Médecins du Monde. We supply medical aid to vulnerable groups everywhere in the world, even in the Netherlands, by promoting the right to access healthcare.

2 Dokters van de Wereld Annual Report 2011 page 1. Access to Medical Care in Overview of the Organisation 7 3. Key Figures Finances Budget Association Dokters van de Wereld International Network of Médecins du Monde Report of Projects Dokters van de Wereld 16 7a. The Netherlands Medoc / Access to Care for undocumented migrants 7b. Operation Smile - Dokters van de Wereld and network 7c. Serbia - Being aware : integration of risk reduction of drug use within the health system in Belgrade 7d. Indonesia, Aceh - Mother and child care project 8. Report of Projects Médecins du Monde France, financially supported by Dokters van de Wereld 24 8a. Ivory Coast - Access to care in times of crisis 8b. Colombia - Access to care for indigenous populations and Afro-Colombians 8c. Indonesia West Papua Improvement of sexual health and birth control 8d. Democratic Republic of Congo - Fighting HIV / AIDS 7e. Zimbabwe - The fight against HIV / AIDS and providing mother and child care in Chipinge 8f. Pakistan Helping women who are victims of violence 8g. Myanmar (Burma) Better care for mother and child 8h. Liberia - Improving the care for the national population 8i. Horn of Africa Kenya -Improving health care for displaced mothers and children 8j. Haiti Improving access to care 2

3 1. Access to Medical Care 2011 Access to medical care for everybody, everywhere in the world. This is what Dokters van de Wereld fights for. This ambition was put under pressure in 2011, amongst others by the bill of the administration to criminalize illegality. Dokters van de Wereld spoke out against this bill, because the threat of criminalization for people without residence permit would make it more difficult for them to realise their right to healthcare. We are pleased the bill has been rejected. One of the most important challenges was formed by the fact that Dokters van de Wereld did not belong to one of the coalitions which received Dutch government support in the form of cofinancing System (MFS). This represented about 1 million euro less income per year for international projects, and has compelled us to take further measures to diversify the fundraising. Just like in 2010 we heavily invested in direct mailing and telemarketing, but also door to door fundraising to acquire structural support for the organisation. We have also invested in inheritances and events, especially for Operation Smile, for which more people can be mobilised. In the coming years we will expand this and increase the visibility and the financial support of the organisation through this program. Growth in strength and expertise by focussing on programs To achieve growth in strength and expertise we focussed on a range of programs under our own implementation, in addition to raising funds for our French sister organisation. In the coming years we will focus on obtaining the access to care for undocumented migrants in the Netherlands and the care for mothers and children living in precarious conditions in developing countries. Additionally we will continue to expand Operation Smile project, in cooperation with Dutch University Hospitals. Medoc - access to care for undocumented migrants In 2011 we opened a new consultation practice in Amsterdam Zuid Oost, which has begun with the inscription of undocumented migrants in general practices in addition to the existing activities of providing information, mediation and outreach. At national level we have more than doubled the total number of patient consultations compared to 2010: 1367 consults in 2011 vs. 643 in More positive news is that we were able to increase the number of successful mediations to 84% (this was 49% in 2010). The accessibility of dental care is particularly bad in the Netherlands: dentists where responsible for 23% of the total number of denials of care. Dokters van de Wereld ran into several situations where patients where forced to pull their own molars. Together with other associations which denounce the issues of refugees and human rights in the Netherlands, Dokters van de Wereld has created a network. These organisations ensure the basic human rights of undocumented migrants in the Netherlands are guaranteed, despite the fact they are labelled as illegal by the government. Care for mother and child The focus of our work lies in developing and implementing sustainable mother and child care programs such as we do in Aceh, Indonesia. We have developed training on demand, train local medical staff and eventually facilitate so-called 'health committees' on community level in 28 villages. The local citizens themselves contribute to the actions to prevent and resolve bottlenecks in care through these committees. Dokters van de Wereld supports them with preventive means to be ready for the birth. Dokters van de Wereld is also actively connecting the communities to the existing local health care services. This way we strengthen the selfreliance of the communities in obtaining medical care. 3

4 In 2011 we visited Myanmar, with the aim to take over the project under Dutch management starting in 2012 for the mother and child care carried out by Médecins du Monde France. Since May 2012 this transfer became effective. Operation Smile Design and implementation of Dutch missions Children with congenital or acquired physical malformations have a particularly difficult life in developing countries. In addition to medical problems, they also have social problems because they are not accepted and are excluded by the communities. For this reason Dokters van de Wereld's Operation Smile conducts missions, in which children receive free reconstructive surgery from Dutch plastic surgeons who work entire free of charge. The purpose of Operation Smile is twofold: in addition to performing reconstructive surgery, local personnel are trained so ultimately they will be able to perform these medical interventions locally. To make the project sustainable we will create a clear link between the Dutch teams and the hospitals where we perform Operation Smile. The medical teams and the hospitals commit themselves to at least 3 years of executive support to the project, in order for a structural knowledge transfer to take place. In 2011 Dokters van de Wereld has performed a research mission in Bangladesh together with the Interplast Nederland foundation, which sends out teams for reconstructive operations since We are looking at how to best shape the cooperation in the coming years. The first Dutch Operation Smile mission took place in Bangladesh in November 2011, where a team of plastic surgeons of the VU University Medical Center (VUmc) and the Academic Medical Center (AMC) operated 126 children in 2 weeks time and trained 8 doctors and 18 nurses. In 2012 a follow-up mission will take place. Additionally preparations were made for two new missions in Sierra Leone in 2012, in cooperation with local hospitals and the University Medical Center Groningen (UMCG) and the Medisch Spectrum Twente (MST). Growth by joining forces and efficiency In 2011 we have taken steps to strengthen our organisation with structural partnerships, calibration of our own overhead costs and innovative ways to raise funds. One of our key partners is the Nationale Postcodeloterij, from whom we again received 500,000 Euros support in Each year the Nationale Postcodeloterij donates 50% of its revenue to charity; in total a sum of 3,5 billion Euros was donated to charity. A further extension of the cooperation was put into motion with Dutch companies. Based on a clear casus, where both Dokters van de Wereld and the company gain financial advantages, we have developed a partnership with companies that fit our social and sustainable business model. In addition to the existing partnership with L'Oreal, who supports our Operation Smile, we have developed a partnership with Weleda, which will be conducted in 2012 for the benefit of our mother and child care projects. In order to obtain a reference point for the percentage of overhead costs, we had the Berenschot management consultancy company make a comparison of other, similar organisations. This showed the total overhead costs per FTE and as percentage of the revenue was at least 15% lower than average at even larger organisations. This means we work efficiently and these costs take up a relatively limited part of our means. With a utilization rate of 86.7% of our objectives in relation to the total spending in 2011, and cost for management and administration at 2.9% of our total cost, this is an additional element in which we positively distinguished ourselves from other organizations. Finally Dokters van de Wereld is actively developing a social enterprise in the Dutch care, in collaboration with health insurers and care institutions. The reason for this is to provide access to quality care to citizens from different walks of life in the context of care impoverishment and 4

5 the growing inequality of health situations. At the same time this innovation creates a structural financial added value for the programs of Dokters van de Wereld. Our vision of the near future In a context where the development sector is under attack, and grants for national and international development projects continue to decline, the European crisis creates a new problem: the deterioration of access to care, especially in southern European countries such as Greece and Spain. The question at hand now is how the strong the European network of Dokters van de Wereld can be used to combat this. Even in the Netherlands we already feel the access to care in under pressure both financially and as a principle of solidarity. Dokters van de Wereld wants to continue to make the difference in relation to the access to medical care. To be able to accomplish this, we will increase our visibility as an organization through the program of Operation Smile and further development of programs at national and European level. We strengthen our resources by increasing sustainable cooperations with businesses and non-profit organizations, further development of events, increasing the number of donors and members. These are intense years in which we are convinced that by focussing in programs, maintaining low costs, innovation in fundraising and new partnerships, we will achieve our goal: access to care for people the world is forgetting little by little. Remco van de Pas Chainman of the Board Dokters van de Wereld Mirjam Koppe General Director Dokters van de Wereld 5

6 Thanks! Dokters van de Wereld would like to thank everyone involved for their dedication and contribution in 2011: Netherlands Ministry of Foreign Affairs / Matra program, Netherlands Ministry of Foreign Affairs / MFS I, Innovation fund Health Insurers, Maria Stroot Fonds, Aids Fonds/SBL, Cordaid, Commission PIN,, Fonds NutsOhra, Skanfonds, Stichting Janivo, Stichting RCOAK, Stichting RC het Maagdenhuis, Kerk in Actie, Congregation of Judie Postel, ING employees, L Oréal, the Nationale Postcodeloterij, the VriendenLoterij, PWC, Stichting Smile Train, interested people, directors, members, volunteers, donors, trainees and employees. 6

7 2. Overview of the Organisation Method of appointing directors & relevant outside activities The board is appointed by the General Assembly (GA), the highest body, also supervisory body of the association Dokters van de Wereld. The GA convenes at least once a year. Name Management function Outside activities Remco van der Pas Chairman (as per 22/02/2011) Tropical doctor Melissa Diaz Secretary Doctor, SOA/HIV combating Std Aids Netherlands Joost van Duin Treasurer (as per 22/02/2011) Financial Interim Manager Bernard Juan General Board Member Entrepreneur Francoise Sivignon General Board Member (Chairman up to 22/02/2011) Harm Peters General Board Member Doctor Casper van Rijn Treasurer (up to 22/02/2011) Radiologist, Mission responsible Burma MdM France Banker TREAs A Technical Referent/External Advisor (TREA) is connected to each project of Dokters van de Wereld. This person works on a voluntary basis and is closely involved in monitoring and supervising the project. In 2011 TREAs have visited their project multiple times and provided advice. The TREAs are: Petra Wisse for our project in Indonesia, Harm Peters for the Serbia project, Gerd Beckers and Tessa Versteegde for the national project for undocumented migrants (Medoc). For the Operation Smile project the TREA position remained vacant. Board of Advice The Advisory Council of Dokters van de Wereld was founded in The Advisory Council serves as a sounding board, opening to networks, booster of new ideas and projects and as a critical listener to the plans of Dokters van de Wereld. The Advisory Council convenes twice a year. The members of the Advisory Council 2011 are: Mr. Emeritus Prof. J. Pronk (Chairman) Mr. Prof. Dr. I.N. Wolffers Mr. Prof. Dr. H.S.A. Heymans Mrs. Prof Dr. C.M.A.M. van der Horst 7

8 Direction The General Director is responsible for the implementation of the strategy, as reflected in the annual plan and long-term plan. The financial framework is determined by the budget as proposed by the Treasurer and approved by the General Assembly. The General Director is also chairman of the management team. This team consists of representatives from the departments Projects, Communication & Fundraising and Finance and HR. The General Director represents Dokters van de Wereld in external meetings. The General Director also maintains contacts with delegations of the international MDM network. Since 1 January 2009 Miriam Koppe is General Director of Dokters van de Wereld. To determine the wages, we use a salary scale in line with similar organizations. In 2011, research by Berenschot indicated the salary levels of Dokters van de Wereld were 5% below the average salary level is similar NGOs. An annual (standard) increase in salary is only possible after good performance. Additionally an inflation adjustment can be applied. The grading of the Director is based on experience, education and age. She is evaluated by the Board once a year. The annual salary of the General Director is 67, gross for a full-time employment of 40 hours per week. Employees In 2011 the number of FTE in the office increased from 8.4 to 8.9 and from 3.3 to 3.9 FTE on projects. The following organisation chart is applicable from January 1, 2011: General Assembly Board Director 1 fte Head of Finance & HR Head of Comms & Fundraising Program Manager Program Manager 0.8 fte 0.8 fte (Int l) (National) HR Coordinator 0.6 fte Office Manager 0.8 fte Bookkeeper 0.4 fte Coordinator Private Fundrasing 0.7 fte Communicatio ns Officer 0.6 fte General Coordinator Aceh 1 fte Project Operation Smile Servia Project (partner VEZA) TREA (2x) Coord inst & event fundraising 0.8 fte Coordinator Medoc Project 0.75 fte TREA (2x Volunteer Office management Coordinator Migrants 0.6 fte Project employee Medoc 0.85 fte Medoc volunteers 45 pr year 8

9 Volunteers Dokters van de Wereld and volunteers are inextricably linked. The volunteers are vital forces for the operations of Dokters van de Wereld and we gladly offer them the opportunity to develop themselves. This applies to office work and to the national and international projects. Dokters van de Wereld believes it is important to keep both the salaried staff and the volunteers involved with all departments and activities of the organization. In volunteers where working at the office, in the following areas: Communication and Private Fund Raising, ISO, HR and Legal Support. The Dutch Medoc project for migrants enjoyed the intensive involvement of 45 (para) medical volunteers. In 2011, 10 medical and para medical professionals where send out to various projects. These volunteers where active in Burma, Liberia, Indonesia, Colombia, Ethiopia, Serbia, Pakistan and Bangladesh. 8 volunteers were involved with the Operation Smile project. 9

10 3. Key Figures Finances Developments in Revenue The total revenue available for the goals decreased from 2.8 million in 2010 to 1.9 million in the year In the budget, the total revenue available for the goal was budgeted at 2.0 million. The decrease in revenue is mainly due to the expiration of the grant from the cofinancing system (MFS I) of the Netherlands Ministry of Foreign Affairs. Developments in Expenditures The expenditures for the goal are broken down in education and awareness, preparation and coordination from the Netherlands for domestic and foreign projects, structural aid and emergency relief. In total 1.7 million Euros were send towards these goals. Our expenditure towards the goal compared to the total expenditures ( 1.96 million) was 86.7%. Key figures Description Standar d % spend on goal n.a. 86.7% 90.1% 91.9% 90.7% 91.3% 2. % own fundraising 25% 24.1% 20.7% 18.8% 16.5% 19.8% 3. % management and administration max 4% 2.9% 2.1% 1.9% 1.3% 0.6% Education and Awareness In 2011 a total of 421,000 was spend on education and awareness. This money was spent on the design and implementation of the education and awareness policy in the form of, among others events, campaigns and public education. Preparation and coordination from the Netherlands for domestic and foreign projects The cost for domestic and foreign projects amounted to 103,000 in 2011 for preparation and coordination from the Netherlands. Structural Aid The expenses for structural aid in 2001 amounted to 1.13 million and consisted of 301,000 for assistance/grants provided to projects directed by Médecins du Monde, 489,000 for projects directed by Dokters van de Wereld and 340,000 cover other implementation costs. The assistance / grants to projects under the direction of Médecins du Monde France include where spent on projects in the Democratic Republic of Congo, Zimbabwe, Ivory Coast, Pakistan, Colombia and Burma. 10

11 Emergency Relief Expenses for emergency aid totalling 46,000 and 45,000 for assistance / grants provided to projects directed by Médecins du Monde and 1,000 covers other implementation costs. The assistance / grants provided to projects directed by Médecins du Monde France have been spent on emergency relief missions in the Horn of Africa and Haiti. Implementation costs own organisation Compared to the year 2010 the costs for management and administration have almost remained unchanged at 56,000 ( 55,000 in 2010). The budget for 2011 was set to 55,000 in total. The organization strives to achieve a maximum of 4% of the total spending on management and administration. For 2011 the expenses amounted to 2.9% of our total spending. Developments in Equity Balance of income and expenses By the end of 2010 our equity showed a positive balance. At that time appropriated reserves were created to enable research of new projects, investments in fundraising and increasing our brand awareness in In 2011 the total expenditures where 77,000 higher than the total income. The reserves where addressed to cover this planned shortage. Reserves In 2011 our reserves decreased from 401,000 to 324,000. The continuity reserve remains stable at 214,000 at the end of The Board seeks a reserve level equivalent to approximately three months of operating costs, in addition to the contribution of Médecins du Monde to guarantee continuity. 11

12 4. Budget 2012 Vereniging Dokters van de Wereld Jaarrekening 2011 Begroting 2012 in EURO s Begroot 2012 Werkelijk 2011 Begroot 2011 Fondsenwerving Baten uit eigen fondsenwerving Baten uit acties derden Subsidies overheden en anderen Médecins du Monde Overige baten Totaal beschikbaar voor doelstelling Bestedingen Voorlichting/bewustmaking Voorbereiding en coördinatie Structurele hulp Noodhulp Kosten eigen fondsenwerving Werving baten (acties derden, subsidies) Beheer en administratie Totale bestedingen Overschot /tekort Toevoegingen / onttrekkingen aan de continuïteits reserve bestemmingsreserve

13 5. Association Dokters van de Wereld Association Dokters van de Wereld Dokters van de Wereld is an international medical development organisation. Our goal is: Supplying medical aid to vulnerable groups everywhere in the world, including the Netherlands, in order to improve the access and the right to health care and to testify in good conscience about the violation of human rights, as well as educating the public. Vulnerable groups We do not make any distinction as to religion, race or political affiliation. Dokters van de Wereld focuses on victims of armed conflicts and natural disasters, refugees, minorities, street children, AIDS patients and drugs addicts. Worldwide and in the Netherlands Dokters van de Wereld is not only active in the medical assistance worldwide, we are also active in health care in Europe and in the Netherlands. Right to access health care Our work consists of offering medical assistance in long term projects and emergency aid projects. Testimonies By publicing testimonies Dokters van de Wereld fights injustice like violations of human rights and injustice in access to health care. Education Dokters van de Wereld informs society about the actual activities in the projects. Our knowledge of medical aid is used to stimulate the conscience in society and to increase the support of the right to access health care. Impartiality We only supply aid in case of emergencies. We supply aid to everybody without making any distinction on religion, ethnical origin, gender, nationality, or political affiliation. Independence We do not promote national or international agenda s. We do not take position for or against the parties in a conflict. We refrain ourselves from financing originating military organisations. Because Dokters van de Wereld is supported by many private donors, we also offer help in areas which are not on the political agenda, but which do need aid urgently. Emergency aid We work on medical aid in crisis situations, as well as providing materials and medicine, building drinking water and sanitary installations. 13

14 6. International network of Médecins du Monde Dokters van de Wereld and Médecins du Monde international network Dokters van de Wereld is the Dutch brand of the international network of Médecins du Monde. The network consists of 14 international delegations with their own (inter-) national projects, which work closely together. Médecins du Monde France supports Dokters van de Wereld both financially and with the implementation of projects. Conversely, the same: Dokters van de Wereld finances projects implemented by Médecins du Monde France. All projects of Médecins du Monde France supported by Dokters van de Wereld in 2011 have been mentioned in the annual account. Additionally doctors and other professionals are recruited in the Netherlands and send out to foreign projects which are implemented by Médecins du Monde France. The annual account 2011 of Médecins du Monde France and the annual report, with an approved account auditor's reports provided by SCP GVA from Paris, can be downloaded via the website International Projects All projects of the international network of Médecins du Monde aim to realise access to care for vulnerable populations. These people have often been excluded because of economic, social, legal, religious or ethnical reasons. In 2011 all organisations of the international network of Médecins du Monde combined have implemented 151 international projects in 64 countries: - in Africa: 68 projects in 24 countries (45%); - in South America: 37 projects in 14 countries (24%); - in Asia: 22 projects in 13 countries (15%); - in North Africa and the Middle East: 17 projects in 8 countries (11%); - in Europe: 7 projects in 5 countries (5%). Médecins du Monde Greece has to deal with a large economic crisis in Greece. Doctors and other volunteers are currently working under difficult circumstances. The requests for help for national projects are growing by the day. More and more people need medical help. Even Médecins du Monde Portugal and Spain see a direct impact of the economic crisis in their national projects. Delegations of Médecins du Monde have supplied care to vulnerable people on the border between Libya and Tunisia during the revolution. All our teams in Haiti have battled the cholera epidemic and helped the Ministry of Health to take over the medical care. National projects, relief in a country with a delegation of Médecins du Monde In 2011 the international network of Médecins du Monde had 190 national projects in 13 countries to help people who did not have access to health care. Testimonies have been recorded and advocacy activities have been held on a regular basis with the health care authorities and politicians. This in order to improve the access to health care for vulnerable groups and to guarantee other fundamental rights. The international network of Médecins du Monde has worked on a specific European Advocacy project in 2011, the report on access to health care for undocumented migrants in Europe. Human Resources None of these projects could have been realized without qualified personnel, local and international. On a daily basis 7700 people worked on projects of the international network of Médecins du Monde. 14

15 Budget The international network of Médecins du Monde had a budget of 113 million Euros in

16 7. Report of projects of Dokters van de Wereld 7a. The Netherlands Medoc / Access to Care for undocumented migrants Dokters van de Wereld has been working since 2005 to improve the access to the Dutch health care for migrants without valid residence papers. Because of the absence of their residence status they are not allowed to take out health insurance. However, they are legally entitled to all medically necessary care. Barriers such as lack of information about rights and financial resources or fear of being arrested, impede good access. Activities 2011: Informing groups of migrants via the website, folders in their own language, local radio, self-help organisations and migrant churches Informing undocumented migrants about their rights and care options during individual consulting hours, at 3 locations (Amsterdam Centrum and Zuidoost, The Hague) and via the telephone helpline Offering blood pressure measurements, blood tests and self-care resources to close the gap to regular care Active inscription of undocumented migrants at GP practices Registration of access problems and mediation with health care professionals and facilities Advocacy with (local) government and health professional organizations, amongst others through a national NGO platform Results 2011: Consultancy and mediations: A total of 1,367 client consultancies have been given (714 in consultancy hours, 653 via telephone). 146 access problems where reported of refused or delayed care. Of these 84% was solved with mediation of Dokters van de Wereld Pilot offering consulting hours Amsterdam Zuidoost was started 78 patients where inscribed in a GM practice, some after intensive mediation Workgroups investigated the themes of Cardiovascular risks, Mental Health and Healthy pregnancy & sexual health examination, by offering different test services, which can be implemented in 2012 Advocacy: In collaboration with the Breed Medisch Overleg (BMO) (Broad Medical Consultation) the closed expert meeting 'Effects of exclusion of the Public Health, casus undocumented' was organized, in which professional organizations and other professionals vowed to actively help find solutions We participated in the International Observatory of the international network of Dokters van de Wereld, with questions about the health and access to care of 103 patients. These will be used (anonymously) for the joint European lobby. 16

17 Numbers 2011: Target audience: Personnel: Financing: migrants with access problems to care 1 project coordinator, 2 coordinators migrant care, 45 volunteers with a medical or social background, 2 medical experts for technical support Commission PIN, Skanfonds, Fonds NutsOhra, Stichting Janivo, Stichting O.K. het Maagdenhuis, Stichting RCOAK, Cordaid, Kerk in Actie, Congregation of Judie Postel, Dokters van de Wereld Expenditure: 150,275 Prospects 2012 The offer from Amsterdam Zuidoost is evaluated and where possible implemented in 2 other consultancy hour locations. By using a group of regular consultation volunteers, intakes consultations, mediation and GP referrals are handled efficiently. An information pack is created about Heart and Vascular diseases and actively offered for group information sessions. The increased reach of migrants through consultation hours and outreach will be continued. 17

18 7b. Operation Smile - Dokters van de Wereld and network Since 1989, delegations of Dokters van de Wereld of Japan, France, Germany, Great-Britain and the Netherlands organise Operation Smile in Asia and Africa. These are short-term missions where children and young adults with cleft lip (harelip) or burn contractures, receive free reconstructive surgery. These conditions result in physical and social problems, but many people in developing countries cannot afford specialized care. Besides conducting operations, strengthening the capacities of local medical personnel is an important objective. In 2011 Dokters van de Wereld has made grade strides. An independent mission was conducted in Bangladesh, with medical staff of the Academic Medical Center (AMC) and VU Medical Center (VUmc). A special experience in which we were able to treat 126 children and young adults. Following contacts in the Netherlands with the Lion Heart Foundation, we also started with the preparation for missions in Sierra Leone. In cooperation with local partners and a local Dutch tropical doctor, we examined five hospitals, two of which are selected for the missions in Activities 2011: Establishing partnerships with Dutch hospitals to jointly carry out missions in developing countries Entering into partnership with Interplast Holland to support (sharing expertise, resources and materials) Implementation of two preparatory missions to Sierra Leone and Bangladesh to select appropriate hospitals and partners Implementation of Operation Smile mission in Bangladesh with a Dutch medical team of AMC and VUmc Development of standard tools to ensure the uniformity, quality and safety of the missions Results 2011: Sending out a Dutch medical team; 3 plastic surgeons, 2 anaesthesiologists and 2 surgical assistants / nurses Offering reconstructive surgery to 126 children and young adults 26 local medical personnel trained through on the job training Alliance started with physicians of 4 Dutch hospitals: AMC, VUmc, University Medical Center Groningen (UMCG) and Medisch Spectrum Twente (MST) Alliance with Interplast Holland started: to support the mission in Bangladesh a team member joined the mission to select hospitals and Interplast Holland has made surgical and anaesthesia equipment available In total, 807 patients were operated in 2011, and Dokters van de Wereld Nederland accepted 126 patients. 18

19 Number 2011: Target audience: children and you adults with met cleft lip or burn contractures Personnel: 7 medical volunteers send out to Bangladesh, 2 field volunteers to prepare the mission in Sierra Leone and Bangladesh and 2 volunteers for the office to support the mission Financing: L Oreal and Dokters van de Wereld Expenditure: Total expenditure MdM network: 450,759; DvdW expenditure: 33,610 DvdW contribution to MdM network: 53,000 Prospects 2012: Next year we will have 4 missions to Bangladesh and Sierra Leone, in collaboration with the aforementioned Dutch hospitals and local hospitals. In support of potential new missions possibilities for cooperation are examined with medical teams from other Dutch hospitals and Interplast Holland. 19

20 7c. Serbia - Being aware : integration of risk reduction of drug use within the health system in Belgrade Since 2009 Dokters van de Wereld collaborates with the local organization VEZA to improve care for drug addicts in Belgrade and provide information on drug use among high-risk groups. The majority of the 10,000 drug addicts live on the street. As a result they run extra risk of infections and are also exposed to discrimination, exploitation and violence. The VEZA team is committed to reach this group through low-threshold activities such as a drop-in center and field activities (outreach). Access to health care and other services is limited because the lack of proper documents and insurance but also because of stigmatisation and negative treatment. We improve laws and regulations (lobby) and increase awareness about the issue (antistigma). In 2011, the last project year, Dokters van de Wereld worked with the Dutch organizations Mainline and Correlation Netwerk to strengthen Veza and partners. Thus they are able to pursue assistance independently and continue to set up and implement training programs for medical personnel. Activities 2011: Providing accessible medical, legal and social assistance to drug addicts in Belgrade with a shelter and field activities Organization of information activities at festivals and clubs to reach young people and inform them about drugs and prevention Organization of round table discussions at national and international levels with relevant partners, government and policy makers to improve laws and regulations to guarantee of care for drug addicts The strengthening VEZA team members so they can train health care personnel of primary and secondary clinics in Belgrade Results 2011: 2,300 beneficiaries took part and traded in their needles in exchange programs 262 social work consultations and 320 medical consultations were given by the team in the shelter 169 medical professionals attended the training (doctors, nurses) 1 national round table session was organised 1 international round table session was organised with participating countries: Romania, Bosnia, Herzegovina, Slovenia Photo exhibition and publication on 3 years of fieldwork at the conclusion of the program Numbers 2011: Target audience: Personnel: Drug addicts in Belgrade, GPs, emergency room physicians, specialists in hospitals, policymakers VEZA team (17 employees), 7 trainers on assignment (Mainline and Correlation Network) 20