EMERGENCY

Life Support for Civilian War Victims
ACTIVITY REPORT 1994-2005

EMERGENCY

In today’s conflicts, 90% of the victims are civilians. Every year war kills or seriously affects the lives of millions of unarmed people worldwide.
EMERGENCY is an independent, nonprofit, neutral and nonpolitical humanitarian organization. It is dedicated to assisting the civilian victims of war and land mines. All of EMERGENCY’s facilities are designed, built and run by specialized international personnel, who provide training for local staff. Since 1994 more than 1,800,000 patients have been treated free of charge in the surgical, medical and rehabilitation facilities run by EMERGENCY worldwide.
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EMERGENCY

EMERGENCY operates in war and postwar zones supporting victims with:
Surgery: Surgical Care for victims of war and land mines Emergency and Trauma Surgery General and Reconstructive Surgery Medicine: Internal Medicine Obstetrics and Gynecology Pediatrics First Aid for victims of war and land mines Primary Health Care Medical assistance for prisoners Rehabilitation: Physiotherapy Prosthesis production Vocational training and cooperative workshops for amputees Assistance to widows and orphans

EMERGENCY provides high-quality, medical, surgical and rehabilitative care free of charge in war-torn areas. EMERGENCY promotes a culture of peace, solidarity and respect for human rights.
EMERGENCY

Uzbekistan Tajikistan Turkmenistan Shebergan Anabah Kabul

China

Afghanistan
Lashkar-gah

istan
EMERGENCY

Iran

Pakistan

EMERGENCY

In 1999 EMERGENCY transformed a former police academy in the village of Anabah, in the Panjshir Valley, into a surgical center for war victims. Over the years, in order to meet the needs of the population, admission criteria have been extended to all surgical emergencies and major traumas. In 2003 a maternity and gynecology center was established inside the hospital compound, and new departments of pediatrics and internal medicine were opened. A second surgical center was established in Kabul in 2001. The EMERGENCY hospital is now the biggest surgical and trauma center in Afghanistan. The facility was upgraded in 2003 with a six-bed ICU, and in August 2005 the only CT-scan equipment in the country was installed. In September 2004 EMERGENCY opened a third hospital in Lashkar-gah, the capital city of Helmand province. The southern regions are seriously underserved; consequently, the surgical center often receives patients coming from other provinces. All hospitals are connected to First Aid Posts (FAPs) and Primary Health Centers (PHCs) located in heavily mined areas or in remote villages where there is no other medical facility. Each FAP is open 24/7, and an ambulance provides safe and speedy transfer of urgent cases to the hospital. Since 2001 EMERGENCY has run a prison program to provide medical assistance to detainees throughout the country.

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Anabah

Surgical and Medical Center
Opened: December 1999 Activities: Surgery for war and landmine victims Emergency Surgery Internal Medicine Pediatrics Facilities: Emergency Room, Outpatient Departments, 2 Operating Theaters, Intensive Care Unit, Patient Wards, Physiotherapy, X-Ray Department, Laboratory and Blood Bank, Pharmacy, Classrooms, Children’s Play Room, Domestic Services, Maintenance Department Bed Capacity: 70 National Staff: 223 Up to December 2005: Patients admitted: 10,306 Outpatient consultations: 33,096 Surgical procedures: 8,177

Kabul

Surgical Center for War Victims
Opened: April 2001 Activities: Surgery for war and landmine victims Trauma Surgery Facilities: Emergency Room, Outpatient Department, 2 Operating Theaters, Sterilization, Intensive Care Unit, Sub- intensive Care Unit, Surgical Wards, Physiotherapy, CT Scan, X-ray Department, Laboratory and Blood Bank, Pharmacy, Classrooms, Children’s Play Room, Domestic Services, Maintenance Department Bed Capacity: 95 National Staff: 303 Up to December 2005: Patients admitted: 10,580 Outpatient consultations: 30,310 Surgical procedures: 12,173

First Aid Posts (FAPs) and Primary Health Clinics (PHCs):
Total Number: 26 Locations: Ahangaran, Anabah, Anjuman, Bagram, Bazarak, Changaram, Charikar, Dara, Dashty Rewat, Grishk, Gulbahar, Horaty, Kapisa, Khinch, Kohi-Safi, Koklamy, Logar, Mirbachakot, Paryan, Rokha, Said Khil, Sayad, Shutul, Shutul Mobile Clinic, Sorobi, Tai Maskan National Staff: 199 Up to December 2005: Patients referred: 10,506 Outpatient consultations: 918,811

Anabah

Maternity Center
Opened: June 2003 Activities: Obstetrics and Gynecology Neonatal Care Facilities: Emergency Room, Outpatient Department, Operating Theater, Intensive Care Unit, Patient Wards, Nursery, Ultrasound Room, Delivery Room, Diagnostic, Technical and Domestic Services Facilities shared with the Surgical and Medical Center Bed Capacity: 25 National Staff: 31 Up to December 2005: Patients admitted: 2,492 Outpatient consultations: 12,968 Surgical procedures: 612 Births: 1,489

Lashkar-gah

Prison Programs:

Surgical Center for War Victims
Opened: September 2004 Activities: Surgery for war and landmine victims Trauma Surgery Facilities: Emergency Room, Outpatient Department, 2 Operating Theaters, Intensive Care Unit, Surgical Wards, Physiotherapy, X-Ray Department, Laboratory and Blood Bank, Pharmacy, Classrooms, Children’s Play Room, Domestic Services, Maintenance Department Bed Capacity: 70 National Staff: 234 Up to December 2005: Patients admitted: 2,231 Outpatient consultations: 14,243 Surgical procedures: 2,314 Duab Prison: 694 patients examined and treated from 2001 until 2003. Shebergan Prison: 13,338 patients examined and treated from May 2002 until June 2004. Kabul Prisons (Governmental Jail, Investigation Department, Pol-eCharki): 64,195 patients examined and treated.

Social Programs:
Carpet Factory
Opened: April 2003 Location: Anabah, Panjshir Valley Teachers: 5 Weavers: 33

12 EMERGENCY

Guinea

Sierra Leone
Freetown Goderich

Atlantic Ocean

leone
Liberia

EMERGENCY

In late 2000 EMERGENCY initiated a surgical program to assist war victims. An abandoned medical clinic in the district of Goderich, on the outskirts of Freetown, was refurbished into a surgical block. New buildings were also constructed in the compound to complete a fully autonomous and high-quality medical center where EMERGENCY provides treatment to survivors of war trauma and to orthopedic and polio patients. Admission criteria are now expanded to include all life-threatening surgical emergencies. In 2003 the government of Sierra Leone allocated an extended area where EMERGENCY could build two more wards, making it possible to open a dedicated pediatric medical ward. Children are the main beneficiaries of the program, most frequently suffering from severe malaria, acute anemia and respiratory tract infections. EMERGENCY’s Surgical Center in Goderich is the only training facility for surgical and anesthesia staff in a nation that is still suffering the consequences of a long and destructive war.

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Goderich, Freetown
Surgical and Pediatric Center

Opened: November 2001 Activities: Emergency Surgery Orthopedic and Reconstructive Surgery Pediatrics Facilities: Emergency Room, Outpatient Department, 2 Operating Theaters, Sterilization, Intensive Care Unit, Patient Wards, Physiotherapy, X-Ray Department, Laboratory and Blood Bank, Pharmacy, Classrooms, Children’s Play Room, Domestic Services Bed Capacity: 100 National Staff: 238 Up to December 2005: Patients admitted: 11,693 Outpatient consultations: 124,280 Surgical procedures: 5,662

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Turkey

Choman

Erbil Sulaimaniya Iran

Syria

Iraq
Baghdad Jordan

Saudi Arabia

Kuwait

EMERGENCY

EMERGENCY

EMERGENCY has been functioning in Iraq since March 1995, initially in the Iraq/Iran border city of Choman. The Sulaimaniya and Erbil surgical centers opened in 1996 and 1998, respectively, offering high-quality surgical assistance to victims of land mines and war. Both centers incorporated specialized units for burn and spinal patients. Hundreds of thousands of war victims have been assisted through the years in these surgical centers, where, with the continuous presence of international staff and uninterrupted on-the-job training of national medical staff, it has been possible to reach complete technical sustainability. In April 2005, once economic viability was also achieved, the Sulaimaniya and Erbil surgical centers and their network of First Aid Posts were transferred to the regional health authorities. The centers are fully integrated into the national health system; they offer their highly qualified services free of charge to all patients. EMERGENCY continues its work in Iraq with a rehabilitation and social reintegration program, which was started in 1998 with the establishment of EMERGENCY’s Rehabilitation and Social Reintegration Center in Sulaimaniya. This center provides lower and upper limb prosthetic services, physical rehabilitation and vocational training to amputees, and assists them in starting professional cooperative workshops.

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Sulaimaniya

Surgical Center for War Victims
(February 1996 - April 2005)

Erbil

Surgical Center for War Victims
(June 1998 - April 2005)

Sulaimaniya
Rehabilitation Center
Opened: February 1998 Activities: Physical Rehabilitation Prosthetics Facilities: Patients Wards, Physiotherapy, Indoor Swimming Pool, Orthopedic and Prosthetic Workshops, Domestic Services Bed Capacity: 41 National Staff: 78 Up to December 2005: Patients treated: 3,792 Upper limb prostheses: 556 Lower limb prostheses: 3,442 Orthotics: 570

Activities: Surgery for war and landmine victims. Medical and Surgical Treatment for burn patients Medical and Surgical Treatment of spinal injuries Facilities: Emergency Room, Outpatient Department, 3 Operating Theaters, Sterilization, Intensive Care Unit, Burn Unit, Spinal Unit, Patient Wards, Physiotherapy, X-Ray Department, Laboratory and Blood Bank, Pharmacy, Classrooms, Children’s Play Room, Domestic Services, Maintenance Department Bed Capacity: 100 Up to April 2005: Patients admitted: 13,449 Outpatient consultations: 83,833 Surgical procedures: 14,756

Activities: Surgery for war and landmine victims Medical and Surgical Treatment for burn patients Medical and Surgical Treatment of spinal injuries Facilities: Emergency Room, Outpatient Department, 3 Operating Theaters, Sterilization, Intensive Care Unit, Burn Unit, Spinal Unit, Patient Wards, Physiotherapy, X-Ray Department, Laboratory and Blood Bank, Pharmacy, Classrooms, Children’s Play Room, Domestic Services, Maintenance Department Bed Capacity: 100 Up to April 2005: Patients admitted: 8,553 Outpatients consultations: 76,929 Surgical procedures: 7,616

Social Reintegration Program
Started: 1998 Activities: Vocational training for war and landmine victims Development of small business cooperatives for disabled survivors Facilities: Classrooms, Vocational Training Workshops (tailoring, leather work, woodwork, light carpentery), Domestic Services. Trainees completing the program: 511 Cooperatives set up: 165

First Aid Posts (FAPs)

Locations: Akra, Azady, Ble, Chamchamal, Choman, Derbendikhan, Dukan, Halabja, Kalak, Khabat, Khormal, Kifri, Koya, Makhmour, Mergasur, Penjwen, Qallachollan, Qalladiza, Ranya, Sidakan, Soran, Tawela Up to April 2005: Patients referred: 6,116 Outpatient consultations: 143,706

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Egypt Libya

Chad

Khartoum Al Fashir

Eritrea

SUDAN
Central African Republic Democratic Republic of the Congo
Uganda

Ethiopia

Kenya

EMERGENCY

EMERGENCY has designed a health program in Sudan, including both emergency surgery facilities in war-torn areas such as Darfur, and basic health care and highly-specialized surgical services in Khartoum. Following a survey in Darfur in spring 2004 and the provision of urgent medical assistance to the hospitals in Mellit and Al Fashir, a humanitarian operation was set up in the state of North Darfur. EMERGENCY refurbished the department of war and trauma surgery within the Al Fashir teaching hospital, the major referral center for the whole state. The hospital serves a population of nearly 250,000. For the past 20 years, about 1.5 million Internally Displaced Persons (IDPs), have been living in wretched conditions on the outskirts of the capital city, Khartoum. For the children of Mayo camp, one of the largest IDP areas, EMERGENCY has established a pediatric center to provide primary health care and early transportation to hospital facilities. The center, which opened in December 2005, is the only medical facility free of charge in an area where 300,000 people live. In addition to the projects noted above, a center for cardiac surgery is under construction in the village of Soba, which is located on the Blue Nile some 20 kilometers south of Khartoum. The new center, to be named the Salam (“peace” in Arabic) Center, will provide highly specialized health care free of charge to patients coming from Sudan and neighboring countries. The center is scheduled to open by the end of 2006.

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Khartoum

The Salam Center for Cardiac Surgery
Construction Started: October 2004 Location: Soba Village, 20 km south of Khartoum, along the Blue Nile Facilities: 3 Operating Theaters, Intensive Care Unit, Subintensive Care Unit, Patient Wards, Emergency Room, Outpatient Clinics, Catheterization Laboratory, Radiology and Ultrasound, CT Scan, Laboratory and Blood Bank, Physiotherapy, Domestic Services, Maintenance, Guesthouse for patients’ relatives Bed Capacity: 67 Referral Clinics: A network of clinics will be set up in the countries bordering Sudan for patient screening and referral to the center. The clinics, run by EMERGENCY international personnel in cooperation with the relevant local authorities, will also be responsible for patient follow-up. A dedicated EMERGENCY aircraft will provide patients with free transportation to and from the Salam Center.

Mayo, Khartoum
Pediatric Center

Opened: December 2005 Activities: Primary Health Care Pediatric First Aid Facilities: Outpatients Clinics, Patient Ward, Laboratory, Domestic Services Bed Capacity: 6 National Staff: 15 Up to December 2005: Outpatient consultations: 1,157 Patients referred: 11

26 EMERGENCY

Thailand

Laos

Battambang Samlot Cambodia Phnom Penh Vietnam

bodia
Gulf of Thailand

EMERGENCY

EMERGENCY’s Surgical Center for war victims was established in Battambang in 1998 to provide highquality surgical care and rehabilitation for victims of war and land mines. No vaccination campaigns were undertaken during the civil war, and therefore a high percentage of the Cambodian population suffers from polio-related deformities. Consequently, EMERGENCY extended its mandate to provide plastic and reconstructive surgery. In 2005, following a memorandum of understanding signed with the Ministry of Health of Cambodia, the EMERGENCY hospital began to admit all patients with trauma injuries or life-threatening conditions requiring surgical intervention. In order to cope with the high number of landmine victims among the refugees returning from Thailand, a field program in the northern Samlot region was established in 1999. EMERGENCY set up four First Aid Posts (FAPs) and a referral system to connect the remote and heavily mined Samlot district with the surgical center in Battambang. A fifth FAP was opened in January 2000 in Tasahn, with an extended care ward equipped for treatment of malaria, endemic in this part of the country. Each FAP is open 24/7, and an ambulance provides transfer of urgent cases to EMERGENCY’s hospital. By the end of 2003 the local staff had completed EMERGENCY’s training program, and four FAPs were transferred to the local health authorities. Currently EMERGENCY is still running the O’Tatiak FAP as well as two mobile clinics, each consisting of an ambulance that makes weekly visits to isolated villages in the jungle to provide primary health care free of charge.

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Battambang

Surgical Center for War Victims
Opened: July 1998 Activities: Surgery for war and landmine victims Trauma Surgery Orthopedic, Plastic and Reconstructive Surgery Facilities: Emergency Room, Outpatient Department, 3 Operating Theaters, Intensive Care Unit, Surgical Wards, Physiotherapy, X-Ray Department, Laboratory and Blood Bank, Pharmacy, Classrooms, Children’s Play Room, Domestic Services, Maintenance Department Bed Capacity: 80 Local Staff: 154 Up to December 2005: Patients admitted: 11,951 Outpatient consultations: 43,027 Surgical procedures: 13,469

First Aid Posts (FAPs)

Total Number: 3 Locations: O’ Tatiak, Samlot district mobile clinics Local Staff: 4 Up to December 2005: Patients referred: 2,295 Outpatient consultations: 160,432*

* These figures refer to those visits made to the FAPs at O’Rotkroh, Chamlong Kouy, Tasanh and O’Chom before the facilities were transferred to local authorities.

30 EMERGENCY

Bay of Bengal

Punochchimunai

Kalutara Gulf of Mannar

Colombo

lanka
EMERGENCY

Sri Lanka

Following an assessment carried out by an advance team a few days after the tsunami of December 2004, EMERGENCY supplied the Kalutara general hospital with surgical instruments and medical consumables, enabling it to prepare for potential further emergencies and to resume routine activities. EMERGENCY placed highest priority on the reconstruction needs of the country and the population most gravely affected. The Tamil Rehabilitation Organisation (TRO), a local NGO, collaborated with EMERGENCY in establishing an integrated program to assist Punochchimunai village, a Muslim minority community on the coast of the Batticaloa district in the eastern part of the country. Punochchimunai is being rebuilt with 91 houses, wells, a community center, a medical center and a preschool. Additionally, a “back to the sea” program was completed at the end of July 2005, with distribution of motor boats, canoes and nets to the community’s fishermen.

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Completed Programs
1994 – EMERGENCY renovated and reopened the surgical department of Kigali Hospital in Rwanda. Over a period of four months, surgical assistance was provided for more than 600 war casualties and landmine victims. A maternity ward was also reopened, where more than 2,500 patients received medical and surgical assistance. 1999 – EMERGENCY supported the Jova Jovanovic Zmaj Orphanage in Belgrade, Serbia. 2000 – EMERGENCY sent a surgical team to Eritrea in response to a request from the Italian Office for Cooperation and Development. During the two-month mission the EMERGENCY team worked in the Mekane Hiwat Hospital in Asmara, treating victims of the war between Ethiopia and Eritrea. 2001 – EMERGENCY built a prosthesis and rehabilitation center in Diana, in northern Iraq, and transferred it to the local health authorities. 2002 – EMERGENCY provided pharmaceutical supplies to “Casa de la Mujer” a network of women’s centers in Managua, Nicaragua. The dispensaries assist female cancer and diabetes patients. 2003 – EMERGENCY supplied Al-Kindi Hospital in Baghdad, Iraq, with generator fuel, medicines and consumable materials. In the same period, tons of medical supplies were donated to the hospital in Karbala, 70 miles south of Baghdad. 2003 – EMERGENCY set up a prosthesis and rehabilitation center in Medea, Algeria. An existing clinic within the public hospital compound was renovated and equipped, and EMERGENCY trained Algerian staff to deliver specialized care. The center, named Amal (“hope” in Arabic), was transferred to local health authorities in 2004. 2003 – EMERGENCY built a prosthesis and rehabilitation center in Dohuk, northern Iraq, and handed it over to local health authorities. 2003 – EMERGENCY intervened in Angola at the request of a local religious organization in Benguela Province. Two health centers were refurbished and equipped with medicines and consumable supplies. EMERGENCY managed the clinic and trained Angolan medical staff for one year. 2003/04 – A surgical team worked in the orthopedic department of Jenin Public Hospital, Palestine. EMERGENCY built a new orthopedic ward, a new department of physiotherapy, a hospital kitchen and canteen. EMERGENCY was also responsible for professional training of the Palestinian medical staff. 2004 – EMERGENCY supported the people of Falluja, Iraq, during the siege of the city in November 2004. Relief items, water and pharmaceutical supplies were given to community leaders and to the local public hospital. 2004/2005 – EMERGENCY rebuilt and equipped the emergency surgical department of the university hospital of Al Fashir in North Darfur, Sudan. The structure includes an operating room and 20-bed ward. The department was transferred to the Ministry of Health in August 2005. EMERGENCY

EMERGENCY

EMERGENCY’s Financial Resources and Legal Status
EMERGENCY was established in Italy in 1994 as a nonprofit organization to assist civilian victims of war and land mines. Since 1999 it has been officially recognized by the Italian Ministry of Foreign Affairs as a Nongovernmental organization (NGO). In February 2005 EMERGENCY was established in the United States. EMERGENCY, USA is registered as a US nonprofit organization in good standing. Its EIN is: 73-1731036. Approval of 501(c)(3) tax-exempt status is pending. EMERGENCY’s financial resources come primarily from donations from individuals, private companies and local governments. From May 1994 through December 2004 (the most recently completed fiscal year) average administrative overhead was 5.11% of total budget.
Year euro Financial resources managed by EMEGENCY to date.
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1994 435,977 1995 317,828 1996 1,582,883 1997 2,754,334 1998 2,157,363 1999 3,979,566 2000 6,200,616 2001 14,147,638 2002 18,440,738 2003 17,440,944 2004 17,240,225 2005 13,500,000*
*Estimated balance

To Support EMERGENCY:
Credit Card (Online)
www.emergency.it (euros)

Personal Check
Payable to: EMERGENCY, USA 10592 Perry Highway #112 Wexford, PA 15090 USA Payable to: EMERGENCY Via Meravigli 12/14 20123 Milan, Italy

Bank Transfer
EMERGENCY, USA Citizens Bank of Pittsburgh Account No: 620-196-0221 Routing No: 0360-76150 For international wire transfer: Swift Code CTZUS33 EMERGENCY Banca Popolare dell’Emilia Romagna (Milan branch) Account No: (IBAN) IT18M 05387 12916 000000005128 For international wire transfer: BPMOIT22

Via Meravigli 12/14 20123 Milan, Italy Phone: +39-02-881881 Fax: +39-02-86316336 E-mail: info@emergency.it www.emergency.it 99/A Via dell’Arco del Monte 00186 Rome, Italy Phone: +39-06-688151 Fax: +39-06-68815230 E-mail: roma@emergency.it www.emergency.it EMERGENCY, USA 10592 Perry Highway #112 Wexford, PA 15090-9244 Phone: 1-724-766-4518 E-mail: info@emergencyusa.org www.emergencyusa.org

“All human beings are born free and equal in dignity and rights.” Recognizing this principle “is the foundation of freedom, justice and peace in the world.”
Universal Declaration of Human Rights, Article 1 and Preamble Paris, December 10, 1948

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EMERGENCY