Distinctive characteristics and independence

DID YOU KNOW?

Our fixed and mobile clinics in Italy always have cultural mediators who play an essential role in getting our patients access to treatment.
The mediators do not just help overcome linguistic barriers; they give patients the information and support they need to exercise their own and their communities’ rights to treatment.

For over 20 years, EMERGENCY has run a network of 45 First Aid Posts and Healthcare Centres in 31 of Afghanistan’s districts, as well as five prisons and twoorphanages in Kabul, which give ill and wounded people concrete access to life-saving treatment and primary medicine. In 2019, our ambulances, which run 24/7, transferred an average of 30 people for treatment every day.

To make it easier for local staff to get to work, EMERGENCY has shuttle buses that stop at a range of pick-up points. In Mayo, on the outskirts of the Sudanese capital Khartoum, this service is essential to the running of our Paediatric Centre and to the safety of our staff when they go back home after their shifts.

Our patients’ health depends on the cleanliness of the facilities that EMERGENCY operates, which is why we take particular care in cleaning its hospitals. In Sierra Leone, 89 of the 381 staff at our Surgical and Paediatric Centre in 2019 were cleaners. 21 of them worked in the operating block, all of them specially trained to keep the facility clean.

OUR WORK:

How we start projects in countries at war[1]

Choosing a new project is a very delicate process. There is a lot to take into consideration: local people’s needs, safety, the specific skills within our organisation that we will rely on, and the assessment we have to do based on certain indicators. This first phase lets us accurately work out the benefits and the risks straight away, thereby laying solid foundations for the project’s launch.

The reputation EMERGENCY has built over its 26 years of humanitarian work around the world has let it cement many good relationships with institutions, which is why in most cases we choose our projects based on requests from local authorities, international organisations or third-sector bodies working in the field. But of course, there is no shortage of cases where we have gone to a new country on our own initiative. In just the last few years, we have chosen many projects as the result of our constant assessment work. Among these was Yemen at the end of 2018, at the suggestion of the World Health Organization (WHO), with which we had worked with in Iraq and had expressed its admiration for our model of work. The Yemeni people’s needs and the worsening of the humanitarian crisis had been on our radar for some time, so we decided to go ahead with our assessment.

In Yemen as with other projects – Libya in 2014 for instance – one thing that made the launch easier was our Regional Programme for referring patients from 30 countries around the world to the Salam Centre for Cardiac Surgery in Sudan. Scarce medical services and long waiting lists meant we already had requests for cardiac surgery from Yemeni patients. The second step of the preparatory phase is choosing the kind of service we want to provide. This is based on a range of factors, for instance local needs that fall within our remit, support from the local authorities and the state of medical facilities in the area. This initial analysis means talking with a lot of interlocutors and it gives us a more objective picture of the situation and the needs at play.

There are things that can put the brakes on a potential project, though, like a lack of safety, no cooperation from local authorities, not being able to send international staff to audit work, or not being able to respect the international humanitarian principles that let us treat patients neutrally and independently. In the north of Yemen, after an official invitation from the de facto government, we sent an initial team of EMERGENCY personnel to plot out local needs and existing services, and visit potential sites for the project.

The choice of building – new or renovated – is dictated in part by how urgent local needs are, which is why in Yemen we chose an existing building that just needed renovation. Once this first phase is over, we go on to fully plan the project, starting with the medical needs and the type of medical work we want to do, and going through the whole technical and logistical side of the project. Without doubt one of the biggest hurdles we came up against in Yemen was access (travel times are about a week between Europe and Hajjah, the city we chose for the project, and getting an entry visa takes several months, given the two separate governments in the country). Even registering as a charity in the country – which is essential if the project is to get off the ground – took a lot of time and effort. Not one international charity had managed to get through the process for five years.

The most fragile and vulnerable people often live in the least accessible countries and find themselves in the remotest crises. Which is why, regardless of the trouble, we have continued launching projects and overcoming all the obstacles. We always strive to bring EMERGENCY where it is needed most.

Emanuele Nannini, Area manager for EMERGENCY Crisis and Development Projects

OUR IDEA OF TREATMENT

We believe that medical treatment is a fundamental human right which, as such, should be available to every individual. In order for treatment to be truly and universally accessible, it must be completely free, and in order to be effective it must be of high quality.

For this reason, we want – and provide every day – treatment based on the principles of:

Equality

Every human being has the right to healthcare, without discrimination, and with the best possible treatments.

Quality

Health services must be of high quality and based on the needs of all, not on those of a select few.

Social Responsibility

Governments must consider the health and wellbeing of their citizens a priority and care must be free and accessible to anyone in need.

This is the EQS Model (Equality, Quality, Social Responsibility) that we outline in our “Manifesto for Human Rights-Based Medicine””; written together with the ministries of health of various African nations.

INSIDE ONE OF OUR HOSPITALS YOU WILL FIND…

FREE HEALTHCARE

EMERGENCY puts into practice the idea of the universal right to treatment. It is not enough just to build a hospital if you want people to have access to it. There are many barriers to them doing so and EMERGENCY accordingly takes measures to dismantle those barriers.

For example, our hospitals are located in places that we choose in agreement with communities, so that they can reach them easily, but that are also far enough away from dangerous places (like barracks or electoral commissions) that could fall victim to fighting.

Our facilities respect local cultures so that they are accessible and acceptable to local people. In Muslim countries, it is essential to have female staff so that women can get treatment in ease and privacy, which is why we set up separate sections based on gender.

In our facilities, free treatment and services such as accommodation and meals dismantle the main barrier to getting treatment – money. Follow-up treatment – which can last a lifetime, as with our rheumatic patients at the Salam Centre for Cardiac Surgery in Khartoum – is also free. We treat patients from the moment they come into our hospitals until they no longer need us, and always in accordance with admission criteria.

HIGH QUALITY

From 12 to 14 June 2019, EMERGENCY took part in the WHO’s Emergency Medical Teams Global Initiative in Bangkok. We helped revise ‘The Red Book: A Guidance Document for Medical Teams Preparing for, Responding to Armed Conflict and Complex Emergencies’, bringing our experience of war and crisisaffected locations.

In regions hit by conflict, a lack of prompt, quality surgical treatment has a large, underestimated socioeconomic impact, for example by leaving many people physically or mentally disabled. That’s why, in the minimum standards we set out for medical and support teams in the ‘Red Book’, we prioritised quality of treatment and putting the patient at the centre. Both these concepts are essential even in the most complicated humanitarian crises if we are to protect the right to health and resilience in populations.

TRAINING LOCAL STAFF

We train local staff at all our projects, because we believe that this is the key to making our work long-lasting. In Asmara, training is the main ingredient in the ‘Emergency initiative in support of opening a cardiology clinic at the Orotta Hospital in Eritrea’, funded by the Italian Agency for Development Cooperation. EMERGENCY helped set up a clinical block for cardiology treatment, sending over a team made up of nurses, a haematologist, logistician and biomedical engineer.

In the first few weeks of work at the new block, the team from the Salam Centre for Cardiac Surgery in Sudan helped Eritrean staff monitor patients with heart conditions, give anticoagulant treatment and maintain biomedical stocks. We also provided equipment, like hospital forms and files for statistics, which are useful for monitoring work and allowing the local team to independently manage their work.

CARE THAT GOES BEYOND TREATMENT

Soran, a teacher at school and in life

Wounded at the age of 12 by an exploding mine, Soran went on to become a teacher, because he wanted the schoolchildren of Iraqi Kurdistan to learn an important lesson.

Telling a child not to do something is often the best way to get them to do it. That is why it can be very difficult to teach children in countries at war, like Iraq, to keep away from the landmines that litter the landscape. What is needed is a simple explanation, better yet
one with a practical, tangible example, like the one Soran Mihamad gives. When he talks in class about landmines, he shows the pupils his prosthesis.

It was a day like any other when, in 1996, Soran’s mother asked him to come with her into the fields to pick vegetables for dinner. The little boy found something odd sticking out of the earth, plucked it out, then threw it on the ground. A violent explosion rocked him, his mother, his sister and his cousin, leaving them all seriously wounded. His relatives came straight away with the only vehicle they had, a tractor, and brought the four of them to a first aid centre in Darbendikhan. His sister died there. The rest of them were transferred to EMERGENCY’s Surgical Centre in Sulaymaniyah.

Soran lost his right leg. His story might have been very different had the Rehabilitation and Social Reintegration Centre not been there to give him treatment after the operation. After three months of physiotherapy he knew he could get by with his prosthesis. First one step, then another, managing to run and kick a ball again. Thanks to this determination, Soran learnt to walk and then to run again. He spent
his hard adolescence learning how to get about in a new way, so he wouldn’t have to give up everything he wanted to do on two legs. And his efforts paid off. Soran managed to join a football team, he went to university and graduated, he got married and had two
daughters, Sima and Saya Now Soran is a teacher. He teaches his pupils art, history and literature, and something else essential, something you can’t find in books. Soran teaches children to keep away from landmines, millions of which still lie hidden all over Iraq.

Soran’s message is much more than a simple recommendation. He shows his pupils photos of mines, explains how they actually
work and the risks you take when you go near a mine field. Finally, he lifts his trouser legs and shows his artificial leg to the class, to give them a real testimony that might just save their lives.

FROM HUMANITARIAN ACTION TO A CULTURE OF PEACE[2]

The promotion of a culture of peace, solidarity, and respect for human rights is one of EMERGENCY’s goals, as laid out in its Statute, and a fundamental part of its mandate.
In order to promote these values, we meet schoolchildren of all ages, publish books for adults and kids, and organise exhibitions, theatrical spectacles, film festivals, events and initiatives, thanks to a widespread network of volunteers.

SOME OF THE CULTURAL INITIATIVES ORGANISED IN 2019:

“OF WAR AND PEACE. IDEAS, METHODS, PEOPLE WHO RESIST”
EMERGENCY’s 18th National Meeting was held in Milan. 10,000 visitors took part in conferences, public meetings, a play, an interactive course, exhibition, concert and children’s workshops. Guests included Gino Strada, Diego Bianchi, Enrico Mentana, Maurizio Landini, Renzo Piano, Massimo Giannini, Nico Piro, Daniele Silvestri, Nina Zilli, Lo Stato Sociale and many others.
“CARA TERE” STORIES AND MUSIC IN MEMORY OF TERESA SARTI STRADA
Ten years ago we lost Teresa Sarti Strada, co-founder and first president of EMERGENCY. We decided to remember her passion and what she taught us with music, at a free concert in the gardens of Casa Emergency with Fiorella Mannoia and Paola Turci.
GUERRA INC. Money, drugs, weapons and blood: the conflict economy

An investigation in three sections (Italy, Afghanistan and Iraq) by EMERGENCY and Corriere della Sera, drawing back the curtain on the best-hidden side of conflict: the economic side. You can read it on corriere.it/esteri/guerraSpa/

“ZAKHEM | WOUNDS. WHEN WAR COMES HOME”
A photographic exhibition by Giulio Piscitelli shows EMERGENCY’s hospitals in Kabul and Lashkar-Gah. First shown at Casa Emergency in Milan, it was repeated outdoors in the same city before travelling to Venice and London. ‘Zakhem’ won first prize in the non-profit category at the ninth edition of the World Report Award, a photographic competition held at the Festival of Ethical Photography in Lodi, Lombardy.
“DESIGN AGAINST WAR”
This was a competition run by EMERGENCY and SOS Design, which invited designers, architects and anyone else in the field to come up with buildings, products and services to meet the needs of people in war zones, including in hospitals. We received more than 150 designs from around the world.
“A QUIET REVOLUTION”. The Maternity Centre in Anabah and women’s empowerment

This is EMERGENCY’s report from its Maternity Centre in Anabah, in Afghanistan. It looks at the effect of this free, specialist hospital on the health and role in society of the women it both treats and employs, and how this model could be replicated in other parts of the country, or indeed in other developing countries. The report is accompanied by a website and a YouTube playlist, and was presented in Milan, Brussels and Kabul.

“BEYOND THE BEACH: THE HELL AND THE HOPE”
Shown at the 76th Venice Film Festival, the documentary film Beyond the Beach: The Hell and the Hope, directed by Graeme A. Scott and Buddy Squires, looks at the profound links between war and migration, through the lives of EMERGENCY’s humanitarian workers.
“APE REGINA” SHORT FILM
Shot by Nicola Sorcinelli on the back of the winning screenplay from the 2018 edition of the ‘Story for EMERGENCY’ contest, the short film Ape Regina (‘Queen bee’) won first prize at the Alice nella città film festival.
“EVERY NAME HAS A MEANING”

The ‘Every name has a meaning’ video shows how war affects people’s lives, so much so as to rob them of all meaning. And it starts with something as simple as it is powerful: their names. That’s the message EMERGENCY chose for the new year.

“SCHERMI MIGRANTI” and “D(I)RITTI ALL’IMMAGINE”
Throughout 2019, our offices in Milan and Venice and our information points in Turin and Rome hosted literary, film and photographic exhibitions, and events on the topics of migration, inclusion, war and human rights. These included ‘Schermi migranti’ (‘Migrant screens’) and ‘D(i)ritti all’imagine’ (a pun on ‘Image rights’ and ‘Straight to the image’).
“PRINCIPLES FOR TAKING ACTION AGAINST WAR”

This was the fourth edition of EMERGENCY’s event for high schools, done by Camila Raznovich and streamed live from Casa Emergency to over 24,000 pupils and teachers. This year EMERGENCY founder Gino Strada, EMERGENCY President Rossella Miccio, legal doctor Cristina Cattaneo, street artist Omaid Sharifi and researcher Matteo Villa took the helm. The five principles for making a difference and changing things now and for the future are: finding out about war, affirming equality, informing oneself to fight the language of hate, cultivating one’s memory and building beauty.

“MINI-FESTIVAL FOR CHILDREN WHO RESIST”
In a corner of Parco Sempione in Milan we put on ‘Gentle resistance’, a mini-festival on matters of peace for children and their families.

EMERGENCY VOLUNTEERS

I started volunteering for EMERGENCY 10 years ago, in 2009. I wanted to make myself useful. I had to find a different balance. I set myself new priorities and learnt to manage my time more flexibly. Working with EMERGENCY has definitely helped me see the world in a different light.

Massimo,

EMERGENCY group volunteer in Milan

In 2019, EMERGENCY counted on the support of over 2,000 volunteers, divided into about 149 local groups and 15 university groups, who are all an integral part of our organisation[3].

In particular, we are engaged in Italian schools at all educational levels, where we organise free meetings with students and teachers. We believe that informing future generations is essential to inspire real cultural change in the short to medium term. In 2019, we met 58,500 high- and middle-school pupils, 27,500 primary-school pupils and 6,000 teachers, through 200 volunteers.

EMERGENCY believes strongly in the social value of volunteering and that is why we are committed to supporting them, including through training and meetings. With their commitment, energy and knowledge, volunteers are a very important resource for spreading a culture of peace, as well as fundraising. Their generous time contribution also reduces the organisation’s expenses when managing events and activities.

SUMMER CAMPS

In July and August 2019, we held the first edition of EMERGENCY’s summer camps. Open to all and lasting one week, they were held in Campotosto (near L’Aquila) and Montorio al Vomano (near Teramo). Anyone was welcome to take part and learn about EMERGENCY’s work and its approach to vulnerable people, particularly those hit by earthquakes in the area. The hero of the event was the Ludovan, the camper van EMERGENCY kitted out to bring fun events to squares in towns and villages hit by the earthquake. Thanks to EMERGENCY’s volunteers and staff, the summer camps were enjoyable for everyone involved. We hope to repeat this experience in future, to help weave back the torn social fabric in these places.