Distinctive characteristics and independence
DID YOU KNOW?
In 2006, we began working in Italy to support some of the most vulnerable people in society: both migrants as well as a growing number of Italian citizens living in poverty, social exclusion and marginalisation, especially in suburban areas. We opened permanent and mobile clinics in the suburbs of various cities. These offer free primary and specialist treatment, nursing services, psychological support and medical education. At our clinics, we help patients in the national health service, with both practical and bureaucratic matters.
EMERGENCY does not operate field hospitals. It both refurbishes and builds permanent hospitals and healthcare centres, in order to guarantee the highest possible level of treatment. Our hospitals are beautiful as well as functional, because beauty is a sign of respect
and dignity. Our aim is to create an environment that is efficient for our staff to work in and comfortable for our patients, always with a view to the long term, planning to stay in the country until we can hand over to the local authorities.
When hiring support staff, we give precendence to the most disadvantaged in society: we give widows, amputees and war victims the chance to be independent and earn a living.
Volunteers for EMERGENCY are the regional point of reference for anyone interested in knowing about, supporting or actively participating in the life of the organisation. In 2018, there were more than 2,200 active volunteers in Italy, organised in around 150 groups spread throughout the country.
EMERGENCY essentially works according to three kinds of intervention. In some cases we decide to enter a country because we believe its people, or some of them, have a specific need, which we can meet thanks to our professional skills in medicine and humanitarian work. We use modern, functional, efficient hospital facilities in our work, which we design and build to ensure the highest possible level of treatment. We sometimes renovate buildings made available to us by the local authorities or other institutions, in these cases we remain in the country until the need we identified at the start has been met and the situation has returned to normal. We may also choose to carry on supporting the country in its recovery and attempt to build a national health service. The long-term goal is always to make our presence in the area redundant, by handing over management of the hospital to the local authorities as soon as they are capable.
In case of serious emergencies, like a conflict or epidemic, we intervene to provide a rapid, effective solution within a defined area. We plan to stay for fixed periods, but even in these emergency circumstances, we prefer to use facilities built or renovated by us, so that we can be sure that they fit our needs and working methods.
Besides these two common kinds of intervention, EMERGENCY has developed a revolutionary idea of humanitarian work in medicine, creating a network of Medical Centres of Excellence that can bring specialist healthcare of the highest level to Africa. It is an innovative idea because it goes beyond the paradigm of many institutions and humanitarian organisations, which prioritise primary healthcare and prevention. We are convinced that only by bringing free, high-quality medical excellence everywhere will we put into practice every human being’s right to treatment. In 2007, we developed the idea of building the Salam Centre for Cardiac Surgery in Khartoum, in Sudan. This is now the only free cardiac surgery centre in Africa, which has so far received patients from 30 countries. We are currently finishing construction of the Centre of Excellence in Paediatric Surgery in Entebbe, Uganda, which will be active from spring 2020.
What are the key elements in the management of our hospitals?
We build the hospitals we work in to ensure the highest possible level of treatment for patients and maximum efficiency in the workplace for staff. We place great attention on welcoming, treating and managing patients, ensuring that all departments are perfectly organised.
Our hospitals are also beautiful, with gardens, play areas for children, and meeting areas. Training for medical staff, nurses and local auxiliary workers is also crucial. All hospital activities are organised as part of a single system, including non-medical departments.
The patient at the centre
The central role of the patient is one of the foundations of our work. We work in countries where healthcare is mostly paid for and where the patient is often seen simply as a customer. Only those who can pay get the treatment they need. But we believe patients are people in a vulnerable situation, who must be looked after, welcomed, and listened to. Right from the design, our hospitals aim to respond to patients’ needs in a comprehensive manner. Excellent care doesn’t just derive from specialist medical attention, but also from the broader care taken over the patient – a welcoming environment, high levels of hygiene, the provision of meals, and all the services necessary for a hospital to function properly. The beauty of the facilities themselves creates an environment contributes to the healing process, where the patient can feel safe and cared for. Hospital activities are organised in a functional way in order to maximise the efficiency of the staff’s work. The choices made regarding technical and biomedical equipment are designed to ensure that the best procedures are available, as well as compatibility with local conditions.
Director of the Field Operations Department (FOD) of EMERGENCY
THE 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:
every human being has the right to healthcare, without discrimination, and with the best possible treatments.
health services must be of high quality and based on the needs of all, not on those of a select few.
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.
IN AN EMERGENCY HOSPITAL YOU WILL FIND…
It should be the duty of the government in every country across the world to guarantee the right to health and treatment. In low-income countries, such as those where we operate, most of the population has no access to medical care – national healthcare systems in such countries are often private, with no system of universal healthcare. The few who can afford to pay for healthcare turn to private facilities, thus not contributing to the financing and development of public ones, but to the growth of inequalities and disparities (see ‘Measurement and Explanation of Inequality in Health and Healthcare in Low- Income Settings’ by E. van Doorslaer and O. O’Donnell, UNU-WIDER, 2008).
In all the countries we work in, we offer healthcare that is completely free of charge to anyone who requires it. his guarantees without discrimination the right to be treated and is indispensable to ensuring the right to healthcare does not become a privilege.
The protection and well-being of the patient are global public health problems, yet, despite efforts to improve the quality of health services worldwide, progress has been limited and little significant impact has been made.
The World Health Organization itself has adopted global resolutions to improve safety and quality of treatment, but its Director, Tedros Adhanom Ghebreyesus, has said we need to raise quality standards and transform the face of healthcare in developing countries. After visiting the Salam Centre in Khartoum, at the World Health Summit in Berlin in October 2018, Dr Ghebreyesus recognised the need for other projects based on the principles of high-quality services. Offering treatment of a high level not only gives people access to specialist as well as primary healthcare, but lets national health services develop their capacities, in terms of structure and staff, to
manage complex illnesses and enter a virtuous cycle that benefits healthcare in the country at all levels.
We train local staff in all our projects. In many of the countries we work in, our training is recognised by ministries of health and other relevant authorities. In Afghanistan, for example, the Surgical Centres for War Victims in Kabul and Lashkar-Gah are recognised by the Ministry of Health for their specialisation in surgery, while the Surgical and Paediatric Centre and Maternity Centre in Anabah are accredited to train postgraduate students in gynaecology and paediatrics. In 2018, seven staff in Anabah were specialising in gynaecology and 13 in paediatrics. In total, 40 postgraduate students have attended courses in 2018 in our hospitals in Afghanistan.
Our Maternity Centre in Anabah is a training centre for Afghan nurses, paramedics and auxiliary workers, all of them women, who work together with international staff every day, receiving practical and theoretical training. This focus on training meets our goal of making our hospital staff autonomous, with a view to an eventual hand-over.
In Sudan, the Salam Centre for Cardiac Surgery is recognised by the Ministry of Health as a training centre for intensive care nurses and students specialising in cardiac surgery, cardiology and anaesthetics. In 2018, thanks to our collaboration with the academy of medical sciences in Port Sudan, we hosted 34 nursing students in training at our paediatric Centre. Thanks to the constant presence of international consultants, we give lengthy training courses, based on EU standards. By training local staff, we also help strengthen the national health service, with a view to sustainability in the long term.
CARE THAT GOES BEYOND TREATMENT
When does treatment end for a patient who has lost one or multiple limbs due to war? What can we do to give disabled patients or those with life-changing injuries the opportunity to reintegrate into their communities?
At our Rehabilitation and Social Reintegration Centre in Sulaymaniyah, Iraq, we offer professional training courses (iron-, wood- and leatherwork, tailoring and shoemaking) and provide assistance (both economic and managerial) toward the opening of cooperatives or handicraft businesses. In 2018, 11 cooperatives opened. We believe this is an important result, which allows individuals to regain their
autonomy and dignity, to reintegrate, and which contributes to the development of local communities.
Yeshoo is 28 years old. She has a degree in Kurdish language and literature, and always carries a crutch since polio left its indelible mark. In a country like Iraq, entering into work is difficult for disabled people. Luckily, even when her destiny seemed fixed, fate stepped in: a friend told her about our Rehabilitation and Social Reintegration Centre, where we provide prostheses and rehabilitation for amputees and disabled patients, as well as organising special training courses for former patients who want to become independent in their work. ‘I liked sewing, so I started learning it on the EMERGENCY course. Now I’ve got a tailor’s shop and I’m always busy. It’s really turned my life around.’
Behind these four walls, cluttered with equipment, Sherwan and Taha have been working as carpenters for a year. Their paths in life led them to our Rehabilitation and Social Reintegration Centre where we provided them with prostheses for their legs and rehabilitation to help them get back to as normal a life as possible. While Sherwan was a soldier before becoming a carpenter, Taha removed mines. These two have stared the same war in the face (albeit from different perspectives), have managed to walk again, and find their place in the world.
Arazoo, 33 years old, came to see us at our Rehabilitation and Social Reintegration Centre in Sulaymaniyah, Iraq. We first met her in 2005, when we produced a prosthesis to replace her hand that she had lost due to a congenital illness. Thanks to one of our training courses she was able to open a small tailor’s shop under her house with our support: ‘Thanks to that course, and thanks to you, I was able to learn a trade that’s suited to my disability. I have plenty of customers now, and they’re all very happy with the clothes I make. One day, I hope my daughter can work alongside me.’
Farid, 44 years old, is a former patient of our Rehabilitation and Social Reintegration Centre in Sulaymaniyah, Iraq. Until recently, he would never have believed he’d be back working, let alone able to live a normal life like everyone else. While he was in an orchard in Taza Dea, he stepped on a mine he couldn’t see, causing the loss of his left leg. After the rehabilitation phase and the training course in carpentry at our centre, we helped Farid to open his carpentry workshop.
FROM HUMANITARIAN ACTION TO A CULTURE OF PEACE
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.
WAR IS MY ENEMY, Vol. 2
The third edition of the initiative for high-school pupils and teachers on the topic of alternatives to war. Participants included Founder Gino Strada, President Rossella Miccio, nurse and Medical Divison member Michela Paschetto, freelance journalist Giancarlo Musumeci and Stefano Allievi, Professor of Sociology at the University of Padua. The event, presented by Camila Raznovich and broadcast from Casa Emergency in Milan, involved 23,000 children and teachers, linked up live from 108 cinemas and screening rooms all over Italy.
WHERE THE GRASS TREMBLES: INVISIBLE LIVES IN ITALY’S COUNTRYSIDE
EMERGENCY’s digital editorial project on agricultural workers in Italy, based on the experiences of Italy programme operators in the areas of Castel Volturno in Campania, Capitanata in Apulia and Piana di Goia Tauro in Calabria, with the help of journalist Stefano Piccoli, and illustrations by cartoonists Gianluca Costantini, Simona Binni, Mattia Surroz and Sio. https://dovelerbatrema.emergency.it/.
Inside a repurposed truck, we set up an interactive journey through an ordinary day at one of EMERGENCY’s war surgery hospitals. Video clips, images, faithful reproductions, and augmented reality are used to trace the steps of patients at our hospitals in Afghanistan. Our medical and nursing staff offer technical explanations on how they manage a hospital in a war zone and the medical protocols followed in emergencies, while 360º virtual reality technology provides a totally immersive experience.
MY NAME IS NOT REFUGEE
The Italian edition of the children’s book written and illustrated by Kate Milner (in collaboration with Les Mots Libres, 2018). A trip through the emotions and thoughts of a child forced to leave his country and finding himself in a new place where he must begin a new life. This book, through direct questions, introduces readers from three years plus to this difficult human issue.
‘On War and Peace’, EMERGENCY’s 17th national meeting was hosted in the historic centre of Trento on Friday 7 and Saturday 8 September, two days of information and activities, including meetings, conferences and debates, which spread awareness of our organisation’s work and commitment to human rights and fighting war. Among the many guests were trade unionist Aboubakar Soumahoro, mayor of Riace Mimmo Lucano, Hellenist and historian Luciano Canfora, director of TG LA7 Enrico Mentana, activist Malalai Joya, television presenter and actor Neri Marcorè, and journalist Francesca Mannocchi. A large, free concert was also held, featuring Fiorella Mannoia, Nek, Ermal Meta and Fabrizio Moro.
AFGHANISTAN IN 360 DEGREES
360° virtual reality technology provides an immersive experience, allowing the viewer to visit EMERGENCY’s projects in Afghanistan. When the headset is put on, you can enter the everyday life of a doctor or patient at one of our hospitals. Guiding you through the experience is an EMERGENCY operator, who will take you through the departments and corridors of the Surgical Centre in Kabul, to let you discover the facility and its patients’ stories.
On the occasion of the 70th anniversary of the Universal Declaration of Human Rights, EMERGENCY assembled in squares in more than 85 cities across Italy to demonstrate that, together, it is possible to oppose racism, hatred, violence and inhumanity. We made our voice heard to assert that every human being is born free and equal in dignity and rights. That is the recipe for building,a fair and free society, where people in need can count on food, medical treatment, education and a roof over their heads.
‘If even one human being is excluded, it doesn’t make sense to talk about human rights, because by definition they apply to everyone.’ (Gino Strada)
PROGRAMMA ITALIA (‘ITALY PROGRAMME’) – TV series for ZELIG TV
The original format, produced by EMERGENCY with Bananas Media Company for Zelig Tv, tells the story of EMERGENCY’s Italy programme and was shown on Zelig Tv. The 10 documentaries give a voice to every place, from Milan to Palermo, Castel Volturno to the earthquake-stricken areas of Central Italy, Piana di Gioia Tauro to Sassari, from our patients to people representing different regions and the organisation itself. Supporters from the world of showbusiness and culture feature, including Flavio Insinna, Gianrico Carofiglio, Fabio Treves, Regina Orioli and Valerio Calzolaio.
EMERGENCY’s headquarters in Milan is a space that is open to the city, to promote a culture of peace and the practice of human rights through public meetings, debates, exhibitions, and concerts. In 2018, it hosted, among other events, the series of conferences ‘Dialoghi sulle migrazioni’ (‘dialogues on migration’), with Giulio Cavalli, Nello Scavo, Maurizio Ambrosini and Paolo Iabichino, and the film screenings Schermi migranti (‘migrant screens’) and D(i)ritti all’imagine (a pun on ‘image rights’ and ‘straight to the image’) on immigration issues.
OFFICES IN ROME AND VENICE
EMERGENCY’s two other Italian offices, in Rome and Venice, also host public initiatives and meetings, such as the film festival D(i)ritti all’imagine. The activities dedicated to EMERGENCY Venice’s culture of peace started in April 2018 with Conoscersi. Incontri in Giudecca (‘Getting to know each other: meetings on Giudecca’), and continued throughout the year with 20 meetings on immigration and multiculturalism, relying on different experiences and languages, includings live presentations from our staff, documentary screenings presented by filmmakers, and book readings by authors.
The involvement of local groups is crucial in helping us spread our message, and supports the work at our head office . We have 2,231 volunteers, divided into 148 local groups and 20 university groups, who are all an integral part of our organisation.
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 2018 alone, we engaged with 61,500 secondary school students, 25,500 primary school students, and 4,100 teachers, with the involvement of over 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.
UNIVERSITY GROUPS AND ‘FUORI AULA’
In 2018, we opened 20 student groups in 20 cities, which organised 63 initiatives in 2018. From 8 to 16 May was the second edition of the national programme ‘Fuori aula’ (‘outside the classroom’), an event organised by university groups to promote a culture of peace among students and all young people.
Many cultural initiatives in a range of university cities were inspired by the theme of ‘look at the world from another point of view and help us change it’. Eighteen events were organised for ‘Fuori aula’, for a total of 2,075 participants (an average of 115 people per event). Funds raised were earmarked for EMERGENCY projects in Afghanistan.