SlideShare una empresa de Scribd logo
1 de 20
Descargar para leer sin conexión
EMERGENCY
n° 0 • July 2009
EMERGENCY ROME
Via dell’ Arco del Monte 99/a, 00186 Rome
T +39 06 688151 - F +39 02 68815230
roma@emergency.it
www.emergency.it
EMERGENCY MILAN
Via Gerolamo Vida 11, 20127 Milan
T +39 02 881881 - F +39 02 86316336
info@emergency.it
www.emergency.it
EMERGENCY USA
4910 Massachusetts Avenue NW, Suite 300
Washington, DC 20016 – T +1 888 501 EUSA
info@emergencyusa.org
www.emergencyusa.org
EMERGENCY UK
PO Box 62437, London, E14 1GA
T +44 (0) 333 340 6411
info@emergencyuk.org
www.emergencyuk.org
AFGHANISTAN
Training
for Critical Care Units
«F
alcon 4 Falcon 4… cardiac arrest in Intensive Care
Unit”. It was ten minutes before midnight, and
someone was calling me on the radio. “Start the
cardiac massage,” I replied as I ran towards the
hospital. Latif, Fahim and Samiullah, just graduated from the Government
School for Nurses at the University of Kabul, and were working the night
shift. The school curriculum offers CPR training. Unfortunately, the quality
of teaching is still very far from acceptable or satisfactory standards. This is
understandable in a country devastated by thirty years of war.
In all of its projects, EMERGENCY strives to provide intensive training for
local staff through daily hands-on experiences with highly qualified doctors
and nurses coming from other countries.
This and other targeted activities provide local staff with current medical
knowledge, and eventually lead to their autonomy. In the first months of 2008,
Daria, Elena, Debbie and I, all international nurses at the EMERGENCY
Hospital in Kabul, have established a Basic Life Support (BLS) course in an
effort to accomplish these goals.
The ABC’s of resuscitation —
Airway, Breathing and Circulation
BLSencompassesallcardiopulmonaryresuscitationproceduresperformed
to rescue a patient who is unconscious, or suffering from cardiac arrest.
Independently from the cause of cardiac arrest, the heart fails to contract and
pump blood to the tissues.
The lack of oxygen supply to the brain cells, known as cerebral anoxia,
causes irreversible damage within 10 minutes of the onset of circulatory
arrest. This implies that the time available to rescue a victim of cardiac arrest
is extremely short before irreversible brain damage occurs.
The goal of BLS is to maintain an “emergency oxygenation” through
artificial breathing and cardiac massage, until more efficient means can be
used to correct the factors that determined the arrest. The BLS procedures
are standardized and recognized as effective by several key international
organizations that provide constant revisions and updates.
To help with memorization, the BLS phases are schematized in three
steps, indicated by the first three letters of the alphabet.
A: Airway – Opening and control of the airway, removal of potential
occlusions (foreign-body, food, blood), and insertion of a plastic tube to keep
airway pervious.
B: Breathing – Sustain breathing by ventilation with Ambu bag (if
unavailable, proceed with mouth-to-mouth breathing).
C: Circulation – Sustain cardio circulatory function by control of carotid
pulse, and potential cardiac massage.
At each step, a vital sign (airway, breathing, cardiac pulse) is checked and
restored, if compromised.
Learning to save Minianne really means
helping Gul Arifa
BLS is of utmost importance in the training of health care staff. For this
reason, it is periodically taught to newly hired staff at all of EMERGENCY’s
hospitals.
This latest course was designed specifically for nurses newly graduated
from the University of Kabul, and working in the critical care areas (ER,
intensive care, surgery room).
It is divided in two sessions. The first session illustrates the guidelines of
the Italian Resuscitation Council (IRC), while the second, besides reviewing
previous material, allows students to practice the reanimation resuscitation
of Minianne.
Minianne is an inflatable manikin provided by the IRC. It is particularly
Basic Life Support Course in Kabul – Emergency Cardiopulmonary Resuscitation (CPR)
2
useful in the teaching of lifesaving maneuvers, since it allows effective
simulation of cardiac massage and manual ventilation.
During this session the nurses, divided into small groups, ask questions
and practice until they feel confident with all the maneuvers. The hands-on
nature of the class has guaranteed the expected results.
In fact, the staff has acquired both physical and psychological confidence
with instruments and maneuvers, and it is now ready to effectively cope with
any emergency situation.
It is midnight. Out of breath, I reach the intensive care unit. I don white
coat and shoe covers and I step inside. Latif is by Gul Arifa’s bed performing
ventilation. Samiullah is standing on a step stool, ready to administer a
cardiac massage.
Fahim, the youngest, looks at me nervously as I come closer. Together we
gaze at the monitor. Gul Arifa’s heart has resumed beating. We smile at each
other. “Great! Well done!”.
NADIA DEPETRIS
Translated by Ada Buvoli
3
AFGHANISTAN
The Consequence of War
H
e arrived at two in the afternoon on 22 July in a car driven by his
uncle. He had been carefully laid on a thin mattress, wrapped in
a plastic cloth, with stained rags used to stop the bleeding from
his wounds.
Six year old Quadratullah is transferred to a stretcher by ER nurses. He
doesn’t utter a single word and through teary, terrorized eyes watches all the
people who are frantically racing around him.
We remove the rags from his wounds. It is a devastating image. His left leg
is gone, ending just under the knee with two bone fragments protruding from his
flesh. The right leg is still okay, but wounded. His left hand is crushed, and the
right hand is wounded. His back and pelvic area have deep wounds resulting
from the explosion.
We should be familiar with these scenes, but we’re not. Each time, the horror
of these scenes doesn’t allow us to become accustomed to them.
As soon as Quadratullah’s condition is stabilized, he is sent immediately to
the operating room.
What remain behind are two apricots,
and the tragedy of a morning that was supposed
to be a celebration
The boy’s father’s arm (Ajimir Aziz) is wounded. When we ask him what
happened, he takes two apricots out of his pocket, and then breaks down
crying. That morning he had gone with Quadratullah to gather some apricots
in a small orchard near their home, in a village a couple of hours from Kabul.
Quadratullah was so happy because his father was dedicating the whole day to
him. It was their time to play, their moment to be together.
Then he saw some ripe apricots on the ground. The boy turned to pick them
up, meaning to take them to his mother and siblings. But, as he bent down
to collect the fruit that’s when it happened. There was an explosion. It was
instantaneous, like always.
Ajimir extends the two apricots out to me. I face him, not knowing what to
do. The nurses encourage me to take the fruit, he is offering them to me. I take
them into my hands. I look down at them, and put them into my pocket - two
apricots and Quadratullah’s life torn apart.
MARINE CASTELLANO
Translated by Paolo Chiappetta
Six year old Quadratullah, Victim of a Landmine Explosion Arrives at our Hospital in Kabul
I
n the summer of 2007, just after the re-opening of our hospitals in
Afghanistan, we were contacted by the representatives of the Ghazni
community from one of the areas most impacted by the war, and which
runs along the road connecting Kabul to Kandahar. They made a
request that we open a First Aid Post to be connected to our surgery center in
Kabul where high standard, free medical assistance is provided to everyone
in the area who is injured or wounded.
We had to wait a few months before starting a new initiative and fulfilling
this request since we had to be sure that the entire Afghanistan Program was
back on track.
In April, a delegation form EMERGENCY completed a first assessment of
the city of Ghazni, capital of the province, to select an appropriate location for
the new project. However, the local authorities had no appropriate building
to offer, and to build a new hospital would take too long given the urgent
needs of the population. The generosity of a wealthy individual provided
the solution. The owner of a small supermarket donated the building, to be
remodeled for the FAP. After a couple of months under construction ─ tiling,
windows and doors, painting, construction of lavatories, and the selection of
the appropriate personnel ─ the Ghazni FAP became operative on July 20th.
The official inauguration took place on August 10th at 2:00 PM. Many officials
were present; the vice-governor of the Ghazni province, a member of the
national parliament, the mayor of the city of Ghazni, the director of the Ghazni
hospital, the community leader and many local citizens. Due to worsening
security along the road connecting the capital with the south of the country, no
one from EMERGENCY was able to participate in the opening ceremony.
The distance from Kabul and Ghazni is about 120 miles, and is normally
about a two hour drive. In recent months, with the increase in military conflict,
the travel time has more than tripled to cover that area (the official delegation
that came to Kabul to thank us for the new facility took seven hours), and the
frequent attacks have made any travel extremely dangerous.
In spite of the fact that the media and the international community seem to
have forgotten, the war in Afghanistan continues, along with our commitment
to mitígate, if only in part, the suffering of the victims.
RM
Translated by Michele Isernia
AFGHANISTAN
Restarting and expansion
In Ghazni, 120 miles south of Kabul, the local population asks for a new FAP (First Aid Post)
AFGHANISTAN
A Flower in the Midst of War
Amongst the Victims Many Children Are Admitted to the Lashkar-gah Hospital
T
he corridors of EMERGENCY’s hospital in Lashkar-gah remind us
of the human cost and consequences of the war in Afghanistan.
Over the past thirty years, more than one and a half million people
have been killed, the majority being civilians.
Our hospital is the only one in the region which provides completely free-of-
charge surgical interventions.
For the most part, the patients suffer injuries sustained while caught in the
middle of military combat, while stepping on one of the many landmines
spread throughout the region, or as they become victims of violence
associated with the drug trafficking trade. Others are wounded by air raids
conducted by international forces.
NATO asserts that troops do their utmost to take precautions to avoid
civilian casualties. In the cases of civilian casualties, an investigation is
conducted, and under the best of circumstances, civilians become eligible
for compensation.
Our patients come not only from the city, but from all over the region. In
order to reach our hospital, they travel on damaged roads on a journey that
can last days.
Some arrive at the First Aid Post in Grishk thanks to an ambulance service
which is open 24 hours a day. Many never arrive, partly because they die en
route, and partly because after aerial bombing raids the Afghan army blocks
the roads not allowing the injured to pass through.
As in all of EMERGENCY’s hospitals, a red and white sign greets the
public as they enter, “We inform that all medical and surgical assistance is
free of charge for the patients”. The treatment is completely free, only a blood
donation from the families of patients admitted to the hospital is requested.
For victims who are severely wounded, numerous blood transfusions are
required, and the hospital’s blood bank needs to be continually replenished.
Usually after making their donation, parents or siblings of patients often return
a few hours later with friends and relatives to also give blood.
Gullandam, beautiful like a flower, in a Helmand
that can no longer claim to be a garden
Yesterday, an Afghan nurse presented us with paperwork that we had not
seen before. The father of Gullandam, a young girl who was under our care
for the past few days, asked us to complete the paperwork out as soon as
possible.
He is required to present the filled-out forms to officials in order to receive
compensation for the explosion that destroyed his family’s home.
We take all the paperwork, and of course will help. As soon as it is filled out
with the relevant information regarding the young girl’s condition, we go with
Paola back to D-Ward, the children’s ward, where we locate the girl’s father,
and return the papers to him.
Gullandam means beautiful like a flower, in Pashtun. She is in the garden
playing amongst the other hospitalized children. At 6 years of age, she has
already bravely faced the amputation of one leg, and many painful medical
procedures to save the other.
And sooner or later, she will have to be told that she has also lost her
mother, and that she no longer has a home to return to.
NADIA DEPRETIS
Translated by Roland Swan
SUDAN
Our Idea of Peace
O
ver 1.5 million people live in Nyala, most of whom are
refugees who fled the war. They live in camps surrounding
the city. Following a request by the local Ministry of Health,
EMERGENCY decided to build a paediatric centre to offer high
standard free of charge medical care 24/7 to children under the age of 14.
The Centre will address prevalent illnesses such as malnutrition, respiratory
infections, malaria, and gastricgastrointestinal infections.
It will implement immunization programs, and preventive efforts to combat
diseases such as rheumatic fever, in addition to providing health and hygiene
education for families.
The Centre will provide screening for patients suffering from heart disease
potentially requiring transfer to the Salam Cardiac Surgery Center in Khartoum
to undergo heart surgery. Post-operative monitoring and care will also be
guaranteed.
The Centre in Nyala will be part of EMERGENCY’s Paediatric and Heart
Surgery Regional Program, with the Salam Centre as its hub. Collaboration
with the Sudanese authorities – both Federal and South Darfur – has been
essential for this project.
The Paediatric Centre will be built on land offered by the South Darfur
authorities, in collaboration with the local Ministry of Health.
Last summer EMERGENCY carried out a feasibility study and assessed the
estimated costs for the structure and start-up costs at 600,000 Euros. This total
became the target amount for our text message fundraising campaign.
The results coming in from the participating phone companies seem
to confirm that we’ve reached the targeted amount. This is an important
achievement since it will help us continue our mission in Sudan and the
neighboring countries. As soon as we have the final results, we will publish the
final tally of funds raised.
In the meantime, we would like to thank everyone who has decided to
participate in helping us build this paediatric centre, working together with us to
concretely achieve Our Idea of Peace.
ROSSELLA MICCIO
Translated by M.A.
A Paediatric Centre in Darfur, Another Goal to Reach
The Our Idea of Peace fundraising campaign to begin construction of another EMERGENCY
health care centre, this time in Nyala, southern Darfur, for children under the age of 14,
ended last October. The Centre in Nyala will further expand EMERGENCY’s Paediatric and
Heart Surgery Program in Africa during 2009.
SUDAN
A Comparison Between
Goals and Results
K
hartoum, July 2008. The temperature outside is about 45°
Celcius (113° Farenheit). The dry heat makes it a bit more
tolerable, but it is certainly not advisable to dwell too long
outside, even in the garden of the Salam Centre — a place
that brings healing to the heart.
This is a familiar place even to the patients of the Centre, who have organized
a creative alternative to ‘outdoor activities’. Every afternoon, once clinical
activities quiet down, a ‘parlor room’ is created alongside the large window
which separates the patients’ wards from the outside world.
The patients awaiting surgery, and the post-op patients who are able to
mobilize, pull up some chairs near this large window, and spend the afternoon
chatting there. Beyond the window, one can see the colorful seasonal flowers,
the trees, the green lawn and bushes. Beyond, it is known that the Nile flows,
and although it cannot be seen, it is “sensed”.
From this large window overlooking
the garden, light comes in as gazes go out
For all of those who have followed the progress, and believed in this hospital
from the very start, from when it was only a ‘crazy’ idea, it has confirmed the
transformation of a utopian dream into a reality - one rooted in the daily lives
of hundreds of people.
I am talking to Raul about this large window.
As the architect, he designed the window with the intention of bringing light
to the long corridor which faces the patients’ rooms.
Now, the patients have chosen it as a place of gathering and relaxation. It
has become a case, one could say, of unplanned consequences to calculated
actions. This novel use was approved and appreciated by the designer
himself, who for the time being does not delve too deeply into discussion
about the ‘diverse nature’ or ‘outcome’ of intended purposes.
Fifteen Months after its Opening — An Update on the Salam Centre for Cardiac Surgery in Khartoum
8
9
This space was transformed by the patients into an
area for chatting, a simple act which lightens tensions,
favors understanding, and fosters friendships.
It is where we often stop to talk with the guests
of the Salam Centre
Barring complications, the average length of stay here in the hospital is
about 10 days, which is sufficient time for people to get to know each other.
It is amazing to see the behavioral transformation of the patients after just
the first few days in the hospital. Initally, everyone looks lost, almost afraid.
For many, the arrival to the Centre is like being left stranded on the moon.
No relatives or ‘co-patients’, as they are called here, are allowed to visit
except on the consented days and times.
In the other local hospitals co-patients provide most of patient care, from
food to laundry, from personal care to even medications.
Here, on the other hand, clean pajamas and showers in the rooms, three
free full meals per day, doctors and nurses, are all available 24/7.
The omnipresent white faces of the khawala (‘white’ people) administer to
everything.
After a few days, patients memorize names, begin to feel comfortable, and
even begin to trust the khawala.
Children, in particular, are the ones who develop the most immediate
rapport. And there are many children in our hospital, about 25% of the 937
patients hospitalized at Salam through the end of July 2008 have been
younger than 15.
There is a long list of cases, difficulties and problems,
and many solutions that have been researched
and found
The small group of teenagers who have been treated at the hospital since
the beginning of July has truly been diverse.
Wail, 14, arrived from Port Sudan. In addition to his young heart struggling
from the damage of recurrent rheumatic heart disease, he suffers from kidney
and lung problems, so we anxiously await definitive signs of healing.
Enas, is an 11 year-old girl, who weighed just 17 kilos (37.5 lbs) when she
was hospitalized. Our cooks prepared a special diet for her over several days
to help her gain a body weight which she probably never had before…and at
any rate, also to help her gain a few kilos before surgery.
Osman “One” (to distinguish him from Osman “Two”), despite being only
10 years old, is a veteran of the Salam Centre. He has been with us since
February, and has had treatment for his right ventricle. The right half of his
heart wasn’t functioning.
Blood taken from the right atrium through a cannula was channelled back
with a pump to the pulmonary artery, to reach the lungs and to oxygenate.
Now he is ready, well enough to go back home to the state of Sinnar, south
of Khartoum. He will be accompanied by his grandfather, who was staying in
the centre’s guesthouse during his grandson’s hospitalization.
Then there is the trio from Darfur. Saddam, 15, of Genina, West Darfur,
urgently hospitalized for a serious heart problem that was treated via
replacement of the mitral valve and surgical repair of the tricuspid valve.
Curly haired, darke eyed Osmad “Two”, 9, is shy and introverted, and was
one of the last of the group to be operated on.
After surgery he was received with a round of applause when he was
transported from the operating room to the intensive care unit where some
of his friends who had already undergone surgery the previous days were
recuperating.
Ali, the smallest of the group, and only nine years old, is from a small village
near Al Fashir, North Darfur. He also needed a mitral valve replacement and
surgical repair of the tricuspid valve.
Araghes the Ethiopian and Sarawit
the Eritrean: distant is the world that would like
to see them be enemies
The unique atmosphere of the Salam Centre makes sure that not only
do ethnic barriers disappear between the beds in the ward, but that also the
linguistic difficulties due to the different nationalities be overcome.
Proof is the story of Sarawit, a very young girl from Eritrea, hospitalized for
a mitral stenosis, and Araghes, an Ethiopian child brought here thanks to the
initiative of a group of Italian volunteers who collaborate with a hospital from
the congregation of Mother Theresa of Calcutta in Addis Ababa.
Araghes speaks onlyAmarico, hence she had difficulties comunicating with
the foreign doctors and nurses, as well as with the Sudanese personnel. But,
her problems are solved thanks to the help of Sarawit who, besides Tigrino,
also spoke Araghe’s language, and she becomes her interpreter.
They were apart only during surgery and immediately afterwards.
We suggested that they become ambassadors of their respective
governments, which have been at war for about ten years now.
We may have been joking, but… their relationship is no longer a joke,
it is real.
A lesson from our first balance sheet —
something we ‘believed in’, is incredible
After a little over a year since its opening a draft of the activity summary for
the Salam Centre is available.
Despite the continual necessity for precautions to be taken, and with the
inevitable problems encountered, we are pleased with the initial results.
Under the circumstances and given the difficulties, in 15 months time we
have been able to progress from one to three open heart operations per day.
About 30 patients are examined daily for triage.
A third of these patients will then need a specialized visit with the
cardiologist. Paradoxically, given the enormous distances in this country,
news ‘by word of mouth’ has produced unexpected results.
More than 43% of the Sudanese patients in our hospital do not live in
Khartoum, but arrive from one of the 25 states that make up the federation.
Even going beyond the Centre’s data and statistics, and the daily operational
routines, the “life” of this hospital suggests a very comforting evaluation.
From the examination rooms to the office administration, from the labs to the
wards, from the kitchen to the laundry rooms, from the operating rooms to the
pharmacy, one can clearly feel that the premises itself suggests the sense of
being in a special place, in so many unique ways.
More often than not, ‘Incredible!’ is the comment heard over and over by
visitors to the Salam Centre for Cardiac Surgery, from the Sudanese, as well
as from foreigners passing through Khartoum for work or vacation. For us this
expression ’incredible’ reminds us of a daily effort, which began with an idea,
went on to be built, fully equipped and furnished and ultimately completed
with the search and assembly of personnel.
It is an effort that continues on with a myriad of new and diverse problems
(sanitary, logistical, technical) to be overcome each day.
But, after a brief pause by the large window that overlooks the garden, and
an exchange of a few words in bizarre, improvised “mixed” languages with
the national staff and patients, we all become part of the incredible vision
sensed by all visitors.
ROSSELLA MICCIO
Translated by Rosalba Perna
10
SUDAN
First the Children
S
ince the EMERGENCY Paediatric Centre first opened its
doors in December 2005, the camp has expanded and is now
surrounded by new homes, at best made from mud and plastic
sheeting. They belong to new refugees from Darfur, and to old
residents driven away from areas that are increasingly urbanised - always a
source of homelessness.
From the hospital’s water tower, the grim view of the camp is a vast sea of
shacks, extending as far as the eye can see, with dust and dirt everywhere.
Although only a mere 12 km from dowtown Khartoum, we are very far from
the skyscrapers dominating the heart of the city.
Our Centre is situated in an area of the camp called Angola, which is
populated by roughly fifty thousand people, fifty per cent are children. When
it first opened three years ago, the Centre’s objective was to guarantee free
medical treatment to the more immediate community in the area.
Now, patients arrive from the rest of the refugee camp as well as far off
neighbourhoods. In the Outpatient Ward, three nurses and two doctors work
with a pharmacist, along with a lab technician who performs urgent blood
tests -- all under the supervision of an international paediatric nurse.
Mothers and children arrive at six o’clock in the morning and are seated
under a protected outdoor veranda.
As they await their turn, they are neat, poised and beautiful in their colourful
clothing.Attilia, the international nurse, together with the local nurses carry out
a rapid triage to evaluate any urgent care cases. Patients with malnutrition,
loss of consciousness, fever and severe respiratory problems are given high
priority.
It seems as if it were summer. There are clear skies and the temperature
is a dry, 28 degrees Celsius.
But, this is their winter, and illnesses such as bronchitis and asthma are
common, just as in any outpatient ward in Italy during this time of year.
Many are suffering the consequences of living under inhumane conditions
in the camp.
Malnutrition, conjunctivitis, and urinary tract infections are among the most
common maladies. Diarrhoea is a consequence from drinking the water from
the donkey tank. Water is sold and distributed house to house from a large
tank transported by mule. It costs between 200 and 300 dinar depending on
the vendor. Daily wages are roughly 1000 dinar.
An Urgent Transfer Leaves Us
With More Questions Than Hope
Every day our staff examines fifty children, and those requiring observation
stay in the ward until closing time. “The Centre has to close at 4:00 PM due
to security reasons”, explains Attilia. “At night the men get intoxicated on
araki, a distilled alcohol with an extremely potent effect, and it is better not to
stay around the area”. The more severe cases are transferred to the two city
In Just Over Three Years More Than 56,000 Patients Have Been Treated in the Mayo Refugee Camp
11
hospitals, the Khartoum Hospital and the Bashir Hospital. Thanks to the
working experience with the Mayo EMERGENCY Paediatric Centre, the
government of Khartoum passed legislation that all care for paediatric
emergency medical cases be provided free of charge.
A mother brings in her child wrapped in a colourful cloth. As soon as she
opens her little bundle, his emaciated face reveals that we are clearly faced
with a very ill infant. “He’s not well, he hasn’t been eating for the past week”,
she says. But the skeletal body, and lack of strength confirms evidence of
long term malnutrition. At forty days old, the baby weighs only 2 kg. The infant
is suffering from an infection, running a 40 degree fever, and does not even
have the strength to cry.
“After the operation, he stopped eating, and is becoming more and more
lethargic”. The operation she refers to is the procedure performed by one of
the twenty tribes living in the camp which believe that by cutting the uvula
and palette of a newborn, regurgitation can be prevented. Every newborn
undergoes the procedure. “Imagine a procedure of this sort, most likely
performed in the middle of the street in a place like this, with instruments
being washed in the camp’s water”, says Attilia, who periodically sees these
cases. The ambulance is ready to go, and we immediately transport mother
and child to the Khartoum Hospital.
During the trip,Attilia asks me to try to stimulate the infant by stroking a pen
along the bottom of his feet, while she keeps the oxygen mask ready for use.
No reaction, he keeps his eyes half closed, and does not even whimper. We
arrive at Khartoum Hospital, a chaotic and dirty place where, even for Attilia
who comes here often, it is difficult to orient oneself.
In a large, half lit room, five doctors seated at their desks examine their
young patients surrounded by a throng of mothers coming and going with their
children. One female doctor quickly checks the baby and asks the mother and
Attilia a few questions. He will be admitted and undergo an antibiotic and an
intensive nutrition treatment.They assure us that “he will make it.”
I ask myself how many more times will this little baby have to “make it”
in order to survive life in Mayo Camp to reach age 5, and survive the infant
mortality statistics of this country.
SIMONETTA GOLA
Translated by Roland Swan
12
CENTRAL AFRICAN REPUBLIC
Good Morning Bangui
News in the Regional Programme for Paediatric Care and Cardiac Surgery
Each day the staff at the Paediatric Centre in Bangui provides free specialized assistance
to forty children. Thanks to periodic visits to the Centre by the international cardiologists,
patients can be screened to determine whether they require surgery at the Salam Centre for
Cardiac Surgery. The required post-operative follow-up care is also guaranteed.
13
I
t is Friday, 6 March 2009, 9:30 AM. “The promise has been kept,”
declares Francois Bozizé, the President of the Central African
Republic. Together with the Prime Minister, the President of the
National Assembly, and the foreign ambassadors present in the
country, Bozizé attended the inauguration of the Paediatric Centre in Bangui,
a new development in EMERGENCY’s Paediatric Care and Cardiac Surgery
Programme in Africa.
The government of the Central African Republic had immediately provided
aid and support for the project, granting EMERGENCY use of a centrally
located plot of land near the Parliament buildings. This is where the Paediatric
Centre would be built. Construction began in March 2008. The project was
assigned to a CentralAfrican company that carried out the plans to perfection,
respecting the deadlines and the predetermined budget.
Finally, the Paediatric Centre was ready for its inaugural opening. With
its red and white coloured external walls, its surface area covers 550
square meters. It includes an internal patio transformed into a play area
with an imaginary grassy plains mural filled with toy crocodiles, rhinoceros,
elephants…
The Centre, which is open 24 hours a day, seven days a week, offers
medical assistance to children up to 14 years of age. Immunisation and
health and hygiene education programmes are also offered.
Duringperiodicevaluationmissions,inthecardiologywardEMERGENCY’s
international specialists come to screen and evaluate patients suffering from
heart disease to determine those in need of transfer to the Salam Centre
in Khartoum for treatment. After surgery, the patients are guaranteed post-
operative check-ups at the Centre in Bangui.
In Bangui, Like Goderich and Khartoum: Malaria
and Diarrhoea are the Most Common Diseases
News of the opening of the Bangui Paediatric Centre spreads rapidly by
word of mouth. In a scene similar to those in other EMERGENCY Pediatric
Centres - such as in Khartoum, Sudan and in Goderich, Sierra Leone - from
the early morning hours mothers and children crowd the entrance of the
hospital, awaiting their turn to be examined.
Each day, Paola a paediatric nurse, and Mariella a paediatrician, assisted
by local doctors and nurses, examine forty children on average. With six
beds in the Centre, the doctors are able to admit serious cases overnight,
as needed. Just one day after its opening, the first patient was admitted.
His name was Jonathan, who at 22 months was weighing in at only 7 kilos.
He arrived suffering from dehydration due to severe persistent diarrhoea. As
soon as he reached the Centre, doctors immediately initiated oral rehydration
treatment, and proceeded with blood tests for Malaria, which came back
positive. Together with his father who accompanied him, Jonathan will
christen the clinic’s new toys with the hope of going back home soon.
PIETRO PARRINO
Translated by Roland Swan
14
CAMBODIA
Cambodian Triptych
Against Violence, Landmines and Accidents — Three Stories of Human Resistance
A plastic surgeon details his encounter with a few patients he treated during his work at the
SurgicalCentreinBattambangbringingtoawarenessthedifficultyoflivingtheconsequences
of war, and facing new cruel realities.
T
hree girls — three stories from this ill – fated country’s history
spanning half a century.
The experiences of these three girls would be very unlikely to
happen in Italy, but if they were to occur, the detrimental effects
of the injuries sustained would be treated through an advanced health care
system, and their lives would be supported by social and public assistance.
In Cambodia these social infrastructures do not exist, at best there might be a
fragile, and not always available family support system to help.
Already faced with difficult lives, these three young women, having
undergone physical surgical reconstruction and prosthetic rehabilitative
training now find themselves facing the added burden of not having full use
of their own bodies. EMERGENCY assisted them in their rehabilitation, and
then when feasibly possible, in job placements, or by some small donations.
But the biggest feats were overcome by their own courage, which was key
to their recovery.
A disfigured face due to jealousy —
Then surgery and a job towards a new life
WhenIfirstsawNhomVuninthefrontgardenoftheemergencydepartment,
only half of her face was visible. Like most young Cambodian women, she
had fine, gentle features. She kept the other half of her face oddly concealed
with a towel which she uncovered as soon she entered the examining room.
What was revealed was a disfiguring two centimeter thick scar, banning
any type of facial movement. Her eyelids were now non-existent due to the
disabling scar, and the eye was wide open, with no protection of an eyelid,
and already covered with sores. Her lower lip was fused to her chin, as was
her upper lip to the side of her nose.
She was only 19 years old. Three years ago, Nhom was raped and
impregnated by a man in her village, who then decided to marry her. In the
two years following the birth of her first child, there were two more births.
And then, all of a sudden the man announced that he was going to Thailand
to find work. Left alone, Nhom Vun found work in the rice fields. But once
the harveting season ended, she had to find other work. She began to pack
and sell sweets, and earn good wages compared to the average Cambodian
salary. The husband, who had actually moved in with another woman in
a nearby village, now revealed a renewed interest in Nhom, and her new
prosperity.
In order to prevent any type of reconciliation between the two, the jealous
lover attacked Nhom by thrusting a bottle of acid over her face. At our initial
consultation, I informed Nhom right away that one procedure would not be
enough to restore a normal physical appearance, and that there would really
be no hopes to totally erase all the effects resulting from the acid burns. I
began the surgical intervention with the reconstruction of her eyelid, in order
to try to avoid loss of the eye. Removing the scar tissue, I realised that some
15
that some of the muscles of the eyelid had been damaged, but still existent.
So I began to reconstruct the eyelid with strips of tissue and cartilage from
behind the ear. The few remaining muscles would allow movement of the
eyelid, thus restore opening and closing of the eye.
The second procedure began by removing the scar tissue over the lips,
where I would have to proceed with a skin graft taken from the back of the
undamaged ear. Her lips began to regain some mobility, even though she
would need further corrective surgical intervention on her lower lip.
Returning to Battambang this year, I encountered Nhom Vun in the hospital.
She wasn’t there for a check-up, but as an employee. She was hired there
as an orderly. EMERGENCY frequently employs its patients to help them
socially reintegrate, especially those patients having undergone particularly
traumatic experiences.
The medical coordinators say that everyone is extremely happy with her
work, and the patients really appreciate her. Every time we pass each other in
the corridor, she shares with me the gift of a beaming smile. The reconstructed
half of her face is not as graceful as the other [undamaged] half, but mobility
is close to normal. I am happy to have been able to contribute to providing this
young woman with the chance to a social life.
An accident at the beginning of a new life —
Landmines don’t know when war has ended
Den Srey Mao is 20 years old, and she has only been married for a few
months to a man so tall and athletic that he does not seem Cambodian. Their
families had given them a small parcel of land with a few animals (chickens,
ducks and goats) as a wedding gift in order for them to begin their new lives
together. They were farming vegetables on the land to sell at the market so
that they could earn enough to buy a pig at the end of the year.
One day while walking to it along the pathway which had undergone
landmine clearance two years earlier, and which she had passed through
countless times before, the young woman saw something strange on the
ground. It was too late, she was unable to avoid stepping on it. It was a
landmine which had been washed onto the path by heavy rains in the previous
days. Dan Srey arrived at the hospital with traumatic amputation of both her
lower limbs, loss of an eye and various wounds to her face.
The amputations were corrected by our orthopaedic surgeons in order to
allow fitting of prosthetic limbs. I was responsible for the reconstruction of the
orbital cavities. Two operations would be necessary: removal of scar tissue,
and enlargening of the ocular cavitiy for fitting of a prosthetic eye.
Three days before my departure Den Srey received her prosthetic eye,
a necessary step in restoring her face with a certain degree of physical
normalcy. While waiting for her leg stumps to heal so she can be fitted with
prosthetic limbs, her husband takes her home - where another new beginning
awaits them.
Two wigs for Proeung
Even hair becomes a form of treatment
Proeung Sreyrotha was 16 years old when I met her last year. She was
harvesting rice when she got too close to the fanbelt of a threshing machine.
Her entire scalp was ripped from her skull - from her eyebrows to her cervical
vertebrae. In the West, depending on how intact the affected skin is, we
treat these cases by surgically reattaching the ripped scalp, and through
microsurgical anastomosis, re-establish the blood circulation to the damaged
skin.
However, in Cambodia, the proper surgical apparatus for microsurgery is
unavailable. So in order to treat Proueng’s condition, she had to undergo
severalskingraftsurgeriestothedamagedarea,amethodnolongerpracticed
in Europe for over 40 years. After 6 operations and much painful medication,
we finally managed to cover Proeung’s skull with a layer of hairless tissue.
Some time later, in a very moving and emotional ceremony of sorts, we
presented her with two gifts. We gave her two wigs - one with short and the
other with long hair - so that she can continue to carry out her life as a normal
young girl.
PAOLO SANTONI-RUGIU
Translated by Roland Swan
16
Worldwide Malnutrition
Malnutrition and undernutrition are some of the effects of a global imbalance that has caused
recent alarm in the political world (under pressure from the speculative push to finance
raw material and consumer markets) especially among those where access to basic food
resources has been undermined.
W
hen the cost of bread rises excessively, revolts break out
for tortillas in Mexico, and mud cookies are baked in Haiti,
then we know that we are facing the disastrous effects of
a global financial manoeuvre that threatens the health and
even the lives of a large portion of the global population.
Even now, according to the Health World Organization, half of all human
beings – about 3 billion people – suffer from some form of malnutrition, a word
with various, but always worrisome, meanings.
Infact,thistermisusedtoindicateanimbalanceintheabsorptionofnutrients
and other factors necessary for a healthy life; this could be undernutrition – lack
of proteins vitamins or minerals, or overnutrition. In developing countries, one
person in five suffers from the worst form of malnutrition: hunger.
Grains produced for livestock feed rather
than human consumption
It is well known that malnutrition is due mainly to unequal access to food
resources rather than to insufficient food production. In fact, current agricultural
production could easily nourish the entire world population. The problem is
certainly underestimated, considering that a large portion of food resources is
diverted to animal feed instead of being utilized as food for the hungry.
Agricultural strategies adopted in recent years have resulted in complete
failure. Public and private institutions have actively promoted large-scale cattle
ranching in developing countries for production of meat and milk, without
considering that farmed animals consume more calories than they produce in
the form of meat, milk and eggs.
When the quarrel about biofuels and conversion of crops for their production
had not yet started, it was already evident that cereals were produced and
introduced in the market in large part to raise cattle rather than to satisfy
human nutritional necessities.
Official statistics, from FAO (the Food and Agriculture Organization of the
United Nations) and WHO (the World Health Organization) in particular, clearly
point out that a shift in cereal production for human consumption to animal feed
has forced developing countries to import grains at high cost, greatly worsening
the problem of malnutrition. In fact, in developing countries, staple foods are
mainly cereals and legumes, which provide the majority of carbohydrates and
proteins necessary for survival.
In a paradox, this diet that could be adopted in industrialized countries with
great health advantages, is now overlooked even in its traditional countries
of origin. Those who can afford it prefer a more occidental diet, where the
majority of the protein requirement derives from meat.
Food subsidies help donor countries and undermine
local economies
Non-governmental international organizations that fight world hunger are in
ferment to counter the steady increase in basic food prices.
Oxfam and CARE, for example, are running worldwide campaigns to raise
awareness and increase political pressure.
In fact, the forecasts of their experts indicate that predicted Eastern and
Western African tragedies could be avoided by immediate action on the part of
governments of wealthy countries.
“Food aids can save many lives”, says Ariane Arpa, responsible for
the Spanish Intermón Oxfam, “Unfortunately, the interests of Western
governments, tied with those of powerful agricultural groups and packaging/
shipping companies, frequently cause aid to arrive too late, at very high prices,
often destabilizing weak local economies”.
The humanitarian organization Oxfam has posted suggestions to remedy
these issues at www.oxfam.org.
In summary the suggestions are: increase donor as well as local
governments investment in small-scale agriculture (especially in sub-Saharan
African countries), cut incentives for biofuel production, and convince the USA
and EU to review their emergency food aid policies and focus assistance on
countries suffering the most serious consequences.
ANGELO MIOTTO
Translated by Ada Buvoli
INTERNATIONAL Human Rights
17
EMERGENCY
EMERGENCY ITALY
via Meravigli 12/14, 20123 Milano
Tel. 02 881881
Fax 02 86316336
E-mail info@emergency.it
http www.emergency.it
via dell’Arco del Monte 99/a, 00186 Roma
Tel. 06 688151
Fax 06 68815230
E-mail roma@emergency.it
http www.emergency.it
EMERGENCY USA
4910 Massachusetts Avenue NW, Suite 300
Washington, DC 20016 – T +1 888 501 EUSA
info@emergencyusa.org - www.emergencyusa.org
EMERGENCY UK
PO Box 62437, London, E14 1GA
T +44 (0) 333 340 6411
info@emergencyuk.org - www.emergencyuk.org
Every year war and poverty destroy the lives of millions of people.
In contemporary conflicts, 90% of the victims are civilians.
Since 1994, over three million patients have been treated in EMERGENCY’s
clinics, hospitals and rehabilitation centres located in war-torn areas.
EMERGENCY is an independent, neutral and non-governmental organisation
that provides free medical and surgical care to the victims of war, landmines
and poverty worldwide.
All EMERGENCY hospitals, clinics and rehabilitation centres are designed,
built and managed by international personnel committed to professionally
train national staff.
The articles featured in this issue were translated from articles that
appeared in EMERGENCY’s magazine, issues 48, 49 and 50:
Training for Critical Care Units, September 2008 (48): 2-3
The Consequence of War, September 2008 (48): 4
Restarting and Expansion, September 2008 (48): 5
A Comparison between Goals and Results, September 2008 (48): 8
Worldwide Malnutrition, September 2008 (48): 14-15
Our Idea of Peace, December 2008 (49): 12
Good Morning Bangui, March 2009 (50): 2-3
A Flower in the Midst of War, March 2009 (50): 9
First the Children, March 2009 (50): 10-11
Cambodian Triptych, March 2009 (50): 14-15
Data Protection Notice — USA
EMERGENCY USA – Life Support for Civilian
Victims of War and Poverty, with registered offices
at 4910 Massachusetts Avenue NW, Suite 300,
Washington, DC 20016, USA, in its capacity as
owner of the data processing, will process your
personal data manually and in electronic form
for the purposes of informing on its institutional
activity and for administrative reasons as a result
of your donations to the organization. The
provision of your personal data is not mandatory.
However, the failure to provide such data or the
subsequent withdrawal of the authorization to
process your personal data will prevent us from
processing your data for the purposes indicated
above. Your personal data may be disclosed
to third parties, also in foreign countries and
outside the European Union, only in connection
with the purposes indicated above. You will be
entitled to exercise the rights granted to you by
law by addressing your request to EMERGENCY
USA, 4910 Massachusetts Avenue NW, Suite
300, Washington, DC 20016, USA, ATTN: Ms.
Graziella B. Costanzo.
Director Carlo Garbagnati
Editorial Office Simonetta Gola
Collaborators on this issue Marco Antonsich
(MA), Ada Buvoli, Marina Castellano, Paolo
Chiappetta, Graziella B. Costanzo, Nadia
Depretis, Maureen Cairns, Robert Dvorak,
Janet Garcia, Anna Gilmore, Simonetta Gola,
Michele Isernia, Rossella Miccio (RM), Angelo
Miotto, Rosalba Perna, Dada Pisconti, Paolo
Santoni-Rugiu, Roland Swan.
Images Emergency’s Archive, Piergiorgio
Casotti, Cosimo Maffone, Samuele Pellecchia,
Naoki Tomasini.
Graphic and pagination Angela Fittipaldi,
Guido Scarabottolo.
Data Protection Notice — ITALY
EMERGENCY – Life Support for Civilian War
Victims ONG ONLUS, with registered offices
at Via Meravigli 12/14, 20123 Milan, Italy, in
its capacity as owner of the data processing,
will process your personal data manually and in
electronic form for the purposes of informing on
its institutional activity and for administrative
reasons as a result of your donations to the
organization. The provision of your personal
data is not mandatory. However, the failure to
provide such data or the subsequent withdrawal
of the authorization to process your personal data
will prevent us from processing your data for the
purposes indicated above. Your personal data
may be disclosed to third parties, also in foreign
countries and outside the European Union, only
in connection with the purposes indicated above.
You will be entitled to exercise the rights granted
by Article 7 of Legislative Decree No. 196/2003
by addressing your request to EMERGENCY
ITALY, Via Meravigli 12/14, 20123 Milan, Italy,
ATTN: Ms. Mariangela Borella.
Data Protection Notice — UK
EMERGENCY UK, with registered offices at
Flat 58, St. David’s Square, E14 3B London,
U.K., in its capacity as owner of the data
processing, will process your personal data
manually and in electronic form for the
purposes of informing on its institutional
activity and for administrative reasons as a
result of your donations to the organization.
The provision of your personal data is not
mandatory. However, the failure to provide
such data or the subsequent withdrawal of the
authorization to process your personal data
will prevent us from processing your data for
the purposes indicated above. Your personal
data may be disclosed to third parties, also in
foreign countries and outside the European
Union, only in connection with the purposes
indicated above. You will be entitled to exercise
the rights granted to you by law by addressing
your request to EMERGENCY UK, P.O.
Box 62437, London, E14 1GA, ATTN: Mr.
Gianluca Cantalupi.
For more information contact:
18
SVIZZERA
Gruppo del Canton Ticino
0041/787122941
emergency-ticino@bluewin.ch
VAL D’AOSTA
Gruppo Aosta
340/9471701
emergency.aosta@libero.it
PIEMONTE
Gruppo di Torino
338/8922094
emergency.to@inrete.it
Gruppo di Pinerolo - TO
334/7925925
emergencypinerolo@rifugiosella.it
Gruppo di Alessandria Casale
335/7182942 - 0142/73254
emergency.al@libero.it
Gruppo di Asti
0141/853487 - 348/5131104
emergencyasti@libero.it
Gruppo di Biella
349/2609689
emergencybiella@gmail.com
Gruppo di Cuneo
334/3154926
emergencycuneo@gmail.com
Gruppo di Novara
339/2300266
emergencynovara@yahoo.it
Gruppo di Arona - NO
335/6005077 - 328/8229117
emergency.arona@virgilio.it
Gruppo di Verbania
348/7266991
emergency.verbania@libero.it
Gruppo di Lago D’Orta VB
339/698808
emergencylagodorta@libero.it
LOMBARDIA
Gruppo della Brianza - MI
340/7784875
info@emergencybrianza.it
Gruppo del Naviglio Grande - MI
339/8364358 - 334/3175776
emergency.buccinasco@libero.it
Gruppo di Cinisello Balsamo - MI
348/0413702
emergency.cinisello@email.it
Gruppo della Valle del Seveso
- MI
348/2340467
emergencyvalleseveso@libero.it
LOCAL VOLUNTEER GROUPS
Volunteering is a fundamental and essential component of EMERGENCY’s work. Volunteers work to inform
the general public and promote a culture of peace through participation in conferences, meetings and workshops
in schools and in workplaces. Volunteers are key to fundraising by hosting dedicated events, presenting specific
projects to local agencies, organisations and businesses, or manning booths at larger events.
Gruppo di Cologno Monzese - MI
347/9669024
emergency_cologno_monzese@
yahoo.it
Gruppo di Magenta - MI
335/77507444
emergencymagentino@gmail.com
Gruppo Martesana - MI
393/2736362 - 02/9504678
emergency.martesana@tatavasco.it
Gruppo di San Giuliano - MI
338/1900172
emergencysgm@hotmail.com
Gruppo di San Vittore Olona - MI
0331/516626
emergencysanvittoreo@libero.it
Gruppo di Saronno - MI
339/7670908
emergencysaronno@gmail.com
Gruppo di Sesto San Giovanni - MI
335/1230864
emergencysesto@emergencysesto.it
Gruppo di Settimo Milanese - MI
02/3281948 - 333/7043439
emergencysettimomi@virgilio.it
Gruppo di Usmate Velate - MI
039/673324 - 039/672090
emergencyusmatevelate@virgilio.it
Gruppo di Bergamo
338/7954104
info@emergencybg.org
Gruppo di Isola Bergamasca - BG
320/0361871
emergencyisolabg@libero.it
Gruppo di Brescia
335/1767627 - 333/3289937
info@emergencybs.it
Gruppo di Crema - CR
335/6932225 - 335/7119651
emergency.crema@gmail.com
Gruppo di Como
333/6163586
emergencycomo@hotmail.com
Gruppo di Lecco - Merate
329/0211011
emergencylecco@libero.it
Gruppo di Lodi
340/0757686 - 335/8048178
emergencylodi@yahoo.it
Gruppo di Mantova
0376/223550 - 320/0632506
emergencymantova@virgilio.it
Gruppo di Monza
334/8670307
emergency.monza@inwind.it
Gruppo di Pavia
346/3307054
emergencypv@hotmail.com
Gruppo di Vigevano - PV
0381/690866 - 328/4237529
emergencyvigevano@tiscali.it
Gruppo della Valtellina - SO
0342/684033 - 320/4323922
emergency.valtellina@virgilio.it
Gruppo di Varese
334/1508540 - 333/8912559
emergencydivarese@gmail.com
Gruppo di Busto Arsizio - VA
0331/341424
emergencybustoarsizio@virgilio.it
VENETO
Gruppo di Venezia
347/9132690
emergencyve@gmail.com
Gruppo delle Città del Piave - VE
335/7277849 - fax 0421/560994
emergencycittapiave@libero.it
Gruppo di Spinea VE
041/994285 - 339/3353868
emergencyspinea@interfree.it
Gruppo di Belluno
348/7793483
emergency.belluno@yahoo.it
Gruppo di Padova
348/5925163
emergencypadova@hotmail.it
Gruppo di Rovigo
348/5609005
emergencyrovigo@libero.it
Gruppo di Treviso
333/4935006 - 340/5901747
emergency_treviso@yahoo.it
Gruppo di Verona
334/1974348
emergency.vr@libero.it
Gruppo di Vicenza
333/2516065
info@emergencyvicenza.it
Gruppo di Asiago - VI
333/6883280
emergencyasiago@tiscali.it
Gruppo di Thiene - VI
349/1543529
emergencythiene@tiscali.it
FRIULI VENEZIA GIULIA
Gruppo di Trieste
347/2963852
emergencytrieste@yahoo.it
Gruppo di Udine
0432/580894 - 339/8268067
emergencyudine@libero.it
Gruppo dell’Alto Friuli - UD
0433/51130 - 347/3172702
emergencyaltofriuli@tiscali.it
TRENTINO ALTO ADIGE
Gruppo di Trento
347/9822970
emergencytrento@yahoo.it
Gruppo dell’Alto Garda - TN
347/4091769
emergencyaltogarda@hotmail.it
Gruppo di Rovereto - TN
339/1242484
emergencyrovereto@libero.it
Gruppo della Valli di Fiemme
e Fassa - TN
347/6805029
emergencyfiemmefassa@yahoo.it
Gruppo di Bolzano
339/6936469
emergencybolzano@yahoo.it
LIGURIA
Gruppo di Genova
010/3624485
emergencygenova@libero.it
Gruppo del Tigullio - GE
0185/288400 - 349/4525818
emergencytigullio@libero.it
Gruppo di Riviera dei Fiori - IM
340/7708004
emergencyriviera@libero.it
Gruppo di La Spezia
349/3503695
emergencylaspezia@gmail.com
Gruppo di Savona
347/9698210
emergencysavona@libero.it
EMILIA ROMAGNA
Gruppo di Bologna
333/1333849
emergencybologna@virgilio.it
Gruppo di Imola - BO
0542/42448 - 339/7021931
emergencyimola@libero.it
Gruppo di Ferrara
333/9940136
emergency.fe@libero.it
Gruppo di Forlì - FC
338/4822684 - 335/5869825
emergency.forli@libero.it
Gruppo di Cesena - FC
329/2269009
emergencycesena@tiscali.it
Gruppo di Modena
059/763110 - 347/5902480
emergencymodena@gmail.com
Gruppo di Fanano - MO
348/4446120 - fax 0524/680212
emergencyfanano@libero.it
Gruppo di Parma
0521/873235 - fax 0521/371631
emergencyparma@polaris.it
Gruppo di Piacenza
0523/617731 - 339/5732815
emergencypc@virgilio.it
Gruppo di Faenza - RA
347/6791373
emergencyfaenza@yahoo.it
Gruppo di Reggio Emilia
0522/555581 - 348/7152394
emergency.re@fastwebnet.it
Gruppo di Rimini
335/7330175
grupporimini@gmail.com
REPUBBLICA SAN MARINO
Gruppo de San Marino
335/7331386
emergency.sanmarino@libero.it
TOSCANA
Gruppo di Firenze
334/7803897
info@emergency.firenze.it
Gruppo di Empoli - FI
338/9853946 - 333/3047807
emergency-empoli@libero.it
Gruppo di Rignano sull’Arno - FI
339/1734165 - 338/4609888
emergency-rignano@email.it
Gruppo di Sesto Fiorentino - FI
055/4492880 - 339/5841944
emergencysestofiorentino@gmail.com
Gruppo di Arezzo
348/6186728
emergencyar@virgilio.it
Gruppo di Grosseto
339/4695161
info@emergencygr.it
Gruppo di Follonica - GR
339/4695161
emergencyfollonica@ouverture.it
Gruppo del Monte Amaita - GR
347/3614073 - 347/6481865
emergencymonteamiata@yahoo.it
19
Gruppo di Livorno
333/1159718 - 346/2318650
emergencylivorno@katamail.com
Gruppo di Piombino - LI
329/8741625 - 380/2599437
emergencypiombino@libero.it
Gruppo di Lucca
0583/578318 - 349/6932333
emergencylucca@yahoo.it
Gruppo della Versilia - LU
328/2062473
emergencyversilia@yahoo.it
Gruppo di Massa Carrara
349/8354617 - 329/5733819
emergencymassacarrara@gmail.com
Gruppo di Pisa
320/0661420
info@emergencypisa.it
Gruppo di Volterra - PI
349/8821421
emergencyvolterra@virgilio.it
Gruppo di Pistoia
348/8401412
emergencypt@interfree.it
Gruppo dell’Altopistoiese - PT
329/6503930
emergency.altopt@tiscali.it
Gruppo di Prato
339/1857826
emergency.prato@tiscali.it
Gruppo di Siena Valdelsa
340/5960950
emergencysienavaldelsa@virgilio.it
LAZIO
Gruppo di Tivoli - RM
347/1640390
volontari_tivoli@yahoo.it
Gruppo dei Castelli Romani - RM
328/2078624 - 347/5812073
castelli.rm.emergency@gmail.com
Gruppo di Rieti
328/4271644
emergencyrieti@hotmail.com
Gruppo di Colleferro - FR
335/6545313
emecolleferro@libero.it
Gruppo di Cisterna - LT
333/7314426
emergency.cisterna@gmail.com
Gruppo di Formia - LT
340/6662756
emergencyformia@libero.it
Gruppo di Monte San Biagio - LT
329/3273024
emergencymsb@libero.it
Gruppo di Cassino - FR
339/7493563 - 347/5324287
cassinoxemergency@libero.it
Gruppo di Vetralla - VT
340/7812437
vetrallaperemergency@gmail.com
MARCHE
Gruppo di Ancona
328/8455321
emergencyancona@libero.it
Gruppo di Fabriano - AN
0732/4559 - 335/5753581
emergencyfabriano@libero.it
Gruppo di Jesi - AN
349/4944690 - 0731/208635
emergency.jesi@aesinet.it
Gruppo di Ascoli Piceno
335/5627500
emergencyascolip@libero.it
Gruppo di Fermo
328/4050710
emergency.fermo@libero.it
Gruppo di Fano - PU
0721/827038 - 338/2703583
emergencyfano@yahoo.it
UMBRIA
Gruppo di Perugia
075/5723650
emergencyperugia@yahoo.it
Gruppo di Città di Castello - PG
347/1219021
emergencycittadicastello@yahoo.it
Gruppo di Foligno - PG
0742/349098
emergencyfoligno@libero.it
Gruppo di Gualdo Tadino - PG
333/8052884
emergencygualdotadino@yahoo.it
Gruppo di Spoleto - PG
340/8271698
emergencyspoleto@libero.it
Gruppo di Terni
320/2128052
emergency_tr@libero.it
Gruppo di Orvieto - TR
329/6197364
emergencyorvieto@libero.it
ABRUZZO
Gruppo di L’Aquila
349/2507878
emergencylaquila@libero.it
Gruppo dell’Alto Sangro - AQ
348/6959121
emergencyaltosangro@gmail.com
Gruppo di Avezzano - AQ
328/8686045
emergencyavezzano@virgilio.it
Gruppo di Pescara
328/0894451
emergencypescara@virgilio.it
Gruppo di Teramo
333/5443807
emergencyteramo@hotmail.it
MOLISE
Gruppo di Isernia
333/2717553
emergency_isernia@yahoo.it
Gruppo di Campobasso
392/3460870
emergencycampobasso@gmail.com
CAMPANIA
Gruppo di Napoli
339/5382696
emergencynapoli@libero.it
Gruppo di Avellino - Benevento
347/1621656 - 329/2047329
emergency_montemiletto@virgilio.it
Gruppo di Caserta
335/1373597
emergencycaserta@katamail.com
Gruppo dell’Altocasertano - CE
333/7370000
altocexemergency@virgilio.it
Gruppo di Pagani - Salerno
338/6254491 - 347/9105378
emergencypagani-prsa@libero.it
Gruppo di Agropoli -
Vallo di Lucania - SA
339/1222497 - 339/3335134
emergency_agropoli@virgilio.it
maria91@libero.it
BASILICATA
Gruppo di Latronico - PT
339/7980173 - 339/2955200
emergency.latronico@libero.it
Gruppo di Matera
329/5921341
emergency-matera@inteldata.biz
Gruppo di Policoro - MT
0835/980459
emergencypolicoro@libero.it
PUGLIA
Gruppo di Bari
340/7617863 - 329/9493241
emergency_bari@libero.it
Gruppo di Bitonto - BA
080/3744455 - 333/3444512
emergency@bitonto.net
Gruppo di Molfetta BA
340/8301344
emergencymolfetta@libero.it
Gruppo di Foggia
340/8345082 - 0881/756292
emergencyfoggia@libero.it
Gruppo di BAT
347/2328063
emergencybat@tiscali.it
Gruppo di Pr. Brindisi - BR
339/4244600
emergencytorress.br@libero.it
Gruppo di Lecce
328/6565129 - 349/5825203
emergencylecce@libero.it
Gruppo di Nardò - LE
338/3379769
emergencynardo@tiscali.it
Gruppo della Valle d’Itria - TA
328/7221897 - 328/6990572
emergency_martinafranca@yahoo.it
CALABRIA
Gruppo di Cosenza
338/9506005 - 349/2987730
cosenzaxemergency@yahoo.it
Gruppo di Catanzaro
393/3842992
emergencycatanzaro@gmail.com
SARDEGNA
Gruppo di Cagliari
339/3365958
emergency.cagliari@gmail.com
Gruppo di Serrenti - CA
347/1411284
emergency.serrenti@gmail.com
Gruppo di Budoni - Nuoro
329/4211744 - 347/6416169
emergencynuoro@libero.it
Gruppo dell’Ogliastra
320/676282
ogliastra.emergency@libero.it
Gruppo di Milis - OR
0783/51622 - 320/0745418
emergencymilis@hotmail.com
Gruppo di Macomer - OR
389/9726753
emergency.macomer@tiscali.it
Gruppo di Sassari
079/251630 - 339/3212345
emergencysassari@yahoo.it
Gruppo di Alghero - SS
347/9151986
algheroemergency@tiscali.it
Gruppo di Olbia - SS
0789/23715 - 347/5729397
insiemergencyolbia@tiscali.it
SICILIA
Gruppo di Palermo
320/5592867 - 091/333316
emergency.pa@libero.it
Gruppo di Campobello di Licata
339/8966821
emergency.campobello@libero.it
Gruppo di Catania
348/5466769 - 339/4028577
emergencycatania@virgilio.it
Gruppo di Caltagirone - CT
328/2029644
emergency.caltagirone@yahoo.com
Gruppo di Piazza Armerina - EN
347/8829781
emergencypiazza.a@virgilio.it
Gruppo di Messina
090/674578 - 348/3307495
messinaperemergency@hotmail.com
Gruppo di Vittoria - RG
338/1303373
emergencyvittoria@tiscali.it
Gruppo di Siracusa
349/0587122
emergency.siracusa@libero.it
Gruppo di Trapani
0923/539124 - 347/9960368
emergency.trapani@libero.it
EMERGENCY USA
info@emergencyusa.org
Atlanta, GA
Atlanta@emergencyusa.org
Boston, MA
Boston@emergencyusa.org
Boulder, CO
Boulder@emergencyusa.org
Chicago, IL
Chicago@emergencyusa.org
Denver, CO
Denver@emergencyusa.org
Los Angeles, CA
LA@emergencyusa.org
Northern California
NorthernCA@emergencyusa.org
New York, NY
NYC@emergencyusa.org
Pittsburgh, PA
Pittsburgh@emergencyusa.org
Washington, DC
DC@emergencyusa.org
EMERGENCY UK
info@emergencyuk.org
London, UK
info@emergencyuk.org
EM
info
Atla
Nic
Atla
Bos
Sou
Bos
Bou
Dad
Bou
Chi
Ge
Chi
Den
Jas
den
Los
Ma
LA@
Nor
Jak
Nor
New
Eric
NY
Pitt
Chi
Pitt
Wa
Shi
DC
EM
info
Lon
Gia
Emergency Magazine

Más contenido relacionado

Destacado

14.16 neoinpresionismo
14.16 neoinpresionismo14.16 neoinpresionismo
14.16 neoinpresionismoUniambiental
 
Bibliografía proyecto 1 evaluación del lenguaje
Bibliografía proyecto 1 evaluación del lenguajeBibliografía proyecto 1 evaluación del lenguaje
Bibliografía proyecto 1 evaluación del lenguajeanatrojas
 
2008 09 - fra - guide des collectifs de cuisine de la catalogne - 100609
2008 09 - fra - guide des collectifs de cuisine de la catalogne - 1006092008 09 - fra - guide des collectifs de cuisine de la catalogne - 100609
2008 09 - fra - guide des collectifs de cuisine de la catalogne - 100609Agència Catalana de Turisme a França
 
Conceptos y construcciones geometricas
Conceptos y construcciones geometricasConceptos y construcciones geometricas
Conceptos y construcciones geometricasjeyly velandia pinilla
 
Wild Things Sanctuary Advertising Campaign
Wild Things Sanctuary Advertising Campaign Wild Things Sanctuary Advertising Campaign
Wild Things Sanctuary Advertising Campaign Patricia Grudens
 
Los makers exhibition Bogota
Los makers exhibition BogotaLos makers exhibition Bogota
Los makers exhibition BogotaJorge Montana
 
Boletin no 9 y programacion domingo 18 de mayo.
Boletin no 9 y programacion domingo 18 de mayo.Boletin no 9 y programacion domingo 18 de mayo.
Boletin no 9 y programacion domingo 18 de mayo.Copa Capital
 
PwC Entertainment, media and communications deal insightsQ3 2015
PwC Entertainment, media and communications deal insightsQ3 2015PwC Entertainment, media and communications deal insightsQ3 2015
PwC Entertainment, media and communications deal insightsQ3 2015PwC
 
Companio AG Unternehmenspräsentation
Companio AG UnternehmenspräsentationCompanio AG Unternehmenspräsentation
Companio AG UnternehmenspräsentationCompanio AG
 
Las mejores 50 StartUps colombianas para Invertir
Las mejores 50 StartUps colombianas para InvertirLas mejores 50 StartUps colombianas para Invertir
Las mejores 50 StartUps colombianas para InvertirMateo CARMONA ARANGO
 
Buku pendaftaran pelajar_ikb_nnov2013
Buku pendaftaran pelajar_ikb_nnov2013Buku pendaftaran pelajar_ikb_nnov2013
Buku pendaftaran pelajar_ikb_nnov2013Baie Pje
 
Infinum Android Talks #13 - Vision API by Filip Vinkovic
Infinum Android Talks #13 - Vision API by Filip VinkovicInfinum Android Talks #13 - Vision API by Filip Vinkovic
Infinum Android Talks #13 - Vision API by Filip VinkovicInfinum
 
Ua Internet Market Development Internet Forum
Ua Internet Market Development Internet ForumUa Internet Market Development Internet Forum
Ua Internet Market Development Internet ForumKatyaMikula
 
Resum 2016 Associació Zen Dana Paramita
Resum 2016 Associació Zen Dana ParamitaResum 2016 Associació Zen Dana Paramita
Resum 2016 Associació Zen Dana ParamitaXavier Martínez
 

Destacado (17)

14.16 neoinpresionismo
14.16 neoinpresionismo14.16 neoinpresionismo
14.16 neoinpresionismo
 
Bibliografía proyecto 1 evaluación del lenguaje
Bibliografía proyecto 1 evaluación del lenguajeBibliografía proyecto 1 evaluación del lenguaje
Bibliografía proyecto 1 evaluación del lenguaje
 
2008 09 - fra - guide des collectifs de cuisine de la catalogne - 100609
2008 09 - fra - guide des collectifs de cuisine de la catalogne - 1006092008 09 - fra - guide des collectifs de cuisine de la catalogne - 100609
2008 09 - fra - guide des collectifs de cuisine de la catalogne - 100609
 
Conceptos y construcciones geometricas
Conceptos y construcciones geometricasConceptos y construcciones geometricas
Conceptos y construcciones geometricas
 
Wild Things Sanctuary Advertising Campaign
Wild Things Sanctuary Advertising Campaign Wild Things Sanctuary Advertising Campaign
Wild Things Sanctuary Advertising Campaign
 
Los makers exhibition Bogota
Los makers exhibition BogotaLos makers exhibition Bogota
Los makers exhibition Bogota
 
Karlitos Marx
Karlitos MarxKarlitos Marx
Karlitos Marx
 
Boletin no 9 y programacion domingo 18 de mayo.
Boletin no 9 y programacion domingo 18 de mayo.Boletin no 9 y programacion domingo 18 de mayo.
Boletin no 9 y programacion domingo 18 de mayo.
 
PwC Entertainment, media and communications deal insightsQ3 2015
PwC Entertainment, media and communications deal insightsQ3 2015PwC Entertainment, media and communications deal insightsQ3 2015
PwC Entertainment, media and communications deal insightsQ3 2015
 
Companio AG Unternehmenspräsentation
Companio AG UnternehmenspräsentationCompanio AG Unternehmenspräsentation
Companio AG Unternehmenspräsentation
 
Las mejores 50 StartUps colombianas para Invertir
Las mejores 50 StartUps colombianas para InvertirLas mejores 50 StartUps colombianas para Invertir
Las mejores 50 StartUps colombianas para Invertir
 
Buku pendaftaran pelajar_ikb_nnov2013
Buku pendaftaran pelajar_ikb_nnov2013Buku pendaftaran pelajar_ikb_nnov2013
Buku pendaftaran pelajar_ikb_nnov2013
 
Infinum Android Talks #13 - Vision API by Filip Vinkovic
Infinum Android Talks #13 - Vision API by Filip VinkovicInfinum Android Talks #13 - Vision API by Filip Vinkovic
Infinum Android Talks #13 - Vision API by Filip Vinkovic
 
Metropol parasol.odp [reparado]
Metropol parasol.odp [reparado]Metropol parasol.odp [reparado]
Metropol parasol.odp [reparado]
 
Ua Internet Market Development Internet Forum
Ua Internet Market Development Internet ForumUa Internet Market Development Internet Forum
Ua Internet Market Development Internet Forum
 
Resum 2016 Associació Zen Dana Paramita
Resum 2016 Associació Zen Dana ParamitaResum 2016 Associació Zen Dana Paramita
Resum 2016 Associació Zen Dana Paramita
 
Recursos software hardware e internet
Recursos software hardware e internetRecursos software hardware e internet
Recursos software hardware e internet
 

Similar a Emergency Magazine

25th nov 2013 organization of disaster releif team for earthquake victims
25th   nov  2013 organization of disaster releif team for earthquake victims25th   nov  2013 organization of disaster releif team for earthquake victims
25th nov 2013 organization of disaster releif team for earthquake victimsKarachi
 
Without Borders June 16
Without Borders June 16Without Borders June 16
Without Borders June 16Marcus Dunk
 
dispatches76_web
dispatches76_webdispatches76_web
dispatches76_webMarcus Dunk
 
Dispatches Summer 2016
Dispatches Summer 2016Dispatches Summer 2016
Dispatches Summer 2016Marcus Dunk
 
MSF Dispatches Autumn 2014
MSF Dispatches Autumn 2014MSF Dispatches Autumn 2014
MSF Dispatches Autumn 2014Marcus Dunk
 
26863_msf_dispatches_autumn_magazine_uk_web
26863_msf_dispatches_autumn_magazine_uk_web26863_msf_dispatches_autumn_magazine_uk_web
26863_msf_dispatches_autumn_magazine_uk_webMarcus Dunk
 
26861_msf_summer_dispatches_uk
26861_msf_summer_dispatches_uk26861_msf_summer_dispatches_uk
26861_msf_summer_dispatches_ukMarcus Dunk
 
obstetric trauma, haemoperitoneum, arrow injury.
obstetric trauma, haemoperitoneum, arrow injury.obstetric trauma, haemoperitoneum, arrow injury.
obstetric trauma, haemoperitoneum, arrow injury.iosrjce
 
First Aid Part I.pptx
First Aid Part I.pptxFirst Aid Part I.pptx
First Aid Part I.pptxPiaJayCalizo
 
Agnesian HealthCare: Living In Good Health Spring 2014
Agnesian HealthCare: Living In Good Health Spring 2014Agnesian HealthCare: Living In Good Health Spring 2014
Agnesian HealthCare: Living In Good Health Spring 2014Agnesian HealthCare
 
EMCC development & EMSS (prehospital).pptx
EMCC development & EMSS (prehospital).pptxEMCC development & EMSS (prehospital).pptx
EMCC development & EMSS (prehospital).pptxbikisliyew
 
Guillaume de SAINT-BON - Sichuan Earthquake 2008
Guillaume de SAINT-BON - Sichuan Earthquake 2008Guillaume de SAINT-BON - Sichuan Earthquake 2008
Guillaume de SAINT-BON - Sichuan Earthquake 2008gdesaintbon
 
Dispatches Autumn 16
Dispatches Autumn 16Dispatches Autumn 16
Dispatches Autumn 16Marcus Dunk
 
First Aid for Allied health students 1.10.22.pptx
First Aid for Allied health students 1.10.22.pptxFirst Aid for Allied health students 1.10.22.pptx
First Aid for Allied health students 1.10.22.pptxanjalatchi
 
First Aid for Allied health students 1.10.22.pptx
First Aid for Allied health students 1.10.22.pptxFirst Aid for Allied health students 1.10.22.pptx
First Aid for Allied health students 1.10.22.pptxanjalatchi
 

Similar a Emergency Magazine (20)

25th nov 2013 organization of disaster releif team for earthquake victims
25th   nov  2013 organization of disaster releif team for earthquake victims25th   nov  2013 organization of disaster releif team for earthquake victims
25th nov 2013 organization of disaster releif team for earthquake victims
 
Without Borders June 16
Without Borders June 16Without Borders June 16
Without Borders June 16
 
dispatches76_web
dispatches76_webdispatches76_web
dispatches76_web
 
Dispatches Summer 2016
Dispatches Summer 2016Dispatches Summer 2016
Dispatches Summer 2016
 
Nightmare
NightmareNightmare
Nightmare
 
MSF Dispatches Autumn 2014
MSF Dispatches Autumn 2014MSF Dispatches Autumn 2014
MSF Dispatches Autumn 2014
 
26863_msf_dispatches_autumn_magazine_uk_web
26863_msf_dispatches_autumn_magazine_uk_web26863_msf_dispatches_autumn_magazine_uk_web
26863_msf_dispatches_autumn_magazine_uk_web
 
26861_msf_summer_dispatches_uk
26861_msf_summer_dispatches_uk26861_msf_summer_dispatches_uk
26861_msf_summer_dispatches_uk
 
obstetric trauma, haemoperitoneum, arrow injury.
obstetric trauma, haemoperitoneum, arrow injury.obstetric trauma, haemoperitoneum, arrow injury.
obstetric trauma, haemoperitoneum, arrow injury.
 
First Aid Part I.pptx
First Aid Part I.pptxFirst Aid Part I.pptx
First Aid Part I.pptx
 
CAL Presentation-July 2015
CAL Presentation-July 2015CAL Presentation-July 2015
CAL Presentation-July 2015
 
Agnesian HealthCare: Living In Good Health Spring 2014
Agnesian HealthCare: Living In Good Health Spring 2014Agnesian HealthCare: Living In Good Health Spring 2014
Agnesian HealthCare: Living In Good Health Spring 2014
 
First Aid Part I
First Aid Part IFirst Aid Part I
First Aid Part I
 
EMCC development & EMSS (prehospital).pptx
EMCC development & EMSS (prehospital).pptxEMCC development & EMSS (prehospital).pptx
EMCC development & EMSS (prehospital).pptx
 
BATUK MERU AND ISIOLO MEDICAL CAMP
BATUK MERU AND ISIOLO MEDICAL CAMPBATUK MERU AND ISIOLO MEDICAL CAMP
BATUK MERU AND ISIOLO MEDICAL CAMP
 
Guillaume de SAINT-BON - Sichuan Earthquake 2008
Guillaume de SAINT-BON - Sichuan Earthquake 2008Guillaume de SAINT-BON - Sichuan Earthquake 2008
Guillaume de SAINT-BON - Sichuan Earthquake 2008
 
GCU
GCUGCU
GCU
 
Dispatches Autumn 16
Dispatches Autumn 16Dispatches Autumn 16
Dispatches Autumn 16
 
First Aid for Allied health students 1.10.22.pptx
First Aid for Allied health students 1.10.22.pptxFirst Aid for Allied health students 1.10.22.pptx
First Aid for Allied health students 1.10.22.pptx
 
First Aid for Allied health students 1.10.22.pptx
First Aid for Allied health students 1.10.22.pptxFirst Aid for Allied health students 1.10.22.pptx
First Aid for Allied health students 1.10.22.pptx
 

Emergency Magazine

  • 1. EMERGENCY n° 0 • July 2009 EMERGENCY ROME Via dell’ Arco del Monte 99/a, 00186 Rome T +39 06 688151 - F +39 02 68815230 roma@emergency.it www.emergency.it EMERGENCY MILAN Via Gerolamo Vida 11, 20127 Milan T +39 02 881881 - F +39 02 86316336 info@emergency.it www.emergency.it EMERGENCY USA 4910 Massachusetts Avenue NW, Suite 300 Washington, DC 20016 – T +1 888 501 EUSA info@emergencyusa.org www.emergencyusa.org EMERGENCY UK PO Box 62437, London, E14 1GA T +44 (0) 333 340 6411 info@emergencyuk.org www.emergencyuk.org
  • 2. AFGHANISTAN Training for Critical Care Units «F alcon 4 Falcon 4… cardiac arrest in Intensive Care Unit”. It was ten minutes before midnight, and someone was calling me on the radio. “Start the cardiac massage,” I replied as I ran towards the hospital. Latif, Fahim and Samiullah, just graduated from the Government School for Nurses at the University of Kabul, and were working the night shift. The school curriculum offers CPR training. Unfortunately, the quality of teaching is still very far from acceptable or satisfactory standards. This is understandable in a country devastated by thirty years of war. In all of its projects, EMERGENCY strives to provide intensive training for local staff through daily hands-on experiences with highly qualified doctors and nurses coming from other countries. This and other targeted activities provide local staff with current medical knowledge, and eventually lead to their autonomy. In the first months of 2008, Daria, Elena, Debbie and I, all international nurses at the EMERGENCY Hospital in Kabul, have established a Basic Life Support (BLS) course in an effort to accomplish these goals. The ABC’s of resuscitation — Airway, Breathing and Circulation BLSencompassesallcardiopulmonaryresuscitationproceduresperformed to rescue a patient who is unconscious, or suffering from cardiac arrest. Independently from the cause of cardiac arrest, the heart fails to contract and pump blood to the tissues. The lack of oxygen supply to the brain cells, known as cerebral anoxia, causes irreversible damage within 10 minutes of the onset of circulatory arrest. This implies that the time available to rescue a victim of cardiac arrest is extremely short before irreversible brain damage occurs. The goal of BLS is to maintain an “emergency oxygenation” through artificial breathing and cardiac massage, until more efficient means can be used to correct the factors that determined the arrest. The BLS procedures are standardized and recognized as effective by several key international organizations that provide constant revisions and updates. To help with memorization, the BLS phases are schematized in three steps, indicated by the first three letters of the alphabet. A: Airway – Opening and control of the airway, removal of potential occlusions (foreign-body, food, blood), and insertion of a plastic tube to keep airway pervious. B: Breathing – Sustain breathing by ventilation with Ambu bag (if unavailable, proceed with mouth-to-mouth breathing). C: Circulation – Sustain cardio circulatory function by control of carotid pulse, and potential cardiac massage. At each step, a vital sign (airway, breathing, cardiac pulse) is checked and restored, if compromised. Learning to save Minianne really means helping Gul Arifa BLS is of utmost importance in the training of health care staff. For this reason, it is periodically taught to newly hired staff at all of EMERGENCY’s hospitals. This latest course was designed specifically for nurses newly graduated from the University of Kabul, and working in the critical care areas (ER, intensive care, surgery room). It is divided in two sessions. The first session illustrates the guidelines of the Italian Resuscitation Council (IRC), while the second, besides reviewing previous material, allows students to practice the reanimation resuscitation of Minianne. Minianne is an inflatable manikin provided by the IRC. It is particularly Basic Life Support Course in Kabul – Emergency Cardiopulmonary Resuscitation (CPR) 2
  • 3. useful in the teaching of lifesaving maneuvers, since it allows effective simulation of cardiac massage and manual ventilation. During this session the nurses, divided into small groups, ask questions and practice until they feel confident with all the maneuvers. The hands-on nature of the class has guaranteed the expected results. In fact, the staff has acquired both physical and psychological confidence with instruments and maneuvers, and it is now ready to effectively cope with any emergency situation. It is midnight. Out of breath, I reach the intensive care unit. I don white coat and shoe covers and I step inside. Latif is by Gul Arifa’s bed performing ventilation. Samiullah is standing on a step stool, ready to administer a cardiac massage. Fahim, the youngest, looks at me nervously as I come closer. Together we gaze at the monitor. Gul Arifa’s heart has resumed beating. We smile at each other. “Great! Well done!”. NADIA DEPETRIS Translated by Ada Buvoli 3
  • 4. AFGHANISTAN The Consequence of War H e arrived at two in the afternoon on 22 July in a car driven by his uncle. He had been carefully laid on a thin mattress, wrapped in a plastic cloth, with stained rags used to stop the bleeding from his wounds. Six year old Quadratullah is transferred to a stretcher by ER nurses. He doesn’t utter a single word and through teary, terrorized eyes watches all the people who are frantically racing around him. We remove the rags from his wounds. It is a devastating image. His left leg is gone, ending just under the knee with two bone fragments protruding from his flesh. The right leg is still okay, but wounded. His left hand is crushed, and the right hand is wounded. His back and pelvic area have deep wounds resulting from the explosion. We should be familiar with these scenes, but we’re not. Each time, the horror of these scenes doesn’t allow us to become accustomed to them. As soon as Quadratullah’s condition is stabilized, he is sent immediately to the operating room. What remain behind are two apricots, and the tragedy of a morning that was supposed to be a celebration The boy’s father’s arm (Ajimir Aziz) is wounded. When we ask him what happened, he takes two apricots out of his pocket, and then breaks down crying. That morning he had gone with Quadratullah to gather some apricots in a small orchard near their home, in a village a couple of hours from Kabul. Quadratullah was so happy because his father was dedicating the whole day to him. It was their time to play, their moment to be together. Then he saw some ripe apricots on the ground. The boy turned to pick them up, meaning to take them to his mother and siblings. But, as he bent down to collect the fruit that’s when it happened. There was an explosion. It was instantaneous, like always. Ajimir extends the two apricots out to me. I face him, not knowing what to do. The nurses encourage me to take the fruit, he is offering them to me. I take them into my hands. I look down at them, and put them into my pocket - two apricots and Quadratullah’s life torn apart. MARINE CASTELLANO Translated by Paolo Chiappetta Six year old Quadratullah, Victim of a Landmine Explosion Arrives at our Hospital in Kabul
  • 5. I n the summer of 2007, just after the re-opening of our hospitals in Afghanistan, we were contacted by the representatives of the Ghazni community from one of the areas most impacted by the war, and which runs along the road connecting Kabul to Kandahar. They made a request that we open a First Aid Post to be connected to our surgery center in Kabul where high standard, free medical assistance is provided to everyone in the area who is injured or wounded. We had to wait a few months before starting a new initiative and fulfilling this request since we had to be sure that the entire Afghanistan Program was back on track. In April, a delegation form EMERGENCY completed a first assessment of the city of Ghazni, capital of the province, to select an appropriate location for the new project. However, the local authorities had no appropriate building to offer, and to build a new hospital would take too long given the urgent needs of the population. The generosity of a wealthy individual provided the solution. The owner of a small supermarket donated the building, to be remodeled for the FAP. After a couple of months under construction ─ tiling, windows and doors, painting, construction of lavatories, and the selection of the appropriate personnel ─ the Ghazni FAP became operative on July 20th. The official inauguration took place on August 10th at 2:00 PM. Many officials were present; the vice-governor of the Ghazni province, a member of the national parliament, the mayor of the city of Ghazni, the director of the Ghazni hospital, the community leader and many local citizens. Due to worsening security along the road connecting the capital with the south of the country, no one from EMERGENCY was able to participate in the opening ceremony. The distance from Kabul and Ghazni is about 120 miles, and is normally about a two hour drive. In recent months, with the increase in military conflict, the travel time has more than tripled to cover that area (the official delegation that came to Kabul to thank us for the new facility took seven hours), and the frequent attacks have made any travel extremely dangerous. In spite of the fact that the media and the international community seem to have forgotten, the war in Afghanistan continues, along with our commitment to mitígate, if only in part, the suffering of the victims. RM Translated by Michele Isernia AFGHANISTAN Restarting and expansion In Ghazni, 120 miles south of Kabul, the local population asks for a new FAP (First Aid Post)
  • 6. AFGHANISTAN A Flower in the Midst of War Amongst the Victims Many Children Are Admitted to the Lashkar-gah Hospital T he corridors of EMERGENCY’s hospital in Lashkar-gah remind us of the human cost and consequences of the war in Afghanistan. Over the past thirty years, more than one and a half million people have been killed, the majority being civilians. Our hospital is the only one in the region which provides completely free-of- charge surgical interventions. For the most part, the patients suffer injuries sustained while caught in the middle of military combat, while stepping on one of the many landmines spread throughout the region, or as they become victims of violence associated with the drug trafficking trade. Others are wounded by air raids conducted by international forces. NATO asserts that troops do their utmost to take precautions to avoid civilian casualties. In the cases of civilian casualties, an investigation is conducted, and under the best of circumstances, civilians become eligible for compensation. Our patients come not only from the city, but from all over the region. In order to reach our hospital, they travel on damaged roads on a journey that can last days. Some arrive at the First Aid Post in Grishk thanks to an ambulance service which is open 24 hours a day. Many never arrive, partly because they die en route, and partly because after aerial bombing raids the Afghan army blocks the roads not allowing the injured to pass through. As in all of EMERGENCY’s hospitals, a red and white sign greets the public as they enter, “We inform that all medical and surgical assistance is free of charge for the patients”. The treatment is completely free, only a blood donation from the families of patients admitted to the hospital is requested. For victims who are severely wounded, numerous blood transfusions are required, and the hospital’s blood bank needs to be continually replenished. Usually after making their donation, parents or siblings of patients often return a few hours later with friends and relatives to also give blood. Gullandam, beautiful like a flower, in a Helmand that can no longer claim to be a garden Yesterday, an Afghan nurse presented us with paperwork that we had not seen before. The father of Gullandam, a young girl who was under our care for the past few days, asked us to complete the paperwork out as soon as possible. He is required to present the filled-out forms to officials in order to receive compensation for the explosion that destroyed his family’s home. We take all the paperwork, and of course will help. As soon as it is filled out with the relevant information regarding the young girl’s condition, we go with Paola back to D-Ward, the children’s ward, where we locate the girl’s father, and return the papers to him. Gullandam means beautiful like a flower, in Pashtun. She is in the garden playing amongst the other hospitalized children. At 6 years of age, she has already bravely faced the amputation of one leg, and many painful medical procedures to save the other. And sooner or later, she will have to be told that she has also lost her mother, and that she no longer has a home to return to. NADIA DEPRETIS Translated by Roland Swan
  • 7. SUDAN Our Idea of Peace O ver 1.5 million people live in Nyala, most of whom are refugees who fled the war. They live in camps surrounding the city. Following a request by the local Ministry of Health, EMERGENCY decided to build a paediatric centre to offer high standard free of charge medical care 24/7 to children under the age of 14. The Centre will address prevalent illnesses such as malnutrition, respiratory infections, malaria, and gastricgastrointestinal infections. It will implement immunization programs, and preventive efforts to combat diseases such as rheumatic fever, in addition to providing health and hygiene education for families. The Centre will provide screening for patients suffering from heart disease potentially requiring transfer to the Salam Cardiac Surgery Center in Khartoum to undergo heart surgery. Post-operative monitoring and care will also be guaranteed. The Centre in Nyala will be part of EMERGENCY’s Paediatric and Heart Surgery Regional Program, with the Salam Centre as its hub. Collaboration with the Sudanese authorities – both Federal and South Darfur – has been essential for this project. The Paediatric Centre will be built on land offered by the South Darfur authorities, in collaboration with the local Ministry of Health. Last summer EMERGENCY carried out a feasibility study and assessed the estimated costs for the structure and start-up costs at 600,000 Euros. This total became the target amount for our text message fundraising campaign. The results coming in from the participating phone companies seem to confirm that we’ve reached the targeted amount. This is an important achievement since it will help us continue our mission in Sudan and the neighboring countries. As soon as we have the final results, we will publish the final tally of funds raised. In the meantime, we would like to thank everyone who has decided to participate in helping us build this paediatric centre, working together with us to concretely achieve Our Idea of Peace. ROSSELLA MICCIO Translated by M.A. A Paediatric Centre in Darfur, Another Goal to Reach The Our Idea of Peace fundraising campaign to begin construction of another EMERGENCY health care centre, this time in Nyala, southern Darfur, for children under the age of 14, ended last October. The Centre in Nyala will further expand EMERGENCY’s Paediatric and Heart Surgery Program in Africa during 2009.
  • 8. SUDAN A Comparison Between Goals and Results K hartoum, July 2008. The temperature outside is about 45° Celcius (113° Farenheit). The dry heat makes it a bit more tolerable, but it is certainly not advisable to dwell too long outside, even in the garden of the Salam Centre — a place that brings healing to the heart. This is a familiar place even to the patients of the Centre, who have organized a creative alternative to ‘outdoor activities’. Every afternoon, once clinical activities quiet down, a ‘parlor room’ is created alongside the large window which separates the patients’ wards from the outside world. The patients awaiting surgery, and the post-op patients who are able to mobilize, pull up some chairs near this large window, and spend the afternoon chatting there. Beyond the window, one can see the colorful seasonal flowers, the trees, the green lawn and bushes. Beyond, it is known that the Nile flows, and although it cannot be seen, it is “sensed”. From this large window overlooking the garden, light comes in as gazes go out For all of those who have followed the progress, and believed in this hospital from the very start, from when it was only a ‘crazy’ idea, it has confirmed the transformation of a utopian dream into a reality - one rooted in the daily lives of hundreds of people. I am talking to Raul about this large window. As the architect, he designed the window with the intention of bringing light to the long corridor which faces the patients’ rooms. Now, the patients have chosen it as a place of gathering and relaxation. It has become a case, one could say, of unplanned consequences to calculated actions. This novel use was approved and appreciated by the designer himself, who for the time being does not delve too deeply into discussion about the ‘diverse nature’ or ‘outcome’ of intended purposes. Fifteen Months after its Opening — An Update on the Salam Centre for Cardiac Surgery in Khartoum 8
  • 9. 9 This space was transformed by the patients into an area for chatting, a simple act which lightens tensions, favors understanding, and fosters friendships. It is where we often stop to talk with the guests of the Salam Centre Barring complications, the average length of stay here in the hospital is about 10 days, which is sufficient time for people to get to know each other. It is amazing to see the behavioral transformation of the patients after just the first few days in the hospital. Initally, everyone looks lost, almost afraid. For many, the arrival to the Centre is like being left stranded on the moon. No relatives or ‘co-patients’, as they are called here, are allowed to visit except on the consented days and times. In the other local hospitals co-patients provide most of patient care, from food to laundry, from personal care to even medications. Here, on the other hand, clean pajamas and showers in the rooms, three free full meals per day, doctors and nurses, are all available 24/7. The omnipresent white faces of the khawala (‘white’ people) administer to everything. After a few days, patients memorize names, begin to feel comfortable, and even begin to trust the khawala. Children, in particular, are the ones who develop the most immediate rapport. And there are many children in our hospital, about 25% of the 937 patients hospitalized at Salam through the end of July 2008 have been younger than 15. There is a long list of cases, difficulties and problems, and many solutions that have been researched and found The small group of teenagers who have been treated at the hospital since the beginning of July has truly been diverse. Wail, 14, arrived from Port Sudan. In addition to his young heart struggling from the damage of recurrent rheumatic heart disease, he suffers from kidney and lung problems, so we anxiously await definitive signs of healing. Enas, is an 11 year-old girl, who weighed just 17 kilos (37.5 lbs) when she was hospitalized. Our cooks prepared a special diet for her over several days to help her gain a body weight which she probably never had before…and at any rate, also to help her gain a few kilos before surgery. Osman “One” (to distinguish him from Osman “Two”), despite being only 10 years old, is a veteran of the Salam Centre. He has been with us since February, and has had treatment for his right ventricle. The right half of his heart wasn’t functioning. Blood taken from the right atrium through a cannula was channelled back with a pump to the pulmonary artery, to reach the lungs and to oxygenate. Now he is ready, well enough to go back home to the state of Sinnar, south of Khartoum. He will be accompanied by his grandfather, who was staying in the centre’s guesthouse during his grandson’s hospitalization. Then there is the trio from Darfur. Saddam, 15, of Genina, West Darfur, urgently hospitalized for a serious heart problem that was treated via replacement of the mitral valve and surgical repair of the tricuspid valve. Curly haired, darke eyed Osmad “Two”, 9, is shy and introverted, and was one of the last of the group to be operated on. After surgery he was received with a round of applause when he was transported from the operating room to the intensive care unit where some of his friends who had already undergone surgery the previous days were recuperating. Ali, the smallest of the group, and only nine years old, is from a small village near Al Fashir, North Darfur. He also needed a mitral valve replacement and surgical repair of the tricuspid valve. Araghes the Ethiopian and Sarawit the Eritrean: distant is the world that would like to see them be enemies The unique atmosphere of the Salam Centre makes sure that not only do ethnic barriers disappear between the beds in the ward, but that also the linguistic difficulties due to the different nationalities be overcome. Proof is the story of Sarawit, a very young girl from Eritrea, hospitalized for a mitral stenosis, and Araghes, an Ethiopian child brought here thanks to the initiative of a group of Italian volunteers who collaborate with a hospital from the congregation of Mother Theresa of Calcutta in Addis Ababa. Araghes speaks onlyAmarico, hence she had difficulties comunicating with the foreign doctors and nurses, as well as with the Sudanese personnel. But, her problems are solved thanks to the help of Sarawit who, besides Tigrino, also spoke Araghe’s language, and she becomes her interpreter. They were apart only during surgery and immediately afterwards. We suggested that they become ambassadors of their respective governments, which have been at war for about ten years now. We may have been joking, but… their relationship is no longer a joke, it is real. A lesson from our first balance sheet — something we ‘believed in’, is incredible After a little over a year since its opening a draft of the activity summary for the Salam Centre is available. Despite the continual necessity for precautions to be taken, and with the inevitable problems encountered, we are pleased with the initial results. Under the circumstances and given the difficulties, in 15 months time we have been able to progress from one to three open heart operations per day. About 30 patients are examined daily for triage. A third of these patients will then need a specialized visit with the cardiologist. Paradoxically, given the enormous distances in this country, news ‘by word of mouth’ has produced unexpected results. More than 43% of the Sudanese patients in our hospital do not live in Khartoum, but arrive from one of the 25 states that make up the federation. Even going beyond the Centre’s data and statistics, and the daily operational routines, the “life” of this hospital suggests a very comforting evaluation. From the examination rooms to the office administration, from the labs to the wards, from the kitchen to the laundry rooms, from the operating rooms to the pharmacy, one can clearly feel that the premises itself suggests the sense of being in a special place, in so many unique ways. More often than not, ‘Incredible!’ is the comment heard over and over by visitors to the Salam Centre for Cardiac Surgery, from the Sudanese, as well as from foreigners passing through Khartoum for work or vacation. For us this expression ’incredible’ reminds us of a daily effort, which began with an idea, went on to be built, fully equipped and furnished and ultimately completed with the search and assembly of personnel. It is an effort that continues on with a myriad of new and diverse problems (sanitary, logistical, technical) to be overcome each day. But, after a brief pause by the large window that overlooks the garden, and an exchange of a few words in bizarre, improvised “mixed” languages with the national staff and patients, we all become part of the incredible vision sensed by all visitors. ROSSELLA MICCIO Translated by Rosalba Perna
  • 10. 10 SUDAN First the Children S ince the EMERGENCY Paediatric Centre first opened its doors in December 2005, the camp has expanded and is now surrounded by new homes, at best made from mud and plastic sheeting. They belong to new refugees from Darfur, and to old residents driven away from areas that are increasingly urbanised - always a source of homelessness. From the hospital’s water tower, the grim view of the camp is a vast sea of shacks, extending as far as the eye can see, with dust and dirt everywhere. Although only a mere 12 km from dowtown Khartoum, we are very far from the skyscrapers dominating the heart of the city. Our Centre is situated in an area of the camp called Angola, which is populated by roughly fifty thousand people, fifty per cent are children. When it first opened three years ago, the Centre’s objective was to guarantee free medical treatment to the more immediate community in the area. Now, patients arrive from the rest of the refugee camp as well as far off neighbourhoods. In the Outpatient Ward, three nurses and two doctors work with a pharmacist, along with a lab technician who performs urgent blood tests -- all under the supervision of an international paediatric nurse. Mothers and children arrive at six o’clock in the morning and are seated under a protected outdoor veranda. As they await their turn, they are neat, poised and beautiful in their colourful clothing.Attilia, the international nurse, together with the local nurses carry out a rapid triage to evaluate any urgent care cases. Patients with malnutrition, loss of consciousness, fever and severe respiratory problems are given high priority. It seems as if it were summer. There are clear skies and the temperature is a dry, 28 degrees Celsius. But, this is their winter, and illnesses such as bronchitis and asthma are common, just as in any outpatient ward in Italy during this time of year. Many are suffering the consequences of living under inhumane conditions in the camp. Malnutrition, conjunctivitis, and urinary tract infections are among the most common maladies. Diarrhoea is a consequence from drinking the water from the donkey tank. Water is sold and distributed house to house from a large tank transported by mule. It costs between 200 and 300 dinar depending on the vendor. Daily wages are roughly 1000 dinar. An Urgent Transfer Leaves Us With More Questions Than Hope Every day our staff examines fifty children, and those requiring observation stay in the ward until closing time. “The Centre has to close at 4:00 PM due to security reasons”, explains Attilia. “At night the men get intoxicated on araki, a distilled alcohol with an extremely potent effect, and it is better not to stay around the area”. The more severe cases are transferred to the two city In Just Over Three Years More Than 56,000 Patients Have Been Treated in the Mayo Refugee Camp
  • 11. 11 hospitals, the Khartoum Hospital and the Bashir Hospital. Thanks to the working experience with the Mayo EMERGENCY Paediatric Centre, the government of Khartoum passed legislation that all care for paediatric emergency medical cases be provided free of charge. A mother brings in her child wrapped in a colourful cloth. As soon as she opens her little bundle, his emaciated face reveals that we are clearly faced with a very ill infant. “He’s not well, he hasn’t been eating for the past week”, she says. But the skeletal body, and lack of strength confirms evidence of long term malnutrition. At forty days old, the baby weighs only 2 kg. The infant is suffering from an infection, running a 40 degree fever, and does not even have the strength to cry. “After the operation, he stopped eating, and is becoming more and more lethargic”. The operation she refers to is the procedure performed by one of the twenty tribes living in the camp which believe that by cutting the uvula and palette of a newborn, regurgitation can be prevented. Every newborn undergoes the procedure. “Imagine a procedure of this sort, most likely performed in the middle of the street in a place like this, with instruments being washed in the camp’s water”, says Attilia, who periodically sees these cases. The ambulance is ready to go, and we immediately transport mother and child to the Khartoum Hospital. During the trip,Attilia asks me to try to stimulate the infant by stroking a pen along the bottom of his feet, while she keeps the oxygen mask ready for use. No reaction, he keeps his eyes half closed, and does not even whimper. We arrive at Khartoum Hospital, a chaotic and dirty place where, even for Attilia who comes here often, it is difficult to orient oneself. In a large, half lit room, five doctors seated at their desks examine their young patients surrounded by a throng of mothers coming and going with their children. One female doctor quickly checks the baby and asks the mother and Attilia a few questions. He will be admitted and undergo an antibiotic and an intensive nutrition treatment.They assure us that “he will make it.” I ask myself how many more times will this little baby have to “make it” in order to survive life in Mayo Camp to reach age 5, and survive the infant mortality statistics of this country. SIMONETTA GOLA Translated by Roland Swan
  • 12. 12 CENTRAL AFRICAN REPUBLIC Good Morning Bangui News in the Regional Programme for Paediatric Care and Cardiac Surgery Each day the staff at the Paediatric Centre in Bangui provides free specialized assistance to forty children. Thanks to periodic visits to the Centre by the international cardiologists, patients can be screened to determine whether they require surgery at the Salam Centre for Cardiac Surgery. The required post-operative follow-up care is also guaranteed.
  • 13. 13 I t is Friday, 6 March 2009, 9:30 AM. “The promise has been kept,” declares Francois Bozizé, the President of the Central African Republic. Together with the Prime Minister, the President of the National Assembly, and the foreign ambassadors present in the country, Bozizé attended the inauguration of the Paediatric Centre in Bangui, a new development in EMERGENCY’s Paediatric Care and Cardiac Surgery Programme in Africa. The government of the Central African Republic had immediately provided aid and support for the project, granting EMERGENCY use of a centrally located plot of land near the Parliament buildings. This is where the Paediatric Centre would be built. Construction began in March 2008. The project was assigned to a CentralAfrican company that carried out the plans to perfection, respecting the deadlines and the predetermined budget. Finally, the Paediatric Centre was ready for its inaugural opening. With its red and white coloured external walls, its surface area covers 550 square meters. It includes an internal patio transformed into a play area with an imaginary grassy plains mural filled with toy crocodiles, rhinoceros, elephants… The Centre, which is open 24 hours a day, seven days a week, offers medical assistance to children up to 14 years of age. Immunisation and health and hygiene education programmes are also offered. Duringperiodicevaluationmissions,inthecardiologywardEMERGENCY’s international specialists come to screen and evaluate patients suffering from heart disease to determine those in need of transfer to the Salam Centre in Khartoum for treatment. After surgery, the patients are guaranteed post- operative check-ups at the Centre in Bangui. In Bangui, Like Goderich and Khartoum: Malaria and Diarrhoea are the Most Common Diseases News of the opening of the Bangui Paediatric Centre spreads rapidly by word of mouth. In a scene similar to those in other EMERGENCY Pediatric Centres - such as in Khartoum, Sudan and in Goderich, Sierra Leone - from the early morning hours mothers and children crowd the entrance of the hospital, awaiting their turn to be examined. Each day, Paola a paediatric nurse, and Mariella a paediatrician, assisted by local doctors and nurses, examine forty children on average. With six beds in the Centre, the doctors are able to admit serious cases overnight, as needed. Just one day after its opening, the first patient was admitted. His name was Jonathan, who at 22 months was weighing in at only 7 kilos. He arrived suffering from dehydration due to severe persistent diarrhoea. As soon as he reached the Centre, doctors immediately initiated oral rehydration treatment, and proceeded with blood tests for Malaria, which came back positive. Together with his father who accompanied him, Jonathan will christen the clinic’s new toys with the hope of going back home soon. PIETRO PARRINO Translated by Roland Swan
  • 14. 14 CAMBODIA Cambodian Triptych Against Violence, Landmines and Accidents — Three Stories of Human Resistance A plastic surgeon details his encounter with a few patients he treated during his work at the SurgicalCentreinBattambangbringingtoawarenessthedifficultyoflivingtheconsequences of war, and facing new cruel realities. T hree girls — three stories from this ill – fated country’s history spanning half a century. The experiences of these three girls would be very unlikely to happen in Italy, but if they were to occur, the detrimental effects of the injuries sustained would be treated through an advanced health care system, and their lives would be supported by social and public assistance. In Cambodia these social infrastructures do not exist, at best there might be a fragile, and not always available family support system to help. Already faced with difficult lives, these three young women, having undergone physical surgical reconstruction and prosthetic rehabilitative training now find themselves facing the added burden of not having full use of their own bodies. EMERGENCY assisted them in their rehabilitation, and then when feasibly possible, in job placements, or by some small donations. But the biggest feats were overcome by their own courage, which was key to their recovery. A disfigured face due to jealousy — Then surgery and a job towards a new life WhenIfirstsawNhomVuninthefrontgardenoftheemergencydepartment, only half of her face was visible. Like most young Cambodian women, she had fine, gentle features. She kept the other half of her face oddly concealed with a towel which she uncovered as soon she entered the examining room. What was revealed was a disfiguring two centimeter thick scar, banning any type of facial movement. Her eyelids were now non-existent due to the disabling scar, and the eye was wide open, with no protection of an eyelid, and already covered with sores. Her lower lip was fused to her chin, as was her upper lip to the side of her nose. She was only 19 years old. Three years ago, Nhom was raped and impregnated by a man in her village, who then decided to marry her. In the two years following the birth of her first child, there were two more births. And then, all of a sudden the man announced that he was going to Thailand to find work. Left alone, Nhom Vun found work in the rice fields. But once the harveting season ended, she had to find other work. She began to pack and sell sweets, and earn good wages compared to the average Cambodian salary. The husband, who had actually moved in with another woman in a nearby village, now revealed a renewed interest in Nhom, and her new prosperity. In order to prevent any type of reconciliation between the two, the jealous lover attacked Nhom by thrusting a bottle of acid over her face. At our initial consultation, I informed Nhom right away that one procedure would not be enough to restore a normal physical appearance, and that there would really be no hopes to totally erase all the effects resulting from the acid burns. I began the surgical intervention with the reconstruction of her eyelid, in order to try to avoid loss of the eye. Removing the scar tissue, I realised that some
  • 15. 15 that some of the muscles of the eyelid had been damaged, but still existent. So I began to reconstruct the eyelid with strips of tissue and cartilage from behind the ear. The few remaining muscles would allow movement of the eyelid, thus restore opening and closing of the eye. The second procedure began by removing the scar tissue over the lips, where I would have to proceed with a skin graft taken from the back of the undamaged ear. Her lips began to regain some mobility, even though she would need further corrective surgical intervention on her lower lip. Returning to Battambang this year, I encountered Nhom Vun in the hospital. She wasn’t there for a check-up, but as an employee. She was hired there as an orderly. EMERGENCY frequently employs its patients to help them socially reintegrate, especially those patients having undergone particularly traumatic experiences. The medical coordinators say that everyone is extremely happy with her work, and the patients really appreciate her. Every time we pass each other in the corridor, she shares with me the gift of a beaming smile. The reconstructed half of her face is not as graceful as the other [undamaged] half, but mobility is close to normal. I am happy to have been able to contribute to providing this young woman with the chance to a social life. An accident at the beginning of a new life — Landmines don’t know when war has ended Den Srey Mao is 20 years old, and she has only been married for a few months to a man so tall and athletic that he does not seem Cambodian. Their families had given them a small parcel of land with a few animals (chickens, ducks and goats) as a wedding gift in order for them to begin their new lives together. They were farming vegetables on the land to sell at the market so that they could earn enough to buy a pig at the end of the year. One day while walking to it along the pathway which had undergone landmine clearance two years earlier, and which she had passed through countless times before, the young woman saw something strange on the ground. It was too late, she was unable to avoid stepping on it. It was a landmine which had been washed onto the path by heavy rains in the previous days. Dan Srey arrived at the hospital with traumatic amputation of both her lower limbs, loss of an eye and various wounds to her face. The amputations were corrected by our orthopaedic surgeons in order to allow fitting of prosthetic limbs. I was responsible for the reconstruction of the orbital cavities. Two operations would be necessary: removal of scar tissue, and enlargening of the ocular cavitiy for fitting of a prosthetic eye. Three days before my departure Den Srey received her prosthetic eye, a necessary step in restoring her face with a certain degree of physical normalcy. While waiting for her leg stumps to heal so she can be fitted with prosthetic limbs, her husband takes her home - where another new beginning awaits them. Two wigs for Proeung Even hair becomes a form of treatment Proeung Sreyrotha was 16 years old when I met her last year. She was harvesting rice when she got too close to the fanbelt of a threshing machine. Her entire scalp was ripped from her skull - from her eyebrows to her cervical vertebrae. In the West, depending on how intact the affected skin is, we treat these cases by surgically reattaching the ripped scalp, and through microsurgical anastomosis, re-establish the blood circulation to the damaged skin. However, in Cambodia, the proper surgical apparatus for microsurgery is unavailable. So in order to treat Proueng’s condition, she had to undergo severalskingraftsurgeriestothedamagedarea,amethodnolongerpracticed in Europe for over 40 years. After 6 operations and much painful medication, we finally managed to cover Proeung’s skull with a layer of hairless tissue. Some time later, in a very moving and emotional ceremony of sorts, we presented her with two gifts. We gave her two wigs - one with short and the other with long hair - so that she can continue to carry out her life as a normal young girl. PAOLO SANTONI-RUGIU Translated by Roland Swan
  • 16. 16 Worldwide Malnutrition Malnutrition and undernutrition are some of the effects of a global imbalance that has caused recent alarm in the political world (under pressure from the speculative push to finance raw material and consumer markets) especially among those where access to basic food resources has been undermined. W hen the cost of bread rises excessively, revolts break out for tortillas in Mexico, and mud cookies are baked in Haiti, then we know that we are facing the disastrous effects of a global financial manoeuvre that threatens the health and even the lives of a large portion of the global population. Even now, according to the Health World Organization, half of all human beings – about 3 billion people – suffer from some form of malnutrition, a word with various, but always worrisome, meanings. Infact,thistermisusedtoindicateanimbalanceintheabsorptionofnutrients and other factors necessary for a healthy life; this could be undernutrition – lack of proteins vitamins or minerals, or overnutrition. In developing countries, one person in five suffers from the worst form of malnutrition: hunger. Grains produced for livestock feed rather than human consumption It is well known that malnutrition is due mainly to unequal access to food resources rather than to insufficient food production. In fact, current agricultural production could easily nourish the entire world population. The problem is certainly underestimated, considering that a large portion of food resources is diverted to animal feed instead of being utilized as food for the hungry. Agricultural strategies adopted in recent years have resulted in complete failure. Public and private institutions have actively promoted large-scale cattle ranching in developing countries for production of meat and milk, without considering that farmed animals consume more calories than they produce in the form of meat, milk and eggs. When the quarrel about biofuels and conversion of crops for their production had not yet started, it was already evident that cereals were produced and introduced in the market in large part to raise cattle rather than to satisfy human nutritional necessities. Official statistics, from FAO (the Food and Agriculture Organization of the United Nations) and WHO (the World Health Organization) in particular, clearly point out that a shift in cereal production for human consumption to animal feed has forced developing countries to import grains at high cost, greatly worsening the problem of malnutrition. In fact, in developing countries, staple foods are mainly cereals and legumes, which provide the majority of carbohydrates and proteins necessary for survival. In a paradox, this diet that could be adopted in industrialized countries with great health advantages, is now overlooked even in its traditional countries of origin. Those who can afford it prefer a more occidental diet, where the majority of the protein requirement derives from meat. Food subsidies help donor countries and undermine local economies Non-governmental international organizations that fight world hunger are in ferment to counter the steady increase in basic food prices. Oxfam and CARE, for example, are running worldwide campaigns to raise awareness and increase political pressure. In fact, the forecasts of their experts indicate that predicted Eastern and Western African tragedies could be avoided by immediate action on the part of governments of wealthy countries. “Food aids can save many lives”, says Ariane Arpa, responsible for the Spanish Intermón Oxfam, “Unfortunately, the interests of Western governments, tied with those of powerful agricultural groups and packaging/ shipping companies, frequently cause aid to arrive too late, at very high prices, often destabilizing weak local economies”. The humanitarian organization Oxfam has posted suggestions to remedy these issues at www.oxfam.org. In summary the suggestions are: increase donor as well as local governments investment in small-scale agriculture (especially in sub-Saharan African countries), cut incentives for biofuel production, and convince the USA and EU to review their emergency food aid policies and focus assistance on countries suffering the most serious consequences. ANGELO MIOTTO Translated by Ada Buvoli INTERNATIONAL Human Rights
  • 17. 17 EMERGENCY EMERGENCY ITALY via Meravigli 12/14, 20123 Milano Tel. 02 881881 Fax 02 86316336 E-mail info@emergency.it http www.emergency.it via dell’Arco del Monte 99/a, 00186 Roma Tel. 06 688151 Fax 06 68815230 E-mail roma@emergency.it http www.emergency.it EMERGENCY USA 4910 Massachusetts Avenue NW, Suite 300 Washington, DC 20016 – T +1 888 501 EUSA info@emergencyusa.org - www.emergencyusa.org EMERGENCY UK PO Box 62437, London, E14 1GA T +44 (0) 333 340 6411 info@emergencyuk.org - www.emergencyuk.org Every year war and poverty destroy the lives of millions of people. In contemporary conflicts, 90% of the victims are civilians. Since 1994, over three million patients have been treated in EMERGENCY’s clinics, hospitals and rehabilitation centres located in war-torn areas. EMERGENCY is an independent, neutral and non-governmental organisation that provides free medical and surgical care to the victims of war, landmines and poverty worldwide. All EMERGENCY hospitals, clinics and rehabilitation centres are designed, built and managed by international personnel committed to professionally train national staff. The articles featured in this issue were translated from articles that appeared in EMERGENCY’s magazine, issues 48, 49 and 50: Training for Critical Care Units, September 2008 (48): 2-3 The Consequence of War, September 2008 (48): 4 Restarting and Expansion, September 2008 (48): 5 A Comparison between Goals and Results, September 2008 (48): 8 Worldwide Malnutrition, September 2008 (48): 14-15 Our Idea of Peace, December 2008 (49): 12 Good Morning Bangui, March 2009 (50): 2-3 A Flower in the Midst of War, March 2009 (50): 9 First the Children, March 2009 (50): 10-11 Cambodian Triptych, March 2009 (50): 14-15 Data Protection Notice — USA EMERGENCY USA – Life Support for Civilian Victims of War and Poverty, with registered offices at 4910 Massachusetts Avenue NW, Suite 300, Washington, DC 20016, USA, in its capacity as owner of the data processing, will process your personal data manually and in electronic form for the purposes of informing on its institutional activity and for administrative reasons as a result of your donations to the organization. The provision of your personal data is not mandatory. However, the failure to provide such data or the subsequent withdrawal of the authorization to process your personal data will prevent us from processing your data for the purposes indicated above. Your personal data may be disclosed to third parties, also in foreign countries and outside the European Union, only in connection with the purposes indicated above. You will be entitled to exercise the rights granted to you by law by addressing your request to EMERGENCY USA, 4910 Massachusetts Avenue NW, Suite 300, Washington, DC 20016, USA, ATTN: Ms. Graziella B. Costanzo. Director Carlo Garbagnati Editorial Office Simonetta Gola Collaborators on this issue Marco Antonsich (MA), Ada Buvoli, Marina Castellano, Paolo Chiappetta, Graziella B. Costanzo, Nadia Depretis, Maureen Cairns, Robert Dvorak, Janet Garcia, Anna Gilmore, Simonetta Gola, Michele Isernia, Rossella Miccio (RM), Angelo Miotto, Rosalba Perna, Dada Pisconti, Paolo Santoni-Rugiu, Roland Swan. Images Emergency’s Archive, Piergiorgio Casotti, Cosimo Maffone, Samuele Pellecchia, Naoki Tomasini. Graphic and pagination Angela Fittipaldi, Guido Scarabottolo. Data Protection Notice — ITALY EMERGENCY – Life Support for Civilian War Victims ONG ONLUS, with registered offices at Via Meravigli 12/14, 20123 Milan, Italy, in its capacity as owner of the data processing, will process your personal data manually and in electronic form for the purposes of informing on its institutional activity and for administrative reasons as a result of your donations to the organization. The provision of your personal data is not mandatory. However, the failure to provide such data or the subsequent withdrawal of the authorization to process your personal data will prevent us from processing your data for the purposes indicated above. Your personal data may be disclosed to third parties, also in foreign countries and outside the European Union, only in connection with the purposes indicated above. You will be entitled to exercise the rights granted by Article 7 of Legislative Decree No. 196/2003 by addressing your request to EMERGENCY ITALY, Via Meravigli 12/14, 20123 Milan, Italy, ATTN: Ms. Mariangela Borella. Data Protection Notice — UK EMERGENCY UK, with registered offices at Flat 58, St. David’s Square, E14 3B London, U.K., in its capacity as owner of the data processing, will process your personal data manually and in electronic form for the purposes of informing on its institutional activity and for administrative reasons as a result of your donations to the organization. The provision of your personal data is not mandatory. However, the failure to provide such data or the subsequent withdrawal of the authorization to process your personal data will prevent us from processing your data for the purposes indicated above. Your personal data may be disclosed to third parties, also in foreign countries and outside the European Union, only in connection with the purposes indicated above. You will be entitled to exercise the rights granted to you by law by addressing your request to EMERGENCY UK, P.O. Box 62437, London, E14 1GA, ATTN: Mr. Gianluca Cantalupi. For more information contact:
  • 18. 18 SVIZZERA Gruppo del Canton Ticino 0041/787122941 emergency-ticino@bluewin.ch VAL D’AOSTA Gruppo Aosta 340/9471701 emergency.aosta@libero.it PIEMONTE Gruppo di Torino 338/8922094 emergency.to@inrete.it Gruppo di Pinerolo - TO 334/7925925 emergencypinerolo@rifugiosella.it Gruppo di Alessandria Casale 335/7182942 - 0142/73254 emergency.al@libero.it Gruppo di Asti 0141/853487 - 348/5131104 emergencyasti@libero.it Gruppo di Biella 349/2609689 emergencybiella@gmail.com Gruppo di Cuneo 334/3154926 emergencycuneo@gmail.com Gruppo di Novara 339/2300266 emergencynovara@yahoo.it Gruppo di Arona - NO 335/6005077 - 328/8229117 emergency.arona@virgilio.it Gruppo di Verbania 348/7266991 emergency.verbania@libero.it Gruppo di Lago D’Orta VB 339/698808 emergencylagodorta@libero.it LOMBARDIA Gruppo della Brianza - MI 340/7784875 info@emergencybrianza.it Gruppo del Naviglio Grande - MI 339/8364358 - 334/3175776 emergency.buccinasco@libero.it Gruppo di Cinisello Balsamo - MI 348/0413702 emergency.cinisello@email.it Gruppo della Valle del Seveso - MI 348/2340467 emergencyvalleseveso@libero.it LOCAL VOLUNTEER GROUPS Volunteering is a fundamental and essential component of EMERGENCY’s work. Volunteers work to inform the general public and promote a culture of peace through participation in conferences, meetings and workshops in schools and in workplaces. Volunteers are key to fundraising by hosting dedicated events, presenting specific projects to local agencies, organisations and businesses, or manning booths at larger events. Gruppo di Cologno Monzese - MI 347/9669024 emergency_cologno_monzese@ yahoo.it Gruppo di Magenta - MI 335/77507444 emergencymagentino@gmail.com Gruppo Martesana - MI 393/2736362 - 02/9504678 emergency.martesana@tatavasco.it Gruppo di San Giuliano - MI 338/1900172 emergencysgm@hotmail.com Gruppo di San Vittore Olona - MI 0331/516626 emergencysanvittoreo@libero.it Gruppo di Saronno - MI 339/7670908 emergencysaronno@gmail.com Gruppo di Sesto San Giovanni - MI 335/1230864 emergencysesto@emergencysesto.it Gruppo di Settimo Milanese - MI 02/3281948 - 333/7043439 emergencysettimomi@virgilio.it Gruppo di Usmate Velate - MI 039/673324 - 039/672090 emergencyusmatevelate@virgilio.it Gruppo di Bergamo 338/7954104 info@emergencybg.org Gruppo di Isola Bergamasca - BG 320/0361871 emergencyisolabg@libero.it Gruppo di Brescia 335/1767627 - 333/3289937 info@emergencybs.it Gruppo di Crema - CR 335/6932225 - 335/7119651 emergency.crema@gmail.com Gruppo di Como 333/6163586 emergencycomo@hotmail.com Gruppo di Lecco - Merate 329/0211011 emergencylecco@libero.it Gruppo di Lodi 340/0757686 - 335/8048178 emergencylodi@yahoo.it Gruppo di Mantova 0376/223550 - 320/0632506 emergencymantova@virgilio.it Gruppo di Monza 334/8670307 emergency.monza@inwind.it Gruppo di Pavia 346/3307054 emergencypv@hotmail.com Gruppo di Vigevano - PV 0381/690866 - 328/4237529 emergencyvigevano@tiscali.it Gruppo della Valtellina - SO 0342/684033 - 320/4323922 emergency.valtellina@virgilio.it Gruppo di Varese 334/1508540 - 333/8912559 emergencydivarese@gmail.com Gruppo di Busto Arsizio - VA 0331/341424 emergencybustoarsizio@virgilio.it VENETO Gruppo di Venezia 347/9132690 emergencyve@gmail.com Gruppo delle Città del Piave - VE 335/7277849 - fax 0421/560994 emergencycittapiave@libero.it Gruppo di Spinea VE 041/994285 - 339/3353868 emergencyspinea@interfree.it Gruppo di Belluno 348/7793483 emergency.belluno@yahoo.it Gruppo di Padova 348/5925163 emergencypadova@hotmail.it Gruppo di Rovigo 348/5609005 emergencyrovigo@libero.it Gruppo di Treviso 333/4935006 - 340/5901747 emergency_treviso@yahoo.it Gruppo di Verona 334/1974348 emergency.vr@libero.it Gruppo di Vicenza 333/2516065 info@emergencyvicenza.it Gruppo di Asiago - VI 333/6883280 emergencyasiago@tiscali.it Gruppo di Thiene - VI 349/1543529 emergencythiene@tiscali.it FRIULI VENEZIA GIULIA Gruppo di Trieste 347/2963852 emergencytrieste@yahoo.it Gruppo di Udine 0432/580894 - 339/8268067 emergencyudine@libero.it Gruppo dell’Alto Friuli - UD 0433/51130 - 347/3172702 emergencyaltofriuli@tiscali.it TRENTINO ALTO ADIGE Gruppo di Trento 347/9822970 emergencytrento@yahoo.it Gruppo dell’Alto Garda - TN 347/4091769 emergencyaltogarda@hotmail.it Gruppo di Rovereto - TN 339/1242484 emergencyrovereto@libero.it Gruppo della Valli di Fiemme e Fassa - TN 347/6805029 emergencyfiemmefassa@yahoo.it Gruppo di Bolzano 339/6936469 emergencybolzano@yahoo.it LIGURIA Gruppo di Genova 010/3624485 emergencygenova@libero.it Gruppo del Tigullio - GE 0185/288400 - 349/4525818 emergencytigullio@libero.it Gruppo di Riviera dei Fiori - IM 340/7708004 emergencyriviera@libero.it Gruppo di La Spezia 349/3503695 emergencylaspezia@gmail.com Gruppo di Savona 347/9698210 emergencysavona@libero.it EMILIA ROMAGNA Gruppo di Bologna 333/1333849 emergencybologna@virgilio.it Gruppo di Imola - BO 0542/42448 - 339/7021931 emergencyimola@libero.it Gruppo di Ferrara 333/9940136 emergency.fe@libero.it Gruppo di Forlì - FC 338/4822684 - 335/5869825 emergency.forli@libero.it Gruppo di Cesena - FC 329/2269009 emergencycesena@tiscali.it Gruppo di Modena 059/763110 - 347/5902480 emergencymodena@gmail.com Gruppo di Fanano - MO 348/4446120 - fax 0524/680212 emergencyfanano@libero.it Gruppo di Parma 0521/873235 - fax 0521/371631 emergencyparma@polaris.it Gruppo di Piacenza 0523/617731 - 339/5732815 emergencypc@virgilio.it Gruppo di Faenza - RA 347/6791373 emergencyfaenza@yahoo.it Gruppo di Reggio Emilia 0522/555581 - 348/7152394 emergency.re@fastwebnet.it Gruppo di Rimini 335/7330175 grupporimini@gmail.com REPUBBLICA SAN MARINO Gruppo de San Marino 335/7331386 emergency.sanmarino@libero.it TOSCANA Gruppo di Firenze 334/7803897 info@emergency.firenze.it Gruppo di Empoli - FI 338/9853946 - 333/3047807 emergency-empoli@libero.it Gruppo di Rignano sull’Arno - FI 339/1734165 - 338/4609888 emergency-rignano@email.it Gruppo di Sesto Fiorentino - FI 055/4492880 - 339/5841944 emergencysestofiorentino@gmail.com Gruppo di Arezzo 348/6186728 emergencyar@virgilio.it Gruppo di Grosseto 339/4695161 info@emergencygr.it Gruppo di Follonica - GR 339/4695161 emergencyfollonica@ouverture.it Gruppo del Monte Amaita - GR 347/3614073 - 347/6481865 emergencymonteamiata@yahoo.it
  • 19. 19 Gruppo di Livorno 333/1159718 - 346/2318650 emergencylivorno@katamail.com Gruppo di Piombino - LI 329/8741625 - 380/2599437 emergencypiombino@libero.it Gruppo di Lucca 0583/578318 - 349/6932333 emergencylucca@yahoo.it Gruppo della Versilia - LU 328/2062473 emergencyversilia@yahoo.it Gruppo di Massa Carrara 349/8354617 - 329/5733819 emergencymassacarrara@gmail.com Gruppo di Pisa 320/0661420 info@emergencypisa.it Gruppo di Volterra - PI 349/8821421 emergencyvolterra@virgilio.it Gruppo di Pistoia 348/8401412 emergencypt@interfree.it Gruppo dell’Altopistoiese - PT 329/6503930 emergency.altopt@tiscali.it Gruppo di Prato 339/1857826 emergency.prato@tiscali.it Gruppo di Siena Valdelsa 340/5960950 emergencysienavaldelsa@virgilio.it LAZIO Gruppo di Tivoli - RM 347/1640390 volontari_tivoli@yahoo.it Gruppo dei Castelli Romani - RM 328/2078624 - 347/5812073 castelli.rm.emergency@gmail.com Gruppo di Rieti 328/4271644 emergencyrieti@hotmail.com Gruppo di Colleferro - FR 335/6545313 emecolleferro@libero.it Gruppo di Cisterna - LT 333/7314426 emergency.cisterna@gmail.com Gruppo di Formia - LT 340/6662756 emergencyformia@libero.it Gruppo di Monte San Biagio - LT 329/3273024 emergencymsb@libero.it Gruppo di Cassino - FR 339/7493563 - 347/5324287 cassinoxemergency@libero.it Gruppo di Vetralla - VT 340/7812437 vetrallaperemergency@gmail.com MARCHE Gruppo di Ancona 328/8455321 emergencyancona@libero.it Gruppo di Fabriano - AN 0732/4559 - 335/5753581 emergencyfabriano@libero.it Gruppo di Jesi - AN 349/4944690 - 0731/208635 emergency.jesi@aesinet.it Gruppo di Ascoli Piceno 335/5627500 emergencyascolip@libero.it Gruppo di Fermo 328/4050710 emergency.fermo@libero.it Gruppo di Fano - PU 0721/827038 - 338/2703583 emergencyfano@yahoo.it UMBRIA Gruppo di Perugia 075/5723650 emergencyperugia@yahoo.it Gruppo di Città di Castello - PG 347/1219021 emergencycittadicastello@yahoo.it Gruppo di Foligno - PG 0742/349098 emergencyfoligno@libero.it Gruppo di Gualdo Tadino - PG 333/8052884 emergencygualdotadino@yahoo.it Gruppo di Spoleto - PG 340/8271698 emergencyspoleto@libero.it Gruppo di Terni 320/2128052 emergency_tr@libero.it Gruppo di Orvieto - TR 329/6197364 emergencyorvieto@libero.it ABRUZZO Gruppo di L’Aquila 349/2507878 emergencylaquila@libero.it Gruppo dell’Alto Sangro - AQ 348/6959121 emergencyaltosangro@gmail.com Gruppo di Avezzano - AQ 328/8686045 emergencyavezzano@virgilio.it Gruppo di Pescara 328/0894451 emergencypescara@virgilio.it Gruppo di Teramo 333/5443807 emergencyteramo@hotmail.it MOLISE Gruppo di Isernia 333/2717553 emergency_isernia@yahoo.it Gruppo di Campobasso 392/3460870 emergencycampobasso@gmail.com CAMPANIA Gruppo di Napoli 339/5382696 emergencynapoli@libero.it Gruppo di Avellino - Benevento 347/1621656 - 329/2047329 emergency_montemiletto@virgilio.it Gruppo di Caserta 335/1373597 emergencycaserta@katamail.com Gruppo dell’Altocasertano - CE 333/7370000 altocexemergency@virgilio.it Gruppo di Pagani - Salerno 338/6254491 - 347/9105378 emergencypagani-prsa@libero.it Gruppo di Agropoli - Vallo di Lucania - SA 339/1222497 - 339/3335134 emergency_agropoli@virgilio.it maria91@libero.it BASILICATA Gruppo di Latronico - PT 339/7980173 - 339/2955200 emergency.latronico@libero.it Gruppo di Matera 329/5921341 emergency-matera@inteldata.biz Gruppo di Policoro - MT 0835/980459 emergencypolicoro@libero.it PUGLIA Gruppo di Bari 340/7617863 - 329/9493241 emergency_bari@libero.it Gruppo di Bitonto - BA 080/3744455 - 333/3444512 emergency@bitonto.net Gruppo di Molfetta BA 340/8301344 emergencymolfetta@libero.it Gruppo di Foggia 340/8345082 - 0881/756292 emergencyfoggia@libero.it Gruppo di BAT 347/2328063 emergencybat@tiscali.it Gruppo di Pr. Brindisi - BR 339/4244600 emergencytorress.br@libero.it Gruppo di Lecce 328/6565129 - 349/5825203 emergencylecce@libero.it Gruppo di Nardò - LE 338/3379769 emergencynardo@tiscali.it Gruppo della Valle d’Itria - TA 328/7221897 - 328/6990572 emergency_martinafranca@yahoo.it CALABRIA Gruppo di Cosenza 338/9506005 - 349/2987730 cosenzaxemergency@yahoo.it Gruppo di Catanzaro 393/3842992 emergencycatanzaro@gmail.com SARDEGNA Gruppo di Cagliari 339/3365958 emergency.cagliari@gmail.com Gruppo di Serrenti - CA 347/1411284 emergency.serrenti@gmail.com Gruppo di Budoni - Nuoro 329/4211744 - 347/6416169 emergencynuoro@libero.it Gruppo dell’Ogliastra 320/676282 ogliastra.emergency@libero.it Gruppo di Milis - OR 0783/51622 - 320/0745418 emergencymilis@hotmail.com Gruppo di Macomer - OR 389/9726753 emergency.macomer@tiscali.it Gruppo di Sassari 079/251630 - 339/3212345 emergencysassari@yahoo.it Gruppo di Alghero - SS 347/9151986 algheroemergency@tiscali.it Gruppo di Olbia - SS 0789/23715 - 347/5729397 insiemergencyolbia@tiscali.it SICILIA Gruppo di Palermo 320/5592867 - 091/333316 emergency.pa@libero.it Gruppo di Campobello di Licata 339/8966821 emergency.campobello@libero.it Gruppo di Catania 348/5466769 - 339/4028577 emergencycatania@virgilio.it Gruppo di Caltagirone - CT 328/2029644 emergency.caltagirone@yahoo.com Gruppo di Piazza Armerina - EN 347/8829781 emergencypiazza.a@virgilio.it Gruppo di Messina 090/674578 - 348/3307495 messinaperemergency@hotmail.com Gruppo di Vittoria - RG 338/1303373 emergencyvittoria@tiscali.it Gruppo di Siracusa 349/0587122 emergency.siracusa@libero.it Gruppo di Trapani 0923/539124 - 347/9960368 emergency.trapani@libero.it EMERGENCY USA info@emergencyusa.org Atlanta, GA Atlanta@emergencyusa.org Boston, MA Boston@emergencyusa.org Boulder, CO Boulder@emergencyusa.org Chicago, IL Chicago@emergencyusa.org Denver, CO Denver@emergencyusa.org Los Angeles, CA LA@emergencyusa.org Northern California NorthernCA@emergencyusa.org New York, NY NYC@emergencyusa.org Pittsburgh, PA Pittsburgh@emergencyusa.org Washington, DC DC@emergencyusa.org EMERGENCY UK info@emergencyuk.org London, UK info@emergencyuk.org EM info Atla Nic Atla Bos Sou Bos Bou Dad Bou Chi Ge Chi Den Jas den Los Ma LA@ Nor Jak Nor New Eric NY Pitt Chi Pitt Wa Shi DC EM info Lon Gia