El Salvador: Earthquake Appeal No. 02/2001 Operations Update No. 21

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Launched on 14 January 2001 for CHF 1,112,360 for 1 month. Revised on 24 January 2001 for CHF 5,422,147 for 154,000 beneficiaries for 14 months; budget revision to CHF 9,385,698 on 4 June and extension of the operation until 31.12.2002; further extension of the operation to 31.12.2003.

Beneficiaries: 154,000
Period covered: 1 February 2003 - 30 April 2003
Last Update: 20 issued 30 January 2003
Next Update 22 expected August 2003

IN BRIEF

Appeal coverage: 112.1%

Related Appeals: 01.47/2003 Pan American Disaster Response Unit; 01.50/2003 Central America

Outstanding needs: None

Summary: The time frame of the El Salvador earthquake operation has been extended until 31 December 2003 given the long term development goals of the programmes. Over the reporting period, the health and care programme saw the continued success of the Salvadorean Red Cross Society (SRC) puppet show which seeks to raise awareness of HIV/AIDS related stigma. In March, the play was presented in five schools in the urban area of San Salvador where HIV/AIDS prevalence is high. The SRC continues to gain recognition for its role in the field of HIV/AIDS. A number of micro projects were developed in vulnerable communities where health posts have been set up, in order to strengthen capacities and to assist female-headed households affected by the coffee crisis. Progress was made with regard to the formation and training of community based disaster preparedness brigades and initial vulnerability and capacity assessments of 50 communities were completed. The SRC national relief plan is under revision and a final draft of an improved plan is under preparation.

Operational Developments

Given the long term development goals of the El Salvador earthquake operation, both in terms of the National Society and targeted communities, together with the balance of funding remaining at the end of December 2002, the earthquake operation has been extended until 31 December 2003. A number of projects continue to be implemented and a major focus of the programme relates to strengthening the capacities of the National Society, both at headquarters and branch level, with a view to ensuring long-term sustainability.

During the reporting period, the Federation continued to support the National Society in the drawing up of a Country Agreement Strategy (CAS) with the involvement of the Participating National Societies. Two drafts of the CAS have been reviewed.

The Salvadorean Red Cross Society presented its experiences in the fields of community health and voluntary non-remunerated blood donation during the XVII Inter American Conference held in Santiago de Chile in April.

During the period covered by the report, elections were held for mayors in the municipalities and for representatives of the National Congress. Elections proceeded normally and the majority of the mayors and National Congress representatives who were elected belong to the left wing FMLN party.

In the health sector, the ongoing crisis continues as a result of a medical union strike implemented as a protest against the privatization of the Salvadoran Institute of Social Security.

The Salvadorean Red Cross Society/Federation are successfully ensuring increased co-ordination with PNS and external partners, particularly in the field of health. An example of coordination between members of the Red Cross Movement is the development of the CAS, approval of which is expected shortly.

Red Cross and Red Crescent action

Objectives, activities and results

Health and Care

The two main projects in health are to improve infrastructure for community well-being and to improve the health conditions in the target communities, whereby health includes physical, psychic and social well being. A memorandum of understanding between the Salvadorean Red Cross Society, the Japanese Red Cross Society which provided funding for the rehabilitation and reconstruction of health infrastructure, and the Federation was signed in March 2002.

Objective 1: To improve directly and indirectly the health care for approximately 115,000 people living in the rural areas of three departments: Sonsonate, La Libertad and Santa Ana, by constructing or rehabilitating a total of 14 health posts and one Red Cross branch clinic.

This objective was met through the construction and rehabilitation of 14 health posts. During a symbolic inauguration, in the presence of the Vice President of the Japanese Red Cross Society, the 14 health posts and one nutritional clinic were officially opened. The Salvadorean Red Cross Society, in coordination with the Ministry of Health (MoH) and health committees, is responsible for verifying that the health posts are functioning well, in accordance with the agreement signed between the parties. Statistics to date show that over 3,338 people have received medical assistance through the curative and preventive health brigades which also undertake health promotion activities in the new health posts. In total, 57,825 people benefit directly from the health posts and almost an equal number of people benefit from these indirectly, resulting in some 115,769 beneficiaries in total.

Due to some very strong winds which occurred in February, the health centres in Cusamaluco, Loma Larga and El Centenario were reported to have been damaged. The head of the Federation delegation and the health assistant visited the centres and witnessed damage to the ceilings and roofs. The construction company was contacted and started immediate repairs under a one year guarantee of the construction work. At the end of April the Ministry of Health confirmed that all damage had been repaired.

Objective 2: To improve the well being of the most vulnerable population of the country through the establishment and strengthening of the Salvadorean Red Cross Society community health office at national level in accordance with a five year plan and five year theoretical framework 2002 -2006.

The SRC, the American Red Cross and the Federation negotiated an agreement for the creation of a community health office (CHO) which became fully operational in April 2002. The two major objectives of this CHO are to define a national health strategy to be implemented by National Society branches and PNS and to create strategic alliances with the Ministry of Health, the Pan American Health Organization (PAHO) and other major health players. The community health office continues its coordinating role as regards community health projects carried out by Participating National Societies.

HIV/AIDS programme: 23 SRC volunteers from the youth department, under the supervision of the national HIV/AIDS coordinator, are carrying out the HIV/AIDS campaign in three departments: San Salvador, La Libertad and Sonsonate. To date, 3,500 young people in these departments have taken part in activities focusing on the prevention of HIV/AIDS financed by the Federation and the Italian Red Cross.

The Canadian Red Cross has confirmed its support to extend this project to the western part of the country through the two branches in Juayua and Nahuizalco in the department of Sonsonate. This is thought to be essential given that the incidence of HIV/AIDS, associated with urban areas, is now spreading in rural areas.

With the help of the Federation, the presentation of the puppet play "Although you are seropositive, you are still my friend" has continued. This method of education through entertainment seeks to contribute to the HIV/AIDS prevention project and sensitize the population view a view to reducing stigmatization. With the puppet play, the Salvadorean Red Cross has reached new groups of youngsters and children. In March, the play was seen by more than 120 orphans and abandoned children in the orphanage "The Garden of Love" in Zacatecoluca. Of these 120 children, 28 of the children under 9 years of age are seropositive, one of which is only one month old.

The Federation, together with the SRC, validated the play as a useful methodology to be used to prevent the spread of the HIV infection and reduce stigmatization and discrimination. The play was presented to representatives of the PNS, the Ministry of Health, the Ministry of Education, UNAIDS, UNICEF and UNDP in February with the aim of promoting constructive feedback.

In March, after coordination with the national network for the fight against AIDS, UNAIDS and the Ministry of Education, the play was presented in five schools in the urban area of San Salvador, where the prevalence of HIV/AIDS is high according to the Ministry of Health.

The work of the SRC, with the support of the Federation, in the field of HIV/AIDS has been recognized by other institutions. The Ministry of Health has requested the help of the National Society to produce and edit a brochure with the title "Help to stop HIV/AIDS". A group of children and youngsters between 8 and 14 years of age from the community, including SRC volunteers, designed and validated the brochure through which awareness-raising on the prevention of HIV/AIDS will continue.

Coordination and Monitoring of health Activities: The SRC community health office developed its work plan 2003, based on the community health strategy. Additionally, the office provided support in the integrated management of childhood illnesses (IMCI) at community level for social volunteers within the health project financed by the French Red Cross and the Golfo de Fonseca project supported through the Federation. Within the frame of the Golfo de Fonseca project, at the end of March a course was given in IMCI to 24 social volunteers from three branches: La Unión, Santa Rosa de Lima and Intipuca, all in the east of the country. The community health office also prepared a course in the IMCI strategy for the other health projects, implemented at a national level by the PNSs.

Advice has been given by the community health office to the Spanish Red Cross, achieving the inclusion of a nutritional promotion and education component in a project seeking to convey key messages in water and sanitation, to avoid diarrhoeal diseases, to undertake vector control strategies and to carry out mother and child health initiatives. The project is to be carried out by SRC social volunteers in 2003 - 2004 under the supervision and technical monitoring of the SRC community health office.

To strengthen integrated community development, the community health office is giving a series of training sessions in community health including modules on health promotion, community organization and social participation, mother and child care, community health (which includes vector-transmitted diseases) and sexually transmitted diseases. Each one of these modules have been validated by the community, the MoH and the SRC. Coordination has been established with PAHO and UNICEF for the final validation and design of the modules. The module on health promotion has been finished and is being printed.

XVII Inter American Conference: During the Conference, the SRC gave a presentation on experiences gained in the area of community health. The results achieved were shared together with the strategy used to approach this part of health care, which includes the recruitment of youth and voluntary blood donors in the communities.

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