MID-TERM REPORTmoveability.icrc.org/wp-content/uploads/sites/111/2017/... · 2017-05-11 · SFD APPEAL AND BUDGET STRUCTURE The 2015 ICRC Special Fund for the Disabled (SFD) budget

MID-TERM REPORT 2015

SFD APPEAL AND BUDGET STRUCTURE

The 2015 ICRC Special Fund for the Disabled (SFD) budget is based on the

objectives set for the year and covers both field and headquarters activities

from 1 January to 31 December 2015. Its structure consists of four separate

field budgets and the headquarters budget.

The 2015 SFD Appeal is therefore divided into the following chapters:

AFRICA

activities of SFD regional offices in Tanzania and Togo;

ASIA - VIET NAM

activities of the SFD regional office in Viet Nam;

ASIA - TAJIKISTAN

activities of the SFD sub-regional office in Dushanbe;

THE AMERICAS

activities of the SFD regional office in Nicaragua.

The operational programme support provided by the SFD’s headquarters

in Geneva and the costs for financial management and administration

have been added on a pro rata basis to the four field budgets.

Donors are encouraged to support the SFD 2015 Appeal as a whole and to

forward their contributions as soon as possible. Funds obtained are subject

to standard SFD reporting (yearly Appeal, Annual and Mid-term Report),

audit and financial review procedures (Annual Report of external auditors).

Ad hoc reports may be produced on special request.

For more information on the SFD and related ICRC programmes, see:

• SFD 2015 Appeal (available on the SFD website)

• SFD 2014 Annual Report

• Ernst & Young 2014 Audit Report

• ICRC Physical Rehabilitation Programmes: Annual Report 2014

• ICRC 2015 Special Mine Action and Disability Appeal

www.sfd.icrc.org provides further information on SFD activities.

ICRC Special Fund for the Disabled Headquarters

19, avenue de la Paix

1202 Geneva

Switzerland

Tel: ++ 41 22 730 23 57 / 24 01 / 31 35

Fax: ++ 41 22 748 91 61

Email: [email protected]

ABOUT THE SFD 2SFD modus operandi 2The ultimate goal 2An alternative technology 2Funding and financial control 2

INTRODUCTION 3Training 3Multidisciplinary approach 4DPOS and national authorities 4Management capacities 5Financial situation 5

ACTIVITIES BY REGIONAfrica 6Asia 17The Americas 27

ABBREVIATIONS AND ACRONYMS 35

CONTENTS

1 | SFD MID-TERM REPORT 2015 | CONTENTS

The ICRC Special Fund for the Disabled (SFD) was created by

the International Committee of the Red Cross (ICRC) in 1983

to ensure the continuity of former ICRC programmes for

populations affected by conflict, and support other physical

rehabilitation centres in low-income countries.

While the SFD activities are not included in the ICRC budget

and are funded independently through the SFD yearly appeal,

the ICRC provides the SFD with logistical and administrative

support.

SFD MODUS OPERANDILike other development organizations aiming to enhance

national capacities, the SFD implements projects that stretch

over several years. The SFD’s assistance is geared towards main-

taining and increasing access to rehabilitation services, and

improving the quality and sustainability of these services. This is

mainly achieved through capacity building and training together

with technical, material and financial assistance. At SFD-sup-

ported centres, the actual physical rehabilitation work is carried

out by the local partner. From the start, project ownership is and

remains with the partner. The SFD carries out regular follow-up

visits over a number of years and provides advice and coaching

not only in technical matters but also for the management, inno-

vation and further development of services. In addition, the SFD

directs advocacy efforts at the authorities concerned, and seeks

to mobilize other actors and foster networking and cooperation

with them.

Formal education remains fundamental to the training of profes-

sional staff. The SFD offers scholarships and supports a number

of prosthetic/orthotic schools worldwide in order to maintain

high education standards. This includes promoting the use of

the polypropylene technology and appropriate clinical train-

ing, organized in collaboration with local schools. The SFD also

encourages and supports training in other fields such as manage-

ment and quality control.

The duration of SFD support is directly linked to the local part-

ners’ commitment to developing their own capacities to provide

rehabilitation services and their ability to become self-sus-

taining, in line with the recommendations and assessments

provided during SFD monitoring visits.

THE ULTIMATE GOALThe entry into force of the United Nations Convention on the

Rights of Persons with Disabilities (UNCRPD) in 2008 and the

2011 recommendations of the World Disability Report (World

Health Organization, World Bank, 2010) have brought further

support to the SFD’s ultimate goal of promoting socio-economic

integration for people living with physical disabilities, while still

focusing on their initial needs.

The aim is to remove – or to reduce as far as possible – restric-

tions on activities and thereby enable people with physical

disabilities to become more independent and enjoy the highest

possible quality of life. Various measures, such as medical care,

physical rehabilitation including physiotherapy, vocational

training, social support, and programmes promoting economic

self-reliance, all come into play. Networking with other providers

of services in this field is indispensable and the SFD therefore

seeks to develop its partners’ understanding of the overall reha-

bilitation process.

AN ALTERNATIVE TECHNOLOGYThe technology for manufacturing orthopaedic devices

favoured by the SFD is based on the polypropylene technology

developed by the ICRC.

This technology is now standard practice for the production of

prostheses and orthoses in many low-income countries and is

being used by a significant number of organizations involved

in physical rehabilitation, including the projects and centres

supported by the SFD. It combines accessible standard compo-

nents (i.e. prosthetic feet, knees, etc.), and raw materials (mainly

polypropylene) that are locally available. Using this technology

has considerably enhanced the technical skills of professionals

working at SFD-supported physical rehabilitation centres, and

thereby improved access to quality services for people with

limited resources.

FUNDING AND FINANCIAL CONTROLThe SFD relies exclusively on voluntary contributions to cover its

costs both in the field and at headquarters. Its donor base consists

of governments, National Red Cross and Red Crescent Societies,

foundations and private donors.

The SFD’s accounts are examined yearly by an external

auditor. SFD projects are regularly evaluated by internal and

external assessors.

ABOUT THE SFD

ABOUT THE SFD | SFD MID-TERM REPORT 2015 | 2

INTRODUCTION

3 | SFD MID-TERM REPORT 2015 | INTRODUCTION

The present report will give a short overview of the activities and

objectives achieved in the four regions where the SFD is active.

Each chapter is composed of a list of the main facts and figures

for each region, followed by highlights on the main achievements

and challenges faced by the SFD in the field. The progress on the

various 2015 objectives, as presented in the appeal, is reported in

tables for each region, country and project that the SFD supports.

The SFD Mid-term Reports are part of the standard SFD reporting

system and thus complement the SFD yearly Appeals, Annual

Reports and the financial reviews established by the SFD’s exter-

nal auditors.

In March 2015, the SFD management prepared a detailed

response to the SFD independent evaluation conducted in 2014.

This prompted a full review of the SFD’s current strategy with the

Board members in May 2015 followed by working sessions with

the SFD team in June 2015 to identify the main elements of the

2016-2020 strategy. One of the avenues explored in the new strat-

egy will be the development of stronger cooperation with Red

Cross/Red Crescent National Societies.

The SFD team and Board members will continue to exchange

ideas on the content of the strategy during the fall of 2015.

TRAINING

Training of professionals of the physical rehabilitation sector

remains a strong component of the SFD’s programme through

direct coaching by SFD specialists and also through SFD support to

schools that train ortho-prosthetists and physiotherapists. During

the first semester, the Tanzania Training Centre for Orthopaedic

Technologists (TATCOT) benefited from SFD financial support to

install modern teaching technology that combines intranet access

to data (access to training manuals, worldwide literature, student

files, etc.) and provide each student with a notebook.

Early 2015, the International Society of Prosthetics and Orthotics

(ISPO) accredited the Prosthetic and Orthotic training unit of

the University of the Rwanda College of Medicine and Health

Sciences (UR-CMHS) in Kigali (Rwanda). All told, the SFD supports

five schools, all accredited by ISPO, in El Salvador, Rwanda, Tanza-

nia, Togo and Viet Nam.

The Ecole Supérieure de Kinésithérapie in Cotonou (Benin) con-

tinues to provide lecturers who take part in the training sessions

organized by the SFD in Togo and initial discussions have been

held with the Kilimanjaro Christian Medical College (KCMC)

in Tanzania for the introduction of a new curriculum to train

assistant-physiotherapists.

Meeting in Viet Nam with the Deputy

Minister of Ministry of Labor,

invalids and Social affairs and the SFD

to discuss the cooperation of the two

parties.

INTRODUCTION | SFD MID-TERM REPORT 2015 | 4

MULTIDISCIPLINARY APPROACH

In order to implement a multidisciplinary approach, the SFD

ortho-prosthetist and physiotherapist team in Tajikistan closely

cooperates with the six prosthetists, who have recently returned

from VIETCOT, the Vietnamese training centre for orthopaedic

technology based in Hanoi, where they attended their training,

and two physiotherapists employed at the State Enterprise Ortho-

paedic Plant (SEOP) in Dushanbe. Over the past year of intensive

coaching and on-the-job training, SEOP has been able to diversify

its range of products and physiotherapy treatments, and enhance

the overall quality of services. However, local authorities and the

centre management have not succeeded in allocating funds to

the renovation of the orthopaedic centre in Khujand (Northern

province of Tajikistan) and the centre is still not operational. In

support to SEOP, the SFD team is currently looking for donors

towards the refurbishing of the Khujand branch.

DPOS AND NATIONAL AUTHORITIES

In Nicaragua and El Salvador, the SFD encouraged local authori-

ties to strengthen their coordination role and management style

regarding the provision of physical rehabilitation services. Indeed

in both countries, the management of decentralized services

is under the direct supervision of regional hospitals that often

focus on priorities outside the physical rehabilitation field and

have no knowledge of P&O services. Discussions have been held

with health authorities from these countries and although there

is a general consensus, the new cooperation agreements have

not been signed, thus delaying the foreseen investment for 2015

(hence the low implementation rate).

As part of efforts to diversify services for persons with disabilities,

pilot partnerships have been created in Africa (Tanzania Federa-

tion of Disabled People’s Organizations – SHIVYAWATA- and the

Fédération Togolaise des Associations de Personnes Handi-

capées - FETAPH) and in Viet Nam (Action Centre for Community

Development- ACDC). Other partnerships with disabled people’s

organizations and local NGOs are being considered in all the

regions where the SFD is present (e.g. PIPITOS in Nicaragua, INKO-

MYAT in Tajikistan).

These partnerships are essential to raise the awareness of national

authorities on the need to extend social protection to persons

with physical disabilities (i.e. forum organized by ACDC in Viet

Nam) and on the need for services in remote areas (i.e. needs

assessment in rural areas has recently been produced by SHIVY-

AWATA in Tanzania). To consolidate the inclusive approach within

SFD teams, a third person with physical disability was recruited by

the SFD office (Togo).

Senior Leadership Programme in Lomé,

during this training, government

representatives, Togolese RC and civil society

work together to facilitate access to physical

rehabilitation and promote social inclusion.

5 | SFD MID-TERM REPORT 2015 | INTRODUCTION

MANAGEMENT CAPACITIES

The development of management capacities is crucial to guar-

antee the sustainability of the physical rehabilitation sector and

Leadership Management and Governance (LMG) organizes a

training, known as the Senior Leadership Programme, in collabo-

ration with Yale University, Medical Science for Health (MSH), ICRC

and SFD. This training is financed by USAID Senator Patrick Leahy

War Victims Fund. Sessions were held in Eastern Africa (2013-2014)

and this year for French-speaking African countries (Togo and

Madagascar) and in Viet Nam. It brings together senior staff from

local authorities (Ministries), service providers, Red Cross/Red

Crescent National Societies and disabled people’s organizations.

ACHIEVEMENTS

During the first half of 2015 the SFD provided financial, material,

technical and/or training support to 39 centres in 17 countries;

it contributed to the rehabilitation of more than 4,500 disabled

persons worldwide, by the fitting of 2,189 prostheses and 6,812

orthoses as well as the provision of 1,149 crutches and 203 wheel-

chairs; 42 local staff members received an SFD scholarship to

attend one- to three-year courses in prosthetics and orthotics at

regional schools (33) or to take distance-learning courses (9); 176

professionals participated in basic training courses lasting one to

four weeks and organized by the SFD (94), and/or were sponsored

to attend regional seminars (82); the SFD carried out 33 technical

support/monitoring visits to 14 centres, which lasted between

one and four weeks and included coaching, on-the-job training

and refresher courses for local personnel.

FINANCIAL SITUATION

SFD progress is noticeable and a new mind-set towards an inclu-

sive approach is developing. However, the financial income in

2015 has not yet allowed the full implementation of the programs

as budgeted in the Appeal 2015 (budget of 6.3 MCHF). Although

new donors have expressed their wish to contribute towards

SFD programmes and additional income is still expected before

the end of the year, in May the SFD Board took a conservative

measure and decided to keep the overall expenses at a maximum

of 4.8 MCHF until new funding is received. According to income

received in the second semester, the rest of the activities could be

implemented.

As of the end of August, a total of CHF 4,379,053 has been

received or firmly pledged so far thanks to the donors’ continuing

and generous support.

In order to fully cover its planned activities in 2015, the SFD still

needs to raise CHF 1,877,261 before the end of the year.

AFRICA | SFD MID-TERM REPORT 2015 | 6

AFRICA

REGIONAL OFFICEDar es Salaam, Tanzania

SUB-REGIONAL OFFICELomé, Togo

OVERALL SUPPORTMaterial and financial assistance was provided to 14 service

providers and 3 training institutions in 9 countries

SFD PERSONNEL3 ortho-prosthetists

2 physical therapists

3 administrative and supporting staff;

2 disability programme officer

TRAININGManagement training: 2

Number of participants sponsored by the SFD: 82

Nationality of the participants: Tanzanian, Togolese

Clinical training (P&O, PT): 5

Number of participants sponsored by the SFD:

58 Participants from 14 nationalities

SERVICES, PROSTHETIC/ORTHOTIC DEVICES AND MOBILITY AIDS PROVIDED BY THE SUPPORTED CENTRESOverall physical rehabilitation services for 9,212 people with

disabilities, including 93 for ERW/mine incident survivors.

Protheses: 652

Orthoses: 3’836

Crutches (pairs) : 1’176

Devices for mine incident survivors:

54 prostheses and 39 orthoses

Devices reimbursed by the SFD:

333 prostheses and 82 orthoses

(in Swiss francs)

Expenditure01.01.2015 – 30.06.2015

Budget2015

Material & financial assistance 253'791 1’505’310

Tuition & staff-related costs 524’490 1’101’490

Premises, equipment, general supplies, audit costs 94’986 300’020

Operational programme support, financial management & headquarters’ administration 154’304 260’165

TOTAL 1’027’572 3’166’985

Children10%

Female29%

Male61%

Prostheses delivered by gender and age group

Female13%

Male14%

Children73%

Orthoses delivered by gender and age group

HIGHLIGHTS

7 | SFD MID-TERM REPORT 2015 | AFRICA

• A comprehensive framework agreement was signed with the Togolese Ministry of Health, describing the objectives of the various

SFD partnerships (CNAO, ENAML, FETAPH) that cover the next three-year period.

• The services of FATO were used to assess the implementation of the National Strategic Plan in Côte d’Ivoire and explore ways of

cooperating with the MoH and services providers in Benin and Côte d’Ivoire.

• Given the sound development of the OADCPH purchasing centre in Togo, discussions were held with partners in Tanzania and with

the OADCPH with a view to opening a branch in Tanzania to facilitate the distribution of materials in eastern Africa and Madagascar.

• A new LMG training session was launched for 6 French-speaking countries: 4 countries supported by ICRC and 2 countries sup-

ported by SFD (Togo and Madagascar).

• A thorough cost calculation exercise was carried out at CNAO in Togo and reviewed at CCBRT, Tanzania.

• Support was given to KCMUC PT school in Moshi to update its curriculum and open a two-year physiotherapy course.

• Four professionals were sponsored to attend the ISPO congress which was held in Lyons, France, bringing together some 4,300

delegates (1 from ENAML, Togo, 2 from CCBRT and TATCOT, Tanzania, and 1 from the Malagasy Ministry of Health).

• TATCOT received new IT equipment (hardware for the intranet system) and the school server was installed.

• Through the services of the Organisation Africaine pour le Dévelopement des Centres pour Handicapés (OADCPH), materials and

components were provided for 11 centres (6 West Africa/ 5 East Africa) and 2 schools.

• The reimbursement of services by the SFD at CNAO and CCBRT (333 prostheses and 82 orthoses) was made through local DPOs,

which ensured that the most economically vulnerable service users benefited.

• 12 sports wheelchairs were donated to FETOSPHA in Togo, while cooperation is building up in Tanzania and Madagascar with the

local Paralympic Federation.

• In general, the commitment of Ministries of Health regarding support to physical rehabilitation services is limited and hinders the

centres’ sustainability.

• The SFD’s partners’ management capacities slow down or even limit the collaboration process.

• Vulnerable patients in remote rural regions have limited or no access to physical rehabilitation and decentralized services, where

available, are often not a priority for local authorities owing to lack of resources.

• Access to services remains one of the main obstacles for people in need of physical rehabilitation in most of the countries where the

SFD supports providers since social protection mechanisms are not in place.

MAIN ACHIEVEMENTS

CHALLENGES

Participants to the SLP training in Togo


ACTIVITIES AT SFD-SUPPORTED CENTRES IN AFRICA: JANUARY – JUNE 2015

Country PartnerSustainability Quality Access Social Inclusion

2015 objectives Achievements 2015 objectives Achievements 2015 objectives Achievements 2015 objectives Achievements

BEN

IN

Service de Kinésithérapie et d’Ap-pareillage Orthopédique, SKAO, Parakou

Sign a multi-year framework agreement with the MoH that supports service providers.

2 field visits were made to Cotonou to meet the MoH and Ministry of the Family to discuss a framework agreement. 1 field trip is scheduled for November for the final round of MoU negotiations and signature.

Ensure that 1 professional attends P&O and Cat. I training.

OADCPH training sessions were scheduled for August 2015 for 1 PT and 2 PO.

Support SKAO and CNHU to facilitate access to physical rehabilitation services for 300 people.

Raw materials and compo-nents delivered through OADCPH.

Map and record collaboration opportunities with Red Cross/Red Crescent National Societies (NS) and DPOs.

A partnership request was addressed to SFD by the Benin Red Cross to support their physical rehabilitation centre. A visit to the centre is scheduled for November 2015.

Contract external evaluator to prepare the ground for setting up a national strategic plan.

The FATO evaluation trip was carried out in April 2015 at CNHU, SKAO, the Ministry of Health and the Ministry of Family. The report has been submitted to the SFD.

Check that 80% of assessed devices match SFD quality standards.

Although the quality of devices is satisfactory, the team has not yet introduced the quality assessment protocol. This will be done during the second semester.

Check that 70% of staff match productivity standards and PT treatment standards.

Low productivity of P&O staff is the consequence of low number of patients access-ing services combined with the slow working capacity of junior staff. The PT is committed to the ultidisciplinary approach and 80% of the P&O service users benefit from consultation and/or PT treatment.

Centre d’Appareillage Orthopédique du CNHU de Cotonou

Develop coordination mechanisms and review sector policies.

Discussions are being held with senior staff from the MoH and hospitals. The coordinating body is not yet in place.

Check that 80% of patients are satisfied with services.

Not yet implemented

Increase management (budget, recruitment of professionals, PMS and cost calculation used).

Postponed until a framework is set up and government commitment is obtained.

Organize 4 visits and meetings with high-level authorities and services providers.

2 visits made by SFD staff to meet CNHU administrative staff, Ministry of Health and Ministry of Family.




CÔTE

D’IV

OIR

E

Vivre Debout, Abidjan.

Sign a cooperation agreement with MoH including a strategic plan for the physical rehabilitation sector.

Signature of an addendum to the current cooperation agreement valid until end December 2015.

Improve the partner’s multidisciplinary approach by recruiting a physiotherapist.

Vivre Debout has not yet suc-ceeded in taking advantage of PT resources available at the local hospital (CHU Yopougon) for its own services.

Support financially the purchasing of materials through OADCPH.

Raw materials and compo-nents delivered through OADCPH.

Map and record collaboration opportunities with NS and DPOs.

Pending.

Contract exter-nal evaluator to prepare the ground for setting up a national strategic plan.

An external evaluation was carried out in April 2015 by FATO to assess the implementation of the national strategic plan in Côte d’Ivoire and explore ways of cooperating with MoH and services providers. The report is to be shared with the parties con-cerned during the second semester.

Train 5 profes-sionals (3 P&O, 2 PT using the services of ENAML).

OADCPH training sessions sched-uled for August 2015 for 2 P&O.

Ensure that 1,200 people have access to services during the year.

Under process.

Organize 2 assessment visits (Lomé team) and 1 follow-up visit (FATO).

1 assessment visit was carried out by FATO at Vivre Debout. A meeting was held with Vivre Debout, the director of the SFD and the SFD head for Africa to discuss the outcome of current cooperation.

Check that 80% of devices match SFD quality standards.

Although the quality of devices is satisfactory, the team has not yet introduced the quality assess-ment protocol. This will be done during the second semester.


The involvement of a third party is essential to avoid any bias. A reliable third party has not yet been identified.

MA

DA

GA

SCA

R

Foyer Akanin’ny Marary, AM, Ambositra

Support AM in diversifying its funding sources and better supporting cost of services for economically vulnerable groups.

Limited change owing to lack of commitment from the centre’s management. Changes in the management team in August 2015 might give better possibil-ities for the end of the year and 2016.

Develop multidisciplinary approach by the allocation of physiotherapy staff.

Limited change of staff due to lack of commitment from the centre’s management. Changes in the management team in August 2015 might bring better opportunities for end of the year and 2016.

Support financially the purchase of materials through OADCPH.

No order made in 2015 owing to lack of management commitment, following an SFD request to have a Plan of Action to define the activities and the collaboration.

Support AM in revising its approach on vocational training (farming, agriculture and promotion of self-em-ployment) to benefit up to 50 persons with disabilities.

There is only limited willingness at the centre to change its approach for the time being.






MA

DA

GA

SCA

R

Foyer Akanin’ny Marary, AM, Ambositra

Ensure that SGS undertakes an NGO bench-marking of AM.

Activity postponed until second semester.

Reinforce the capacity of pro-fessionals (P&O, PT) through coaching and tailor made training.

In May 2015 2 people from AM participated in the Iranian Red Crescent Society training session on appropriate orthotic solutions.

Ensure that 300 people have access to services.

No donation of materials made in 2015 because of manage-ment’s lack of commitment. Funds re- allocated to a main order for the CRMM.

Advocate the integration of AM in the National Coordination body led by MoH.

Discussions are being held with the MoH to keep AM in the loop of the decisions taken for the other centres, including those regarding mate-rial support.

Check that 80% of devices match SFD quality standards.

Reduction of support following the limited commitment of the centre’s management and the lack of tech-nical supervision (declining interest of AM manage-ment in physical rehabilitation activities).

Promote the enrolment of 24 bene-ficiaries of services in the Paralympic Federation as basketball players; SFD provides sports wheelchairs.

2 meetings organized with Paralympic Federation did not succeed in obtaining the enrolment of beneficiaries.

Centre de Rééducation Motrice de Madagascar, CRMM, Antsirabe

Review the current strategic plan and implement coordination mechanisms.

Plan of Action under discussion with partners for both CRMM.


The participation of MoH and service providers in the LMG training session, held in Addis Ababa is devel-oping partners’ awareness of quality of services and satisfaction of users. However, the beneficiary satisfaction questionnaire to be used by a third party is not yet available.

Support MoH in mapping reha-bilitation centres and assessing barriers faced by PwD.

MoH not ready yet to do the mapping, but support given to the LMG team to carry out a mapping in one specific region.

Facilitate the adoption by MoH of a multi-year plan of action for service providers and national coordination body.

Under way (6 months delay on the part of the MoH)

Facilitate exter-nal coaching (100/120 days) to allow CAM to improve quality and diversify services

The Iranian Red Crescent Society (IRCS) training on appropriate footwear was held at CAM. The SFD P&O gave support for the training and helped evaluate the needs at CAM with a view to upgrading the working environment.

Ensure that 250 people have access to services.

Order placed for CRMM.Order to be placed for CAM in second part of 2015 or early 2016

Centre d’ap-pareillage de Madagascar, CAM, Antananarivo,

Kick-start a central pur-chasing unit in Madagascar.

Contact was made with the Antananarivo existing medical central stock. Possible collaboration to be developed with MoH (with SFD support).




MA

LI

PROPHETE, Bamako

Ensure that SGS undertakes an NGO bench-marking of AM.

Owing to the current circum-stances in Mali, the ICRC will take over SFD support starting in January 2015. To facilitate the handover, the SFD will organize a field visit including an assessment of services.

Raw materials and components were delivered through OADCPH (thanks to earmarked funding from the Government of Monaco).

RWA

ND

A

University of Rwanda College of Medicine and Health Sciences, UR-CMHS, Kigali

Support efforts by UR-CMHS to obtain accreditation for their P&O Cat. II training by ISPO.

The college has obtained ISPO accreditation; recommen-dations are being drawn up and future SFD support mechanisms discussed.

Work with ENAML and TATCOT to implement the use of existing training manual.

A new MoU between UR-CMHS and SFD is under discussion which will for the time being exclude TATCOT. This initiative might find support with the newly created Pan African Education forum.

Support focuses exclusively on strengthening the training programme.

The proposed MoU to start in 2016 concentrates on training pro-gramme including the setting up of a P&O facility with machines and a clinical area. A visit to UR- CMHS took place in April.

The partner being a school, no activity planned.

Upgrade working environment for students’ clinical placement.

Letter of understanding agreed to ensure materials will arrive before the MoU takes effect in 2016. Practical sessions and clin-ical placements require proper components and materials.

SOM

ALI

A

Somali Red Crescent, SRCS, Hargeisa

Somali Red Crescent, SRCS, Galkayo

Somali Red Crescent, SRCS, Mogadishu

Sign a tripartite agreement with the Somali Red Crescent and the Norwegian RC, setting the conditions to reinforce the management capacity of SRCS.

Participate in the organization of 2 management training sessions by Norwegian RC/SFD (Nairobi) and one field visit (annual coordinating meeting).

A three-year tripartite agreement was signed early 2015.

A coordination meeting was attended in Nairobi. Management training is planned for December as elections during October might hamper interna-tional travel.

Organize 2 tech-nical training sessions for 3 professionals (PT and P&O) in Dar es Salaam.

Select 3 phys-iotherapists to enrol in a BSc course at the UR-CMHS.

Ensure that 3 people are enrolled as Cat. I students at TATCOT.

1 PT and 1 P&O participated in the Iranian Red Crescent’s orthotic training in January 2015.

Change to possible physio-therapy training for 4 people to be started in September 2016 in Tanzania if SFD support to the PT school in Moshi is feasible (if not Rwanda will be kept for training).

2 applications currently being processed with NECTA (National Examinations Council Tanzania). Students are due to start in Oct 2015).

Advise SRCS and Norwegian RC on acquiring necessary materials and equipment, through the services of OADCPH.

Ensure that a total of 2,200 people have access to services at the 3 centres managed by SRCS.

Technical support given.

Donation of materials and components made accord-ing to the expected target Discussions were held regarding the possibility of opening a central purchas-ing warehouse in Dar es Salaam.

Encourage SRCS to include this aspect in its programme.

No develop-ments yet.






TAN

ZAN

IA

Tanzania Training Centre for Orthopaedic Technologists, TATCOT, Moshi

Follow up the implementation of the multi-year framework agreement signed with the MoH which includes support to three centres and one school.

Follow-up discussions with MoH related to the framework agreement have been conducted through the LMG training group (named Bongo team).

Ensure that a centralized intranet data-base (teaching materials, guidelines, time-tables and key organizational documents) is regularly updated and accessible to staff members.

Hardware was installed and is accessible throughout the school. Initial database with teaching materials for first intake of Diploma year students is available.

Support MOI and KCMC to reach an agreement to accommodate clinical placements for TATCOT that will indirectly provide access for physically 120 disabled people.

Through TATCOT the SFD supports KCMC to reach an agreement to accommo-date clinical placements for TATCOT students. The number of beneficiaries will be indicated in the annual report if an agreement with KCMC is reached. Collaboration with MOI is no longer envisaged by SFD.


Support the MoH in improving its coordination role and participation in the drawing up of a plan of action for each one of SFD-supported structures.

Discussions are under way within the Bongo team. The drafting of the official strategy plan of the MoH for 2015-2020 has been delayed, it is however expected later this year.

Complete the editing of all of training manuals.

One manual for Diploma students in orthotics, materials science and workshop technology was completed.

Organize 10 meetings with the working group composed of senior officials from MoH, services providers and civil society to set recommen-dations on the implementation of UN CRPD.

3 meetings have been held with senior MoH offi-cials to discuss recommenda-tions to achieve implementation of UN CRPD objectives.

Support the organization by the CCBRT/TATCOT faculty of 4 training sessions.

3 training sessions in the faculty delivered in cooperation with the Norwegian overseas exchange programme (FK): ischial contain-ment (2) and lower-extremity orthotics (1).

Set up the CCBRT/TATCOT faculty-training unit.

Renovation of the old medical warehouse has gone to tender. Training unit/faculty will be complete in begining 2016.

Organize 4 visits to TATCOT.

6 visits carried out.

Review the cooperation between SFD, MoH, CCBRT and TATCOT under MoH authority.

Review meetings took place in January 2015.

Ensure that 2 SFD staff members participate in end of year exam as external examiners.

1 SFD staff member partici-pated as external examiner.

Put in place and check tools to improve the management of services (PMS, product cost calculation).




TAN

ZAN

IA

Comprehensive Community Based Rehabilitation in Tanzania, CCBRT, Dar es Salaam

Introduce finan-cial indicators to measure the evolution of the proportions invested by partner and SFD.

Discussions are being held regarding the choice of indicators satisfactory to both parties (to be implemented later in 2015).

Analyse data recorded from interviewing 120 disabled people according to the SFD question-naire (quality, access and inclusion).

52 interviews have been conducted using the SFD questionnaire at the services centre. 20 home visits using the questionnaire have been conducted by the DPO.

Ensure that 300 people (Dar es Salaam outskirts and rural areas) have their treatment costs subsidized by SFD.

91 Beneficiaries have received appliances subsi-dized by the SFD, i.e. almost 10% of beneficiaries receiving services at CCBRT.

In collabo-ration with CCBRT social services, support SHIVYAWATHA (a DPO) to ensure that 10 persons with physical dis-abilities access employment (i.e. launching small business initiative like Baja taxis).

5 PwD have been referred to the CCBRT employment desk.

Provide 2 physical therapy scholarships for training in Rwanda.

Pending, due in second semester.

Ensure that 1,200 physically disabled people have access to services.

1,300 physically disabled people received services.

Sponsor 6 disabled chil-dren to access educatio

SFD sup-ported 6 full scholarships that include medical devices and uniforms to attend school for five years.

Promote the multidisciplinary approach through training of professionals (combined team of 8 P&O/ PT from other African country).

On-the-job training for 1 PT assigned to the P&O unit at CCBRT.Support to improve the clinical assess-ment using a multidisciplinary approach.

Ensure that CCBRT builds a dormitory dedicated to persons with physical disabili-ties undergoing treatment.

Under discus-sion with CCBRT management.

Set up the OADCPH central purchasing unit for East Africa at CCBRT.

Under discussion.

Muhimbili Orthopaedic Institute, MOI, Dar es Salaam

Evaluation under way.

Kilimanjaro Christian Medical Centre, KCMC, Moshi

MoU between KCMC and TATCOT under revision.

Physical Rehabilitation Centre, Zanzibar

Evaluation under way.

TOG

O

École National des Auxiliaires Médicaux, ENAML, Lomé

Sign a multiyear framework agreement with the MoH which includes direct SFD support to CNAO and ENAML.

The MoH in Togo and the SFD signed a cooper-ation agreement in May 2015 with the aim of implementing activities related to physical rehabilitation in line with the related articles of the UNCRPD. The Agreement includes SFD support for FETOSPHA, ENAML and CNAO.

Ensure that all clinical placements are centralized in the unit managed by CNAO and coordinated by both ENAML and CNAO.

CNAO has been used for clinical placements; however repetitive strikes in the public sector affected further organi-zation of clinical placements.

During training of students, the materials provided are used to offer P&O services. Subsidize the cost of 300 services.

Provision of material was made in April.







TOG

O

Support the MoH in improving its coordination role and participation in the drawing up of a plan of action for each one of SFD-supported entities.

Discussion are being held but no plan of action has been adopted yet.

Translate all TATCOT curricu-lums into French.

Curriculums have been received by ENAM. ENAM is analyzing its possible use (to much LMD specifications).

Facilitate the setting up of a working group including senior officials from MoH, services providers and civil society with support from Yale/MSH (Senior Leadership Training; based on Tanzania experience).

A working group is in place, including officials from the MoH, Ministry of Social Action, Ministry of Finance, a DPO, and the Togolese Red Cross. This group has taken part in training and coaching offered by Yale University and Medical Science for Health (MSH): 10 meetings and 2 LMG workshops were held.

Implement ISTM (French training institute) rec-ommendations and measure progress on manage-ment and methodology.

SFD sponsored 1 secretary at ENAML employed to facilitate efficient coordination between SFD and ENAML and to reduce teachers’ administrative workload.

Monitor short regional P&O modules under ENAML man-agement and responsibility.

P&O training modules postponed and scheduled for August 2015. ENAML in collaboration with OADCPH accepted full management responsibility.

Participate in the PT curricu-lum update.

Pending, due in second semester.

Centre National d’Appareillage Orthopédique, CNAO, Lomé

Review twice a year the cooper-ation between SFD, MoH, ENAM and CNAO under MoH authority.

Accomplished. Ensure that the training unit is adequately equipped and offers clinical placement for 20 students.

All clinical placements cen-tralized at CNAO. CNAO registers patients for the clinical place-ment activities. 18 students are monitored by ENAML teachers in collaboration with CNAO staff.

Subsidize the cost of 300 services.

CNAO social services prepared a list of beneficiaries and material was provided.

Check that beneficiaries identified by FETOSPHA are provided with wheelchairs.

12 sports wheelchairs provided for FETOSPHA.

Put in place tools to improve the manage-ment of services (PMS, product cost calculation).

Cost calculation done for CNAO devices.

Check that 80% of devices assessed match SFD quality standards.

Interviews started in May.

Ensure that 4,000 physically disabled people access services at CNAO.

SFD support to CNAO continues according to addendum signed for 2015 to ensure the reimbursement of services to CNAO for 300 vulnerable disabled people. Cost calculation of devices done at CNAO.

Move the bas-ketball court to ENAML premises.

FETOSPHA basketball court will be completely renovated by December 2015.




TOG

O

Introduce financial indica-tors to measure the evolution of the proportion of funds invested by the partner and the SFD.

Under process. Organize specific SFD training on PT for 12 mothers of children with physical disabilities.

4 “Hambisela” training sessions for 32 mothers took place at CNAO with the support of SFD.

Ensure that 100 children and mothers from rural areas are referred to CNAO for two weeks’ training.

Planned for the second semester.

Facilitate the identification of 14 service users from CNAO by the Togolese Paralympic sport fed-eration and provide them with sports equipment.

New disabled athletes will be registered during Disability Day and integrated into the basketball team.

Continue coop-eration with the French Institute Supérieur de Technologie de Montplaisir to improve the overall manage-ment of ENAML.

Under way. Leadership Development Programme(part of LMG) modules have been implemented with ENAML adminis-trative staff and teachers.

This is part of the national coordina-tion mechanisms under discussion with MoH.

Support the recognition by the World Confederation of Physiotherapists (WCPT) of the physiotherapy association (AMKITO) con-gress.

Pending. Cooperate with FETAPH to improve its capacity and further promote social inclusion in its programme.

Discussions were held with FETAPH ADD TO LISTto facilitate access to existing the micro-credits programme for the disabled (promotion of an inclusive programme).Consolidate

CNAO management and technical capacity to allow smooth coordination of services at regional level.

Analyse data collected from interviews of 120 disabled people according to the SFD question-naire (quality, access and inclusion).

Disabled people are interviewed according to SFD questionnaire and data are analysed.

Encourage provincial health directorate, MoH and CNAO, to support Kara centre.

Centre Régional d’Appareillage Orthopédique du Kara, CRAO, Kara

Train staff on the use of PMS and cost calculation tools.

MoH will launch training during second semester on PMS that will include staff from Kara, CNAO and MoH.

Ensure that Kara benefits from CNAO technical back-up and coordination.

Under process.

ZAM

BIA

Zambian Italian Orthopaedic Hospital, ZIOH, Lusaka

Analyse the impact of past SFD support, including the outcome of the LMG working group.

No report on the SFD’s impact has been produced yet (due in the 2nd semester). The LMG working group has: influenced the creation of an MoH service dedicated to physical rehabili-tation; set priorities for developing a data collection tool to be integrated in the Health Management Information System; and established monthly meetings of the LMG team. Nevertheless, owing to internal difficul-ties at ZIOH, SFD support remains essential to ensure the continuation of services.

Assess the PT services within the multidisciplinary approach.

Progress is very slow in spite of SFD recom-mendations and less than 5% of clients in ZIOH benefit from a multidisciplinary approach that includes physiotherapy.

Ensure that 500 physically disabled people have access to ZIOH.

240 PwD received services at ZIOH through materials subsidized by SFD.



The Organisation Africaine pour le Développement des Centres pour Personnes Handicapées (OADCPH) was created in 2012 to bring

together the various actors involved in physical rehabilitation. The OADCPH has developed contacts with local, national and interna-

tional entities working in the field of physical rehabilitation, with whom it establishes various forms of cooperation in order to exchange

experiences and expertise, and seek funding for its activities.

With aims very similar to those of the SFD, a firm partnership agreement between the two organizations was clearly a must; it was signed

in 2013. The SFD takes part in OADCPH Board meetings and plays an advisory role in the choice and delivery of components. OADCPH

also established a partnership with CR Equipments/CR Machinery, one of the leading suppliers of materials for physical rehabilitation,

which has provided the ICRC and its SFD with materials for decades.

The OADCPH’s key achievement has been the creation of a centralized purchasing office to provide its 74 partners and other centres in 24

African countries with appropriate machinery, components and good quality devices at affordable prices. On the basis of SFD recommen-

dation, an increasing number of its partner centres now purchase their supplies via the OADCPH, which has the additional advantage of

being exempt from taxes and offering payment by instalments. In 2014, with the help of Japanese international aid obtained with SFD

backing, the OADCPH built a large warehouse and offices in Togo to manage and stock its bulk orders.

Given the success of this venture, the OADCPH and the SFD are now planning to set up a second purchasing office and warehouse to

serve centres in southern and eastern Africa, to save on the cost of transport all the way from Togo; to this end, the SFD has already

established contacts in Tanzania.

The OADCPH also aims to improve the quality of services through training and has held a number of courses. In 2015 it signed an agree-

ment with the SFD’s leading partner in Western Africa, the ENAML school for prosthetic-orthotic technology. For its part, the SFD has set

up the secretariat to organize the joint courses and finances participation for members of the OADCPH.

OADCPH AND SFD: A STRONG PARTNERSHIP DEVELOPS

17 | SFD MID-TERM REPORT 2015 | ASIA

ASIA - VIETNAM

REGIONAL OFFICEHo Chi Minh City, Viet Nam

SUB-REGIONAL OFFICEDushanbe, Tajikistan

(see separate section in the report)


providers and 1 training institution.

SFD PERSONNEL1 ortho-prosthetist

1 project assistant

3 administrative staff (1 person at 50%)

TRAININGType of training:

1 train the trainers course on basic P&O and rehabilitation

knowledge to support lobbying for universal health coverage

1 course on basic P&O and rehabilitation knowledge to facilitate

identification of PwDs in need of P&O devices

Number of participants sponsored by the SFD:

10 from ACDC for the first course; 15 from Can Tho DPO for the

second course

Nationality of the participants: Vietnamese


disabilities, including 186 for ERW/mine incident survivors (i.e.

those supported by SFD).

Protheses: 952

Orthoses: 592

Crutches (pairs): 369


496 prostheses

Devices reimbursed by the SFD:

374 prostheses and 1 orthoses.

(in Swiss francs)

Expenditure01.01.2015 – 30.06.2015

Budget2015

Material & financial assistance 58’963 382’225

Tuition & staff-related costs 152’434 315’786



TOTAL 275’129 891’491

Female17%

Male30%

Children53%

prostheses delivered by gender and age group

Children2%

Female10%

Male88%

orthoses delivered by gender and age group

ASIA | SFD MID-TERM REPORT 2015 | 18

HIGHLIGHTS

• Thanks to efficient cooperation with ACDC, the work on universal health coverage gained momentum notably, but not only,

with the involvement of the SLP group which resulted in the inclusion of orthoses in the list of rehabilitation items given in the

revised MoH decree; this should ultimately open the door for State health insurance coverage of these devices.

• The ambitious terms of reference for the National Study on Mobility Devices funded by the SFD in collaboration with the MoH

and the MoLISA have been discussed and accepted by all parties although not yet officially launched.

• The Senior Leadership Programme (SLP) funded by USAID gave the SFD and ACDC the opportunity to extend their working

relationship with key people at the MoH and MoLISA; they became strong advocates of physical rehabilitation, thanks also to

the participation of VIETCOT’s director who helped to expose the challenges facing the P&O sector to “outsiders”.

• Thanks to ICRC support, the Swiss embassy agreed to organize a Disability Awareness workshop run by the SFD for Swiss

companies operating in Viet Nam, aiming to promote employment of persons with disability.

• The SFD team is preparing a new agreement with a private company (Otto Bock), VIETCOT and the Viet Nam National Sport

Training Centre, with multiple benefits: firstly for a few athletes with disability who will be fitted with advanced assistive devices

for sports, and secondly for the VIETCOT school and its students who will experience working with cutting edge technologies.

• Lengthy ministerial procedures are delaying the final validation of the terms of reference for the National Study and thus the start of

the survey.

• Several State actors with different roles and responsibilities are involved in health insurance related issues which complicates the

identification of the right interlocutor to further promote the inclusion of physical rehabilitation treatments in health insurance

scheme.

• The low number of assistive devices it funded in the first semester has prompted the SFD to review its procedure for reaching out to

its beneficiaries; the VNRC branches now deliver invitations directly instead of relying on postal services.

• VNRC finally rejected the grant offered by the government that could have allowed it to take over the employment project previ-

ously funded by the Spanish Red Cross, and to which SFD was contributing for the fitting of persons in need of assistive devices.

MAIN ACHIEVEMENTS

CHALLENGES

SFD director visiting a beneficiary of the social inclusion project

carried out by the Spanish and Vietnamese Red Cross.


ACTIVITIES AT SFD-SUPPORTED CENTRES IN ASIA: JANUARY – JUNE 2015



VIE

T N

AM

Vietnamese Training Centre for Orthopaedic Technologists, VIETCOT, Hanoi

Rehabilitation Hospital, Can Tho

Rehabilitation Hospital, Da Nang

Rehabilitation Centre, Ho Chi Minh City

Rehabilitation Hospital, Quy Nhon

Organize 4 meetings with partners and authorities targeting Universal Health Coverage.

2 ACDC-SFD meetings for planning activities during 2015. 1 training of trainers in P&O for 10 ACDC staff carried out by VIETCOT.1 meeting was held with MoH, MoLISA, VIETCOT and ACDC for brainstorming session on universal health coverage. Subsequently, the SFD supported the revision of one decree to add a number of orthoses that should have been included in the list of rehabilitation items.

Collect users’ feedback through interviews done in cooperation with DPOs and VNRC.

103 beneficiaries have been interviewed by VIETCOT and 32 by VNRC volunteers.

Support 1,700 persons through subsidies for the cost of services.

Low imple-mentation with 375 persons receiving SFD support during the period. Corrective measures already implemented should, however, allow VIETCOT to reach the annual target.

Participate in the devel-opment of P&O services dedicated to physically disabled athletes with VIETCOT to ensure that 5 athletes are identified by the Paralympic committee and provided with appropri-ate devices.

An agreement was drafted with the Viet Nam National Sport Training Centre, VIETCOT and a private company. The fitting of 3 disabled athletes is scheduled for early September.

Ensure ACDC publishes 12 newsletters to raise awareness of issues related to physical rehabilitation services.

6 newsletters have been published with 4 containing an article directly related to P&O, one about the Senior Leadership Programme (SLP) process and another about the physical reha-bilitation training for ACDC staff (10 participants) that VIETCOT carried out with SFD funding.

Check that 70 % of services comply with quality stan-dards among samplings selected in the different SFD-supported centres and assessed by VIETCOT.

The indi-vidual user assessments carried out by VIETCOT at the 4 SFD-supported centres show that 91% comply with quality standards.

Ensure selected DPOs, VNRC and Spanish Red Cross participate in the referral of PwD in need of services.

Two DPOs (Can Tho and Da Nang) have agreed to refer patients to services providers. Formal agreements will be signed at the beginning of the second semester.

The Spanish Red Cross project was ended owing to the lack of funds.

Organize disability awareness information for private companies regarding employment of disabled people and measure the outcome.

Session to be held in the 2nd semester.

Validate with the authorities the terms of reference for the assessment of the P&O sector, identify external resources and launch the study.

The terms of reference of the survey have been accepted by both the MoH and MoLISA but not officially endorsed, which delays the start of the study.A meeting was held with the General Statistics department to select the pop-ulation sample appropriately.

Support the organization by VIETCOT of 2 training sessions on PP technology.

Delayed implementation. However, given the number of training modules and current lectures already planned, only one such training session will be possible during the second semester.

Engage with private compa-nies to initiate contributions to services costs for the most vulnerable persons.

Following last year’s training of SFD team by the Australian Red Cross (in Cambodia), a Disability Awareness workshop for Swiss companies working in Viet Nam with the support of the Swiss embassy was organized and scheduled for mid July 2015.

Ensure that social workers’ counseling reaches 500 services beneficiaries and offers opportunities for education, vocational training or micro credit.

Discussions with MoLISA and DoLISA continue towards including social workers in their pay-roll.


ACTIVITIES AT SFD-SUPPORTED CENTRES IN ASIA: JANUARY – JUNE 2015



VIE

T N

AM

Establish the revised multidisciplinary treatment procedure at 4 centres.

Will finally not be implemented as this objective requires the employment of a Vietnamese physiotherapist and cannot be covered by the present budget.

Ensure that 40 physicians have improved their skills for P&O services prescription.

Training will be carried out in the second half of the year.


Disability: right shoulder disarticulation and a bilateral trans-tibial amputation due to electric shock.

Following a right shoulder disarticulation and a bilateral trans-tibial amputation after suffering severe electric shock, young Vượng, 17 years

old, was first fitted with a pair of trans-tibial prostheses at the VIETCOT Centre in April 2014. Soon after, owing to stump shrinkage, the

prostheses were renewed in July the same year with some adjustments to facilitate use in the mountainous topography of the village where

the boy lives.

The boy was nevertheless feeling desperate and his family, of a Tày ethnic minority village in the highland province of Cao Bang (near the

Chinese border), was deeply worried. Life is always difficult in remote areas; what could the boy do now without his limbs?

Vuong proved to possess a high degree of physical adaptability. A few months after the accident, he could walk steadily again on his

prostheses. With just one hand, he could manage putting on and off his devices and tying his shoe-laces on his own.

But things are not so easy. The boy has withdrawn into himself and lost all his willingness to continue his studies. His case is one among

many others requiring support to ensure social reintegration and further education. A lot still needs to be done.

The SFD is aware that prosthetic and orthotic assistance, by restoring mobility and dignity, is an essential part of social inclusion but

equally aware that further action must be undertaken to give persons with disabilities, especially young people living with a handicap, the

encouragement, incentive or support they need to help them move forward and make the best of their lives.

A BENEFICIARY CASE STORY FROM CAO BANG PROVINCE, VIET NAM SOCIAL REINTEGRATION, BEYOND PHYSICAL REHABILITATION


ASIA - TAJIKISTAN

REGIONAL OFFICERegional SFD office in Ho Chi Minh City, Viet Nam, with support

from SFD headquarters in Geneva

SUB-REGIONAL OFFICEDushanbe, Tajikistan

OVERALL SUPPORTTechnical assistance was provided to 1 service provider

SFD PERSONNEL1 ortho-prosthetist

1 physiotherapist

TRAININGType of training: Single discipline P&O training at VIETCOT

Number of participants sponsored by the SFD: 4

Nationality of the participants: Tajik


disabilities, including 17 for ERW/mine incident survivors.

Protheses: 233

Orthoses: 499



17 prostheses and orthoses

(in Swiss francs)

Expenditure01.01.2015 – 30.06.2015

Budget2015





TOTAL 237’040 653’642

Children12%

Female21%

Male67%


Children85%

Female7%

Male8%



HIGHLIGHTS

• The State programme on disability has been drafted by the Ministry of Health and Social Protection (MoHSP) after discussions with

all actors in the field of physical rehabilitation (including the SFD).

• 6 out of 7 Tajik students returned after completing their training at VIETCOT and are successfully integrated into the SEOP team.

• The physiotherapy and ortho-prosthetic departments at the SEOP benefit from the technical support provided by the SFD team

and a multidisciplinary approach is used during consultations.

• A new assistive devices unit has been set up at the SEOP and has started manufacturing products (walking aids, seats for cerebral

palsy children).

• The SFD supported SEOP to find donors for the renovation of the Khudjand branch premises.

• The new MoHSP has difficulty in playing a significant supervisory and guiding role to support the SEOP.

• The heavy bureaucratic system still in place between MoHSP and SEOP slows down all decision mechanisms.

• Although a modest incentive has been allocated to staff (in particular newly trained P&O), low wages remain a demotivating factor.

• The working environment at the SEOP has not yet met with sufficient interest from authorities to channel funding into a plan to

refurbish the premises.

• The budget provided by the MoHSP to the SEOP is low and monthly allocations are often late.

MAIN ACHIEVEMENTS

CHALLENGES

Spinal Orthotic seminar

conducted by the Iranian Red Crescent Society

at the SEOP, Dushanbe


ACTIVITIES AT SFD-SUPPORTED CENTRES IN TAJIKISTAN: JANUARY – JUNE 2015



TAJI

KIST

AN

State Enterprise Orthopaedic Plant, SEOP, Dushanbe

Satellite centre, Khujand

Advocate the validation of appropriate policies and coordination mechanisms by the MoHSP.

The State programme on disability drafted by MoHSP includes all the mechanisms for the appropriate functioning of the physical rehabil-itation sector in Tajikistan. The document was prepared with the support of WHO in collaboration with all stakeholders, including SFD (participation in round tables, feedback, etc.).

Review and update working procedures and patients’ management to allow a multidisciplinary approach (P&O & PT).

Working proce-dures have been updated, the multidisciplinary approach has been introduced and used regularly at the SEOP.

Support SEOP and Khujand satellite centre in the fitting of 1,400 physical disabled persons with new devices.

Although needs for services are obvious in the Northern Province, the opening of the Khudjand branch is still pending.

10 selected service users benefit from specific devices to perform sports activities.

Not achieved yet.

Support SEOP in the validation of its development plan by MoHSP.

Relations between MoHSP and SEOP are quite new but progressing. SEOP’s develop-ment plan will be part of the MoHSP Action Plan. This will be further discussed during the second semester.

Promote physiotherapy treatment and counselling to improve quality of services (in particular for orthotics and physiotherapy).

The SFD physiotherapist is conducting on-the-job train-ing for the PT staff at the SEOP. Types of treatment new to SEOP are being shown and imple-mented. Pulley therapy has been installed at the PT department

Ensure that the supply chain for materials and components is autonomously and efficiently managed by SEOP.

SFD is regularly supporting SEOP in the selection and ordering of materials and components. The process still needs to be improved as the system for tendering and ordering from the MoHSP is extremely heavy and bureaucratic.

Map existing socio economic programmes to facilitate the enrolment of persons with disability identified at SEOP.

Under discussion with DPO and Ministry of Social Labour and Protection.

Promote the use of appropriate management style to improve HR management and appropriate mechanisms to retain staff (career develop-ment scheme).

Not achieved yet. Implement, in cooperation with a DPO, users’ feedback through interviews.

Under discussion. Support SEOP in diversifying proposed services (orthotics, wheelchairs and physio-therapy) to attract new patients.

With the support of the SFD team, the assistive devices unit has been set up at the SEOP. The manufacturing of samples is now finished and the SEOP is preparing the production line.

Ensure SEOP creates a department dedicated to social services.

This issue is under discussion with MoHSP and is to be part of the National Plan for Health.

Ensure the 7 staff members trained in Viet Nam are employed according to observed needs.

6 of 7 staff members trained in Viet Nam are successfully employed at the SEOP.

Organize 2 weeks training on trunk orthot-ics to improve the quality of the delivery and the diversity of services.

Together with the Iranian Red Crescent Society, the SFD team prepared the curriculum for the trunk orthotics seminar (scheduled for the second semester).

Mobilize DPOs and the Tajik Red Crescent to improve access to services.

Discussions under way with the local DPO Inkomyat.

Help SEOP to promote its visibility by organizing a national confer-ence on mobility assistive devices and by par-ticipating in 4 relevant forums.

Pending. By informing on amputation techniques, improve the quality of surgery and prosthetic fitting.

Postponed and planned for second semester.


ACTIVITIES AT SFD-SUPPORTED CENTRES IN TAJIKISTAN: JANUARY – JUNE 2015



Support SEOP presence on the international scene and participation in ISPO and WCPT world congress.

Postponed. Check that 70 % of services comply with recognized/ acceptable quality stan-dards.

On average, ser-vices at the SEOP have reached an acceptable level. However the quality standards protocol has not been introduced yet.Facilitate donor

networking and external contributions.

Donors have been approached with SEOP.

Ensure SEOP benefits from an efficient data collecting tool that allows follow-up and planning.

Pending.


Two students have recently returned to Tajikistan after SFD-

funded ortho-prosthetic training at VIETCOT in Viet Nam.

Both are enthusiastic about the skills and experience acquired

and keen to develop services for disabled people in their own

country.

The first interviewed student says she finds it hard to live far

from home and is eager to start working at the Khujand branch

as soon as it opens. She is equally eager to acquire further skills

and complete her training. In her own words: “I want to continue

in this job. I plan to get more education in this field. We aren’t

talking about money; we want to have a good workshop to

work, so we can help others. If life is good, work is good as well.”

Money may not be her main objective, yet she does add: “I want

to have a good salary and better conditions.”

The second student, while still determined to help others, which

is why he chose to be an ortho-prosthetic technician, is more

critical of the working conditions he found when he returned

to his home country: “When I was at VIETCOT I made plans. But

when I came back to the real life, the work proved to be very

difficult. There are a lot of challenges in being far from home.

I’m dissatisfied because the profession of prosthetist is not rec-

ognized in Tajikistan. I am treated like an ordinary bench worker.

I hope that the conditions get better; otherwise I won’t be able

to continue working… We would like to create a national society

for Prosthetics and Orthotics. And to improve the quality of

work. People could walk with a wooden pirate leg (peg leg) but

this is not the 19th century, we would like to improve and make

modern prostheses for people.”

TWO STUDENTS RETURN AFTER SFD-SPONSORED TRAINING IN VIET NAM: FIRST IMPRESSIONS

27 | SFD MID-TERM REPORT 2014 | THE AMERICAS

THE AMERICAS

REGIONAL OFFICEManagua, Nicaragua


providers and 1 training institution in 6 countries: Nicaragua

(5), El Salvador (3), Haiti (1), Peru (1), Ecuador (1) and Dominican

Republic (2)

SFD PERSONNEL1 expatriate ortho-prosthetist

3 national administrative staff members

TRAINING8 students from Nicaragua (4), Ecuador (2), Peru (2)

are enrolled at UBD for distance learning

3 students completed their P&O Cat. II training

(all from Haiti)

11 professionals from Nicaragua (6), El Salvador


disabilities, including 43 for ERW/mine incident survivors (6

women and 37 men).

Protheses: 507

Orthoses: 2’254


Devices for mine incident survivors: 43 prostheses

and orthoses

Devices reimbursed by the SFD: 24 prostheses

and orthoses

(in Swiss francs)

Expenditure01.01.2015 – 30.06.2015

Budget2015





TOTAL 215’040 1’544’196

Children7%

Female32%

Male61%


Children60% Female

22%

Male18%


THE AMERICAS | SFD MID-TERM REPORT 2014 | 28

HIGHLIGHTS

• In Nicaragua, the preparation of a new multi-year framework agreement with the MoH is marking the start of a new and ambi-

tious collaboration with the MoH (national coordination unit, elaboration of a national plan of action, creation of a national

logistics unit, global assessment of the rehabilitation sector, National technical supervision by CENAPORTO, etc.).

• An annual framework agreement was signed with the Los Pipitos, a Nicaraguan NGO, to identify and follow up services users

and to promote a multidisciplinary approach within rehabilitation centres.

• A meeting with a Ministry of Health representative in Ecuador provided an opportunity to introduce ICRC polypropylene tech-

nology as the SFD’s preferred choice of technology that could also be used in the MoH rehabilitation centres; the difficulties

faced by FHM regarding heavy tax on imported material were also discussed.

• Thanks to efficient cooperation with UDB in El Salvador, 8 orthopaedic technicians (from Peru, Ecuador and Nicaragua), spon-

sored by the SFD, are taking the distance-learning course; this will improve the quality of services in their respective countries.

• Three orthopaedic technicians from Healing Hands for Haiti (HHH) validated their training (ISPO-accredited diploma); they had

been coached on site by UDB teachers during the past three years.

• Financial support was also allocated by SFD to HHH to pay the salary of one senior P&O technician to supervise and guide the

newly certified P&O technicians in 2015.

• In Nicaragua, lengthy ministerial procedures are delaying the signature of the multi-year framework agreement with the MoH

and thus the start of the cooperation and the implementation of activities.

• After many years of support, FURWUS (Nicaragua) is still very dependent on SFD financial backing (over 40% of its budget); this

situation has been prevailing for the past years and threatening the sustainability of services.

• The critical economic situation (Ecuador) or the State’s low budget allocation to the sector of rehabilitation (Haiti, El Salvador),

limits access to services.

• Recently accredited professionals, have little experience and need solid mentoring and coaching that is not available at all

sites, thus external resources (Haiti) need to be recruited or backup from a centre of reference organized.

• Importation of raw materials continues to be complicated for physical rehabilitation centres in El Salvador, Ecuador and Haiti

owing to lengthy administrative procedures and heavy importation tax.

MAIN ACHIEVEMENTS

CHALLENGES

Students at UDB in El Salvador


ACTIVITIES AT SFD-SUPPORTED CENTRES IN LATIN AMERICA: JANUARY – JUNE 2015



ECU

AD

OR

Hermano Miguel Foundation, FHM, Quito

Use FHM experience and efficiency to train other private initiatives in the region (CAPADIFE, FURWUS and HHH).

No achievements.

Introduce ICRC manufacturing guiding principles to implement quality control mechanisms.

Not yet introduced (see section on UDB).

Ensure that 5,000 people have access to services, including physiotherapy and specialized services (700 of them access P&O services).

As at end June, 2,439 peoples had accessed FHM services; 306 received P&O services (290 orthoses and 16 prostheses).

Strengthen collaboration with CONADIS.

Regular meet-ings between CONADIS and the FHM were held but the SFD was not involved in the process. No meeting was held with CONADIS during the SFD field visit.

Involve CONADIS Ecuador in exchanges and seminars with CONADIS in Nicaragua and El Salvador.

No meeting yet with CONADIS Ecuador.

Introduce services users’ satisfaction interviews by third party (NS, DPO).

One meeting took place with the Ecuadorean Red Cross which showed interest in interviewing services users (see Nicaragua section: organization of regional training).

Encourage the establishment of a purchasing centre to distrib-ute components and materials in and outside Ecuador.

Regular discussions with an external provider of P&O materials are under way, but the FHM must first obtain exemption from import tax.

Launch micro-project initiatives.

Owing to SFD limited financial capacity , no micro-project initiatives by partner could be supported (to be implemented according to resources).

Start discussions with the MoH on possible SFD support (techni-cal support).

1 meeting with the MoH took place on possible cooperation, in particular to introduce a cost effective technology for the production of mobility aids (PP technology) in the various reha-bilitation centres it manages.

Assess the level of physiotherapy treatment and possible support FHM is able to offer to other centres in the region.

Under discus-sion with FHM.

Analyse criteria to identify vulnerable patients.

On track. The SFD is finalizing the tools that will be used.

Introduce tools to improve service man-agement and planning (PMS, cost calculation, stock control).

Under way. Moreover, a new SGS NGO benchmarking is due to be carried out in November 2015.

Promote the organization of training on service quality management for other centres under private initiative in the region (Nicaragua and Haiti).

To be imple-mented after the introduction of the ICRC manufacturing guiding principles.

Review coopera-tion agreement with FHM for a new period of cooperation 2015-2017.

The 3-year framework agreement is finalized. It will be signed during the next SFD field visit.

Support training costs for 2 technicians (distance-learn-ing programme run by UDB).

The 2 orthopae-dic technicians have finalized the 4th module (out of 5) with excellent results.

Analyse capacities of FHM to become a reference institute for rehabilitation centres in Ecuador.

Planned for the second semester.

Invite 2 professionals to participate in a modular training session organized with UDB.

1 professional participated in a modular training session organized with UDB.





EL S

ALV

AD

OR

University of Don Bosco, UDB, San Salvador

Review coopera-tion agreement with MoH, in particular for the management and follow-up of activities run in Santa Ana under supervision of ISRI.

Under SFD ini-tiative, meetings with the Santa Ana hospital director, the CRIO Santa Ana director (under ISRI supervision), the President of the ISRI, the President of the CONAIPD and one representa-tive of the MoH took place in order to discuss the possibility of transferring the Santa Ana hospital P&O workshop to the CRIO in Santa Ana.

Facilitate access to modular training sessions for 15 profes-sionals from the region.

One modular training session for 11 profes-sionals took place.


As at end June, 1,358 peoples had accessed services at UDB, ISRI and Santa Ana; 733 received P&O services (654 orthoses and 79 prostheses).


Map and record collaboration opportunities with the Red Cross National Society, DPOs and INGOs.

A first meeting took place with CONADIS. A second meeting will be carried out in the second half of the year.

Promote the role of UDB as a reference for quality assur-ance of services and counselling.

Under way. The approach will first be tested with ISRI, before applying it in El Salvador and offering a training module for other centres in the region.

Professionals from ISRI and Santa Ana par-ticipate in the modular training organized with UDB.

4 professionals (3 from ISRI and 1 from Santa Ana) participated in a modular training session on orthotics organized with UDB.

Persuade government to alleviate prohibitive impor-tation tax and to allocate appro-priate budget for purchase of materials.

ISRI cannot import raw materials. Discussions are being held with key actors in order to examine the possible involvement of the Nicaraguan Ministry of Health to facilitate the importation of materials (Nicaragua becom-ing the distributor).

Design coordina-tion mechanisms and review physical reha-bilitation sector policies covering public and private initiatives (all services in the country).

A first meeting with CONAIPD and with key actors from UDB and ISRI to review national policies was held.

Participate in end of year/modules examinations.

SFD participated in the final examination for the 4 Nicaraguan orthopaedic technicians, organized at CENAPRORTO.

Provide materi-als to all centres.

The 2014 reimbursement of materials (UDB and Santa Ana) was made in 2015 because the UDB did not provide the necessary financial documentation in time. One new order has been prepared for the ISRI and some additional raw materials stored at the SFD Managua will be sent directly to the partners.

Introduce tools to improve service man-agement and planning (PMS, cost calculation, stock control).

The UDB and the SFD are looking into the pos-sibility of UDB organizing a training module dedicated to the enhancement of administrative skills (under development).

Examine the feasibility of introducing foot-wear training.

A new modular training session has been developed and implemented with UDB (clini-cal orthoses).

Persuade authorities to recruit additional professionals for UDB, ISRI and Santa Ana.

Following the resignation of the only P&O tech-nician at Santa Ana hospital, the hospital has recruited a new one. However, the lack of human resources at Santa Ana remains problematic.





EL S

ALV

AD

OR

Instituto de Rehabilitación Integral, ISRI, San Salvador


The ICRC manu-facturing guiding principles are not finalized. The following step will include training of UDB tutors who will be in charge of introducing the principles in all centres in and outside El Salvador.

Santa Ana General Hospital, Santa Ana


The SFD did not have the capacity to introduce this element (see Nicaragua section: organi-zation of regional training).

HA

ITI

Healing Hands for Haiti Foundation, HHH,Port au Prince

Check the use of management and planning tools (PMS, cost calculation, stock control).

Both PMS and the stock control tool are used by the partner. During the SFD visit the order-ing procedures were revised.

Support training costs for 4 HHH technicians (ISPO Cat.II course run by UDB).

3 HHH techni-cians received their ISPO accreditation.

Encourage the establishment of a purchasing unit to distribute components and materials in Haiti and the Dominican Republic.

No visit to the Dominican Republic is planned: given the deterioration of the relations between the Dominican Republic and Haiti and the lack of national coordination mechanisms, this activity has been suspended.

Map and record collaboration opportunities with the Red Cross National Society and DPOs as well as INGOs.

Given the socio-eco-nomic context, the promotion of social services or the development of opportu-nities with new partners (NS, DPO) would require the full-time presence of at least one SFD staff member.


Not yet intro-duced by UDB.

Ensure that 1,800 people have access to ser-vices, including physiotherapy and specialized services (650 of them access P&O services).

As at the end of June, 1,083 people had received HHH services; 277 accessed P&O services (234 orthoses and 43 prostheses).

Promote the creation of social services units in all centres managed by MoH.


The SFD did not have the capac-ity to introduce this element (see Nicaragua section: organization of regional training).

NIC

ARA

GU

A

Centro Nacional de Producción de Ayudas Técnicas y Elementos Ortoprotésicos, CENAPRORTO, Managua

Sign a multi-year framework agreement with the MoH that supports service providers.

The multi-year framework agreement is currently with the MoH for a final review.


Not yet intro-duced by UDB.


As at end June, 773 peoples had had access to services at the 3 MoH centres; 609 received P&O services (423 orthoses and 186 prostheses).


Map and record collaboration opportunities with Red Cross National Society and DPOs as well as INGOs.

Promote the creation of social services units in all centres managed by MoH.

Discussions are on-going with National Authorities and the Nicaraguan RC.

The creation of social services is not yet a priority for the service providers.





NIC

ARA

GU

A

Assist the Ministry in man-aging services delivered in the regions of Trinidad and Bilwi.

Implementation pending signature of MoU.


An MoU is in preparation with the Nicaraguan Red Cross. The SFD is looking into organizing regional training of Red Cross staff including Ecuador, El Salvador and Nicaragua (to be held in Nicaragua).

Persuade authorities to recruit additional professionals for Bilwi and La Trinidad.

In March 2015, one new orthopaedic technician was recruited by the MoH for La Trinidad.

Set up one regional seminar with senior representatives from authorities concerned and other actors of physical rehabilitation from Ecuador, Nicaragua and El Salvador to encourage authorities to allocate resources to the sector.


Sponsor 4 tech-nicians’ training (ISPO Cat. II distance-learn-ing programme run by UDB; i.e. 1 technician from Walking Unidos, 3 technicians from CENAPRORTO).

2 orthopaedic technicians have finalized the 3rd module, 1 orthopaedic technician has finalized the 2nd module and 1 orthopaedic technician has finalized the 1st module. The results of the final module examination are not yet published.

Design coordina-tion mechanisms and review sector policies covering public and private initiatives (all services in the country).


Train adminis-trative staff to manage tools like PMS and cost calculation.

Discussions have begun with the MoH in order to decide which patient database will be used in Nicaragua (PMS or MoH system). Cost calculation will be reviewed after the signature of the multi-year framework agreement.

Increase management capacity of service provider (budget, recruitment of professionals, PMS and cost calculation used).


Puerto Cabezas Hospital, Bilwi

Organize 4 visits and meetings with high-level authorities and services providers.

2 meetings and visits took place with the director of La Trinidad hospital, the director of the SILAIS (Provincial Health Authority), and representatives of the MoH and of CENAPRORTO.





NIC

ARA

GU

A

La Trinidad Hospital, La Trinidad

Organize a national mapping of physical rehabili-tation services.


Capacidades Diferentes, CAPADIFE, Managua

Review the cooperation agreement with both organizations.

One 3-year framework agreement has been signed with FURWUS (includes Walking Unidos and CAPADIFE).


As at end of June, 624 peoples had accessed services at CAPADIFE and Walking Unidos; 301 received P&O services (184 orthoses and 117 prostheses).

Assess the pilot phase of FURWUS eco-nomic support programme.

A NGO was identified to assess this pilot phase. However, after revision of the SFD evaluation (June 2015), it was decided to stop developing the economic support programme.

Promote the inclusion of representatives from both organizations in a national coordi-nation body.

Implementation pending signature of MoU with MoH.

Ensure that 50 vulnerable patients receive economic support from FURWUS.

Suspended according to SFD evaluation.

Walking Unidos, León

Analyse and improve criteria to identify vulnerable patients.

On track. The SFD is finalizing the tools that will be used.

PERU

Instituto Nacional de Rehabilitación, INR, Lima

Persuade high level authorities to facilitate importation of materials and components and to alleviate prohibitive importation tax.

Meetings were held with INR management, CONADIS, MoH and the director of the Seguro Integral de Salud.

Sponsor 2 tech-nicians’ training (ISPO Cat. II distance-learn-ing programme run by UDB).

The 2 orthopae-dic technicians have finalized the 4th module (out of a total of 5) with excellent results.

Ensure that 20,000 people have access to services, including physiotherapy and specialized services (1,000 of them access P&O services).

As at end June, 13,931 people had accessed INR services; 535 received P&O services (469 orthoses and 66 prostheses).

Map and record collaboration opportunities with Red Cross National Society and DPOs as well as INGOs.

Provide neces-sary materials to allow access to services.

Stand by as importation procedures are not solved by the partner.

DO

MIN

ICA

N

REPU

BLIC

Innovación Ortopédica, IO, Santo Domingo

Given the positive technical results, only scholarships to take UDB courses and limited quantities of material assistance are provided to accompany the phasing out of the SFD.

Patronato Cibao de Rehabilitación, CBR Santiago


Rafael has had to overcome obstacles and mainly rely on his own hard work to fulfill his goal of becoming an orthopaedic technician.

Until 2009 he had a steady job as a medical assistant at a private clinic, he attended amputee patients who explained to him how hard it

was to get reliable rehabilitation services at an affordable price.

A friend told him that a public centre, CENAPRORTO, was recruiting for the post of workshop assistant with a three-month trial period.

“I took the risk and quitted my job at the private hospital and applied for the post. I was accepted in 2009, and once the MoH had

approved the budget for my permanent employment, I was hired.”

In 2013, he and another colleague were selected to receive an SFD scholarship. “Having a previous experience was a plus. I am currently

attending the third of the five modules. My colleague and me are studying together, I feel very confident that in the near future I will qualify

as an orthopeadic technician (ISPO, Cat. II).”

“I´m also sharing what I have learnt with the new technician who is now finishing the second module. We form a students and co-workers

team. I think that CENAPRORTO and the SFD are really working together to improve services in the country.”

RAFAEL’S QUEST FOR A FULFILLING CAREER

35 | SFD MID-TERM REPORT 2015 | ABBREVIATIONS AND ACRONYMS

ABBREVIATIONS AND ACRONYMS

ACDC Action Center for Community Development Center

AFO Ankle-foot orthosis

AM Foyer Akanin’ny Marary, Madagascar

CAPADIFE Capacidades Diferentes, Nicaragua

CBR Community-based rehabilitation programmes

CCBRT Comprehensive Community Based Rehabilitation in Tanzania

CENAPRORTO Centro Nacional de Producción de Ayudas Técnicas y Elementos Ortoprotésicos, Nicaragua

CIR Center for International Rehabilitation

CNAO Centre National d’Appareillage Orthopédique, Togo

CNHU Centre National Hospitalier Universitaire, Benin

CMC Christian Medical College, India

CRE C.R. Equipements, Geneva

CRIO Centro de Rehabilitación Integral de Occidente

CRMM Centre de Rééducation Motrice de Madagascar

CONADIS Comisión Nacional Asesora para la Integración de las Personas con Dis-capacidad, Peru

CONTRAMINAS Centro Peruano de Acción contra las Minas Antipersonal, Peru

COPE Cooperative Orthotic & Prosthetic Enterprise, Laos

DPOs Disabled persons’ organizations

ENAM École Nationale des Auxiliaires Médicaux, Lomé, Togo

ERW Explosive remnants of war

ESK École Supérieure de Kinésithérapie, Benin

FATO Fédération Africaine des Techniciens Orthoprothésistes

FECONORI Federación de Asociaciones de Personas con Discapacidad, Nicaragua

FETOSPHA Fédération Togolaise de Sport pour Personnes Handicapées

FHM Fundación Hermano Miguel, Ecuador

FURWUS Fundación para la Rehabilitación Walking Unidos, Nicaragua

GHI Global Health Initiative

HHH Healing Hands for Haiti International Foundation Inc.

IBR Instituto Boliviano de Rehabilitación, Bolivia

ICRC International Committee of the Red Cross

IO Innovación Ortopédica, Dominican Republic

IREP Instituto de Rehabilitación Psicofísica, Argentina

ISPO International Society for Prosthetics and Orthotics

ISU Implementation Support Unit

KAFO Knee-ankle-foot orthosis

LRCS Lao Red Cross Society

LMG Leadership, Management and Governance

MI Mobility India

MoH Ministry of Health

MoLISA Ministry of Labour and Social Affairs, Viet Nam

MoU Memorandum of understanding

NORCROSS Norwegian Red Cross

NRCS Nicaraguan Red Cross Society

OADCPH Organisation Africaine pour le Développement des Centres pour Personnes Handicapées

P&O Prosthetist & orthotists/Prosthetic & orthotic

PP Polypropylene

PT Physiotherapist /Physiotherapy

PWD Persons with disabilities

RCI Rehabilitation Council of India

SEIP Social, Economic and Education Inclusion Project, Nicaragua

SEOP State Enterprise Orthopaedic Plant, Tajikistan

SFD ICRC Special Fund for the Disabled

SGS Société Générale de Surveillance

SRCS Somali Red Crescent Society

TATCOT Tanzania Training Centre for Orthopaedic Technologists

UDB Universidad Don Bosco, School for Prosthetics and Orthotics, El Salvador

UNCRPD United Nations Convention on the Rights of Persons with Disabilities

UNSAM Universidad Nacional de San Martín, Argentina

UXO Unexploded ordnance

VIETCOT Vietnamese Training Centre for Orthopaedic Technology

VNRC Vietnamese Red Cross Society

VISIONPersons with impaired mobility develop their full

potential in an inclusive society.

MISSIONThe ICRC Special Fund for the Disabled strengthens

national capacity in less-resourced countries to remove

barriers faced by people with impaired mobility, by

fostering sustainable, accessible and quality physical

rehabilitation services and promoting inclusion.

Layout designed by:

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ICRC Special Fund for the DisabledDonations can be made into the SFD’s account:

Post Finance SABern - Switzerland

Fonds spécial du CICR BIC: POFICHBEXXXIBAN CH15 0900 0000 6049 3552 6

Documents

MID-TERM REPORTmoveability.icrc.org/wp-content/uploads/sites/111/2017/... · 2017-05-11 · SFD APPEAL AND BUDGET STRUCTURE The 2015 ICRC Special Fund for the Disabled (SFD) budget