THE FORMER MOBILE HEALTH CARE PROGRAMME

This is a report by our long serving Director of Programmes, Julia Smyth, who retired a few years ago but in late 2013 kindly agreed to visit the projects in Romania - most of which she had set up - and report on their progress.

ITS DEVELOPMENT AND LEGACY

History

This project was started in 1992 with a Mobile Health Centre in the form of a caravan adapted as a mobile surgery with UK volunteer doctors, a UK nurse/co-ordinator and Romanian translator. Medicines were provided free of charge and obtained from ECHO in the UK [a great specialist medical advisory charity sadly since reporteldy ruined by "consultants].

It worked in 14 remote, rural villages were there were no doctors. In the whole of south east rural Bacau county with a population of 27,000 there were but two doctors to whom the project also gave support and supplies.

One of the two Romanian doctors, Dr Tudor Rosu, obtained via RFFR a Royal College of GP’s travel scholarship to study rural General Practice in the UK. In 1995 Dr Rosu took over as project doctor and Gabi Achihai, the former translator took over as Co-ordinator.

Project change and development

This is most clearly outlined in the attached Activities Graph. By 2001, there were 9 Romanian doctors working in the area and the programme evolved to provide a Mobile Pharmacy and vehicle support to the Romanian doctors. The programme also added:

Nurse Valache who has worked with RFFR and FSC since 1992. She should have retired but continues as an unpaid volunteer nurse.

 
 
  • A RFFR funded Medical Dispensary at Huruiesti 2003 - 2005 (The Mayor has agreed to complete disabled access and Edward Parry has sent a letter to him September 2013 officially confirming the commitment)
  • 2006 a Network of Community Workers were trained- most of them were subsequently employed by the local councils and thanks to their experience are now coordinating the local CoE teams
  • Mobile Pharmacy 2007 – 2009
  • 2004 – 2009 Vehicle and FSC Co-ordinator support to Romanian GP’s to do home visits.
  • Family planning (recently stopped - there was a period when the doctor worked voluntarily but it could not be maintained in the long term. However, most women have been informed and can now obtain contraception from the local pharmacies.)
  • Mother and Baby corners: these were handed over to the local surgeries, to be managed by the doctors
  • Health Promotion in schools
  • Social support and grants to very poor families in a new project "Out of the Poverty Trap"
  • Partnership development with local mayors and authorities

In 2010: 4 Community Transport vehicles

  Were supplied to Stanisesti, Huruiesti, Gaiceana and Motoseni Communities . These were funded by the large Norwegian grant (Innovation Norway grant with Selbu being the Norwegian partner.) They are used to transport babies, sick people and the elderly for doctor and hospital appointment, for vaccinations etc. The Mayors pay the driver and for petrol but FSC manage the programme using the Mayor’s Social Workers as Project Co-ordinators and ensuring standards and rules are abided by. 

Project Beneficiaries

Beneficiary numbers start in 1997 at 900 with a peak in 2007 to 9,000 (introduction of Mobile Pharmacy) and currently running at around 4,000 p.a. The beneficiaries are the sick, elderly, children, poor families, Local Mayors and health workers. The projects have now developed to include whole communities.

Partnership development with local mayors and authorities

This has been one of the most significant outcomes of the programmes in this area. FSC have successfully got the Mayors "on side" over the years of serving their communities and they now pay for the Care of the Elderly Rural Areas Home Carers’ salaries. In the early days, it was difficult to engage the mayors in any commitment to their communities and in many cases there was a distinct lack of concern for the plight of the rural sick, elderly and poor. Of course there were many claims on their funds and there was little precedent for primary care, home visits or home care. Now Mayors contact FSC directly and often for their help.

  • In 2012, FSC facilitated, along with 10 mayors from rural local councils and two local MP’s a visit to the Ministry of Works and Social Protection to lobby for funding services in rural areas and they were successful in obtaining higher priority for the service provision in rural areas. The only means of funding from central budgets to NGO’s was Law 34.

Current Services in the former MHCP areas

  • Community transport for children, sick and elderly
  • Home Care of the Elderly in 4 communities
  • Liaison, collaboration and Co-ordinator services from Community Social Workers
  • "Clubs with Glue" in 4 communities supporting poor families and children (separate report)
  • Summer Schools associated with the "Clubs with Glue"
  • High School and University Scholarships for children from poor families (separate report)

The Legacy of the MHCP

Huruiesti Dispensary

  • In 2011 there were 11 GP’s now resident in the area
  • Most Communa main villages now have dispensaries
  • There is community transport to get to hospitals, doctors and dispensaries
 

FSC’s main focus has switched from the original medical services to providing support to existing medical services, direct Home Care of the Elderly and social and educational support to poor families and their children in the projects listed above.

The Mobile Health Care Programme has acted as a seed project and has led to the development of health and social services in the area. It has:

  • Served and helped thousands and thousands of the rural poor. Current FSC beneficiary numbers for the whole area in its 3 projects are estimated as being close to 20,000
  • The length of time RFFR/FSC have worked in this area, FSC’s Social Study of the problems and hardships faced and their experience were the basis for some large funding grants which in turn allowed the development of direct services.
  • The MHCP work and experience led to the Care of the Elderly service in the area which has pioneered the sale of services to the state via the local mayors
  • Acted as a model for other organisations
  • MHCP experience and knowledge of the area and its problems led to FSC being able to develop work and relationships in a positive way.
  • Lobbied for reform and funding by networking with other NGO’s and the Mayors of this area

 

Julia Smyth
11 October 2013