Annual Report 2011

> Financial Report

> Summary of Projects

> Project Countries

> Overall Result

> Organisational Structure medico international

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edico's total budget for 2011 was

€ 20,234,329.46. This is a further

slight increase on the previous year,

due primarily to extensive reserves for pro-

jects for which funds were provided in 2010

but could not be spent until 2011. A carry-for-

ward to the following year is essential where –

as in the case of the disasters in Haiti and

Pakistan – donations received immediately

are also intended for use in carefully planned

reconstruction projects with long-term effect.

Income

Medico's total donations for 2011 were

€ 4,944,543.19, including € 1,755,000.00 in

donations forwarded from the ‘Development

Works Alliance’ (BEH), which extensively

benefited victims of the famine in East Africa.

Excluding the BEH donations, income from

donations was € 3,189,543.19. This was a

slight decrease, although only in comparison

with 2010, when donations were unusually

high at € 3,727,098.89 as a result of the two

major disasters. Government grants increased

(€ 5,011,074.51, compared with

€ 4,243,319.61 in 2010), primarily due to the

expansion of our work in Palestine. Grants

from the medico international foundation

increased from € 44,857.66 in 2010 to

€ 80,000.00 in 2011, not least as a result of

increased endowments. The continued increa-

se in donor membership is gratifying, rising

from 1,985 in 2010 to 2,205. This enables us

to work in a long-term and stable manner with

our partners in the global South.

Expenditure

In 2011 medico again received the Seal of

Approval of the German Central Institute for

Social Issues (DZI). The income statement on

the following pages is based on the DZI’s

expenditure categories, which distinguish bet-

ween operational expenditure and expenditure

on advertising and administration. Operational

expenditure includes project funding, project

management and campaigning and aware-

ness-raising work. In 2011 operational expen-

diture totalled € 9,915,243.17, or 91.89% of

total expenditure. This breaks down into

€ 8,228,932.95 (76.26%) spent on project fun-

ding, € 911,435.56 (8.45%) on project

management and € 774,874.66 (7.18%) on

campaigning and awareness-raising work. We

funded a total of 90 projects in 2011, including

large programmes such as humanitarian mine

clearance in Afghanistan, continuing recon-

struction aid for Pakistan and Haiti, work on

the West Bank and aid for the victims of the

famine in East Africa. We also gladly funded

small and often highly labour-intensive aid

programmes in 2011, e.g. direct medical assi-

stance to people on Cairo’s Tahrir Square, in

cooperation with our Egyptian partners. Ex-

penditure on advertising and administration

was € 875,490.76, 8.11% of total expenditure.

(DZI regards a share of less than 10% for

administrative costs as low.)

Risks and opportunities

The annual result for 2011 again confirmed the

solid financial basis of medico’s work. While

the 2011 budget was still dominated by the two

major disasters in 2010, it maintained the

slight rise in donations in previous years,

excluding the donations received in 2010 for

Haiti and Pakistan. The goal is to stabilise this

trend while at the same time seizing other

opportunities. medico’s specific approach of

working with local partners instead of sending

its own staff is also proving justified in view of

the negative consequences of globalisation.

Where other organisations are taking greater

and greater risks from growing violence by

assigning aid workers, medico is able to main-

tain and intensify its solidarity with and support

for partners who are often all the more depen-

dent on this in the face of great hardships and

risks.

Conclusion: Two good reasons give opportu-

nities the edge over risks. First, the financial

and organisational solidity of medico as an

organisation, and second the ongoing interest

in medico’s work on the part of a critical public.

medico international

2011 Financial ReportCurrent status and trends

M

AfricaMali

• Contribution to AME annual budget for 2011 and 2012, Association

Malienne des Expulsés (AME)

• Support to deported migrants in Mali and improvement of reception con-

ditions, Association des Refoulés d´Afrique Centrale au Mali (ARACEM)

€ 55,000.00

Mauretania

• 20 years of AMDH – review and strategy development, Association

Mauritanienne des Droits de l'Homme (AMDH)

• Improvement of health services to migrants in Nouadhibou, Mission

Catholique de Nouadhibou

€ 9,610.60

Migration, West Africa

• Contribution to the Counter-Summit of Civil Society Actors from Africa and

Europe in parallel with the 3rd Euro-African Ministerial Conference on

Migration and Development in Dakar, 22.11.2011, CONGAD Senegal

€ 2,000.00

East Africa

• Emergency aid in the Garissa District – access to health services and

advocacy work, PHM Kenya Circle

• Emergency aid to East Africa, cofinancing famine crisis, Deutsche

Welthungerhilfe (DWHH)

€ 562,553.39

Sierra Leone

• Strengthening the poor population in the diamond region of Kono, Network

Movement for Justice and Development (NMJD)

€ 24,886.00

Zimbabwe

• Right to health in the constitution and in practice – campaigning and

strengthening PHC structures in local communities, Community Working

Group on Health (CWGH)

€ 180,946.86 (incl. support from the German Federal Ministry for Economic

Cooperation and Development (BMZ))

Summary of Projects by Region

Project

Countries

2011

• Afghanistan• Bangladesh• Brazil• Cambodia• Chile• Colombia• Egypt• El Salvador

• Guatemala• Haiti• India• Israel• Kenya• Kurdistan/Iraq

• Lebanon• Mali• Mauretania• Mexico• Nicaragua• Pakistan

• Palestine• Sierra Leone• Sri Lanka• South Africa• Western Sahara• Zimbabwe

South Africa

• Institutional promotion of the self-help organisation for apartheid victims,

Khulumani Support Group

• Support for children in families and communities affected by HIV/AIDS,

Sinani-KwaZulu Natal Programme for Survivors of Violence

• Legal advice for refugees and migrants and xenophobia prevent in South

Africa, Zimbabwe Exiles Forum (ZEF)

• Conceptual and organisational capacity development for local develop-

ment actors in peace and development work phase 3, Sinani

€ 191,643.61 (incl. support from ifa zivik)

Western Sahara

• German subtitles for the film ‘El Problema’, MundoDoc Film

• Western Sahara ECHO MdMGR 2011 evaluation

• Provision of medication and medical supplies to Saharan refugees

€ 54,869.32 (incl. support from ECHO)

AsiaAfghanistan

• Humanitarian mine clearing in Afghanistan: Promoting the mine clearing

programme of the Mine Detection and Dog Centers (MDC)

• Mine awareness for women and children in Central Afghanistan,

Organisation for Mine Clearance and Afghan Rehabilitation (OMAR)

• Supporting the MDC polyclinic: promoting the physical therapy and psy-

chology components, MDC

€ 3,094,342.35 (incl. support from German Federal Foreign Office)

Bangladesh

• Rural health programme in Bhatshala, Sherpur District, Gonoshasthaya

Kendra (GK)

€ 18,491.74

Pakistan

• Campaign work for structural reforms in the reconstruction process,

Pakistan Institute for Labour Education & Research (PILER)

• Reconstruction of 20 villages in the Jocababad and Jamshoro Districts,

Health & Nutrition Development Society (HANDS)

• Emergency aid for victims of the 2011 monsoon in the Badin District,

HANDS

€ 459,505.00

Sri Lanka

• Flood aid for returnees from Kanakarayankulan, Social Economical &

Environmental Developers (SEED)

• Provision of land for a centre for people with special needs, SEED

• Medical support for workers in free trade zones, Free Trade Zones and

General Services Employees Union (FTZGSEU)

• Resettlement of internal exiles in North Sri Lanka, SEED

€ 270,718.26 (incl. support from the German Federal Ministry for Economic

Cooperation and Development (BMZ))

Latin AmericaBrazil

• Training Waiapi health promotors, Instituto de Pesquisa e Formação

Indigena (IEPE)

• Patent law, improving public health policy and access to essential drugs,

Associaçao Brasileira Interdisciplinar de Aids (ABIA)

€ 25,920.00 (incl. support from Climate Alliance)

Chile

• Human rights work, Corporación de Promoción y Defensa de los

Derechos del Pueblo (CODEPU)

€ 5,500.00

El Salvador

• Strengthening the National Health Forum, Alianza Ciudadana contra la

Privatización de la Salud (ACCPS)

• Contribution to social fund for people with artificial limbs in El Salvador,

Promotora de la Organización de Discapacitados de El Salvador (PODES)

• Awareness raising for schoolchildren on the effects of migration, Museo de

la Palabra y la Imagen (MUPI)

• Capital fund for buying materials to make artificial limbs, PODES

• Support for the International People´s Health University in El Salvador,

PHM & ALAMES

• Emergency aid in 11 districts of the provinces of San Salvador and La

Libertad, Asociación de Promotores Comunales Salvadoreños

(APROCSAL)

• Expenditure on the Central America project office

€ 101,575.19

Guatemala

• Empowerment of young persons and children in indigenous communities

in northern Guatemala, Asociación Coordinadora Comunitaria de Servicios

para la Salud (ACCSS)

• Psychosocial work and investigations in the context of the search for the

‘disappeared’ and executed and exhumations, Equipo de Estudios

Comunitarios y Acción Psicosocial (ECAP)

• Forestation project (CO2 capture), Fundación Centro de Servicios

Cristianos (FUNCEDESCRI)

• III. International Film Festival, Guatemala 2012, Internationale Solidarität

und Kulturaustausch e.V. (ISKA)

• Struggle against impunity and strengthening democratisation of the justice

system, Central American Section of the International Commission of

Jurists

• Emergency relief for tropical depression 12-E, ACCSS

• Social and legal support for the right to integral restitution and justice,

Asociación Campesina para el Desarrollo Integral Nebajense

(ASOCDENEB)

• Expenditure on the Central America project office

€ 300,654.49 (incl. support from the German Federal Ministry for Economic

Cooperation and Development (BMZ))

Haiti

• Strengthening the primary health services of the Service Oecuménique

D'Entraide (SOE) in Artibonite

• Construction of a bridge in Carrefour Feuilles, Comité de Gestion de

Cité 9 (COGEC9)

• Construction of Centre for Women and Children, promotion, advisory ser-

vices and vocational training, Movimiento de Mujeres Dominico-Haitianas

(MUDHA) & Association des Femmes pour le Développement communau-

taire (AFDC)

• Construction of 50 family and ten public toilets, Asosy Asyon Peyizan pou

Devlopman Kolora (APDK)

• Construction of cisterns, Tét Kole Ti Peyizan Ayisyen (Tét Kole)

• Equipment (cameras, toys) for partner organisations for orphans

• Participation of SOE representatives in an IPHU course and the World

Social Forum in Dakar

• Transport costs for portable water treatment plants for project partners

(GEDDH, SOE, AFDC)

• Drawing up a community development plan in Aquin, Centre de

Recherche et de Formation Economique et sociale pour le Développement

(CRESFED)

• Pilot project for integrated rural development in the Commune Léogâne,

Groupe Ecologique pour un Dévelopement Durable en Haiti (GEDDH)

• Reafforestation and planting of fruit trees in Carnifice, Mouvement pour le

Développement Rural de Gros-Morne (MODERUG)

• Construction and operation of a health station in Fauché, Organisation des

Paysans Progressistes de Fauché (OPPF)

• Expansion of organisational capability and production capacity at

CESCAL, Centre de formation, éducation civique, d´assistance commu-

nautaire et aux cooperatives (CEFECACC)

Summary of Projects by Region

• Accommodation for young Haitian activists at MST federal training centre,

Escola Nacional Florestan Fernandes (ENFF)

• Establishment of chicken farming and political training for organisation

members, Tét Kole

• Defending human rights and implementing the rule of law, Réseau

National Defense des Droits Humains (RNDDH)

• Integrated reafforestation programme in Roy Sec, APDK

• Third dental brigade for Haiti, Asociación Coordinadora Comunitaria de

Servicios para la Salud (ACCSS)

• Expenditure on the Haiti project office

€ 1,044,151.48

Colombia

• Support for a community-based mine awareness programme, Mines

Advisory Group (MAG)

• Mine awareness and assistance to victims of armed conflict, Fundación

Tierra de Paz (TdP)

€ 38,636.04

Mexico

• Community health and herbal medicine in Chiapas, Salud y Desarrollo

Comunitario A.C. (SADEC)

• Caravan for relatives of disappeared migrants from Honduras and

Nicaragua, Movimiento Migrante Mesoamericano (MMM)

• Expenditure on the Central America project office (5.9%)

€ 36,368.01

Nicaragua

• Construction and equipment of preschool and library/multipurpose room

and promotion of reading circles in La Palmerita, Moviemento de Mujeres

Maria Elena Cuadra (MEC León)

• Health awareness raising for children and adolescents, Centro de

Información y Servicios de Asesoría en Salud (CISAS)

• Integral community development in La Palmerita, MEC León

• Support for self-organisation in the area of the production fund in La

Palmerita by Coopcove

• Strengthening children and youths as actors for a healthier environment,

CISAS (incl. support from the German Federal Ministry for Economic

Cooperation and Development (BMZ))

• Chronic renal insufficiency aid fund for drugs and laboratory supplies,

Nicaragua Forum Heidelberg

• Expenditure on the Central American project office

€ 175,335.24 (incl. support from Initiative Eine Welt Köngen)

Near East/Middle EastEgypt

• Emergency aid for victims of political violence, PHM Global, Cairo Office

• Defending the right to adequate housing in Ezbet El Haggana Slum,

Al Shehab Foundation for Comprehensive Development

€ 23,931.61

Kurdistan

• Support for assistance to juvenile detainees at the detention facility,

Sulaimania, Khanzad, Haukari FFM

• Prevention of and information on domestic violence against women and

children through a preventive health programme in Qadir-Qaram and

Doloy Jafatee, Kurdistan Health Foundation, Haukari FFM

• Support for juvenile detainees in Sulaimania and support for public educa-

tion in the rural region of Doloy Jafatee, Khanzad, KHF, Haukari FFM

€ 48,430.00

Lebanon

• Empowering Palestinain Youth and enhancing their capacities (Ein el

Hilweh Camp), Nashet Association

• Support for reproductive health clinic, Marsa Sexual Health Center

• Assistance with rental costs for nursing school, Chouah Al Nour

Educational Professional Association (CENEP)

• Strengthening political and social human rights of children, youths and

women in Palestinian communities, Popular Aid for Relief and

Development (PARD)

€ 106,551.44 (including support from German Federal Ministry for Economic

Cooperation and Development (BMZ)

Palestine/Israel

• Health services for chronically ill and community-oriented emergency aid

in Gaza & Westbank, Palestinian Medical Relief Society (PMRS)

• Improving basic health services for marginalised communities and repairs

to health centre in the Gaza Strip, PMRS

• Training and campaign for early diagnosis of breast cancer and medical

and psychological counselling for breast cancer victims in Gaza, Culture

and Free Thought Association (CFTA)

• Erecting wind and solar installations to assist the population of the

southern West Bank, Community Energy Technology in the Middle East

(COMET-ME)

• Human rights work in the Gaza Strip, Al Mezan Center for Human Rights

• Mobile clinics along the wall, basic health services and first-aid courses in

marginalised communities in the occupied regions, PMRS

• Awareness raising on aspects of a potential return of Palestinian refugees

to Israel, Zochrot

• Refuge for young women in emergency situations, Women against

Violence (WAV)

• Mobile clinics in marginalised communities in the West Bank, Physicians

for Human Rights-Israel (PHR-IL)

• Health work in East Jerusalem, Medical Relief Society

• International advocacy and institution building, PHR-IL

• Playback Theatre, psychodrama & trauma training programme, The

Freedom Theatre, Jenin

• Support for school for female health workers, PMRS

• Legal costs after raids and attacks by Israeli military, The Freedom

Theatre, Jenin

• Expenditure on Ramallah project office

€ 1,179,877.62 (incl. support from German Federal Foreign Office, DETA

from the German Federal Ministry for Economic Cooperation and

Development (BMZ), medico international Switzerland)

Thematic health programmes

• Understanding and resisting pharmaceutical advertising – a learning

programme of Health Action International (HAI)

• Feasibility study for drug supplies in Jharkhand, India, Community

Development Medicinal Unit (CDMU)

• Democratisation of global health policies, People's Health Movement

(PHM)

• Support to Urban Health Initiative in KG Halli, Bangalore, India, Institute

for Public Health Bangalore (IPH)

• Strengthening regional PHM groups and network building in Subsaharan

Africa (PHM)

• Health policy meeting of civil society actors, New Delhi, India

€ 139,434.70 (including support from German Federal Ministry for Economic

Cooperation and Development (BMZ))

Other

• Salud Mental – study on trauma intervention and research into violence in

war and crisis areas, Katrin Groninger, INA FU Berlin – € 2,000.00

• Mine victims – humanitarian mine clearing as a prerequisite for community

development in Cambodia, Mines Advisory Group (MAG) – € 20,000.00

• Refugee assistance project in North Rhine Westphalia, Interkulturelles

Solidaritätszentrum e.V., Essen – € 56,000.00

Monetary donations

Third-party donations

Grants – public funding

Grants – non-public funding

Contributions of the medico international foundation

Bequests

Fines

Third-party fines

Interest and other income

Member fees

Other revenues

Total Income

Reserves

According to § 58 No. 6 of the German fiscal code

As at 01.01.2011

For projects that were scheduled in 2010 but whose issuing

of funds could not or could only partially be completed by

31.12.2010, and for earmarked remaining funds

Free Reserves according to § 58 No. 7a

of the German fiscal code

Association Capital

As at 01.01.2011

BudgeT 2011

€ 3,189,543.19

€ 1,755,000.00

€ 5,011,074.51

€ 164,087.05

€ 80,000.00

€ 166,900.73

€ 446.90

€ 0.00

€ 78,888.65

€ 6,387.08

€ 13,869.05

€ 10,466,197.16

€ 7,480,944.81

€ 2,073,000.00

€ 214,187.49

€ 20,234,329.46

€ 3,727,098.89

€ 8,466,803.34

€ 4,243,319.61

€ 253,274.03

€ 44,857.66

€ 45,753.56

€ 6,600.00

€ 1,770.00

€ 26,403.83

€ 6,487.08

€ 14,217.89

€ 16,836,585.89

€ 1,340,891.51

€ 800,000.00

€ 263,595.58

€ 19,241,072.98

2011 2010InCome

Financial Report 2011 - Overall Result

Evolution of Income (in million euros)

| 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 |

9 –

8 –

7 –

6 –

5 –

4 –

3 –

2 –

1 –

0 –

Direct donations

to medico

Third-party

donations

Grants

Other income

Project funding

Project management

Campaigning and education work and awareness raising

in line with statutes

Advertising and general public relations work

Administration

Total expenditures

Reserves

According to § 58 No. 6 of the German fiscal code

As at 31.12.2011

For projects that were scheduled in 2011 but whose issuing

of funds could not or could only partially be completed by

31.12.2011, and for earmarked remaining funds

Free Reserves according to § 58 No. 7a

of the German fiscal code

Association Capital

As at 31.12.2011

BudgeT 2011

€ 8,228,932.95

€ 911,435.56

€ 774,874.66

€ 296,222.54

€ 579,268.22

€ 10,790,733.93

€ 7,322,279.55

€ 1,911,000.00

€ 210,315.98

€ 20,234,329.46

€ 6,835,115.89

€ 1,133,396.75

€ 756,099.94

€ 225,742.76

€ 522,585.34

€ 9,472,940.68

€ 7,480,944.81

€ 2,073,000.00

€ 214,187.49

€ 19,241,072.98

2011 2010expendITuRes

Project Expenditures by Region

Others

Caribbean,

Central and

South America

Africa

Near and Middle East

Southern and

Central Asia

medico international Association Organisational Structure(as at April 2012)

Supervisory Board

Brigitte Kühn, Chair

Prof. Dr.-Ing. Alexander Wittkowsky, Deputy Chair

Prof. Dr. Joachim Hirsch, Deputy Chair

Dr. med. Anne Blum, Rainer Burkert, Stephan Hebel, Board Members

Internal Audit Committee

Lars Grothe

Horst Pfander

Michael Rumpf

Thomas Gebauer

Executive Director

Medico Office Central America

Dieter Müller, Office Director

Herlon Vallejos, Project Finances

Annual General Meeting

Management

Project Support and Coordination

Afghanistan

Mohammad Hamayun

Medico Office Palestine & Israel

Luke McBain, Office Director

Maisa Alnatsheh Project Finances

Nizar Qabaha, Project Assistent

Financial Project Coordination

Cofinancing and Donations

Anita Heiliger

Till Küster

Elena Mera

Nicole Renner

Rita Velásquez

Medico Office Haiti

Anne Hamdorf, Office Director

Morris Viertel, Project Finances

NN

Assistant to the Executive Director

Karin Urschel

Head of Projects

Johannes Reinhard

Head of Administration & Finance

Katja Maurer

Head of Public Relations and Press,

Spokeswoman

Projects Department

Dr. med. Andreas Wulf,

Deputy Head of Department, Project

Coordination Medicine, Lebanon

Eva Bitterlich,

Project Coordination Afghanistan

Sabine Eckart,

Project Coordination Migration,

West Africa, Zimbabwe

Dr. Annelie Koschella

Project Coordination, West Sahara

Usche Merk,

Project Cordination Africa,

Psychosocial Work

Riad Othman,

Project Coordination Emergency

Relief

Doris Pfeiffer-Götze

Project Coordination Haiti

Maarg Semere,

Office Management

Dr. Sönke Widderich

Project Coordination Southern and

Southeast Asia/ Mine Action

Administration & Finance

Department

Jens-Alexander von Bargen,

Deputy Head of Department,

Controlling, Finance and Accounts,

Bookkeeping

Anna Huber,

Human Resources, Association and

Foundation Administration

Jan Krabbe

Donations Administration and Support,

Legacies, Field Offices

Bernadette Leidinger-Beierle,

Donations administration, accountancy

Uwe Schäfer,

EDP & IT

Public Relations Department

Martin Glasenapp,

Deputy Head of Department,

Texts, Advertising

Marek Arlt,

Head Office, Event Organisation,

Proofing

Tsafrir Cohen,

Coordination Palestine & Israel

Bernd Eichner,

Press Relations, Online Editor

Anne Jung,

Campaigns

Gudrun Kortas,

Donations and Legacy Fund Raising

Dr. Ramona Lenz,

Donation Fund Raising, Texts

Claire Schäfer,

Office Management, Head OfficeKirsten Schubert,

Health Advocacy Officer

Dr. Thomas Seibert,

Project Public Relations and

Networking, Themes

Jürgen Wälther,

Website

medico Office Central America & Mexico:

mueller@medico.de

medico Office Palestine & Israel:

ho-jlem@medico.de

medico Office Haiti:

ho-haiti@medico.de

Project Office Western Sahara

(in Algeria)

Sonia Diverres, Project Coordination

Amokrane Taguett, Project Finances

Arezki Sahmoun, Logistics, Technical

Operations

The Work of medicointernational

> Emergency Relief

> Health

> Psychosocial Work

> Human Rights

> Acting in Networks medico international

Table of Contents:

3 Introduction

4 Emergency Relief – Haiti, Pakistan, Nicaragua

6 Health – Guatemala, Zimbabwe, Sri Lanka

8 Psychosocial Work – Nicaragua, South Africa, Palestine

10 medico Projects in Brief – Bangladesh, Chile, Guatemala, Egypt

12 Human Rights – Migration / Mali

14 medico’s Work with Partners

16 Campaign to Ban Lanmines

18 medico in Alliances

20 Global Health Networking

For more than 40 years medico international has been promoting

the human right to health. In 1997 medico and other members of the

International Campaign to Ban Landmines were awarded the Nobel

Peace Prize.

Information and Acknowledgements:

medico internationalBurgstraße 106D-60389 Frankfurt am Main

Tel. +49(0)69 944 38-0, Fax +49(0)69 436002info@medico.de, www.medico.de

Donations account: 1800, Frankfurter Sparkasse, Bank code 500 502 01

For donations from abroad:

IBAN: DE21 5005 0201 0000 0018 00BI/SWIFT: HELADEF1822

Editors: Katja Maurer, Usche Merk, Thomas Seibert

Report authors: Martin Glasenapp, Ramona Lenz, Andreas Wulf

Translation: transparent Language Solutions GmbH

Layout: ostpol

October 2011

Photographic credits:

Cover front:

Young woman in Afghanistan,

photo: www.one-step-beyond.de

Cover back:

Rehabilitation in Pakistan -

project partner HANDS,

photo: medico

Solidarity among Equals medico international is struggling for the right to health

medico international has been campaigning for health to be recognised as a human right for more than 40 years. In 2010 alone, the Frankfurt-based aid and human rights organisation provided funding for over 100 projects run by its partner organisations in Africa, Asia and Latin America.Defending aid, questioning aid and overcoming aid arethe guidelines of medico international’s work. By supporting partner organisations, raising public awareness inGermany and Europe, and networking with health initiatives globally, we are contributing to the struggle to changethe causes of poverty and adversity. In practical terms this might mean direct emergency aid to survivors of theearthquake in Haiti, for example, which was provided within a few days of the tragedy by our Dominican Republicpartners, the health organisation Cosalup, and funding for the International People’s Health University in Kisumu.Both actions have seen the emergence of a new concept of solidarity: one forged between equals in this one world.Haitians do not need the expertise of ‘white’ aid workers to overcome their marginalised situation. It needs their ownexpertise and support for their resources for self-help and recovery. By strengthening solidarity from below ratherthan sending own staff, we are making a stand against paternalistic approaches to aid that all too often increasedependence of marginalised people rather than addressing it. Our support for the IPHU is also an attempt to retain,develop and pass on alternative expertise, to go against the ever more mainstream assumption that people’saccess to health is subject to market forces. The IPHU convenes regularly in various locations throughout the globalsouth (and also in Brooklyn, New York in 2011) and promotes the exchange of knowledge and specific practicalexperiences.

Since the banking crisis of 2008 we are experiencing a global renaissance of the idea of social justice. Whether in Cairo, Santiago, Madrid or Tel Aviv, people are going out on to the streets and are demanding democracy infusedwith the notion that ensures everyone participates. ‘Another world is possible’ is the slogan of the global socialforums. For many years this slogan faced criticism from politicians across the world who claimed there was no alter-native to a global economic order based on rising inequality. Now we are experiencing an – albeit fragile – return ofpolitical thinking. Inherent therein is the idea that all human beings are citizens of this world and thus have rights.The work that medico international carries out is dedicated to ensuring that these rights take shape. We do this asequals among equals in association with our partners across the world and our supporters and donors in Germany.

Introduction

The medico team in Frankfurt, photo: Christoph Boeckheler

3

hen the earthquakestruck Haiti on 12January 2010 the

capital Port-au-Prince wasalmost totally destroyed andover 250,000 people losttheir lives. In the midst ofsuch an apocalyptic night-mare, emergency aid provi-ded by Haiti's neighboursprovided a ray of hope. Inaddition to the solidarityHaitians showed through nu-merous examples of self-help, neighbouring Domini-can Republic also providedassistance. One of the orga-nisations supported by medi-co international using fundsraised in Germany was theDominican health associati-on Cosalup. As part of the‘Ayuda Haiti’ network it wasin charge of basic healthcare at emergency shelters inLéogâne, where volunteer doctors and care workersmaintained a health supply chain for several weeks.medico has known Cosalup for many years through thehealth activist networks in Latin America. Like medico, itis a member of the People’s Health Movement.

This was the first project funded by medico in Haiti andthe approach adopted in it remains an important featureof medico’s programming to this day. medico fundedGuatemalan dental health promoters to undertake twomissions to Léogâne, only to find that even this was notenough to cover basic needs. This gave us the idea oflearning from other partners’ positive experiences insimilar situations of exclusion and poverty. Aid was alsoprovided by a grassroots organisation in a rather moredistant neighbour – Brazil. The Landless People’s Move-ment in Haiti has links with the Landless People’s Move-ment in Brazil (MST) through the Via Campesina net-work and medico has been working with the Braziliansfor several years. We are now providing funding to trainHaitian peasant activists at MST’s training centre inBrazil. They attend courses ranging from organic farming

to political training, learningpractical ways of advocatingfor their rights and politicalaction. The aim is to streng-then Haitian grassroots orga-nisations and civil societystructures in order to providesupport not only for rebuildinginfrastructure but also for poli-tical and social (re-)construc-tion. These include the ruralcommunity-based organisati-on APDK, which is attemptingto stave off the next disasterthrough an environmentally-friendly reforestation program-me; the NGO CRESFED,which is setting up a participa-tive community developmentscheme with the help of advi-sers from Benin; the Haitian-Dominican Women’s Organi-sation (AFDC), which has its

origins in emergency aid but has also begun developinga long-term operational programme to support women’srights in Haiti; and finally the Haitian human rights orga-nisation RNDDH, whose aim is to monitor transparencyand the rule of law during the national reconstruction andpursue abuses through the courts.

This approach arises directly from medico’s experienceof humanitarian aid over a number of decades and itsoften ambivalent consequences for the victims, of whichHaiti is a classic example. On the one hand, the pre-sence of many NGOs – whose number has tripled sincethe earthquake – is needed to ensure the population’sbasic humanitarian needs are met. On the other hand,they present a serious problem as they undermine theHaitian’s own capacities to recover and move on fromthe disaster. medico is attempting to address this dilem-ma by actively encouraging public debate about thelimits and responsibilities of international aid organisati-ons and by strengthening South-South cooperation. Thisis something we have already had success with in othercontexts.

South to SouthHow emergency aid from neighbouring countries turned into a long-term programme

4

W Emergency Relief

At medico international

‘critical emergency

relief’ means more than

disaster management.

Our approach involves

providing victims the

support they need to

help themselves, under-

stand the underlying

political and economic

causes and deal with

the psychological and

social trauma they have

suffered as a result of

the disaster.

Haiti

hen Pakistan was overwhelmed by floodsalong the Indus and other regions in August2010, medico’s partner HANDS (Health and

Nutrition Development Society) was one of the first civilsociety organisations on the scene. In the Sindh regionHANDS evacuated tens of thousands of people trappedby the floods, quickly set up camps to ensure their survi-val and is now supporting the return of the refugees. Thiswas possible because HANDS had been working in thepoor regions affected by the disaster for decades andwas able to mobilise thousands of volunteers rapidly.HANDS was just one of many other civil society organi-sations in Pakistan that demonstrated their capacity toact during disasters. medico was able to provide consi-derable amounts of money for HANDS due to the overw-helming generosity and solidarity shown by Germandonors. It had previously had contacts with health andcommunity-based organisations over many years via thePeople’s Health Movement. HANDS’ approach to emer-gency relief is based on both providing basic health careand supporting flood victims to organise themselves. Asa result of this shared approach and the shared under-standing that health is a basic human right, the work car-ried out by medico and HANDS to deal with the dis-astrous flood in Pakistan has become a paradigm for acritical understanding of emergency relief work.

t can often take many years to assess the long-term effects, if any, of humanitarian aid in post-disaster situations. One example is the situation

in Nicaragua following Hurricane Mitch in 1998. There,medico international had been supporting partners andprojects since the mid-1970s and responded with huma-nitarian aid immediately after the hurricane. The emer-gency relief programme brought us into contact with sur-viving campesino families who had been forced to fleefrom their villages and land by a mudslide. Returninghome was not an option. Most of them had lost many oftheir relatives during the mudslide and were in a state ofsevere shock at the total collapse of their normal livingconditions. Despite this, they managed to establish a vil-lage at a new site, set up an agricultural cooperative,restore their own livelihoods and even develop pro-spects for their children’s futures. Since then the village,called El Tanque, has become a symbol of a viable alter-native to neoliberal approaches to development.

Strengthening Self-Help medico’s partner HANDS wasready to act immediately

IntegratedCommunity Development An emergency relief projectwith long-term results

W

IPakistan

Nicaragua

Rebuilding houses for flood victims – HANDS, Pakistan, photo: HANDS

Farming in El Tanque Nicaragua, photo: medico

6

edico’s cooperati-on with the acti-vists of the Guate-

malan health and communityorganization ACCSS beganduring the fight against themilitary dictatorship in the1980s. medico supportedindigenous refugees whosought protection from thejunta’s policy of extermina-tion in camps in Mexico and,in so called ‘resistance villa-ges’ in the forests of the nort-hern border region. medicosupported the refugees withmedicines and training forhealth and dental care pro-moters. After the end of thecivil war medico continuedthis support as they organi-zed the refugees’ return. Theaim was to transfer the expe-rience of autonomy andemancipatory health con-cepts into the new, post warGuatemalan context and todevelop them further. This has proved successful inmany aspects. One example is the health and trainingcentre that ACCSS has built on the outskirts of the pro-vincial town Playa Grande in the north of Guatemala, co-funded with a subsidy from to the German Ministry forEconomic Cooperation and Development. The single-floor building is full of air and light. The doors to theoffices are kept open. There are rooms for training andprofessional development of health promoters; a work-shop where young people can attend basic vocationalcourses; a recycling system that clears waste water intodrinking water quality; and a tropical medicinal plant gar-den that is a riot of colour. But even more importantly, thecentre is seen as an oasis or Noah’s ark for a differentfuture mainly because of the way that all those involvedinteract with each other and with the project itself.

Among them are Santos Chen, Sebastián Bartolo,Viviano Matias and Juana Perez. The three men comefrom the hidden resistance villages and were already

involved in community workas youth; while Juana joinedlater. Santos talks about howhe once operated on a younggirl with a tumour under hertongue. Her father had per-suaded him to operate afterfailing to get help from thepoorly equipped public health-care system. Like the otherpromoters Santos has recei-ved further training in dentalcare, traditional herbal medici-ne and acupuncture. For ma-ny years he also learnedmuch from experts from thecity and from abroad. Sebas-tián, who has completed athree-step dental training pro-gramme and a course in ac-counting, not only provides hisfellow villagers with dentaltreatment but also looks afterthe cooperative’s accounts.ACCSS has trained around100 dental promoters in thisway in recent years.

Results of the work in the region of Ixcán give evidencethat the Primary Health Care concept – understoodholistically in its full political dimension – can impactmuch more than basic health care. Since 2009 ACCSSworks in 28 villages with children and youth in schoolsand youth committees to strengthen their self organisati-on and participation. While focusing on health interestsand problems of children and youth, groups also discussother social and political developments in the villages:the displacement of peasants in the interest of big plan-tations, the return of the military, which is justified interms of the fight against drugs, and human rights abu-ses by the state and the drug syndicates. Hugo Rosetti,a professor from Argentina specialising on PrimaryHealth Care, evaluated the work of ACCSS in 2011. Hisconclusion: “I have seldom visited health projects likeACCSS which not only focus on certain health indicatorsbut works as comprehensively on health.”

A Long Common History medico’s support for the health association ACCSS

M Health for All

The concept of primary

health care is the

guiding principle for

medico when supporting

direct healthcare proj-

ects. Health outreach

teams, cooperation with

local institutions,

training of health pro-

moters, the democratic

participation of local

communities in develo-

ping these structures –

these are just some of

the cornerstones of the

concept, which focuses

primarily on people’s

health needs rather

than on market needs.

Guatemala

he devastating cholera epidemic of 2008 inZimbabwe, in which thousands of people died,was the worst consequence of the dramatic

situation facing health in that country. This disaster is pri-marily a political one: Since the collapse of the healthca-re system in the 1990s the situation has continued todeteriorate and diseases that could be prevented byclean water supply are spreading.

The crisis has inspired a committed health movementwhose members include medico’s partner CommunityWorking Group on Health. As its name implies, civilsociety is a key focus. The CWGH is closely linked to thelocal community through its grassroots structures: 25regional health committees provide the community withexpertise and tools they can use to work together to im-prove their own situation. The committees were also acti-ve during the cholera epidemic. Through their healthcentres they provided information on prevention measu-res and distributed sanitary products to prevent thedisease from spreading further. The CWGH combines itsaction on health with criticism of the government: ‘Thecrisis in healthcare is partly to blame on the increasingnumber of people with no access to education, transportor water;’ says Itai Rusike.

CWGH is therefore attempting to raise the profile ofbasic health care on the political agenda and is current-ly campaigning for the right to health to be adopted inZimbabwe’s new constitution.

atunayake Free Trade Zone is 30 kilometresfrom the capital Colombo. ‘Eighty per cent ofthose employed here are women,’ says Anton

Marcus from medico’s partner the Free Trade Zone andGeneral Services Employees Union (FTZ&GSEU). Thewomen live in cramped boarding houses, three to aroom, with an open fire for cooking outside and a coupleof showers. Working conditions are tough, the supervi-sors are ruthless and the wages are so low that most ofthe women ‘volunteer’ to do overtime.

Following years of operating illegally, FTZ&GSEU is nowthe strongest union in Sri Lanka’s free trade zones. It isconcerned not only about wages and employment law,but also its members’ health. The workers simply do nothave the time to go to the state hospitals – and a visit toa private doctor would easily cost an entire month’s sala-ry. The union provides assistance twice a week, suppor-ted by medico, at its own offices and after the end of theworking day. One doctor and one assistant doctor attendaround twenty women per session and a small pharma-cy provides the most important medicines. The serviceeven includes a cookery course for which the unionrecruited a popular TV chef. How and what can thewomen cook when they only have half an hour in theevening to prepare meals in the flickering light of thekerosene cooker? The TV maestro’s main message isthat the women need to share the shopping and cookingand – just as with the fight for wages and employmentrights – you can’t do it alone.

Small Victoriesmedico’s partners in Zimbabwefight for the right to health

Between Strikeand Cookery A trade union in the legalvacuum of Sri Lanka’s globalmarket factories

T

KZimbabwe

Sri Lanka

Health committee members of CWGH, Zimbabwe, photo:medico

Union cooking course with the TV chef, Sri Lanka, photo: medico

8

edico has beensupporting Nicara-guan civil society

in its attempts to implementsocial and political changesin the country since thestruggles against the So-moza dictatorship. The newbeginning, marked by therevolution in the 1980s, wasfollowed by disenchantmentover neoliberal policies inthe ‘90s and a discussionabout misjudgements, globalpower relations and the roleof psychosocial dynamics.‘In order to understand andcome to terms with our ownhistory, we also need to ana-lyse the history of our coun-try,’ explains Marta Cabrera,head of the ecumenical cen-tre CEAV founded in 1979that offers a ‘psychosocialtraining programme for soci-al change’ in a number of re-gions of Nicaragua. The trai-ning courses are attendedby local grassroots organisations and disseminatorscommitted to social change. CEAV’s one year trainingprocess, which is divided into several workshops, is theresult of a decade’s experience of psychosocial work. Itwas prompted by the observation that all the communityworkshops and local development projects on self-deter-mination, gender issues or ecological sustainability inNicaragua had only had a limited positive impact. Asthey tried to identify the reasons why many peoplelacked the initiative to take a pro-active approach tochanging their life and the social situation, they came tothe conclusion that Nicaragua as a country had been‘wounded’ in many ways by the succession of socialupheavals and natural disasters over the last decades.Many people fought in different ways to bring about theSandinista revolution and social change. When the de-feat came they were left to deal with it on their own, asthere was no collective space in which to publicly

express the pain, mourningand other emotions accumula-ted over the many years ofsacrifice and struggle, in orderto come to terms with themeaning of their experiencesover that period.

Many people, as they spoke ofwhat they had lost, started totouch on other problems thathad previously been hidden,such as a woman from León,who told us: ‘I am very sorrythat I have lost my home butwhat is far worse is that I can-not sleep at night because Iam frightened that my hus-band will lie in my daughter’sbed and abuse her.’ CEAVdecided to develop a multi-dimensional approach tostrengthening social organisa-tions and the issues they dealtwith: ‘We wanted to bring issu-es to the table that no-onewas addressing: subjective,psychological, spiritual.’ Star-

ting from the complexity of the realities of life and fullyrecognising the multilayered nature of what people haveexperienced, this is a holistic approach that does notequate development with economic growth and does notview society as something external and independentfrom individuals. Institutional structures also needed tobe examined. ‘In Nicaragua many organisations want touse a machete to carry out a heart operation,’ saysMartha Cabrera. ‘They want to change the world whilstreproducing an outdated style of leadership inside orga-nisations that makes any change impossible.’ The work-shops gave them an opportunity to analyse and discussthe consequences of the revolution as well as the rapidsocial change resulting from the globalisation process ofthe last twenty years. They also helped them to under-stand why it is necessary to acknowledge the past ‘so wecan go forward on a firm footing’.

Moving on – Looking BackOrganisational development for social change – the Centro AntonioValdivieso (CEAV)

M Psychosocial Work

Psychosocial work has

been at the core of

medico’s work for

decades. It started

with support for vic-

tims of political vio-

lence, and today it has

extended its activities

to the consequences of

political, economic and

social exclusion and

violence. There are

many facets of this

work from individual

therapeutic support,

psychosocial community

work to political

interventions and lob-

bying to establish

human rights standards.

Nicaragua

inani, which has been one of medico’s projectpartners for many years, grew out of a group ofcommitted psychologists who provide thera-

peutic support to prisoners and torture victims of theapartheid regime. SINANI’s work in marginalised, exclu-ded and violence-ridden communities in KwaZulu Natalis driven by the conviction that help for transformationprocesses must cover all needs and be organised on aholistic basis. Since 1995 SINANI has been working inaround 20 communities prone to systemic violencewhere political, social and domestic violence are closelyintertwined. These communities are also dominated byextreme poverty and high HIV infection rates. SINANI’swork combines empowering individuals by restoring rela-tionships and connections within the communities andwith public institutions. The aim is to increase the self-empowerment of political and social actors in communi-ties through training and developing social and econo-mic programmes, to promote conflict resolution in anattempts to transform the causes of poverty and violen-ce in a constructive way.

SINANI’s success over many years in providing assi-stance to communities designed around their needs isreflected in the fact that SINANI is now being requestedby government agencies to provide training and compilea curriculum for training community workers who willwork in areas of extreme poverty and violence.

uliano Mer Khamis was an extremely paradoxi-cal phenomenon. Son of a Jewish Israeli motherand a Palestinian father, he embodied the bor-

der. He did not allow himself to be confined to one campor the other, but preferred to sit on the fence: an unpro-tected place. He was murdered on April 4, 2011 outsidehis Freedom Theatre. He journeyed to Jenin in the occu-pied West Bank in the footsteps of his mother Arna, arri-ving in a town where the people knew Israelis only assoldiers. He continued her work with the children’s andyouth theatre that she had founded there. The theatrerepresented a protected space in which young peoplecould process the violence and feelings of powerless-ness they experienced in their everyday lives. To thetheatre the first Palestinian drama school was added,and their productions were among the best that thePalestinian theatre had to offer. In the glare of the thea-tre’s spotlights, a battle was fought on two fronts: againstthe Occupation that made prisoners of Jenin’s populati-on; and against the development of reactionary type ofattitudes and opinions growing up as a consequence ofisolation and occupation. Juliano’s companions are da-ring to continue with the venture. This dual struggle cli-maxed in the scandal-rocked production of George Or-well’s parable ‘Animal Farm’, in which young Palestini-ans are robbed of their life chances by occupation (thehumans) and their own authorities (the pigs). Juliano’smurder should not be allowed to be the final act of theFreedom Theatre. His associates are hoping that thetheatre will continue to shine out, even after his violentdeath. Their next project is the Playback Theatre, aninteractive theatre experience for Jenin and the surroun-ding area. It will allow the public to tell their own stories,which will then be improvised on stage by actors andmusicians – a powerful way of articulating the commonstruggle and the strength of resistance.

TransformingPoverty and ViolenceThe work of Sinani KwaZulu-Natal Programme for Survivorsof Violence

At the Edgeof the World The Freedom Theatre in Jenin

S

South Africa

Palestine

J

Community workers training Sinani South Africa, photo: medico

Freedom Theatre performance, Palestine, photo: Bärbel Högner

Solidarity from BelowRickshaw pullers establish a healthcare insurance cooperative

t every intersection in the 15-million-strongmetropolis of Dhaka armies of tricycle rick-shaws jostle through the inevitable traffic jam,

even mounting the pavements if necessary. It’s serious-ly hard work: the drivers stand up on the pedals, pedalthree, four, five times, gain momentum, sit down, thenhave to brake and start all over again all day for up to ten

hours. They rest after their shifts at the ‘garage’ belon-ging to their ‘rickshaw lord’, where they all roll out theirsleeping mats. The lord deducts the rent directly fromtheir daily wage of just 8 Euro. Since this gives themslightly more room for manoeuvre than many other poorpeople, medico’s partner Gonoshastaya Kendra (GK)wants to try out a specific experiment with them: the

Gonoshastaya Rickshawpullers HealthCooperative. This is a mutual health in-surance fund that costs the drivers1 Euro per year. GK provides mobileclinics and basic (primary) healthcarewith drugs and comprehensive healthawareness-raising in the garages. Morecomprehensive examinations and treat-ments are offered to the insured mem-bers in the high-rise GonoshasthayaNagar Hospital in the city centre. InBangladesh, however, this is certainlynot a step towards privatising healthca-re provision: it is a grassroots initiativein the fight for statutory health insuran-ce. medico also supports the project inmemory of the history of the Germanworkers’ movement which started outwith similar mutual associations.

he pharaoh had to go, and nothing will ever bethe same again. Still in February 2011, medicowas helping our Egyptian partners in the

People’s Health Movement, donating €10,000 as a rapidresponse to meet the needs of the injured in TahrirSquare. A mobile team of doctors and nurses cared forthe wounded; colleagues from the Al Shehab Foundationgave legal advice; and work has begun on documentingthe events of the uprising. medico’s partner Al Shehab is

Democracy Is the Cure!Urban health in Cairo

also at work in Cairo’s Ezbet Al Haggana district. Thisslum has grown up without planning and without a sani-tation, educational or health infrastructure. Al Shehabsupports its residents – locals and immigrants – in theircampaign for the right to adequate living conditions: theaim is to forge a civil society alliance, bolster the activi-ties of the local community and educate people abouttheir rights. In this way democracy is taking root in thecommunity.

10

A

T

Rickshaw puller ‘garage’ in Dhaka, Bangladesh, photo: medico

medico in brief

Egypt

Bangladesh

n a windowless hallyoung women andmen with facemasks

and gloves sit in long rows sif-ting through yellowing, dustybooks of files. The staff treatthe material with the greatestcare. For these files hold pri-celess information about agrisly chapter in Guatemala’srecent history: this is the his-torical archive of Guatemala’sNational Police. Discoveredalmost by chance in 2005, itcomprises 80 million files go-ing back over 100 years andalso documents the period of the civil war that lastedfrom 1960 to 1996. During that period the military, thepolice and death squads murdered 200,000 people.Another 45,000 disappeared. The archive is now in thehands of the victims and their families. In Latin America,with its history of brutal military dictatorships, this is uni-

he coastal village of Tirúa was particularly badlyhit by the severe earthquake that devastatedSouthern Chile in February 2010. Many Ma-

puche Indians live here, who were persecuted during thePinochet dictatorship and also have little voice in socie-ty under the neoliberal economic model. Poverty ratesare well above the average for the country. Since littlewas to be expected from the state, medico’s partner ofmany years, Corporación de Promoción y Defensa delos Derechos del Pueblo (CODEPU), quickly decidedafter the earthquake to provide emergency relief and

Providing Emergency Relief CODEPU supports indigenous victims of the earthquake

assistance with reconstruction. With medico’s support,twenty destroyed houses had been rebuilt by the start of2011. But CODEPU’s core aims are actually rather differ-ent: for many years the organisation has been workingalongside victims and survivors of the Pinochet dictator-ship, providing legal assistance and psychotherapy. InTirúa CODEPU had recently begun an oral history pro-ject to write down the history of the Mapuche. medico willcontinue to support colleagues at CODEPU on this andother projects.

que. medico funds the psychological support of thePolice Archive staff who are regularly faced with trauma-tic histories as they inspect the files. medico is also invol-ved in funding screenings of the film ‘La Isla’ by theGerman documentary film-maker Ulrich Stelzner, who isdocumenting the work of the archive.

An Archive of CrimeGuatemala’s Police Archive makes the civil war crimes publiclyavailable

I

T

11

Chile

Guatemala

Filing the National Police Archives, Guatemala, photo: Ulrich Stelzner

12

he West Africancountry of Mali is amigration hub with

traditional routes withinAfrica to Arabic countriesthat stretch back to antiqui-ty. This is partly a result ofthe weakness of the econo-my but also an expressionof societal traditions of aculture of mobility entirelyseparate from the nationstate. As in many WestAfrican countries, peopleare generally free to travelin Mali, state borders orpassports have had littlesignificance since post-colonial independence.

Mali is one of the poorestcountries in the world. The minimum salary is approxi-mately 12,300 CFA francs (35 Euro) for an unskilled wor-ker and approximately 50,000 CFA francs per month fora skilled worker. Many of the unofficial convoys of refu-gees that cross the Sahara in pick-ups to reach hiddenharbours on the North African coast start out from thedesert regions in North-Eastern Mali.

Because Mali is not only thehomeland but also a transitcountry for many migrants fromthe southern part of West Af-rica, European foreign policyhas selected the country for anexperiment in migration ma-nagement. It shares the atti-tude of the former colonialpower, France, that treats fran-cophone West Africa and Maliin particular as a Special Eco-nomic Zone. Since Europeandemand for cheap African la-bour has dwindled and the1990 Schengen Agreement en-ded the visa waiver for Europe,Mali is now treated as a peri-pheral dumping ground towhich unwanted, ‘undocumen-ted’ people are deported from

Europe. For some time now, not only deported migrantworkers from Mali land at Bamako airport – those fromits West African neighbours do as well.

The Office for Migration Management (Centre d’Infor-mation et de Gestion des Migrations au Mali) in the capi-tal Bamako is currently drafting models for a selectivemigration procedure on African soil designed to keep the

T

Mali

What We Mean by FreedomMigration and cross border networks

Human Rights

medico’s work involves

an equal mix of defend-

ing and implementing

political, social and

economic human rights.

We always connect our

human rights work with

the daily struggle for

social justice, educa-

tion and health and

particularly when sup-

porting people in

migration or flight.

majority of prospective migrants in Africa and restrictaccess to the EU labour market to just a few. The EU istargeting existing self-help associations of deportees tomake use of their local and regional support networksand to appear to be embedded in the local community.Solidarity networks such as the Association Maliennedes Expulsés (AME), an association of deported per-sons, has so far resisted these attempts to promote stop-ping migration. AME is a partner of medico international.It provides direct assistance to deportees at the Malidesert borders and Bamako airport and is also directlyengaged in Mali’s internal politics as an organisation ofaffected people.

Ousmane Diarra, AME’s president, described in Mali’sparliament the 21st-century odyssey undertaken bymigrants and the exposure of hundreds of thousands ofpeople caught between structural poverty and forcedimmobility in the following terms: ‘After arriving in ourhomeland and completing border formalities we are leftto fend entirely for ourselves. After so many years spentelsewhere, we deportees are left completely alone. Mostof us had to leave our wives, children and propertybehind. Destitution has become part of our life. Now weare back in Mali we think of our other life far away thatlies in tatters. So many of our young brothers and sistershave migrated from rural areas and then emigrated, onlyto end up on the desert roads. If they don’t drown in thesea these migrants return as deportees after sufferinglong periods of imprisonment, harassment, violence andhunger. They are passed from border to border only tobe abandoned in Northern Mali. They are left alone tolive in the wild. It is a living hell.’

There are many aspects to the work of the West AfricanNetwork for Migrants’ Rights. AME is also responding tothe increasingly visible European migration policy in theregion by opposing the tightening up of border controls

in sub-Saharan West Africa, which was formerly entirelyexempt from EU visa requirements with a cross-bordersolidarity. Working jointly with another of medico’s part-ners, the Mauritanian human rights organisationAssociation Mauritanienne des Droits de l’Homme(AMDH) in conjunction with human rights defenders inNorth-Eastern Morocco, AME is attempting to build up atransnational solidarity network. The concern is not limi-ted to emergency assistance for deportees or directcooperation, such as in the Mauritanian-Malian borderarea where people are found half-dying of thirst everyday and cared for, but also with creating a public opposi-tion movement defending migrants’ rights through trans-national workshops and demonstrations. In Bamako theAME is also providing a particular type of developmentassistance: with its advice and support, the Associationdes Refoulés d’Afrique Centrale au Mali (ARACEM) wasfounded, a self-help group of deportees from CentralAfrican countries (Cameroon, both Congolese republics,the Central African Republic, Chad, Gabon), that at-tempts to provide hundreds of stranded migrants withessential supplies (medicines, water, food).

Our partner network in West Africa is starting to organi-se itself. Its staffing and financial resources are still fartoo small to be able to care for even a fraction of thosewho are flown out by aeroplane, detained at desert bor-ders between African countries or captured in the boatsalong Europe’s southern coastline. But an important stephas been taken: the ‘voiceless’ people have started tofind their voice and are increasingly demanding theirrights from their own authorities, who are all too ready todefer to Europe. In doing so, they criticise not only theinhumanity of the European border regime, but also theneoliberal European economic reality which allows thefree movement of goods but restricts the movement ofhuman beings. They demand that they too should havefreedom of residence and movement to Europe.

13

Detained ‘illegal’ migrants at the Mali-Algerian border, photo: Reuters

14

edico does not imple-ment developmentprojects itself but sup-

ports the work of partner orga-nisations in Africa, Asia andLatin America. In many casescooperation lasts for manyyears and we develop a closerelationship with our partners.However medico is also ente-ring into cooperation with newpartners. Before agreeing tobecome partners, both sidesneed to check whether theirrespective aims and objectivescoincide. The partner organi-sations then submit specificfunding applications. During acooperation programme weconsult with our partners onwhether we are on track to-wards achieving our commonobjectives and reflect on whatimprovements we can make.At the end of a project we also check what went well andwhat we should do differently next time. This process isoften referred to as planning, monitoring and evaluation,or PME for short, but we prefer the terms reflectivepractice and partner dialogue.

Finding partners

When medico decided some years ago to become moreactive in the field of migration we wanted to find partnerswhose politics and programming matched medico’s visi-on. While researching on the internet and discussing thiswith colleagues from other non-governmental organisati-ons, one of medico’s staff came across the AssociationMalienne des Expulsés (AME), a self-help group ofdeported migrants in Mali. A visit to Mali confirmed thatmedico should cooperate with AME. The organisationnot only provides emergency relief for individuals whohave been deported or expelled immediately followingtheir return, but also carries out public awareness cam-paigns and is politically active. It is a committed memberof national, regional and international migration policy

and anti-globalisation net-works and encourages thedeportees and expellees tohelp themselves and to be-come involved in shapingtheir political reality. Thiscomprehensive approachclosely matches medico’sobjectives and way of wor-king and AME’s first applica-tion in 2008 was approved.Since then medico and AMEhave been working together.Cooperation based on mu-tual respect is the basis ofevery partnership for medi-co. This also includes re-cognising our partners’ au-tonomy and their specificfeatures since they workunder a wide range of con-ditions. A standardised PMEprocess would be too rigidto cover all this diversity. We

therefore apply PME tools flexibly, for example tailoringthem to the size and capacities of the partner organisa-tion. We use them primarily as a means of communicati-on at the various stages of cooperation. By maintaininga constant dialogue both sides can reflect on their ownwork and learn from each other. This allows a relations-hip of trust to be built up which also makes it easier toovercome difficulties and conflicts.

Joint evaluation

In December 2010 AME and medico staff met to evalua-te the cooperation so far and to discuss future plans.Two colleagues from La Cimade, one of AME’s Frenchpartner organisations, also attended, since AME, likemany other organisations, is not only funded by medico.This means its work needs to be coordinated and agreedwith a wide range of stakeholders. The interim evaluati-on report stated that: ‘AME has made impressive pro-gress since 2007: its political position is sounder and theorganisational structure has improved.’ But it was alsoclear that AME had taken on too much and that it was

M

How to cooperate

Reflective Dialogue Matching aims and objectives

medico’s Workwith Partners

medico works with peo-

ple and organisations

in Africa, Asia and

Latin America who want

to see short- and long-

term political and

social change. Working

together includes con-

tinuously learning from

and for each other.

Planning, monitoring

and evaluation (PME)

methods also help us in

our critical and

reflective dialogue.

losing sight of its core tasks. The joint report stated: ‘It isimportant for AME to remain true to its mandate and toset priorities to avoid weakening the organisation.’However the joint evaluation was not only used toassess AME’s work, but also to reflect on how the diffe-rent organisations were cooperating with each other. Forexample, the report states: ‘The relationship betweenAME, La Cimade and medico is very good; we speak“the same language” and our organisations complementeach other.’ As so often, here too, we saw that otherdonors wanted to tie their funding to specific activities;whereas, medico also finances the organisational infra-structure such as office space, staff costs, etc. medico isbucking the trend of funding publicly visible projects atthe expense of expanding and maintaining local organi-sational infrastructure.

This is as unsatisfactory for medico as it is for our part-ners: the constant need to apply and bill for individualprojects to different donors places a huge administrativeburden on them. Therefore, in AME’s case, an agree-

ment was made following the joint evaluation that allpartners should pay into a pooled budget in future anduse this to fund the organisational infrastructure as wellas projects. For AME, this means not only that fundingfor their infrastructure is more secure, it also relieves theburden by standardising administrative procedures. Thepooled budget was also approved over a longer term,which also reduces the administrative burden for allsides.

The joint interim evaluation of AME, La Cimade andmedico in December 2010 was thus not merely a chan-ce to consult and plan future cooperation. Agreementswere made on very specific improvement measuresaffecting all the organisations involved. At the next eva-luation we will need to check the extent to which theagreed changes have been implemented and whetherthey have had the expected impact. Until then, however,we will still consult frequently with our AME colleagues,remaining open to any changes and maintain our part-nership.

15

Team members of AME, Mali, photo: medico

16

he InternationalCampaign to BanLandmines was

founded in 1991 by medicointernational in cooperationwith the Vietnam Veterans ofWar Foundation.

In 1997 the InternationalCampaign to Ban Land-mines was awarded theNobel Peace Prize. The ideadeveloped into a movementfor a global ban. Withoutglobal support, the cam-paign would never have be-come so significant. The‘most successful civil societyinitiative in the world’ (as Kofi Annan, then UN Secre-tary-General, then called it) succeeded in forcing themilitary in many countries of the world to ban theseweapons. The Ottawa Treaty came into force in 1999,banning the production, stockpiling, transfer and use ofanti-personnel mines as well as stipulating that financialresources be provided for mine clearance and minevictim assistance programmes. Finally, for the first time,the number of mines being cleared is exceeding thenumber of new mines being laid.

There are many reasons for the success of the cam-paign. One of the most important is that the InternationalCampaign to Ban Landmines (ICBL) succeeded in buil-ding up an independent ‘international public’ that enab-led it to turn a military issue into a public one. At its heightthe ICBL consisted of a global network of more than 60national campaigns.

Much has changed since the landmine campaign startedback in 1991. The number of people killed or maimed bymines has been drastically reduced. That large areasaround the world are now being cleared of mines is also

due to a network of institutionsset up since then to ensure theimplementation of the OttawaTreaty in all countries. Thepressure brought to bear bythe ICBL in the last two de-cades has not just lead to theestablishment of a new inter-national standard, a ban onlandmines under internationallaw, but to an institutionalstructure which is essentialto reduce the danger posedby landmines as well. Theinstitutions that have emergedsince the signing of the Treatyinclude regular conferencesheld by the Treaty signatories

concerned with the political implementation of the provi-sions of the Treaty; civil society monitoring programmessuch as the ‘Landmine Monitor’ that watch over compli-ance with the resolutions; the UN Mines Action Service(UNMAS) that coordinates the mine awareness andmine clearance programmes enforced around the world;the Swiss-based Intergovernmental Geneva Internatio-nal Centre for Humanitarian Demining (GICHD) providesessential materials and has developed appropriate mineclearance processes, compiling the standard operatingprocedures for mine removal. This might sound like toomuch bureaucracy, but these quality standards are final-ly crucial life or death decisions.

It took a lot of work to convince people – a form of ‘citi-zen diplomacy’ – and to persuade the individual Treatysignatories including Germany to fulfill multilateral mineclearance and victim assistance duties. The continuingneed to keep up this type of multilateral commitment onthese issues is evident in Afghanistan today, where thesuccesses of the past years risk being superseded by anumber of military strategies, whether these are called ‘acomprehensive approach’ or ‘networked security’.

A Successful GlobalInitiativeThe International Campaign to Ban Landmines

T

Global Networking

Global Networking

medico supports the

realisation of social

and political human

rights within global

networks. States and

other global actors can

only be forced to abide

by laws and ensure

human rights through a

global agreement.

The violent conflict in Colombia is far from over. Thegovernment’s military strategy to take the fight directly tothe midst of populated areas is having fatal consequen-ces. Colombia has the highest accident rates from land-

PODES is Spanish for ‘You Can’. This organisationemploys mostly people injured by mines laid duringthe war as artificial limb technicians and managers. Theyhave been injured and traumatised by the long yearsof fighting. But at PODES they make artificial limbs,

Landmine War on a Daily Basis

Artificial Limbs on the Principle of Solidarity

Colombia

El Salvador

Millions of mines and unexploded devices have been leftbehind by the conflict in Afghanistan and now present ahuge danger to the population. Before fields, schoolsand roads can be repaired and used to the full, the muni-

Anti-Landmine Sniffer Dogs

Afghanistan

In Vanni, an area previously under the control of the Ta-mil Tigers (LTTE), there was severe fighting shortly be-fore the end of the conflict. Large areas are riddled withlandmines and unexploded devices. Returning refugeesare in great danger: already in a precarious situation,

Mine Awareness Protects the Civil Population

Sri Lanka

Examples of mine clearance and victim rehabilitation projects

funded by medico:

17

mines and explosives in the world. medico’s partnerTierra de Paz focuses on protecting children: schools aredeclared conflict-free zones and teachers become mineawareness-raisers.

tions must be removed from zones used by the popula-tion. MDC has 1,500 Afghan employees and is traininglandmine sniffer dogs to detect mines.

they have no free access to their fields and have notbeen made aware of the danger posed by landmines. Toprevent further accidents, CTF raises awareness of ex-plosive remnants of war and trains up community acti-vists to disseminate knowledge as broadly as possible.

supports and spare parts to international standards andearn enough to support their entire families. Another suc-cess story due to a long-term cooperation partnershipwith medico.

Mine awareness with children, Tierra de Paz Colombia, photo: medico

ive years ago medico, Brot für die Welt, Mise-reor, terre des hommes and Welthungerhilfeformed the Alliance Development Works (Bünd-

nis Entwicklung Hilft or BEH in German): It has sincebeen joined by other German partners including Kinder-nothilfe, Christoffel-Blindenmission, Eirene and Welt-friedensdienst.

Their joint aim is to provi-de immediate and long-term assistance in emer-gency situations and dis-asters simultaneously bysupporting experiencedindigenous partners. Inaddition the public shouldbe informed in a profes-sional and engaged man-ner of the background tothe emergency and the opportunities for overcomingpoverty and misery. During the disasters in Haiti andPakistan, this tried and tested method of cooperationagain proved successful both in the field and back at

The AllianceDevelopment WorksActing fast and sustainable

home. The spontaneous, widespread civic solidarity, thehigh standing of the organisations in the alliance and thesupport of the German ARD TV network led to an extra-ordinarily high level of donations.

The alliance ensured that it was reported in a trans-parent way with several press conferences and com-

prehensive documen-tation of the wide vari-ety of aid acivities atwww.entwicklung-hilft.de.The Alliance’s directorPeter Mucke empha-sized what the memberorganisations had incommon despite the diffi-culties that are unavoi-dable in countries likeHaiti and Pakistan: ‘With

our approach of interlinking emergency relief, preventivemeasures and development we aim to strengthen stand-alone civil society structures over the long term. That isnot something you can do in one year.’

18

Global Networking

F

photo: medico

he bloodiest year of the war in Afghanistan was2010, with the civil population the hardest hit bythe violence. For development aid organisations

working in the country this was a reason to intensify co-operation with one another and increase their contactswith the peace movement. VENRO, an umbrella organi-sation of non-governmental development organisationsin Germany, also has an Afghanistan Working Group,whose members include medico, Caritas International,Deutsche Welthungerhilfe, Misereor, medica mondialeand Oxfam. They are united by an uncompromising op-

he People’s Health Movement (PHM) wasfounded in December 2000 in Savar,Bangladesh. 1600 people from 93 countries

came together at the premises of medico’s partnerGonoshasthaya Kendra: activists, professionals andacademics who in their various activities are committedto the concept of primary health care (PHC). medicocame across many old partners at the PHM, fromCentral America, South Africa, India and Palestine – and

Sri Lanka Advocacy Joint lobbying in Berlin, Brussels and Geneva

The People’s Health MovementA worldwide network for the right to health

found new partners: for example in Egypt, where a teamof doctors and nurses connected to the PHM providedassistance to those wounded on Tahrir Square. Theirjoint activities range from projects in the field to demon-strations and lobbying against the neoliberal erosion ofhealthcare systems, the exclusion of minorities andrefugees, punitive drug patents, protectionism and worldmarket prices and strives for a comprehensive democ-ratisation of the World Health Organisation.

position to the policy of ‘networked security’ under whichaid and development NGOs are expected to cooperatemore closely with the German Bundeswehr (army) as itbegins to move into ‘out-of-area’ interventions. By estab-lishing regular communication with the peace move-ment, the NGOs are looking for an ally through which thevoice of the partners in Afghanistan can also be heard.In 2010 development NGOs and peace activists had se-veral meetings towards preparing a conference in 2011to present their shared objective jointly to a wider public.

Challenging the War Development and peace organisations discuss Afghanistan

lthough the war in Sri Lanka ended in 2009, thecountry’s Tamil-populated north is not at peace.Quite the reverse: their land is completely occu-

pied, tens of thousands live in internment camps andthousands are in prison. Lawlessness is also increasingin the south, with journalists ‘disappearing’, trade unionactivists being arbitrarily detained, any opposition gag-ged. This is also placing the work of medico and otherdevelopment non-governmental organisations (NGOs)

in a precarious position: any statement about Sri Lankaendangers the work of our partners on the ground, whichis all the more important in the uncertain post-war period.To protect them and safeguard their mutual assistanceand support, the network ‘Sri Lanka Advocacy’ was for-med at the start of 2010 as a means for a number ofNGOs, including medico, to coordinate lobbying activi-ties in Berlin, Brussels and Geneva and run a joint web-site at www.lanka-advocacy.org.

A

T

19

T

ealth is an essential condition for human andsocial development. That is why the right tohealth is enshrined in the Constitution of the

World Health Organization, in the International Covenanton Economic, Social and Cultural Rights (CESRC) andin over 130 national constitutions worldwide. (…)

Even now, when global health and poverty reduction are

relatively high on the international policy agenda, andgovernments are launching directs assaults on povertythrough various programmes, health inequalities withinand between countries are on the rise. Persistent pover-ty and growing inequalities, these intractable foes, arestark reminders that economic globalization and marketliberalization have not created an environment conduci-ve to sustainable and equitable social development. (…)

H

In early May 2011 representatives of organisations

and institutions campaigning for health and

social justice came to a meeting in New Delhi

organised by the Indian health organisation

Prayas, the Community Health Cell Bangalore,

the People’s Health Movement, the Public Health

Foundation India and medico international.

The aim of the meeting was to develop a shared

vision of how health could achieve the status of

Global networking

Health as a Common GoodThe Delhi Statement on democratising Global Health

a human right and to introduce that idea into

current debates, particularly on the role and work

of the World Health Organisation (WHO). This

led to the Delhi Statement which caused a stir

at the WHO’s World Health Congress held a few

weeks later. Some excerpts are given here.

The full text can be accessed at www.medico.de

and also on the website of the initiative

www.democratisingglobalhealth.org.

20

Health activists of CWGH and TARSC, Zimbabwe, photo: medico

Global Health Policy has no shortage of initiativesand experts, but the voice of the stakeholders them-selves is often ignored; medico fights to make theirvoices heard. Working through international civil so-ciety networks, we strive to prevent the right to healthfrom being sacrificed to commercial interests or sub-jected to a narrowly technocratic interpretation.

Since 1981 medico international has been campai-gning within the global network Health Action Inter-national so that access to essential medicines is notsubordinated to profits for the Big Pharma lobby.

In 2000 the People’s Health Movement was launchedas a strong voice for everyone’s right to health. Oneof its key demands is that people should be involvedin decisions that affect their health. The fact that somany activists and groups from the People’s HealthMovement were involved in the work of the WorldHealth Organisation’s Commission for the SocialDeterminants of Health in 2005–2008 attests to theglobal achievement of this initiative.

Against this backdrop of success, medico strength-

Listening to theGrassroot Voicesmedico’s health campaigning

ened its critical campaigning in Germany, organisingan alternative event at the first ‘World Health Summit’in 2009. While the summit was aimed exclusivelyat technical solutions for the issues of health anddisease, ignoring their social dimension, medicoorganised a conference in Berlin in 2010 that broughttogether international speakers and a national net-work for global health. The network is not only madeup of international initiatives but local public healthcampaigners, trade unions and migrant groups areinvolved. We are convinced that ‘Global Health startsat home’. This joint approach is designed to provideconstructive criticism of German policy on globalhealth issues.

The most recent step in this direction is the emer-gence of a distinctive, single voice of civil societyamid current debates on ‘Global Governance forHealth’. Before now, the sheer number of separateinitiatives on Global Health have made coordinationdifficult and reduced the movement’s capacity tocounter the influence of the many actors who focuson their own commercial self-interest rather thanhealth as a public good.

Health is a common good that demands collectiveresponsibility. Instead, structural violations of the right tohealth are produced by the dominant market dynamicsand the uncontrolled influence of profit-driven transnatio-nal corporations, supported by the policies of internatio-nal financial and trade institutions – the InternationalMonetary Fund, the World Bank and the World TradeOrganization. Such violations are often unmonitored,unmeasured, and are too numerous to quantify. As theyform part of a process of systematic violations of otherrights – to gender equality, to water and food, to workand income, to housing and education – any commit-ment to the right to health cannot be conceived in isola-tion from a broader approach of universal social protecti-on as a key policy to human development.

As the UN health agency, the WHO remains in today’sglobalised world the “directing and coordinating authori-ty” for the realization of the right to health and universalcoverage. Its role as the sole global legal authorityin health is embedded in its constitution, and needs to bestrongly supported. The last few decades, however,have witnessed the rapid emergence of new actors whohave highlighted health as a priority and largely shapedthe global agenda, but who have also contributed tomuch fragmentation in health governance. Their increa-sing prominence has produced a shift in institutional cul-ture, favouring the penetration of market values intoareas where they do not traditionally belong and resul-ting in a new sphere of influence in health policies. (…)

21

The topics of global health governance and the WHOreform agenda were prominently featured during theWHO Executive Board debate in January 2011, a deve-lopment we welcome. Fire has been lit and WHO,through its Member States, needs to take responsibilityfor the policy dialogue opportunity it has opened up. It isa collective responsibility, too.

(…) We are convinced that WHO needs to rediscoverits fundamental multilateral identity. Drawing on itsstrengths, the organisation has to take advantage ofits reform process to rethink and reassert itself as theleading actor in a broader governance for health thatis coherent with the need for solid public policy respon-ses to the neoliberal prescriptions, so that globalizationbe shaped around the core values of equality and socialjustice.

We, the participants in the New Delhi consultation

1. Call on Member States to strengthen the enforceabili-ty of the right to health, and the other economic, socialand cultural rights. (…)

2. Are convinced that the primary responsibility to enfor-ce the right to health lies with national governments. (…)Without people’s mobilization, human rights cannot bemet. The right to health is no exception. (…)

3. Favourably consider the proposal by WHO for innova-tive consultation mechanisms that allow meaningful par-ticipation of the multiple actors involved in global healthand require that the WHO consult with public interestgroups to this end. (…)

4. Strongly challenge the increasingly disproportionateparticipation of the corporate private sector in WHO pro-cesses without a robust mechanism to address conflictof interests. WHO needs to develop a comprehensiveframework that would guide interaction with commercial

actors as well as develop and implement measures toavoid and properly manage conflict of interest situations.These go beyond transparency and include a clear defi-nition of institutional conflict of interest, clear entry crite-ria and sunset clauses; (…)

5. Urge Member States to focus on taxation as one ofthe key policy instruments to enhance revenue capacityto advance human welfare, and in particular to finance ahome-grown health agenda. (…) The world is awash inmoney and time has come to focus on wealth as a wayto reconnect redistribution and social policy with econo-mic and fiscal policymaking. (…)

6. Recall that international solidarity is essential in manycountries with insufficient financial potential to ensurethe necessary human and material resources to guaran-tee the right to health. Today’s non binding provisionsneed to be turned into mandatory arrangements if we areto make such support predictable and long term.

7. Strongly encourage Member States to increase theirfinancial contributions to WHO and enhance their impactin the organisation. (…)

Signed by:

Salud y Desarollo, Bolivia; Wemos – Health for All,Belgium; Prayas, India; medicus mundi, Switzerland;Geneva Health Forum, Community Working Group onHealth, Zimbabwe; Partners in Health, USA; Trainingand Research Support Centre, Zimbabwe; Section 27,South Africa; O’Neill Institute for National and GlobalHealth Law, USA; Southern and Eastern African Trade,Information and Negotiations Institute, Zimbabwe/Uganda; World Social Forum, Brazil; Tax Justice Net-work, Kenya; Community Health Cell, India; Equinet,Southern Africa; World Council of Churches, Geneva;Action Group for Health, Human Rights and HIV/AIDS,Uganda; Diverse Women for Diversity, India; medicointernational, Germany, People’s Health Movement.

22

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Health – Social Support – Human Rights

medico works... with partners

The assistance provided by medico is more than the supply of reliefgoods in emergency situations. We see our work as an element withincomprehensive social action that aims at the implementation of theright to health. Our concern is to cooperate in a spirit of solidarity andtrust with people who are autonomous partners and anything but mererecipients of aid. Our common point of departure is marked by thepolitical and social aims that we share with our partner organizations in the South.

medico works... in context

Wars and affliction are never a bolt out of the blue. They have under-lying reasons that must be challenged. Those who through avoidanceof important political and cultural linkages do not understand the rootcauses of human distress will not be able to react adequately to suchdistress.The aim of our efforts is not simply targeted at alleviating hu-manitarian crises, but at overcoming them permanently.

medico works... for change

Any assistance granted to people leaves traces that will remain longafter the original intervention. Therefore, assistance aimed at overcom-ing the status quo presupposes a socio-political vision of a differentand more just world. It must develop strategies that can serve as aroadmap. There are no humanitarian solutions to humanitarian crises.We believe that assistance is an element within social action that fightsfor democracy, social justice and respect for human rights – togetherwith the victims of destitution and despotism.

medico internationalBurgstraße 106D-60389 Frankfurt am Main

medico international

Tel. +49(0)69 944 38-0Fax +49(0)69 436002

E-Mail: info@medico.deInternet: www.medico.de