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Russian FederationFollowing its claim for independence from Russia 12 years ago, two successive wars have brought the Chechen Republic not only physical destruction, but also deep mental trauma amongst its people. Psychosocial counseling is an important component of most of MSF’s activities here. Despite formal restoration of power and official reports about the stabilization of the situation, security is precarious. Violent upsurges occur in Chechnya and the neighboring republics of the Russian North Caucasus, and MSF has seen that many needs of the population remain unmet, including medical care. In Grozny, the Chechen capital, MSF mobile medical teams provide basic healthcare for the residents of six temporary accommodation centers (TAC) – the “homes” of refugees who returned from Ingushetia only to find their houses ruined and with little means to create a livelihood. MSF has also rehabilitated two clinics and runs free pharmacies in Grozny. Medicines are prescribed and distributed under the supervision of an MSF doctor. With a specific focus on mother and child health, Chechen MSF doctors provide pediatric and gynecological care, reproductive health and family planning consultations, undertaking approximately 3,000 consultations per month in total. In the remote, economically depressed Shelkovskoy district, MSF runs a primary health clinic, conducting approximately 1,000 consultations monthly, and supports district hospitals in Shatoy, Sharoy and Itum-Kale. MSF is developing its tuberculosis DOTS (Directly Observed Treatment, Short-course) treatment program in four supported tuberculosis (TB) dispensaries serving a population of 300,000. The Chechen healthcare system lacks a general plan and funding to care for people with TB and there are only five functioning dispensaries in the Republic in total. MSF implements the DOTS strategy of TB treatment and provides patients with supplementary high-energy nutrition for better recovery. The rates of the treatment success in the program are high, and this is reinforced by the work of the MSF TB educators’ team, who ensure that patients adhere to the difficult and lengthy treatment course. In July 2006, MSF opened a reconstructive surgery project in Grozny hospital No. 9, to care for people with crippling war-related injuries that were not properly treated, such as badly set limbs. Over 200 surgical interventions had taken place by May 2007. In the same facility, the main Republican trauma hospital, MSF supports the neurosurgical and trauma wards, where lifesaving surgery for violence-related injuries are performed. Reduction and closure of programsIn early 2007, MSF closed most of its projects in Ingushetia, bordering Chechnya (pediatric, pre- and ante-natal consultations, and primary healthcare mobile clinics) because of the massive return of the Chechen refugees, the target population of the programs. The MSF clinic in the capital city Nazran continues to serve remaining residents of spontaneous internally displaced settlements and MSF psychosocial consultants continue working in Ingushetia. In March 2007, MSF handed over the street children and teenagers project in Moscow to another NGO. MSF developed a working model of re-socialization for these children, which combined daily outreach work and the follow-up work of doctors, psychologists, educational and social workers in the day center. A report entitled Building a Bridge Between the Street and Society: MSF’s Experience and Analysis of Assistance to Street Children in Moscow (2003-2006) was published in 2007. MSF has worked in the Russian Federation since 1988 and North Caucasus since 1999. |
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