Chad 1998

International staff : 26 National staff : 164 ACCESS TO HEALTHCARE A PRIORITY The elected government has remained in place despite an armed opposition operating in the Lake Chad region and in the east of the country. Although Chad had a record cotton harvest in 1996-97 and looks forward to oil revenues starting in 2000, cereal crops are insufficient and there are repeated epidemics of cholera and meningitis. MSF's long-term programme in Mayo-Kebbi now extends towards Eastern Logone (covering 20% of the total population). A similar programme is underway in the Koumra district of Sahr prefecture (pop. 177,000). The objective is to provide support to the health system for preventive and curative care by ensuring supplies of drugs and medical material, and setting up a cost recovery system for health centres to become self-financing. Every effort is made to guarantee access to medicines is guaranteed, as well as quality in health care. Infrastructure is being constructed and rehabilitated and ongoing training provided for health workers. Emphasis is placed on the importance of working in partnership with local health professionals to ensure long-term sustainability. In collaboration with local NGOs, education programmes were started covering AIDS and other health matters, and family planning advice is available when requested. MSF also provides technical assistance in support of EPI. MSF worked with the Ministry of Health in response to a meningitis epidemic that began in early 1998. A team provided logistical and technical support for mass vaccinations. While assisting with this, four MSF expatriate staff were held hostage for several days by members of an armed opposition force.