1 November 1998
International staff: 7 National staff: 36 HEALTHCARE SERVICE LACKS RESOURCES The health service is under-resourced and around 20% of the population only has access to traditional medicine. MSF has been working in Cotacachi since January 1996. The objective is to improve access to health care for the rural ethnic minority of 15,000 people excluded from the national health service for cultural, geographic and economic reasons. The project aims to create a complementary healthcare service, integrating traditional and western medicine, and linked with Ministry of Health services. However, the continuous political crisis affecting all Ministries has made collaboration with the Ministry of Health very difficult. Activities developed include training for community sanitation and health personnel, mother-and-child health, the construction and equipping of a health training centre, and logistical support to Ministry of Health vaccination programmes. In March 1998, MSF launched a three-month emergency intervention in Guayaquil to assist the population affected by floods resulting from the "El NiÃ?±o" phenomenon. Five mobile brigades travelled to the affected communities to provide medicines and basic health care. In early June, MSF extended the intervention to assist with a cholera outbreak that began when water levels fell.