1 November 1998
International staff: 18 National staff: 114 EMBARGO HITS HEALTH SERVICES HARD Although the economy is improving and UN-sponsored negotiations work towards resolving disputes with South Ossetia and Abkhasia, the political situation deteriorated sharply in February 1998 following an assassination attempt against President Shevarnadze and the kidnapping of UN personnel. MSF works inside South Ossetia and Abkhasia, and on the Georgian side of the border with Abkhasia. The economic blockade imposed by Russia on the two would-be republics has impoverished their health services. The overall objective is to reduce soaring TB levels by introducing WHO protocols, renovating TB hospitals in Sukhumi (Abkhasia) and Tskhinvali (Ossetia), and drugs distributions. In Abkhasia, 3,000 vulnerable people (mainly elderly, excluded Georgians and Russians without families) receive free medical consultations and drugs from an MSF dispensary and two social workers make home visits. A similar programme runs for vulnerable groups in Ossetia. In Tchalendija, on the Georgian border with Abkhasia, a project to improve access to health services throughout the district includes health education, management training, pharmacy management, health structure renovations and maintenance, the quality of care and the health information system. The team also gives technical assistance and assists with vaccination programmes. Support focuses on two hospitals, a polyclinic and eight health centres. An education and information programme in Zugdidi (Georgia) for the general population and health personnel aims to improve access to primary health care. This includes specialised workshops and a teaching video. Efforts are also being made to improve and rationalise the drugs distribution system outside the main towns in this region.