Palestinian Authority 1998

International staff: 16 National staff: 22 Psychological support continues map The Israeli government continued to build new settlements in the Occupied Territories resulting in a deadlocked peace process and heavy clashes between Israeli and Palestinian communities. A psychological support programme to mothers and malnourished children continues in Hebron district at two levels: home visits in villages and therapeutic activities in facilities set up by MSF within nutritional support centres run by the INGO, Terre des Hommes. Psychologists also train community health workers and centre staff to recognise when psychological support might be needed in a mother-child relationship. It has taken two years for this work to gain acceptance within the very traditionally religious culture of Hebron. In January 1998, MSF initiated an academic research programme based on this work focusing on a clinical approach to the typical interactive patterns existing between the mother and malnourished child. Also in Hebron district, the first primary health care project (16 health posts built and equipped and 19 new community health workers trained) was handed over to the Ministry of Health in February 1998. A second project then began to renovate the 50 so-called health posts that already exist and to upgrade the skills and training of 53 community health workers. The principal aim of these projects is to improve health conditions in the community with a particular emphasis on preventive medicine and mother-and-child health. This is being achieved through establishing treatment protocols, supplying basic drugs, developing the management of the pharmacy system at the district level, establishing a referral system and implementing a health information system. Community health workers are trained to set up and implement control systems in regard to pregnancy, growth in healthy children and immunisation, including anti-tetanus and detection of those at risk. They also learn to organise health education and to use home visits for the early detection of problems. The Ministry of Social Affairs set up a rehabilitation centre for former detainees in 1996 in support of 7,000 people, of whom 4,000 live in Hebron. It was recognised that most were suffering psychologically as a result of their detention. Since March 1997, MSF promotes psychological help for ex-detainees requiring it and trained a psychological counsellor. The team has drawn up a list of ten questions for social workers at the rehabilitation centre to use to identify those in need of help. This support is now being extended towards their families as well. MSF has an ongoing programme in five villages in the Gaza strip aimed at the physically handicapped, numbering 2,706 out of a total population of 66,158 - a high percentage for a developing country. The programme is based on a specific rehabilitation plan for each individual and activities aimed at their social integration. It seeks to secure their access to health services and participation in community activities while promoting the principle of equal opportunities. As tensions increased in the autumn of 1997, MSF ensured supplies of emergency kits for the main hospitals on the West Bank.