Primary and emergency health care

International staff : 24 In the western province of Kayanza, MSF carries out medical supervision in the provincial hospital and health centres. MSF runs a therapeutic feeding centre in the southern town of Matongo and distributes supplementary rations. In Makamba, an MSF team runs a surgical programme for the war wounded in the province's main hospital. MSF also supplies medicine to 22 provincial health centres. In the eastern province of Ruyigi, MSF is in the last phase of its programme to support the health care system since 1994. MSF teams have worked in the referral hospital and nine health centres. The team has reintegrated a feeding centre into the paediatrics ward of the hospital and is running several feeding programmes out of the health centres. MSF monitors patient care in the 50-bed Kinyinya hospital and provides logistical backup. In Karusi, MSF works in an 80-bed referral hospital and seven health centres, providing surgical support, supplying medicine and supervising nursing care. MSF runs a therapeutic feeding centre which will soon be reintegrated into the paediatrics ward. MSF supports the provincial health centres' feeding programmes. In the poor, isolated province of Cankuzo, MSF carries out a surgical programme in the 120-bed hospital. In the newly reopened 50-bed hospital in Murore, MSF supervises health care and completes its medical supply. MSF also trains health care staff and traditional birth attendants for eight health centres. Following a nutritional survey in August 1998, MSF continued to run nutritional programmes out of eight provincial health centres. In central Bujumbura, MSF runs a centre for the wounded as many people are afraid to go to hospital for treatment. Many patients have been wounded in the fighting which continues sporadically in the city. MSF treats cases where possible and refers the more serious injuries to hospital. MSF also runs a therapeutic feeding centre in the city. Since July 1998, MSF has intervened in several cholera emergencies throughout Bujumbura province and in neighbouring Bururi province. MSF has been able to intervene more effectively because of the emergency response centre it set up in the capital.