Microsoft word - rep_total-annual2005.doc

ARD EL INSAN – PALESTINIAN
BENEVOLENT ASSOCIATION
Community Health and Nutrition
Rehabilitation Center
ANNUAL REPORT
Ard El Insan – Palestine
Gaza Programmes , Palestine
P. O Box 1099
Tel : +(970 8 )2868138
Mobile : + (970-8)059412759
Fax : +(970 8) 2842516
E-mail : [email protected]
I/ Introduction:

Ard El Insan (AEI) is a local Palestinian Non Governmental Organization based in the Gaza Strip.
AEI was established in 1984 as an affiliate of the Swiss Agency “Terre Des Hommes” and was
localized to become an independent local organization on 1997, registered with the Palestinian
National Authority / Ministry of Interior under the number (6703). AEI is managed by a steering
committee of local board of directors.
AEI works in nutrition and community health within the context of Primary Health Care (PHC).
AEI has become as a recognized body/partner in the nutritional health at national/international
academic and professional levels (Nutritional health researches with Terre Des Hommes (THD)
1995 “Accion Contra El Hambre” Madrid Spain 2003; IMCI Integrated Management of Childhood
illness WHO-MOH/PNA-unicef 2003-2004; Palestinian National Nutritional Plan MOH/PNA and
Norwegian Government 1996; Maternal and Child Nutrition Protocols USAID-MOH 2004-2005.
AEI approaches the society development theme via community groups, mass media, and university.
Four Community Health and Nutrition Management Centers (CHNMC) provide preventive,
curative and health education services to the beneficiaries all over the Gaza Strip:
¾ Gaza City ¾ Middle Camps ¾ Khan Younis ¾ Rafah. ¾ One nutrition station in Jabalya.
Besides the nutrition-health activities, AEI developed and integrated psychological health care
within its nutritional/health program in Gaza and Middle Camps to offer adequate psychological
support for children followed in AEI, their mothers and families .
Support to poorest families is given through relief and in kind-assistance as well as sponsorships for
orphans.
Mission
Palestinian children and families live a good nutritional, physical and psychological health in
a safe environment.

ƒ Improving nutritional/health status of Palestinian children under age five by reducing morbidity and mortality rates relating to nutritional and health problems. ƒ Improving nutritional status of Palestinian families at household level. ƒ Improving psychological health status of Palestinian children, mothers and close family ƒ Contribution in developing national policy in community and child health and nutrition. Strategies
As consequence of socio-economic situation in the Gaza Strip, AEI adopts a complete approach to
manage nutrition, health, psychological and social condition. To facilitate achieving this, AEI
provides the following: nutritional-health preventive; curative and relevant counseling services
targeting children less than five years old, as well as psychological support for them and their
families; in kinds-assistance to the needy families; health staff training; develop policies on
nutritional health; mobilize the community participation in activities; coordinate with different
NGOs; cooperate with national and international bodies and conducting relevant scientific
researches.

Beneficiaries
ƒ Children less than 5 years old suffering from malnutrition (macro and micronutrient deficiencies) whether associated or not with common childhood illness. ƒ Children under age six months with breast-feeding problems. ƒ Children and adults suffering from celiac disease. ƒ Cases of childhood bronchial asthma. ƒ Children, mothers and families with psychological problems. ƒ Orphan children. ƒ Mothers and families ƒ Health staff.
2/ Socio-political situation:
The most significant events occurring over year 2005 in Palestine: • Election of President Mahmoud Abbas on January 2005. • After 38 years of occupation, Israeli’ disengagement in September 2005 has restored internal mobility in the Gaza Strip. It also returns 55-75 square kilometers of lands in Gaza where the settlements were. Disengagement has limited impact on the Palestinian economy since Israelis keep control on flow of imports and exports; control of air and fishing zone is restricted.
Socio-economic situation in the Gaza Strip
According to different surveys conducted in the Gaza Strip, poverty levels are high and worsening.
The World Bank estimates that 65% of the population in the Gaza Strip was living under the
poverty line (less than $ 2 per day) at the end of 2004. The main reasons for the climbing poverty
rates are unemployment; damage to business and lands has also contributed in income loss; mobility
restrictions are also important contributing factors. In Gaza, second quarter 2005, unemployment
stood at 33, 3%. Prior to Intifada, the unemployment rate was 15, 4%(1).
------------------------------------------------------------------------------------------------------------
(1) World Bank, stagnation of revival, 2004


Following the disengagement, labor flows to Israel are zero.
The Palestinian Central Bureau of Statistics (PCBS) confirmed the findings during the Palestinian
Expenditure and Consumption Survey (PECS) income based definition of poverty. Adopting an
income based poverty level definition, 44% of people are spending less than $ 1.60 per person per
day (2)
PCBS conducted survey on the “Impact of the Israeli measures on the economic conditions of
Palestinian households”; the main findings revealed that food represents the 1st top priority of the
Palestinian households (34, 1%), followed by job opportunity (24,9%) and money (18,3%). 51,2%
of Palestinian households in the Gaza Strip indicated that their income has decreased during Al
Aqsa Intifada ; of which 58,3% lost more than 50% of their usual income Household’s income has
decreased from NIS 1600 before Al Aqsa Intifada to NIS 1000 during the 3d quarter 2005.
In 2005, 47% of Gazans reduced their expenditures on basic needs. 55,2% of the polled households
declared that they received humanitarian assistance during the third quarter 2005 (3).
Nutritional-Health situation:
FOA estimates that about 40% of the Gazans population was food insecure in 2003 and an
additional 30% was under threat of becoming food insecure in the near future (4)
Dietary habits have been adversely affected by increasing poverty level. Malnutrition results from
either inadequate macronutrient (energy and protein) intake or from micronutrient (vitamin and
mineral) deficiencies and/or infections. The decrease in quality and quality of food consumption can
have severe implications for children’s learning abilities and cognitive skills as well as health and
well-being.
Food aid is the main form of support for food insecure population groups. A massive food aid
operation was launched after 2000 which is view as having been instrumental in preventing and
lowering levels of malnutrition. There is no evidence; however that food aid has had any impact on
child nutritional status (5)
Iron deficiency anemia (IDA) is the major nutritional problem in the Palestinian Territories. The
screening for hemoglobin level among children 9 months age attending governmental clinics
showed that 46,5% of them were anemic in the Gaza Strip (6).
The prevalence of Vitamin A deficiency is 26,5% in Gaza Strip (according to WHO a prevalence >
20% constitutes a severe public health problem (7). Severe vitamin A deficiency causes visual
impairment and eventually blindness.
------------------------------------------------------------------------------------------------------------
(2) PCBS PECS 2004, Press release-July 2005
(3)PCBS Impact of the Israeli measures on the economic conditions of Palestinian households
(14th Round: July-September 2005)
(4) Food Security Assessment West Bank and Gaza, Food and Agriculture Organization of the
United States in collaboration with World Food Program 2003, p 28
(5) The State of Nutrition West Bank and Gaza Strip. A comprehensive review of nutrition
situation of West Bank and Gaza Strip; MOH WHO unicef, June 2005
(6 )MOH, 2004
(7) MARAM project, 2004

WHO considers that stunting <20% is low mild public health problem sector. In the Gaza Strip, the
prevalence of stunting was estimated at 6,7% in 1996; 7% in 2000 and 8,6% in 2004 (8). The
deterioration of economic and political situations mirrored the increase of stunting levels. Stunting
is evidence of chronic malnutrition and is irreversible beyond the second to third year of a child’s
life.
Wasting levels (acute malnutrition) and underweight malnutrition are low standing: 1,9% and 4%
respectively (8).

Psychological situation:
Adverse living conditions, low socioeconomic levels, unemployment, destruction of properties and
on going geopolitical conflict situation as found in the Gaza Strip, constitute important etiologic
factors for the increase in psychological disorders among children and adults.
Epidemiologic researches find increase in the rate of mental health disorders among children, 14%
to 20% of all children have one or more mental health disorders in the moderate to severe range;
80% of the children are undiagnosed and therefore don't receive any intervention.
A study conducted in 2004 in Gaza Strip, on gender and other predictors of anxiety and depression
showed that 73% of patients visiting primary care clinics in the Gaza Strip had mental disorders.
The prevalence amongst females was higher (76.8%) than males (67%). Living in refugee camps
was predictive of both anxiety and depression, while low educational level was more a predictor of
anxiety and not being married is more linked to depression. The survey found that about 6% of the
variance of anxiety could be accounted for in regression by sex, place of residence and education
with gender being the most robust predictor; only about 2.9% of depression can be accounted for
sex, marital status, and education (9).
In 2003, a survey carried out by the "Palestinian Plan of Action" revealed that violence and
unpredictable external events severely undermined parental confidence in being parents. 89% of the
polled parents reported symptomatic traumatic behavior amongst their children such as nightmares,
bedwetting, increased aggressiveness and hyperactivity, as well as a decrease in attention span and
concentration. 25% of the parents admitted not spending time with their children because they were
stressed or burdened by other concerns. 100% felt that their ability and capacity to protect their
children decreased since the start of the Intifada (10).
(8) PCBS, 2004
(9) Gender and Other Predictors of Anxiety and Depression in a Sample of People Visiting
Primary Care Clinics in an Area of Political Conflict: Gaza Strip, Dr. Abdel Hamid Afana; Rahat
Medical Journal, vol.2, No.1; Feb 2004
(10) "A Psychological Assessment of Palestinian Children". Secretariat for the National Plan of
Action for Palestinian Children, July 2003


A/ Nutritional health programmes
1/ Project implementation progress over year 2005:
End of 2004 and all over 2005, AEI developed a strategy to combat the major nutritional problem in
Gaza: Iron Deficiency Anemia (IDA). According to WHO criteria, the cutoff point below which
anemia can be considered to exist is 11 g/dl in children under 5. Therefore, all children under five
found with hemoglobin (Hb) level below 11g/dl were enrolled in AEI program. Infants below 6
months were not supposed to be tested for anemia since their iron storage during pregnancy is
sufficient for the 1st six months of life. Nevertheless, according to clinical findings or Hb level (test
done outside AEI center) IDA in babies under 6 months age have been treated.
Diagnose of IDA was done through medical clinical examination and confirmed by CBC (Complete
blood count) test. Children with hemoglobin level between <11-9g/dl> classified as mild anemic
were followed and received iron treatment for a period of three months at community level
(children from areas not covered by community health workers were seen in AEI center). Children
with hemoglobin level <9-7g/dl>, moderate anemia, were followed and treated over a period of 4
months. Whilst children having hemoglobin level < 7 g/dl are severely anemic and were followed
for a period of six months with close follow-up (twice weekly during the 1st month).
Improvement in level of Hb is evaluated by screening and comparing Hb at admission and
discharge (10% of the admitted cases with mild anemia were tested at discharge, as well as 10% of
the moderate cases while all children with severe anemia at admission were tested at time of
discharge).
Anthropometric measurements of the under fives allow diagnose of underweight malnutrition as
well as stunting and wasting.
A“Height for age” (H//A) deficit indicates stunted growth. Children with this deficit suffered from
chronic malnutrition. Low “Weight for height” (W//H) or acute malnutrition indicates a deficit in
body tissue and fat in relation to the expected values for a child in the same height. Underweight
defined by “Weight for age” (W//A) reflects body mass relative to age.
Children suffering from underweight malnutrition were admitted in AEI program using Gomez
classification to define the degree of underweight malnutrition. Children affected with moderate
(W/A <75%-60%> and severe (W//A < 60%) underweight were admitted for a period of 4 and 6
months respectively. They received prepared meals during their follow-up in the center and
therapeutic food at home.
Mild underweight children (W//A <80%-75%>) were followed over a period of 3 months at
community level.
Recommendations state that breast feeding should begin immediately after birth and infants should
be exclusively breast fed for the first six months of life. Guidelines and policies for management
and monitoring of breast feeding were up-dated since AEI decided to stop provision of infant
formula and developed a strategy to promote and support exclusive breast feeding for the first six
months of life. The objective is to enable all mothers attending AEI programmes to exclusively
breast fed their infants for the first six months of life. This include mothers who stop completely
breast feeding as well as mothers who never start breast feeding because their babies stay in hospital
for a certain period after delivery (few days to one month).
Therapeutic milk is given only in case of severe or moderate malnutrition besides intensive support
to continue and intensify breast feeding.
Malnutrition increases morbidity from infection diseases as well as recurrent common childhood
illness augments the risk of malnutrition. Therefore, management of common childhood illnesses
was part of the program.
Children suffering from nutritional disorders such as rickets, malabsorption syndromes and celiac
disease were also enrolled in the program and treated accordingly (medical investigations,
therapeutic food and milk were prescribed besides relevant treatment).
The strategy for improvement of nutrition in children includes a balanced mix of curative and
preventative interventions. Different strategies, at center and community levels, were elaborated to
modify positively mothers and community knowledge, attitudes and practices (KAP) towards
nutrition. Individual and group counseling, practical training on proper food preparation, lectures,
TV spots, radio messages, production and distribution of educational leaflets, interventions in
schools, other associations and formation of women committees, ambulatory nutritional assessment
days were integral parts of the preventative nutritional program.
Staff capacity building is another key element which contributes in program success; AEI
developed the staff capacity in all trends of AEI's specialties.
Monitoring of the program was reinforced by conception of a software data base for patients' files
and management of pharmacy.
2/ Planned activities 2005:

• Clinical assessment, laboratory and medical investigations, treatment and follow-up of underweight malnourished, anemic, those suffering from rickets, malabsorption syndrome, celiac disease as well as sick children. • Facilitation of proper referrals to other relevant health services. • Health education (individual or in groups) and counseling plus practical training on • Provision of balanced food rations, micronutrients supplementation and special food adapted to the children’s pathologies. • Counseling and support for mothers having breast feeding problems. • Promotion of exclusive breast feeding till age of 6 months through the breast feeding campaign and public awareness among the community. • Home visits for follow-up of malnourished children and breast-fed infants. • Formation of women committees to enhance the health and nutritional concerns among their community. Health education lectures given in schools. • Production of health education messages, TV spots, radio messages. • Promotion of household food security, distribution of handbooks, leaflets about security • Ambulatory Medical Nutritional Assessment Days. • Networking with local NGOs and health providers in order to improve the children’s • Monitoring of the project through monthly reports, revision of patients' files and field 3/ Achievements during year 2005:
According to criteria for admission, 10 237 children were enrolled in AEI program; of them, 1490
were admitted in the Breast Feeding Promotion Unit (BFPU).
I/ Visits to AEI center:

MNAU FU BFPU

Priority of care for anemic and underweight malnourished children has limited progressively the
number of attendants. Food relief was another project activity which composed the two faces to one
coin. In one face, it met the need of the economically disadvantaged families. On the other face,
people tended to see the benefit of the health education program from angle of relief work.
Provision of food was gradually stopped.
High energy biscuits were distributed only for the malnourished children and no food aid for
families.
Admissions in Middle Camp center were stopped beginning of December; patients were referred to
Gaza or Khan-yunis according to proximity
-----------------------------------------------------------------------------------------------------------------------
MNAU: Medical Nutritional Assessment Unit.
FU: Follow-up Unit.
BFPU: Breast feeding Promotion Unit.
II/ Gender distribution of admitted children:
Gender distribution of admitted
children in AEI

4850 males and 5387 females were admitted in the program.
III/ Age distribution of admitted children:

Age distribution of admitted children
55,4% of admitted children were below 1 year (2103 in the age group 0-6 months and 3569 in the age group 7-12 months); 3166 children (30,9%) were between 13-24 months and 1399 (13,6%) were above 25 months. IV/Reasons for admission in AEI program:

Diagnosis at admission

Clinical diagnosis of anemia was confirmed by CBC test.
77,4% (7923 children) of admitted cases were found anemic (3265 children (31,8%) had anemia
only and 4658 children (45,5%) had anemia associated with underweight malnutrition, stunting
and/or wasting). 2314 children (22,6%) were admitted as non anemic but with underweight
malnutrition

V/ Iron Deficiency Anemia (IDA):


a. Distribution of anemic children by degree of anemia:
Distribution of the anemic cases by
81,8% of the anemic children had hemoglobin level between <11-9 >gr/dl; 17,7% had hemoglobin level between <9-7>gr/dl. 0,5% children had severe anemia, Hb <7 gr/dl b. Association of IDA and other forms of malnutrition.
IDA and low anthropometric
measures

60% of the admitted children presented IDA associated with other forms of malnutrition such as
underweight, stunting, wasting.
c. Distribution of anemic children by age group and degree:
Distribution of anemic children by degree
and age-group
23% of the age group 0-6 months are anemic (19,5% have mild anemia and 3,2% moderate anemia). New born babies of anemic mothers are at risk to be anemic. Anemia in pregnant women is estimated at 20,9% in MOH clinics and 38,3% in UNRWA clinics (MOH, 2004). The non breast fed infants in this group age are more at risk of infections, diarrhea and therefore at risk for malnutrition and anemia. Prevalence of IDA is similar in children age group 7-12 months and 13-24 months with a rate at 92,5% and 93,8% respectively. Whilst, 84,7% of children aged 25-59 months were anemic. VI/ Underweight malnutrition amongst children 7-59 months (8134 children):
Prevalence of underweight malnutrition has to be taken with caution since 13,8% of the total
admitted children, were born with low weight (birth weight < 2500g).
LBW* infants differ in growth status from infants of normal birth weight even after chronological
ages are adjusted for gestational age. Therefore, Gomez classification is not used with LBW. Hence,
analyze of results concerning underweight malnutrition will consider age group 7-59 months.
Infants admitted in BFPU are possibly LBW, malnourished, normal body weight but in need for
breast feeding support.

a. Distribution of underweight children by degree of underweight:
Distribution ofadmitted children by
degree of underweight (7-59 months)

The cutoff point of underweight malnutrition was 80% of W//A according to Gomez classification
instead of 90%.
Prevalence of underweight malnutrition amongst admitted cases aged 7-59 months was 32,5%
(2649 children).


b. Distribution of underweight children, age-group 7-59 months, by degree of underweight:
Distribution of the underweight children by
degree of underweight and age group (age group
7-59 months)
Degree of underweight

Amongst children 7-59 months (8134 children admitted), prevalence of mild underweight
malnutrition is 19,1%; whilst prevalence of moderate underweight malnutrition is 12,4% and 0,9%
for the severe form.
VII/ Distribution of wasting, stunting, wasting & stunting amongst children aged 7-59
Distribution of wasting/Stunting/Wasting &
stunting by degree(Age group 7-59 months)
ren 1200
ild 1000
Amongst admitted children 7-59 months (8134 children), prevalence of stunting is 21,6%; prevalence of wasting is 20,6% and prevalence of wasting and stunting (acute malnutrition associated with chronic malnutrition) is found at a rate of 16,6%. Early malnutrition can have lasting effects on growth. Children over 24 months with deficit in height for age (stunting) will not recover.
VIII/ Associated illness treated amongst children attending AEI center:

Associated illness treated in AEI
Number of 2500
episodes

Respiratory tract infection (RTI), urine tract infection (UTI), intestinal parasites and diarrhea are
registered only if episode of illness happens at time of admission or follow-up in AEI but not if
already diagnosed and treated in other health facilities.
IX / Laboratory investigations

Laboratory investigations
Urine and stool analysis prescribed by AEI doctor are not always performed in AEI laboratory since samples are not available during patients' presence in AEI center.
XI/ Breast Feeding Promotion Unit (BFPU):

1951 infants (0-6 months) were followed in the BFPU; 1490 of them admitted during year 2005.
In addition to mothers of admitted children, another 2439 benefited from counseling for one time.
55% of infants born with normal body weight became underweight malnourished in the first months of life. Inadequate feeding practices, such as lack of exclusive breast feeding in the first six months of life, early introduction of infant formula and dilution of milk formula, lack of hygiene are the main reasons for malnutrition in early age. LBW are more at risk of malnutrition therefore necessitate close, accurate follow-up and support for breast feeding. Type of feeding at admission in BFPU
Infants fed with breast milk and formula were more dependants on formula than on their mother's milk. The average length of the stay in the unit was 8 weeks and the average weight gain per week was 190g. ------------------------------------------------------------------------------------------------------------------------ EBF: Exclusive breast feeding Predominant breast feeding: breast feeding and water or other fluids XII/ Outcome of the work in the community:
• Follow-up of the children with mild degree anemia or underweight malnutrition:
Number of follow-up visits performed by the CHWs: 15 875.
• Health education:
Number of women committees: 225
Number of participants attending the women committees: 8203. Each women committees
received four lectures (nutrition/malnutrition, anemia, breast feeding).
Number of lectures given in secondary schools: 322
Number of students attending the lectures: 13 227.
• Number of Ambulatory Health/Nutritional days organized: 48
Number of children assessed: 4058
In August, AEI participated in the breast feeding international week. The campaign was oriented towards supplementary feeding "Breast feeding and family food: love and health". Breast feeding counselors and community health workers gave lectures on topics related to breast feeding in different hospitals, Primary health care clinics, associations and in AEI centers. During the breast feeding international week, 2370 women received information about breast feeding Baby's suits and T-shirt were distributed to mothers followed in AEI who succeed to exclusively breast fed their infants. B/ TRAINING
Continuous training is offered to AEI staff on regular basis aiming at up-dating knowledge, attitude and practices in nutritional health within the context of primary health care and community health. • One staff nurse and nutritionist attended 5 days TOT training in the use of the mother and child nutritional protocols in PHC setting. (MARAM.). • AEI Medical Director participated in a workshop on “Operational plan of action for the national nutrition strategy (MOH/WHO). • Two staffs attended 3 days workshop on “Nutritional surveillance system” • One staff nurse attended a 4 days training on IMCI, “Integrated Management of Common Childhood Illnesses” (MOH). • Lab-technician participated in one day training on “Adopting quality assurance on medical laboratory” (MOH). • One staff had 4 days training on “Lot quality assurance sampling” (Hanan In 2005, AEI conducted different training: • One week training on breast feeding for 8 staff nurses and one health • Doctors from MOH and other NGOs received training in AEI on “Integrated Management of Common Childhood Illnesses” (MOH). • Ten staff nurses had 4 days training to work as health educators on the project “Milk for preschools program” The objective was to train teachers from preschools in the Gaza Strip and mothers having their children in these kindergartens. 118 kindergartens were enrolled in the training; 4612 mothers and teachers partipated in the training sessions. • Staff from different NGOs in Nuseirat, attended a 2 days workshop on “Working under stress”. The training was organized by AEI psychologists AEI centers are used as practical training places for health students from different universities in Gaza.
C/ Psychological support programme.

The project purpose is to reduce the magnitude of risk of psychological problems and trauma amongst
children and families in the Gaza Strip.
Psychological support is provided to children followed in Gaza and Middle Camp AEI centers.
Their mothers and families benefite also from the programme.

In 2005, the psychological support programme achieved:
Activities with children:
• Individual Counseling for children
Over a period of six months, individual counseling is offered for all detected children. During counseling session, psychologist counselor and client become able to analyze and recognize the problem and put plan to get a suitable solution. • 742 Children were seen for one time consultation only.
• 189 Children were detected from Ard El Insan’s Centers.
Behavioral problems, post traumatic stress symptoms, elimination and habit disorders, fear and anxiety represented the most common symptoms found amongst the children followed. • Support group
381 children aged 8 to 12 years with post traumatic symptoms and secondary symptoms to trauma ,
participated in the counseling sessions . Each support group consists of 10-12 children.
• Intervention in schools
19 Schools were targeted. Teachers received lectures on child problems, symptoms, causes and way
of intervention. 12 Psycho education sessions were conducted for 143 children.
Activities with mothers:
291 Women had consultation session, 123 of them were followed for depressed symptoms.
• Activities with orphans:
131 families of orphans sponsored by Irfan-Canada were screened through home visits. 65 families were
in need for intensive counseling.
• Public awareness:

414 lectures on psychological disorders were conducted in diferent associations.
D- ORPHAN SPONSORSHIPS PROJECT
In the year 2005, 1066 Children orphans received sponsorships.

The project sponsors children under 14 years old whose fathers had died and they are victimized with
poverty and low socio-economic situation.
Each orphan admitted to sponsorship, receives a monthly allowance of 55 Canadian Dollars and in-kind
assistance support from his donor.
Through regular home visits, AEI social workers evaluate the orphan’ needs, psychological situation
and inter-relations with other members of his family. The project works closely with the psychological
project.
"You cannot bring back their father or mother but you can offer some joy by providing food, medical
care, safety home and attention”.
Shereen, AEI Social worker.

E- AEI RELIEF MISSION DURING THE UPRISING (Intifada)
1- Food Aid
16,200 food packages distributed to AEI beneficiaries
The International Relief fund for Afflicted and Needy (IRFAN- Canada) financed 4000 food packages
for families of malnourished children .
In Ramdan The International Relief fund for Afflicted and Needy (IRFAN- Canada) financed 3,200
special “breakfast food basket” for the orphans families and other hardship families.

Through a partnership with the World Food Programme 5000 malnourished children/families
received with food portion.
ECHO/Terre des Hommes provided food packages to 4000 malnourished children.
2- Al- Adha feast meat
Meat parcels were provided to 7950 poor families of the malnourished children following AEI centers during the year 2004. Each portion weighs 2 kilograms of fresh cows meat per family of five members. Cows are slaughtered in the first ,second and third days of Al-Adha feast. This is funded by IRFAN Canada to provide direct in kind help to the poorest sector who suffer the tragic living situation during Intifada. Kinder-Pal also financed fresh cows meat to 1920 poor families from Rafah . Each portion weighs 2 kilograms of fresh cows meat per family of five members 3- School bags
1150 children received school bags
This type of relief work activity has been funded by IRFAN/ Canada .
Schools bags were offered to 800 orphans sponsored through Irfan- Canada and to 350 poor children
fom Naser area/ Morage (Rafah). This area was particularly targeted by Israeli’s army and many
families lost their home.
4- Urgent medical help

Urgent medical help was provided to 347 children. This urgent medical help afforts surgery and medical
follow-up abroad, artificial limps, ear aid, glasses, special medications, medical analysis, special
formula, nebulizers, medical equipment to be used at home for poorest children from the Gaza Strip



F- AEI STAFF

All activities are operated by a multi-disciplinary team composed of managerial and operational team.
Executive Director
Medical Director
Deputy Executive Director
Monitoring Officer
Nutritionist
Administrative secretary
Accountants
Project Officers
Medical doctors
Pharmacists
Staff nurses
Breast-feeding counselors
Psycologists
Social workers
Lab-technicians
Secretaries
Health Educators
Community health workers
Drivers
Cleaners
Relief workers

G- PROGRAMMES PARTNERS AND DONORS
Ard El Insan with the support of different partners and donors was able to operate the activities and
emergency projects, which provide essential services to people especially malnourished children, their
mothers and families.
Terre Des Hommes - Lausanne (TDH) is funding part of the project "Community health and
nutrition rehabilitation programme Gaza main center".
The International Relief Fund for the Afflicted and Needy (Irfan / Canada) is funding:
1. The project "Community health and nutrition rehabilitation center in the Middle Camps". 2. The project "Psychological support for mother and child programme". 3. Sponsorship for Orphans project. 4. Funds for medications, medical and laboratory equipments and appropriate food, school bags, Ramdan food basket, El adahi fresh meat, urgent medical help. Norwegian People’s Aid (NPA) is funding:
1. The project: "Healthy Children in Rafah".
European Commission Humanitarian Aid Office (ECHO), through partnership agreement with
Terre Des Hommes – Lausanne, is covering the project "Reducing prevalence of malnutrition and
iron deficiency anemia among children aged 0 to 59 months from the poorest population of the
govern orates of the Gaza Strip.
World Food Program through co-finance of Saoudi Arabia supported malnourished children and
their families with food.
Welfare Association with co-finance of Aid French Development (AFD) financed the basement,
second floor, and surrounding the building of Khan-Yunis.
Japanese International Volunteer Center (JVC) financed salary of one nurse for one month.
ANERA and Islamic Relief financed the project "Training of trainers for teachers of
kindergartens".
MERLIN financed 2 generators for Rafah and Khan-Yunis centers.


H- TOTAL BUDGET
Total budget of AEI during the year 2005 was $ 1,960,351.27

Source: http://ardelinsan.ps/site/wp-content/uploads/2013/03/Rep_Total-annual2005.pdf