Medair | 2012 Annual Report

Our region is very large but has no roads. Thank you for all the faraway places you have reached. Nobody else would send a car 200 kilometres for one patient who would die without referral. But you, Medair, have done this. Even one single person was important for you.

- Ibrahim Jama Mohamed, Deputy Governor, Caynabo, Sool district, Somaliland.

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For all seven billion of us on earth, there are times we suffer. times we feel engulfed by sorrow and pain. the grief of losing a loved one. the torment of a serious illness. the shock of a

sudden change that uproots us from the life we have known.

as i travel to countries in crisis with medair, i meet many families living through pain and suffering. most face not one but many agonies all at once, with little outside support or comfort.

medair is committed to relieving human suffering; we believe that no one should suffer in silence without relief. that core belief drives us to the farthest corners of the earth to reach families who need our help. it motivates not only what we do—health care, nutrition, water, shelter—but also how we do it—with compassion for those who are in pain, with respect for individual dignity, with hope for a brighter future.

when you choose to stand with someone in crisis, instead of all the other places on earth you could be, you are telling them that

they are not alone, they are not forgotten. time and again, we’ve seen how much this means to the people we serve. they show us through songs of thanks, through nods of appreciation, through cups of tea shared in simple shelters, through warm embraces when the time comes for us to leave.

thank you for your continued support in 2012. your compassion is the driving force behind the work that we do. your generosity has made a real difference to the health, dignity, and hopes of nearly a million people whose suffering has not been forgotten.

Message froM JiM ingraM, Medair Ceo

Jim ingram, medair ceo

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Photo: Jim Ingram visits with children being vaccinated during a measles outbreak in remote South Sudan.

Medair is a humanitarian organisation inspired by Christian values to relieve human suffering through a range of emergency relief and recovery services.

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Medair in 2012

Health and Nutrition• 402,086 patients treated at a health clinic or mobile outreach• 92,521 people vaccinated against deadly diseases• 43,313 people received nutrition services

Water, Sanitation, and Hygiene (WASH)• 198,992 people gained improved access to safe drinking water• 90,181 people have a new or improved latrine or bathing facility• 99,297 people trained in life-saving hygiene practices

Shelter and Infrastructure• 22,157 people received emergency or transitional shelter• 5,186 people received permanent homes• 8,358 local residents trained in construction and related skills

Internationally Recruited Staff

126Nationally

Recruited Staff

633

Headquarters Staff

72Affiliate Offices in Europe

and North America

5Countries Assisted

1988 to 2012

3110Country

Programmes

Direct Beneficiaries

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Medair helps people who are suffering in remote and devastated

communities around the world survive crises, recover with dignity,

and develop skills to build a better future.

diRect beneficiARies: 9,4 4 4

In September, with more refugees fleeing Syria every day, Medair sent emergency response teams to Jordan and Lebanon to bring them relief.

In Jordan, Medair focused on the threat of malnutrition. We helped integrate nutrition into general health services, partnering with a local NGO to provide training in six health clinics. Jordanian health providers learned to assess and manage acute malnutrition and provide counselling on improved nutrition practices.

In Lebanon’s Bekaa Valley, tens of thousands of refugees were living in quickly built shelters, and they needed protection from the elements to survive the coming winter. Medair and a local partner raced against the clock to distribute essential weather-proofing materials before the first snow.

We gave out shelter kits to 1,262 families, significantly improving the water-resistance and heat-retention of their shelters. We also provided families with blankets, mattresses, and wood-burning stoves. Having fled from a conflict zone, people had been suspicious of us at first, unsure whom they could trust. After the distributions, they welcomed us

into their shelters as friends who stood up for them when they needed it most.

“I am the grandmother of everyone here,” said Marella. “We are very happy. The blankets, mattresses, and the stove—it is all so good for us. Already it is much warmer. We would like to thank everyone who has helped us continue our lives. You have helped us to stand again.”

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As syria’s conflict escalated, half a million people fled their homes for safe refuge in neighbouring countries like Lebanon and Jordan.

Syrian CriSiS

yOU HaVE HELPED US TO STanD aGain

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Wessam and his young family fled from Syria in October. “For me, I had many prob-lems in Syria,” he said. “People would come into my home and hassle me, my wife, and my children.”

The family of five crossed the Lebanese border and slept on the streets for two nights, until a kind Lebanese man offered them a half-constructed building where they could stay. Wessam was grateful for the help, but the windowless structure was cold.

When we first met him in November, his baby daughter Lilith lay sleeping on a mattress on the cold, concrete floor. Wessam’s eyes, red from lack of sleep, grew moist as he struggled for words to express his shame and sorrow at not being able to care for his wife and children with winter approaching. “I want my children to be warm, and to have enough food to eat,” he said.

In December, Medair gave Wessam and his family a winter survival package including blankets, mattresses, and a wood-burning stove. He was delighted, hugging our team and slapping us on the back.

A week later, we visited him in his much-improved home, his new stove heating up the room. He laughed and smiled as we drank tea with his wife and children. “What an incredible change from the teary-eyed man I had met in November,” recalled Medair’s Andrew Robinson. “It was hugely encouraging to see his transformation from hopelessness to cautious optimism for the future.”

OUT Of THE COLD

  MedAiR.oRg/syRiAn-cRisis

Photos, left: A young Syrian refugee helps a Medair staff unload blankets in Lebanon’s Bekaa Valley. above: Baby Lilith sleeps on the concrete floor of the half-built house where her family is sheltering in Lebanon.

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diRect beneficiARies: 10,756   MedAiR.oRg/hAiti

“Things have changed for me,” said 69-year-old Sansélie Jacotin, beaming with joy. “I have more water to drink, to cook with, and to wash my clothes with. My misery to get water is ended.”

In 2012, Medair delivered projects designed to make a life-changing difference for fami-lies in remote Côtes-de-Fer. We supported the construction of 150 new disaster-resilient homes and repaired another 107 homes to make them more resilient to hurricanes and earthquakes. We also built 287 water tanks and 182 latrines.

“There are a lot of changes,” said Vagery Veuillo, a Haitian working for Medair. “The people have more water to drink and to use, which has helped change their living condi-tions. The building of latrines should also help to reduce the cases of cholera, diarrhoea, typhoid, and stomach ache. Great improve-ments will be made in the people’s health.”

Two major storms struck the region in 2012. Floodwaters roared down the mountainsides, eroding away roads and crop-lands and destroying homes. We provided urgent responses, supporting road repairs through a cash-for-work programme that al-lowed families to buy food and avoid debt.

Thankfully, 100 percent of Medair’s 3,490 transitional shelters and perma-nent homes withstood the hurricanes and storms. “I won’t be scared of any hurricanes in the future because the house is built to stand, even when there are heavy rains and strong winds like Sandy,” said Madenièse Valentin.

CARIBBEAN SEA

CARIBBEAN SEA

ATLANTIC OCEAN

GOLFE DE LA GONÂVE HAITI

Port-au-Prince

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Côtes-de-Fer Jacmel

haiti suffers frequent natural disasters—hurricanes, drought, floods, and outbreaks of cholera—and is still recovering from the devastating 2010 earthquake.

HaiTi

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Photo: Sisters Marlie Jean Pierre (left), age 7, and Betina Jean Pierre, age 9, inside their new Medair house in Jacmel.

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diRect beneficiARies: 339,850   MedAiR.oRg/congo

Our mandate to help the most vulner-able pushed us deeper into D.R. Congo to reach remote communities in 2012. Nowhere was this more evident than in our bridge-building project, where we reha-bilitated 37 bridges and culverts to open up humanitarian access and economic opportu-nities for more than 500,000 people.

At the same time, we expanded our support to reach more remote health clinics across the northeast. We provided free access to health care and medicine for families dis-placed by conflict, supporting more than 175,000 consultations and the delivery of almost 8,000 babies. “My first contact with the clinic was during my antenatal care where I was given a safe delivery kit,” said Josephine Zezio at Dafia clinic. “As a displaced person with nothing, this gesture meant so much to me.”

We improved access to water, sanitation, and hygiene at health clinics, benefit-ing more than 45,000 people. “There has been a decline in waterborne diseases like diarrhoea and dysentery since Medair reha-bilitated the well at the clinic and constructed latrines,” said Oscar Mweze, a nurse at Kiliwa clinic.

Medair also launched an ambitious HIV project that provided support to more than 8,000 people and education for more than 30,000. “I can see a change in behaviour based on increased awareness,” said HIV-positive advocate Jean Claude Likoye. “I have come across many people—especially those below age 18—who are already HIV-positive. Sharing my experience gives them hope.”

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in orientale province, brutal attacks have displaced hundreds of thousands while underdevelopment has left millions isolated without health care or safe water.

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Photo: Day labourers rebuild a bridge in Tapili, Haut Uélé district.

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diRect beneficiARies: 98,434   MedAiR.oRg/MAdAgAscAR

In February, Cyclone Giovanna slammed into the east coast of Madagascar, destroying homes and crops, killing livestock, and contaminating water sources. To combat the threat of waterborne disease, we distributed 4,760 WASH kits with buckets, chlorine solution, cups, and soap. We disinfected 27 wells and built eight raised water points, while conducting hygiene education to keep communities safe.

Medair also trekked into remote villages to distribute cash to more than 4,200 vulner-able families to help them rebuild their dam-aged homes. “We are very honoured that you have come all the way here to help us,” said the leader of Ambodivoananto. “You are the only ones who have come to us. People are very, very pleased with Medair’s support, first with the WASH kits, and now the training and the money to rebuild our homes.”

In 2012, Medair continued working to build community resilience against future cyclones. Perhaps no one benefited as profoundly as the village of Ambodin-mandrorofo. When Cyclone Irina struck the village, residents had received enough early warning to prepare their homes, move their livestock, and take refuge in their new Medair-built cyclone shelter.

“Previously, when a cyclone struck, it was thought right away that we would lose,” said Rafara, mother of 11. “We did not know what to do or how to prepare. But during Irina, we took refuge in the shelter house, and we were there in absolute peace and quiet. We had never felt so calm during the passage of cyclones in the past.”

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Toamasina

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frequent cyclones and tropical storms bring high winds and flooding that devastate homes, ruin crops, contaminate water sources, and cause disease outbreaks.

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Photo: A widow in Vatomandry district sits in the doorway of her house that was repaired after Cyclone Giovanna, thanks to a Medair cash distribution.

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diRect beneficiARies: 113,604   MedAiR.oRg/soMALiA

“I was hungry every day before Medair started helping my family,” said Sagal Omar. Medair’s nutrition services helped more than 17,000 people survive the food crisis in 2012. “Thanks to Medair, I got Plumpy’nut [ther-apeutic food] for my daughter and some food for my family,” said Sagal. “When my daughter started eating the Plumpy’nut she became fat very quickly. It is very good for children.”

Medair trained community volunteers to deliver vital health, nutrition, and hygiene messages, reaching more than 47,000 people. We also rehabilitated 47 berkads (reservoirs) and 60 shallow wells and built rainwater sys-tems at nine schools to improve water access. Medair worked to strengthen local health care services, extending support to 27 health facilities and working alongside the Ministry of Health to provide primary health care, medicine, and training and supervision for health professionals. Maternal and child health care was a major priority area, and we vaccinated almost 23,000 people.

In August, Medair concluded its 12-month emergency response to isolated villages in Sool and Sanaag regions. At the closing cer-emony, 145 village leaders expressed their

gratitude. “I want to thank Medair for the work you’ve done and I thank you from all the villages that came to this ceremony,” said Dr. Caray, Regional Health Officer, Sanaag. “Medair is a loyal and honest organisation, the best I have ever seen. We are not sad, because what Medair left us is great and we need to work with this now.”

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drought conditions have begun to improve, but millions still face food shortages and malnutrition.

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*Somaliland declared itself independent from Somalia in 1991. Its independence has not been recognised by the international community.

Photo: Boys enjoy Plumpy’Nut therapeutic food distributed by Medair’s nutrition programme.

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diRect beneficiARies: 205,930

In 2012, Medair responded to sudden and long-term emergencies, working with agencies and local government to provide health, nutrition, and WASH services. We also trained hundreds of South Sudanese to deliv-er improved essential services after we leave.

At the end of 2011, tribal conflict killed 1,000 people and displaced many more in Jonglei. In early 2012, we travelled there to repair hand pumps destroyed in the conflict, build latrines, and train hygiene promoters. We also began a nutrition programme that reached 5,800 people.

“In 2011, there was widespread optimism for the future of this country,” said Caroline Boyd, Country Director. “But 2012 brought ongoing setbacks. You could say it was the year in which reality set in after the honeymoon, revealing both massive long-term needs and successive humanitarian emergencies.”

In Renk, Medair worked to ensure re-turnees had safe drinking water and latrines. We also supported seven primary health care units and nutrition programmes, providing 37,000 patient consultations and 30,000 vaccinations.

In Maban, 110,000 exhausted refugees from Sudan arrived on foot. Medair started a clinic providing free health care, vaccinations, and antenatal care, set up two cholera treatment units, and constructed 450 latrines. With the refugee crisis expected to become a long-term situation, we expect this will be a major ongoing project for us.

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Malakal the world’s newest country faces steep challenges: conflict, a mass influx of refugees and returnees, and a general lack of health care, nutrition, safe water, and sanitation.

SOUTH SUDan

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The exiled people of South Sudan con-tinued to return home in 2012. “There are many challenges but this is my country,” said returnee Flora Poul. “Here I can try to improve my life and realise my goals, and by doing this, I will improve my country as well.”

In May, 12,248 South Sudanese were airlifted from Khartoum to Juba after being in Sudan since the war began more than 20 years ago. For the returnees, stepping onto South Suda-nese soil was a momentous occasion. They wore their best clothes. They left everything behind to come here; all that they carried was contained in a suitcase.

Medair and other NGOs worked tirelessly to prepare a temporary home for the returnees at Gudele transit site, near Juba. We gave every family blankets, mosquito nets, cooking equipment, soap, jerry cans, and sleeping mats.

“Life was very hard for us in Kosti [Sudan],” said Mary, 40. “I am very happy to be back, but anxious about the future. It’s great to see people like you, Medair, who can support us by giving us cooking pots and other things.”

Medair coordinated all of the water, sanita-tion, and hygiene (WASH) response, facili-tating the construction of 136 latrines and 90 bathing stations in just two weeks.

“I have lived in Sudan as long as I can remem-ber,” said Beatrice. “At the moment I am glad that we have a place to stay, but what is going to happen next? It worries me. Thank you for welcoming us with these things and for remembering us.”

THiS iS my COUnTry

Photos, left:Jalala Hassen, age 6, waits with her father for health care services at the Batil refugee camp in Maban, Upper Nile state. above: South Sudanese health promoters attend a Medair training in Maban, Upper Nile state.

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diRect beneficiARies: 32,141   MedAiR.oRg/ziMbAbwe

In 2012, Medair worked to improve the water supply for clinics and schools in Bulilima and Mangwe districts in Matebele-land South. We installed rainwater harvesting systems in 16 schools and 14 clinics. “I wanted to quit my job since there was no water,” said nurse Peter Burayay. “But I changed my mind when Medair installed tanks to capture water.”

These systems are easy to maintain and will last for up to 20 years. “Before Medair arrived, pupils would have to collect water before leaving for school, and that water

was unprotected and open to all kinds of diseases,” said Washington Ndlovu, Medair driver. “Since Medair’s help, these diseases have been reduced drastically.”

When Medair’s Hylton Cannon visited the Bango Clinic after the rainwater tanks had been installed, the clinic’s Environmental Health Technician told him: “Now that there is water at the clinics, expectant mothers are coming back to the clinics to have their babies.”

Medair also rehabilitated 10 wells to secure safe water access for 5,000 residents in Bulilima and Mangwe. “Water has always been a serious problem in Mangwe,” said Grey Ncube, Mangwe Rural District Council. “Medair has done a good thing.”

In all our projects, we promoted health and hygiene to reduce the risk of water-related illness. “I truly believe that Medair has made a major impact in the districts we worked in this year,” said Hylton. “There is now safe water for schools, clinics, and communities that was lacking before we started our projects.”

BOTSWANA

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Lack of safe water threatens vulnerable lives, especially in health clinics and schools in drought-prone regions like Matebeleland south.

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Photo: Children gather water from the new water pump at their school in Bambadzi.

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diRect beneficiARies: 31,272   MedAiR.oRg/AfghAnistAn

In Waras district, people drink unsafe water knowing it might make them sick. “It is normal for children to always be sick,” said Ajmal, a high school principal. “I have seen students vomiting or having diarrhoea while they are trying to do their exams.” Since 2008, Medair has worked to bring about transformative change in Waras. More than 40 percent of Waras’ villages now have improved access to safe water, sanitation, and hygiene education (WASH). Children are healthier, with fewer cases of malnutrition. In 2012, Medair improved WASH access for 103 more villages and six schools.

Medair also provided nutrition services at eight locations in Badakhshan province. We treated more than 500 malnourished children, 700 women, and reached almost 10,000 people with nutrition services and hygiene promotion.

In May, Medair experienced a serious security incident when five staff were abducted while travelling to a remote nutri-tion clinic. Thanks to the help of international security forces, and a well-rehearsed internal crisis plan, all of the staff were safely freed, but the incident led to the difficult decision to close operations in Badakhshan after 12 years.

“Our work in Badakhshan saved thousands of lives,” said Mark Screeton, International Director. “Our legacy is the long-term impact achieved through improved water and sani-tation services, major upgrades to the pro-vincial health care system, new schools and clinics, and greater household knowledge of hygiene, health, and nutrition.”

UZBEKISTAN

TAJIKISTAN

TURKMENISTAN

IRAN

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Kabul

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BehsudWarasJalalabad in rural Afghanistan, people endure frequent natural

disasters, unreliable harvests, malnutrition, and poor access to health care, water, and sanitation.

afGHaniSTan

iT’S nOrmaL fOr CHiLDrEn TO aLwayS bE SiCK

Photo: Children carry Medair hygiene kits distributed in Deh-e-nabi village.

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Funding Partners 2012 Organisational donors listed alphebetically ≥ USD 15,000.

UniTED naTiOnS anD inTErGOVErnmEnTaL ParTnErSDemocratic Republic of Congo Pooled FundEC Directorate-General for Humanitarian Aid and Civil ProtectionEC Directorate-General for Development and Cooperation – EuropeAidSouth Sudan Common Humanitarian FundUnited Nations Children’s FundUnited Nations High Commissioner for Refugees

GOVErnmEnT ParTnErSDepartment for International Development (UK)Swedish International Development Cooperation AgencySwiss Agency for Development and Cooperation United States Agency for International Development

inSTiTUTiOnaL ParTnErSEO Metterdaad (NL) Swiss SolidarityTearfund (UK)

PriVaTE ParTnErS Arcanum Foundation (CH) Caritas COFRA Foundation (CH)Däster-Schild Foundation (CH) Demaurex & Cie SAGebauer Foundation (CH) Gertrude Hirzel Foundation (CH) La Fondation du Protestantisme (FR) Läkarmissionen (SE)Mennonite Central Committee, with Canadian Foodgrains Bank Pierre Demaurex Foundation (CH) Red een Kind (NL) Trade Aid (UK) Woord en Daad (NL)

GifT-in-KinD ParTnErSArnold & Porter, LLP (UK)Google International Organization for MigrationMayer Brown, LLP (US) Microsoft (UK)United Nations Children’s FundWorld Food Programme

My sincere thanks to everyone who supported Medair in 2012.

Your gifts enabled us to save lives without delay in places where people were in critical need. Thanks to you, we were for example able to bring relief to thousands of Syrian refugees who had fled from conflict. We were able to help devastated families get back on their feet after massive storms hit Haiti and Madagascar. Your donations made our emergency responses possible.

With deep appreciation,

Gregory Pasche, Director of Communications

and Fundraising

Words from Our Partners

Medair’s shelter programme has been hugely successful at adapting their construction designs to meet the needs of the local communities. The Medair houses are well-built and well-appreciated by the homeowners. The houses have good structural integrity and fit well with the local environment and culture, while also allowing residents to provide their own design solutions and finishing touches. Medair has acquired an undeniable expertise in reconstruction techniques that work well in rural Haiti.

- Béatrice Boyer, architect and team leader, Groupe URD (independent experts hired by funding partner Swiss Solidarity to assess Medair’s work)

I feel extremely proud to be partnering with Medair in assisting refugees from Syria. I am quite shocked to see that Medair is one of the few international agencies responding to their needs. I have been encouraged to see the solidarity of many of these refugee families who welcome new arrivals and take them into their tents until they can find a place of their own to stay. If they can demonstrate such solidarity then surely we, who have so much more, can do something to contribute towards meeting this great need.

- Conny Sjöberg, funding partner Läkarmissionen (SE), after a visit to Lebanon’s Bekaa Valley

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Operating income 2012

Foundations and NGOs 22.4%

Private Donations 19.2%

Gifts-in-Kind 4.1%

Governments, E.U., U.N. 53.5%

Other Income 0.8%

beneficiary Expense by Sector 2012

Nutrition 4.7%Other 0.3%

Water, Sanitation, and Hygiene 38.7%

Agriculture and Food Security 1.1%

Shelter and Infrastructure 20.1%

Health Services 29.5%

Disaster Risk Reduction 5.6%

Operating Expense 2012

Humanitarian Expense (direct) 74.6%

Humanitarian Expense (indirect) 8.9%

Fundraising 8.2%

General Management 8.3%

Financial Statistics

Programme income and Expense 2012 (USD)

Afghanistan Chad D.R. Congo Haiti Madagascar Somalia/Somaliland Sudan South

SudanSyrian Crisis Zimbabwe

Income 3,882,725 105,362 5,783,410 3,557,528 1,548,401 6,132,199 2,180,751 9,648,571 664,047 1,379,778

Expense 3,560,636 65,837 5,515,569 4,171,792 1,407,131 6,644,297 1,857,555 9,103,015 457,235 1,287,431

10,000,000

9,000,000

8,000,000

7,000,000

6,000,000

5,000,000

4,000,000

3,000,000

2,000,000

1,000,000

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operating income 2012 (usd)Governments, E.U., U.N. 20,841,912

Foundations and NGOs 8,716,835

Private Donations 7,501,985

Gifts-in-Kind 1,609,667

Other Income 318,611

total 38,989,010

operating expense 2012 (usd)Humanitarian Expense (direct) 30,426,199

Humanitarian Expense (indirect) 3,644,301

General Management 3,397,725

Fundraising 3,329,930

total 40,798,155

Photos, left: A young girl carries blankets at a Medair distribution centre in Bekaa Valley, Lebanon. right: Medair staff enthusiastically participate in a community WASH celebration in Zimbabwe.

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medair.org/donatePublished in June, 2013

Together, we have the power to help the world’s most vulnerable people. Make your gift and join the team today at medair.org/donate

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Photos,  front cover: A young Syrian girl holds onto a tall wire fence at the site of temporary makeshift shelters where her family and other refugees are living in Lebanon’s Bekaa Valley. © Medair/Andrew Robinson back cover: A boy draws water early in the morning from the taps at the Medair-built water source in Mina returnee camp, Renk, South Sudan.

mEDair HEaDqUarTErSChemin du Croset 91024 EcublensSwitzerlandTel.: +41 (0) 21 694 35 35

mEDair UKUnit 3, Taylors Yard67 Alderbrook RoadLondon, SW12 8ADUnited KingdomTel.: +44 (0)20 8772 0100united.kingdom@medair.org

mEDair USP.O. Box 4476Wheaton, IL 60189United States of AmericaToll Free in US +1 (866) 599 1795united.states@medair.org

Charity registered in England & Wales no. 1056731Limited Company registered in England & Wales no. 3213889

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