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EMERGENCY

N° 0 • JULY 2009

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AFGHANISTAN Basic Life Support Course in Kabul – Emergency Cardiopulmonary Resuscitation (CPR)

Training
for Critical Care Units

«F
alcon 4 Falcon 4… cardiac arrest in Intensive Care are standardized and recognized as effective by several key international
Unit”. It was ten minutes before midnight, and organizations that provide constant revisions and updates.
someone was calling me on the radio. “Start the To help with memorization, the BLS phases are schematized in three
cardiac massage,” I replied as I ran towards the steps, indicated by the first three letters of the alphabet.
hospital. Latif, Fahim and Samiullah, just graduated from the Government
School for Nurses at the University of Kabul, and were working the night A: Airway – Opening and control of the airway, removal of potential
shift. The school curriculum offers CPR training. Unfortunately, the quality occlusions (foreign-body, food, blood), and insertion of a plastic tube to keep
of teaching is still very far from acceptable or satisfactory standards. This is airway pervious.
understandable in a country devastated by thirty years of war.
B: Breathing – Sustain breathing by ventilation with Ambu bag (if
In all of its projects, EMERGENCY strives to provide intensive training for unavailable, proceed with mouth-to-mouth breathing).
local staff through daily hands-on experiences with highly qualified doctors
and nurses coming from other countries. C: Circulation – Sustain cardio circulatory function by control of carotid
This and other targeted activities provide local staff with current medical pulse, and potential cardiac massage.
knowledge, and eventually lead to their autonomy. In the first months of 2008,
Daria, Elena, Debbie and I, all international nurses at the EMERGENCY At each step, a vital sign (airway, breathing, cardiac pulse) is checked and
Hospital in Kabul, have established a Basic Life Support (BLS) course in an restored, if compromised.
effort to accomplish these goals.

The ABC’s of resuscitation — Learning to save Minianne really means


Airway, Breathing and Circulation helping Gul Arifa
BLS encompasses all cardiopulmonary resuscitation procedures performed BLS is of utmost importance in the training of health care staff. For this
to rescue a patient who is unconscious, or suffering from cardiac arrest. reason, it is periodically taught to newly hired staff at all of EMERGENCY’s
Independently from the cause of cardiac arrest, the heart fails to contract and hospitals.
pump blood to the tissues. This latest course was designed specifically for nurses newly graduated
The lack of oxygen supply to the brain cells, known as cerebral anoxia, from the University of Kabul, and working in the critical care areas (ER,
causes irreversible damage within 10 minutes of the onset of circulatory intensive care, surgery room).
arrest. This implies that the time available to rescue a victim of cardiac arrest It is divided in two sessions. The first session illustrates the guidelines of
is extremely short before irreversible brain damage occurs. the Italian Resuscitation Council (IRC), while the second, besides reviewing
The goal of BLS is to maintain an “emergency oxygenation” through previous material, allows students to practice the reanimation resuscitation
artificial breathing and cardiac massage, until more efficient means can be of Minianne.
used to correct the factors that determined the arrest. The BLS procedures Minianne is an inflatable manikin provided by the IRC. It is particularly

2
useful in the teaching of lifesaving maneuvers, since it allows effective It is midnight. Out of breath, I reach the intensive care unit. I don white
simulation of cardiac massage and manual ventilation. coat and shoe covers and I step inside. Latif is by Gul Arifa’s bed performing
During this session the nurses, divided into small groups, ask questions ventilation. Samiullah is standing on a step stool, ready to administer a
and practice until they feel confident with all the maneuvers. The hands-on cardiac massage.
nature of the class has guaranteed the expected results. Fahim, the youngest, looks at me nervously as I come closer. Together we
In fact, the staff has acquired both physical and psychological confidence gaze at the monitor. Gul Arifa’s heart has resumed beating. We smile at each
with instruments and maneuvers, and it is now ready to effectively cope with other. “Great! Well done!”.
any emergency situation.
NADIA DEPETRIS
Translated by Ada Buvoli

3
AFGHANISTAN Six year old Quadratullah, Victim of a Landmine Explosion Arrives at our Hospital in Kabul

The Consequence of War

H
e arrived at two in the afternoon on 22 July in a car driven by his What remain behind are two apricots,
uncle. He had been carefully laid on a thin mattress, wrapped in and the tragedy of a morning that was supposed
a plastic cloth, with stained rags used to stop the bleeding from to be a celebration
his wounds. The boy’s father’s arm (Ajimir Aziz) is wounded. When we ask him what
Six year old Quadratullah is transferred to a stretcher by ER nurses. He happened, he takes two apricots out of his pocket, and then breaks down
doesn’t utter a single word and through teary, terrorized eyes watches all the crying. That morning he had gone with Quadratullah to gather some apricots
people who are frantically racing around him. in a small orchard near their home, in a village a couple of hours from Kabul.
Quadratullah was so happy because his father was dedicating the whole day to
We remove the rags from his wounds. It is a devastating image. His left leg him. It was their time to play, their moment to be together.
is gone, ending just under the knee with two bone fragments protruding from his Then he saw some ripe apricots on the ground. The boy turned to pick them
flesh. The right leg is still okay, but wounded. His left hand is crushed, and the up, meaning to take them to his mother and siblings. But, as he bent down
right hand is wounded. His back and pelvic area have deep wounds resulting to collect the fruit that’s when it happened. There was an explosion. It was
from the explosion. instantaneous, like always.
We should be familiar with these scenes, but we’re not. Each time, the horror Ajimir extends the two apricots out to me. I face him, not knowing what to
of these scenes doesn’t allow us to become accustomed to them. do. The nurses encourage me to take the fruit, he is offering them to me. I take
As soon as Quadratullah’s condition is stabilized, he is sent immediately to them into my hands. I look down at them, and put them into my pocket - two
the operating room. apricots and Quadratullah’s life torn apart.

MARINE CASTELLANO
Translated by Paolo Chiappetta

4
AFGHANISTAN In Ghazni, 120 miles south of Kabul, the local population asks for a new FAP (First Aid Post)

Restarting and expansion

I
n the summer of 2007, just after the re-opening of our hospitals in The official inauguration took place on August 10th at 2:00 PM. Many officials
Afghanistan, we were contacted by the representatives of the Ghazni were present; the vice-governor of the Ghazni province, a member of the
community from one of the areas most impacted by the war, and which national parliament, the mayor of the city of Ghazni, the director of the Ghazni
runs along the road connecting Kabul to Kandahar. They made a hospital, the community leader and many local citizens. Due to worsening
request that we open a First Aid Post to be connected to our surgery center in security along the road connecting the capital with the south of the country, no
Kabul where high standard, free medical assistance is provided to everyone one from EMERGENCY was able to participate in the opening ceremony.
in the area who is injured or wounded.
We had to wait a few months before starting a new initiative and fulfilling The distance from Kabul and Ghazni is about 120 miles, and is normally
this request since we had to be sure that the entire Afghanistan Program was about a two hour drive. In recent months, with the increase in military conflict,
back on track. the travel time has more than tripled to cover that area (the official delegation
that came to Kabul to thank us for the new facility took seven hours), and the
In April, a delegation form EMERGENCY completed a first assessment of frequent attacks have made any travel extremely dangerous.
the city of Ghazni, capital of the province, to select an appropriate location for In spite of the fact that the media and the international community seem to
the new project. However, the local authorities had no appropriate building have forgotten, the war in Afghanistan continues, along with our commitment
to offer, and to build a new hospital would take too long given the urgent to mitígate, if only in part, the suffering of the victims.
needs of the population. The generosity of a wealthy individual provided
the solution. The owner of a small supermarket donated the building, to be RM
remodeled for the FAP. After a couple of months under construction tiling, Translated by Michele Isernia
windows and doors, painting, construction of lavatories, and the selection of
the appropriate personnel the Ghazni FAP became operative on July 20th.

5
AFGHANISTAN Amongst the Victims Many Children Are Admitted to the Lashkar-gah Hospital

A Flower in the Midst of War

T
he corridors of EMERGENCY’s hospital in Lashkar-gah remind us For victims who are severely wounded, numerous blood transfusions are
of the human cost and consequences of the war in Afghanistan. required, and the hospital’s blood bank needs to be continually replenished.
Over the past thirty years, more than one and a half million people Usually after making their donation, parents or siblings of patients often return
have been killed, the majority being civilians. a few hours later with friends and relatives to also give blood.
Our hospital is the only one in the region which provides completely free-of-
charge surgical interventions. Gullandam, beautiful like a flower, in a Helmand
For the most part, the patients suffer injuries sustained while caught in the that can no longer claim to be a garden
middle of military combat, while stepping on one of the many landmines Yesterday, an Afghan nurse presented us with paperwork that we had not
spread throughout the region, or as they become victims of violence seen before. The father of Gullandam, a young girl who was under our care
associated with the drug trafficking trade. Others are wounded by air raids for the past few days, asked us to complete the paperwork out as soon as
conducted by international forces. possible.
NATO asserts that troops do their utmost to take precautions to avoid He is required to present the filled-out forms to officials in order to receive
civilian casualties. In the cases of civilian casualties, an investigation is compensation for the explosion that destroyed his family’s home.
conducted, and under the best of circumstances, civilians become eligible We take all the paperwork, and of course will help. As soon as it is filled out
for compensation. with the relevant information regarding the young girl’s condition, we go with
Our patients come not only from the city, but from all over the region. In Paola back to D-Ward, the children’s ward, where we locate the girl’s father,
order to reach our hospital, they travel on damaged roads on a journey that and return the papers to him.
can last days. Gullandam means beautiful like a flower, in Pashtun. She is in the garden
Some arrive at the First Aid Post in Grishk thanks to an ambulance service playing amongst the other hospitalized children. At 6 years of age, she has
which is open 24 hours a day. Many never arrive, partly because they die en already bravely faced the amputation of one leg, and many painful medical
route, and partly because after aerial bombing raids the Afghan army blocks procedures to save the other.
the roads not allowing the injured to pass through. And sooner or later, she will have to be told that she has also lost her
As in all of EMERGENCY’s hospitals, a red and white sign greets the mother, and that she no longer has a home to return to.
public as they enter, “We inform that all medical and surgical assistance is
free of charge for the patients”. The treatment is completely free, only a blood NADIA DEPRETIS
donation from the families of patients admitted to the hospital is requested. Translated by Roland Swan

6
SUDAN A Paediatric Centre in Darfur, Another Goal to Reach

Our Idea of Peace


The Our Idea of Peace fundraising campaign to begin construction of another EMERGENCY
health care centre, this time in Nyala, southern Darfur, for children under the age of 14,
ended last October. The Centre in Nyala will further expand EMERGENCY’s Paediatric and
Heart Surgery Program in Africa during 2009.

O
ver 1.5 million people live in Nyala, most of whom are The Paediatric Centre will be built on land offered by the South Darfur
refugees who fled the war. They live in camps surrounding authorities, in collaboration with the local Ministry of Health.
the city. Following a request by the local Ministry of Health, Last summer EMERGENCY carried out a feasibility study and assessed the
EMERGENCY decided to build a paediatric centre to offer high estimated costs for the structure and start-up costs at 600,000 Euros. This total
standard free of charge medical care 24/7 to children under the age of 14. became the target amount for our text message fundraising campaign.
The Centre will address prevalent illnesses such as malnutrition, respiratory
infections, malaria, and gastricgastrointestinal infections. The results coming in from the participating phone companies seem
It will implement immunization programs, and preventive efforts to combat to confirm that we’ve reached the targeted amount. This is an important
diseases such as rheumatic fever, in addition to providing health and hygiene achievement since it will help us continue our mission in Sudan and the
education for families. neighboring countries. As soon as we have the final results, we will publish the
final tally of funds raised.
The Centre will provide screening for patients suffering from heart disease
potentially requiring transfer to the Salam Cardiac Surgery Center in Khartoum In the meantime, we would like to thank everyone who has decided to
to undergo heart surgery. Post-operative monitoring and care will also be participate in helping us build this paediatric centre, working together with us to
guaranteed. concretely achieve Our Idea of Peace.
The Centre in Nyala will be part of EMERGENCY’s Paediatric and Heart
Surgery Regional Program, with the Salam Centre as its hub. Collaboration
with the Sudanese authorities – both Federal and South Darfur – has been ROSSELLA MICCIO
essential for this project. Translated by M.A.

7
SUDAN Fifteen Months after its Opening — An Update on the Salam Centre for Cardiac Surgery in Khartoum

A Comparison Between
Goals and Results

K
hartoum, July 2008. The temperature outside is about 45° From this large window overlooking
Celcius (113° Farenheit). The dry heat makes it a bit more the garden, light comes in as gazes go out
tolerable, but it is certainly not advisable to dwell too long For all of those who have followed the progress, and believed in this hospital
outside, even in the garden of the Salam Centre — a place from the very start, from when it was only a ‘crazy’ idea, it has confirmed the
that brings healing to the heart. transformation of a utopian dream into a reality - one rooted in the daily lives
This is a familiar place even to the patients of the Centre, who have organized of hundreds of people.
a creative alternative to ‘outdoor activities’. Every afternoon, once clinical I am talking to Raul about this large window.
activities quiet down, a ‘parlor room’ is created alongside the large window As the architect, he designed the window with the intention of bringing light
which separates the patients’ wards from the outside world. to the long corridor which faces the patients’ rooms.
The patients awaiting surgery, and the post-op patients who are able to Now, the patients have chosen it as a place of gathering and relaxation. It
mobilize, pull up some chairs near this large window, and spend the afternoon has become a case, one could say, of unplanned consequences to calculated
chatting there. Beyond the window, one can see the colorful seasonal flowers, actions. This novel use was approved and appreciated by the designer
the trees, the green lawn and bushes. Beyond, it is known that the Nile flows, himself, who for the time being does not delve too deeply into discussion
and although it cannot be seen, it is “sensed”. about the ‘diverse nature’ or ‘outcome’ of intended purposes.

8
This space was transformed by the patients into an Araghes the Ethiopian and Sarawit
area for chatting, a simple act which lightens tensions, the Eritrean: distant is the world that would like
favors understanding, and fosters friendships. to see them be enemies
It is where we often stop to talk with the guests The unique atmosphere of the Salam Centre makes sure that not only
of the Salam Centre do ethnic barriers disappear between the beds in the ward, but that also the
Barring complications, the average length of stay here in the hospital is linguistic difficulties due to the different nationalities be overcome.
about 10 days, which is sufficient time for people to get to know each other. Proof is the story of Sarawit, a very young girl from Eritrea, hospitalized for
It is amazing to see the behavioral transformation of the patients after just a mitral stenosis, and Araghes, an Ethiopian child brought here thanks to the
the first few days in the hospital. Initally, everyone looks lost, almost afraid. initiative of a group of Italian volunteers who collaborate with a hospital from
For many, the arrival to the Centre is like being left stranded on the moon. the congregation of Mother Theresa of Calcutta in Addis Ababa.
No relatives or ‘co-patients’, as they are called here, are allowed to visit Araghes speaks only Amarico, hence she had difficulties comunicating with
except on the consented days and times. the foreign doctors and nurses, as well as with the Sudanese personnel. But,
In the other local hospitals co-patients provide most of patient care, from her problems are solved thanks to the help of Sarawit who, besides Tigrino,
food to laundry, from personal care to even medications. also spoke Araghe’s language, and she becomes her interpreter.
Here, on the other hand, clean pajamas and showers in the rooms, three They were apart only during surgery and immediately afterwards.
free full meals per day, doctors and nurses, are all available 24/7. We suggested that they become ambassadors of their respective
The omnipresent white faces of the khawala (‘white’ people) administer to governments, which have been at war for about ten years now.
everything. We may have been joking, but… their relationship is no longer a joke,
After a few days, patients memorize names, begin to feel comfortable, and it is real.
even begin to trust the khawala.
Children, in particular, are the ones who develop the most immediate
rapport. And there are many children in our hospital, about 25% of the 937 A lesson from our first balance sheet —
patients hospitalized at Salam through the end of July 2008 have been something we ‘believed in’, is incredible
younger than 15. After a little over a year since its opening a draft of the activity summary for
the Salam Centre is available.
Despite the continual necessity for precautions to be taken, and with the
There is a long list of cases, difficulties and problems, inevitable problems encountered, we are pleased with the initial results.
and many solutions that have been researched Under the circumstances and given the difficulties, in 15 months time we
and found have been able to progress from one to three open heart operations per day.
The small group of teenagers who have been treated at the hospital since About 30 patients are examined daily for triage.
the beginning of July has truly been diverse. A third of these patients will then need a specialized visit with the
Wail, 14, arrived from Port Sudan. In addition to his young heart struggling cardiologist. Paradoxically, given the enormous distances in this country,
from the damage of recurrent rheumatic heart disease, he suffers from kidney news ‘by word of mouth’ has produced unexpected results.
and lung problems, so we anxiously await definitive signs of healing. More than 43% of the Sudanese patients in our hospital do not live in
Enas, is an 11 year-old girl, who weighed just 17 kilos (37.5 lbs) when she Khartoum, but arrive from one of the 25 states that make up the federation.
was hospitalized. Our cooks prepared a special diet for her over several days Even going beyond the Centre’s data and statistics, and the daily operational
to help her gain a body weight which she probably never had before…and at routines, the “life” of this hospital suggests a very comforting evaluation.
any rate, also to help her gain a few kilos before surgery. From the examination rooms to the office administration, from the labs to the
Osman “One” (to distinguish him from Osman “Two”), despite being only wards, from the kitchen to the laundry rooms, from the operating rooms to the
10 years old, is a veteran of the Salam Centre. He has been with us since pharmacy, one can clearly feel that the premises itself suggests the sense of
February, and has had treatment for his right ventricle. The right half of his being in a special place, in so many unique ways.
heart wasn’t functioning. More often than not, ‘Incredible!’ is the comment heard over and over by
Blood taken from the right atrium through a cannula was channelled back visitors to the Salam Centre for Cardiac Surgery, from the Sudanese, as well
with a pump to the pulmonary artery, to reach the lungs and to oxygenate. as from foreigners passing through Khartoum for work or vacation. For us this
Now he is ready, well enough to go back home to the state of Sinnar, south expression ’incredible’ reminds us of a daily effort, which began with an idea,
of Khartoum. He will be accompanied by his grandfather, who was staying in went on to be built, fully equipped and furnished and ultimately completed
the centre’s guesthouse during his grandson’s hospitalization. with the search and assembly of personnel.
Then there is the trio from Darfur. Saddam, 15, of Genina, West Darfur, It is an effort that continues on with a myriad of new and diverse problems
urgently hospitalized for a serious heart problem that was treated via (sanitary, logistical, technical) to be overcome each day.
replacement of the mitral valve and surgical repair of the tricuspid valve. But, after a brief pause by the large window that overlooks the garden, and
Curly haired, darke eyed Osmad “Two”, 9, is shy and introverted, and was an exchange of a few words in bizarre, improvised “mixed” languages with
one of the last of the group to be operated on. the national staff and patients, we all become part of the incredible vision
After surgery he was received with a round of applause when he was sensed by all visitors.
transported from the operating room to the intensive care unit where some
of his friends who had already undergone surgery the previous days were ROSSELLA MICCIO
recuperating. Translated by Rosalba Perna
Ali, the smallest of the group, and only nine years old, is from a small village
near Al Fashir, North Darfur. He also needed a mitral valve replacement and
surgical repair of the tricuspid valve.

9
SUDAN In Just Over Three Years More Than 56,000 Patients Have Been Treated in the Mayo Refugee Camp

First the Children

S
ince the EMERGENCY Paediatric Centre first opened its a rapid triage to evaluate any urgent care cases. Patients with malnutrition,
doors in December 2005, the camp has expanded and is now loss of consciousness, fever and severe respiratory problems are given high
surrounded by new homes, at best made from mud and plastic priority.
sheeting. They belong to new refugees from Darfur, and to old It seems as if it were summer. There are clear skies and the temperature
residents driven away from areas that are increasingly urbanised - always a is a dry, 28 degrees Celsius.
source of homelessness. But, this is their winter, and illnesses such as bronchitis and asthma are
From the hospital’s water tower, the grim view of the camp is a vast sea of common, just as in any outpatient ward in Italy during this time of year.
shacks, extending as far as the eye can see, with dust and dirt everywhere. Many are suffering the consequences of living under inhumane conditions
Although only a mere 12 km from dowtown Khartoum, we are very far from in the camp.
the skyscrapers dominating the heart of the city. Malnutrition, conjunctivitis, and urinary tract infections are among the most
Our Centre is situated in an area of the camp called Angola, which is common maladies. Diarrhoea is a consequence from drinking the water from
populated by roughly fifty thousand people, fifty per cent are children. When the donkey tank. Water is sold and distributed house to house from a large
it first opened three years ago, the Centre’s objective was to guarantee free tank transported by mule. It costs between 200 and 300 dinar depending on
medical treatment to the more immediate community in the area. the vendor. Daily wages are roughly 1000 dinar.
Now, patients arrive from the rest of the refugee camp as well as far off
neighbourhoods. In the Outpatient Ward, three nurses and two doctors work An Urgent Transfer Leaves Us
with a pharmacist, along with a lab technician who performs urgent blood With More Questions Than Hope
tests -- all under the supervision of an international paediatric nurse. Every day our staff examines fifty children, and those requiring observation
Mothers and children arrive at six o’clock in the morning and are seated stay in the ward until closing time. “The Centre has to close at 4:00 PM due
under a protected outdoor veranda. to security reasons”, explains Attilia. “At night the men get intoxicated on
As they await their turn, they are neat, poised and beautiful in their colourful araki, a distilled alcohol with an extremely potent effect, and it is better not to
clothing. Attilia, the international nurse, together with the local nurses carry out stay around the area”. The more severe cases are transferred to the two city

10
hospitals, the Khartoum Hospital and the Bashir Hospital. Thanks to the No reaction, he keeps his eyes half closed, and does not even whimper. We
working experience with the Mayo EMERGENCY Paediatric Centre, the arrive at Khartoum Hospital, a chaotic and dirty place where, even for Attilia
government of Khartoum passed legislation that all care for paediatric who comes here often, it is difficult to orient oneself.
emergency medical cases be provided free of charge. In a large, half lit room, five doctors seated at their desks examine their
A mother brings in her child wrapped in a colourful cloth. As soon as she young patients surrounded by a throng of mothers coming and going with their
opens her little bundle, his emaciated face reveals that we are clearly faced children. One female doctor quickly checks the baby and asks the mother and
with a very ill infant. “He’s not well, he hasn’t been eating for the past week”, Attilia a few questions. He will be admitted and undergo an antibiotic and an
she says. But the skeletal body, and lack of strength confirms evidence of intensive nutrition treatment.They assure us that “he will make it.”
long term malnutrition. At forty days old, the baby weighs only 2 kg. The infant I ask myself how many more times will this little baby have to “make it”
is suffering from an infection, running a 40 degree fever, and does not even in order to survive life in Mayo Camp to reach age 5, and survive the infant
have the strength to cry. mortality statistics of this country.
“After the operation, he stopped eating, and is becoming more and more
lethargic”. The operation she refers to is the procedure performed by one of
the twenty tribes living in the camp which believe that by cutting the uvula SIMONETTA GOLA
and palette of a newborn, regurgitation can be prevented. Every newborn Translated by Roland Swan
undergoes the procedure. “Imagine a procedure of this sort, most likely
performed in the middle of the street in a place like this, with instruments
being washed in the camp’s water”, says Attilia, who periodically sees these
cases. The ambulance is ready to go, and we immediately transport mother
and child to the Khartoum Hospital.
During the trip, Attilia asks me to try to stimulate the infant by stroking a pen
along the bottom of his feet, while she keeps the oxygen mask ready for use.

11
CENTRAL AFRICAN REPUBLIC News in the Regional Programme for Paediatric Care and Cardiac Surgery

Good Morning Bangui


Each day the staff at the Paediatric Centre in Bangui provides free specialized assistance
to forty children. Thanks to periodic visits to the Centre by the international cardiologists,
patients can be screened to determine whether they require surgery at the Salam Centre for
Cardiac Surgery. The required post-operative follow-up care is also guaranteed.

12
I
t is Friday, 6 March 2009, 9:30 AM. “The promise has been kept,”
declares Francois Bozizé, the President of the Central African
Republic. Together with the Prime Minister, the President of the
National Assembly, and the foreign ambassadors present in the
country, Bozizé attended the inauguration of the Paediatric Centre in Bangui,
a new development in EMERGENCY’s Paediatric Care and Cardiac Surgery
Programme in Africa.
The government of the Central African Republic had immediately provided
aid and support for the project, granting EMERGENCY use of a centrally
located plot of land near the Parliament buildings. This is where the Paediatric
Centre would be built. Construction began in March 2008. The project was
assigned to a Central African company that carried out the plans to perfection,
respecting the deadlines and the predetermined budget.
Finally, the Paediatric Centre was ready for its inaugural opening. With
its red and white coloured external walls, its surface area covers 550
square meters. It includes an internal patio transformed into a play area
with an imaginary grassy plains mural filled with toy crocodiles, rhinoceros,
elephants…
The Centre, which is open 24 hours a day, seven days a week, offers
medical assistance to children up to 14 years of age. Immunisation and
health and hygiene education programmes are also offered.
During periodic evaluation missions, in the cardiology ward EMERGENCY’s
international specialists come to screen and evaluate patients suffering from
heart disease to determine those in need of transfer to the Salam Centre
in Khartoum for treatment. After surgery, the patients are guaranteed post-
operative check-ups at the Centre in Bangui.

In Bangui, Like Goderich and Khartoum: Malaria


and Diarrhoea are the Most Common Diseases
News of the opening of the Bangui Paediatric Centre spreads rapidly by
word of mouth. In a scene similar to those in other EMERGENCY Pediatric
Centres - such as in Khartoum, Sudan and in Goderich, Sierra Leone - from
the early morning hours mothers and children crowd the entrance of the
hospital, awaiting their turn to be examined.
Each day, Paola a paediatric nurse, and Mariella a paediatrician, assisted
by local doctors and nurses, examine forty children on average. With six
beds in the Centre, the doctors are able to admit serious cases overnight,
as needed. Just one day after its opening, the first patient was admitted.
His name was Jonathan, who at 22 months was weighing in at only 7 kilos.
He arrived suffering from dehydration due to severe persistent diarrhoea. As
soon as he reached the Centre, doctors immediately initiated oral rehydration
treatment, and proceeded with blood tests for Malaria, which came back
positive. Together with his father who accompanied him, Jonathan will
christen the clinic’s new toys with the hope of going back home soon.

PIETRO PARRINO
Translated by Roland Swan

13
CAMBODIA Against Violence, Landmines and Accidents — Three Stories of Human Resistance

Cambodian Triptych
A plastic surgeon details his encounter with a few patients he treated during his work at the
Surgical Centre in Battambang bringing to awareness the difficulty of living the consequences
of war, and facing new cruel realities.

T
hree girls — three stories from this ill – fated country’s history What was revealed was a disfiguring two centimeter thick scar, banning
spanning half a century. any type of facial movement. Her eyelids were now non-existent due to the
The experiences of these three girls would be very unlikely to disabling scar, and the eye was wide open, with no protection of an eyelid,
happen in Italy, but if they were to occur, the detrimental effects and already covered with sores. Her lower lip was fused to her chin, as was
of the injuries sustained would be treated through an advanced health care her upper lip to the side of her nose.
system, and their lives would be supported by social and public assistance. She was only 19 years old. Three years ago, Nhom was raped and
In Cambodia these social infrastructures do not exist, at best there might be a impregnated by a man in her village, who then decided to marry her. In the
fragile, and not always available family support system to help. two years following the birth of her first child, there were two more births.
Already faced with difficult lives, these three young women, having And then, all of a sudden the man announced that he was going to Thailand
undergone physical surgical reconstruction and prosthetic rehabilitative to find work. Left alone, Nhom Vun found work in the rice fields. But once
training now find themselves facing the added burden of not having full use the harveting season ended, she had to find other work. She began to pack
of their own bodies. EMERGENCY assisted them in their rehabilitation, and and sell sweets, and earn good wages compared to the average Cambodian
then when feasibly possible, in job placements, or by some small donations. salary. The husband, who had actually moved in with another woman in
But the biggest feats were overcome by their own courage, which was key a nearby village, now revealed a renewed interest in Nhom, and her new
to their recovery. prosperity.
In order to prevent any type of reconciliation between the two, the jealous
A disfigured face due to jealousy — lover attacked Nhom by thrusting a bottle of acid over her face. At our initial
Then surgery and a job towards a new life consultation, I informed Nhom right away that one procedure would not be
When I first saw Nhom Vun in the front garden of the emergency department, enough to restore a normal physical appearance, and that there would really
only half of her face was visible. Like most young Cambodian women, she be no hopes to totally erase all the effects resulting from the acid burns. I
had fine, gentle features. She kept the other half of her face oddly concealed began the surgical intervention with the reconstruction of her eyelid, in order
with a towel which she uncovered as soon she entered the examining room. to try to avoid loss of the eye. Removing the scar tissue, I realised that some

14
that some of the muscles of the eyelid had been damaged, but still existent. lower limbs, loss of an eye and various wounds to her face.
So I began to reconstruct the eyelid with strips of tissue and cartilage from The amputations were corrected by our orthopaedic surgeons in order to
behind the ear. The few remaining muscles would allow movement of the allow fitting of prosthetic limbs. I was responsible for the reconstruction of the
eyelid, thus restore opening and closing of the eye. orbital cavities. Two operations would be necessary: removal of scar tissue,
The second procedure began by removing the scar tissue over the lips, and enlargening of the ocular cavitiy for fitting of a prosthetic eye.
where I would have to proceed with a skin graft taken from the back of the Three days before my departure Den Srey received her prosthetic eye,
undamaged ear. Her lips began to regain some mobility, even though she a necessary step in restoring her face with a certain degree of physical
would need further corrective surgical intervention on her lower lip. normalcy. While waiting for her leg stumps to heal so she can be fitted with
Returning to Battambang this year, I encountered Nhom Vun in the hospital. prosthetic limbs, her husband takes her home - where another new beginning
She wasn’t there for a check-up, but as an employee. She was hired there awaits them.
as an orderly. EMERGENCY frequently employs its patients to help them
socially reintegrate, especially those patients having undergone particularly Two wigs for Proeung
traumatic experiences. Even hair becomes a form of treatment
The medical coordinators say that everyone is extremely happy with her Proeung Sreyrotha was 16 years old when I met her last year. She was
work, and the patients really appreciate her. Every time we pass each other in harvesting rice when she got too close to the fanbelt of a threshing machine.
the corridor, she shares with me the gift of a beaming smile. The reconstructed Her entire scalp was ripped from her skull - from her eyebrows to her cervical
half of her face is not as graceful as the other [undamaged] half, but mobility vertebrae. In the West, depending on how intact the affected skin is, we
is close to normal. I am happy to have been able to contribute to providing this treat these cases by surgically reattaching the ripped scalp, and through
young woman with the chance to a social life. microsurgical anastomosis, re-establish the blood circulation to the damaged
skin.
An accident at the beginning of a new life — However, in Cambodia, the proper surgical apparatus for microsurgery is
Landmines don’t know when war has ended unavailable. So in order to treat Proueng’s condition, she had to undergo
Den Srey Mao is 20 years old, and she has only been married for a few several skin graft surgeries to the damaged area, a method no longer practiced
months to a man so tall and athletic that he does not seem Cambodian. Their in Europe for over 40 years. After 6 operations and much painful medication,
families had given them a small parcel of land with a few animals (chickens, we finally managed to cover Proeung’s skull with a layer of hairless tissue.
ducks and goats) as a wedding gift in order for them to begin their new lives Some time later, in a very moving and emotional ceremony of sorts, we
together. They were farming vegetables on the land to sell at the market so presented her with two gifts. We gave her two wigs - one with short and the
that they could earn enough to buy a pig at the end of the year. other with long hair - so that she can continue to carry out her life as a normal
One day while walking to it along the pathway which had undergone young girl.
landmine clearance two years earlier, and which she had passed through
countless times before, the young woman saw something strange on the PAOLO SANTONI-RUGIU
ground. It was too late, she was unable to avoid stepping on it. It was a Translated by Roland Swan
landmine which had been washed onto the path by heavy rains in the previous
days. Dan Srey arrived at the hospital with traumatic amputation of both her

15
INTERNATIONAL Human Rights

Worldwide Malnutrition
Malnutrition and undernutrition are some of the effects of a global imbalance that has caused
recent alarm in the political world (under pressure from the speculative push to finance
raw material and consumer markets) especially among those where access to basic food
resources has been undermined.

W
hen the cost of bread rises excessively, revolts break out
for tortillas in Mexico, and mud cookies are baked in Haiti,
then we know that we are facing the disastrous effects of
a global financial manoeuvre that threatens the health and
even the lives of a large portion of the global population.
Even now, according to the Health World Organization, half of all human
beings – about 3 billion people – suffer from some form of malnutrition, a word
with various, but always worrisome, meanings.

In fact, this term is used to indicate an imbalance in the absorption of nutrients


and other factors necessary for a healthy life; this could be undernutrition – lack
of proteins vitamins or minerals, or overnutrition. In developing countries, one
person in five suffers from the worst form of malnutrition: hunger.

Grains produced for livestock feed rather


than human consumption
It is well known that malnutrition is due mainly to unequal access to food
resources rather than to insufficient food production. In fact, current agricultural
production could easily nourish the entire world population. The problem is
certainly underestimated, considering that a large portion of food resources is
diverted to animal feed instead of being utilized as food for the hungry.

Agricultural strategies adopted in recent years have resulted in complete


failure. Public and private institutions have actively promoted large-scale cattle Food subsidies help donor countries and undermine
ranching in developing countries for production of meat and milk, without local economies
considering that farmed animals consume more calories than they produce in Non-governmental international organizations that fight world hunger are in
the form of meat, milk and eggs. ferment to counter the steady increase in basic food prices.
Oxfam and CARE, for example, are running worldwide campaigns to raise
When the quarrel about biofuels and conversion of crops for their production awareness and increase political pressure.
had not yet started, it was already evident that cereals were produced and In fact, the forecasts of their experts indicate that predicted Eastern and
introduced in the market in large part to raise cattle rather than to satisfy Western African tragedies could be avoided by immediate action on the part of
human nutritional necessities. governments of wealthy countries.
“Food aids can save many lives”, says Ariane Arpa, responsible for
Official statistics, from FAO (the Food and Agriculture Organization of the the Spanish Intermón Oxfam, “Unfortunately, the interests of Western
United Nations) and WHO (the World Health Organization) in particular, clearly governments, tied with those of powerful agricultural groups and packaging/
point out that a shift in cereal production for human consumption to animal feed shipping companies, frequently cause aid to arrive too late, at very high prices,
has forced developing countries to import grains at high cost, greatly worsening often destabilizing weak local economies”.
the problem of malnutrition. In fact, in developing countries, staple foods are The humanitarian organization Oxfam has posted suggestions to remedy
mainly cereals and legumes, which provide the majority of carbohydrates and these issues at www.oxfam.org.
proteins necessary for survival. In summary the suggestions are: increase donor as well as local
governments investment in small-scale agriculture (especially in sub-Saharan
In a paradox, this diet that could be adopted in industrialized countries with African countries), cut incentives for biofuel production, and convince the USA
great health advantages, is now overlooked even in its traditional countries and EU to review their emergency food aid policies and focus assistance on
of origin. Those who can afford it prefer a more occidental diet, where the countries suffering the most serious consequences.
majority of the protein requirement derives from meat. ANGELO MIOTTO
Translated by Ada Buvoli

16
EMERGENCY
Director Carlo Garbagnati Every year war and poverty destroy the lives of millions of people.
Editorial Office Simonetta Gola
Collaborators on this issue Marco Antonsich In contemporary conflicts, 90% of the victims are civilians.
(MA), Ada Buvoli, Marina Castellano, Paolo Since 1994, over three million patients have been treated in EMERGENCY’s
Chiappetta, Graziella B. Costanzo, Nadia
Depretis, Maureen Cairns, Robert Dvorak,
clinics, hospitals and rehabilitation centres located in war-torn areas.
Janet Garcia, Anna Gilmore, Simonetta Gola,
Michele Isernia, Rossella Miccio (RM), Angelo
Miotto, Rosalba Perna, Dada Pisconti, Paolo
Santoni-Rugiu, Roland Swan. EMERGENCY is an independent, neutral and non-governmental organisation
Images Emergency’s Archive, Piergiorgio that provides free medical and surgical care to the victims of war, landmines
Casotti, Cosimo Maffone, Samuele Pellecchia,
Naoki Tomasini. and poverty worldwide.
Graphic and pagination Angela Fittipaldi,
Guido Scarabottolo.

All EMERGENCY hospitals, clinics and rehabilitation centres are designed,


built and managed by international personnel committed to professionally
train national staff.
For more information contact:

EMERGENCY ITALY
via Meravigli 12/14, 20123 Milano
The articles featured in this issue were translated from articles that
Tel. 02 881881 appeared in EMERGENCY’s magazine, issues 48, 49 and 50:
Fax 02 86316336
E-mail info@emergency.it
http www.emergency.it
via dell’Arco del Monte 99/a, 00186 Roma
Tel. 06 688151 Training for Critical Care Units, September 2008 (48): 2-3
Fax 06 68815230 The Consequence of War, September 2008 (48): 4
E-mail roma@emergency.it
http www.emergency.it Restarting and Expansion, September 2008 (48): 5
A Comparison between Goals and Results, September 2008 (48): 8
EMERGENCY USA
4910 Massachusetts Avenue NW, Suite 300 Worldwide Malnutrition, September 2008 (48): 14-15
Washington, DC 20016 – T +1 888 501 EUSA Our Idea of Peace, December 2008 (49): 12
info@emergencyusa.org - www.emergencyusa.org
Good Morning Bangui, March 2009 (50): 2-3
EMERGENCY UK A Flower in the Midst of War, March 2009 (50): 9
PO Box 62437, London, E14 1GA
T +44 (0) 333 340 6411
First the Children, March 2009 (50): 10-11
info@emergencyuk.org - www.emergencyuk.org Cambodian Triptych, March 2009 (50): 14-15

Data Protection Notice — ITALY Data Protection Notice — USA Data Protection Notice — UK
EMERGENCY – Life Support for Civilian War EMERGENCY USA – Life Support for Civilian EMERGENCY UK, with registered offices at
Victims ONG ONLUS, with registered offices Victims of War and Poverty, with registered offices Flat 58, St. David’s Square, E14 3B London,
at Via Meravigli 12/14, 20123 Milan, Italy, in at 4910 Massachusetts Avenue NW, Suite 300, U.K., in its capacity as owner of the data
its capacity as owner of the data processing, Washington, DC 20016, USA, in its capacity as processing, will process your personal data
will process your personal data manually and in owner of the data processing, will process your manually and in electronic form for the
electronic form for the purposes of informing on personal data manually and in electronic form purposes of informing on its institutional
its institutional activity and for administrative for the purposes of informing on its institutional activity and for administrative reasons as a
reasons as a result of your donations to the activity and for administrative reasons as a result result of your donations to the organization.
organization. The provision of your personal of your donations to the organization. The The provision of your personal data is not
data is not mandatory. However, the failure to provision of your personal data is not mandatory. mandatory. However, the failure to provide
provide such data or the subsequent withdrawal However, the failure to provide such data or the such data or the subsequent withdrawal of the
of the authorization to process your personal data subsequent withdrawal of the authorization to authorization to process your personal data
will prevent us from processing your data for the process your personal data will prevent us from will prevent us from processing your data for
purposes indicated above. Your personal data processing your data for the purposes indicated the purposes indicated above. Your personal
may be disclosed to third parties, also in foreign above. Your personal data may be disclosed data may be disclosed to third parties, also in
countries and outside the European Union, only to third parties, also in foreign countries and foreign countries and outside the European
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You will be entitled to exercise the rights granted with the purposes indicated above. You will be indicated above. You will be entitled to exercise
by Article 7 of Legislative Decree No. 196/2003 entitled to exercise the rights granted to you by the rights granted to you by law by addressing
by addressing your request to EMERGENCY law by addressing your request to EMERGENCY your request to EMERGENCY UK, P.O.
ITALY, Via Meravigli 12/14, 20123 Milan, Italy, USA, 4910 Massachusetts Avenue NW, Suite Box 62437, London, E14 1GA, ATTN: Mr.
ATTN: Ms. Mariangela Borella. 300, Washington, DC 20016, USA, ATTN: Ms. Gianluca Cantalupi.
Graziella B. Costanzo.

17
LOCAL VOLUNTEER GROUPS

Volunteering is a fundamental and essential component of EMERGENCY’s work. Volunteers work to inform
the general public and promote a culture of peace through participation in conferences, meetings and workshops
in schools and in workplaces. Volunteers are key to fundraising by hosting dedicated events, presenting specific
projects to local agencies, organisations and businesses, or manning booths at larger events.

SVIZZERA Gruppo di Cologno Monzese - MI Gruppo di Pavia Gruppo di Udine Gruppo di Cesena - FC
Gruppo del Canton Ticino 347/9669024 346/3307054 0432/580894 - 339/8268067 329/2269009
0041/787122941 emergency_cologno_monzese@ emergencypv@hotmail.com emergencyudine@libero.it emergencycesena@tiscali.it
emergency-ticino@bluewin.ch yahoo.it
Gruppo di Vigevano - PV Gruppo dell’Alto Friuli - UD Gruppo di Modena
Gruppo di Magenta - MI 0381/690866 - 328/4237529 0433/51130 - 347/3172702 059/763110 - 347/5902480
VAL D’AOSTA 335/77507444 emergencyvigevano@tiscali.it emergencyaltofriuli@tiscali.it emergencymodena@gmail.com
Gruppo Aosta emergencymagentino@gmail.com
340/9471701 Gruppo della Valtellina - SO Gruppo di Fanano - MO
emergency.aosta@libero.it Gruppo Martesana - MI 0342/684033 - 320/4323922 TRENTINO ALTO ADIGE 348/4446120 - fax 0524/680212
393/2736362 - 02/9504678 emergency.valtellina@virgilio.it Gruppo di Trento emergencyfanano@libero.it
emergency.martesana@tatavasco.it 347/9822970
PIEMONTE Gruppo di Varese emergencytrento@yahoo.it Gruppo di Parma
Gruppo di Torino Gruppo di San Giuliano - MI 334/1508540 - 333/8912559 0521/873235 - fax 0521/371631
338/8922094 338/1900172 emergencydivarese@gmail.com Gruppo dell’Alto Garda - TN emergencyparma@polaris.it
emergency.to@inrete.it emergencysgm@hotmail.com 347/4091769
Gruppo di Busto Arsizio - VA emergencyaltogarda@hotmail.it Gruppo di Piacenza
Gruppo di Pinerolo - TO Gruppo di San Vittore Olona - MI 0331/341424 0523/617731 - 339/5732815
334/7925925 0331/516626 emergencybustoarsizio@virgilio.it Gruppo di Rovereto - TN emergencypc@virgilio.it
emergencypinerolo@rifugiosella.it emergencysanvittoreo@libero.it 339/1242484
emergencyrovereto@libero.it Gruppo di Faenza - RA
Gruppo di Alessandria Casale Gruppo di Saronno - MI VENETO 347/6791373
335/7182942 - 0142/73254 339/7670908 Gruppo di Venezia Gruppo della Valli di Fiemme emergencyfaenza@yahoo.it
emergency.al@libero.it emergencysaronno@gmail.com 347/9132690 e Fassa - TN
emergencyve@gmail.com 347/6805029 Gruppo di Reggio Emilia
Gruppo di Asti Gruppo di Sesto San Giovanni - MI emergencyfiemmefassa@yahoo.it 0522/555581 - 348/7152394
0141/853487 - 348/5131104 335/1230864 Gruppo delle Città del Piave - VE emergency.re@fastwebnet.it
emergencyasti@libero.it emergencysesto@emergencysesto.it 335/7277849 - fax 0421/560994 Gruppo di Bolzano
emergencycittapiave@libero.it 339/6936469 Gruppo di Rimini
Gruppo di Biella Gruppo di Settimo Milanese - MI emergencybolzano@yahoo.it 335/7330175
349/2609689 02/3281948 - 333/7043439 Gruppo di Spinea VE grupporimini@gmail.com
emergencybiella@gmail.com emergencysettimomi@virgilio.it 041/994285 - 339/3353868
emergencyspinea@interfree.it LIGURIA
Gruppo di Cuneo Gruppo di Usmate Velate - MI Gruppo di Genova REPUBBLICA SAN MARINO
334/3154926 039/673324 - 039/672090 Gruppo di Belluno 010/3624485 Gruppo de San Marino
emergencycuneo@gmail.com emergencyusmatevelate@virgilio.it 348/7793483 emergencygenova@libero.it 335/7331386
emergency.belluno@yahoo.it emergency.sanmarino@libero.it
Gruppo di Novara Gruppo di Bergamo Gruppo del Tigullio - GE
339/2300266 338/7954104 Gruppo di Padova 0185/288400 - 349/4525818
emergencynovara@yahoo.it info@emergencybg.org 348/5925163 emergencytigullio@libero.it TOSCANA
emergencypadova@hotmail.it Gruppo di Firenze
Gruppo di Arona - NO Gruppo di Isola Bergamasca - BG Gruppo di Riviera dei Fiori - IM 334/7803897
335/6005077 - 328/8229117 320/0361871 Gruppo di Rovigo 340/7708004 info@emergency.firenze.it
emergency.arona@virgilio.it emergencyisolabg@libero.it 348/5609005 emergencyriviera@libero.it
emergencyrovigo@libero.it Gruppo di Empoli - FI
Gruppo di Verbania Gruppo di Brescia Gruppo di La Spezia 338/9853946 - 333/3047807
348/7266991 335/1767627 - 333/3289937 Gruppo di Treviso 349/3503695 emergency-empoli@libero.it
emergency.verbania@libero.it info@emergencybs.it 333/4935006 - 340/5901747 emergencylaspezia@gmail.com
emergency_treviso@yahoo.it Gruppo di Rignano sull’Arno - FI
Gruppo di Lago D’Orta VB Gruppo di Crema - CR Gruppo di Savona 339/1734165 - 338/4609888
339/698808 335/6932225 - 335/7119651 Gruppo di Verona 347/9698210 emergency-rignano@email.it
emergencylagodorta@libero.it emergency.crema@gmail.com 334/1974348 emergencysavona@libero.it
emergency.vr@libero.it Gruppo di Sesto Fiorentino - FI
Gruppo di Como
055/4492880 - 339/5841944
333/6163586
LOMBARDIA Gruppo di Vicenza emergencysestofiorentino@gmail.com
emergencycomo@hotmail.com
Gruppo della Brianza - MI 333/2516065 EMILIA ROMAGNA
340/7784875 Gruppo di Lecco - Merate info@emergencyvicenza.it Gruppo di Bologna Gruppo di Arezzo
info@emergencybrianza.it 329/0211011 333/1333849 348/6186728
emergencylecco@libero.it Gruppo di Asiago - VI emergencybologna@virgilio.it emergencyar@virgilio.it
Gruppo del Naviglio Grande - MI 333/6883280
339/8364358 - 334/3175776 Gruppo di Lodi emergencyasiago@tiscali.it Gruppo di Imola - BO Gruppo di Grosseto
emergency.buccinasco@libero.it 340/0757686 - 335/8048178 0542/42448 - 339/7021931 339/4695161
emergencylodi@yahoo.it Gruppo di Thiene - VI emergencyimola@libero.it info@emergencygr.it
Gruppo di Cinisello Balsamo - MI 349/1543529
348/0413702 Gruppo di Mantova emergencythiene@tiscali.it Gruppo di Ferrara Gruppo di Follonica - GR
emergency.cinisello@email.it 0376/223550 - 320/0632506 333/9940136 339/4695161
emergencymantova@virgilio.it emergency.fe@libero.it emergencyfollonica@ouverture.it
Gruppo della Valle del Seveso FRIULI VENEZIA GIULIA
- MI Gruppo di Monza Gruppo di Trieste Gruppo di Forlì - FC Gruppo del Monte Amaita - GR
348/2340467 334/8670307 347/2963852 338/4822684 - 335/5869825 347/3614073 - 347/6481865
emergencyvalleseveso@libero.it emergency.monza@inwind.it emergencytrieste@yahoo.it emergency.forli@libero.it emergencymonteamiata@yahoo.it

18
Gruppo di Livorno Gruppo di Fabriano - AN Gruppo di Avellino - Benevento SARDEGNA EMERGENCY USA EM
333/1159718 - 346/2318650 0732/4559 - 335/5753581 347/1621656 - 329/2047329 Gruppo di Cagliari info@emergencyusa.org info
emergencylivorno@katamail.com emergencyfabriano@libero.it emergency_montemiletto@virgilio.it 339/3365958
emergency.cagliari@gmail.com Atlanta, GA Atla
Gruppo di Piombino - LI Gruppo di Jesi - AN Gruppo di Caserta Atlanta@emergencyusa.org Nic
329/8741625 - 380/2599437 349/4944690 - 0731/208635 335/1373597 Gruppo di Serrenti - CA Atla
emergencypiombino@libero.it emergency.jesi@aesinet.it emergencycaserta@katamail.com 347/1411284 Boston, MA
emergency.serrenti@gmail.com Boston@emergencyusa.org Bos
Gruppo di Lucca Gruppo di Ascoli Piceno Gruppo dell’Altocasertano - CE Sou
0583/578318 - 349/6932333 335/5627500 333/7370000 Gruppo di Budoni - Nuoro Boulder, CO Bos
emergencylucca@yahoo.it emergencyascolip@libero.it altocexemergency@virgilio.it 329/4211744 - 347/6416169 Boulder@emergencyusa.org
emergencynuoro@libero.it Bou
Gruppo della Versilia - LU Gruppo di Fermo
Gruppo di Pagani - Salerno Chicago, IL Dad
328/2062473 328/4050710
338/6254491 - 347/9105378 Gruppo dell’Ogliastra Chicago@emergencyusa.org Bou
emergencyversilia@yahoo.it emergency.fermo@libero.it
emergencypagani-prsa@libero.it 320/676282
Gruppo di Massa Carrara Gruppo di Fano - PU ogliastra.emergency@libero.it Denver, CO Chi
349/8354617 - 329/5733819 0721/827038 - 338/2703583 Gruppo di Agropoli - Denver@emergencyusa.org Ge
emergencymassacarrara@gmail.com emergencyfano@yahoo.it Vallo di Lucania - SA Gruppo di Milis - OR Chi
339/1222497 - 339/3335134 0783/51622 - 320/0745418 Los Angeles, CA
Gruppo di Pisa emergency_agropoli@virgilio.it emergencymilis@hotmail.com LA@emergencyusa.org Den
320/0661420 UMBRIA maria91@libero.it Jas
info@emergencypisa.it Gruppo di Perugia Gruppo di Macomer - OR Northern California den
075/5723650 389/9726753 NorthernCA@emergencyusa.org
Gruppo di Volterra - PI emergencyperugia@yahoo.it BASILICATA emergency.macomer@tiscali.it Los
349/8821421 Gruppo di Latronico - PT New York, NY Ma
emergencyvolterra@virgilio.it Gruppo di Città di Castello - PG 339/7980173 - 339/2955200 Gruppo di Sassari NYC@emergencyusa.org LA@
347/1219021 emergency.latronico@libero.it 079/251630 - 339/3212345
Gruppo di Pistoia emergencycittadicastello@yahoo.it emergencysassari@yahoo.it Pittsburgh, PA Nor
348/8401412 Gruppo di Matera Pittsburgh@emergencyusa.org Jak
emergencypt@interfree.it Gruppo di Foligno - PG
329/5921341 Gruppo di Alghero - SS Nor
0742/349098
emergency-matera@inteldata.biz 347/9151986 Washington, DC
Gruppo dell’Altopistoiese - PT emergencyfoligno@libero.it
algheroemergency@tiscali.it DC@emergencyusa.org New
329/6503930
Gruppo di Gualdo Tadino - PG Gruppo di Policoro - MT Eric
emergency.altopt@tiscali.it
333/8052884 0835/980459 Gruppo di Olbia - SS NY
Gruppo di Prato emergencygualdotadino@yahoo.it emergencypolicoro@libero.it 0789/23715 - 347/5729397 EMERGENCY UK
339/1857826 insiemergencyolbia@tiscali.it info@emergencyuk.org Pitt
emergency.prato@tiscali.it Gruppo di Spoleto - PG Chi
340/8271698 PUGLIA London, UK Pitt
Gruppo di Siena Valdelsa emergencyspoleto@libero.it Gruppo di Bari SICILIA info@emergencyuk.org
340/5960950 340/7617863 - 329/9493241 Gruppo di Palermo Wa
emergencysienavaldelsa@virgilio.it Gruppo di Terni emergency_bari@libero.it 320/5592867 - 091/333316 Shi
320/2128052 emergency.pa@libero.it DC
emergency_tr@libero.it Gruppo di Bitonto - BA
LAZIO 080/3744455 - 333/3444512 Gruppo di Campobello di Licata
Gruppo di Tivoli - RM Gruppo di Orvieto - TR emergency@bitonto.net 339/8966821 EM
347/1640390 329/6197364 emergency.campobello@libero.it info
volontari_tivoli@yahoo.it emergencyorvieto@libero.it Gruppo di Molfetta BA
340/8301344 Gruppo di Catania Lon
Gruppo dei Castelli Romani - RM
emergencymolfetta@libero.it 348/5466769 - 339/4028577 Gia
328/2078624 - 347/5812073 ABRUZZO emergencycatania@virgilio.it
castelli.rm.emergency@gmail.com Gruppo di L’Aquila Gruppo di Foggia
349/2507878 340/8345082 - 0881/756292 Gruppo di Caltagirone - CT
Gruppo di Rieti emergencylaquila@libero.it
328/4271644 emergencyfoggia@libero.it 328/2029644
emergencyrieti@hotmail.com emergency.caltagirone@yahoo.com
Gruppo dell’Alto Sangro - AQ Gruppo di BAT
348/6959121 347/2328063 Gruppo di Piazza Armerina - EN
Gruppo di Colleferro - FR emergencyaltosangro@gmail.com
335/6545313 emergencybat@tiscali.it 347/8829781
emecolleferro@libero.it emergencypiazza.a@virgilio.it
Gruppo di Avezzano - AQ Gruppo di Pr. Brindisi - BR
328/8686045 339/4244600 Gruppo di Messina
Gruppo di Cisterna - LT emergencyavezzano@virgilio.it
333/7314426 emergencytorress.br@libero.it 090/674578 - 348/3307495
emergency.cisterna@gmail.com messinaperemergency@hotmail.com
Gruppo di Pescara Gruppo di Lecce
328/0894451 328/6565129 - 349/5825203 Gruppo di Vittoria - RG
Gruppo di Formia - LT emergencypescara@virgilio.it
340/6662756 emergencylecce@libero.it 338/1303373
emergencyformia@libero.it emergencyvittoria@tiscali.it
Gruppo di Teramo Gruppo di Nardò - LE
333/5443807 338/3379769 Gruppo di Siracusa
Gruppo di Monte San Biagio - LT emergencyteramo@hotmail.it
329/3273024 emergencynardo@tiscali.it 349/0587122
emergencymsb@libero.it emergency.siracusa@libero.it
MOLISE Gruppo della Valle d’Itria - TA
Gruppo di Cassino - FR Gruppo di Isernia 328/7221897 - 328/6990572 Gruppo di Trapani
339/7493563 - 347/5324287 333/2717553 emergency_martinafranca@yahoo.it 0923/539124 - 347/9960368
cassinoxemergency@libero.it emergency_isernia@yahoo.it emergency.trapani@libero.it

Gruppo di Vetralla - VT Gruppo di Campobasso CALABRIA


340/7812437 392/3460870 Gruppo di Cosenza
vetrallaperemergency@gmail.com emergencycampobasso@gmail.com 338/9506005 - 349/2987730
cosenzaxemergency@yahoo.it

MARCHE CAMPANIA Gruppo di Catanzaro


Gruppo di Ancona Gruppo di Napoli 393/3842992
328/8455321 339/5382696 emergencycatanzaro@gmail.com
emergencyancona@libero.it emergencynapoli@libero.it

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