Army Calvery Wear 2010

Benin Mission 2009: A successful operation

Vous avez suivi avec le plus grand intéret notre feuilleton "Géraldine au Bénin" et vous vous demandez ce qu'il en est ressorti.
Cette mission était la deuxiéme étape de la phase de supervision (que l'on peut résumer ainsi : quels sont les résultats des dispositifs ou actions de la phase de réalisation Previous what worked well, what is to review, what is a failure and how to make adjustments after the whole process is pérénisée).
Here are some selected excerpts from the final report of the commission given by Geraldine

But first, we're in the mood Benin:








I. Mission Objectives
 Make an inventory of the operation of distribution depots Zone (DZ) and Gros Pharmacies Hospitals in the Area (PGHZ) of the Department of Borgou / Alibori: personnel, structure, retention of drugs, financial management, viability.
 Provide training on software PharMeg
  Evaluate use
Facing your performance with ground realities need to
 Correct any discrepancies.
 Develop the Management Assistance (Monitoring) are health facilities.
 Highlight indicators work of DZ and PGHZ through the use of PharMeg
 Raising the status of construction of new DZ, participate to the development of DZ already built, making recommendations for the management of DZ to build.

II. Partnership
The operation was organized locally by Dr. Delphin AIDEWOU, Head of Department of Pharmacies and diagnostic evaluation at the DDS Borgou / Alibori and facilitated by Dr. Razack ADONON, Development Director Health Zone. Logistics was greatly facilitated by all teams of area offices for the homestay and for journeys between cities.

IV. Achievements during this mission (excerpts)

G. General comments

• The cold chain is often not respected products as sensitive to heat (antivenom serum TT ...) are often stored in freezers (used minimum temperature) and not in the refrigerator so that the products should not freeze. In addition, power outages are not relayed by a generator and freezer temperature can rise sharply. According to our observation, the product temperature fluctuates between a temperature below 0 ° C and a temperature of 25 ° C that is to say beyond the limits set by the manufacturer. Their quality is far from guaranteed.
→ No solution possible outside the installation of a refrigerator and the establishment of effective monitoring of temperatures.

• Neither monitoring nor archiving prices sale of drugs to avoid selling at a loss (against DZ) or too expensive (to the detriment of patients).
→ Suggestion: publish a tariff with the sale price to FS and selling prices to patients by FS, the output of the catalog of CAM with reference price (annually), then notify the parties concerned by memos (via computer or handwritten) changes occurring during the year, notes that should be archived with the catalog of the year.

• Neither monitoring nor archiving average monthly consumption / maximum stock / stock security.
→ Suggestion: print once a year from PharMeg list of medications with these management indicators. Then archive the whole.

• Managers are generally of good will but they have no concept Pharmaceutical (unable to recognize the necessities, to equivalences ...), their level computer est souvent insuffisant et leurs notions de gestion de flux de médicament sont souvent incomplètes, alors que, de part sa nature particulière (toute rupture peut entrainer l’aggravation ou la mort du patient), le médicament ne puisse être géré comme une simple marchandise.
→ Par la rigueur qu’elle impose et les facilités qu’elle offre, l’informatisation de la gestion des flux est donc indispensable. PharMeg répond aux attente des gestionnaire et des équipes des bureaux de zone (coordinateurs, CAR)

• Les formations sanitaires, ont une bonne connaissance des paramètres usuels (CMM ou stocks limites) acquise grâce aux formations de Pharmaciens Sans Frontières 85, mais ne les mettent que très rarement en pratique pour passer leur commande. Le suivi que propose PharMeg « monitorage des formations sanitaires » peut donc les aider à mieux évaluer leurs be soins, passer des commandes mieux équilibrées, réduire le taux de périmés et de ruptures. Il serait aussi possible de faire des projections des besoins du DZ à moyen terme fiables. L’accès aux médicaments de la population serait ainsi notablement facilité.
→Seule la participation active des FS permettra d’atteindre cet objectif ce qui nécessite une très bonne sensibilisation de celles-ci au projet. Les résultats de PharMeg ne seront good if and only if, the necessary data supplied by the FS (and stocks day breaks) is accurate. During our visits to the FS, we realized that the days of fractures are rarely reported on REMECAR. Moreover, the determination of the stock is not simple. Indeed, each FS has a reserve of drugs (stock card) and at least one pharmacy delivery (with REMECAR). It is therefore necessary to compile more data to know the stock (card stock, plus one or more REMECAR based on the number of pharmacies) which increases the work of staff already heavily used.

• New deposits built or under construction does not take into account the number of FS-served by the filing. Indeed, their dimensions are identical, while deposits of E 14-44 FS to serve and not the same storage needs! The shelves are provided
weak and at risk of rapid subsidence (too deep, too long and with reinforcements sufficient).
Their arrangement along the wall is very functional and makes the storage of solutes (for which no range is provided!) Impossible.
Finally, the first tier of shelves is 50-60m and the board reserves therefore find themselves on the floor.
Significant work with teams was required to produce development plans for these new deposits according to their needs and improving their management.
→ Suggestion: consider when planning for future deposits attached recommendations

• Financial management is very different depending on the deposit and nothing is standard at county level or national level. It is often easy to identify as many deposits held emerging surpluses. •

PharMeg really answers the needs of teams using it and managing the flow of drugs is greatly improved with the arrival of the software.
→ But that efficiency continues, it is necessary to follow the teams and set up their training.

VI. Conclusion

If the Department's desire was to standardize the DZ in their structure, functioning and management, the goal is far from being achieved. Each
DZ has its own rules of operation. This heterogeneity does not facilitate their evaluation and monitoring. It therefore seems essential to DZ create a reference for all DZ Benin.
Supervisors of DDS do not currently have any specific assessment tool (operation, management, analysis of results) to DZ. It is therefore proposed to develop such tools to facilitate the work of teams of State or National supervision. For this it will be necessary to study the functioning of DZ in the whole country and develop specific indicators DZ.
Good management of the flow of drugs requires a long-term work to change the working methods and thus enter a virtuous circle will result in better access to medicines for people. To achieve such an outcome will require collaboration of all teams and structures related to drugs in Benin, the Central Purchase National devices to health facilities.
We always aim to generalize the use of PharMeg across DZ Benin. But to do this, you will need
• validate the feasibility of visiting every DZ.
• train Benin maintenance and training of PharMeg so that the project is sustainable and fully meets the needs teams. •
follow particular teams already working on PharMeg to better adapt the software to field requirements and continually improve by taking into account all the difficulties encountered by users.
training of trainers and installing licenses are complex operations which we must already think golds.

VII. Outlook

November or December 2009: Participation in the Days of Health organized by the MOH and includes a morning promotional PharMeg

January-February 2010: Mission an months:
• establishment of a deposit box Malanville by reference to the planned development with teams in place. •
consultation with all the different DZ Borgou-Alibori PharMeg to obtain the best possible performance.
• Improve and redefine as needed with DZ and FS conditions optimal "monitoring"

May-September 2010: In collaboration with
ISPED (Public Health Institute of Epidemiology and development of Bordeaux), conduct Mission comprehensive study of how the tog the DZ of Benin to develop a strategy for implementation of national PharMeg and develop a scorecard of its structures for management teams.


As you see, there is still much to do but we are moving much faster than the baobabs ..

Lg Voyager Moisture Indicator

new stage for Pharmacists Without Borders-International Committee

Faced with major financial and structural difficulties, our friends from the PSF-CI throw in the towel. recovery by ACTED will continue in the short term, in part activities PSFCI and longer term to relaunch its dynamics.
This painful situation does not affect the autonomy of actions PSF37 and other associations and national labeled French always have to respect the Charter of the Movement of Pharmacists Without Borders.

Below is the full release of PSFCI


"Bordeaux, October 28, 2009 - After 24 years of operations and initiatives to ensure everyone, everywhere, access to care and quality medicines, Pharmacists Without Borders - International Committee, in receivership since July 2009, has been put into liquidation Judicial this Tuesday, October 27.


Approached by our administrator, association ACTED (Agency for Technical Cooperation and Development), a leading French international solidarity associations, has offered to take some of the projects carried out by PSF -CI to ensure the continuation of such actions on the ground. She answered that call with a proposal for resumption of activity in some countries where our teams are operating and with prospects for revival of activity on some of our missions has been stalled for several months.


For the projects it takes, the association ACTED hopes to continue the mission of Pharmacists Without Borders - International Committee in ensuring the continuity of its commitments on access for vulnerable populations to quality care and promoting the use Essential Generic Medicines rational, in full conformity with the Charter of the Movement Pharmacists Without Borders, the humanitarian principles of universality, impartiality, quality and transparency in assisting people in need.


To assure continuity, the association ACTED will build on the experience and expertise of Pharmacists Without Borders - International Committee. This very difficult time for all of us do not mark the end of Pharmacists Without Borders - International Committee. This is a new step in our humanitarian project.


Today I want to thank all my heart those who have contributed to the action of Pharmacists Without Borders - International Committee, our field teams and France, all of our members and our volunteers, all entities Movement Pharmacists Without Borders, our partners and donors, and all those who have trusted us throughout these years and without whom nothing would have been possible.


is with all national and international entities belonging to the Movement Pharmacists Without Borders will be relaunched as a dynamic that will contribute to the sustainability of the project and common values we share since 1985. I hope I can count on the support of all to help the association to continue ACTED missions Pharmacists Without Borders - International Committee. "

Jean-Jacques Gaye

President PSFCI

Here the press release issued jointly ACTED:



"The association takes part ACTED activities
of Pharmacists Without Borders - International Committee


Paris, October 28, 2009 - The Association ACTED (Agency for Support Technical Cooperation and Development) announced the partial resumption of activities of Pharmacists Without Borders - International Committee (PSF-CI) following a decision of the Tribunal de Grande Instance de Bordeaux took place this Tuesday, October 27, 2009.

Faced with serious difficulties financial and in receivership in July 2009 l’ONG Pharmaciens Sans Frontières – Comité International avait sollicité dernièrement, par le biais de ses représentants, l’association ACTED, qui a répondu à cet appel avec une proposition de reprise de l’activité dans une partie des pays où les équipes de PSF-CI sont opérationnelles, et des perspectives de relance d’activité sur certaines des missions en sommeil depuis quelques mois.

Dans l’immédiat, l’association ACTED reprend la mission de Pharmaciens Sans Frontières – Comité International au Cambodge ainsi que ses 62 salariés, et va discuter avec les bailleurs institutionnels pour une reprise des projets en cours.

Association ACTED is also considering a resumption of activity in certain missions to sleep for a few months, Chad and the Democratic Republic of Congo, as well as the mission PSFCI in Tajikistan, which currently closing its projects course.

ACTED was unable to resume the activities and funding from other missions Pharmacists Without Borders - International Committee, and the liabilities and assets of the association are included in the receivership imposed October 27, 2009.

We hope in future years to contribute, in conjunction with all those who participated the adventure of Pharmacists Without Borders - International Committee of the Movement and Pharmacists Without Borders, to rebuild a dynamic based on the promotion of universal access to essential medicines.

This approach will complement the interventions conducted by ACTED association for 15 years to respond to emergencies, to support the reconstruction effort and to support the dynamic development of vulnerable populations in nearly 30 countries. "



Contacts:
Danièle Adler (Committed to the branch)
01 42 65 33 33 - daniele.adler @ acted.org

Marie-Pierre Caley (General Representative)
01 42 65 33 33 - Marie-pierre.caley @ acted.org

Frederic Roussel (Development Director)
01 42 65 33 33 - frederic . roussel@acted.org

Average Bra Size By Country 2010

it worked!

On September 20 you were to walk 120 to Hike Annual PSF37.Comme we had announced in June, it was very beautiful . Sache is a very pleasant city and municipal staff, the Mayor in mind, we were warmly welcomed in the Hall Christmas in the city.

Some of you took the opportunity to visit Balzac in his castle. It will undoubtedly enjoyed this distinguished honor of walkers, which he did not hesitate to go to Tours feet.

It is pleasant walks in the countryside of Tours who only end goulayage to drink and feast. This was done during an excellent meal prepared by Xavier Debonno, master chef of Noble Performed Performed at the Towers.

We can not thank that all the friends who made this meeting a party: Travel Atlantis, The Medical France, Healthcare Alliance Tours, Tours OCP, The Fiducial , W Finance , Calberson , Hexatours La Boulangerie Maxipaul.

And of course, our volunteers without whom nothing would be possible and that you have shown us their expertise and efficiency PSF37.

Big thank you to you all: your spirit, your mood and your generosity are our reward.

you next year? With the same formula?

Those who have suggestions to make this event even more festive we do know.

PSF37

How To Rid Impetigo Scars

J-10 before returning

My stay in Benin coming to an end.
If a word were to sum up my stay, it would be: natural.
Yep, everything seemed to go without saying. I've never experienced any problems, I was lucky that everything went smoothly for the transport, health and work. I found my place in both families (Sometimes after a little more time than others, but in the end it was always difficult to leave ...) and in work teams. Really no problem of integration!
As I said before, it takes a lot of energy to move just a bit. But this is part of the Africa, with its charms and small defects. I tried to do my best in every place I went. The software PharMeg , despite some minor flaws that are discovered and corrected in its daily operation is a tool that has become essential for Deposits. The sample Malanville and Banikoara is obvious. Since PharMeg longer works there (after the failure of computers at the whim of local voltages!), The management of pharmaceuticals has become chaotic and most importantly, financial tracking (sacred credits!) Is catastrophic. Must be noted however, that the lack of rigor leads alone many aberrations, both for the financial monitoring for the storage and archiving of various documents. The administrative fragmentation of responsibilities does not encourage taking initiative, each preferring to stay in its little sphere that helping your neighbor. As for communication (and yet we are at home for talking), many do not know what that means!
to us (but not only) of instill the motivation for the good will is not lacking. Just see the desire to learn and progress of all team members.
I think of Bachirou and Julien. But with a special mention for Bachirou because with less training than that Julien is a thoroughness and professionalism in his work that commands respect. In addition, control perfectly PharMeg and desire to progress is remarkable. A very good example for all!

Obviously, I do not forget the inevitable Adamou, Manager of Pharmacy of the HZ Malanville , called by all "the Consultant" because formatted PharMeg by Alain 3 years, and who does not hesitate to visit the deposits, even weekend to help his colleagues.

For a first brief assessment of the work done here, I'm satisfied. I know that my stay was useful even though I have not solved all the problems (impossible! lol)

Otherwise, daily life was full of new experiences and wonderful encounters. A great big thank you to Bachirou , Lékiatou , Ralyatou , Julian Daoudou , Just, Christian for their welcome, their hospitality, their kindness and especially for the moments of exchange and all the laughter ... And also for all the discoveries I made through them, as well as customs of food (my dad always told me: "Eat Local for not being sick ... "I can tell you that it right!). I think in fact have all tasted the pasta Benin available ... my preference is really yam looted, it is eaten alone and after it rests for 48 hours. I admit that even when the fruit (although I found several times in small bananas that have seen the sun, not like those of France) and I miss a little salad. Fried and starchy foods are banned from my diet for the next month ... lol .

For the last little anecdote: I have eaten pancakes in Benin. Yes, yes ... Well, pas aussi bonnes que celles de ma grand-mère mais avec un bon petit goût de France. Je suis parti acheté des poulets et des pintades, vivants. C’était la première fois que je tenais ces animaux là vivants…on voit bien là la Parisienne…Après il a fallu les tuer et les plumer. C’est Caret la fille de Christian qui a 12ans qui s’en est occupée. Personnellement je ne vois pas ma petite sœur qui a le même âge faire ça (moi non plus,d'ailleurs!). Si chez nous l’enfant est roi, ici l’enfant doit grandir vite et se rendre utile le plus rapidement possible…

Sinon, la région de Malanville is superb. There are "fields" such as baobab and it is the rainy season, everything is green. Color contrast with the red soil (laterite) is amazing. I had the opportunity to visit a large number of health facilities in the area Malanville-Karimama , it allowed me to leave the "tar" and magnificent views. The view takes in the vastness of the fields, because here there is little relief. We are in the Niger Valley . By cons, these places are not accessible: The tracks are really bad and the rains do not help. I really thought that we would spend ever, but the driver is accustomed, and it goes ... In the market
Malanville , I found lots of small objects back to France. I made the day a old lady: 2000 FCFA small stuff. She was happy, the lady.

I come back with lots of images in my head (too little in the camera ...) and a bunch of memories to unpack . And experience, both personal and professional especially, has really enriched. Remains the writing of the thesis that all contribute to "a little" to improve Circuit Benin the drug ... it would be such a satisfaction to see things a little change!
But one thing is certain: what I like it! ...

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I smell the end ...

2 weeks and my stay is over ... I am both pleased to return for France I miss a little, but eventually it mean hello Benin and the resumption of classes. Especially this year it may be loaded from the 6th year of pharmacy, the internship and thesis ... should not that I think I will too if not completely panic !!!!!!
For the moment I am still in Benin and I still have many things to do in Malanville. Their computer is not repairable in Benin. I'll see if I can take it to France. And I do not know when they will recover their data. And that, it would be the worst thing that can happen to them. In short, I'll have to work up before leaving for that all goes well after my departure.
Otherwise I must finalize several things both PharMeg, as the information that I get for my thesis. This is something that concerns me. Is what I have worked in the right direction for my thesis? Is what I got the right data? I know that everything will fall into place slowly but I confess that the teams had such a need additional training on PharMeg that sometimes I put aside my thesis and I really have not had time to reflect on since my arrival here. I just did the data collection but I have not analyzed. There will be Labour's return to France! And I'm lucky to have a very good supervisor (thanks Alain) that will help me if I have problems I'm ...
Otherwise, everything is fine. Apart from that I am eaten by mosquitoes ... they love the "white" ... lol
Christian bring me for a ride along the River Niger with the sunset. Wonderful!

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me here in the NORTH! Also in Benin

I came to Malanville Friday.
I was very surprised to Alain as Friday which helped me solve the problem in Banikoara PharMeg. I return to Banikoara August 28 to work with Just PharMeg depot manager. In fact, I took the hospital director Malanville, Christian, or Banikoara to go with him on Malanville. The computer problems
PharMeg are often associated with power outages and viruses! While it does not mix with PharMeg. But they have the means to prevent power cuts with UPS. A Banikoara, they bought a 5 months ago but there is a problem making. You just change it. A Nikki ago had the same problem when I was there and they settled within 24 hours, here it's been over 5 months and they have done nothing! " Ahhh! it's really attitudes that bother me. And as the saying goes "he who sees a problem but does nothing to solve it is part of the problem"
I confess that I have to show great patience Banikoara because really, I feel that it takes more than the push to get things done!! Management really is not rigorous, and the initiatives and good will are not really there! I told you they had not helped dans le magasin du dépôt en 5 mois, malgré les recommandations de PSF. J’ai donc pris les choses en main et vendredi matin j'ai été avec eux pour déplacer tous les solutés et les étagères pour trouver de la place pour tout bien ranger! Chose qu'ils auraient très bien pu faire sans moi...Mais bon, ils n'auront plus d'excuses pour avoir un magasin mal rangé à partir de maintenant. Je leur ai dit que je reviens dans 15 jours et que je veux voir tout bien rangé avec étiquettes et tout. De plus j'ai demandé que l'onduleur soit arrangé afin de ne plus avoir de problème avec PharMeg!!Si cela n'est pas fait je me demande au pire si je dois continuer la formation…Au mieux,je would not really unhappy! So here I am

Malanville. I am housed in the Christian hospital director. Yesterday I have seen Adamou the pharmacy manager for wholesale hospital. He had a little problem with PharMeg he had clearly communicated to Alain. But this is solved! A good thing done. But at the depot. Big worry, the computer will not turn over. A current conduction problem (probably blown circuit?) In the computer. Fortunately I have had the coordinator on such and explain the problem. The computer went today to Parakou. What hope can fix it! In the interim I am going visiter les formations sanitaire avec la gestionnaire du dépôt pour renforcer le monitorage. Car cela n'est vraiment pas bien suivi par les Formation sanitaires. Affaire à suivre...

Dans 3 semaines c'est fini...
j'ai prévu de passé 15 jour à Malanville puis 3 jours à Banikoara et puis une journée à Kandi, Bembéréké, Parakou, Tchaourou, Kokoro et Cotonou...la dernière semaine va être épuisante mais je pense que c'est nécessaire pour vérifier une dernière fois le bon fonctionnement du logiciel et pour faire les dernières mise à jour

Je ne pense pas pouvoir vous donner des nouvelles rapidement car il n'y a pas de cyber à Malanville and now I'm in the office of Christian hospital

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..

Yes, yes I'm still here but tough to get internet for 10 days ... I feel cut off from everyone! lol
Banikoara here I am. Deep in Benin. Everything is fine even if the work is important and fatigue aussi.Mon stay Kandi is all over. The work was very intense, I do my max will be seen in the evolution ... Here in

Banikoara I was a little disappointed when I arrived because all the recommendations we made in May with Michele and Alain were not taken into account. To believe they will not improve. it's a little discouraging !!!!!!!!!!

management is weak, more for lack of jurisdiction, in my opinion, that will, but the lack of rigor is always a great fault !!!!!!!!!!!

I am a bit perplexed by what I can do here. I make my assessment of filing and a little work on PharMeg, but I do not think I could do more ... it would take me weeks to start from the basis !!!!!!
I'm Just housed in the depot manager and his wife and child of 9 months. I room with my bed and everything, seal shower and no toilet but done with and I really feel. really well. His wife is extremely nice. Otherwise

August 1st I attended the parade of independence in Kandi. Was heterogeneous (the military judo club and football through traditional dances) but very nice. ft. and we went to a football match! "And I ate Tofi, condensed milk with sugar, like caramel, very good!! Daoudou's family arrived on Sunday. He has three children: two girls and a boy of 3 years. A real fun starts dancing to the cut-shifted as the big ... Great moment of laughter. I pounded the iniam say ... I did a test, but not too much force in arms ... lol. Otherwise, I was eaten the head and gut kid ... say that if we do not think the look is not bad ... but that's not what I prefer in Benin ... I went to the market for small things to bring back to France ... I replace the things in France that I give as a gift by small gifts of Benin for the French!! So I'm still loaded! lol. I certainly plenty of other things to say but the inspiration and not enough time. I'll be there next week for 2 weeks and Malanville ft start coming fast. I can not believe that it's been over six weeks that I'm back in France là.Le will be intense in my opinion but as always we will do with and I intend to do my thesis as soon as possible to be done with these damn studies ... and become a big Foufoune! lol.Mais before that VACATION !!!!! I need do nothing except laugh and see my friends !!!!!!!!!

Night Calls Tiffany Granath Clips

Always there ... but the internet more difficult ...

Banikoara Here I am in the depths of Benin.

all is well!

Unable to give news as soon as possible internet access for over a week!