A group of guests who came to participate in the 20th Anniversary celebrations visited the village of Selemet with the Mobile Clinic team. The Mayor is Tatiana Badan
Medical care problem
On the State Level
The standard of medical care in Moldova is below that available in some other European countries. Moldova is the poorest country in Europe and one of the thirty most corrupt countries in the world.
Citizens have to pay for prescription medicine (children under five are exempt) and medical treatments deemed nonessential, like cosmetic surgery, dental care, massage and some laboratory investigations. Patients also make under-the-table payments to doctors, consultants and nursing staff. Such payments may be in the form of a gift or actual monetary payments.
The Moldova health care system has improved immensely over the years but still there is less availability of modern equipment in the hospitals of Moldova.
All the changes are mostly in the cities. In the rural areas the health care network is still seen as substandard, even though it has been improving recently. There is a lack of good medical staff in the country. The medical doctors continue to receive a very low income and many are leaving their professions for other work.
Almost all marginalized citizens of villages still do not have an access to the professional medical care. Many have never left their villages to travel into the cities for better medical treatment or for any other need. The average income is $150 - $200 per month for the employed. However, many people in the villages never have actual money but trade their products for clothing etc. Pensioners receive $50-$80 per month and invalids on the lowest pension scale only have $ 30 and many can only purchase bread. Sometimes even bread they cannot have daily.
Rural hospitals offer a limited service, which includes basic specialist treatment and some surgery.
There is a private health system in Moldova; however, the system is used by a limited number of people like MPs and wealthy entrepreneurs because the treatments are extremely expensive. Patients who use private doctors make out-of-pocket payments directly to the doctors to pay for the cost of their treatment. Private practice is still limited to a small number of consultancies, which offer diagnostic rather than curative services.
Private healthcare services are not available for many people in Moldova, especially for marginalized people.
Major health problems
The people of Moldova mainly suffer from cardiovascular diseases, cancer and respiratory diseases. The consumption of alcohol is so high among the Moldova citizens that it has turned into a major reason behind the deaths occurring in Moldova. The extensive use of different kinds of herbicides as well as pesticides by the people of Moldova has helped in the growth of deadly diseases.
Tuberculosis is a big problem, and Moldova has 232,7 cases pr. 1000 inhabitants. HIV/Aids registered cases is 0,2% and malnutrition is 10,8%
Only 35 % of the population has access to adequately iodized salt which causes thyroid diseases.
Pharmacies throughout Moldova are not always stocked to western standards. The health situation in Moldova decreased as medicines prices increased in recent years.
In addition, knowledge about basic hygiene is very limited. For example, in some of the villages people even do not brush their teeth.
Effects of the problem
Poor health care, insufficient nutrition and lack of knowledge about self-hygiene leads to high mortality rate, high rate of congenital diseases and disabilities. The average life expectancy in Moldova is 69 years and the elderly suffer many diseases which could be prevented if the health care was improved.
Our response to the need
The Salvation Army in Moldova saw the need for medical care to poor people in the villages of Moldova. The Mobile Clinic visits 12 villages 3 times a year providing villagers professional medical consultations, medicines and other kind of support.
We have a team of qualified and skilled personnel who can travel around Moldova. One of the doctors is the coordinator of the project. He has good contacts with the health department of Moldova and good experience in working in the national health system.
Involvement of the local authorities
The project operates for about 10 years and is well known in the country. Mayors from the villages hearing from other mayors sometimes call our office or send requests by fax/ e-mail as they want their village to be chosen for MC visits. All the requests are considered at our Divisional Projects’ Board.
The Salvation Army cooperates with the local authorities when it comes to implementation of this project.
The mayors of the villages or the local doctors invite poor and needy people to come when we visit. They arrange for a place to set up the Clinic where the facilities are suitable for the purpose.
When we come to the same village, we see that cooperation with the local authorities develops in a good way. Also Social workers, Medical workers (if there are any) and the Mayor provide all the documentation and lists stamping it as a confirmation that all beneficiaries received the consultations, medicines, orthopaedic equipment etc. The local communities carry the responsibility of the administrative burden.
We encourage the local communities to make local contribution such as: premises for free for the patient’s examination, full or partial transport costs payment, hot meal for doctors
The target group
The target group includes: elderly, children, and mothers with babies, men and women, invalids. All the people that we serve
are of all nationalities, but our main target will always be those in need, and our goal is to meet human need irrespective of race, creed and gender. The Salvation Army wants to focus on what is the most obvious need in the society, and try to find ways of helping people to get a better life and hope for the future.
The Coordinator of this project cooperates with the local authorities when it comes to selecting and inviting people to come to the Mobile Clinic.
The Local authorities in the villages will inform and select the neediest people in the community and invite them to the clinic. This will be the pensioners, the invalids, the families with many children and small children, and the people who have obvious diseases.
The estimated number of people helped by this programme is 7 200 per year. Some will be followed up and have consultations more than once. This help includes doctors’ consultations, medicines and different kind of aid given out, and people sent to other specialists or hospitals for treatment or operations.
There are three aims of the MC activity which correspond to the primary health care (PHC):
1. First aim is to deliver basic primary healthcare to people living in 12 chosen villages that have little or no access to advanced healthcare. The supporting therapy is one the great impact for human lives.
1.1 The plan will be 3 visits per year to 12 villages. Estimated number of patients consulted every time will be 200 - 250. 2-4 visits per month performed by the team. A schedule is made of the beginning of the year but it is flexible to the weather conditions and to the time when local authorities are ready to host the Mobile Clinic.
1.2 To provide the medicines needed for 6 200 people to recover.
1.3 To provide 36+ beneficiaries with hearing aids
1.4 To provide 540+ beneficiaries with glasses according to the tests results performed by the Clinic specialist
1.5 To provide 900+ new-born babies with Baby Milk and/or Baby food
Guidelines for the MC paediatrician and gynaecologist
• Infants growth monitoring and consultation
• Oral rehydration therapy (consultation)
• Breastfeeding (consultation)
• Family planning (consultation)
• Female education (consultation)
• Give prescriptions for the food supplementation: for example, iron and folic acid fortification/supplementation to prevent deficiencies in pregnant women
The population ageing factor is taken into consideration also.
The MC patients will receive examinations of their health, consultations and prescriptions. A special attention “deserves” a non-communicable disease, such as diabetes and osteoporosis.
2. The secondary goal is to teach and educate population knowledge about health care and hygiene which will aid them in obtaining a healthier lifestyle.
2.1 To perform 5 preventive seminars for children about importance of hygiene per year
2.2 5 seminars about cardio diseases and prevention of it led by team cardiologistper year
2.3 2 video-seminars about prevention and overcoming tuberculosis per year
2.4 To continue distribute “food pyramid” magnet in 12 villagesper year
We plan to continue the involvement of community to care and help after the MC stopped attending the certain village/community. Preventive work will have a long action. People will be able to care about their health and make a healthy choice using the prevention seminar's information, and TSA Mobile Clinic informative brochures. That's a great impact for children's health to have skills of the correct brushing for their teeth, for example. In 2013 -2014 we plan to create and print a few kinds of brochures and magnets, like a «Healthy fruit/meal choices" and "Smoking prevention info".
The most important health issues in Moldova are: tuberculosis, the high arterial pressure and heart problems, diabetes, women's health, care and feeding for newborns. That's why I think that prevention work is one the good solution on health care for population.
Our doctors advise people and give them recommendations about the necessary treatment for the present and for the future in general. We plan to print a list of recommendations and diets for the main types of diseases. This list will be also provided to the MC patients.
3. Third aim is the ‘Emergency Assistance’. There is a category in the MC budget "Emergency Assistance". We plan to provide TSA MC Contacts for the local social and medical departments. The idea of this is: if someone from the villagers needs a surgery or another costly medical treatment urgently, the local representative will send us an urgent request for help. The priority will be given for the cases where there is a threat for human life.
4. Social component
4.1 To provide 10+ with wheelchairs to invalid persons who can’t walk per year
4.2 To provide with 40+ sticks for those who cannot walk without supportper year
4.3 to provide with diapers to 240+ bed-ridden people per year
4.4 To distribute 150 kilograms of second-hand closes the needy familiesper year
4.5 To distribute 300 food parcels to needy familiesper year
4.6 To distribute 10 sanitary chairs (toilet-chair for disabled) per year
5.1 To perform 36 short devotional messages for the villagersper year
5.2 To run 8 outreach Evangelization Programs for Childrenper year
5.3 To provide Christian literature to those who are interested
5.4 To provide spiritual support to beneficiaries (personal prayer and counselling, Bible talks with bed-ridden)
NB! All the services are free of charge for our beneficiaries, as we try to cover the needs of the poorest villagers.
Budget for 2013 is $ 171 370
The Salvation Army’s Mobile Clinic recently welcomed special guests from the USA when the team of doctors and their social worker visited the village of Braviceni. Salvation Army officers from Florida, Commissioners Raymond and Merlyn Cooper enjoyed being part of the team for the day!