1. Project for prevention and fighting against tuberculosis

2. Project period : Project period : October 2003 – May 2004 October 2003 – May 2004 General objective: General objective: –To contribute to the reduction of spreading the TB among the most vulnerable people. Specific objectives: Specific objectives: –Education and information sharing to encourage an early access to health care facilities if TB is suspected; –Reducing stigma and discrimination towards people with active TB and thus faciliting early diagnosis of TB.

3. Global Incidence of TB in Romania 2003 – 138,7%000

4. Description of the project Romania is presently confronted with a serious TB epidemic placing it among the first places of cases in Europe; Romania is presently confronted with a serious TB epidemic placing it among the first places of cases in Europe; The project was implemented in two stages:The financing covered the implementation of the first stage, as a pilot-project in Bucharest. The project was implemented in two stages:The financing covered the implementation of the first stage, as a pilot-project in Bucharest. There were strong arguments for the selection of Bucharest for the implementation of the pilot project: There were strong arguments for the selection of Bucharest for the implementation of the pilot project:

5. The target-groups: the poor population at the out- skirts of the city ; the poor population at the out- skirts of the city ; the Romma communities. the Romma communities.

6. Project Activities Training a group of volunteers; Training a group of volunteers; Distribution of materials in public places; Distribution of materials in public places; Fighting against TB-support for the outpatient treatment ; Fighting against TB-support for the outpatient treatment ; Information activities; Information activities; Highlighting the World Day of fighting against TB; Highlighting the World Day of fighting against TB; Evaluation and monitoring. Evaluation and monitoring.

7. Training a group of volunteers Volunteers were recruited in September, with the support of the Red Cross branches in Bucharest, from among medicine students and with the support of the counsellor on Romma matters of the Minister of Health; Volunteers were recruited in September, with the support of the Red Cross branches in Bucharest, from among medicine students and with the support of the counsellor on Romma matters of the Minister of Health; 13 medicine students and 3 Romma ethnic health mediators were trained; 13 medicine students and 3 Romma ethnic health mediators were trained; The seminar took 3 days: The seminar took 3 days: 2-4 October 2003; 2-4 October 2003; Initially, the volunteers acted in sector 5, the sector with the highest TB rate, where also exists the highest density of Romma population; Initially, the volunteers acted in sector 5, the sector with the highest TB rate, where also exists the highest density of Romma population; The action plan for the territory was established together with medical doctors of TB dispensaries and the Red Cross branch directors from Bucharest. The action plan for the territory was established together with medical doctors of TB dispensaries and the Red Cross branch directors from Bucharest.

8. Distribution of materials in public places. The Polytechnic Institute Bucharest and students hostels – 400 leaflets; The Polytechnic Institute Bucharest and students hostels – 400 leaflets; 11 polyclinics and 6 cabinets of family medical doctors - 600 leaflets; 11 polyclinics and 6 cabinets of family medical doctors - 600 leaflets; 2 street activities in cross- road distribution of materials to pedestrians and to people driving waiting for lights chancing 500 folders, particularly in TB Day - March 2004. 2 street activities in cross- road distribution of materials to pedestrians and to people driving waiting for lights chancing 500 folders, particularly in TB Day - March 2004.

9. Fighting against TB 39 persons having received DOTS at home accompanied by information activities and distribution of materials; 39 persons having received DOTS at home accompanied by information activities and distribution of materials; This activity was mainly covered by the health mediators of Romma ethnic particularly in Romma communities; This activity was mainly covered by the health mediators of Romma ethnic particularly in Romma communities; The entire activity was carried on under the co- ordination and cooperation with the medical and health personal from TB dispensaries. The entire activity was carried on under the co- ordination and cooperation with the medical and health personal from TB dispensaries.

10. Information activities Information activities covered mainly the following: 1.15 schools at the outskirts of Bucharest; 61 information activities: direct beneficiaries about 3000 school students. 2.In three sector Mayors ( 1, 5, 6) during the days when social aid was distributed for the needy population (3 days per month) - 5 actions and about 400 direct beneficiaries; 3.Romma communities – discussion between the health mediators and community members accompanied by distribution of materials. It is estimated that 500 direct beneficiaries received information materials during the active project period.

11. Highlighting the World Day of fighting against TB Activities: Drawing contest (watercolour) with prizes in cooperation with the Ministry of Education; Drawing contest (watercolour) with prizes in cooperation with the Ministry of Education; Distribution of 300 leaflets - in the street and in the transportation means. Distribution of 300 leaflets - in the street and in the transportation means.

12. Highlighting the World Day of fighting against TB The first place on the drawing contest: The first place on the drawing contest:

13. Evaluation and monitoring Periodical evaluation. Every 2nd or 3rd week the programme coordinator met with the volunteers. Every 2nd or 3rd week the programme coordinator met with the volunteers. Meetings consisted of presentations on activities carried out by the volunteers and of planning ahead other activities; Meetings consisted of presentations on activities carried out by the volunteers and of planning ahead other activities;

14. Evaluation and monitoring A special e-mail address was set up by the volunteers witch facilitated the communication among the group and the organisation of activities all the time. A special e-mail address was set up by the volunteers witch facilitated the communication among the group and the organisation of activities all the time. Between November 2003 – May 2004, 196 messages were sent on this address. Between November 2003 – May 2004, 196 messages were sent on this address. voluntari_tbc@yahoogroups.com During the programme implementation 3 more medicine students joined the initial groups. During the programme implementation 3 more medicine students joined the initial groups.

15. Final evaluation All people involved participated: volunteers, one representative of the TB Institute, medical doctors from TB dispensaries; All people involved participated: volunteers, one representative of the TB Institute, medical doctors from TB dispensaries; An evaluation questionnaire was filled in ; An evaluation questionnaire was filled in ; The most useful activities were in schools and the display of posters in public places; The most useful activities were in schools and the display of posters in public places; Also DOTS administration at home and information activities in TB hotbeds were mentioned; Also DOTS administration at home and information activities in TB hotbeds were mentioned; The volunteers are willing to continue their activity as Red Cross volunteers within this programme or others; The volunteers are willing to continue their activity as Red Cross volunteers within this programme or others; The TB Institute appreciates the activity and health education as o necessary component limiting the TB epidemic. The TB Institute appreciates the activity and health education as o necessary component limiting the TB epidemic.

16. Results achieved The information activities accompanied by the distribution of materials ensured by volunteers reached more than 400.000 persons. The information activities accompanied by the distribution of materials ensured by volunteers reached more than 400.000 persons. The population of Bucharest who received information know more about TB. The population of Bucharest who received information know more about TB. The request for TB related information and for support in outpatient treatment for bedridden patients is exceeding the number of involved volunteers. The request for TB related information and for support in outpatient treatment for bedridden patients is exceeding the number of involved volunteers.

17. The continuation of the project The evaluation proved the necessity to continue and extend it to other parts of the country; The evaluation proved the necessity to continue and extend it to other parts of the country; Romanian Red Cross, in cooperation with technical support of American Red Cross drew up a project programme and submitted it for bid access to funds from the Global Fund to fight against AIDS, TB and Malaria. Romanian Red Cross, in cooperation with technical support of American Red Cross drew up a project programme and submitted it for bid access to funds from the Global Fund to fight against AIDS, TB and Malaria. The project is entitled "Implementation of an incentive system for TB patient in Romania“. The Organisation “Doctors of the World” will be co-partner. The project is entitled "Implementation of an incentive system for TB patient in Romania“. The Organisation “Doctors of the World” will be co-partner. It includes a health education component based on the acquired experience in the present pilot project. It includes a health education component based on the acquired experience in the present pilot project.

18. Volunteer Group - TB