Médicos del Mundo (MdM) has been developing and implementing mother and child health programmes in Mauritania since 1993. Since 2000, MdM has favored the name "sexual and reproductive health" and has made it a point of honor to work with an approach based on human rights. This is visible in its SRH policy developed in 2008. In 27 years of experience in Mauritania, MdM has developed more than 50 interventions in development cooperation and humanitarian action. In the field of humanitarian action, the organisation has responded to health emergencies of various kinds: cholera in Nouakchott, floods in Hodh El Gharbi, migration crises in the regions of Nouadhibou and Rosso, nutritional crises in Guidimakha and work on rapid response mechanisms from emergency plans in the intervention zones. With regard to development, interventions have focused on strengthening primary health care in various areas and geographical areas: 1) the strengthening and decentralization of tuberculosis services at the national level with the establishment of treatment centres in the regions of Nouakchott, Assaba, Hodh El Gharbi, Hodh el Chargui, and Nouadhibou. 2) Strengthening existing mechanisms and services, which guarantee equitable access to the population in vulnerable situations, from a health and socio-economic point of view, in the regions of Nouakchott and Guidimakha. 3) The development of preventive and communication actions and the improvement of the technical health, organizational and advocacy skills of community networks and national civil society organizations (CSOs). 4) Through a gender-sensitive approach, improving access, organization and quality of sexual and reproductive health care, including emergency obstetric care and the national HIV/AIDS programme, as well as child health, including emergency neonatal care and severe acute malnutrition in the primary health facilities of Nouakchott, Nouadhibou, Guidimakha and Trarza. In this sense, the organisation has developed interventions focused and adapted on the SSR of adolescents and young people since 2017. In addition, given the public health problem related to gender-based violence (GBV), since 2012 the organisation has begun to develop programs specifically focused on prevention, protection and advocacy on GBV, as an integral part of sexual and reproductive health. After two years of advocacy and since 2017, continuous efforts have led to the opening of three Special Units for comprehensive medical, psychosocial and legal care of GBV (USPEC). A national health-gender communication campaign has also been developed since November 2019 to inform and raise awareness among Mauritanian youth about GBV, by communicating about their causes and consequences, as well as the existence of Care Units for Victims of Gender-Based Violence; and on SRH, to promote the right of access to information on this theme, and to promote prevention. This multichannel campaign, particularly events-based campaign, aims to change behaviours and practices that undermine fundamental human rights by pushing the Mauritanian population to question. After a first phase between November 2019 and March 2020, a second phase, adapted to the COVID19 pandemic began in February 2021. The first case of COVID19 in Mauritania was recorded on 13 March 2020. While the following two months had fewer than ten cases, mid-May was marked by a sudden increase in the number of cases, triggering the first wave of the epidemic in Mauritania, which peaked in the third week of June 2020. The actual number of people who have contracted COVID-19 or are still ill remains very relative in Mauritania. Indeed, the population does not always have access to care, nor to diagnostic testing, for financial means, means of transport, or lack of knowledge of the virus and means to protect themselves from it. Masks, hydroalcoholic gel, but also soap and water are also not accessible to all. The situation therefore remains unstable and barrier measures are more than necessary. The number of vaccines planned for the country is also not yet known. In terms of communication, MdM Mauritania is part of the Risk Communication and Community Engagement pillar of the National COVID-19 Response Plan. Tools to raise awareness of barrier measures were developed and widely disseminated in spring 2020 and again in December-January 2021. The second phase of the health-gender campaign should make it possible to continue raising awareness, drawing attention to the resurgence of GBV in times of crisis, in particular by providing information on the mechanisms for reporting, assisting and taking charge of GBV maintained during the pandemic.
Operational details & security context
Medicos del Mundo works in Mauritania mainly in two geographical areas: Nouakchott and Guidimakha. Each of the bases has a house of passage and the work offices for all the teams in the city centers. We have 5 pick up cars.
In terms of Human Resources, the team of the MdM mission in Mauritania is composed of thirty-two people between Guidimakha and Nouakchott, the capital (a finance, accounting, a country logistics manager and an administration-log manager at the Guidimakha base). Coordination with headquarters in Madrid is done on a regular basis to ensure proper planning, implementation and monitoring of activities.
With regard to the technical and financial partners on the ground, Médicos del Mundo works in close collaboration with the Country's Social Registry Directorate, the Ministry of the Interior, the Ministry of Health and the Ministry of Women, Family and Children(MASEF) at the central level. Regarding the decentralized level we work in collaboration with the regional health, Islamic affairs and MASEF directorates of Nouakchott North, East, West and Guidimakha. We collaborate with schools of public health and high schools and public schools. Médicos del Mundo participates at the national level in all consultation frameworks concerning health, GBV, human rights and nutrition in general and discusses with international technical and financial partners such as WHO, UNICEF, IOM, UNFPA, the Human Rights Office of the United Nation System, the European Union, the Embassy of France, AECID/OTC and international NGOs. As national partners, we work with 4 civil society organizations: SOS PE, AMSME, AFCF and Action.
In relation to security, Medicos del Mundo participates in national security meetings with the rest of international partners in order to assess the security situation. Currently, the security situation in the country is stable. The first existing risk is the traffic accident. For this, the organization relies on an adapted response and risk plan, which is monitored and respected by the entire national and expatriate team. Médicos del Mundo in its policy of neutrality, works more on the acceptance and protection of staff and assets of the organization and to do so, it has set up security management tools that are always validated by the headquarters in Madrid. The safety rules will be shared with all volunteers for a knowledge before their deployment in the field. Assistance is also available from headquarters, including a security officer, a gender counsellor, and a psychological intervention protocol in case of emergency.
In terms of health, vaccination against yellow fever is mandatory, even if it is not requested upon entry into the country. It is to be done in an approved center. Anti-malarial treatment is to be expected, as well as food hygiene vaccines (typhoid fever and hepatitis A.).
MdM has a list of health structures, specialists and reference laboratory when needed. Namely that le.la volunteer will have international health insurance in case of significant necessity and medical expatriation, as well as evacuation protocols.