Centro Sanitario “Mama Carla”


Il Centro Sanitario Mama Carla, si trova a Bangui capitale della Repubblica Centrafricana. Struttura sanitaria ubicata in uno dei luoghi più poveri al mondo dove l’assistenza medico sanitaria è pressoché inesistente soprattutto per le fasce più povere. 

Il Centro Sanitario Mama Carla si occupa di prestare gratuitamente le cure sanitarie sia ai bambini ospitati dal Centro “La Joie de Vivre”, sia alla popolazione locale dei quartieri più desolati di Bangui.

Il Centro Sanitario Mamma Carla: operatività e potenziamento nel corso del 2020 

Anno 2019… solo qualche dato:

  • circa 20.000 visite/anno
  • circa 1600 visite/mese
  • 48% degli accessi al Centro Sanitario riguardano la malaria
  • 25% infezioni delle vie respiratorie (polmonite)
  • 12% infezioni gastrointestinali
  • 800 i bambini malnutriti seguiti
  • 130 i pazienti HIV presi in carico e trattati con opportuna terapia antivirale

Negli ultimi mesi del 2019 l’Associazione, grazie al supporto di AICS (Agenzia Italiana per la Cooperazione allo Sviluppo) promuove un progetto di potenziamento del Centro Mama Carla.

Anno 2020… solo qualche dato:

  • organico del Centro Sanitario: 1 Responsabile Progetto Sanitario, 4 medici centrafricani, 8 infermieri locali, 3 assistenti di salute locali, 1 attivista per appoggio psico sociale locale
  • 1^ trimestre gennaio/marzo 2020: circa 10.700 visite
  • l’avvio del progetto di collaborazione con l’Ospedale Pediatrico di Bangui per il trasferimento con l’ambulanza dell’Associazione di 30 bambini /giorno presso il nostro Centro sanitario Mama Carla: ciò permette di alleggerire l’afflusso all’unica grande struttura ospedaliera pediatrica di Bangui
  • l’associazione, in base anche alle esigenze individuate dal Ministero della Sanità locale, garantisce la formazione in ambito sanitario: 4 medici impegnati nella formazione in ecografia, 32 sessioni formative sull’igiene personale nei quartieri della Capitale, 3 formazioni mirate alle principali urgenze epidemiche: Poliomielite, Morbillo e attualmente COVID-19
  • l’associazione promuove corsi di sanità pubblica rivolti a docenti ed alunni con lo scopo primario di sensibilizzare sia sull’importanza della prevenzione sia sulla piaga della malnutrizione in età pediatrica
  • l’avvio di un laboratorio di analisi per indaginiematologiche e biochimiche e microbiologiche, l’acquisizione di test rapidi per la determinazione sierologica delle principali infezioni a trasmissione ematica e sessuale
  • in fase di attivazione un servizio di ecografia per la diagnosi precoce di problematiche ostetrico-ginecologiche, per patologie infettive e neoplastiche addominali, nonché per la diagnosi di processi patologici polmonari

…  PUNTI DI FORZA e SFIDE del CENTRO SANITARIO MAMA CARLA:

  • Estensione copertura 0-15 anziché 0-5: offrire cure gratuite non solo ai bambini da 0 a 5 anni come previsto dal programma Ministeriale centrafricano, bensì estendere le cure sino ai 15 anni, garantendo così una buona condizione di salute per tutto il periodo scolare-formativo del bambino. MA ciò triplica l’impegno finanziario dell’associazione
  • Formazione continua: necessaria pergarantire e mantenere standard operativi elevati MA richiede importante impegno di risorse umane scientificamente preparate, lunghi tempi di programmazione e notevole impegno economico per assicurare la presenza in loco di formatori espatriati
  • Impiegare personale locale: fondamentale per la futura sostenibilità del progetto e favorire la crescita del livello operativo sanitario centrafricano. MA richiede una continua supervisione e un notevole adeguamento delle tempistiche, nonchè una modulazione degli approcci educativi alla cultura ed alle tradizioni locali
  • Integrazione del Centro con la rete sanitaria dello Stato Centrafricano: solo collaborando si ottiene una progressiva conoscenza di quelle che sono le esigenze prioritarie in sanità secondo la politica locale, supportando al contempo una crescita qualitativa degli interventi secondo standard europei. MA questo richiede tempi molto più lunghi e lungaggini burocratiche
  • Adeguamento della struttura e dello strumentario del Centro: la crescita delle attività è fondamentale MA richiede importanti sforzi finanziari per adeguare gli edifici ed i materiali sanitari
  • Emergenza COVID-19: necessaria la sospensionedi alcuni servizi individuati come non essenziali e la creazione di spazi per il triage dei casi sospetti. MA difficile reperire mascherine, visiere, farmaci, camici monouso…

In sintesi: curare e promuovere la cultura della salute 

In Repubblica Centrafricana la situazione medico sanitaria è particolarmente grave: la piaga maggiore è l’infezione malarica che colpisce la popolazione con una media annuale di 2/4 accessi febbrili; la mortalità infantile è tra le più elevate e l’aspettativa di vita non supera i 45 anni di età. Inoltre l’autoimmunità in Centrafrica risulta inspiegabilmente più bassa rispetto alle altre aree dell’Africa Sub-Sahariana. Le cure sanitarie sono inaccessibili alla maggior parte della popolazione e la prevenzione è un concetto non cosciuto sul quale è necessario fare formazione.

L’associazione vuole investire con continuità in progetti sanitari che possano offrire cure mediche di qualità ed agevolare l’iter diagnostico identificando così la corretta terapia medica. A tal fine è stato avviato un laboratorio di analisi ematologiche e biochimiche (rilevazione dei livelli di anemia, dei principali parametri della funzione epatorenale, della glicemia e ionemia) e microbiologiche (depistaggio di HIV e Tubercolosi, determinazione in biologia molecolare di HIV RNA e TBC per il monitoraggio di queste infezioni che costituiscono i due principali problemi infettivi dopo la malaria), l’acquisizione di test rapidi per la determinazione sierologica delle principali infezioni a trasmissione ematica e sessuale. 

E’ prevista inoltre l’attivazione di un servizio di ecografia per la diagnosi precoce di problematiche ostetrico-ginecologiche, per refertare patologie infettive e neoplastiche addominali, nonché per la diagnosi di processi patologici polmonari (in Centrafrica non vi è alcun servizio radiologico).

Nel centro è inoltre operante una farmacia abilitata alla distribuzione di farmaci di qualità e al counsellingmirato al rafforzare la compliancedei pazienti e dei loro caregiver.

L’associazione inoltre, all’interno del progetto sanitario, promuove corsi di sanità pubblica rivolti a docenti ed alunni con lo scopo primario di:

  • sensibilizzare sull’importanza della prevenzione poiché l’igiene è fondamentale per il prevenire le malattie;
  • sensibilizzare sulla piaga, assai diffusa, della malnutrizione in età pediatrica cercando così di limitarne l’incidenza.

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