"We all - the mobile groups and stationary medical points - need new radio equipment," Mikhail Safronenko, regional coordinator of the Russian Red Cross Society, says. "We may use the frequency of 27 MHz. I explored the issue - this is a civilian frequency, and so we will not interfere with the military. Can WHO help us to get it for our own use?" WHO’s Officer Vyacheslav Matveev promised to pass the request on to his office.

"I work next door to WHO’s office," Georgi Meltauri, UNICEF stuff in Vladikavkaz says. "Whenever I need any consultation I can rely on WHO’s expertise."

One of the most vivid illustrations of the large-scale consensus developed in health-related fields was a ban on the distribution of anti-tuberculosis drugs. The treatment of TB is a systematic process and cannot be interrupted in mid-course. The situation in the Northern Caucasus does not permit launching of a large-scale treatment campaign. The migrating IDPs, if being supplied with drugs now, risk developing multi-drug resistance as a result of uncontrolled treatment. This would only worsen their condition.

"They have nothing at all in their hospitals for us. Only aspirin to cure all illnesses," Malika Malsagova, 50, an IDP from Chechnya staying now in Nazran, Ingushetia complaines.

"It is common that IDPs complain about the shortages. They expect that the more they ask, the more they would be given. Our data shows that the medical supplies given to us by humanitarian organisations are properly conducted," says Kambulat Uzakhov, the Health Minister of Ingushetia.

These two statements illustrate why it is important that WHO constantly monitors the health and health care in the affected areas. One result of the monitoring in the North Caucasus is the creation of a database on disabled IDPs. It was not a simple task. No statistics could be obtained from official sources. The collected information then helped to implement the programme for prosthetic assistance. Another task for the monitors is to assess the capacity of the primary health care system - IDP camp first aid points, ambulatories, and local outpatient clinics. They report on the conditions of the technical facilities, transport, specialists, drugs and medical materials available, so that WHO could, in cooperation with other agencies, take the necessary actions.

"The last time I was given a new prosthesis was in 1991," Hussein Djambulatov, a villager from the Chechen settlement of Goity, recalls. "Since that time the workshops making things for the disabled in Chechnya were not working and assistance was provided only to the participants of the first Russian-Chechen conflict of 1994-1996. The Chechen government was sending them to Baku or to Makhachkala. The ordinary Chechens never enjoyed such a privilege."

"WHO provides three-quarters of the all the prostheses that we distribute," said Vladislav Yesiev, the head of prosthetic workshop in Vladikavkaz. "And WHO-supplied prostheses are the most popular among our patients." "Usually we provide our assistance to 15 - 20 amputees a month, but after WHO helped to upgrade our workshop, giving us new equipment and sending specialists from St. Petersburg to train our personnel, the workshop could make 50 prostheses in a month."

June 2000. - The Anarik IDP Camp near Nazran, Ingushetia. The dark warehouse of a bakery that was working here in the calm old days, now houses 35 Chechen families. Divided up by partitions of grimy planks and raggy pieces of old cloth, the room resembles a honeycomb. An old woman lying at the top bunk of a plank bed in the middle of the warehouse starts coughing. She coughs long and loudly, her body shaking with each spasm. Half-conscious, she does not answer questions.

“She is coughing all the time,” a neighbour sighs. “For two months already, may be three. Of course, we worry about ourselves. During the daytime we try to keep our kids outdoors, but they cannot stay there forever. But we will never throw this woman out to die.”

“And what if she has tuberculosis?”

“We pray to Allah she has not.”

A training seminar on the care of new-borns and advanced breast-feeding methods was organised by WHO in Tver in June.

The main aim of the seminar was to change the ideology and technique of caring for healthy newborns. Unfortunately, many health care workers are of the erroneous opinion that pregnant women and new-borns should be treated as though they are sick. The seminar, attended by 20 specialists in various fields, was dedicated to this very attitude. Neonatologists, obstetrician-gynaecologists, nurses, family doctors, and administrators discussed infant care, breast-feeding, and the difficulties associated with it, as well as the care of sick new-borns and new-borns with low birth weight, and their feeding.

Maria Petevi, the WHO expert on mental health of refugees, made in July an assessment of the situation among the displaced community in Ingushetia. WHO plans to start actions to help people in distress as soon as possible to prevent further deterioration of the health of the chronic mentally ill and retarded, and individuals with severely injured psyche. The whole community is suffering from the psychosocial consequences of the war and needs urgent support. Ms. Petevi found that so far very few agencies are providing any mental health assistance, despite the extremely high needs. The visits to two camps for internally displaced persons revealed enormous psychosocial pressure upon their inhabitants. In addition to the war and related atrocities they had faced in their native land, they face very difficult exile conditions and precarious camp life. There is considerable anger and anxiety on the one hand, and depression and idleness on the other. Great discontent is generated by very poor living conditions, lack of school education for children, no prospect for employment, and no end to the conflict and hope to return home. These are factors, which gradually weaken people physically and mentally. Medecins du Monde, a non-governmental organisation active in the North Caucasus, reported a clear general decline in mental health of the people. Their despair over the fate of relatives back home and the feelings of hopelessness and helplessness run deep. Their dependency upon others and the international community is a very disturbing factor. The whole community is suffering from psychosocial consequences of the war and needs urgent support. Psychiatric treatment is not enough. Action needs to be focused on improving the quality of life of the people. A WHO Mental Health Committee for the North Caucasus will be created to implement, monitor and evaluate a comprehensive mental health programme. It will establish strong links with UNHCR and UNICEF. The Committee and its local and international collaborators will organize training, establish and maintain networks and improve coordination. It will also see that adequate psychiatric care and mental health projects are provided in Ingushetia and Chechnya. A Psychosocial Rehabilitation Centre will be set up in Pliyevo, a village near Nazran, the capital of Ingushetia. The Centre will first serve as a clinic for care of chronic psychiatric patients so as not to send them to other republics of the Russian Federation. It will also serve as a base for the WHO Mental Health Committee.