NEXT onlus
O.N.G.

Officially Recognized by Italian Government "NGO Suitable for International Cooperation" Ministerial Decree 2006/337/003828/0 of 16/10/2006 of Ministry of Foreign Affairs

WHO WE ARE

NEXT onlus was founded in 1998 by will of a scientific researcher, LUIGI BELLINI, who, after a trip to Madagascar, deeply touched by the terrible living conditions of the large majority (80%) of the population who lives on less than 1 $ a day, decided to help these people with all his energy and resources.

The organizational and welfare work was gradually developed particularly focusing on the health sector in northern Madagascar, where, progressively, some significant works have been implemented, and are still on going, interacting with the existing public health system.

The activity of NEXT, initially financed with personal wealth, with no contribution by third parties, has been acknowledged by the Italian Government, who granted it the legal status of NGO (Non Governmental Organization) in October 2006. This award will enable NEXT to participate to cooperation projects with International Organizations (UN, UNICEF, FAO, etc.) in its own field of activities. Up to the present date, NEXT hasn’t received any financial assistance from the Italian State, but its action was supported by individual citizens and the Committee for Charitable Assistance to the Third World of the C.E.I. (Italian Episcopal Conference).

In twelve years of work NEXT has accomplished the following:

  • Health and social care for 1000 children on the island of Nosy Be (since 1999 until now).
  • Scholarships for students of primary and secondary schools in Madagascar (since 1998 until now).
  • Vocational training and university education in Italy (since 2004 until now).
  • Repair of school facilities damaged by hurricanes (2003).
  • Construction of one kilometer of paved road to connect the Center “Le Samaritain” with the national road RN5 (2006).
  • Construction of a public fountain in the SCAMA district of Antsiranana (2005).
  • Construction, staff training and activation of the largest Diagnostic Center of Madagascar, which is at the service of private citizens and Public Hospitals, with free services for 35% of patients requiring medical treatment (since 2004 until now).
  • Medical assistance to 800 students of Antsiranana in collaboration with the French NGO “Coeur et Conscience” (at the beginning of 2010).
  • A 100 bed capacity Surgery and Maternity Clinic in Antsiranana (currently nearing completion).
  • Participation to the establishment of the Faculty of Medicine which will be gradually completed within the next 6 years.

IN MADAGASCAR. WHY?

Madagascar is an island-state having 2 times and a half the territorial width of ITALY. Its geological history, with the separation from Africa 200 million years ago, caused a biological evolution and an absolutely unique history. It’s been inhabited for only 2000 years undergoing successive waves of immigration by population from Southeast Asia, India and Arabian Peninsula. Subsequently colonized by Portuguese, Spanish and finally French, it has been exploited for its resources of precious woods and spices. Currently, it is formally a Presidential Republic with approximately 20 million inhabitants. His conditions are underdeveloped and its GDP per capita of 329 U.S. dollars per year makes it one of the last three countries in the world.

The dramatic parameters of its reality:

  • Life expectancy (average): 50 years
  • Mortality rate due to childbirth (estimated value): 4,69 %
  • Infant mortality rate under 5 years (official data): 12%
  • Malnutrition: 63% of the population
  • Malaria: 25% of the population
  • Tuberculosis: 11% of the population
  • Parasites: 36% of the population
  • Cholera: endemic in some areas
  • Leprosy: 50.000 patients
  • Plague: outbreaks in the North – 500 cases per year
  • Income per capita: 329 U.S. dollars /year
  • Drinking water: 8% of the population
  • Access to electricity: 20% of the population
  • Literacy: 40% of the population

The seriousness of the epidemiological situation in Madagascar is due to the inaccessibility to the national health system and to its inefficiency. 80% of those patients who seek the health facilities can’t afford the cost of care; instead, those who are able to access medical treatments receive a poor quality service. This is not surprising if you consider that the financial funding that the Malagasy State destines to Public Health is equal to 5 € per person per year, a paltry and insufficient amount to ensure the presence of qualified personnel, the supplying of essential medicines and the appropriate facilities’ equipment procurements. Such level of public expenditure causes the hospitalization and medicalization costs to fall entirely on the patient, resulting not only in the payment of medical services, but also of everything is necessary for any possible surgical operation, from medical drugs to the yarn of suture. Finally, in addition to the cost of care also the distance is a real problem, because of the insufficient number of existing health facilities and the lack of ambulance services.

Andapa village (Antsiranana Province): a woman with diabetes and without any medical treatment. Old man assisted by NEXT in Andrianakonko village (Antsiranana Province)) Medical visits of NEXT in a village near Andapa (Antsiranana Province)

GEOGRAPHICAL LOCATION

MadagascarThe Center “Le Samaritain” as well as the Maternity and Surgery Clinic currently under construction are in the DIANA region, belonging to the Province of Antsiranana, located in Northern Madagascar, but the action of NEXT extends to adjacent regions within a radius of 400 km where about 3,000,000 people live. The health facilities are 3 km away from the city-centre of Antsiranana, the capital of the homonymous province (the choice of this location was established by the Malagasy Ministry of Health in 2003). To reach the health care complex you must take the national road 6 and continue for 200 meters before turning left onto “Rue de la Fratenité”, where you can find the Center and the Clinic.

THE MAIN ACCOMPLISHMENTS OF NEXT

MEDICAL-DIAGNOSTIC CENTER “Le Samaritain”

Medical-Diagnostic Center “Le Samaritain” The Medical-Diagnostic Center "Le Samaritain" in Antsiranana, whose construction began in 2002, was completed and inaugurated in 2006 with the participation of all political, administrative and religious Institutions of the homonymous Province. The latter conferred to NEXT onlus an official decoration of Malagasy State to show their satisfaction for the project execution. With a structure of 3000 m² and a modern equipment of European level, the Center is the main point of reference for medical diagnostics in northern Madagascar. It serves the entire population, and has adopted a policy which meets different users’ possibilities for payment contributions. The Center collaborates with NGOs, Social Groups and other facilities of Malagasy Public Health (the cooperation agreement with Public Hospitals of Antsiranana and other northern cities) ensuring discounts on the cost of services, but above all it delivers for free the 35% of services for the care of indigent people.

HUMAN RESOURCES

Currently, 22 people, all Malagasy, work in the Center "Le Samaritain" and they are employed under employment contracts in compliance to the Labor Code of Madagascar. The professionals include: doctors, biologists, physicists, technicians, administrative staff, engineers for maintenance and auxiliary staff.

THE MAIN ACTIVITIES

The activity fields of the Center are:

  • A) medical biology
  • B) imaging diagnostic (radiology, ecography, scanner)
  • C) cardiovascular diagnosis
  • D) basic medical visits
  • E) specialist medical visits
  • F) ambulatory surgery (ophthalmology and orthopedics)
A)MEDICAL BIOLOGY

The Center disposes of a clinical tests laboratory, headed by a Malagasy medical specialist in biology and divided into 5 areas:

  • clinical biochemistry
  • microbiology (bacteriology and micoparasitology)
  • hematology
  • cytology
  • immunoserology.

The laboratory staff consists of:

  • 1 medical specialist in clinical biology (Director of laboratory),
  • 1 chemist,
  • 2 biologists (of which one is religious),
  • 1 laboratory technician,
  • 1 nurse,
  • 2 secretaries,
  • 1 equipment maintenance engineer,
  • 4 auxiliaries.

The analysis and operational procedures in force conform to international rules and regulations as of the Guide to Proper testing (GBEA) and the equipment used are in line with European standards. Currently, the Center has been recognized by the Malagasy State as a "Reference laboratory for the fight against Sickle Cell Disease in Madagascar”.

Sr. Hortensia: Biologist at “Le Samaritain” Center Tests laboratory at “Le Samaritain” Center

B)IMAGING DIAGNOSTIC

It is divided into 3 sectors:

  • the RADIOLOGY department has got 2 traditional radiology equipments, 1 mammography, 1 orthopantomography, 1 scanner.
  • the ECOGRAPHY department has got 1 equipment for two-dimensional ecography M MODE N/B and 1 Color Doppler ecographer.
  • within the FIBEROPTIC/ENDOSCOPY department are made the upper gastrointestinal endoscopy or gastroduodenoscopy, the lower gastrointestinal endoscopy or colonoscopy, bronchoscopy.

The staff of this Department is composed of:

  • 1 physician specialist in radiology,
  • 1 medical specialist in gastroenterology,
  • 1 medical specialist in pulmonology,
  • 1 physicist,
  • 1 health technician of medical radiology,
  • 1 nurse.

Dr. Jacques Delon - France – Pulmonologist Dr. Eugene Morel – Madagascar - Gastroenterologist Gravina company – Caserta – Radiological devices

C)CARDIOVASCULAR DIAGNOSIS

In this Department are performed the Electrocardiogram (for which there are 3 complete equipments), the Ecocardiography and the Vascular Diagnostic (Color-Doppler). The staff is made of 1 cardiologist and 1 nurse.

Dr. Rafiakarana Adrienne – Madagascar – Cardiologist

D) BASIC MEDICAL VISITS

Two Malagasy doctors, on a daily double shift basis, carry out general medical visits.

E) SPECIALIST MEDICAL VISITS

These visits are carried out by specialist volunteer doctors who come from foreign health facilities and work closely with Malagasy doctors of the Center. The specializations are: cardiology, nephrology, internal medicine, gastroenterology, ophthalmology, gynecology, orthopedics, surgery.

Dr. Esther Sgambato – Columbus Roma – Internist

F) AMBULATORY SURGERY

The Center is equipped with a block of ambulatory surgery to perform some simple surgical operations of orthopedics and ophthalmology nature.

ONCOLOGY

Since its opening in January 2006, the Center has placed among its priorities the Oncological Diagnostics, completely absent in Madagascar, giving the possibility to carry out a series of preventive examinations to reduce the incidence of this disease: the Pap Test (Papanicolaou Test), to detect the cervical cancer; the tests on tumor markers; and the mammography, which is important for the breast cancer diagnosis. All these modern techniques of investigation used in the Center are helping to spread in the Malagasy medical world a greater sensitivity and attention towards this disease and the importance of early diagnosis, but there is still a great amount of work to be done.

SERVICES PROVIDED BY THE “Le Samaritain” CENTER FROM 2007 TO 2010

YEAR NUMBER OF PATIENTS ASSISTED
2007 4.000
2008 6.000
2009 9.000
2010 11.500

TEACHING AND PROFESSIONAL TRAINING

Starting from 2004 the Medical-Diagnostic Center “Le Samaritain” provides to professional training for its staff both in Madagascar, with the collaboration of personnel coming from others European health facilities, and directly abroad, with training periods of variable duration (with a minimum of a two months period) as needed.

Currently, the Center is training the following Malagasy collaborators:

  • a religious Medicine female student at University of Mahajanga, in Madagascar;
  • a religious female student in Economics at “Cattolica” University in Rome, Italy;
  • a religious female biologist for a in-depth course for the duration of three months in Parasitology at University of Pisa, Italy;
  • a medical specialist with a scholarship of one year in Neurological Diagnosis at University of Pisa, Italy;
  • a medical specialist with a scholarship in Cardiology at the Hospital of Benevento, Italy;
  • two students in Economics in the three-year program degree at University of Benevento, Italy.
THE CENTER ALSO CONTRIBUTES TO THE TRAINING OF HEALTH STAFF COMING FROM OTHER ORGANIZATIONS

It has got an internet access to enable students and professionals engaged in researches and theses to consult the bibliographical materials on-line. Starting from 2006 the following external professionals have been prepared at the Center “Le Samaritain”:

DUTY FIELD PERIOD CURRENT PLACE OF EMPLOYMENT
1 General practitioner medical radiology 6 months International NGO
1 General practitioner medical cardiology 1 year Public Health Department of Madagascar
1 Biologist biochemistry 6 months University of Antsiranana
1 Biologist DEA biochemistry 6 months Laboratory of the Antsiranana Public Hospital
1 nurse laboratorial tests 1 year Head of the Public Dispensary in Nosy Be
1 Student thesis in pharmacology 6 months Student at the University of Tananarive
2 Technicians trainees medical laboratory 3 months Students at the Paramedic School of Tananarive

INTERNATIONAL COLLABORATIONS

The Center “Le Samaritain” works with several partners:

  • since its opening in 2006, with Doctors Volunteer Italian and French who take turns in the structure to ensure free advice in their respective areas of specialization;
  • since 2009, with the l’Association “Terre Rouge” of the Reunion Island in the field of orthopedic surgery;
  • since 2010, with the Association “Coeur & Conscience” of Antsiranana (with an office also in Paris) to help children with diabetes, which are numerous in the North of Madagascar;
  • with the Second University of Naples for sending of medical teachers or for internship stages;
  • with the University of Pisa to carry out internships for Malagasy doctors.

PARTNERSHIPS AND AFFILIATIONS

Professor Franco Mosca – Surgeon – University of Pisa President of the Foundation A.R.P.A. – Genuary 2010 Ongoing cooperation (project Hope) with NEXT onlus NEXT onlus collaborates since 2000 with the Sisters Congregation of St. John the Baptist, who currently manages the administration of the Center “Le Samaritain”; since 2002 withECAR (Malagasy Catholic Church), which granted the land on which the Center has been built and now there is also the Clinic of Maternity and Surgery; since 2008 it is accredited at the “Committee for charitable actions in favor of the Third World” of IEC (Italian Episcopal Conference), which has provided a contribution to help build the Clinic of Maternity and Surgery; in November 2010, the Association has promoted a humanitarian Association under Malagasy law, to better meet the regulations of international cooperation which impose bodies with Malagasy juridical personality. The latter will be affiliated to NEXT onlus.

H.E. Mgr. Martin Nugent – Apostolic Nuncio in Madagascar Professor Natale De Santo - Nephrologist 2nd University of Naples Promoter of the 1st Dialysis Center in Northern Madagascar

CLINIC OF MATERNITY AND SURGERY

The current objective of NEXT is “Providing medical assistance for Maternity and Surgery for common diseases of the population in the districts of Antsiranana and in all provinces of northern Madagascar” through the construction and equipment supplying for a 5000 m² Clinic having capacity of 100 beds, located next to the Medical-Diagnostic Center “Le Samaritain”.

This new three floors building will include the maternity, general surgery and medicine departments and will be set up with:

  • a main operating room, dedicated to the elective surgery operations;
  • an emergency or secondary operating room;
  • a delivery room with two chairs for delivery and related care facilities for the newborn;
  • a sterilization room;
  • a post-operative ward with 70 beds capacity;
  • a hemodialysis center (which will be the first across Northern Madagascar);
  • an emergency room service.

Also, some additional works will be needed for its operability:

  • the asphalting for the road and the forecourt in front of the Clinic;
  • the installation of 2 lifts for patients;
  • the installation of 2 auxiliary generators (or solar panels), with a power of 50 KW, to provide electricity during the frequent cases of power interruption supplied by the urban electricity power network;
  • the construction of a reserve basin for water with capacity of 400.000 liters.

Clinic of Maternity and Surgery (under construction) – November 2010 Clinic of Maternity and Surgery (under construction) – November 2010 Clinic of Maternity and Surgery behind the Diagnostic Center “Le Samaritain”

EDUCATION

The training is a fundamental aspect of the intervention strategy of NEXT onlus and an essential element for the quality sustainability of services offered. For this reason, the project provides traineeships and higher training in surgery both for medical personnel, trained in general surgery, and for the nursing staff. This training and traineeships program will include a practical part, which will take place in the Italian Universities and Hospitals, and a theoretical part, for which material and tutors will be provided to trainees in a study area dedicated to them.

PARTICIPATION IN THE FOUNDATION OF THE FACULTY OF MEDICINE AND SURGERY

Foundation Act of Medicine Faculty with the Minister of University Tongavelo  Athanase Madagascar, 10 September 2010 In September 2010 the NEXT onlus signed with the Malagasy State and the Rector of the University of Antsiranana an agreement to establish the Faculty of Medicine and Surgery in Antsiranana. It will be gradually activated within six years and in November 2010 the first year of the course has taken its start with 25 students selected with strict criteria of merit. For them now it there is a necessity to find all types of teaching materials as well as resources to finance student housing. NEXT is committed both in terms of contribution to the teaching part and at the level of development of training and building cooperative relationships with medical Faculties abroad.

AWARDS

The accomplishments of NEXT onlus have received an important award in the Week of International Solidarity, held in Paris from 13 to 21 November 2010.

PARIS, 20 November 2010: International Solidarity Week – world preview of documentary-film «FIHAVANANA. 5 HOMMES D’EXCEPTION» On this occasion, the documentary-film “FIHAVANANA” by director Vernet Damien was viewed as a preview. It tells about the social work of “5 exceptional men”: Amedée (Coeur et Conscience), Père Pedro (Akamasoa), Dr. Nour’Aly (Global Medical Center), Rola Gamana (Hors Circuit) and Luigi Bellini (NEXT onlus).

These men, religious or secularized, with different stories and paths, share a big dream: to offer a more dignified life for the people of Madagascar, whose vast majority, still today, live in a state of poverty almost unknown to the western world and absolutely unacceptable..

Others Awards:

  • 2006: Medal by the Catholic Malagasy Church.
  • 2007: Appointment as “Chevalier de l’Ordre National” by the Malagasy State.
  • 2007: Honourable Conferment by the Italian Institute for Philosophical Studies – NAPLES.
  • 2008: “Premio Internazionale per la Solidarietà Padre Pio” (Father Pious International Solidarity Award) – ITALY.
    ITALIAN INSTITUTE FOR PHILOSOPHICAL STUDIES - NAPLES Conference “Missione sanitaria in Madagascar: idealità, impulso e coscienza” – 4 April  2007 (Health mission in Madagascar: ideal, pulse and consciousness) The dr. Luigi BELLINI and the lawyer Gerardo MAROTTA (President of the Institute)
    ITALIAN INSTITUTE FOR PHILOSOPHICAL STUDIES - NAPLES Conference “Sopravvivere non basta” (Surviving is not enough) – March 2010 The dr. Luigi BELLINI and the philosopher Edgar MORIN
    Text by Gerardo Marotta, President of the Institute for Philosophical Studies, published in the main Italian newspapers.
 
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