A presentation on IOM Resettlement Program in East Africa

1. A presentation on IOM Resettlement Program in East Africa

2. A presentation on IOM Resettlement Program in East Africa

3. Departure Statistics 2008-2009 Individuals

4. Departures 2009, by FD

5. Refugee Processing Flowchart UNHCR US EMBASSY CHC AHC JVA (3 steps) IOM DHS IOM GoC, CIC Cultural Orientation Medical Cultural Orientation Medical Security Sponsorship GoA, DIAC JVA CHC JVA US Volag USG AHC Cultural Orientation Medical Security Assurance JVA IOM Bookings, Clothes Pre-dept meds, Escorts

6. MRF Nairobi • Supports activities in 10 countries • Kenya, Uganda, Ethiopia, Sudan • Tanzania • Burundi, Rwanda, Somalia, Djibouti, Eritrea

7. Resettlement Activities • Medical Screening • Cultural Orientation • Operations

8. Operations • Offices in Kampala, Khartoum, and Addis Ababa operate independently. • Nairobi facilitates all other departures from ER, SO, TZ, KE, DJ, BU, RW. MRF Nairobi also books family reunification and USRP cases from DRC. • More then travel services……

9. STAFFING AND MIMOSA USE PER LOCATION

10. Operations (cont) • Operation’s services • Projections of Departures. • Logistical support of OPE, resettlement interview missions. • Ground Transportation to the point of departure. • Individual and group bookings. • Receiving travel documents from the embassies, OPE for Kenya and the region, tracking and sending back, if required (expired, for amendment, correction). • Communication with sponsors in resettlement country and related government agencies. • Liaison with UNHCR. • Finger printing. • Arranging for pre-departure medical checks. • Coordination of DNA projects (Eg.: Italian cases).

11. Operations (cont) • Operations service (cont) • Provide clothing (when necessary) • Provide escort (when necessary) • Provide overnight accommodations • Facilitate ground transport to airport • Provide charter flights • Confirm identity and checking baggage • Facilitating pre-embarkation formalities. • Exit formalities (liaison with Immigration and Refugee Affairs Departments) • Facilitating transit assistance. • Logistical support to US, Danish, Dutch, Finnish CO missions (Under Operations).

12. MIMOSA and OPS needs 29 users in different units: Airport, Data Entry, Finance, Operations Assistants (bookings), Management. • Needs: 1. Periodical report for cases/individuals departed with UNHCR reference numbers (currently produced manualy). 2. Report “Cases received, not on movement” needs to show all case members, case size needs to be indicated for PA only for easy calculation of total numbers. Especially important for non-USRP cases, as for USRP we have at list MTIF for cross check and verification. 3. Access to the regional Mimosa data. MRF has a strong need for different periodical statistical reports, and it is always a challenge to get data correct and on time.

13. MIMOSA and OPS needs 4. Option for a BIO data report by case, as we have cases registered, but they are not yet imported into Movement Module (no MTIF from OPE), this is used for communication with OPE, PRM, HCR on different reasons, like case composition questions, family relation verification, etc. 5. CBU list should be kept as we use it for communication to the airlines - it is more user friendly than ABN for the airline staff. It is useful as it has a breakdown by case/family, not just a list. “Name list to the airline” is useless as we use CBU, which has case composition and sequence as ABN for easy reference. 6. Periodicals do not produce a report by only one required PC. 7. Movement’s status DEP generates DNS/NRS. In Nairobi, we have a separate step and staff for this, and we are not ready to generate this report on the departure date. Changes required. 8. Slow printing of PNs. 9. We have always an issue with a case split by OPE after medicals are done. In this case, Mimosa has old case composition, and MTIF importation fails. We are never informed by OPE on the splits and new case numbers, when splits are being done by OPE.

14. MHD

15. TUBERCULOSIS SCREENING ALGORITHM (1991) < 15 Years of Age ≥15 Years of Age Medical History P.E HIV CXR Sputum smears only for active TB cases. Treat smear positive cases 1991 TECHNICAL INSTRUCTIONS FOR TUBERCULOSIS SCREENING

16. TUBERCULOSIS SCREENING ALGORITHM (2007) < 2 Years of Age 2 – 14 Years of Age ≥15 Years of Age Medical History P.E TST Abnormal CXR consistent with TB: Sputum analysis (smears and cultures) CXR HIV 2007 TECHNICAL INSTRUCTIONS FOR TUBERCULOSIS SCREENING

17. SUSPECTED TB HIV Positive Sputum analysis SUSPECTED TB HIV Negative Sputum analysis NO TB HIV Positive Sputum analysis TUBERCULOSIS SCREENING ALGORITHM (OCT 2009) 2 -14 Years of Age <2 Years of Age ≥15 Years of Age Medical History P.E Contact to TB disease, or TB sign or symptom (for <2 years) Chest radiograph PA for ≥ 10 years PA-Lateral for <10 years. Tuberculin skin test TST TST ≥10 mm Sputum analysis (smears and cultures) NO TB or B2 TB or B3 TB HIV negative

18. MMIF, photos are uploaded to MIMOSA and the relevant photos are linked MHD in coordination with the OPS develops required HA schedules IOM local Nursing Section in coordination with the head nurse develops an action plan for a given period The local medical section coordinates with the OPS on a timetable for HA Refugees are informed about the date of the HA at least one week prior to the HA DS and consent forms are printed TST of required age group are administered Consent forms are signed & counseling is performed Refugees are brought to the screening point ‡ Provide OPE with the original copy of DS forms Preliminary interview is completed by the nurses ¥ Blood tests , vaccinations and CXRs procedures are completed Physical Exams (MHP) & Vaccination (Nurse) ¥ ABN is issued, OPS and CO procedure are completed Treatment or/and investigations, other than TB, can be completed within a short period? Refugees with abnormal findings Yes No No MEDICAL CLEARED * Investigations result arrived or/and treatment completed satisfactorily Yes PDMS, complete/do vaccinations, dewarming Malaria test/Rx No Yes Refugees with active/inactive TB, class A or/and any other conditions not fit to travel No Yes Hard copies of required documents are included in the medical envelopes € Yes No Wait for Dx or to complete Rx and other required investigations/procedures Re-medical if need be. Stable or not any new findings in the required repeated MS S/C negative TB, cured TB case, class A with approved waiver and other stable abnormal conditions Electronic copy of DS forms are uploaded to CDC database after departure USRP Medical Screening (MS) Procedures ¥ Nursing section and the panel physician make sure correct identification of examinees and follow the update technical instructions and TB TIs for each step of the HA procedures. Consult CMHP or/and CDC if there is any exceptional circumstances. PRM/OPE informs IOM about the the registered cases to undergo Health Assessment (HA) ‡ Local responsible nurse and medical clerk make sure that all required documents and medical reports have been prepared prior to the arrival of refugees for PE by the panel physician, including immunization records of children and any previous treatment particularly for TB. * Panel physicians do not forget to fill the travel requirement sheet in for any requirement including medical escort.

19. BOTSWANA BURUNDI CONGO BRAZZAVILLE KENYA MAURITIUS UGANDA TANZANIA ETHIOPIA ZIMBABWE ERITREA RWANDA SOUTH AFRICA SWAZILAND NAMIBIA MOZAMBIQUE DJIBOUTI ZAMBIA MHD Department: COUNTRIES UNDER MHD NAIROBI AND IN MIMOSA

20. COUNTRIES UNDER MHD NAIROBI NOT IN MIMOSA • WEST AFRICA • MIDDLE EAST • EGYPT • These countries report to MHD Nairobi • Data kept in these locations not in Nairobi MiMOSA • Compilation of periodic reports in Nairobi • Policy formulation and streamlining of work systems

21. Countries of Resettlement and MHD Mimosa activities • USA (Refugees and Self Payers) • USA HA DS Form in Mimosa • AUSTRALIA (Refugees and Self Payers) • Australia HA Data Entry Form in MiMOSA • CANADA (Refugees and Self Payers) • Canada HA Data Entry Form in MiMOSA • NEW ZEALAND (Refugees and Self Payers) • IOM HA Data Entry Form in MiMOSA • UK (Refugees and Gateway Program) • IOM HA Data Entry Form in MiMOSA • DENMARK (Refugees) • IOM HA Data Entry Form in MiMOSA • IRELAND (Refugees) • IOM HA Data Entry Form in MiMOSA • NORWAY (Refugees) • IOM HA Data Entry Form in MiMOSA

22. Health Assessment Procedures • OPE produces a quarterly Schedule of circuit rides • OPE sends a list of pre or post DHS circuits and photos to IOM • MHD imports the list and photos into MiMOSA • Individual and document statuses are updated • Medical forms are printed for HA • Forms transmitted to respective locations (outside Nairobi) • Completed medical forms and those on hold are returned to DaProFo for QC and onward transmission to OPE • Status is updated in MiMOSA for both Hold and cleared files • Files are scanned for Data Entry • Files are returned to OPE • A CD of scanned files are sent to OPE • Except: • Dadaab (Kenya) printed form are sent to OPE • MHAC (Kenya) printed form are submitted to OPE and the Embassy from Mid January, hopefully • Ethiopia: Printed form will be sent from February

23. PDMS Pre-departure Medical Screening • These refugees undergo PDMS check twice before travel • Dadaab Refugee Camp - Kenya • Kakuma Refugee Camp - Kenya • Kibondo Refugee Camp – Tanzania • Other locations depends on the distance from the airport, undergo PDMS once or two times • The data of PDMS is not captured by MiMOSA

24. KENYA

25. ETHIOPIA

26. TANZANIA

27. OTHER COUNTRIES

28. Challenges for MHD: • Approval list takes time because DHS avails lists after completion of circuit rides • Transmission of photos is manual (CD) because of size for large caseload. Sometimes it cannot be uploaded • Transmission of medical forms to remote locations receiving and receive back • MiMOSA is relatively slow compared to that of 2004 • Some MiMOSA bugs force the user to close the application • Radiologist unavailability and logistical challenges • Working with panel physician is not easy

29. Proposed Solutions: • If OPE can provide pre DHS list to MHD. Denied cases can be archived. • Direct connection between Mimosa and WRAPs? • Option of printing case by case from Mimosa for large caseloads. • Some other option for draft file print. • PDF files should be organized to print case by case and file by file for field locations. • Web based MiMOSA will be a best solution.