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The prevention program in Caritas begun in 1987 through awareness campaigns addressed to the officials and individuals dealing directly with the youth like religious leaders, Ministry of education and Ministry of youth personnel.

These awareness campaigns included lectures in subjects such as the harmful effects of drugs, theories explaining reasons of youth addiction, and plans of action to avoid intake of such drugs, as well as providing information to the youth themselves and answering their questions in schools and social clubs.

Patients are received by specialists who evaluate them as regard as to the type of addiction, duration, severity of withdrawal symptoms, desire of abandoning addiction and motivation for rehabilitation. Severe cases are referred to departments for detoxification in governmental hospitals or to private medical hospitals. In both conditions, cases are visited and followed by social workers and psychiatrist of the outpatient center when possible.

Some cases are managed at home with few drugs, under the support of the family and the outpatient center’ staff through regular visits and phone contact.

After detoxification, the client attends the social rehabilitation center. Therapy plan is decided and agreed between therapist and client.

Psychiatric sheet is done too, to exclude dual diagnosis if the patient will attend the rehabilitation program in the Oasis of Hope.

Opened in1995, the patients come to the center 3 times per week where they undergo a rehabilitation program under the supervision of a team which includes psychiatrists, a social worker, physical trainer and some ex addicts. The following services are provided:

5. Follow up of ex drug addicts to support them and prevent them relapsing again.

The patients continue visiting the center for several months until they fulfill the rehabilitation program.

Established in the year 2000, located at km 72 north/west of Cairo near the desert highway, it aims at rehabilitating drugs abusers and admits the cases after the phase of withdrawal.

Admission is based on two factors: a sincere desire to abandon addiction and to be rehabilitated and the

assessment conducted by the treating staff to health, psychological and legal aspects of the patient.

The rehabilitation can be divided into 3 phases: assessment, renewal and changing and finally social reintegration.

The duration of the rehabilitation is variable according to each individual case. The maximum duration usually is 6 months where psychological, social, family, occupational and work therapies are conducted.

Activities of the prevention department of Caritas Alexandria

The following services are provided

1. Training programs for those involved with youth in order to provide them with skills and abilities to conduct well planed productive programs among those youth groups to increase their awareness and master the important life skills needed to combat drug addiction.

2. Awareness campaigns aimed directly at youth groups in cooperation with the official authorities.

3. Highly specialized training courses for those working in drug rehabilitation.

4. Cooperation with other agencies and organizations working in the drug prevention and rehabilitation.

Was established since the year 2000.
Aims to provide information, support, counseling and medical advice to all callers and to respond to all their questions.
Complete secrecy and discreetness is assured in order to allow callers to ask freely about sensitive issues and personal concerns.
9 a.m. till 9 p.m. everyday.
Cairo: (02) 576 22 42; Alexandria (03) 484 41 69

The project’s overall goal for this phase is in line with the UNAIDS goal. It aims to;

For the project to achieve its overall goal, the following set of specified objectives has been identified:

1. Establish/sustain Anti-AIDS clubs in schools as a focal point for the school-based intervention,

2. Mobilize at least 5% of the students in the selected schools to participate with a fair share in actual program delivery at school level,

3. Increase awareness and preventive practices regarding HIV/AIDS related health risky behaviors among students by at least 10 % in the selected schools,

4. Apply two different intervention programs addressing HIV related behaviors -short and long term expanded programs- among delinquents in 4 delinquency centers,

5. Provide -in liaison with concerned bodies- voluntary counseling and testing services “ VCT ” to those in need , upon request,

6. Utilize and maintain the AIU help-line services for provision of information and anonymous unlinked counseling services,

7. Design and implement a capacity building program for concerned health care/social care providers to strengthen their HIV- related knowledge, skills and preventive practices.

8. Advocate and encourage close partnership with other interested potential stakeholders, both governmental and non-governmental.

The project in this expansion phase is planning to expand its umbrella of coverage, to enable its intervention messages to reach more target groups and beneficiaries, these include:

Indirect beneficiaries : Apart from the broad base of the direct beneficiaries, the intervention messages may reach a quite fair number of indirect beneficiaries e.g.:

The first case of AIDS was diagnosed in Egypt in November 1986. Following which a National AIDS Program and a National AIDS Committee were established in 1986.

A number of ministerial decrees were issued to guard against the introduction and further transmission of HIV in the country. The second decree issued in 1986 added AIDS/HIV to the list of notifiable infectious diseases. Standard case reporting form for all suspected HIV and AIDS cases were developed. Standard case definition based on WHO-Bangui case definition was issued to all diagnosing physicians especially in Fever Hospitals.

Central and Peripheral Public Health Laboratory testing was established in 1987, and all blood for transfusion has been screened since then. The network of peripheral laboratories performs ELISA in all requests for testing and all reactive samples are sent to the Central Laboratory for a second ELISA and confirmatory test. All positive blood samples are linked and followed back to the individual who is given post-test counseling and notified on the HIV/AIDS report form. All laboratories submit a monthly report to the Central Laboratory on the type and number of population groups tested and results.

Ensuring sterile conditions for skin piercing and surgical procedures, reducing transmission among drug users, and preventing prenatal transmission.

Providing health care for HIV infected persons, with and without AIDS symptoms, reducing the social impact of HIV infection including support for families and communities, and promoting action to reduce social and economic consequences of the epidemic.

VCT objectives:
To provide counseling about risk reduction for HIV-negative person, to identify HIV-infected persons for clinical interventions, and to provide counseling to HIV-positive persons about potential transmission, and to give the needed support.

VCT as part of a package:
VCT will be part of a package of comprehensive services, from which the client can benefit. The package will be offered in form of one-stop-shop.

There are 27 peripheral laboratory one in each governorate for voluntary counseling and testing in addition to central public health laboratory which serve great Cairo.
Voluntary HIV testing is done also in more than 120 private laboratory mainly in big cities but no counseling services are available.

Prevention of perinatal transmission through:
Sentinel surveillance for pregnant women
Counseling for women married to HIV +positive husband
Public awareness about HIV/AIDS prevention

Hotline service:

Part of IEC strategy was the establishment of the Egyptians AIDS Hotline Service. This has been established in co-operation with Ford Foundation. The Hotline has been started since September 1996 to inform the public about AIDS and STD. Making available counseling, information, support and referrals regarding HIV/AIDS and sometimes sexually transmitted diseases to all members of the Egyptian population and even to members of Arab Speaking states. The line has received about 33,000 calls; some were from the Arab and from Europe.

Collaboration with international agencies:

The international agencies as World Health Organization, UNICEF and UNDP support Egypt National AIDS Control Program control since 1986 with technical assistance and training of the nationals, and financing the different activities of the program.

Increasing collaboration with the international research institutes of the donor agencies especially in the areas of vaccine and virus typing.

Supporting the national institutes in the field of research concerning the social, psychological, and economic impact of AIDS at individual or community levels.

Egypt started cooperation with UNAIDS program since 1996 through the UNAIDS theme group implementation of different interventions to control HIV/AIDS epidemic. These interventions include protecting blood supply, treatment of sexually transmitted infections, youth program and promote voluntary counseling and testing.

Multi-sectoral approach to cross-sectoral problems:

The health sector has been often left with the role responsibility of dealing with epidemics in general. The same has been true with the AIDS epidemic yet, it has been found that prevention, care and addressing the impact and psychosocial sequel of AIDS, are the responsibility of the whole society. To turn around a runaway epidemic, a sustainable multi-sectoral action is needed. This has been presented as the mean to decrease risk behavior and diminish the rate of new HIV infection.
Accordingly, since the beginning of the epidemic, Egypt has implemented a broad based action on a national real working to integrate a response to AIDS in almost everything from education to religious aspects, from students to people in workplace, from youth to public at large. This strategy has been proven to be effective in establishing and sustaining prevention interventions among vulnerable groups and in promoting national understanding and support to HIV positive persons.

The Egyptian National AIDS Program tried to involve different ministries and departments along with schools, universities religious communities businesses and NGOs. All these have regular access to various population groups that they can educate about HIV/AIDS.

Coordination with other Health Sectors:

Which include, TB control program, blood banks, STD control program, Research institutes and central and peripheral laboratories.

Ministry of education:
Implemented different actions to increase students awareness. First HIV/AIDS information has been integrated into the basic school curricula. Based on the fact that AIDS education but useful life skills as how to avoid risk situations or drug use, this was supplemented by seminars, peer education programs, contacts and training workshops for school teachers and students all over the country.

Co-operation with Ministry of Awakaf and Religious Affairs:
To implement training of trainers program for religious leaders, to increase awareness of the public in relation HIV/AIDS prevention and control.

Co-operation with Ministry of Labor:

At 5 industrial cities and tourist areas, to increase awareness of factory and tourism workers about sexuality and AIDS to promote safe sexual behavior among young people.

Co-operation with Media Sector:

Which includes radio, TV, national and local newspapers and magazines to update their information in relation to HIV/AIDS epidemiology and national and global situation. Media plays an important role to raise national awareness of the status of the epidemic and its current and potential socio-economic impact.

NGOs participation:

For community mobilization against HIV/AIDS this includes, increase community awareness about vulnerability to HIV/AIDS, motivate community leaders to support HIV positive persons and their families, and strengthen the status of women in order to reduce there vulnerability to HIV and AIDS. In Egypt there 12 NGOs have different prevention activities especially with high risk behavior groups.

Leprosy is a chronic infectious disease caused by mycobacterium leprous. Leprosy affects mainly the peripheral nerves, the skin and the mucosa of the upper respiratory tract.
How do leprosy patients start noticing it?
The earliest complaints vary in order from one person to another; i.e. some people complain of hypo aesthesia or an aesthesia in a skin lesion suggestive of leprosy, others complain of the skin lesions before noticing the sensory problems, skin lesions can be single or multiple, usually less pigmented than the surrounding normal skin (hypo pigmented) sometimes the lesion is reddish or copper colored. A variety of skin lesions may be seen sometimes a flat discoloration, sometimes raised masses that vary in size. Commonly the nerves affected are those of the

Leprosy may cause loss of eyebrows, unblinking stare i.e. the patient wouldn't blink so he would look like he's staring, there's a lid gap when the patient attempts to close his eyes, his eyelids could be turned abnormally outwards or inwards, the eye lashes could be turned inwards which makes them rub the cornea and cause irritation, white spots may be seen on the cornea as well as redness around it's margins, also the pupils may not react quite normally constrictive pupils irregular in shape,reacting sluggishly to light could be a sign of eye affection in leprosy.

3.nerve enlargement (i.e. nerves get thicker that is felt by palpating the nerve),

However it's worth mentioning that the main cause of morbidity in leprosy is the neurological manifestations, these are responsible for the great bulk of disabilities and deformities displayed by many leprosy patients.

Diagnosis of leprosy is based on its signs and symptoms that are quite familiar by a trained health worker, only in rare instances is there a need to use laboratory and other investigations to confirm diagnosis.

Leprosy in an endemic area an individual should be regarded as having leprosy if he shows ONE of the following cardinal signs:

1. Skin lesion consistent with leprosy and with anesthesia or hypo aesthesia, with or without thickened nerves.

A person presenting with skin lesions or with symptoms suggestive of nerve damage, in whom the cardinal signs are absent or doubtful should be called a "suspect case" in the absence of any immediately obvious alternate diagnosis. Such individuals should be told the basic facts of leprosy and advised to return to the center if signs persist for more than 6 months or if at any time worsening is noticed .suspect cases may be also sent to referral clinics with more facilities for diagnosis.

Man is the only recognized source of infection .it's transmitted from one untreated patient carrying the organism through the respiratory tract or skin. The major sites from which the organisms escape from the body of an infectious patient are the nose and the mouth. They enter the body through the nose mainly, minor skin abrasions may also get contaminated, however most individuals have considerable natural immunity and many infections are suppressed.

However it's hard to get new leprosy cases in non-endemic areas without known close contacts.

The period between the time of entry of the organism and time of onset of clinical signs is called incubation period. The incubation period could be as short as 6 months or long up to 30 years. The average incubation period is 2 to 4 years. Leprosy can affect all ages and both sexes.

We carry out our activities through 18 provincial leprosy clinics sited at the capital of the provinces with sub centers in the districts.
There are also two leprosaria, one at Abu Zaabal near Cairo, and the other at Amriya near Alexandria.
Caritas developed control programs following the various trends in control adopted on international level i.e. segregation in leprosaria then outpatient treatment ,mono therapy then multi drug therapy, social services through local leprosy relief associations etc. Caritas together with the WHO and ILEP members (the German leprosy relief association and the Damien Foundation) achieved the following:

1. all leprosy clinics work as integrated leprosy dermatology clinics and are adequately stuffed and equipped.

2. introduction of computer facilities at central level which resulted in more accurate monitoring of the field activities and correct statistics.

3. regular training for the staff of the program as well as for the staff of primary health care, dermatologists, social workers and nursing students.

4. a plan for tracing of defaulters was started in 1996 and proved very effective in bringing defaulters back to treatment .a success rate of 70% was reached.

5. a plan for active case detection by examination of contacts of all newly detected cases was adopted and implemented regularly.

7. ulcer care was established in all leprosy units and performed by trained nursing staff.

8. prevention of disabilities by early detection and proper treatment of reactions and neuritis .

11. reconstructive surgery was planned for correction of consequences of the disease.

The program was supervised and the field work was monitored by the senior staff of the program.

In 1987, Caritas Egypt established SETI Center in answer to the persistent problem of lack of suitable services for persons with mental disability. SETI stands for Support, Education, Training for Inclusion. The center aims at improving the quality of life of the largest possible number of persons with disability, especially those with low financial means and living in difficult socio-economic conditions. A low cost approach is adopted, through the interaction between skills of existing organizations and resources present in the local communities. This approach is a family and community-oriented approach.

Why a family and community-oriented approach? Statistics indicated that among more than two million persons with disability, only few thousands have access to some sort of service, i.e. a percentage of maximum 1 to 2%.

The remaining 98%, representing all age groups, types and degrees of handicap are deprived from educational, recreational or rehabilitative programs of any sort, causing problems to hundreds of thousands of families.

Traditional solutions like the provision of trained manpower and the building of new centers cannot alone face the extent of the problem on a national level. Even a tenfold expansion of available resources would not be sufficient to reach all those in need! Hence, SETI Center adopted a Family and Community-Oriented Approach, which considers family and community members to be the main component of the rehabilitation and integration process for persons with disability.

In order to achieve SETI’s goal, and according to its approach, SETI established a number of services as pilot projects to be adopted and duplicated by other organizations.

Minimal fees are charged in order to fulfill Caritas’ objectives of reaching the neediest of the needy. It also runs training programs to modify society’s attitude and to train personnel working in the filed. Around 2,500 persons benefit annually from SETI’s services, while more than 5,000 persons attend community awareness programs.

Training and Information: suitable training programs at different levels are arranged for educators, psychologists, social workers, parents, volunteers, etc. in order to improve their performance and help them adopt a family and community oriented approach. Technical support and advice is provided for researchers and centers wishing to establish services for persons with disability. Awareness programs are also organized for students, professionals and various sectors of society to help modify their attitude towards persons with disability.

Family Rehabilitation: Guidance and Counseling are provided to families of persons with disability, referral to existing services or follow-up of home-based programs. The Early Intervention unit trains children with disability from birth till age 4 and their families, while the Family Empowerment unit trains children with disability from 4 till 12 and their families individually or in groups.

In this context, a “Directory for Services for Persons with Special needs in Greater Cairo Area” has been published in 2005 and can be obtained from SETI Center.

Vocational Rehabilitation: provides training on certain jobs for adolescents and young persons with disability in sheltered or open workshops. It also helps them establish small family projects to earn their living and become productive members of society.

Community Based Rehabilitation establishes small community rehabilitation programs, in poor districts and remote areas, whereby the above services are performed with the person with disability in his environment through trained family and community members.

Inclusion Department extends and improves access to quality education for children with disabilities thus developing models for inclusive education in primary schools and kindergartens which can be replicated and benefit all children on a national level and influences policy makers to develop changes in the educational system.