World AIDS Day

Each 1st December is an opportunity to raising awareness about the importance of prevention and finding about this disease

People in the world have, or should have guaranteed health right as well as the right to housing, sanitation, drinking water, nutritious food and justice. In this way, it would be easier to detect, treat and cure an infection such serious as AIDS, which is one of the biggest public health problems, as the World Health Organization (WHO) affirms. AIDS is a pandemic disease included in the Sustainable Development Goals (SDG) program with the aim to be eradicated by 2030.

AIDS
During 2016, a million people died of HIV related causes of human immunodeficiency virus. This virus "affects the cells of the immune system, altering or annulling its function. The infection causes a progressive deterioration of the immune system, with the consequent "immunodeficiency," as the WHO describes. When it's get to more advanced stages it is considered that the person is infected by the syndrome of acquired immunodeficiency (AIDS) and this occurs when there is a presence of over 20 infections or related cancers of the HIV.

Currently, there are only three possible ways of transmitting HIV. On the one hand, sexually (unprotected sex). On the other, by blood (transfusion of contaminated blood or share contaminated sharp, needles and syringes). And finally, maternal-infantile route (during pregnancy, giving birth or breastfeeding). Despite the efforts of the global community to combat the disease, it has not found any cure or vaccine for AIDS yet.

AIDS in figures
  • This year, there have been 1.8 million new HIV infections around the world.
  • 54% of adults and 43% of infected children are on antiretroviral therapy (TAR) for life.
  • Between 2000 and 2016 the number of new HIV infections has been reduced by 39% and deaths associated with the virus have decreased by one third. This means that during this period 13.1 million of lives have been saved thanks to TAR.
  • There are population groups most vulnerable to getting infected by the virus: men who have homosexual relations, the injecting drug users, prisoners, sex workers and their clients and transsexuals.
  • During 2016 the new infections for the AIDS virus in minors has been reduced to 56% in East and South Africa -the region most affected by HIV- and 47% worldwide.
  • HIV infections have been reduced in boys and girls as pregnant women have undergone preventive treatment.
 

Recently, UNAIDS –the United Nation Organization that works to end up the AIDS epidemic-has published a report that explains the advances in access to antiretroviral treatment of people living with HIV. It notes that in 2000 only 685,000 people living with HIV had access to antiretroviral treatment while in June 2017 the number is around 20.9 million people. Another scientific revelation that is underlined in the report is that it is demonstrated that "a person living with HIV and adhering to an effective antiretroviral treatment system has up to 97% less likely to transmit the virus". Thus, the antiretroviral treatment is a very good preventive strategy.

Probitas also fights against AIDS
In this context, Probitas Foundation is also sensitive to the worrying situation that stems from the HIV virus. Therefore, following the philosophy that seeks to transfer experience, knowledge and resources in the field of health in the most vulnerable areas of the world, has three active projects aimed at improving the detection and treatment to fight the AIDS virus.

GLI-Peru
One of them is the GLI-Peru program in collaboration with UNICEF and the Ministry of Health has created the first comprehensive care model for HIV/AIDS, hepatitis B and sexually transmitted infections (STIs) to adapt the national protocol to the context in which the indigenous population lives, in which resources are lacking to make an adequate diagnosis of the main diseases of the area. The project, which began in 2014, is already in the last phase of execution in which it is carried out to analyse the efficiency, efficiency and impact it has had.

The final figures of the project estimate that in Peru there are 72,000 people are living with HIV, 64% of them have the diagnosis, 55% have achieved retention in the program, 46% of people are living with it viruses have received highly active antiretroviral therapy (TARGA) and 37% have achieved viral suppression.

Finally, the results of the project, which consisted in remodelling infrastructures, laboratory equipment, training of local staff and working with the community, focus on achieving an improvement in the resolute capacity of health services, including laboratory capacity of the Condorcanqui Health Networks, Datem del Marañón for the diagnosis and timely treatment of communicable diseases such as HIV/AIDS, which affect children and adolescents, pregnant mothers and the general population of the indigenous communities of the Amazon. The execution of the project has allowed to improve the capacities between the health personnel that during the 2016 has facilitated the registry of 134 new cases of infected by the HIV in the network of Condorcanqui.

Cooperative project in Central America
Probitas since 2015 promotes a project improves the diagnosis of TB in patients with HIV in Central America, particularly in Guatemala, which consist in to implement a Point -of- care (POC) test which is done by the diagnosis of tuberculosis (TB) in patients with HIV. The results of this initiative are intended to guide future post-validation studies with the potential to improve the diagnosis of tuberculosis in patients who are co- infected with HIV.

Thanks to this project, which is being carried out by Ohio University in collaboration with the Ministry of Health and the IDEI Foundation, it has been shown that the co- infected HIV-TB population presents a significant delay in diagnosis and a high morbidity and mortality due to the difficulty and cost of its diagnosis and treatment. Many of the HIV-TB patients do not have access to a correct treatment and follow-up and suffer from lack of infrastructure and equipment in public hospital systems. All of these join the stigma and discrimination associated with both illnesses that exacerbates the negative social and economic consequences of the people who suffer them.

Precisely this is one of the reasons that led to the entities linked to the project to establish itself as one of the main objectives of the study to reduce the time of diagnosis of tuberculosis in HIV patients and thus improve the control of follow-up of patients to improve the prognosis and reduce transmissibility. The indirect beneficiaries of the program are approximately 620,000 people infected with HIV and who live in Central America areas.

Cooperative project for vulnerable populations of the Department of Escuintla, Guatemala
The third project that Probitas Foundation supports is the prevention, diagnosis and comprehensive care of STIs, HIV and opportunistic infections in vulnerable populations of Escuintla, Guatemala. The main objective of the initiative is to improve the attention and coordination of the different Hospital services involved. The results are expected to have adequate space for the diagnosis of STIs, HIV and other infections, as well as get an improved system for recording data.

In a context starring 87.252 people affected by HIV -which represents 0.08% of the adult population- it is estimated that there are 8,908 new infections annually. The main project activities are focus on improving care coordination from the National Hospital of Escuintla through the training of health care providers of the Integral Care Unit (IAU), the clinic Barcelona and the AIDS and Society Foundation (FSIS) in communication and integrated coordination, among other actions. The direct beneficiaries of the project are 1,210 people living with the AIDS virus.

With the completion of these projects Probitas Foundation brings its values and know how to the villages that have difficulty providing access and social and health resources to their communities, thus contributing to the improvement of the living conditions of the poorest populations worldwide.
 
 
 

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Monitoring of the Bacteriology course at the laboratory of the Maternal and Children's Care Hospital in Kumasi (Ghana)

Probitas Foundation backs the GLI program with the support of the Microbiology Department at the Vall de Hebron University Hospital

Between 26 and 29 September 2017 a microbiologist from the Microbiology Department of the Vall de Hebron University Hospital, Mateu Espasa, visited the city of Kumasi (Ghana) with the goal of supporting and supervising the work done there since October 2016, within the framework of the GLI Kumasi project, launched in 2012. The GLI (Global Laboratory Initiative) programme in this African city focuses on bolstering the laboratory service of the Maternal and Children's Care Hospital (MCHH), the only infrastructure specialised in the treatment of severe childhood malnutrition in the country's south-central region.

GLI-Kumasi
Since its inception GLI Kumasi has adopted as its main objectives strengthening the diagnostic capabilities of the Maternal and Children's Care Hospital and providing health care to the most vulnerable rural communities, living on cocoa plantations under precarious conditions with limited access to healthcare. The effective implementation of this project will contribute, in the long-term, to reducing maternal morbidity and infant mortality rates, as well as improving the diagnosis of malaria and other serious diseases affecting mothers and children in the health centre's area of influence.

Monitoring the operation of the laboratory in relation to bacteriological diagnoses
Last year a 15-day training programme was offered (between September 26 and October 7) on the diagnosis of bacteriological infections via cultures, taught by microbiologists at Barcelona's Vall de Hebron University Hospital. In addition to the course, Probitas provided the Kumasi hospital laboratory with specialised equipment for work with bacteriological cultures, and support for the purchase of reagents for haematology and other laboratory materials.

This year the visit to the Kumasi Hospital focused on monitoring the development of the laboratory technicians' skills acquired in the previous course, as well as reinforcing knowledge of antibiotic susceptibility techniques. The specific objectives that were set during the stay were to identify the possible limitations of the laboratory with regards to bacterial microbiology, and to review the theory and practice of work with bacterial diseases, the processing of samples, the detection of bacteria, the identification of bacteria, and susceptibility tests.

Some of the strengths worthy of note with reference to current conditions at the hospital, and specified by the microbiologist on site in the territory, were:
 
  • The work with bacterial cultures is progressing satisfactorily.
  • Hospital staff are skilled and motivated in the work they do.
  • The diagnosis of patients has been improved.
  • The demand for cultures has increased.
  • The clinical protocol is being observed.
  • The appropriate antibiotics are prescribed, depending on the results of the cultures.

However, some of the most visible weaknesses detected during the visit, and which merit attention, were also highlighted:
 
  • The request system
  • The registration of test results
  • The drafting of reports
  • The collection of samples

Going Forward
After Probitas' involvement, and that of the Vall de Hebron University Hospital, it can be stated that the Kumasi Hospital has seen significant improvement in the diagnosis of infectious diseases and effectiveness in their treatment.

Going forward, what Probitas expects, along with the Microbiology department at Vall de Hebron University Hospital, is that the hospital will be increasingly less dependent on help and, little by little, self-sustaining. The local community is also expected to be even more aware of the benefits that lead to good health care, and more committed to being part of it, in order to encourage infrastructure improvements.

 

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Soft-GLI implementation course

Probitas Foundation receives two staff members from the Health Center Valentin de Pablo of Bamako to train them in the computer software system

On November 20th, 21st and 22nd, Probitas Foundation received the visit of the director of the Center Valentín de Pablo, Dr. Boré Hssane and the head of the laboratory of this center, Ms. Djenebou Mariko. Both of them are part of the staff from the Valentín de Pablo Health Center located in the Téléphone sans fils district (TSF), one of the most vulnerable neighbourhoods of Bamako, the capital of Mali. The reason of the visit was to offer them an advanced training in laboratory operation and management through computer software -Soft -GLI- a program developed to computerise the management of GLIs' laboratories. From this software it will be possible to analyse request, to monitoring stocks, to check the history laboratory patients, to get the database, etc. This system will allow them to improve the quality of patients care and the quickness in providing solutions to the needs that arise.

In order to facilitate laboratory management, the program will allow the obtaining of epidemiological data of the population automatically and making predictions of the evolution of inhabitants' health so as to make decisions in the field of public health.

The third day, Dr. Bore and Ms. Djenebou, together with a part of Probitas team, went to visit the Grifols Biomat plant, located in Parets del Vallès (Barcelona). In there, they could learn and see how monitoring control systems works since the plasma reaches the installations (from the US and other parts of Spain and Europe) until the substance is sent to the Grifols Institute where the fractionation process keeps going up to the final products are obtained.

Bamako's Health Center context
In 2004, faced with the lack of state services, citizens proactively created Mutuelle Benkan, a non-profit group that, using membership fees, carries out general interest interventions to improve its inhabitants' quality of life. One of these is the Valentin de Pablo Health Center -supported by Probitas and the City Council through the GLI Bamako-, in line with the Ministry of Health and Social Development's program, which focuses its work on primary health care, care during childbirth and child vaccinations program.

This situation guides Probitas to get involved with the aim of improving the healthcare center conditions. Throughout the years of involvement, GLI-Bamako has given, to the vulnerable population, health access through the betterment of the clinical diagnosis. In addition, as Dr. Boré expresses, the GLI has offered the chance to enhance infrastructure at the center and offer quality medical services that effectively respond to the national healthcare policy.

The current situation
Currently, Valentín de Pablo Health Center can be considered a self-sufficient center, which has already tripled the number of vaccinations for children, has increased by 12% the number of pregnant women attended and 25.2% in medical consultations. In terms of sustainability, Probitas has facilitated the installation of photovoltaic energy that allowed lowering the electricity bill and investing more in other laboratory's costs. In regard to sanitation, sewerage has been built and a section of the TSF neighbourhood has been paved with community participation. Finally, community awareness and education activities for health have also been carried out.

Téléphone sans fils
The center Valentín de Pablo is where the first GLI program (Global Laboratory Initiative) of Probitas Foundation in 2012 was done. What led to its execution were the precarious conditions of the area in terms of health at that time. Téléphone sans fils is a neighbourhood of approximately 15,000 inhabitants, where the population lives without access to potable water, electricity and wastewater channelling. These conditions of insalubrity favour the transmission of infectious diseases, especially respiratory, cutaneous and digestive ones. Probitas' support over these years has made Bamako ‘s Health Center increasingly self-sufficient and gradually weans the support of the Foundation.

 

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Objective 2020: To Eradicate 10 of the Neglected Tropical Diseases

Probitas Foundation commits to the fight against this type of disease by supporting projects to eradicate them

Neglected Tropical Diseases (NTD) are, according to the World Health Organization (WHO), "those that occur only, or mainly, in the tropics. It refers to the infectious diseases that predominate in hot and humid climates, such as leishmaniasis, schistosomias and onchocerciasis, lymphatic filariasis, Chagas, African trypanosomiasis, and dengue, among others".

In order to eradicate them, the WHO organizes global meetings with NTD partners, who already are working with NTD, where the latest reports on the situation are presented and milestone achievements made over the last 10 years are made known. These events also serve to maintain and increase the financial support that make possible the achievement of the objectives set for 2020 by the WHO, and also to call on members to make the most of the resources available after this date. Representatives of the Member States are expected to attend the meetings, along with donor agencies, foundations, the private sector, university officials, environment and other interested agents.

The second world meeting took place on April 19, 2017 in Geneva (Switzerland), under the motto "Collaborate. Accelerate. Eradicate". The theme referred to the turning point marked by the first global meeting of members in 2007, which emphasised global efforts to combat and eliminate diseases linked to poverty, as the WHO explains. In the year 2012 the members signed the London Declaration, in which they pledged to provide support to the WHO to combat and eliminate 10 NTDs from now until 2020.

The WHO also wishes to ensure that the treatment of NTDs is included in what is commonly considered "universal health coverage", asserting that this will only be possible when "NTD interventions are integrated into national health systems". A report published by the WHO addressing integration in the fight against NTDs and health and global development points out that through consistent political support, charitable donations of medicines, and improvements in living conditions, "programmes for the control of these diseases can be continuously expanded in the countries where they are most prevalent".

Neglected Tropical Diseases
Some 20 NTDs have been identified and defined to date. The main populations affected are the poorest residents of urban neighbourhoods and underdeveloped countries. These diseases were formerly prevalent in several areas of the world, but now are mainly restricted to tropical and subtropical regions where hygiene and sanitation are insufficient, living conditions are not adequate, and the incomes of the population are limited or low. So, they are diseases related to poverty. The 20 NTDs are the following:
 
  1. Dengue
  2. Rabies
  3. Trachoma
  4. Buruli ulcer
  5. Yaws
  6. Leprosy
  7. Chagas disease
  8. Human African trypanosomiasis (sleeping sickness)
  9. Leishmaniasis
  10. Teniasis and neurocysticercosis
  11. Dracunculiasis (Guinea Worm Disease)
  12. Echinococcosis
  13. Foodborne trematodesis
  14. Lymphatic filariasis
  15. Mycetoma
  16. Onchocerciasis (river blindness)
  17. Schistosomiasis
  18. Soil-transmitted helminthiasis
  19. Scabies
  20. Poisonous snakebites

Unfortunately, this group of diseases still affects 149 countries and more than 1 billion people worldwide, causing severe disabilities and lifelong impairments, as described by the Universities Allied For Essential Medicines (UAEM).

Probitas's commitment to the fight against NTDs
For years Probitas Foundation has supported initiatives that significantly contribute to improving the health of the beneficiary population, whether through projects having to do with water, hygiene and sanitation, nutrition and food security, health education, community work, or directly to health care. Therefore, support for initiatives addressing infectious diseases also forms part of this wide range.

However, this year Probitas decides to focus the criteria of the International Cooperation Projects (ICP) call and center its attention supporting projects that are working entirely on the prevention (sensitization, active detection of new cases, etc.), diagnosis (provide equipment and materials for laboratories, staff training and evaluation of procedures), treatment (ensure access to treatment and carry out a massive administration of the necessary drugs), follow-up (measure the actions taken to analyze the real impact of the project ) and WASH (water and sanitation) of Neglected Tropical Diseases or also called forgotten diseases. The main reason for limiting the call is because the specialization in a specific type of projects will allow all Probitas knowledge and effort to be focused on a single objective, generating more impact, better results in the medium and long term and will benefit the population more.

The new period that starts in 2018 aims to be more solid thanks, also, to multilateral agreements with other relevant organizations, such as the case of WHO, which has proposed a strategy to control, eliminate and eradicate NTD in 2020. This is why all parties are required involved (donors and entities working in the field) to collaborate in order to reach the same objective.

In addition of adjusting on neglected diseases, Probitas adds 3 more that have a major health impact in low-income countries such as malaria, HIV/AIDS and tuberculosis.

For their part, the receiving entities commit themselves to apply the mechanisms and resources available to them to detect, treat and control the neglected tropical diseases on which their respective projects are focused and collaborate in the achievement of the global objective of ending the 10 of the 20 forgotten diseases.

Probitas projects on neglected tropical diseases
Probitas is currently engaged in different projects underway focused on the treatment of infectious diseases. These include the following:
 
  • Improving the health conditions of children in the poorest neighbourhoods of Bacolod, Philippines, an area where the young population is very vulnerable to contracting pneumonia, asthma, diarrhoea, malaria, dengue and tuberculosis.
     
  • In the Colombian Amazon it is carrying out a project to improve prevention and control coverage and the elimination of 6 neglected infectious diseases: scabies, pediculosis, geohelminthiasis, cutaneous larva migrans, tungiasis and ocular trachoma.
     
  • In Cochabamba, Bolivia, a GLI program is underway to combat Chagas disease, one of the prevalent illnesses in the area.
     
  • Also in Bolivia, but in the municipalities of Sucre, Villa Huacaya, Villa Vaca Guzman, Sapina and Comarapa, the programme seeks to consolidate the shared management model for the prevention of Chagas.

These are just four examples of projects that Probitas Foundation is working on, all designed to detect, prevent, treat and monitor neglected infectious diseases. For a complete list of projects that Probitas supports addressing neglected diseases, see the website. The "interactive map" tab on the menu contains all the latest information on each project.

 

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Human Nutrition and Dietetics Conference

Probitas Foundation attended the event to refresh its knowledge in the area of healthy eating

On 17 and 18 November the 5th Conference of the Association of Catalonian Nutritionists and Dieticians (CODINUCAT) and the Second Congress of the Catalonian Nutrition and Clinical Dietetics Association (SCADC) were held in the city of Reus, under the motto Managing the Message on Dietetics and Nutrition.

The two days of presentations reflected on the incorporation into the health system of recent graduates, and its main objective was to educate, help and persuade the public to make permanent and healthy changes in its eating habits, without confusing it.

The sessions were directed at professionals in the health sector, as well as teachers and students, and all those interested in understanding the latest trends in the areas of nutrition and health.

The talks were given by national and international speakers, renowned in their respective fields. They addressed issues like the role of nutritionists in cross-cutting health programmes, the use of new teaching technologies in Human Nutrition and Dietetics, and the risks and benefits of different foods. On the second day of the conference the topics focused on child nutrition and other food-related health issues that generate social alarm.

Strengthening the RAI Programme
These two conferences were attended by Probitas Foundation's two nutritionists, Clara Sistac and Elisabet Solà, in order to stay up to date and informed regarding the latest trends affecting the food sector and to continue to bolster and refine the main nutrition programmes backed by Probitas Foundation in this area. Since its founding in 2012 the Child Nutrition Reinforcement (CNR, or RAI, from the Spanish) programme has enabled more than 17,100 children in vulnerable situations to receive support throughout the school year.

The latest developments in the area of healthy eating will serve to strengthen Probitas programme and reinforce its current foundations. The CNR/RAI Ayudas Comedor (School meal support) is a project that provides support to families who cannot cover the cost of their children's school meals. Most families in vulnerable situations have been forced to reduce the nutritional quality of meals to cope with high food prices and the difficulty of finding quality products at a lower cost.

Staying abreast of the main trends in nutrition and food will allow the Foundation's nutritionists to bolster the CNR/RAI programme and continue to promote the healthy physical, mental and emotional development of the most vulnerable children and young people.
 
 

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World hunger rises for the first time since 2003

The Probitas Foundation, along with several other entities, is backing projects in the territories most affected by the spike in food insecurity

The UN's Food and Agriculture Organization (FAO) recently published a report highlighting the increase in people around the world who do not get enough to eat each day, a figure that exceeded 815 million in 2016 – 17 times the population of Spain.

The study "The State of Food Security and Nutrition in the World, 2017" points out that for the first time since 2003 world hunger increased considerably, after years during which it did not see substantial changes.

One of the countries where hunger grew the most this year is South Sudan, where there are more than 250,000 children suffering from severe acute malnutrition, according to UNICEF data. It is not the only country, however, as Yemen, Somalia and northern Nicaragua, among others, as the report explains, are also suffering this humanitarian crisis. In addition, the FAO laments that the demand for food aid will intensify during the rest of the year.

The reasons for malnutrition
One of the main reasons for this food insecurity situation (the guarantee of sufficient calories) lies in the fact that these countries are at war. Hence, internal conflicts often erupt leading the population to live under conditions of severe poverty, in addition to being dry territories, or areas vulnerable to the impact of the climate. These conflicts trigger the displacement of many people to other regions where access to food and resources is more difficult. This makes the almost two million displaced people even more vulnerable, subjecting them to lives of poverty and malnutrition.

The second part of the report stresses how these conflicts affect food security and how food security, in itself, can lead to conflicts and additional problems. In order to improve conditions in these regions, the organisations involved in achieving the 2030 Sustainable Development Goals (SDGs) – approved by the UN's 193 member states – are focusing on SDG number 2 and SDG number 16, which seek to put an end to conflict, ensure food security, and achieve peace. The report explains that focusing on improving food security and nutrition can help prevent conflicts in the territories and foster peace.

In addition, there are other factors that aggravate the food crisis, such as "the educational level of women, the resources that governments allocate to national nutrition policies and programmes for mothers, infants and young children; access to clean water, basic sanitation and quality health services, ways of life, the food environment, and culture," the report said.

The consequences of malnutrition
The impact of malnutrition stunts children's growth and exposes them to an increased risk of impaired cognitive ability, poorer performance at school and at work (for adults), and, in the worst cases, greater susceptibility to infections. Paradoxically, the report points out that in low-income countries there coexist "different forms of malnutrition", as there are, simultaneously, high rates of child malnutrition and obesity in children and adults.

Probitas is involved in reversing the situation in the most affected areas
The Probitas Foundation is also engaged in addressing the situation of vulnerability, malnutrition and poverty in these areas by supporting food projects that aim to provide a nutritious and healthy diet for the affected populations. These are efforts whose geographical scope encompasses South America (Bolivia and Peru), Central Africa (Democratic Republic of Congo, Ethiopia and Tanzania), the Middle East (Lebanon), India (Mumbai) and southern Europe (Greece).

Projects in South America
The "Bolivia Alimentación" project, with a focus on local development, and carried out in collaboration with the World Food Program (WFP), mainly focuses on contributing to the development of local food production chains and the reduction of food insecurity through the promotion of cultivated crops for school lunches. The direct beneficiaries are approximately 3,600 children in the area.

In Peru, the project "Anemia No" aims to contribute to the prevention and sustainable reduction of child undernutrition through family practices of prevention and control that are culturally relevant, capacity building in the health sector, and social programmes. In this way, more than 500 children will benefit. This is an initiative launched in concert with Action Against Hunger.

Projects in Central Africa
In the Democratic Republic of Congo, the project "Improving Food Security for the Population of Kasando", launched in concert with the Fundación Internacional de Solidaridad de la Compañía de María, or International Solidarity Foundation of the Company of Mary Our Lady (FISC), aims to improve food security at the Kasando Health Center by enhancing its infrastructure and conducting training sessions for the personnel on nutrition and health. It is slated to benefit some 7,085 people.

In Ethiopia, the Probitas Foundation has supported a project, in collaboration with UNHCR, to Contribute to the international protection of refugees in Ethiopia, ensuring access to essential basic services at the camps. The project seeks to improve the nutritional status of children under age five, and pregnant and breastfeeding women in the country's five Somali and Eritrean refugee camps. Direct beneficiaries include over 10,046 Eritrean and Somali refugees, more than 8,270 children under age five, and 1,600 pregnant or breastfeeding women.

The third project carried out is in the district of Kilombero, in Tanzania, made possible thanks to assistance provided by the Ifakara Health Intitute (IHI). It focuses on supporting nutritional rehabilitation and improving maternal and child health in the area's population in order to reduce the mortality rates of undernourished children. More than 380 people are benefited.

Project in the Middle East
In order to support displaced persons and, specifically, children affected by the war in their countries of origin (especially Syria), Probitas has been providing financial support during the 2016/2017 academic year to a project that has made it possible to ensure school lunches for 550 Syrian and Lebanese children who participated in the school nutrition programme, carried out in concert with the World Food Program.

Project in India
In the Mumbai area the Probitas Foundation supports a project carried out with the organisation Proinfants based on providing outpatient and nutritional medical assistance in collaboration with Ankur Children's Home . The purpose of the initiative is to provide health and nutritional assistance to identified groups of children and mothers in two impoverished quarters of Mumbai, with an average of between 50 and 80 beneficiaries per day, for 24 months.

Project in Southern Europe
Probitas supported an initiative benefitting northern refugee camps in Greece, carried out in collaboration with Save The Children and Nutrition in Northern Greece, which aims to promote, protect and support breastfeeding practices and nutrition for infants and children in emergencies, as well as to respond to the dietary needs of mothers and newborns up to age 2. The direct beneficiaries of the project were 2,366 mothers and children.

In this way the Probitas Foundation provides knowledge and resources to improve the situations of those populations most affected by hunger, fight child malnutrition, and promote healthy eating habits for communities.
 

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The Probitas Foundation promotes new projects of the "RAI-Secundary!"

This year, it plans to open new programs at Santa Coloma and Vallès Occidental institutes

The 2016/2017 school year ended with a total of 304,548 students (148,004 girls and 156,544 boys) enrolled in Compulsory Secondary Education (ESO) in Catalonia, according to the latest data recorded by the Department of Education of the Generalitat de Catalonia (regional government) in the month of July. Of all these students enrolled, some 5,000 ESO students received school meals stipends, according to Education Counsellor Meritxell Ruiz. This figure, however, represents less than 2% of Catalonia's Compulsory Secondary Education students who receive nutritional funding, compared to the 13.6% who receive it in Primary and Secondary education. Therefore, when passing from primary school to secondary, the number of students receiving funding drops 89%.

These stipends are subsidies paid for using public funds and intended for students of compulsory school age belonging to families in precarious socioeconomic situations, regardless of their nationality or origin. The entity responsible for handling the funding and setting their limits is the Department of Education, while regional councils are responsible for administrating the stipends, which partially or fully cover the cost of the service.

The source of the problem
In 2012 the Parliament of Catalonia implemented an abbreviated school schedule at the ESO level, which meant the closure of many school cafeterias at the region's public secondary schools, due to a lack of demand. Over the years the measure has meant that poorer families are not ensured a healthy lunch for their young people, who need it most, exposing them to the serious risk of malnutrition, which has serious consequences for their physical and cognitive development.

This is a currently a topic being debated in the Parliament, as there is an effort underway to replace the previous decree, approved in 1996, which is still in force today. The revision of the decree, according to government sources, speaking to the online newspaper directe.cat, will reconsider criteria such as the ratio of supervisors at school cafeterias; and, for example, the maximum price of a complete lunch, currently set at €6.20, a figure that has been frozen for years. The development of the decree's new content is in a very early stage, and is being discussed by parents' associations and the companies that offer the services, with a view to its implementation for the upcoming 2018/2019 academic year.

The new decree – temporarily withdrawn due to a lack of consensus in the educational community – would put an end to the management of cafeteria services by some AMPAs (Students' Parents Associations).

The Federation of Students' Parents Associations of Catalonia (FAPAC) is asking the Generalitat (Catalonian government) to make these lunches free at public grade schools and high schools. Among the arguments advanced is that guaranteeing universal access to school lunches may be a first step to ensuring fairness and equal opportunities. In addition, proponents argue that the two hours between lunch and recess must be considered part of the school's educational programme.

Probitas's role
In this context the Probitas Foundation is strongly engaged in trying to improve the situation of many children who have difficulties affording school cafeteria costs, or who at age 12, when they begin ESO (Obligatory Secondary Education), no longer have the right to cafeteria funding.

As part of the Child Nutrition Reinforcement (RAI) project initiated in 2012, Probitas backed the "RAI-ESO ¡Comemos Juntos!" programme two years later, which aims to offer a healthy lunch and a protective space in which to offer socio-educational activities to young people ages 11 to 17 at the risk of social exclusion. In this case, the programme includes access to a healthy lunch and leisure, athletic and educational support activities between 2 and 5 pm. In addition to ensuring a nutritious meal each day and providing a protective space, the objectives of the programme include promoting healthy habits, publicising the need to open high school cafeterias, and working together as a network.

During the 2016/2017 academic year the "RAI-ESO Comemos Juntos!" programme had facilities fully operational in 6 municipalities in Catalonia, with 6 collaborating entities and 401 beneficiaries from 18 high schools. The areas where the programme is present are Hospitalet de Llobregat, Terrassa, Granollers, Sabadell, Montornès del Vallès and Salt.

New spheres of action this year
For this new 2017/2018 school year Probitas has started a "RAI-ESO ¡Comemos Juntos!" programme in Santa Coloma de Gramenet. Specifically, it was initiated on Monday 2, October at two secondary schools, where approximately 70 children between the ages of 12 and 14 will be beneficiaries of the "RAI-ESO ¡Comemos Juntos!" programme. In addition to offering a healthy meal, at the centre there will also be athletic, socio-educational and school reinforcement activities for adolescents at risk of social exclusion in the time slot spanning from 2:30 to 5:00 pm.

The two schools where the program is implemented are the city's Puig Castellar and Tierra Roja. The initiative has been possible thanks to the agreement signed between Probitas, the entities Casal de los Niños, Risas, and the City of Santa Coloma. The implementation of this programme will help to raise awareness of the need to open school cafeterias at secondary schools, and to promote the joint efforts being made by all the agents involved.

In addition to its collaboration with the two high schools in Santa Coloma de Gramenet, Probitas also plans to launch the "RAI-ESO ¡Comemos Juntos!" project, of a socio-educational nature, to guarantee healthy food for secondary students in Vallès Occidental. The Regional Council of this territory laments that less than one student in every 100 there receives a cafeteria stipend, and that only 2.8% of all the stipends granted in the region are for secondary school students. This fact means that many boys and girls receive no aid after passing from grade school to high school. According to data from the Regional Council, during the 2016/2017 academic year 1,014 6th-grade students received school lunch funding, while in 2017/2018 only 204 first-year ESO (Obligatory Secondary Education) students benefited.

Hence, Probitas has established a collaboration framework with the Vallès Occidental Regional Council to guarantee the benefits of the "RAI-ESO ¡Comemos Juntos!" programme. For both parties this agreement promises to have an impact with a regional scope. The Foundation will also be promoting the RAI-ESO project at high schools in Cornellà (Baix Llobregat) and at schools in different cities in Vallès Occidental.

The strong reception given the programme by all the different educational agents (local councils, high schools, entities and families) has prompted Probitas to gradually expand its scope of action, as it increasingly meets the needs of more vulnerable children.
 

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