Stichting Hulp Aan Limanowa
p/a Alteveerstraat 233
7906 CH Hoogeveen
Tel : 06 40 228 783
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Bezoek in Nederland (english)
The goal of this document is to have some notes of the discussions, appointments made and actions defined in the meetings, which have taken place during the visit of the Polish delegation to Hoogeveen in June 2000.
The Polish delegation consists of the following persons:
· Wiktoria Zelek – General Manager Hospital Limanowa
· Julita – Doctor in Limanowa Hospital
· Wojtek – Doctor in Limanowa Hospital
· Wladek – Mayor of Limanowa Powiat (Limanowa District)
The Polish delegation visited the office of BBNN in Groningen. They got information from the managing director about the way the early detection of breast cancer is organised in the Netherlands, and also about the results after ten years experience. It is possible to realise a reduction in mortality of 35% in the group women from 50-69 years if they are invited for an examination every two years. Every examination costs about 90 Dutch guilders, but it is free for the participants. It was stressed that the quality of the whole project needs to be very high, to realise the target of mortality reduction.
The delegation explained cancer is still a taboo in Poland. It is not (yet) common to use the word cancer. The patient (or the family of ) doesn’t want to hear or to talk about cancer. That’s why it is very important to inform the people about the possibilities to treat cancer and about the survival of cancer
After the visit of the office, a mobile screeningsunit of BBNN in Assen was inspected.
Action: Wladek would have a meeting with the Minister of Health Care to discuss the necessity of a program for early detection of breast cancer in Limanowa. Herman Meerholz will ask the Erasmus University to send information about the costs, effects, result and so on to the hospital in Limanowa
(The delegation already got lots of information before they left to Poland)
There has been a meeting of the delegation with representatives of DUH. These people explained to the delegation the possibilities of a co-operation between DUH and the hospital in Limanowa. DUH needs patients for clinical trials, therefore they can place medical equipment and hospital staff, also at the disposal of the hospital. The patients in Limanowa can be examined with the newest and most dedicated equipment.
The representatives also told about the co-operation with a hospital in the North of Poland with positive experiences about this kind of working together.
Action: Julita, Wojtek and Victoria will discuss this proposal in the hospital. They will be visited in Limanowa by the Polish representative of DUH.
DUH likes to know the exact names, titles and so on of the delegation
The mayor of Hoogeveen Mr. Willlem Urlings and the alderman for Social Affairs, Welfare, Public Health Care, Sports and Employment Mr. Wietze van der Zwaag warmly welcomed the Polish delegation
During the meeting the following topics were discussed:
· The city of Hoogeveen has a very small budget for foreign development help for projects abroad. The condition is that citizens of Hoogeveen must participate in the project. This could be of interest and it could be worth trying to apply for some money from this fund. Action: Wladek to come with useful projects; Gert/Henk: apply for the money in case of useful projects
· The brochures of Limanowa made by Gert were handed over to the mayor in order to give him some background information about the work done so far in Limanowa
· The people from Limanowa told the mayor that they are very grateful for the help they have received so far.
· Limanowa would like to cooperate with Hoogeveen in the area of:
· Health care
· Cultural affairs
· Special focus on young people
· A handicap for further development of the relation between Hoogeveen and Limanowa is the distance. Hoogeveen has a partner-city in Slovakia called Martin, also very far away and the distance problem is also experienced in that relationship. Hoogeveen has already enough problems in maintaining this partnership and are therefore a little reluctant concerning new partnerships.
· Mr. Urlings stated that he is always fond of stimulating spontaneous relationships of his citizens and that he is always prepared to support and stimulate it in an informal and enthusiastic way. For this he can use his network and he recommends us to build up a network as well, both in Hoogeveen as well as in Limanowa. Action: Wladek for establishing a network in Limanowa; Gert/Henk: use networks in Hoogeveen and establish new ones
· Wladek stresses the importance of face-to-face communication and he really hopes that people from Hoogeveen will visit Limanowa every now and then and especially the youngsters who have the future.
· Wiktoria explained the needs and the financial troubles of the hospital in Limanowa. Mr. Urlings replied that it is always good and useful to learn from each other and he pointed out the similarity with the Dutch situation, Dutch hospitals are also very much depending on fund raising.
· It is quite often more easy to establish contacts between business people. Is there a business club or service club in Limanowa? According to Wladek there is. Action: try to establish contacts between business clubs in Limanowa (Wladek) and Limanowa (Hank/Gert)
· Another good possibility for an exchange might be Sports according to Wladek. Limanowa has some good sports clubs, e.g. football club. There quite a lot sports facilities in the neighbourhood of Limanowa as well, like football, volleyball, skiing, mountain biking and mountain climbing. Eastern Europe gets more and more interesting for Dutch sporters. Wietze v.d. Zwaag replied that might be a nice area, but emphasizes that Limanowa sport clubs first must make themselves known here, then make contacts and after that one can start trying some exchange activities.
· Action: Limanowa will prepare a list of possible exchange activities, especially focussed on youngsters.
· There were also discussions on the possibility that the Dutch government gives subsidies to Dutch companies who make investments in Eastern Europe. Action: Wladek will prepare a list for potential projects in this area. Once the list is known Gert/Gert will investigate the interest of Dutch companies and the subsidies possibilities. As an example Wladek mentioned the plans for building a gondola (ski) lift in the Limanowa area. Another potential project could be a so-called ‘Aqua park’ because there are thermal and salt-water sources in the area of Limanowa. The Polish government doesn’t want to give subsidies for it, so it can be interesting to see if Dutch businessmen are interested for some development.
· Wladek mentioned that more and more people from Poland are going to work abroad. It might be good for our mutual relationship if some people from Limanowa could work in Hoogeveen. Wietze van der Zwaag could imagine this, but explained that the Polish people are still non-EU citizens and therefore need labour permission, which is still quite hard, but not impossible. He cannot do much about it, it is a matter between a company, the employee and the Dutch labour authorities. There is some shortage for teachers in Holland and there are examples and ideas to bring them in from e.g. Poland, same for nursery personnel. But the municipal is never a party in this kind of matters.
The polish delegation has brought a very fruitful visit to the Bethesda hospital in Hoogeveen. The Manager Patients Care, Mr. Maarten Imkamp, kindly welcomed them. Also the General Manager Mr. Bert Aukema was present during the morning part of the visit.
Dutch Healthcare – Bert Aukema
Bert Aukema told the Polish delegation almost everything about the Dutch Health Care system and how it works within in organization like hospital Bethesda. In order to support his presentation he had made some overhead slides of which everybody got a hardcopy. Most information can be found there.
Some additional items:
· Most of the hospitals in NL are private foundations, except for the academic hospitals.
· Bert Aukema is the Dutch representative in the European platform for hospital management. The Polish representative is from a hospital in Krakow. The next time they will meet, Bert will certainly tell the Polish representative about this interesting meeting. Maybe Wiktoria can find out as well who he is and make some contacts with him.
· Home care is getting more and more important in Holland. The Polish people confirmed that this is also the case in Poland.
· Bethesda hospital covers an area of roughly 75.000 inhabitants.
· Bethesda has around 50 – 55 medical doctors.
· There about 900 employees taking 550 FTE’s (Full Time Equivalents)
· More and more focus on cost rationalization and better systems for budgets. This is also a hot item in Poland.
· The role of Patient unions in NL is getting stronger and stronger.
· Doctors involve their patients more and more in expertise and treatment esp. for chronically diseases like diabetes.
Cooperation between hospital Limanowa and Bethesda – Maarten Imkamp
· Wiktoria stated the following. The hospital in Limanowa has a much lower quality and standard than Bethesda and they are looking for the following ways of cooperation:
ü Exchange and/or training of the medical staff and/or nurses. On itself it is possible was replied by Mr. Imkamp. They have already had a Polish Children disease Specialist. This has to be taken up with the medical staff. Also sending nursery or medical staff for some days to Limanowa might be a possibility. He will study it and comes back on it. Action: Maarten Imkamp.
ü Redundant equipment for Bethesda but still functioning might be of great use for Limanowa. Maarten Imkamp replied: it is indeed the policy to give this kind of equipment to other hospitals. It is a matter of the Purchase Department. Limanowa has already been dropped there as a candidate, for now wait and see if any results will happen. Action: Maarten Imkamp.
ü Is it possible to employ Polish nurses in Hoogeveen? There is unemployment in Poland and we heard about a shortage in Holland. Maarten Imkamp: the possibility is there indeed, the language is a very important matter!!! The highest and most painful shortage of nurses is in the crowded western part of Holland. Action: Maarten Imkamp will check some more. Discussion might be continued later on.
ü Wiktoria and Wladek expressed their thanks to the Bethesda hospital and said that a delegation from Bethesda is always very welcome for a counter visit!
ü The delegation made a guided tour to the modern digital X-ray department of the hospital.
· The goal of the visit was to meet Mr. Hank Kaman vice-chairman of the Stichting Zuidwolde e.o. helpt Polen (Foundation Zuidwolde and surroundings help Poland) and to see two of the warehouses of the Foundation.
· The meeting with Mr. Kaman was open and friendly. Mr. Kaman stated that there were some times that Foundation has considered to stop the aid transports to Limanowa due to bad feedback from Limanowa and no concrete proposals from Limanowa for structural projects.
· The situation is much better now in Limanowa, it is a big advantage that Dorota speaks English and she is always reacting in time on faxes and phone calls.
· The intention of the Foundation is to go over more and more to support structural projects locally next to helping poor families. The hospital and Home Care project are promising opportunities for structural aid to Limanowa.
· Gert elucidated what has happened within the Working Group Limanowa, which exists in Hoogeveen. When the heard about possibly stopping the help to Limanowa some heads were put together and the general opinion was: No way stopping with Limanowa. Therefore contacts with the hospital have been made, a good relation with Dorota Musial has been established. The working group is very much focused on offering structural help to Limanowa and they try to establish a network in Hoogeveen and hope the same will happen in Limanowa. This has resulted in the visit now of this delegation to Hoogeveen and Zuidwolde. The Working Group in Hoogeveen has good confidence in establishing a structural help to Limanowa. Bert Kleinleugenmors is the linking pin to the Foundation.
· The storage of clothes was shown to the delegation. Also for Wladek it was shown how the disinfections are done and how bad or worn out clothes are sorted out. It is not workable to disinfect clothes just before the transport leaves, some clothes are remaining and clothes are brought in the whole year. Wladek could use this information for his contacts with the Customs and Health Inspection in Limanowa.
· The visit to the second warehouse of Mr. Freek Mulder was also very useful. A lot of medical equipment etc. stored there is still very useful for Limanowa, either for the hospital and/or for the Home Care project. The board of the Foundation will discuss internally which goods can be sent to Limanowa. Action: Bert Kleinleugenmors and Henk Kaman.
The following action items were defined in general through out the whole visit.
· Talk to Health Inspection in Limanowa about the quality of the clothes sent to Limanowa and try to create better understanding and less checking. Action: Wladek
· Talk to responsibles for Customs in Warszawa and Limanowa on the fact that these are aid transports and no trade and try to get rid off paying import duties. Action: Wladek.
· Give some more information about the Home Care project in Limanowa area, next time Limanowa will be visited. Action: Wiktoria/Julita and the October delegation to Limanowa.