EL BLOG DE LA FIIAPP. Cooperación Española

According to the Ministry of Health, Social Services and Equality, Spain has been the world leader in organ and tissue transplants for 24 years. In 2015, there were 13 transplants per day performed in our country, or more than one transplant every two hours. These figures make the Spanish donation and transplant system a global reference. 

A large part of the credit for this success belongs to the Catalan Transplant Organisation (OCATT). Created in 1984, this organisation was a pioneer in creating a system for extraction, distribution and transplant of organs and tissues based on coordination between hospitals which has been exported to other countries.

OCATT is currently working on two public cooperation projects, both financed by the European Commission and managed by FIIAPP, aimed at establishing a transplant system in Croatia and Moldova similar to the one in place in the European Union.

Taking advantage of the monographic training course on the Spanish transplant system being held at our headquarters in Madrid, OCATT Director Jaume Tort answered some questions on the project he has been working on since 2013 in Moldova, a country with strong Catholic beliefs.

What are the strengths of the Spanish model?

It’s a donation system based on coordination between hospitals that has been shown to be, over the years, the best system in the world, and that allows you to expand it to other countries reliably, because you know and have the experience that it works.

There are students—in more established countries like Croatia—that are nearly at Spain’s level at the moment, and they’re copying, in the best sense of the word, the Spanish model. And Ibero-America is also increasing its number of donations very rapidly, also by applying the Spanish model. Since it’s accepted and recognised that we are the leader, everything is much easier, because you have a basis for working with confidence.

During the project, training courses were held for Moldovan specialists, both in Moldova and in Spain and France. What have been the biggest challenges and difficulties of the project in Moldova?

 The difficulties are in the setting, it’s a poor country. Along with Albania, it’s the poorest country in Europe, and that means that in the context of healthcare, hospitals don’t have reasonable minimum conditions for working on donation and transplants. Maybe in the most basic things, yes, but at this level, which requires intensive care units, there is still a lot of work to be done.

Another basic issue is the cultural and social profile of the professionals, which is very conservative and individualistic. Teamwork is an issue that needs to be promoted and worked on in the country.

So clearly it’s a complex setting. There’s also an added factor in the field of donation, because they are coming from a history of organ trafficking and, therefore, the image society has of organ transplantation is negative and needs to be changed. This situation makes the work even more difficult, but at the same time more interesting.

How would you describe the experience of leading the project in Moldova?

 Very interesting and attractive, but complex at the same time, because the organisational and administrative cultures of the governments are different. Even in the way the ministry works is much more pyramidal and extremely bureaucratic. On top of that, there are very few management instruments, which means that the work is a bit hierarchical, and you need a great deal of flexibility and impetus in these things, so these structures make it difficult.

You have to chip away at it, in a good sense, keep talking to people and have them see our experiences. To bring as many people as possible to our country, or to France, which has been the country co-leading the project. This experience has been very positive because the Moldovan professionals were able to come, and they’ve seen another working environment. If they have the experience of seeing what is being done in a country objectively, they learn better and much faster.

How would you describe the experience of leading the project with France?

The experience with them has been fantastic, no problem, perfect. Coordinating with the people from the French Biomedicine Agency has been perfect. They have marvellous professionals and a fantastic team. For example, if on occasion a professional coming from France couldn’t make it, a Spaniard would fill in, and vice versa.

How do you think the work with the Moldovan professionals will be in transmitting what was learnt in the project to society and the rest of the professionals?

 That’s going to be harder to do, and it’s going to be in the hands of the team at the Moldovan transplant agency. The coordinators are going to have to do the work of raising awareness internally in the hospital, because they are the people who are trained and motivated for that, and they are the ones who understand the subject of transplants.  They are going to help the country, within their environment. At the societal level, the Moldovan transplant agency is also going to take responsibility for doing this.

Now that the project is ending, could you tell us about the current system of transplants in Moldova going forward?

In the area of donation and transplants, they are in a position to perform kidney and liver transplants on a fairly normal basis. They’re already doing some with great caution.

They need a certain amount of time to get used to the donation process that exists. They have some donors but, even so, it’s necessary to keep insisting, and there’s still a need to look after the people leading the donor theme in hospitals.

So while they are already doing transplants, they are in the first phase. I’m sure that the time and willingness of the professionals is going to bring them good results, but we’re still at the beginning.

Ensuring the security of citizens is a major objective in FIIAPP’s work. All over the world, the Foundation develops cooperation projects funded by the European Commission in the areas of security, the fight against drug trafficking, the eradication of terrorism and money laundering, and the prevention of natural disasters and nuclear, radiological, biological and chemical threats.

The experience exchanges it facilitates between European Union member states and the beneficiaries result in changes to laws, regulations and working strategies that enable the receptor countries to offer a more secure life to their citizens.

In this conversation, Ana Hernández fills us in on the details of the work of the Foundation in the fight against drug trafficking and other areas in this sector, and how the European Union, in response to the current context, has put the focus on preventing radicalisation and terrorism.

Where is FIIAPP’s work concentrated in terms of illegal drug trafficking and why?

We are focused mainly on the ‘Cocaine Route’, which theoretically runs from Latin America to Europe, through Africa; and on the ‘Heroin Route’, which runs from Afghanistan and has one branch through Asia and another through the Black Sea. These are the two routes we concentrate on for developing projects, because the Commission is focused on these two routes.

What do we do there?

Right now we have many types of projects. In the ‘Cocaine Route’, we have projects focused both on ports and container control, and on fighting money laundering of the proceeds of drug trafficking. In Latin America, through AMERIPOL, we are also trying to create a new police network in Latin America. This means applying a global approach to the fight against drug trafficking. In the ‘Heroin Route’, we’ve also been working on human trafficking and on the creation of information networks so that police forces can exchange information and conduct monitoring.

Are more and more projects of this type being funded?

The European Union has a very powerful security strategy right now and is funding large projects. What we’ve observed is that they are funding large-scale projects: they want various member countries to join together to develop these projects with a more global approach to contribute their experience, along with Spain, to other countries—for example, Ghana or Venezuela—with very different idiosyncrasies, so that they can benefit from this knowledge. In the end, this means creating networks, creating links, learning together. Often, when it’s our policies or our civil guards that are going to these countries, you realise that there are many things over there that they can learn from, and synergies and good relationships end up being created.

Is the EU starting to work in new areas?

Lately they are focusing on issues related to terrorism. Large-scale programmes are being launched to fight terrorism, and radicalisation is being attacked. The EU is realising the great power terrorist groups have in communication media, on the Internet, and in all these networks, for getting their messages out, and that many people who were not radical are becoming radicalised, being recruited… So they’re making a great effort in this area. In fact, one of the large projects for which we have submitted a proposal recently is specifically on the issue of radicalisation. Although it’s also true that this aspect is included in all terrorism projects.

Another issue being addressed increasingly in Europe is cybercrime. It’s an issue which is rising in importance and which, evidently, is being developed increasingly and has great potential.

And, lastly, the EU is working on the fight against money laundering. This is also important because of its role in financing terrorism and organised crime. The fight against money-laundering and financing networks, which in the end is what feeds these groups, is also a way of eradicating this problem.

Cybercrime is a growing concern in Croatia. To address it, the Croatian government in 2011 requested the support of the European Union, and the response was the launch of a cooperation project, or Twinning, led by the FIIAPP. The project includes the collaboration of the Spanish National Police Force and the Civil Guard. The agent, Antonio Domínguez, coordinator of the Twinning project, takes us inside the project.

Sometimes, life sends you opportunities and it’s up to you as the individual to decide whether to seize them and take on the responsibility or not. One such opportunity that came my way was the NAF*. Who’d have thought that I could be part of something new? Perhaps no one. In the beginning, maybe we were a little intimidated by the recruitment process, where many fell by the way side. But were we lucky? Hmmm, I don’t think so. Well perhaps in my case, but more than luck, it was a question of perseverance, studying hard and, above all, feeling the need to be part of something.

They say that it’s not easy to start something new, of course it’s not. Particularly when you are not used to interacting with others. I don’t mean that I’m someone who doesn’t socialise with other people, but this is very different to just talking to your friends, because your friends know you and if you make a mistake they will let you know, with a little ribbing and mockery along the way. But trying to interact with taxpayers was horrible in the beginning! My legs were shaking! I would think “What if I make a mistake? What will I do? Should I just go? I know, it’s a little immature for someone of my age and especially for someone in their final year at university, but I was scared. And then the first taxpayer arrived. She was a very nice dark haired lady, a real delight, and it was then that I understood how unjustified my fear had been, because not all taxpayers are ogres (no offence intended).

Then it was our turn to do a “tax fair” for the inauguration of NAF. We had to set up the marquee the night before the fair. What a drag! But it was for our own benefit so off to work we went. We learned two things that day: firstly, that putting up a marquee is not a simple thing to do, and secondly, that working on a fair requires team work. On the following day all the members of NAF were really nervous and very tired, of course, but it was worth the effort because the fair went ahead without a hitch. Dozens of people stopped to see the stand and others to ask for information or for the NAF opening hours. In short, it was an immense satisfaction to all of us. Finally, NAF open the doors to its first office in Bolivia, in the city of El Alto. What joy! Our hard work was paying off.

In our office at last! Well, the office that the university has loaned us, but it was just as though it was our very own. We had to put into practice everything that we had learned up to this point. In the beginning we had days where we only saw a handful of taxpayers and other days were we saw no one at all. Is that frustrating? Well yes it is, very. Even though we saw approximately 100 different taxpayers in our first month, we thought that this was not good enough and that we needed to be more efficient. Personally, I felt disappointed in myself.

But now we know that 100 is a good number to start with and that we shouldn’t feel frustrated or disappointed because we are giving our best every day. We are a new service, people still don’t know about us, but over time everyone will be talking about NAF.

I don’t want to change the world, the country or even this city alone, I want to change and help that person that comes to NAF for help, because by helping that person, he or she will go on to help another, and he or she will go on to help another, and by doing so, together we can make the world a better place to live. Someone once said that all changes starts with something simple.

My time at NAF is now drawing to an end; the time has flown by. I would love to stay longer but I need to make way for new people.

We aren’t geniuses here and we make mistakes just like anyone else, but whilst we are helping people who need assistance with their accounting and tax affairs, we will always be part of NAF.

*About NAF: Tax Support Centres, better known as NAFs, are part of a university social responsibility initiative promoted by the Brazilian Tax Administration, (Receita Federal).Through NAFs, students studying accounting and finance degrees who have received the necessary training from the tax administration can offer a free advisory service to low income individuals and entities in relation to basic tax issues. NAFs are available at 50 universities in Brazil, and with the backing of EUROsociAL, an EU cooperation programme, they have now been extended to 66 universities in Latin America: Mexico, Costa Rica, Honduras, Ecuador, Chile, Bolivia & Guatemala

Colombian President Juan Manuel Santos signs the decree partially regulating the country’s transparency law (January 2014).

In 2014, Colombia passed the Law on Transparency and Access to Public Information for the purpose of reducing corruption levels in the country. According to public opinion polls, corruption is a major concern of the population. It has nearly the same importance as security, violence and unemployment issues.

The Colombian Secretary of Transparency, Camilo Enciso, in this video analyses the role of the EUROsociAL programme in implementation of the Law on Transparency and Access to Public Information.

Complete interview with Camilo Enciso here

Andrei Galescu is a urologist at the Republican Clinical Hospital in Chisinau, Moldova. Through the “Strengthening the Transplant Agency of the Republic of Moldova” project, financed by the European Commission and managed by the FIIAPP, along with experts from the OCATT (Catalonian Transplant Organisation), he has had the opportunity to spend a month in Barcelona at the Puigvert Clinic gaining practice in the field of transplants from living donors, a therapeutic option for patients suffering from a terminal renal disease.

Below he tells us some of the differences between Spain and Moldova, and about his experience over this month.

Could you describe to us the current situation of the transplant system in Moldova?

The Moldovan transplant system has great experience dating back to 1982, but at the moment we are in a phase of re-launching transplant surgery. In addition, with a 12-year lag in our country, transplants from deceased donors are being resumed.

What did your stay in Barcelona consist of?

The objective of my visit was to gain practice in the field of transplants from living donors. But during my stay at the Puigvert Clinic, I’ve had many opportunities to learn, and not just about transplants. I’ve had the opportunity to visit other departments, such as lithiasis, oncology, nephrology and others.

During this month you’ve had the chance to be in the operating theatre and assist in transplants. Tell us about your experience.

During this month I’ve seen some 10 transplants and I’m impressed, both by the technical procedures used and by how these transplants were performed. I asked myself how everything was organised, I’m referring to the fact that everything functions perfectly, like a Swiss watch [smiling].

This type of transplants, are they the most needed ones in Moldova?

Definitely yes, but we have also increased the number of transplants from deceased donors.

Besides being in the operating theatre, have you been able to assess patients needing transplants with the Puigvert Clinic’s medical team? What differences are there with Moldova in this assessment?

As far as I know, the Moldovan Transplant Agency is working now on creating a transplant protocol and a series of guidelines adapted to our country. I believe that the majority of these conditions will be the same as in Spain.

What is the greatest difference you’ve been able to note between the Spanish and Moldovan transplant systems?

 The technical team, the instruments, and clearly the material financed by the government in this area.

Do you believe that with the help of this European Commission-financed cooperation project, Moldova will improve its transplant system?

Definitely yes. In fact I would like to take this opportunity to express my gratitude to this project.

 After this month of working in Spain, what experience are you taking back to Moldova?

I’ve had the chance to learn new things. The staff at the Puigvert Clinic showed me a ton of tips and tricks during surgery, things you can only learn through practice, not in books.

But the main lesson I’m taking home with me is about the need to learn a lot and work hard.