This record is a partial extract of the original cable. The full text of the original cable is not available.

UNCLAS SECTION 01 OF 02 ACCRA 001222 
 
SIPDIS 
 
STATE FOR PRM/A, GENEVA FOR RMA 
 
E.O. 12958:  N/A 
TAGS: PREF PHUM GH
SUBJECT: PRM A/S DEWEY'S DISCUSSIONS WITH IOM - "HOLDING 
THE PROGRAM IN YOUR HANDS ON A DAILY BASIS" 
 
 
¶1.  Summary:  A/S Dewey and the International 
Organization for Migration (IOM) Chief of Mission held 
fruitful discussions during the recent trip by A/S Dewey 
to W. Africa.  Touching on issues related to security, 
fiscal management and panel physician concerns in the 
region, Dewey was presented with a debriefing of IOM's 
role as PRM's "go to" partner for difficult support 
operations in the region.  End Summary. 
 
¶2. During a representational dinner and private 
luncheon with IOM COM Antonio Polosa, A/S Dewey was 
briefed on the extensive support that IOM has provided 
to the USRP in the region over the past three years. 
The two focused on three general areas of concern: 1) 
the expanded role of IOM as a result of 9/11, 2) the 
cognizance of fiscal responsibility as sound program 
performance and 3) medical delays and the role of panel 
physicians. 
 
¶3.  Expanded Role of IOM - Our "go to" Partner.  Polosa 
outlined the dramatic increase in IOM responsibilities 
since the events of 9/11.  As a result of ensuing 
security concerns associated with the event, DHS ceased 
interviewing in refugee camps in W. Africa.  The USRP 
then had to bring the caseloads to DHS, which often 
involved bringing thousands of refugees from remote 
areas in the bush to capital cities.  While the 
logistics were challenging enough for IOM, a need to 
have IOM bear the burden of providing infrastructure to 
OPE and DHS during interviews emerged as a top 
priority.  As no other entity could enter into 
fiduciary contracts with vendors outside of Ghana, IOM 
was tapped by PRM to provide everything from building 
leases, to copiers to car rentals. In addition to this 
physical support, IOM routinely stepped in to take up 
the slack of UNHCR efforts in areas where staff was 
limited or where there was no presence whatsoever. 
This support included, but wasn't limited to, posting 
notifications for refugees, providing expediting 
services at airports for OPE staff and completing odds 
and ends like photographing refugees.  (Comment: While 
not mentioned in the discussion, it should also be 
noted that IOM has been the entity assigned to conduct 
fingerprinting of all refugees determined in need by 
PRM.  End Comment). 
 
¶4.  Fiscal Responsibility - Understanding Funding 
Limitations.  A/S Dewey and Polosa discussed the 
current low level of funding in which the admissions 
program finds itself.  Polosa acknowledged PRM's 
concerns noting it was well understood within the ranks 
of IOM.  Committed to sound program performance, Polosa 
stated that IOM/Accra was cognizant of ensuring fiscal 
responsibility went hand in hand with project 
development. 
 
¶5.  Medical Delays - Panel Physicians Still Cause 
Problems.  A/S Dewey queried Polosa about the role IOM 
plays regarding the medical examinations in the region. 
Explaining the support role to panel physicians, the 
conversation eventually turned to the continuing 
problems faced with some panel physicians in the 
region.  Refcoord provided a few glaring examples of 
instances where refugees were delayed for years due to 
panel physician slowness or ineptitude.  Polosa 
reinforced that if the medicals did not come in from 
the panel physicians, then the refugees could not move. 
Refcoord discussed some creative ways the field had 
gotten around problem physicians, noting "facilitated" 
exams by IOM doctors sent to posts to "assist" panel 
physicians, sending cables to posts encouraging face-to- 
face discussions on poor performance.  Noting that IOM 
was tapped to provide the medical services in Abidjan 
for the recent operation, Refcoord remarked that the 
decision to utilize IOM was not only to benefit the 
very strict timeline, but also because our experience 
with the Abidjan panel physicians were so poor in the 
past that we couldn't risk having them jeopardize the 
operation.  Further describing dramatic cost 
discrepancies between fees for the Canadians vs. the 
Americans, Refcoord noted that this was an additional 
issue that needed attention.  For example, in Banjul 
the panel physician charges the USG at least 3 times 
the rate of the same exam for the Canadians. 
 
¶6.  "Holding The Program in Your Hands on a Daily 
Basis".  To summarize the issues, Polosa noted that 
there were so many permutations to the operation that 
one had to hold the program in his hands on a daily 
basis.  A/S Dewey appreciated the comment, carrying it 
through to other meetings throughout the trip.  Voicing 
strong appreciation for IOM efforts, the Assistant 
Secretary yet again provided heartfelt encouragement to 
 
SIPDIS 
the daily efforts of a valued USRP team member.