VZCZCXRO9326
RR RUEHDE RUEHDIR
DE RUEHMS #0782/01 2260628
ZNR UUUUU ZZH
R 140628Z AUG 07
FM AMEMBASSY MUSCAT
TO RUEHC/SECSTATE WASHDC 8613
INFO RUEHZM/GULF COOPERATION COUNCIL COLLECTIVE
RUEAUSA/DEPT OF HHS WASHDC

UNCLAS SECTION 01 OF 03 MUSCAT 000782 
 
SIPDIS 
 
SIPDIS 
 
STATE FOR NEA/ARP, IO/T, G/TIP, DRL 
 
E.O. 12958: N/A 
TAGS: TBIO SOCI KOCI MU
SUBJECT: UN AGENCIES FOCUS ON IMPROVING HEALTHCARE IN OMAN 
 
 
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Summary 
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¶1. Three UN agencies have established constructive working 
relationships with the Omani government in efforts to promote 
better healthcare through educational initiatives.  Aside 
from highlighting the importance of child nutrition, the 
organizations are also raising awareness of community 
involvement and disease prevention measures as programmatic 
priorities.  Some limitations remain, however, reflective of 
the conservative and self-sufficient culture in which they 
operate.   End Summary. 
 
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A "Graduate Country" 
-------------------- 
 
¶2. Poloff discussed UN efforts to promote healthcare 
initiatives in Oman during separate meetings with Zakiah 
Rashid, Program Assistant from the United Nations Children's 
Fund (UNICEF), Nora Alnahedh, Resident Representative from 
the United Nations Population Fund (UNFPA), and Dr. Jihane 
Tawilah, the World Health Organization's (WHO) representative 
in Oman.  Rashid commented that her organization, which has 
been able to foster a stable and cooperative relationship 
with the government, views Oman as a "Graduate Country" due 
to its progress in advancing the rights of children and 
promoting education and healthcare.  Aid and support from the 
Omani government, including a generous donation of four 
million USD for the contracted session 2007-2010, has 
facilitated cooperation.  She remarked that because the 
relationship has been so productive, UNICEF will evaluate the 
merits of keeping its Muscat office open after the current 
contract concludes. 
 
¶3. Alnahedh noted that since 2006, Oman has served as UNFPA's 
regional office for studying population, reproductive health, 
women's health, population strategies and policies.  She 
stated that UNFPA based its decision on account of the 
Sultanate's progressive stance on health and gender issues 
and its collaboration on projects that focus on improving 
health facilities, raising awareness, and constructing 
educational programs.  Despite this progressive outlook, 
Alnahedh said that UNFPA does face opposition from 
conservative elements in Oman and its neighbors, stemming 
from an underlying fear that the UN may be promoting an 
agenda contradictory to traditional beliefs. 
 
¶4. Tawilah remarked that Oman is very influential in this 
region, as it boasts one of the "most developed healthcare 
systems" in the Middle East, especially within the school 
system.  She highlighted the important and "mutually 
beneficial" relationship that the WHO shares with the Omani 
government, especially with the Ministry of Health (MoH). 
She commented that the Ministry's enthusiasm for WHO's 
presence has facilitated close collaboration on technical 
issues, facility and health care functions, and in-depth 
review and reevaluation services.  The Ministry does not 
provide monetary assistance to the WHO; however, it does 
sponsor a number of responsible and important research 
studies that benefit the programs initiated by the WHO, 
including data analysis and surveys.  Tawilah cited Oman's 
facilitation of the World Health Survey, investment in 
studies on behavioral change, and leadership on research on 
genetics as several examples reflective of the Sultanate's 
interest in WHO collaboration. 
 
------------------------- 
Improving Child Nutrition 
------------------------- 
 
¶5. According to Rashid, UNICEF's main focus is improving 
Oman's child healthcare system.  On the positive side, she 
pointed out that 99% of Omani children (nationals only) 
receive vaccinations, and that Polio has been completely 
eradicated in the Sultanate.  Rashid noted, however, that 
varying UNICEF reports from previous years indicate concern 
over child malnutrition, which affects 17% of Omani children. 
 UNICEF has determined that malnutrition is largely due to 
parental negligence, as parents are often unable to 
adequately care for their children even when resources are 
readily available.  UNICEF is targeting this problem with 
educational programs, emphasizing its "Parenting Support" 
program established in 1999. 
 
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Active in the Community 
----------------------- 
 
 
MUSCAT 00000782  002 OF 003 
 
 
¶6. Tawilah emphasized that the WHO's work focuses on 
community development and protection.  Through its "community 
initiative" strategy, the WHO is working with the Ministry on 
the three components necessary to achieve adequate 
healthcare.  The first "social" component serves to develop 
life skills through training, marketing, and production of 
goods and services.  The second "economic" component is 
geared towards specific areas and works to eradicate poverty. 
 These two components are implemented specifically to exploit 
any of the problems found in the third component, Oman's 
healthcare system.  Tawilah anticipated that the successful 
and productive development of the economic and social sectors 
will help the Omani government see lingering faults, which 
would lead to further investment in community development. 
 
-------------------------- 
Keen on "Healthy Villages" 
-------------------------- 
 
¶7. In support of the WHO's involvement in community 
development, Tawilah raised the organization's efforts to 
sponsor city programs based on its "Healthy Villages" 
initiative.  In the fast-growing industrial city of Sohar, 
the government and WHO have successfully implemented the 
"Sohar Project," which focuses on promoting positive 
healthcare in all areas of life.  This program, which is now 
serving as a model for other GCC countries, began with the 
municipality's conducting of an overall evaluation of its 
infrastructure, economy and healthcare systems.  According to 
Tawilah, from this evaluation, city health officials 
identified hypertension and diabetes, caused from bad diets, 
smoking and lack of health facilities, as the most 
problematic health concerns.  With this information in mind, 
health officials are now promoting healthy lifestyles by 
sponsoring facilities that will address these problems. 
 
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Addressing Health Concerns 
-------------------------- 
 
¶8. While Tawilah assessed the overall state of healthcare in 
the Sultanate as "very good," she pointed out that programs 
focusing on menopause and elderly women need to be improved. 
She found that problems this demographic faces, such as 
cancer and arthritis, can be prevented with the 
implementation of behavioral changes.  To assist the 
government in addressing these concerns, Tawilah stated that 
the WHO has sponsored a Pro-Lead (leadership) conference.  In 
addition, through studies and scientific strategies proposed 
by the WHO, the Omani government is addressing harmful social 
habits like smoking and obesity. 
 
¶9. Tawilah characterized the Ministry of Health as the 
"steering wheel" for putting these programs in motion within 
the Sultanate.  It is not the Ministry of Health's 
responsibility to promote health in education for example, 
but it can encourage the Ministry of Education to adopt 
relate curricula based on the WHO's recommendations.  As part 
of the Pro-Lead program, Tawilah remarked that the WHO 
encouraged the ministries to develop a number of Diet and 
Physical Activity Strategies (DPAS). 
 
------------------------------------ 
Promoting Better Access to Healthcare 
------------------------------------- 
 
¶10. Each representative raised her concerns about access to 
healthcare.  Alnahedh noted that Oman's elevated crude birth 
rate (18.28 per every 1,000 births) is due primarily to a 
lack of medical facilities in outlying areas.  For small, 
less urban communities located in the interior, medical 
treatment is simply not available.  In response, UNFPA has 
suggested midwife training programs to increase survival of 
both the mother and the child in cases of emergency.  The 
Omani government has resisted implementing this program based 
on its belief that all medical treatment should occur in 
clinics and hospitals.  The Ministry, however, has been more 
receptive to establishing, in conjunction with UNFPA, a 
professional service that can travel from door to door to 
meet the needs of the elderly and incapable. 
 
¶11. For Oman's large population of South Asian expatriates, 
use of medical facilities is readily available, but not free 
of charge.  For this reason, Alnahedh voiced her concern that 
inadequate accommodations exist for those in Oman who can't 
access the national healthcare system, yet at the same time, 
can't pay for private services. 
 
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Focus on HIV 
 
MUSCAT 00000782  003 OF 003 
 
 
------------ 
 
¶12. Both UNICEF and UNFPA are focused on raising awareness of 
HIV/AIDS in the Sultanate.  Rashid remarked that with 973 
reported cases, HIV is present in all areas of the country. 
In response, she commented that the Ministry of Health 
launched a "Get Tested" campaign in 2005 that encouraged all 
Omanis to discard the shame associated with HIV infection. 
Over 800 Omanis participated, including the Under-Secretary 
of the Ministry of Health, who was reportedly the first 
person to get tested during the campaign.  Additionally, 
UNICEF reports that the Ministry of Health provides excellent 
accommodations for Omanis infected with HIV.  In hospitals, 
HIV patients are treated in a separate area, where they 
receive medication, and counseling from licensed physicians. 
 
 
¶13. Rashid emphasized UNICEF's role in supporting the 
government's efforts.  For example, with the assistance of 
UNICEF, the Ministry now publishes leaflets and posters for 
schools and health clinics.  The pamphlets, which provide 
useful information about prevention, detection and acceptance 
of HIV, are available throughout Oman.  Through collaborative 
efforts, the Ministry has released a censored "sexual 
education" program in its high schools that discuss how HIV 
is spread and how it can be avoided. 
 
¶14. In addition to providing medical treatment and counseling 
services, UNICEF helped establish a 24 hour telephone hotline 
to offer help to those who contract HIV.  Rashid said that 
UNICEF advocates a "no shame" approach to HIV infection, 
emphasizing that a healthy outlook can lead to a healthy 
life. 
 
¶15. UNFPA also is raising HIV awareness in Oman through 
peer-training programs, which uses youth volunteers (defined 
as less than 30 years of age) to disseminate information 
throughout the region.  Alnahedh noted that Oman was the 
first country to successfully train an expert on HIV 
prevention, who is now authorized to conduct training 
seminars for Omani youth.  Contraception for both men and 
women is widely available in Oman; however, male use is rare, 
diminishing the effectiveness of condom use in slowing HIV 
transmission rates. 
 
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Trafficking and the Sex Trade 
----------------------------- 
 
¶16. Responding to Poloff's inquiry regarding the dangers the 
sex trade posed to spreading HIV in Oman, Alnahedh admitted 
that prostitution, as the "oldest profession in the world," 
was a problem.  She found that domestic violence toward women 
and toward domestic workers was widespread, with no help 
offered for victims in the Sultanate.  Alnahedh cited the 
fact that GCC states are not comfortable talking about 
prostitution as one obstacle hindering efforts to address 
this issue.  She believed that the GCC needed to become more 
aggressive in dealing with issues such as prostitution, and 
that HIV prevention programs should be targeted toward 
high-risk populations. 
 
---------------------- 
Omani Self-Sufficiency 
---------------------- 
 
¶17. Another concern facing the three UN agencies is the Omani 
government's tendency toward self-sufficiency.  For example, 
Tawilah commented that, in spite of the WHO's close 
relationship with the Ministry of Health, Oman turned down 
her immediate offers of assistance in responding to Tropical 
Cyclone Gonu, even with the surge in medical emergencies 
following the storm.  However, the Omani government was 
receptive to WHO guidance on various aftermath recovery 
strategies, presented primarily through education and media, 
and worked with the organization on improving dialogue 
amongst the ministries, creating a more effective process of 
delegating tasks.  Tawilah noted that the government had also 
taken onboard WHO advice on assessing the potentially fragile 
mental health of Omanis following the storm.  Currently, a 
new intervention program implemented to deal with the 
inconsistencies that have developed in the health sector is 
in formation, and will last for up to 18 months. 
 
 
 
GRAPPO