Project to create a Oncology Network Environmental Health.

“ R.O.S.E. “

Canton Una Sana
Bosnia and Herzegovina

JUNE 2021

Bosnia and Herzegovina
Una Sana canton is in great health difficulty

With the collaborative will of the international community, the complicated situation will remain complex but simple!
The time for action has come.

More than 25 years of presence with the populations of Bosanska Krupa (Canton Una Sana – BIH), the association Potentiel 3.0 launches an appeal to international responsibility and to France to transform the dynamics of abandonment and poverty of this Canton to that of sharing and solidarity.
There is a health emergency to take into account.
Even if the context remains complex and delicate, inaction would be incomprehensible.

Summary

1- Diagnosis of the situation
1.1 The observations
1.2 Why this project
1-3 Environmental state of the Canton Una Sana
1-4 The war redrawn the borders while destroying the organized systems
1.5 The project put forward by Potentiel 3.0 is based on this observation

2- Environmental health and oncology network project
2-1 Environmental health project
2-2 Project of an oncology network
2-2-1 Impact of the project
2-2-2 Variation of the project
a) Work on the project diagnosis
b) Project setup
c) Milestones to be processed
d) Respond to urgent needs
e) Long-term project
2-3 Systemic dimension of the project
2-4 Main areas for this project
a) Environmental health
b) Oncology network
c) Project management and monitoring
d) Supervision, control, evaluation

3- Positioning and organization: Place and role of Potentiel 3.0 in this project
3-1- Logic of realization and organization of a global project
3-2 The 4 bricks of the proposed:
3-2-1- Environmental health
3-2-2- Oncology network
3-2-3- Project management and monitoring
3-2-4- Supervision and planning of the project, areas of expertise, controls, evaluation

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1 – Diagnosis of the situation

1-1 The observation
The Dayton Peace Accords isolated Una Sana Township in northwestern Bosnia. Global isolation and disruption of economic, health and social dynamics. Far from the capital, this area sinks in a dramatic regression for the population.
Let us remember that all these inhabitants were surrounded, locked up, poisoned 1201 days, in the “Pocket of Bihac”. They were under the bombs for four years. They experienced the deliberate pollution of water and food, without being able to get out of this hell.

“Even if we have to turn the page, we can’t forget!  »

1-2 Why this project

September 2018, first awakening on the health issue in Canton Una Sana, for our association.
Many requests have reached us revealing a deep distress on the part of the populations:
– 4 months to live for a young student in fifth year of medicine. He has very serious cancer. The challenge was clear: can we do something? This request transformed into actions: welcoming the patient in France, meeting with the team from the Paoli Calmette institute in Marseille, quotation, fundraising, treatments, operations, lodging in a private home, 25,000 euros of funding to be put in place. Two years later, the care journey continues. The patient is still alive. He still needs 35,000 Euros.
– A child was also taken care of by Roussy Hospital in Paris thanks to the action of the French Embassy in Sarajevo.
– Italians have followed the evolution of a child who lost her leg during the war to adapt her prosthesis over the years.
These three examples highlight a reality that is much larger and more diverse. Random surveys carried out with local health actors in 2020 reveal a situation of very serious illness (mainly cancer) in almost every house or apartment in Bosanska Krupa, Bihac…

In the period from December 2020 to January 20, 2021, only on Bosanska Krupa, we had the great sadness to learn of the deaths, due to cancer, of more than 20 people. Local radio struggles to think positively in broadcasting such information on a daily basis.
Without reliable technical capacity, without training in these extreme pathologies, without means, the health of the canton is experiencing a considerable delay which makes some doctors say that the situation is worse than in the 1960s, for certain services!
The consequences of the war, the collapse of the economy, the latest earthquakes are determining factors that trigger the legitimate reasons for this project.
A challenge to take up, a responsibility to assume. A population to save, revitalize and integrate into the EEC.

1-3 Environmental state of the Canton of Una Sana

To understand the meaning of the Potentiel project and its systemic dimension, addressing the environmental dimension is essential. Indeed, it is not about blaming everything on the war and looking for responsibility.

Before the war: economic activity was stronger than now. The intensive breeding of chickens, concrete plants, garages and mainly their vulcanization actions, various polluting companies were discharging their waste into the Una (main river of the township and in the adjacent rivers). To say that is to go back 60 years in France. Our hospitals observed cancer in these professionals, a large number of whom died at the age of 60. This observation underlines a serious delay in environmental health for this canton. The pollution comes from afar. It has a definite impact on the populations.

During the war: Due to a very degraded environmental situation, the war in Una Sana township was particularly productive of air and water pollution.

The causes are multiple:
– Industries continued to use rivers for their harmful discharges
– The intensive bombing in this township contaminated the air and water. The number of bombs that were dropped on Bosanska Krupa, Bihac, Cazin, Vélika – Kladusa etc, is enough to explain these poisonings. Some bombs had phosphorus or depleted uranium. Phosphorus-based flare shells were used between belligerents and on the population. Anti-personnel mines, deposited by the thousands, have contributed to this environmental deterioration.
– The population was locked up for 1201 days with the constraint of eating and drinking what was available on the spot. Obviously, this was out of compliance with minimum hygienic conditions.
– Armies threw away their canned food, some of which dated back to 1933. The inhabitants rushed in for food.
– Drinking water was difficult to access and the groundwater are polluted.
– A plan was drawn up and executed by an army to deliberately poison the besieged populations. Food was thus distributed with harmful products to the inhabitants of the canton (evidence and witnesses available).
– Numerous illegal dumps (At least five just for the town of Bosanska Krupa) allowed the dumping of weapons dismantled after the war. Hospital waste was thus dumped in these places. The same was true for expired drugs, many of which came from the international community. You could also throw corpses there. Clearly, since the end of the war, these wild places served as trash cans for both Bosnia and foreign countries anxious to get rid of products that had become unnecessary and cumbersome. These pollutions are still present today.
Tap water is not recommended for drinking. On December 11, 2020, Bihac radio was still broadcasting a water quality alert!

After the War: The environmental situation remains greatly degraded. Few resources have been allocated to sanitation of water. Unauthorized dumping continues to pollute, especially after periods of rain. Although grants may have been awarded by the UN or other funders, the work was below what would have been needed. Many examples could be put forward to illustrate these words.

Conclusion:
All of this pollution, some of which is still active, largely explains the abnormally high number of cancers in this region.
Leukemia in young children is on the rise. Children of war develop serious cancers from the age of 26. Many soldiers are at the end of the road around 55 to 65 years old and the population, present during the siege of this canton, is not doing better.
Everyone knows this without taking the problem to the level of its gravity?
Denial produces immobilizes which installs perverse functioning.
It is in terms of observation that this project is being developed.
Whatever the past may be, we must return to the here and now.

1-4 The war has redrawn the borders while destroying organized systems!

When the Dayton Accords resulted in the reconfiguration of the boundaries of the new countries of the former Yugoslavia, the impact of the decisions produced some negative effects. This is especially true for Una Sana township. He saw his health organization shattered. It is now cut off from any close hospital complementarity.

Before the war this canton was attached to the hospitals of Zagreb, Banja Luka and Belgrad.

Today these networks are no longer accessible. Banja Luka could remain a low-level alternative. The resentment of the war creates a psychological border which does not allow to consider, at the present time, objective and positive reciprocities between these different communities.

While Zagreb is 140 km from Bihac, it is towards Sarajevo that emergencies are now directed. The route is 370 km for a journey time of 5 to 6 hours?

A person who felt unwell at his home went to Bihac hospital. Return home after a quick visit because of lack of means of in-depth investigations. A few hours later another illness brought this patient to Bihac hospital again. Decision is made to take him urgently to Sarajevo? In the end, the conditions of care led to the death of the person.
This example reflects many identical situations linked to the sanitary isolation of this canton. No adequate technical and human resources have come to compensate for this isolation

1-5 The project put forward by Potentiel is based on this observation.

For heavy iterative treatments, in addition to Sarajevo, the city of Tuzla is sometimes called upon. It’s 310 KM and a 5 hour drive. Patients who are often poor must find their own solutions in terms of transport, accommodation and food. Chemo or radiotherapy becomes an obstacle course detrimental to the quality of care. These proposals are often incompatible with the financial capacities and the state of health of the patients.
Between poverty, high cost and difficulties in accessing healthcare facilities, it is understandable that the patient waits until the last moment to seek treatment. Doctors note this state of affairs and deplore it. The outcome becomes fatal for a large number of patients. There are too many of them in this situation to allow such a device to continue. Peace does the reverse of what should be. It’s a real paradox.

Families have gone abroad. They somehow manage to be covered by the laws of the host country and thus seek treatment. Others, who remain in the Canton, sell their goods to finance health care. A desperate process often leads them into extreme poverty. A math teacher who taught for over 40 years on Bihac can no longer afford to live properly with a very small pension (400 KM or 200 Euros per month). Positive for Covid 19, he could not finance his need for oxygen. A doctor, a former student of this professor recognized him. He took care of this problem. The professor was able to be treated! This is a sad reality which underlines the urgency to reconfigure a decent and fair health network.

In conclusion, the isolation of Canton Una Sana from a relatively relevant health network, the chronic poverty in which a majority of inhabitants find themselves, the degraded state of hospital and health infrastructure and environmental health make this canton a disaster area that will not be able to get out of this situation without international aid.

As long as the health care difficulties remain at this high level of seriousness, it is illusory to think of economic recovery strategies in this sector.
Maslow clearly underlined the necessary response to be made to satisfy the essential needs before thinking of any evolution of the population, of the society.
For now, the resourcefulness, individualism and private interests provide unsatisfactory and perverted answers.
This project has the necessary strength to change the paradigm and restart a health system in danger. It carries with it all the ingredients necessary to relaunch a society on a good road. It rekindles hope for a population trapped by « learned helplessness. » It responds to systemic logic capable of reviving the more global economy.
It is an opportunity with multiple consequences that has the privilege of being highly human. It is a positive approach that aims to change the outlook on this country. Finally, it is to give an isolated canton the possibility of becoming attractive to neighboring regions and regaining a beneficial influence to regulate relations between towns and villages. A win-win approach whose effects militate more for peace than the opposite.

2 – Environmental health project and oncology network.

It is concomitantly that these two dimensions of the project are being considered. Work on environmental health can start without delay, leaving the heavier investment project time to mature through consultation between experts and local officials. The only requirements to ensure global relevance is to affirm that one does not go without the other and that these objectives are shared. A collaboration contract with France and its regions, the EEC, should be offered to the political leaders of this Canton (or even the country) to initiate such an approach.

2-1 Environmental health project
Investigative work is required to address this theme. The process must be set in time. It is not a question of doing in the place but of doing with the available local forces.
No doubt that prior coordination will be necessary to assess the local capacity to act. Depending on this reality, adaptations will have to be proposed: Formation of actors, methodological, educational and logistical support and accompaniment will have to be developed.
France and its regions, the EEC have excellent specialists in environmental health to imagine this step as a formality rather than an obstacle.
We have to expect some stern conclusions. They will impact the know-how, environmental regulations and compliance assistance for the businesses and local communities concerned. This compliance will have to integrate European environmental requirements in order to keep the final objective of Bosnia and Herzegovina entering Europe within ten years.

2-2 Project of an oncology network
If we were thinking of an oncology center in Bihac, the evolution of practices, the various exchanges with doctors and oncology specialists lead us to think in terms of an oncological network.
Ambulatory medicine has made great progress. City medicine learns to build multidisciplinary networks between specialties, between cities, hospitals and patients.
Algorithms and software make it possible to follow the patient journey in a flexible and always up-to-date way with respect for people.
The patient partner of the process is the actor of his destiny.
The hospital, outside the walls, reduces investment costs and humanizes the care, some of which can be done at home with the support of hospitalization at home (HAH), for example.
Telemedicine and teleconsultation reinforce the flexibility of practices to imagine the project with such advances.
These developments suggest a more diversified and graduated distribution of technical platforms. Rather than a centralized logic in Bihac, it is towards developments spread over the canton that we must reflect in particular on Bihac, Bosanska-Krupa, Cazin and Kladusa. This involves screening and prevention as close as possible to the populations.
Bihac would remain the bridgehead of these logics with a more elaborate technical platform (operation room, quality laboratory and specialized technical platform for the heaviest situations).
To advance in this reflection and support the doctors of the canton, the Assistance Publique-Hôpitaux de Paris, the Paoli Calmette Institute in Marseille and undoubtedly the Gustave Roussy Hospital in Paris are ready to support this objective. Other structures are potentially willing to participate in this challenge whether they are in Switzerland, Germany or another EEC country. The Provence-Alpes-Côte d’Azur (Paca) region has expertise in oncology that is recognized worldwide. The export of these would be a great opportunity to anchor health and economic dynamics between these two regions.
IT companies have let us know their support by providing licenses to operate management software suitable for this project. A response to the request for supervision and expert oncology consultations, formulated by local doctors, is ready to be activated.
A French organization specializing in the construction of hospitals abroad is able to get into the dance around this project. No doubt the French Development Agency will be able to provide its expertise to regulate and control all of this.

2-2-1 Impacts of the project
The impact of the project on the populations is multiple and easy to understand.
It is direct on the quality of patient care. It concerns the individual but also the whole community. It gives hope.
These psychological, physical, social and economic effects are almost immediate as soon as this project does not become a lark mirror.
This canton thus opened up, would once again become radiant and influential in this region of Bosnia and Herzegovina but also for the adjoining Croatian territories within a radius of approximately 170 km.

2-2-2 Variation of the project
The file is complex and very strategic. The ambition of such a program takes 8 to 10 years of work. We must also take a position in the face of the urgency to act in a dramatic situation. There are too many deaths, currently in Una Sana township, due to pollution and cancer.
Without precisely defining the strategy to be implemented, a few points will need to be addressed.

a) Work on the diagnosis of the project:
• What technologies are available locally? (Inventory of technical and human resources and assessment of the real need)
• What are the levels of knowledge and training in relation to cancers?
• What is the patient care system? What possible evolutions can we go to improve the system?

b) Project setup
Concurrently with the setting up of the project, meetings and exchanges with resource persons, various experts and politicians elected in national and international organizations will have to be made to put this project on track. The course may be long, hence the importance of not delaying the launch.
Cancer research will shake things up in the coming years. The outpatient clinic will take a prominent place in the future. The fluidity of information will have to be organized by putting the patient and his participation at the heart of the project. The practices will call on strong network strategies, powerful and protected algorithms around a complementary and transversal organization. This is a major paradigm shift that will have to be supported in a particularly individualistic country, reluctant to teamwork and somewhat distorted by perverted influences that will have to be circumvented.

To conceive of such a project, it must be conceived with a rise in power which primarily addresses the urgency to act until the final realization.

This project is subtle and highly systemic. It is as much economic, health, political as it is human. It is in a very disturbed international context, in a depressed, anemic and dysfunctional economic and social environment.
The art of negotiation will have to be at its peak.
The involvement of those approached, their commitments and their expertise will be decisive for the rest of the process.
The values and purpose of the project as well as the conditions under which it is to be carried out must be stated from the outset. The local team should take ownership of the project with a real desire for success. The collaborative and complementary spirit is essential in such an approach, from the start. These are reciprocal commitments.

c) Steps to be processed:
Beforehand it is necessary to write down the rules of the game and to make sure that the decisions taken are followed by the facts.
To guarantee the long-term implementation of such a program, we must think about the organizational and managerial form of the project so that it is not hijacked or looted by malicious organizations. (International structure that manages the funds during and after the implementation of the program as long as the conditions for normal operation and in accordance with the project are not met).
Define an expert methodology for all these negotiations.

Diagnostic phase
a) Reality of the field (diagnostic plan to be developed)
b) Level of knowledge and practices that can be mobilized in Bosnia and abroad (expert group to be created)
c) Ability to interact with foreign players (search for partners such as Unicancer, IPC for Marseille, but also on the side of Paris AP-HP, Gustave Roussy, Montpellier, Lyon or Bordeaux, Lausanne….
d) Calibration of the diagnostic phase with an expert and multidisciplinary team mixed Europe, Switzerland and BIH for the canton of Una Sana.
e) Costing of this phase
f) Etc.

d) Respond to urgent needs.

– How to respond to the urgency of the situation?
Ability to make reliable medical diagnoses and take care of extreme cases in European hospitals (agreement between state / Europe).
To set up reliable medical diagnostics, it is necessary to consider a first stage of investments to be installed in existing premises in Bihac: scanner, colonoscopy, fibroscopy, laparoscopy around a high-performance lab (cost of a bunker: around 8 to 10 million of euros). No doubt we will have to think about the accessibility of efficient drugs with the help of large laboratories (preferential and exclusive rates for this program, even support from foundations etc.)
While waiting for this first stage of investments, agreements should be put in place between hospitals specializing in oncology in Europe and the Bosnian medical community to accommodate the very serious situations observed (over a minimum of three years). French State (or other) funds earmarked for international medical cooperation could be mobilized
At European level, an urgent envelope could be made available for this objective. The « Berlin Process » could also be engaged as could the USA, Canada, Australia directly or through their embassies….

• Plan and organize screening for people at risk (28–55 years)
Policy to be supported for such a program (management, management and administration of the project, patient monitoring and professional remuneration)
Beforehand, local referring physicians should be trained who will have the authorization for such actions. If possible, plan to associate them with training courses on the management of this disease in a network approach.
Costing these steps is necessary both in terms of investment and operation.
The response to urgent needs must be able to be spread over three years from the start of the overall project.

e) Long-term project
Along with the first phase of emergency response, long-term work should be initiated.

Project development:
• QQCOQP (who, what, how, where, when, why and for whom…)

Cost evaluation:
• Costs on the feasibility of the program and preliminary project in investment and operation.
• Shared work to create an oncology network in a poor and technically backward country. (Multidisciplinary and international team)
• Calibration of the basic project. It must be adaptable over time and technical, medical and economic developments.
• Provisional budget and long-term financing plan (international aid + IMF + European Bank + Foundations + Subsidies, Donations, Bequests, participation of Bosnia, etc.).
• State the conditions for the management and monitoring of the project and those relating to the transfer of the latter to Bosnia after ten operations « under supervision » or more, if necessary, maximum 15 years.

At this stage of the process, it is difficult to go further without having taken the first steps to raise awareness and support the program on the part of the prospective players.

To minimize costs, the 90 million assessed will be spread over 10 years. That is 9 million Euros per year (linear) for Europe with 26 countries, which corresponds to an effort of 346,154 Euros per year per country. If we add the participation of the United States, Canada, Australia, the IMF and some large world foundations the cost will be further reduced.
The effects will be multiple for the inhabitants of the Una Sana canton, for the modernization of local practices, for health solidarity between countries, for the stability of the populations and their survival, for the respect of the peoples.

2-3 Systemic dimension of the project
The project for an oncology center in Bihac, in the canton of Una Sana has highly systemic implications that could give France and Europe more influence in this country. A necessity to take the path of lasting peace.
It is also a higher path that would shatter the binary and symmetrical behaviors that trigger conflicts. It would be a way of unifying more than maintaining and promoting the risks of conflict.
This could slow down the processes of destabilization that the great external powers are trying to create for divergent interests:
– China divides the region to favor its modern Silk Road project via the Balkans
– Serbia wants to recover Montenegro with the support, understandably, of Russia.
– Turkey, Syria, Saudi Arabia and other countries that harbor fundamentalism would like to use Bosnia as an advanced base towards Europe
– The United States is waiting for a misstep from the Bosnian Serbs to legitimize a strengthening of their presence in the Balkans. This is a way for them to slow down Russian and Chinese ambitions while disregarding the role that
Europe should have in this highly sensitive sector. They are playing with fire in Greece to counter China and promote their pipe-line project (TAP).
– The migratory flows in all the countries of the Balkans and in Greece are also opportunities for destabilization, pressure and political issues in disregard of human tragedies.
– The absence of strong authority in these regions favors parallel powers, deviant behavior, large-scale embezzlement. The ingredients for a hybrid war to ignite this entire sector are in place.
– Etc.
The project, proposed by the association Potentiel 3.0, is not just a simple investment. It could, through its working methods, restructure the functioning and organization of a drifting health system. It would help economic and political leaders and those in the health sector to change the paradigm.
The effectiveness of a well thought out action, which protects against deviant behavior allows the inclusion of new practices, relationships, governance and management through its health organization.
It is this systemic aim that should propel this project in a perspective of global changes to join the values of Europe and then Europe.
This humanitarian, health and social project would send a strong sign of understanding and support to a population unable to cope without significant support, although they have real skills that are hidden or restricted. It should be remembered that Bosnia and Herzegovina had strong collaborations with France, the SOUTH region, in particular with a Eurocopter subcontracting plant in Mostar.
Behind this medical network focused on oncology there is the whole outpatient dimension that will have to be developed. In this way, we stimulate a real system of interventions between the hospital and the city medicine.
The system effects are evident in the local economy: work for companies, job creation, stabilization of the population, training of actors in the health sector, ability to take charge, in extreme situations, of the health aspect of migrants. and above all save human lives….
One way to build confidence in order to consider other bricks of more economic and commercial collaborations aimed at strengthening Bosnia’s capacity to become a partner of Europe, France and its regions.
The global coronavirus pandemic calls on politicians to rebalance the human in international relations by reducing essentially economic aims. This project is a real gateway to a peace process.
This is succinctly the reason for the commitment of the association which targets this second wave of victims after the war in Bosnia from 1992 to 1996. They pay the price for intoxications, poisonings, pollution, contaminations which the international community cannot be unaware of. clear it by forgetting.
As we can see, this complex issue deserves a comprehensive, fine, subtle and determined strategy.
If the obvious interest of this project obtains a favorable opinion, it would be urgent to be able to release 200,000 Euros to finance the feasibility study and its preliminary draft (150,000 Euros).
In view of these studies and given the urgency to act, the establishment of teleconsultations / supervision between Bosnian and French doctors would be relevant (50,000 Euro / year over 3 years minimum).
As a reminder, the 80-90 million requested for the entire project would be spread over five years, represents 16 to 18 million per year, derisory on a European scale!
This project is the result of more than 28 years of the association’s presence in this area of Bosnia. It aims to restore health to a population, to revive technological challenges in a territory while moving from a health logic to an economic logic. Indeed, this project can develop wealth, knowledge about the professions of tomorrow in health as well as in the hotel industry, in construction, fluid management, information around new environmental, anti-seismic and energy-saving technologies …

2-4 main areas for this project:

A – Environmental Health
B – Oncology Network
C – Project management and monitoring
D – Supervision, Control, Evaluation

3 – Positioning and organization.

Place and role of Potentiel 3.0 in this project.

This project is particularly complex. It is highly human and strategic for France and Europe in health, environmental, economic, social, political and ethical terms.
The Potentiel 3.0 association and its Bosnian counterpart Potencijal Una Sana have a clear position. Our knowledge of the field and of the people has been built up over nearly 30 years. Confidence is in place and our legitimacy is acquired as actors capable of moving the lines and eliciting aid from the international community.
The very structure of the Potentiel 3.0 association does not correspond to the model of traditional NGOs whose organizational charts show a lasting intention to carry out humanitarian actions, by specializing more or less around specific themes (children, food, literacy, human rights). human, health, migrants, environment etc.). These large associations have project managers, administrators, project managers, various delegations that have been relocated. They are in financial logic which obliges them to run after grants, contracts and thematic projects in order to ensure their functioning. They monitor financial flows and often stop their actions as soon as the funds allocated by donors are exhausted. They consume a lot of resources for their structural costs which is not the case with Potentiel 3.0 (more than 25 years of humanitarian actions and cooperation without subsidy, without permanent and yet things have been done as close as possible to the populations). 100% of the resources mobilized went to carrying out projects at no cost other than accommodation and travel costs.

Potentiel 3.0 raises a catastrophic human reality in a region of Bosnia (The Canton Una Sana or Poche de Bihac). She identifies the problem. She justifies her steps after having obtained proof of the health and environmental tragedy (industrial pollution, harmful weapons, voluntary poisoning of water and food, etc.) of which the inhabitants of this Canton have been and still are victims. Potentiel 3.0 is on this issue and will stop its commitment at the end of this project.
To date, the presentation of the project to the French Embassy in Sarajevo, to the SOUTH Region of France, to the Paoli Calmette Institute in Marseille, to expert figures such as the Minister of Health of the Canton Una Sana (BIH); to Sirs François Crémieux, Deputy Director General of AP-HP; J F Penciolelli specialist in computer networks such as Smart-city, hospital, city medicine, funders and patients; to Nermin Halkic head of the surgery department at the Lausanne University Hospital (Switzerland); to the director of the hospital of Bihac (BIH), to doctor Mirsada Avdagic Terzic, endocrinologist, research doctor and to twenty doctors from Canton Una Sana, was recognized as relevant, necessary, urgent and highly useful. The support of these actors was expressed by underlining a strong interest in this proposal. Relays in Holland, Australia and Quebec are also following this project. Expert groups in health, environment, organization and implementation are emerging as a result of the work accomplished by the association Potentiel 3.0
The cabinet of the President of the Republic, E. Macron, forwarded our request to his Minister for Europe and Foreign Affairs. The latter, through his director of the Continental Europe Directorate, encourages us and supports our efforts. The Ministry of Health has been informed of the intentions of our association and is working in coordination with the Ministry of Foreign Affairs. The French Embassy is working on this project from Sarajevo in consultation with its supervisory ministry. She is in contact with AFD (French development agency) and foreign funders. AFD is entering into agreements with Bosnia to develop collaborations. Numerous expert contacts are planned and should enrich our approaches while strengthening the quality of the project.

3-1 Logic of realization and organization of a global project

The association, promoter of the project, retains the leadership position to bring it to fruition.
We offer a modern approach with a flexible and adapted organization where the sharing of skills remains the guarantee of the success of the project.
To do this, we suggest creating a collaborative project which Potentiel 3.0 will lead. Its action would be confined to the intermediation, supervision, control and evaluation of the stages of the project and to report to donors on the progress of the program and its financial management.
Given the complexity of this file, we propose to divide it into 4 essential bricks. They will be at the origin of different poles of competence depending on the character of these bricks.
In its intermediation function, the association is responsible for creating these poles of skills, for building each round table corresponding to these poles with the relevant people and companies, for monitoring them, for coordinating and supervising them. , monitoring and evaluation.
It will be up to the association and its Bosnian counterpart to propose the various contracts guaranteeing the smooth running of the project (contract
with funders, contracts with stakeholders, functional rules for the centers of expertise, accounting rules to secure compliance and funding. programs etc.).
Expert firms will be able to come in support-to-support Potentiel 3.0 in these steps.
French companies have know-how recognized worldwide. This project is an additional opening for them. This is an opportunity to promote this French excellence. The collaborative nature of this program guarantees the integration of Bosnian devices into these initiatives.
This participatory and integrative approach drives the dynamics of a significant renewal of environmental health in this Una Sana canton.
This is an important prerequisite for establishing the oncological network project expected by the population and the health, economic and political leaders of this region.

3-2 The 4 bricks of the proposed project are:

Prerequisite: An international and Bosnian, transdisciplinary expert group will define the framework of this overall project and the preliminary draft. It will cover the fields of environmental health and the oncology network. He will follow all the stages of the project. In particular, he will be responsible for points 3 and 4.

3-2-1 – Environmental Health:
a) – Inventory, recommendations and action plan
b) – Implementation of environmental improvement measures around an action plan and an assessment with local stakeholders.

3.2.2 – Oncology Network:
a) Clinical dimension:
– Training of all stakeholders (means and content)
– Teleconsultation and telemedicine. Clinical supervision on site or by reception in the form of seminars or internships in establishments and services in France.

b) Investment: It corresponds to studies, financing and realization on:
– The built
– Technical platforms and associated equipment.

c) E-management:
– Internally at the hospital (administrative, medical equipment etc.)
– With city medicine, laboratories, healthcare funders.
– Around the patient, his path and his protected and shared file.
– Consistency of all IT systems and interconnection.

3.2.3- Project management and monitoring
a) – organization and animation
b) – Intermediation
c) – management of skill centers

3.2.4- Supervision of the project, its planning, areas of expertise, controls, evaluation.
This proposal is representative of the intentions of Potentiel 3.0 and Potencijal Una Sana. This will require finer development when starting the process, brick by brick. The goal is to remain flexible and adaptive in a rigorous and demanding environment.
The challenge is to give France and its regions the ability to implement its wishes to reinvest in the Western Balkans and to export French know-how to a neglected area which is destined to return to European Europe. here 10 to 15 years.
The 4 bricks are not hierarchical and the proposed numbering is not chronological. The approach is essentially systemic and constrained by the delayed arrival of funding.
The funding of Potentiel 3.0 would depend on the funding obtained. The role of intermediation could rise to 4%. 1% of the committed budgets would go for headquarters costs. (Proposal to be negotiated but this is a basis that will allow the establishment of a project manager and ensure the financial management of operations)
The impact of this project is enormous on the human, health, environmental, economic and social levels for Europe, France as well as for Bosnia and Herzegovina and its canton Una Sana

“People do not die of disease but of lack of care,
in a degraded environment! « 

Association régie par la loi du premier Juillet 1901. Numéro : W133031617
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