Corps Of Engineers Assisting in Building Health Clinics in Iraq
By BJ Weiner
Special to American Forces Press Service
TALLIL, Iraq, Jul. 7, 2005 With its mortality rate for children under 5 a staggering 14.2 percent and 12.8 percent for children under 12 months old, Iraq needs much more than a temporary solution to its crippling dilemma. Now, 150 new primary health care facilities of three different types are being built, with 60 of them planned for southern Iraq.
A construction worker brings mixed gypsum to pour into the foundation base on a construction site in Nasiriyah, Iraq. The project, which will become a primary health care center, is one of 60 such clinics being built in southern Iraq. The U.S. Army corps of Engineers Gulf Region South is providing quality assurance on the project. Photo by BJ Weiner
(Click photo for screen-resolution image);high-resolution image available.
According to the United Nations Children's Fund, the Iraqi child-mortality figures have risen sharply to their present levels since 1991.
The new medical facilities are being built with the help of the U.S. Army Corps of Engineers Gulf Region South District and the Project and Contracting Office, according to Juan Vargas, PCO health program manager.
"This project was coordinated at the Ministry of Health in Baghdad," Vargas said. "Project sites were based on demographics and needs. The ministry decided which type of clinic they wanted at each location."
The $80 million program for the 60 southern clinics does not include administrative costs, according to Dr. Shah Alam, GRS program manager. The figure does include program and medical equipment costs.
"The nice thing about it is there is a real need for the clinic program, and it feels good to know that something good is coming to the people," he said. Each clinic would cost about $800,000 to build, and another $500,000 in medical equipment costs, bringing the total package for each clinic to $1.4 to $1.5 million.
Vargas explained that three types of clinics were designed, and that all 150 would fit into one of the three categories. Type A, he said, offers basic care. Type B has teaching facilities, with classrooms for doctors. Type C clinics are geared more toward maternity and emergency needs.
"The designs were planned and approved by the ministry and the PCO," he said. "They were finalized by the end of 2004. Site assessments began in November of that year based on a list provided by the MOH. Construction on the first clinic began in December, and incrementally we have started all of them."
"I want to stress that we have been working with the communities," Alam said. "They have been supporting us because they want to see health care clinics being built. That is why, when we face problems, we have always found that the neighbors of the site in the area are very helpful. In one case, one of the religious leaders solved the problem. And in another case, we found archeological remains." He added that in some cases the directors general solved the issue in a matter of days because they recognized how badly the clinics are needed.
Each contract was developed and based on U.S. practices and planning, according to Vargas, but those standards are adjusted because of each site. "We are also overcoming construction materials testing delays," he said. "So we are on the right track now that we have them started. Construction has been temporarily halted on the archeological site until the Ministry of Antiquities has finished its work."
Another problem that has surfaced concerns the Iraqis and the lack of control they think they have over construction, Alam said. However, Iraqis are always welcome at the site, and if they find inconsistencies, they can bring them to the attention of the GRS resident engineer.
"The resident engineer has contractual authority and can get the contractor to correct the problem," Alam said. He added that in addition to the clinics, state-of-the-art medical equipment and training classes on using the equipment are being provided.
"Every governorate we go to and everyone we have spoken with has always been receptive and wonderful to work with," Alam said. "And any help we have needed they have gone out of their way, in some cases giving us permission to go forward with construction with the understanding that the issue could and would be solved. We have made many good friends and associates."
(BJ Weiner is assigned to the U.S. Army Corps of Engineers Gulf Region Southern District.)