Newtraid proposal to support Atutur Hospital redevelopment 

The proposal is based on the use of volunteer consultants to identify and support possible solutions to the needs of redevelopment of Atutur Hospital as defined in the report “Review of priority needs for the redevelopment of Atutur hospital, Kumi, Uganda” prepared by Dr. Richard Priestley and Ms. Hannah Ryan in October 2006.

Background

Newtraid.org is a "virtual" organization set up to provide a "Meeting Place for Volunteer Consultants and Clients". At present there are over 100 people on the data base, most of whom are professionally qualified with a variety of backgrounds including engineering, management and health care. More information about Newtraid can be found on this web site.

Although volunteers can provide a substantial degree of support it is recognized that some key personnel need to be recruited locally to provide management of equipment procurement, site development work and continuing maintenance of installed equipment and facilities.

Newtraid has agreements with other organizations who could be asked to supplement our volunteer base in specific areas.

Method of working

To fulfill each requirement it is proposed that the work is carried out by Newtraid volunteers in three stages;

Stage 1 - Initial Study

In order to carry out the necessary studies to provide detailed specifications and proposal drawings and other information it will be necessary to carry out a review of the existing facilities and equipment. This should include all the areas mentioned in the infrastructure items listed below.

This study should clearly identify which items can be economically repaired and which need replacement.

Ideally this initial study should be carried out with consultant and the appointed Project Manager and Building/Maintenance technician. The maximum involvement from the existing Hospital Staff will be sought.

Stage 2 - Conceptual Study 

This will be carried out by a consultant using information from the initial study. The objective is to identify and provide cost estimates of the optimum solution for each of the defined requirements.

Some conceptual studies can be carried out without the need for detailed information from the on site study, for example, an investigation into power supplies from sources other than conventional generation.

Stage 3 - Material specification and lists

This will be provided in sufficient detail for local quotations to be obtained for supply and installation. The method of procurement will be agreed during the initial study. for each group of items.

Project Planning

A provisional Project Plan will be produced before the Initial Study. This will then be updated after the study to identify key target dates for funding and requirements for resources from other organizations. It is proposed to use the Newtraid site for an interactive planning system which will facilitate maximum involvement from all approved personnel.

Scope of services

  This proposal only covers the items listed in sections 5.1 and 5.4 of the "Review of priority needs for the redevelopment of Atutur hospital, Kumi, Uganda" report.

  It is possible that Volunteers can assist in other areas such as clinical services (equipment specification) and procurement and liaison with UK based charities for provision of drinking water and a dental surgery. These are not included in the existing proposal.

Detailed Proposal - Infrastructure

Requirement

The provision of power supplies by means of a 3 phase 50 KVA emergency generator and / or solar energy panels. Power provision must be sustainable and it must be possible to run the generator affordably, accounting for the fact that it should provide power for 70% of the time.

Initial Study

Review existing power and lighting circuits, check installation and identify circuits that need replacement and where additional circuits are required. The need for a computer LAN will be reviewed. (See Appendix 1)

Conceptual study

Consultant should review all available technology and propose optimum solution for on site generation. (see Appendix 2 ) Costing of alternatives to be made available for review.

Material specification and lists

Based on the initial study a consultant will produce a complete list of all materials required including cables, circuit boards, lamps power outlets etc., A circuit block diagram will be prepared for use by local contractor who will produce wiring diagrams.

Installation responsibilities of the power generation system will be dependant on system choice.

Requirement

The renovation of the waste disposal and sewage system

Initial Study

Review existing waste disposal and sewage system. Identify existing sewage pipework routing and as far as possible damage/blockage to underground system. Check and identify drainage pipework that need replacement and where additional WCs and drains are required.

Review all existing WCs and identify those that need replacement or repair.

Review type and location of existing treatment system and consider whether repair is possible.

Review existing methods of clinical waste disposal.

Review requirements for "sharps" disposal.

Conceptual study

Consultant should review all available technology for sewage treatment and propose optimum system. (see Appendix 2 ) Consideration to be given to anaerobic digestion. Specification and costing of alternatives to be made available for review.

Investigate system for clinical waste disposal.

Investigate system for "sharps" disposal.

Material specification and lists

Based on the initial study a consultant will produce a complete list of all materials required including toilets and cisterns, drainage pipes pumps and long term maintenance needs. .

Installation responsibilities of the sewage treatment system, clinical waste disposal and "sharps" disposal will be dependant on system choice.

Requirement

The provision of clean water supplies

Initial Study

Review existing provision of supply, storage and treatment. Investigate possible provision of wells, rainwater catchment and storage. Investigate availability of local data. Water heating provision should be included in the study.

Conceptual Study

Consider alternatives in relation to climate, rainfall and possibility of catchment. Investigate alternative methods of water heating.

Material specification and lists

Based on the initial study and conceptual study a consultant will produce a complete list of all materials required covering pipework, tanks, pumps and long term maintenance needs. (see Appendix 3)

Requirement

The renovation of wash hand basins, WCs, bathrooms and kitchens for the wards and clinics.

Initial Study

Review existing provision for these facilities. Identify replacement needs, additional requirements in all areas. (WCs covered in Waste Disposal section above)

Material specification and lists

Based on the initial study and a consultant will produce a complete list of all materials required covering hand wash basins, bathrooms and kitchen equipment and long term maintenance needs..

Requirement

The establishment of a new post of a building / maintenance technician to help keep equipment and services in running order

Comments

Consultant should prepare outline job description for this person. Ideally he/she should be involved in Initial study stage, reviews of material lists.

Detailed Proposal - Staff Facilities

Requirement

The renovation of staff accommodation to improve recruitment and provide for visiting staff, including power supplies, WCs, and new staff quarters

Initial Study

Review existing provision for these facilities. Identify replacement needs, additional requirements in all areas. (WCs covered in Waste Disposal section above) Discuss the requirements and how best to improve the facilities, including space for visitors, training and library.

Conceptual Study

Depending on results of Initial Study the consultant will produce layout drawings and specification for Staff accommodation.

Material specification and lists

Based on the initial study and conceptual study a consultant will produce a complete list of all materials required covering building modification and extensions, electrical supplies, bathrooms and kitchen equipment.

Requirement

Improve access to staff training and education both on site and access to local and national programmes by means of Continuing Professional Development. Staff should be able to update their skills by having access to books and journals, and by creating links with other facilities.

Comment

It is possible that Newtraid can find a suitable Volunteer to develop and coordinate training. Upgrading of Staff facilities shall incorporate a library and training room.

 

Requirement 

The availability of computing facilities with internet access.

Initial Study

This will be considered together with the overall provision of internet facilities on site. See also Appendix 1

 

Appendix 1

Internet connections and computers

This proposal is based on the use of the internet and Email for communications in the short and long term.

This applies to liaison during the conceptual study stage and transmission of documents relating to material list and specification.

It is also proposed that project planning is carried out interactively using the Newtraid web site. This will be accessed and updated by approved personnel.

Investigation of existing and potential facilities will need to be reviewed in depth at the Initial Study phase. Physical security of any on site equipment and the security of power supplies will need to be considered at an early stage.

The supply of the internet system and computers must include provision for:

• Communication during development phase.
• Patient record keeping using approved software.
• Distance learning and training.
• Links with hospitals to facilitate knowledge exchange.

Appendix 2

Power supplies

The consultant's brief will be to provide information and life cycle costing of alternative systems. He/she will need to specify a system which is sustainable physically and economically for at least 20 years.

Power must be available for at least 70% of the time and have a very high level of reliability during that time. Back up power supplies must be considered.

Appendix 3 

Equipment maintenance.

The specification of all major equipment items shall include the requirement to supply :

1. Spares for two years normal operation.

2. All necessary Operation and Maintenance manuals in English.

3. On site training for the Maintenance technician.

This requirement shall apply to new and used equipment.