PRT/QALENOW: THE SPANISH BRING MODERN MEDICINE TO

UNCLAS SECTION 01 OF 03 KABUL 000955 SIPDIS SIPDIS DEPARTMENT FOR SCA/FO, SCA/A, S/CR, SCA/PAB, S/CT, EUR/RPM STATE PASS TO USAID FOR AID/ANE NSC FOR AHARRIMAN OSD FOR KIMMITT CENTCOM FOR CG CFC-A, CG CJTF-76, AND POLAD E.O. 12958: N/A TAGS: PGOV PREL EAID AF SUBJECT: PRT/QALENOW: THE SPANISH BRING MODERN MEDICINE TO BADGHIS ¶1. (U) SUMMARY: One of the primary objectives of the Spanish Development Agency (AECI) is to expand and improve healthcare throughout Badghis. AECI places a special focus on medical care for women and newborns. It aims to transform the central hospital in Qal-e Now into a fully functioning provincial medical center and to increase access to medical services for all Badghis residents by establishing EMT service province-wide. In addition to these major infrastructural improvements, AECI is concentrating on less flashy, but equally important, issues such as increasing human capacity and hospital space allocations. PRT Qal-e Now is establishing an Afghan led provincial medical system that could serve as a best practice for other provinces. END SUMMARY. ¶2. (U) In May 2006, AECI began a three-pronged approach to reform Qal-e Now's antiquated and disorganized hospital by focusing on infrastructural improvement, increasing human capacity, and reorganizing the hospital's staffing and space allocations. The goal of the project is not simply to present provincial authorities with a new hospital building, but to involve them in the far greater task of developing a sustainable medical system that will be Afghan-led and, increasingly, Afghan-funded. -------------- Medical Facilities Being Rebuilt -------------- ¶3. (U) The most noticeable parts of AECI's hospital reform efforts are the many infrastructural improvement projects being conducted on the hospital grounds. The old main hospital building, the women's hospital, a number of service buildings and the building used for laboratory and administrative functions were all recently renovated. Construction of a new hospital wing is almost fifty percent complete. Construction of a new building to house administrative offices and the province's first nursing school will begin shortly. When completed, the hospital complex will consist of a stand alone out-patient center, a maternity and pediatric building, a main hospital ward with surgery and emergency areas, a nursing school and administration building, a laboratory building housing the hospital's blood bank, and a series of outbuildings including a mosque, laundry, restrooms and kitchen. The hospital compound's capacity will increase from 62 beds to over 120, and the level of care will be vastly improved. -------------- Office Reorganization Improves Effectiveness -------------- ¶4. (U) The AECI manager of the hospital project, Luis de la Fuente Martin, stresses that while the physical improvements are impressive, operational and capacity building parts of the reform effort will also contribute greatly to improved medical care. During the initial assessment of the hospital, Martin found the organization structure in complete disarray. Administrative offices were intermingled with patient treatment areas, wards and labs were located randomly throughout the building, and newborn babies were co-located with adults suffering from both blunt force trauma wounds and infectious diseases. ¶5. (U) The massive remodeling project enabled AECI to reorganize and reallocate space, which greatly improved the hospital's functionality. One reorganizational highlight includes relocating various labs into one central area. Providing cross-training to the lab technicians ensures that more than one lab technician who can perform a specific function and that 24-hour laboratory assistance is available. Separating pregnant women and newborns from the general hospital population was also achieved, and a separate out-patient facility was established. -------------- Building Staff Capacity Is Key Component -------------- KABUL 00000955 002 OF 003 ¶6. (U) AECI is working to increase the human capacity of the hospital with training and mentoring. In April, a Spanish hospital management specialist will conduct a training needs assessment and begin a month-long training program in medical care. Six other specialists will subsequently conduct month-long training programs in gynecology, anesthesia, and general surgery. Martin mentors the hospital administrator and leads medical staff on a wide-range of issue areas on a daily basis. -------------- Goal: Afghan-Led and Funded Hospital -------------- ¶7. (U) A key component of AECI,s reform plan is the agency's financial commitment to establish and maintain the hospital while ensuring that it transitions toward an Afghan-led and eventually funded institution. Initially, AECI provided almost all the hospital's operational funding, including salaries, patient meals, medicine, generator fuel and large amounts of donated medical equipment. The GOA now pays the basic salaries of most hospital employees. AECI continues to provide incentive pay and covers costs associated with meals, medicine and many operational aspects. The hospital is a long way from self-sufficiency, but steps are being made in the right direction. -------------- Goal: Increase Hospital (vs Home) Births -------------- ¶8. (U) Part of the challenge in reforming the hospital has been improving the public's impression of the services offered by the hospital. AECI has devised a program aimed at encouraging more women to opt for giving birth in the hospital, as opposed to choosing more traditional locations. In 2006, 319 children where born at the hospital compared to 271 in 2005. This year, each baby born in the hospital will receive a newborn kit that includes a blanket, towel, hygiene supplies and Dari language health-related material. Based upon initial reaction to this program, AECI estimates that at least 600 babies will be born in the hospital this year. -------------- 4WD Ambulances Will Reach Remote Areas -------------- ¶9. (U) AECI is embarking on a project to create an EMS system to increase the reach of the province's medical staff. AECI will provide each district with a four-wheel-drive ambulance complete with anti-mine protection, radio, and basic life-support equipment. The Qal-e Now hospital will also receive two ambulances, a mobile vaccination unit, and a coordination center that will enable hospital staff to monitor, advise and direct EMS operations province-wide. AECI plans to conduct a month-long EMT course in May for all ambulance staff to ensure that the ambulances are more than merely a taxi service to the hospital. When fully deployed, the EMS system will be able to reach individuals in need of medical attention in remote areas, transport patients from district hospitals and clinics to Qal-e Now, and transport patients to the Herat hospital if their injuries cannot be treated adequately in Qal-e Now. The infrastructural improvements, including the EMS system and nursing school are scheduled to be completed in 2008. -------------- COMMENT -------------- ¶10. (U) AECI coordinators realize that the financial support, mentoring and training aspects of their hospital project will continue many years into the future. AECI is not only committed to the long-term success of the medical system in Badghis, but to the lengthy process of slowly increasing Afghan control and responsibility for their medical system. AECI,s long-term project to drastically improve the quality of life for the average resident of Badghis mixes a blend of rebuilding (and in many cases KABUL 00000955 003 OF 003 creating) infrastructure, increasing staff capacity, and empowering locals in ways that could serve as a model for other health sector reform efforts in Afghanistan. END COMMENT. NEUMANN