REQUEST INL APPROVAL FOR CONTRACT TO CONSTRUCT ATS

UNCLAS VIENTIANE 000806

SIPDIS

SIPDIS

DEPT FOR INL/RM-BARRY
DEPT ALSO FOR INL/C-BROWNE
DEPT ALSO FOR INL/AAE-BOULDIN
FRANKFURT FOR RPSO

E.O. 12958: N/A
TAGS: SNAR ASUP LA
SUBJECT: REQUEST INL APPROVAL FOR CONTRACT TO CONSTRUCT ATS
DRUG TREATMENT CLINIC IN VIENTIANE PROVINCE

REF: NAS VIENTIANE FY-2007 DRUG DEMAND REDUCTION

PROJECT ADVANCED ACQUISITION PLAN


1. (U) Summary and Action Requested (see also para 9): This
message requests INL/RM approval for NAS Vientiane to
authorize RPSO Frankfurt to contract for design and
construction of a drug abuse treatment clinic in Vientiane
Province, Laos, specializing in treatment of addiction to
amphetamine-type stimulants (ATS). NAS proposes to employ
components of a standard GOL design that has been used in
three other provinces. Unlike those earlier projects,
however, NAS is recommending that this facility be
constructed only to the more limited patient capacity
(probably initially 20-30 patients) that Vientiane province
can demonstrably support, in terms of both operating funds
and trained personnel. NAS Vientiane also requests INL/C
concurrence to use any remaining FY 2006 demand reduction
funds to address continuing deficiencies in the habitability
of the Vientiane Municipal treatment facility at Somsagna.
End Summary.


2. (U) Background: Sale and abuse of ATS has been
identified in the INCSR, by UNODC, and by the GOL as a
significant and increasing concern that has now reached
virtually all socio-economic levels and geographic regions in
Laos. The response of the Government of Laos continues to be
impaired by a shortage of treatment facilities, lack of
trained treatment personnel, and insufficient operating
resources.


3. (U) Several international donors have already responded
to this problem: UNODC, Japan, Singapore, the USG, and
others have assisted the Somsagna drug abuse treatment center
in Vientiane Municipality, which is the de facto national
treatment and training facility. The Government of Thailand
built a 100-bed center in Champassak Province in 2005. The
USG funded construction of a center using similar plans in
Savannakhet Province that opened in 2006. China has built a
facility following the Champassak/Savannakhet plan in Udomxai
Province, which opened in 2007. In addition to these three
built to relatively standard designs, Brunei constructed two
small clinics in Xaignabouri Province during 2006 that are
not yet functional. Bokeo Province operates a small clinic
of its own in the village of Nam Chuam, and UNODC donated its
former headquarters in Boun Neua, Phongsaly Province, for use
as a clinic. With the exception of Udomxai, the Embassy
plans to provide limited assistance to all of these
facilities in FY 2008, especially with regard to building
staff competence and expanding vocational training.


4. (U) Unfortunately, even with these existing facilities,
the Government of Laos (GOL) lacks the capacity to treat even
a fraction of its addict population. Total annual patient
throughput, were all facilities operating at capacity, would
not exceed 2000 patients per year. The GOL estimates the
number of ATS addicts nationally at 40,000 (and growing); NAS
Vientiane estimates that there may be as many as 200,000 ATS
users of all types in Laos. Unfortunately, all of the
treatment facilities, save Somsagna, are operating well below
their physical capacities, for want of both trained staff and
adequate funding. Consequently, Somsagna, the only major
facility with competent personnel, is operating well over
capacity, routinely handling patient loads of 600-700 in a
center that could reasonably accommodate perhaps 400.
Somsagna, for the reasons detailed above, is the current
default for addicts from Vientiane Province. NAS Vientiane
believes that construction of a center in Vientiane Province
(which is a separate administrative entity from Vientiane
Municipality) could help to mitigate some of the overcrowding
at Somsagna, as the proposed site for the new center is 70
kilometers north of the city, in an area currently without a
treatment center.


5. (U) Vientiane Province Center. To avoid some of the
problems that have plagued other facilities, Vientiane
Province officials have agreed to establish an operating
budget for the center in advance, and to construct only the
treatment capacity that the province can support. This
decision in principle followed Embassy-funded travel by
provincial officials to existing treatment centers where they
were able to see for themselves the problems intrinsic to
building large but operationally expensive facilities. The
Lao National Commission for Drug Control and Supervision
(LCDC) informed the NAS that Vientiane Province has
established an annual operating budget of US$20,000. NAS
Vientiane estimates that US$20,000 per annum could

potentially support the operations in Laos of an ATS
treatment center with up to 55 beds. The GOL claims that
patient expenses, primarily food and medication, run
approximately US$0.75-0.80 per day in existing centers, and
has told the NAS that staff salaries are paid by provincial
governments separately from the operating budget. Using one

dollar per patient-day as a conservative figure in Laos,
US$20,000 could in theory support an annual throughput of 110
patients (meaning, since the GOL uses a 180-day treatment
cycle, capacity of 55 patients at a time).


6. (U) However, NAS intends to urge that the new facility be
initially constructed on an even smaller scale, considering
that a well-equipped center with a more modest patient
capacity is the best option for Vientiane Province until Laos
can correct its current deficiencies in staff training.
Drawing on plans developed for the existing centers in
Champassak, Savannakhet and Udomxai, the Vientiane Province
center could be designed to accommodate further expansion in
the future, when the province is better able to provide
additional staffing and financial support. For that reason,
NAS would urge construction of a Vientiane Province facility
with an initial target capacity of 20-30 in-patients. We
consider this preferable to building another larger facility
that would be underutilized because of limits on professional
staff and patient support funding.


7. Somsagna Facility. (U) The amount of FY 2006 demand
reduction funds provided by INL/C that would be used for the
smaller Vientiane Province center would thus be somewhat less
than the total now available. NAS Vientiane would therefore
also propose to use any remaining FY 2006 provided by INL/C,
above what is necessary to construct the Vientiane Province
center, to renovate portions of the existing men's
rehabilitation facility at Somsagna, along lines similar to
the renovation of the women's facility now being completed.
As noted above, Somsagna, as the only fully functional
treatment facility in Laos with an effective staff, is
heavily overcrowded and suffers severe habitability problems.
Though intended only to care for addicts from the capital,
it has assumed the role of a national treatment center
because families will not entrust their troubled youth to the
semi-trained staffs in the provincial centers. (Note: The
Director of Somsagna recently told the NAS that 60 percent or
more of the patients are committed by their families. End
note.) NAS Vientiane believes that the savings from a
reduced scope Vientiane provincial center could best be
utilized in Somsagna, where 500-600 young men are crammed
into dormitories that can reasonably house half that number.


8. (U) Timing: The rainy season should be ending in
Vientiane Province shortly, and construction of the Vientiane
Province center, and renovation work at Somsagna, could begin
at any time after that. NAS understands demands upon RPSO,
but hopes that if NAS can secure quotations for a small
initial design contract, RPSO would be able to place this
order promptly to enable advertising and evaluation of actual
construction bids and a start of construction with as much of
the dry season as possible left to complete it.


9. (U) Action Requested: NAS Vientiane requests INL/RM
approval for the NAS to authorize RPSO Frankfurt to contract
for the design and construction of a drug treatment center in
Vientiane Province. The NAS also requests INL/C/CJ
concurrence to utilize any remaining FY 2006 demand reduction
funds not subobligated for the Vientiane provincial project
on habitability enhancements at the Somsagna drug treatment
center in the Municipality of Vientiane.


10. (U) Post again thanks INL/C/CJ for its strong support of
drug demand reduction programs in Laos.
HUSO