Basrah Children's Hospital

 

The rendering

 

Basrah Children’s Hospital Summary

The new Basrah Children’s Hospital represents a state-of-the-art Pediatric Acute Care Hospital providing both general and specialty surgical services, as well as comprehensive Oncology care, for the Basrah / Southern Iraq region. This 94-bed facility provides both inpatient and outpatient care in a 16,200 SM facility designed for future expansion. The new facility, to be staffed and operated by the Iraqi Ministry of Health, has been planned as a teaching hospital and includes residences for Physicians and Nurses. Highlights include:

  • 94 Beds total (86 general Medical / Surgical beds and 8 Intensive Care beds)
  • 20 Outpatient ExamRooms for Primary Care, Surgery, Specialty (ENT & Dental), and Consulting Doctor Clinics
  • 2 Operating Rooms and 1 Special Procedure Room with 10 pre- and post- operation holding beds
  • 8 Bed Pediatric Intensive Care Unit (PICU) and 7 Bassinette Neonatal Intensive Care Unit (NICU)
  • 4 General Nursing wards with full range of private, semi-private, and open-ward bed configurations
  • Comprehensive Oncology Treatment Center including Cancer Diagnostic and Treatment Planning, Chemotherapy, and Radiotherapy services
  • Complete Imaging Department featuring Radiography, Flouroscopy, CT, MRI, and Ultrasound modalities
  • Fully contained Emergency Department with 1 full Trauma Room, 4 Exam Rooms, and 6 Low Acuity “23-Hour” Beds
  • Fully contained Outpatient Endoscopy Suite
  • 71,000 SM Site with 209 new Parking Spaces
  • On-site Residences for 32 Nurses and Physicians

 

All of the clinical and patient treatment departments have been designed to front onto a central “ Medical Main Street” which is activated with family waiting, play areas, open dining, patient education features and public amenities. The exterior will feature regional stone veneer construction and references to traditional Islamic and Iraqi architectural forms. The site will be landscaped to evoke a traditional Basrah palm grove motif and will represent an “Oasis” in the Basrah region.

 

 

NORTH ELEVATION

 

SITE PLAN

 

The new hospital footprint has been designed to expand in multiple directions allowing for future additions of diagnostic and treatment spaces and patient beds without disruption to ongoing operations. The hospital is fully secure within a decorative perimeter wall with three manned guard houses controlling access to the facility. Additional features include:

 

 

 

FRONT ENTRANCE

 

The 13 acre site under a foot of water Nov 03 during site search by USAID. Site was provided by the Iraq Ministry of Health. Site work began a year later in the fall of 04.

 

 

 

 

Lifting the site by two meters of fill, Jan 05. Site work already started while design development underway in Amman

 

 

 

 

Engineer Asma directs location for test piles after soils analysis tests showed that a pile foundation would be required

 

 

 

 

NW corner 4 April - setting up contractor's camp and building the perimeter security wall

 

 

 

 

23 May 05 - 1200 piles and five driving rigs

 

 

 

 

Main Gate - The 9 ft cement block perimeter wall was our security perimeter against being seen and shot at from outside

 

 

 

 

Pete and the design team work out concept design, design development and final designs in Amman

 

 

 

 

Design-Build contractor interviews and selection in Amman

 

 

 

 

Multiple meetings with Project Hope, USAID and Iraq Minister of Health and staff in Amman to work out Project Hope medical equipment scope and management responsibilities

 

 

 

 

Slaughtered sheep in celebration of first concrete pour on the project

 

 

 

 

PM on site! Windy and over 120 degrees.

 

 

 

 

Last section of ground floor concrete pour

 

 

 

 

Doctors and nurses residence building and power plant building keeping pace with the main hospital

 

 

 

 

Dec 2005 - begining 2nd floor formwork

 

 

 

 

Mrs. Laura Bush and Secretary of State Condoleezza Rice Speak at Project HOPE Benefit for Creation of Basrah ( Iraq) Children's Hospital

20 October 2005

 

Mrs. Laura Bush and U.S. Secretary of State Condoleezza Rice addressed a benefit dinner last night for the creation of the Basrah Children's Hospital of Iraq at the Mellon Auditorium in Washington D.C. The dinner was hosted by Project HOPE, which is participating in an alliance with the U.S. and Iraqi Governments to complete construction of the hospital by late 2006.

" Iraq's medical professionals have endured hardship and tragedy in their careers," said Mrs. Bush. "They've lived through personal trauma, at times risking their lives to continue to provide care for patients. The hope of these doctors and nurses is only matched by the hope of mothers and fathers who will soon have a near place to their home where children can receive care and get well."

"After decades of neglect under Saddam Hussein's brutal dictatorship the challenges that confront Iraq's health care system are great and so are the medical needs of its children," said Secretary of State Condoleezza Rice. "The Basrah Children's Hospital will make a real difference, a life saving and lasting difference, to the thousands of children and their families."

"We are building a house of healing, the Children's Hospital of Basrah," said John P. Howe, III, M.D., President and CEO of Project HOPE. "In a troubled world, in a country recovering from decades of dictatorship, we can't forget the vulnerable children whose fate it was to be born in Iraq. We will help provide the hope that medical care and health can bring to the children."

Dr. Howe, on behalf of Project HOPE, visited Iraq two years ago at the request of Mrs. Bush. A report to Mrs. Bush and Dr. Rice found that the Iraqi health care system had seriously deteriorated over the past two decades under the regime of Saddam Hussein. Iraq's ability to provide adequate medical care for seriously ill and injured children is virtually nonexistent. Consequently, child mortality is very high, especially in Southern Iraq, where 150 out of 1,000 children are dying before reaching the age of five - most before their first birthday. Doctors - although highly skilled and motivated - lack access to continuing medical education and the tools necessary to effectively do their jobs, and there the country lacks a state-of-the-art pediatric hospital to treat its most seriously ill children.

The Basrah Children's Hospital will use modern hospital management and treatment techniques and will have a special focus on children with cancer. In addition, the hospital will become a training facility to improve the skills of health professionals throughout the country - and a model for all new medical facilities to be built in the new Iraq. Project HOPE has already started training programs for medical staff and is securing commitments from corporations for equipment.

The project is a public private partnership between the Iraq Ministry of Health, the White House, Project HOPE, and the United States Agency for International Development (USAID). Funding for the project has been appropriated by the U.S. Congress, and more than 500 construction workers are currently at the site.

"The Basrah Children's Hospital is on schedule to open a year from now. It will meet that deadline," said Howe. "When the first suffering child is brought through the doors into the welcoming and strong arms of a new generation of trained doctors, nurses, and medical staff, we will all feel a sense of pride and accomplishment. But the true beneficiaries will be the children as they are given the gift of a future."

Dinner co-chairs are Ed Ludwig, CEO of BD, and Curt Selquist, Company Group Chairman of Johnson & Johnson Healthcare Systems.

Founded in 1958, Project HOPE (Health Opportunities for People Everywhere) is dedicated to providing lasting solutions to health problems, with the mission of helping people to help themselves. Identifiable to many by the SS HOPE, the world's first peacetime hospital ship, Project HOPE now conducts land-based medical training and health education programs in 33 countries across five continents.

 

 

 

 

 

 

OAS_AD('Top');

ENR Content Purchase Questions

View Cart

My ENR Content

My ENR Account

finance & business

RECONSTRUCTION

Bechtel Speaks About Work in a War Zone 10/30/2006

By Tom Sawyer and Andrew G. Wright

USAID's lead contractor soldiered on even as the security situation spiraled out of control

On the last day of October, Bechtel Corp.’s three-year, $3.2-billion contracts to reconstruct critical infrastructure in Iraq expires. The company’s few remaining personnel in Iraq are closing out operations and turning over operation and maintenance duties to Iraqis. A handful of executives who played key roles in Bechtel’s Iraq Reconstruction Project sat down with ENR editors in New York to break the their self-imposed silence on projects, discuss Bechtel’s performance and share critical lessons learned.

Until now, Bechtel executives have largely remained silent on their work and the conditions in Iraq. The debriefing in New York City on Oct. 18 included Cliff G. Mumm, president of Bechtel Infrastructure Corp.; Michael Dodson, chief program manager; Donna Bonghi, manager of human resources on the project; and Drew Slaton, an onsite communications manager for the past year. Bonghi flew in from Kuwait for the debriefing. All had worked a year, and some considerably longer, for Bechtel in Iraq.

Mumm explained the firm’s prior silence: “Because of security and the general instability in the country…we really took a very tight-lipped approach.” He said it was driven to keep projects, and people secure. “We just really didn’t talk to the press, other than to occasionally defend ourselves,” said Mumm.

"What the Iraqi work force…has to endure to come to work every day is something that you can't begin to imagine."

 

— Donna Bonghi, Human Resources Manager

The story they told was one of pride of accomplishment, commitment, frustration, depression, patriotism and loss.

“We don’t like to talk about this a lot because we don’t want it to become a statistic, and we know those that we lost and we’re pretty emotional about it,” said Mumm. “In total there were 101 casualties associated with our work, and of those, 52 died,” he said. Casualties included security people,

subcontractors and Iraqi employees. “We had a large number kidnapped,” Mumm said.

The burden of security grew dramatically heavier after the company won its first bid in the spring of 2003. Mumm said one of his abiding frustrations is that it has been almost impossible to erase the perception that the company’s contracts were awarded without competition.

“We were chosen both times as the best qualified and best technically qualified and the lowest cost. That was a normal basis…but maybe it makes it a little less interesting that people actually competed for this, than if something kind of  strange happened,” said Mumm.

Bechtel’s first task was to scope the needs for infrastructure repair around the country, which had fallen into a lull between invasion and insurgency. The first contract authorized $680 million. “With that money, we were asked to cover the waterfront on infrastructure, but with a particular emphasis in the early days on reconstructing war damage and providing humanitarian relief,” said Mumm. “Ultimately, with Phase II awards and additions, mission creep took the assignment much further as popular demand for utility services increased and political pressures grew on the coalition and the Iraqi government to satisfy the people. ”

Photo: Bechtel Corp.

The contractor struggled to impose its standards on a work force isolated for decades.

Bechtel is leaving with 97 of 99 projects completed. Bechtel turned over the two unfinished jobs—a Sadr City water treatment plant and a children’s hospital in Basra—to the client, the U.S. Agency for International Development, and the U.S. Army Corps of Engineers’ Gulf Regional Division to restart and complete when conditions improve.

Dodson said that projects that do not finish with the rest of the program can become a burden for both contractor and customer whenever security issues made finishing them a near impossibility.

“We have the Sadr City plant at 88%, but the conditions got so bad that managers fled and then sub-managers fled, so there was really no way to do the kind of work you have to do to ensure that you have a good product,” Dodson said. Bechtel recommended that the client bring the projects to an orderly holding point and let them “sit until you have the conditions right, and then start again.”

"They took people and systematically executed them…That was, 24 dead people just trying to get the civil work done."

 

— Cliff Mumm, Infrastructure President

The Basra children’s hospital is the most extreme situation. “In the beginning, our site security guy was assassinated, and our site manager was chased off with a death threat,” Mumm said. “Then the site engineer’s daughter was kidnapped and he was told to get out of there or she was dead. He left. Then they took 12 people from our electric/ mechanical contractor and systematically executed them. And then one day—and this is ‘Mafia,’ you just don’t really know why this stuff happens—11 people were marched out from our concrete supplier and stood out in front of a building and executed. That was 24 dead people, just trying to get the civil work done.”

Mumm added, “The question has to be answered, how much blood and how much money is that 96-bed hospital worth? There’s already 24 dead people right around that thing. So we get intolerably sensitive about the risk we took with our people to get that thing stabilized and in a position where it’s not lootable.” 

Bechtel is finding jobs for many of its Iraqi workers on other projects outside the country. They’ve earned it, Bonghi said.  “What they have to endure to come to work every day is something you can’t begin to imagine, because of the risk for their safety and security and for their families as well,” she added.

+ click to enlarge

Insurgents frequently destroy power lines.

In the early days of the project, Iraq was a safe and welcoming place. “We went everywhere,” Mumm said. “We looked at every railroad station, power station, water treatment plant, sewage treatment plant.” The company estimated that it would cost a little over $15 billion to bring the infrastructure to a functional level, by regional standards.  Mumm now thinks the mission will take 20 years. “Against that we had $680 million. We had to very carefully pick and choose what we would do,” he added.

The company’s first priorities, including reopening the port of Um Qsar, were guided by instructions to create a platform for immediate humanitarian relief and also for the Iraqis to use later.

Mumm said Bechtel made several  decisions about entering into the project. One of them was that USAID would be its sole client, which he said avoided a lot of confusion. Bechtel also thought USAID’s infrastructure restoration mission was a good fit. “ We wanted the program to make sense and have something to say about what that program was,” he said.

Bechtel also decided not to mix funding streams. “We would only work with USAID funds authorized by Congress, and that’s exactly what we’ve done,” Mumm said.

"There are tests: Is the power coming out of the plant? Is it reliable power? Is the water clean? Is the water treatment plant operational?"

 

— Mike Dodson, Program Manager

A constant question is whether the Iraqi people they are better off now than under Saddam Hussein’s regime. “There are a couple of tests,” Dodson said. “Is the power coming out of the plant? Is it reliable power? Is there water coming out? Is the water clean? Is your waste treatment plant operational, or is it in bypass, and how many people do you serve?

Dodson said Bechtel’s metrics show “about 7 million [people] in water, about 7 or 8 million in wastewater, and you say, ‘that’s a lot of people,’ but there are 23 million people in Iraq. But this is around Baghdad where conditions were pretty bad. A lot of people never had any clean water. So the metric really, in the water case, is how many cubic meters are coming out, and it is clean.”

Mumm said the contractor’s role changed as U.S. policy changed. “It started out [that] the reconstruction was to fix up any war damage and to provide humanitarian relief,” he explained. “Then reconstruction became, ‘Build a platform upon which the Iraqis can go forward in a stable environment.’ And then suddenly it just sort of moved seamlessly to, ‘Provide electricity to all the houses, make kitchens work, things like that.’ And… people went around and said, ‘Well I can’t get power to my house. I can’t do this, I can’t do that.’” Bechtel got the powerplants running and reconfigured the grid, but the municipality hooks up  houses, said Mumm. “That’s more a failing of the ministries themselves,” he said.

Mumm thinks water is the best example. “You have a limited amount of money,” he said. “We spent about $500 million in the end between the contracts on water, but in the early days, we had a limited amount. When we got to Iraq there was a mass panic about cholera in the south. The Sweetwater Canal was full of sewage, all the raw sewage in Baghdad. No Iraqis knew that their sewage treatment wasn’t working and that it was all bypassed right to the river. That had been done for years. We think it was done intentionally by Saddam as kind of a campaign against the Shiia.”

Mumm explained that the sewage went down the Sweetwater Canal, which runs about 270 kilometers south of Baghdad. He said effluent formed “a sort of sewage delta,” where water was pumped out by two remaining pumps to provide the water supply for Basra. “As we said, if you take the sewage out in the north, then you’ll automatically clean the sewage in the south,” said Mumm.

The mostly Shiia population in the south derived benefits after years of persecution by Saddam’s regime. In addition to the reconfigured power grid, “the rural water program is just a fantastic success support,” said Slaton. “[For] villages of approximately 5,000 people or less…the total capacity of the whole program was about 30,000 cu m per day. The target population to be serviced is almost 500,000 people, and these are people who never ever had clean drinking water.”

The main take-away for Bechtel is that “there’s a security element now that’s become part of our core business in many parts of the world,” said Mumm. “It was always there but it’s a larger issue and I guess what I would tell you is that we don’t outsource that. We manage that ourselves and we manage the program ourselves.” Mumm said the violence “hasn’t stopped interest in us doing work in other parts of the world, but we do consider very carefully the level of security or insecurity. It is troubling.”

He points to Basra as an example. The city was relatively secure in 2003, after Baghdad fell. Initial security costs were estimated at $13 million, but that jumped to $48 million as the situation there deteriorated.

Despite tremendous obstacles and violence, Bechtel managed to turn a profit on the Iraq reconstruction project. “We made a profit,” said Mumm. “We met our expectations.”

 

 

 

 

 

Postscript

In spite of the tremendous hazards and logistics challenges, the work on the hospital continues. With financial grants from many nations, and additional medical equipment and training funds collected by Project Hope, the Jordanian contractor MID Construction was able to continue to build. The Army Corp of Engineers provided oversite remotely from the Basrah Airport enclave. Construction should be completed sometime this year (2010), and medical equipment installed late this year. Training and medical staff development will take another 6 months. But, it is really happening!

 

 

 

 

Return to Basrah

 

Return to Iraq