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Hatch Ltd. - Evaluate Earthquake Damage to Two Hospitals SJHS Haiti Field Report ISO 9001 , Rev. 0, Page 1 © Hatch 2010/04 Project Report April 20, 2010 Hatch Ltd. Evaluate Earthquake Damage to Two Hospitals DISTRIBUTION B. Guest J. Yates SJHS Haiti Field Report Table of Contents 1. Disclaimer ............................................................................................................................................... 3 2. Introduction ............................................................................................................................................ 3 3. Field Safety and Collaboration ................................................................................................................ 4 4. Structural Features / observations – La Paix Hospital .............................................................................. 4 4.1 Balcony/Access Way – along “Pediaterie” area............................................................................... 4 4.2 Internal Medicine – first floor ......................................................................................................... 8 4.3 Main Entrance and hallway – ground floor ................................................................................... 10 4.4 Parapet walls along the high roof perimeter ................................................................................. 12 4.5 Emergency (Urgences) area at ground floor .................................................................................. 15 4.6 Stairway – close to the emergency area: “Urgences” .................................................................... 15 4.7 Morgue area................................................................................................................................. 16 4.8 External Clinic (Clinique Externe) – Ground Floor ........................................................................ 18 4.9 East fence wall ............................................................................................................................. 21 4.10 Other areas .................................................................................................................................. 23 5. Structural Features/observations – Children Hospital ........................................................................... 23 5.1 Laboratories ................................................................................................................................. 23 5.2 Pharmacy ..................................................................................................................................... 23 5.3 Waiting area for tests (Blue and white) ......................................................................................... 23 5.4 General Administration Building – by the main entrance ............................................................. 24 5.5 Clinics and Administration Building ............................................................................................. 26 5.5.1 Administration area (Patient accounts)- first floor ................................................................ 26 5.5.2 Clinic (for HIV and TB) Area – ground floor ....................................................................... 29 5.6 In-Patient Ward and Maternity Building ....................................................................................... 29 5.6.1 In-Patient Ward / Intensive Care Unit- first floor.................................................................. 29 5.6.2 Maternity section – ground floor ........................................................................................ 33

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Hatch Ltd. - Evaluate Earthquake Damage to Two Hospitals SJHS Haiti Field Report

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Project Report

April 20, 2010

Hatch Ltd.

Evaluate Earthquake Damage to Two Hospitals

DISTRIBUTION B. Guest

J. Yates

SJHS Haiti Field Report

Table of Contents

1. Disclaimer............................................................................................................................................... 3

2. Introduction ............................................................................................................................................ 3

3. Field Safety and Collaboration ................................................................................................................ 4

4. Structural Features / observations – La Paix Hospital.............................................................................. 4

4.1 Balcony/Access Way – along “Pediaterie” area............................................................................... 4 4.2 Internal Medicine – first floor ......................................................................................................... 8 4.3 Main Entrance and hallway – ground floor................................................................................... 10 4.4 Parapet walls along the high roof perimeter ................................................................................. 12 4.5 Emergency (Urgences) area at ground floor .................................................................................. 15 4.6 Stairway – close to the emergency area: “Urgences” .................................................................... 15 4.7 Morgue area................................................................................................................................. 16 4.8 External Clinic (Clinique Externe) – Ground Floor ........................................................................ 18 4.9 East fence wall ............................................................................................................................. 21 4.10 Other areas .................................................................................................................................. 23

5. Structural Features/observations – Children Hospital ........................................................................... 23

5.1 Laboratories ................................................................................................................................. 23 5.2 Pharmacy..................................................................................................................................... 23 5.3 Waiting area for tests (Blue and white) ......................................................................................... 23 5.4 General Administration Building – by the main entrance ............................................................. 24 5.5 Clinics and Administration Building ............................................................................................. 26

5.5.1 Administration area (Patient accounts)- first floor ................................................................ 26 5.5.2 Clinic (for HIV and TB) Area – ground floor ....................................................................... 29

5.6 In-Patient Ward and Maternity Building ....................................................................................... 29 5.6.1 In-Patient Ward / Intensive Care Unit- first floor.................................................................. 29 5.6.2 Maternity section – ground floor ........................................................................................ 33

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5.7 Unidentified area- ground floor under Administration (Patients’ Accounts) section....................... 34 5.8 Eye Clinic..................................................................................................................................... 36

6. Summary / Recommendations ............................................................................................................... 38

6.1 La Paix Hospital ........................................................................................................................... 38 6.2 Children’s Hospital ...................................................................................................................... 38

7. Attachments .......................................................................................................................................... 39

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1. Disclaimer This report was prepared by Hatch Ltd. (“Hatch”) for the sole and exclusive benefit of St. Joseph’s Health System (the “Operator”) for the purpose of assisting the Operator to assess and repair damage caused by an earthquake to two hospitals located in Haiti. This report is for informational purposes only, and should not be relied upon. Hatch has performed its review using its best efforts, however, the review performed by Hatch was based on incomplete information provided to Hatch and did not incorporate standard engineering quality control procedures that would have been incorporated on similar projects otherwise performed by a professional engineering firm. Hatch makes no representations or warranties as to the accuracy, correctness or completeness of the information contained in this report and disclaims all liability arising herefrom.

2. Introduction The Haiti earthquake was of a magnitude 7 with an epicentre near the town of Leogane, approximately 25 km west of Port-au-Prince. The earthquake occurred at 16:35 local time and caused extensive damages. An estimated 230,000 people were killed; another 300,000 injured and about 1,000,000 made homeless. A current estimate is that 250,000 residences and 30,000 commercial buildings collapsed or were severely damaged.

Following the January 2010 Haiti Earthquake and as discussed and agreed with the St Joseph’s Health System (SJHS), Hatch mobilised some staff to assist with damage assessment at two hospitals in Port-au-Prince, Haiti. The objective of the field visit was to provide preliminary structural assessment and observation for the “la Paix (Peace) Hospital” and “Children Hospital” free of charge.

Representing Hatch were Mohamed Dali and Predrag Jokovic who were in Port-au-Prince from March 22nd to March 26.

Table 2-1 – Hatch Staff Mobilisation

Sites Visited Field Visit Date / Time Hatch Staff Hospital representatives

La Paix Hospital

23/24 March, 8 to 5pm

M. Dali and P. Jokovic

Jean Charles Gilbert – Administrateur Hopital De La Paix Dr. Alezandre Dauphin - SJHS Eddy Romage – Membre du Cabinet du Ministre, Ministere de la Sante Publique et de la Population

International Child Care

25th March M. Dali and P. Jokovic

Dr. Rudolph MACGLOIRE – Directeur Executive Melanie Yates - Volunteer

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3. Field Safety and Collaboration Prior to departure, a conference call was organized by the SJHS. Hatch representatives and other volunteers were familiarized with relevant risks and hazards associated with the field work and the trip to Haiti.

Upon arrival in Port-au-Prince, M. Dali and P. Jokovic were met by Mr. Alez Dauphin.

During the stay, M. Dali and P. Jokovic were provided the transportation, services of translators and the cooperation of local hospital personnel and volunteers.

4. Structural Features / observations – La Paix Hospital The La Paix Hospital structures were built approximately in 2004/2005. The general structural system consists of reinforced concrete moment resisting frames (beam/ columns) with infill masonry block walls. Larger hospital buildings are structurally subdivided by expansion joints.

Over the course of March 23rd and March 24th, M. Dali and P. Jokovic walked through the miscellaneous facilities and took photos and field notes of the damaged areas. Architectural drawings were provided and used as means for orientation purpose and for taking notes and marking the damages. No structural drawings or geotechnical reports were available at the time of the visit.

The field observations will be discussed in the following sub-sections.

Accessible locations with observed damages are marked on the attached “Plan D’Eclairage Rez de chaussee E-1” and referenced in the attached scanned field sketches.

4.1 Balcony/Access Way – along “Pediaterie” area

This location is designated as Mark 3 in the attached field notes and on the plan drawing. The following damages were observed:

• cracks, in the order of 1 to 2 mm wide, were observed in the balcony concrete slab,

• fine hairline cracks were also observed in the 1st floor beam close to the support, suggesting a shear action,

• 1 to 2.5 mm wide cracks were observed in the 2nd floor beam close to the support, suggesting shear action. Some spalling was also observed on the vertical sides of the beam close to the support,

• localized damages (spalling and corner chipping) were observed at the very top of a major column; these are not considered significant in nature,

• as a result of pounding action between the slab and the column, some localized spalling was observed on the column,

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• a masonry block-work parapet wall was extensively cracked horizontally at its base and vertically close to the expansion joint. It needs to be demolished and replaced, ideally by a metal handrail.

It is recommended that a post be installed to support the balcony near the expansion joint. The post needs to be designed to carry full dead, live and seismic load from the balcony. It is recommended that a steel post be used, similar to the existing one.

Figure 1: Post to be installed in this location

Proposed location of new post

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Figure 2: Damaged area close-up

Figure 3: Damaged floor at expansion joint

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Figure 4: Same area, current arrangement of temporary posts

Figure 5: Damaged floor and parapet wall

Demolish and replace with handrail

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4.2 Internal Medicine – first floor

The balcony section on the first floor is located along the building expansion joint. Masonry block parapet wall has cracked horizontally near the base and vertically near the joint. There is also visible surface damage in the floor, ceiling and wall as a result of pounding earthquake action between different building sections. No substantial structural damage was noted through visual inspection.

It is recommended that the wall be replaced with a metal handrail and the remaining damaged area repaired.

The following damages were observed and recorded in the area labelled Mark 11:

• vertical and diagonal cracks, about ½ mm wide, were observed on the infill masonry walls, usually originating from the window bottom corners.

• hairline cracks were observed at the bottom of the balcony wall all along its length. At the end of the west side of the balcony the wall was extensively damaged and presents a risk in case of similar event.

In the area labelled Mark 12, floor tiles popped out due to the movement in the expansion joint. They were rigidly connected to the structure on both sides of the expansion joint. About 2 m long portion of the balcony wall was extensively damaged and currently presents a risk.

Figure 6: Damaged parapet wall

Demolish and replace with handrail

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Figure 7: Damaged parapet wall, close-up

Figure 8: Damaged ceiling along the expansion joint

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Figure 9: Damaged ceiling- continuation

4.3 Main Entrance and hallway – ground floor

In this area, there are three separate sub-areas marked 4, 5, 6 and W. The following damages were observed:

Mark 4: Damages were observed at top of column due to pounding between slab and column,

Mark 5: cracks in the order of 1-2 mm wide, were observed on both sides of entrance wall,

Mark 6: damage due to pounding of two separate structures, was observed in the slab adjacent to the column,

Mark W: minor masonry separation walls vertical and horizontal cracks, in order of 1-2 mm wide, were observed.

It is recommended that the column and surrounding area be repaired. The column should be thoroughly cleaned and repaired in such manner that the original load bearing capacity and connection to the surrounding structure is restored with the exception of the connection to the slab that is structurally laterally tied to the adjacent building. Our recommendation is that all buildings presently partially separated by expansion joints, be fully physically separated at expansion joints by a gap as per original design.

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Figure 10: Damaged upper part of the column

Figure 11: Damaged slab where expansion joint is at the column and both slabs are connected to it

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Figure 12: Vertical crack in the wall

4.4 Parapet walls along the high roof perimeter

The following damages were observed:

Major vertical cracks and localized horizontal damages were observed in the wall around the expansion joint above the internal medicine rooms. The damages extend over a distance of about 2 to 3 m. This parapet wall is located along the perimeter of the higher roof, does not have any significant connection to the rest of the building structure and presents a risk in case of a similar earthquake. It needs to be repaired. Our recommendation is that the height of the wall be reduced to no more than 0.3 m. If required, the additional parapet height can be easily achieved by using some lighter material. An alternative is to laterally support the wall at this height to ensure it does not sustain further future damages under similar or stronger earthquake.

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Figure 13: Roof parapet damage at expansion joint

Figure 14: Parapet damage close-up

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Figure 15: Vertical crack at expansion joint

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4.5 Emergency (Urgences) area at ground floor

The following damages were observed in the area labelled Mark 8:

-minor diagonal cracks, in the order of 1/4mm wide, usually originating from bottom corners of windows were observed on masonry separation walls.

These cracks are not considered a sign of a significant structural damage. They only need some repair and painting from outside.

Figure 16: Typical wall cracks

4.6 Stairway – close to the emergency area: “Urgences”

This area is labelled Mark 9. The following damages were observed:

-major horizontal cracks were observed on the inside face of the stairway wall at the base of the concrete grillage window/ wall. This wall has only minor load bearing capacity. If left as is, it may become unstable if subjected to a similar earthquake. It therefore needs to be repaired and laterally supported. The lateral supports can be designed in a form of simple lateral stops, connected to the remaining structure at strategic locations. An alternative is to replace it with a similar structure made of lighter material.

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Figure 17: Crack along the perimeter of the stairway wall

Figure 18: Extent of the horizontal crack around the wall

4.7 Morgue area

The following damages were observed in this area, labelled Mark 10:

-at the entrance to the morgue and specifically at the top of the wall above the door and adjacent to the east-west parapet wall, minor localized damages were observed around the expansion joint. The top masonry wall above the door needs to be repaired.

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Figure 19: View at expansion joint at the roof

Figure 20: Morgue damaged area, close-up

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4.8 External Clinic (Clinique Externe) – Ground Floor

The following damages were observed in the area labelled Mark 13:

• It seems that a roof slab extension, parapet walls and an additional truss above the roof were added after the initial construction which could explain ceiling cracks along construction joints. These cracks appear to be minor in nature. Nevertheless, the structure needs some repairs. The existing additional roof truss diagonal members are not properly positioned and appear inadequate.

We recommend that a concrete case be built around the truss. This case should completely cover the truss with dimensions approximately matching the existing parapet walls. We consider this to be a simple way to ensure the member shear transfer capability and stability of the top chord.

In addition, we recommend installation of additional supports for the cantilevered portion of the slab, as shown in the scanned field sketches. If any clarification is required, Hatch is willing to stay in contact with the contractor performing the work.

Figure 21: External Clinic, parapet wall and damaged roof slab on the right

Proposed frame location (shown in black)

Proposed frame location (shown in black)

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Figure 22: Crack in the roof slab, view from below

Figure 23: Roof slab crack, close-up

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Figure 24: Existing additional roof truss

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4.9 East fence wall

The following damages were observed:

A major upper portion of the masonry concrete fence wall broke off and fell on the ground. This wall was essentially non- reinforced with small triangular columns. If the decision is made to re-build the wall, it needs to be done using properly designed columns and top beams.

Figure 25: Fence wall damage

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Figure 26: Fence wall damage, close-up

Figure 27: Fence wall, crack in remaining part

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4.10 Other areas

In general there were many other areas or sections of the facility which underwent some minor damages in the form of minor hairline cracks, popped tiles, spalling of concrete, minor separation of masonry walls from beams, pounding damages at location of expansion joints. These types of damages are expected in major earthquakes and should not be looked at as critical ones, and rather treated as of secondary or lower priority.

Figure 28: Typical wall crack pattern observed in many hospital areas

5. Structural Features/observations – Children Hospital The Children Hospital structures were built approximately 40 to 50 years ago. The general structural system consists of reinforced concrete moment resisting frames (beam/columns) with infill masonry block walls. On March 25th, M. Dali and P. Jokovic walked through the miscellaneous facilities and took notes of the earthquake damages. No drawings, geotechnical or construction reports were available and therefore observations were on a qualitative basis only. These observations will be discussed in the following sub-sections. The hospital sections names appear in this Report as provided to us by volunteer guides.

5.1 Laboratories

The laboratory building is an independent, one storey structure with masonry walls and metal roof. No damages were observed.

5.2 Pharmacy

The pharmacy area, which is partially underground and housed in a common building with the waiting area, shows no visible damages.

5.3 Waiting area for tests (Blue and white)

The test waiting area, a slopped roof structure in shape of a hat, shows no significant damages.

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Figure 29: Waiting area shown did not suffer any significant damage

Figure 30: The only damage observed in this area is a relatively minor wall crack

5.4 General Administration Building – by the main entrance

The general administration offices are located in a one storey building. This reinforced concrete building experienced only minor damages, as illustrated here:

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• Minor diagonal step-like cracks, approximately 1mm wide, in the main interior corridor,

• Minor vertical, horizontal and diagonal cracks, less than 1mm wide, in partition walls,

• Slight settlement which appears to be around 5-6 mm in the hallways,

Figure 31: Minor wall cracks

Figure 32: More pronounced wall crack, still considered minor

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5.5 Clinics and Administration Building

The clinics are located on the ground floor whereas the administration offices are on the first floor. The building structural system is a reinforced concrete moment resisting frame with infill walls. The damages observed were as follows:

5.5.1 Administration area (Patient accounts)- first floor

The following was observed:

• Columns significantly sheared with reinforcing exposed at the top and bottom, all considered beyond repair,

• The stairwell was significantly damaged,

• The masonry partition walls showed significant diagonal cracks and shearing,

• Broken windows and glass over the floor

This building was damaged beyond repair and will have to be demolished.

Figure 33: Illustration of structural damage

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Figure 34: Damage at lower part of a column

Figure 35: Damage at upper part of a column

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Figure 36: Upper column beyond repair

Figure 37: Damage to stairs

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5.5.2 Clinic (for HIV and TB) Area – ground floor

The following was observed:

• Walls exhibiting significant cracks,

• Major column cracks

The building was damaged beyond repair and will have to be demolished.

5.6 In-Patient Ward and Maternity Building

The in-patient ward is housed on the first floor whereas the maternity is in the ground floor.

5.6.1 In-Patient Ward / Intensive Care Unit- first floor

Extensive damages that are beyond repair were in general observed. The following summarises those observed damages:

• Columns significantly sheared and reinforcing exposed at the top and bottom and beyond repair,

• Grillage walls damaged,

• Other walls damaged,

• Access through stairwell damaged; corner wall broke off and fell down, In general the first floor is beyond repair and needs to be demolished.

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Figure 38: Building outside view

Figure 39: Outside view, larger area

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Figure 40: Close-up of damaged area

Figure 41: Damaged walls

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Figure 42: Damaged structural joint

Figure 43: General damage in the area

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5.6.2 Maternity section – ground floor

This area seems to be in a good condition with only minor repairs required. Our assessment, based on limited information we have had, is that this entire section can be saved and used immediately after the damaged upper level structure was demolished and removed or replaced with a lighter structure.

Figure 44: Minor crack in the wall

Figure 45: Maternity section seems structurally in good condition

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Figure 46: Minor crack needs to be repaired

5.7 Unidentified area- ground floor under Administration (Patients’ Accounts) section

Prior to any demolition in this area, the decision has to be made whether to save the ground floor in this building or demolish the entire structure.

In case the decision to save the structure is reached, a thorough structural analysis will have to be conducted. Provided that the heavy top floor structure is completely removed or replaced with a lighter structure, it seems that the ground floor of this building can be adequately reinforced and repaired. Currently, the damage here is localised at a few concrete columns and wall cracks that can be classified as minor. The damaged concrete columns can be repaired by providing a new properly reinforced concrete encasement around them. The new concrete will have to be properly connected to the upper slab and the foundation below. Strategically placed reinforced concrete walls can provide structural resistance to seismic shear forces.

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Figure 47: Surveying the damaged walls

Figure 48: Damaged column

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Figure 49: Wall damage considered minor

5.8 Eye Clinic

The following was observed:

The eye clinic building was built around 1997 and further expanded in 2007. The building is in excellent condition; the design seems to have been professionally done and no damages were observed with the exception of few hairline cracks usually originating at windows’ bottom corners. The only noticeable cracks were observed around the door frame located near the structural expansion joint between the original and more recent structure. A purpose of an expansion joint is to separate two parts of the building and it can be expected that the buildings hit and locally damage each other during an earthquake. The damage observed does not constitute any significant structural risk, but needs to be repaired.

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Figure 50: Eye clinic, outside view

Figure 51: Localised damage around door frame

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6. Summary / Recommendations 6.1 La Paix Hospital

The general recommendation is to repair minor damages listed in the paragraph 4.10 over time as part of the operating budget of the hospital, and immediately focus on the critical ones, as listed below:

1. Install the new balcony supporting post. Repair existing damaged concrete members in the vicinity of the expansion joint. Modify and repair existing concrete parapet wall or preferably replace it with metal handrail. (See 4.1)

2. Repair the existing concrete elements in the area of the expansion joint. Replace the existing heavy parapet concrete wall with a lighter metal handrail. (See 4.2)

3. Repair the existing damaged round concrete column near the main entrance and all surrounding concrete slabs. The structures should be separated along the expansion joints to allow independent lateral movement due to horizontal loads. (See 4.3)

4. Reduce height of the existing roof parapet wall or alternatively provide lateral support. Repair all remaining structures in this area. (See 4.4)

5. Repair existing grillage window/ wall and provide top and bottom lateral stops to prevent lateral displacement. Alternatively, replace it with a similar lighter structure. (See 4.6)

6. Repair damages near the morgue entrance roof area. (See 4.7)

7. Provide concrete encasement for the existing additional roof truss. Provide new post under the cantilevered portion of the slab. (See 4.8)

8. Demolish remaining upper part of the fence wall and build properly designed and anchored wall instead. (See 4.9)

6.2 Children’s Hospital

As with the La Paix hospital, a general recommendation is to repair observed minor damages in the Laboratories, Pharmacy, Waiting Area, General Administration Building (by the Main Entrance) and Eye Clinic over time as part of the operating budget of the hospital, and immediately focus on priorities related to Clinics/ Administration Building and In-Patient Ward/ Maternity Building.

The priorities are as follows:

1. The Clinics/ Administration Building is damaged beyond repair and has to be demolished. (See 5.5)

2. A decision has to be made whether to save the ground floor in the In-Patient Ward/ Maternity Building (See 5.6) and in the area which is in this Report marked as “Unidentified Area- Ground floor under Administration (Patients’ Accounts) section” (See 5.7). The upper level structures above both areas have to be demolished. Our recommendation is that their

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replacement with lighter structures be considered. The structure in the “Unidentified Area- Ground Floor under Administration (Patients’ Accounts) section” needs to be properly analysed, reinforced and repaired and therefore saved. The ground floor structure in the Maternity Building can be saved as is, with only minor repairs.

7. Attachments • Attachment – Drawing E-1

• Attachment - Field Sketches

Predrag Jokovic/Mohamed Dali PJ/MD:yd Attachment(s)/Enclosure

End of Report

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Attachment – A

Drawing E-1

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Attachment – B

Field Sketches

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