Health Project: Sumala - Icla...Health Project: Sumala - Icla 4 Photograph 2. Current health center...

Health Project: Sumala - Icla

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PROJECT:

Expansion and Equipment for the Health Center in the community of Sumala

Project Description:

Expansion and Equipment for the Health Center in the community of Sumala.

General description of the Sumala community

Department: Chuquisaca Province: Zudañez Municipality: Icla

Population: 800 inhabitants Number of other communities: 5

Basic services available: Non-potable well water, electricity by solar panel, mobile phone network.

Distance from the city of Chuquisaca: 178 km

Introduction

Mano a Mano Bolivia is a nongovernmental organization, legally recognized in Bolivia, which has been supporting social development through the implementation of health, educational, and road infrastructure projects as well as smaller health and educational programs, since 1995. The organization is composed of a multidisciplinary team of workers and volunteers. Many of the communities that benefit from our work are part of municipalities with limited economic resources. They do not have the means to independently develop adequate health, educational, and transportation infrastructure, which traps them in a state of economic and social development, and is reflected in:

• The low Human Development Index of these regions.

• Elevated rates of maternal and infant mortality.

• High school drop-out rates.

• Limited support from government programs due to the absence of an adequate infrastructure.

• High migration rates from rural communities to more developed cities.

All of this widens the opportunity gap and contributes to the high poverty rates in these regions of Bolivia.

As of the writing of this report, Mano a Mano Bolivia has constructed:

• 165 health establishments, including clinics and hospitals

• 61 schools, which in addition to classrooms, have a bathroom, shower, and laundry area.

• 58 road infrastructure projects that help connect isolated areas to neighboring communities.

We implement a work model that ensures the sustainability of all of our social infrastructure development projects.

All of our health establishments, schools, and roads remain in use. The following groups participate in each project:


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The municipalities provide financial support for the project and their representatives and technical personnel supervise the work. They also guarantee that they will provide financial resources to maintain the infrastructure long after its inauguration.

During the execution of the project, the benefitting communality provides voluntary labor for the construction of the project, and later ensures the appropriate use of the infrastructure.

Mano a Mano Bolivia seeks funding for each project from volunteers and friends. We then develop and execute projects under our direct management for efficient cost management and quality control. This in turn ensures that each project is completed in a timely manner and is of excellent quality.

With this work model, the construction costs are 30 to 40% less than the commercial costs, which does not even consider the fact that our projects are equipped with medical and school supplies after construction. We inaugurate each infrastructure approximately 5 months after we begin work. The Bolivian state, through its ministries of health and education, provide the human resources for the infrastructures. They are also in charge of planning and administering public health and educational programs. While we are an independent, non-governmental organization, Bolivian legislation regulates and monitors our work.

Current Situation and Justification

Photograph 1. Opening day of the health center in Sumala on the banks of the Pilcomayo River, the flood prevented the

crossing in to the community.


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Photograph 2. Current health center in the community of Sumala

Photograph 3. Panoramic view of the community of Sumala, in the background you can see part of the Pilcomayo River.

Sumala is an isolated rural community in the Municipality of Icla, which belongs to the Department of Chuquisaca,

the community is located on the banks of the river Pilcomayo. In 2005, thanks to the cooperation of the Rotary

Clubs of the United States, Mano a Mano Bolivia managed to build a small health post (75 m2) in which a technical


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auxiliary nurse could work. The difficulty of the project was moving the construction material across the river

Pilcomayo, since there was no access road available. This infrastructure covered the basic need for health.

Photograph 4. The nurse is working in the hallway due to a lack of workspace.

Photograph 5. New homes were built in the community of Sumala, thanks to the construction of the road.


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The community is characterized by their location in a very isolated place of its municipal capital. In the rainy

season the flooding of the river prevents access to the sector. For this reason in 2017 Mano a Mano Bolivia

developed, along with the Rotary Clubs and the municipalities of Icla and Tarvita, the opening of a 13-kilometer

road to allow vehicular access to the community (previously the community could only be reached on foot or by

means of pack animals).

Currently, due to population growth, the Bolivian government assigned a doctor to work with the nursing

staff.

More health programs and equipment were also assigned by the Bolivian government and the municipality

of Icla, this situation has caused overcrowding in the health center.

The doctor's office also functions as a pharmacy.

The current infrastructure model only has one bedroom that is assigned to the Physician.

The hospitalization room functions as the Nurse's bedroom, but if necessary it functions as a delivery

room and secondary for the hospitalization of patients

The corridor has become an area for nursing care and healing; it also functions as a vaccine storage area

and for the management of clinical history; When patients are occupying the hospital rooms, the nurse

must improvise her bedroom by laying a mattress on the floor of the corridor

Photograph 6. New homes were built in the community of Pueblo Pampa close to Sumala (25 new homes).

The improvement of this situation will allow a better performance of health personnel and public health programs,

mainly benefiting this community by giving mothers and children access to free benefits.

The community of Sumala and the municipality of Icla have requested support for the extension of the current

health center in Sumala. Because the new road has improved transportation of this population, its development

has brought a demographic increase of population and a greater demand for health services, including of settlers


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coming from other communities. Proof of this is the construction of 25 new homes (13 homes in the town of

Sumala and 12 homes in the community of Pueblo Pampa.

Photograph 7. The hallway serves as an infirmary, a deposit for archives and medical devices and sometimes as a dormitory.

Photograph 8. A nurse with a patient in the health center of Sumala.


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Photograph 9. The Physician, the health promoters and the nurse, in training of new health programs.

Photograph 10. Arrival of an ambulance filled with medical supplies for the health center in Sumala, right after the road was

finished.


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Photograph 12. Rotary volunteers and the local authorities on the opening day of the road to Sumala.

Geographical location:

Sumala is located 178 km from the city of Sucre (the first 60 km of the road are asphalted, 40 km are a cobble

stone road and the last 78 km are dirt road). Vehicle access to the community is very difficult in some sections

especially in the rainy periods, the 78 km from the capital of the Municipal Icla is only possible in two and a half

hours by cars with four wheel drive. The community is located in an area surrounded by mountains and serpentine

roads. The semi-tropical climate in the area is suitable for the varied cultivation of fruits and vegetables.

Economic situation:

The Municipal of Icla has a population of 7764 people, the community of Sumala has 800 inhabitants, the economy

of the people in the community is based on the agricultural production of citrus fruits, bananas, peanuts, grapes

and a variety of vegetables; the community also has a small production of poultry and cattle. More than 50% of

the population speak two languages, Quechua and Spanish.

The Municipal of Icla presents a Human Development Index (HDI) of 0.420 classified according to the United

Nations Development Program as a low index. 72.36 % of the poor population are people living in households

below the poverty line which was established as a standard for Bolivia. The available basic services are: clean

water, access to mobile phones and only one electric power source which consists of solar panels.

The Government of Icla and the community of Sumala do not have enough economic resources in order to build

new health infrastructure with their own resources and doctors with their current government budget.

This shows the immediate need for financial support for the development of projects in this impoverished region

of Bolivia.


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Graphic 1. Comparison of the international HDI with the local HDI of the municipality of Icla and the community of

Sumala.

Beneficiaries:

The direct beneficiaries are the community´s 800 inhabitants (according to the local census)

The indirect benefits are the approximately 900 inhabitants in the surrounding communities. Ruditayo, Pueplo

Pampa, Kollpa Pampa, Huerta Pampa and Tranquitas.

Global objective of the Project

General objective:

Develop the expansion of the current Health Center in Sumala

Specific objective:

Build the enlargement of the Health Center according to established standards in a maximum time of 4

months

Take advantage of the old infrastructure and redecorate the interior with new functions.

Completely equip the built infrastructure in coordination with the Municipal of Icla

Secure Empowerment and participation in the volunteer work of the community members.

USA

Chile

Argentina

Bolivia

Municipality of Icla

Community of Sumala


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Project Participation

Community of Sumala: The inhabitants of this and neighboring community will have the following responsibilities:

Provide a part of the financial budget.

Provide a lot or land for the construction site.

Provide volunteer labor support to the construction workers.

The municipal government of Icla: The municipal government and their representatives will have the following

responsibilities:

Provide part of the financial budget.

Contribute local construction materials.

Contribute equipment to the infrastructure once it is constructed.

Mano a Mano Bolivia: As the director of this project, Mano a Mano Bolivia will have the following responsibilities:

Look for funds to complete the project budget.

Develop architectural plans in coordination with and the approval of the community and local government.

Lead and execute the project under its direct administration, ensuring the timely completion of plans and the quality

of work.

Supervise the construction of the project through its own personnel.

Complete the equipment of the infrastructure in coordination with the community and local government.

Organize an inauguration ceremony and begin seeing patients within 5 months of initiating construction.

Present financial reports, both while the project is in progress and after the inauguration and construction. This will

include economic reports that detail expenses and audiovisual reports.

General Project Description

This primary health care clinic will be completed cost-efficiently under our direct administration in under four

months. It will be completely equipped and span 245 m 2.

The enlargement will have an area of 170 m 2, which will be added to the 75 m 2 of the old infrastructure, reaching

a total of 245m 2. They will reassign new functions to the old infrastructure depending on the entire construction.

The new rooms will be fully equipped with current and new equipment.

All of the rooms in the new building will be constructed with brick and concrete. It will have a ceramic floor and

wide windows lined with aluminum, wooden doors, a Spanish-style roof, and adequate electrical and lighting

installation. Everything will be designed according to local norms and with the local climate in mind. It will have:

An inpatient room with two beds

Medical consultation room

Dental consultation room

Nursing station

A room for storing vaccines


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A birthing room

A room for sterilizing equipment, instruments, and other materials

A room for treating patients with tuberculosis

A multifunction room with a pharmacy and medical archives

A small kitchen

A general area

A bathroom and changing area for medical personnel

Two public and patient bathrooms

All rooms will be joined by a hallway that doubles as a waiting area.

Deposits for medication and supplies.

Graphic 2. Project blueprints. (The red lines present the current infrastructure, the dotted lines show a projection

of the new infrastructure)


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Graphic 3. Project blueprints.

The furniture and equipment, which will include metal desks, metal bookcases, metal seats, an examination

table, an OB/GYN table. All besides the bookshelves which will be constructed at our organization.

The local municipality will provide scales for adults and babies, examination flashlights, oxygen tanks, and other

medical equipment.

The local municipality, in coordination with the programs of the Ministry of Health, will provide medicines,

vaccinations, and cleaning equipment.

The health providers will be medical personnel and nurses employed by the municipality and national government.


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Budget

The project cost is $74,087. 00 US dollars.

1.- DIRECT COSTS : Partial Total

1.1.- MATERIALS 31,526.00

Natural Materials (sand & stones) 1,868.00

Cement 2,845.00

Bricks (whole, halves, Sika ®) 2,461.00

Hardware (iron, sanitary, plumbing, other) 2,476.00

Roofing (beams, laths, boards) 3,719.00

Cover Materials (calamine - plate gutters, downpipes) 1,879.00

Plaster 898.00

Flooring (ceramic coating implements) 1,001.00

Paint 823.00

Metallic Carpentry 1,017.00

Aluminum Carpentry 1,564.00

Wooden Carpentry 4,009.00

Identification Plaque and Other Minor Tools 216.00

Transport of Cement, Materials, and Equipment 5,747.00

Contingency for Materials and Installations 1,003.00

1.2.- SUPERVISION 9,310.00

Supervisory Personnel 2,184.00

Technical Support 1,379.00

Cost of Feeding and Housing Field Staff 5,747.00

1.3.- LABOR FORCE 12,750.00

Bricklayers 10,761.00

Labor Taxes 1,989.00

2.- INDIRECT COSTS:

2.1.- EQUIPMENT & OTHER INAUGURATION COSTS 9,006.00

Furniture 6,486.00

Contingency Supplies for Furniture 222.00

Cleaning & Other Supplies 1,149.00

Inauguration 1,149.00

2.2.- ADMINISTRATION AND OTHER COSTS 11,495.00

Administration Costs 5,747.00

Training Course for Health Personnel and Providers (for 3 years) 4,310.00

Infrastructure Contingency (minimum 3 years) 1,007.00

Donated supplies ( 3 years) 431.00

Total budget (USD) 74,087.00


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Municipality58%

Financing Support

41%

Beneficiary contribution

1%

Table 2. Financial contribution of each project participant (in dollars)

Project Participants Community Municipal

government External Financial

Support Total

Amount each participant will contribute

867.00 43.244.00 29,976.00 74,087.00

Percentage of total budget 1.17% 58.37% 40.46%

100.00%

59.54% of total local contribution.

44,111.00 USD 40.46% financial

support

Graphic 4.Comparison of construction costs.

Important notes:

Project Beneficiaries

Without our support, Sumala and its municipality will spend $123,478.00 USD to complete this same project.

This amount does not even include the cost of equipping the Health Clinic.

The cost of the project using our methodology is $74,087.00 USD, which is 40% less than the commercial cost.

The local government and community can only obtain 59.54 %, or 44,111.00 USD of the total budget.

Unless we can find $29,976.00 USD in external support, this project cannot be completed.

Mano a Mano Bolivia Cost: $74,087.00 Commercial Cost: $123,478.00

Local municipality and private business

(without Mano a Mano Bolivia’s

support)


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The direct beneficiaries are the community's 800 inhabitants (According to local census data)

The indirect benefits are the approximately 900 inhabitants in nearby communities. (Ruditayo, Pueplo Pampa,

Kollpa Pampa, Huerta Pampa and Tranquitas).

Project Goals, Besides Infrastructure Construction

Besides the infrastructure construction, the main project goal is:

To improve the health conditions and the lives of the inhabitants of the community of Sumala and the nearby

communities, contributing to the social and economic development of the region.

Mano a Mano Bolivia will actively participate in the administration of the new health center through:

Offer regular support, including continuing medical education classes for the health staff.

Contribute supplies regularly.

Create a health promoter program.

Offer statistical information about provision of health services to the project donors every trimester.

The Bolivian Ministry of Health, the municipal authorities, and the local health authorities will:

Assign permanent health personnel in coordination with the municipal government.

Establish public health policies and programs at the new health center.

Provide and encourage preventative health and education in the community.

Organize biweekly visits by the dental health team from the Icla hospital.

Project Reach

In the short term, this project will benefit the local economic development of Sumala and its neighboring communities

through:

The reduction of maternal and infant mortality.

Improved and increased number of medical consultations.

Improved quality of medical attention.

Decreased risk associated with childbirths.

Improved continuing medical education and opportunities for health providers.

Increased preventative medical attention, including vaccination services.

Improved public health education.

Progressively improving the staffing and medical supply needs at the health center.

Increased workplace satisfaction for health personnel.

Cochabamba, October 2018

Health Project: Sumala - Icla...Health Project: Sumala - Icla 4 Photograph 2. Current health center...

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