KABUL. REHABILITATION OF KHAIR KHANA HOSPITAL
Great commitment of Intersos, the Italian Cooperation and the United Nations Agencies.
Finally, a real engagement by Afghan Institutions

INTERSOS was involved in the rehabilitation and enlargement of the Khair Khana Hospital in Kabul between 2002 and 2003. This was a UNFPA (United Nations Population Fund) promoted project funded by the Italian Cooperation. At the end of the works, the building was tested and handed over to the Afghan Ministry of Health for its management, care and maintenance. The municipality of Kabul was in charge of the connection to the urban sewage network. Unfortunately this has not materialized. Furthermore, the mismanagement, the lack of any maintenance, thefts of several equipments, and the arbitrary modification of the original structural equipment have led to hospital’s precarious conditions. Even if it has continued operating with 200 medical doctors, nurses, technicians and assistants.
Given this deterioration, which INTERSOS himself considers appalling, somebody has brought up unfunded allegations on possible frauds and agreements between United Nations and Intersos at the expenses of the hospital, linking them to the widespread corruption which today dominates in Afghanistan.
Since INTERSOS has always fought against all forms of corruption, and has got the firm conviction to have operated correctly, complying with all the commitments, it has been providing, whenever requested, all information in detail with transparency and clarity. Too often however these documental information have not been taken into account as they carried the threat to dismantle presumptive journalistic scoops. In other instances, information provided have been used either instrumentally or outside of the original context, thus giving a distorted view of the situation, with the only aim of forcefully making up a scandal.
Unfortunately when the media machine starts, especially on the Internet and on TV, it is impossible to track it, to defend oneself and to protect one’s image in the continuously increasing number of sites and blogs blatantly reproducing the so called scoop without any verification. These repetitions are frequently accompanied by biased and insulting statements which are totally undeserved, and which represent an unconceivable example of violence and injustice, which is almost impossible to fight back. Indeed this is the scandal.
Therefore we have decided, since Dec. 2008, to use our own website to tell and document the truth.
This is the true story of Khair Khana Hospital in Kabul.

In 2002 INTERSOS was selected to implement the rehabilitation and enlargement of the hospital “Khair Khana”, 52 beds, in a popular area of Kabul. The hospital was part of the UNFPA, United Nations Population Fund, program in Afghanistan; the Italian Cooperation was the donor. The new building was realized under the daily supervision of  the UNFPA Senior Technical Advisor, monitored by UNOPS, United Nations Office for Project Services, whose Project Engineer realized several field visits. At the end of the works, in May 2003, the hospital was inspected by a commission coordinated by the Director of the Department of Constructions of the Afghan Ministry of Health. A further inspection was performed in May 2004 at the end of the one year of INTERSOS’ responsibility foreseen by the contract.

INTERSOS guaranteed the planning, coordination and direction of the works; the purchase and transport of materials for the reconstruction; the logistic, organizational, and administrative support. Four Italian technicians were employed: a coordinator with ten-year experience in conflict areas and previous experience in Afghanistan; an architect with consolidated experience in Italy and abroad; an engineer with sound technical experience in building hospitals in the Italian region Trentino-Alto Adige; a surveyor with 35 years experience abroad in building companies, plus around ten Afghans charged with logistic and administrative tasks. Afghan companies realized the works, while the procurement of the material was partially done in Pakistan and partly in Italy, under the supervision of the UNFPA Senior Technical Advisor.

The Kabul Municipality and the Ministry of Public Health approved designs and drawings as they were agreed in the projects. They requested some adjustments and followed all the steps of the construction till the final hand over to the local institutions.

The intervention was mainly characterized as an emergency rehabilitation and enlargement to 102 beds; seven months of practical works had been planned, from 15th August 2002 to 15th of March 2003, but because of the harsh winter, religious holidays and some logistic delays, the works totally lasted almost 9 months.

UNOPS verified the accountability of the expenses, finalized the contracts and paid INTERSOS as soon as different phases of the projects were accomplished and only after having verified and approved the precision, quality and quantity of works, of purchases and of all connected activities.. INTERSOS handed in to UNOPS five copies of the final technical documentation, made of several notebooks in A4 and A3 and comprehensive of drawings, construction works, purchased material, instructions of material purchased. The documentation was delivered as follows: 2 copies to the Afghan Ministry of Public Health, 1 copy to the hospital, 1 copy to UNFPA and 1 copy to UNOPS.

The hospital was handed over the 1st of May 2003 to UNFPA, that took formal responsibility and custody jointly with the Afghan Ministry of Health. The hospital was officially inaugurated the 14 of July 2003 (http://www.unfpa.org/news/news.cfm?ID=359&Language=1) with the presence of Afghan, Italian and International authorities. It was UNFPA duty, jointly with the Afghan Ministry of Health, to provide the hospital with medical equipment and to guarantee monitoring, training and support on the hospital management.

After the one year’s guarantee period, in May 2004, an evaluating committee inspected the hospital. The committee was composed of the Director of the Department of Building and Construction of the Ministry of Public Health; the Director of the new hospital; the UNFPA Vice-Director of Operations and Program Officer; the UNOPS Program Officer and Project Engineer; INTERSOS Head of Mission, Engineer and Administrator. On behalf of the commission, UNOPS asked to INTERSOS some technical clarifications, which were promptly given. Therefore, UNOPS released the Final Handing Over Certificate.

The hospital has been visited by authorities and by several people, both Afghan and international (see as an example: http://www.unfpa.org/news/news.cfm?ID=482) and the photos here annexed.

The Afghan Ministry of Public Health was in charge of harmonizing the new structure with the health public services at national level; of recruiting and training the personnel; and of the management, maintenance and control of the hospital. Kabul Municipality was charged of connecting the electricity and the external sewage system, this following the previous agreement taken in 2002 when, answering to a specific request, part of the hospital’s terrain was reserved for widening the city road and sewage systems.

As the structure was not completely new, but a rehabilitation and enlargement of a previous building with hospital activities, it was expected that the authorities, national and local, would have been able to guarantee the functioning of the hospital. Unfortunately the Kabul Administration did not respect its duties and the Ministry of Public Health did not guarantee any support and assistance to the hospital .

Even more, in the spring of 2004 a heavy earthquake (6,8° Richter) caused some damages that should have been repaired to avoid the leaking of the rain water. As from the technical assessment the building structure was verified in perfect conditions, this would have implied just ordinary maintenance as. But nobody ever took care of it and the management of the hospital let, along the years, the ice and the winter magnify the damages.

Mismanagement has led to serious and unauthorized modifications to the original project as well as thefts of equipments (equipment moved into unsuited and unguarded rooms; inappropriate usage of the electrical system with consequent burnings and melting; the air cooling equipment disappeared and was replaced with electrical fans damaging the roof; the originally planned usage of some premises modified; new windows inappropriately and badly built in sterile rooms as the surgery; sanitary fittings replaced with others of inferior quality with plumbing tampered and seepages, etc.

The consequences of the lack of management, care and maintenance have soon became evident: the hospital and its facilities have progressively deteriorated.

In 2005-2006 the Afghan authorities, in the person of the Attorney General, began an investigation to verify the regularity of the project’s execution. INTERSOS received the following requests: analysis of the documentation and reports (already handed over to the Afghan authorities by UNOPS in 2003, when the activities were completed), contracts, expenses for the construction, equipment and support costs. INTERSOS deemed its own duty to fully collaborate and provided the Attorney General with all the documentation requested.

This has been followed by the diffusion in Afghanistan of unverified information which amounted to a discredit of INTERSOS, UNOPS and UNFPA, indirectly touching the same Italian funds which had been made available for the project. Also some international Blogs and TV took the ‘news’ re-launching it. UNOPS and the Italian Embassy in Kabul released several statements - both oral and written - to strongly support the regularity of the project implemented. 

Until now, for the sake of transparency, we have been paying major attention providing all the information on the issue. And we will continue doing so. But to counter the incorrectness of few journalists who, although having needed information and knowing the reality of facts, deliberately ignore all of them or show them in an ambiguous and doubtful way, linking sentences out of their context in order not to lose their “scoop”, INTERSO has undertaken legal actions, seeking compensation for the serious damages caused to its public image.

The Guardian has immediately withdrawn a video from its website as You Tube had done following all of our requests. Another video is continuing to circulate, released for the first time on Canal Plus which presents the Khair Khana hospital within a wider discourse on corruption in Afghanistan (to which INTERSOS should have allegedly participated) although the author had full knowledge and documentation on facts. Against the author and the production we are employing legal means, given the damage suffered by INTERSOS following the circulation of this very video on other international TV channels.

However, INTERSOS will continue its efforts in order to lobby the Afghans authorities take the responsibility of the hospital. Cooperation means mutual commitment and responsibility. Until a few months ago, although feeling sorry to say so considering the bound we have with the afghan country and its people, this commitment has been lacking from the Afghan side. It was too easy, and also deeply unfair, to free oneself of its responsibilities by discharging them to the detriment of a foreign NGO.

However, a new warmly welcomed hope is arising. The Direction of the hospital - responsible of negligence and decay over the recent years – has been removed and substituted with new management in 2009. They are manifesting a well different approach and a renewed commitment to bring the hospital back to full functionality. The World Bank has recently confirmed its confidence in this new management and agreed in supporting the Hospital in this new phase.

We would like to express our deepest disesteem toward those (few, to be honest) who, without any scruple have made up a scandal by manipulating the reality of facts with the only aim of creating a “journalistic scoop” (and to those who have taken up these alleged scandals without further verification), deceiving the public opinion with true images presented in a deceptive and sometimes false way, thus inserting the reconstruction of the hospital, in 2002, among the examples of corruption in Afghanistan.

Following some data that might contribute
to the transparency and clarity of the news given above

             
2)  FINAL REPORT:  “Rehabilitation of Khair Khana 52-Bed Hospital in Kabul, Afghanistan” >>>

PHOTOS OF CONSTRUCTION WORKS>>>

MATERIALS >>>

STRUCTURAL CALCULATIONS >>>

PHOTOS OF INAUGURATION 12/6/2003 >>>

PRESENTATION OF THE HOSPITAL BY THE NEW MANAGEMENT>>>