Local Health Centers Project

Local Health Centers Project – Presentation – Daniel Foster da Silva real-estate-practice.eu 2009

Here is a short reality-check on what has happened regarding what I developed in Angola back in the 80s & 90s. HISTORY Back in the 80s I was working as a trainer and consultant for a american-portuguese company called FORM/Tecnoforma, training people from most of the oil companies operating in Angola, at an Institute named Instituto Nacional dos Petróleos which is located sme 15 km from Sumbe in the Kwanza-Sul Province. The Health Deputy for the province, who has since passed away, and the central government had lines of credit from the World Bank and at-the-time-named CEE (European Union) to rebuild 3 main hospitals: Porto Amboim, Gambela and Sumbe. As a side-line, he wanted to implement the recovery or setting up of local heath centres through the province. And he approached me because he knew I was studying Architecture at the time. He dribbled an idea and, when I return a month later, for my shift there, I had drawn-up a real sketch. He was elated!... I was able to gathered together, back in Portugal, a team of specialists: An architect, a builder, a nurse and a doctor, an economist, and a few others with life experience in ex-Portuguese Africa. Meanwhile, while in Angola, I was given free-access to the villages and other locations, so I fed the project with the main elements that made sense to local, self-generative network of health/training centres, where not only health experts would be trained (para and full-fledged nurses) but also plumbers, electricians and other artisans...; Communication between local health centers and the trades established would generate a local economy as well... Al-in-all, we made a proposal for 15 of such centers, to be built, trained and implemented over a 3 year period in that province, with an over cost at the time of 2,500,000 USD. We attained a cross-Ministry approval, and initial accreditation from World Bank and CEE credit lines. Then came the Luanda War of 1992... Among other typical problems, I then moved to seek the aid of different ONGs, having one of them simply copied and tried to implement it in Angola, behind my back some 2 or 3 years later. THE BASICS HEALTH CENTER IN RURAL AREA WITH THE PEOPLE´S PARTICIPATION PROJECT PRESENTATION OF PROJECT AND DEVELOPMENT PLAN PRINCIPLES OF THE PROJECT THE REALITY ON THE GROUND Rural communities, displaced from large urban centers and structures of modern development, are deprived of basic infrastructure in promoting development: employment, media, healthcare and education which, coupled with the lack of infrastructure and high birth rate, resulting in the claim of many lives, particularly among children and young people - the future of a country. This project was prepared in a specific framework: In the early 90s and at the request of the Ministry of Health Government of Angola with the support of the World Bank, was a comprehensive survey of housing conditions and methods of construction in the province of Kwanza - southern Angola, and given a line guiding the hinge axis was the immediate need to refocus the work of NGOs in the field which resulted in the dispersal of resources ineptitude of effectiveness desired. WEAKNESSES TO OVERCOME There are several different types of deprivation that afflict the rural population, and this Local Health Center Project with their participation wants to help overcome this: PRIMARY HEALTH CARE # # # # #

pregnancy and childbirth neonatal care obstetric and pediatric supervision vaccination general practitioners

Local Health Centers Project – Presentation – Daniel Foster da Silva real-estate-practice.eu 2009

HOUSING HELP # Building their homes from precarious to solid homes # Adapting to family size and sanitary necessities of the household # Bringing natural light in homes and caring for in-house air quality. SANITATION # water supply # garbage deposit and collection # disposal of waste- and dirty-waters LOCAL HOUSING Its structure consists of a cylinder or paralelipipado, the walls are of mud and grass (tail-board) or a block of clay (adobe), 40x20x20 cm. The roof is of straw or dried leaves of palm or of grass, with a structure of thin logs of wood, trees or shrubs from local, but also being used today in the luzalite or zinc plate. This type of construction does not seem to have the conditions necessary to provide a home health care. But you can find a traditional building based on the local population understand and master and add a certain level of complexity that can easily be assimilated in order to raise it to levels required for this type of public service - ensuring a gradual development of such methods in the near future. GENERAL FEATURES OF THE WORK * MATERIALS # # # # # #

blocks of clay manufactured ceramic tiles dirt in the surrounding areas cement luzalite wood

* DETAILS # flooring in cement and ceramic craft tiles # masonry walls made form locally-made bricks, handmade ceramic tiles coating walls up to 120 cm high # window and door frames of wood # standard wooden doors # standard windows, equipped with wooden shutters and mosquito net # wooden structure to support roof # luzalite roofs

Local Health Centers Project – Presentation – Daniel Foster da Silva real-estate-practice.eu 2009

BUILDING AS A TRAINING TOOL The training related to the project, understood in its broadest sense as a school of life and not education, to provide local people the opportunity to improve their African construction techniques, thus ensuring the health and longevity of the Health Center and a professionalism of players such as masons, carpenters and potters. Being something that benefits the entire community, local participation will subsequently provide help to the remaining population to improve their own dwellings. THE HINGE TO DEVELOPMENT In view of the fact that rural people, their daily life and programs of the Health Care Rural Population of the Ministry of Health of the Government of Angola, this project presents a possible happy union between the people and technology, where the population participates in the structuring of something it belongs and that is identified from the first moment: Instead of the passive spectator on a final enjoys without having assimilated the appropriate technology will be transmitted through short courses, manuals and training thus enabling, and under the aegis of the Government and the Provincial Health Delegation, to promote the self-taught and self-sufficiency. THE DEVELOPMENT PLAN Each Health Center can become a pole of a social regeneration of small communities throughout the province. This requires thinking in a Development Plan to facilitate the implementation of the assistance program of each Provincial Health Delegation to the population, through a coordinated effort by the Angolan Ministry of Health and supported this project. The project is not intended to be an individual action: Over the years there has been the involvement of NGOs needs to be dialogue and cooperation between them, allowing an implementation with benefits for local people, not just the immediate but also long after NGOs have broken. Accordingly, the Center for Health presented this proposal is in the qualities required for this type of conduct that lead to the following factors:

1 - Multiplication factor - Phase 1 Model Center reproducible at low cost

2 - Expansion Factor - Phase 2 Model Center reproducible at low cost with proportional growth capacity

3 - Factor of Consolidation - Phase 3 Consolidation of the Regional Centers in the Creation or Rehabilitation of Municipal Hospitals

Local Health Centers Project – Presentation – Daniel Foster da Silva real-estate-practice.eu 2009

Accordingly, the Center for Health presented this proposal is in the qualities required for this type of conduct that lead to the following factors:

1 - Multiplication factor - Phase 1 Model Center reproducible at low cost # Multiplication of Local Health Centers LOCAL HEALTH CENTER DESCRIPTION Radius of Action: Population: Definition:

Up to 30 km Up to 10,000 people Immediate assistance to delivery and newborn for the local population

2 - Expansion Factor - Phase 2 Model Center reproducible at low cost with proportional growth capacity # Expansion of a Local Health Center for Regional Health Center, and establishment of a Regional Center REGIONAL HEALTH CENTER DESCRIPTION Radius of Action: Population: Definition: a nurse and a resident

Up to 50 km From 10,000 to 30,000 people Local immediate care to birth and the newborn, internment of several cases, small operations, with the addition of an outdoor amphitheater for lectures informative, flanked by 2 new facilities (a nurse with the ability for doctor and a recycling room, where the training or retraining of technicians can be made).

3 - Factor of Consolidation - Phase 3 Consolidation of the Regional Centers in the Creation or Rehabilitation of Municipal Hospitals # With local and regional development conditions arise that create sufficient capital for the direct involvement of regional and national governments in the recovery or creation of the roots of modern hospitals. MUNICIPAL HOSPITAL DESCRIPTION Radius of Action: Population: Definition:

above 100 km over 30,000 people Functions to be defined in light of regional and national requirements

CONCLUSION We present a model of health centers that can serve as a response to the most basic health needs of rural populations and urgent as a single entity and individual. However, this project finds its true calling when applied methodically and across the province, thereby creating a further incentive to strengthen the self of the people towards a revitalized economy. FINANCIAL FILE The overall project cost and schedule performance of the work will always be prepared in light of prior study of the country, area of implementation, and with the lifting of the framework and needs of the project. In the initial period provided for in the schedule to Angola, the construction of each center was also covers the time deemed necessary for vocational training of staff - skilled and semi-skilled - in various operational areas.