VZCZCXRO4606
OO RUEHDBU RUEHIK RUEHYG
DE RUEHBUL #0955/01 0831307
ZNR UUUUU ZZH
O 241307Z MAR 07
FM AMEMBASSY KABUL
TO RUEHC/SECSTATE WASHDC IMMEDIATE 7013
INFO RUCNAFG/AFGHANISTAN COLLECTIVE
RUEHMD/AMEMBASSY MADRID 0370
RUEKJCS/JOINT STAFF WASHINGTON DC
RHEHAAA/NATIONAL SECURITY COUNCIL WASHINGTON DC
RUEAIIA/CIA WASHINGTON DC
RHEFDIA/DIA WASHINGTON DC
RUEKJCS/OSD WASHINGTON DC
RUEKJCS/SECDEF WASHINGTON DC
RHMFIUU/HQ USCENTCOM MACDILL AFB FL
RUCNDT/USMISSION USUN NEW YORK 3815
RUEHNO/USMISSION USNATO 3553

UNCLAS SECTION 01 OF 03 KABUL 000955 
 
SIPDIS 
 
SIPDIS 
 
DEPARTMENT FOR SCA/FO, SCA/A, S/CR, SCA/PAB, S/CT, EUR/RPM 
STATE PASS TO USAID FOR AID/ANE 
NSC FOR AHARRIMAN 
OSD FOR KIMMITT 
CENTCOM FOR CG CFC-A, CG CJTF-76, AND POLAD 
 
E.O. 12958: N/A 
TAGS: PGOV PREL EAID AF
SUBJECT: PRT/QALENOW: THE SPANISH BRING MODERN MEDICINE TO 
BADGHIS 
 
¶1. (U) SUMMARY: One of the primary objectives of the Spanish 
Development Agency (AECI) is to expand and improve healthcare 
throughout Badghis.  AECI places a special focus on medical 
care for women and newborns.  It aims to transform the 
central hospital in Qal-e Now into a fully functioning 
provincial medical center and to increase access to medical 
services for all Badghis residents by establishing EMT 
service province-wide.  In addition to these major 
infrastructural improvements, AECI is concentrating on less 
flashy, but equally important, issues such as increasing 
human capacity and hospital space allocations.  PRT Qal-e Now 
is establishing an Afghan led provincial medical system that 
could serve as a best practice for other provinces.   END 
SUMMARY. 
 
¶2. (U) In May 2006, AECI began a three-pronged approach to 
reform Qal-e Now's antiquated and disorganized hospital by 
focusing on infrastructural improvement, increasing human 
capacity, and reorganizing the hospital's staffing and space 
allocations.  The goal of the project is not simply to 
present provincial authorities with a new hospital building, 
but to involve them in the far greater task of developing a 
sustainable medical system that will be Afghan-led and, 
increasingly, Afghan-funded. 
 
-------------------------------- 
Medical Facilities Being Rebuilt 
-------------------------------- 
¶3. (U) The most noticeable parts of AECI's hospital reform 
efforts are the many infrastructural improvement projects 
being conducted on the hospital grounds.  The old main 
hospital building, the women's hospital, a number of service 
buildings and the building used for laboratory and 
administrative functions were all recently renovated. 
Construction of a new hospital wing is almost fifty percent 
complete.  Construction of a new building to house 
administrative offices and the province's first nursing 
school will begin shortly.  When completed, the hospital 
complex will consist of a stand alone out-patient center, a 
maternity and pediatric building, a main hospital ward with 
surgery and emergency areas, a nursing school and 
administration building, a laboratory building housing the 
hospital's blood bank, and a series of outbuildings including 
a mosque, laundry, restrooms and kitchen.  The hospital 
compound's capacity will increase from 62 beds to over 120, 
and the level of care will be vastly improved. 
 
-------------------------------------------- 
Office Reorganization Improves Effectiveness 
-------------------------------------------- 
¶4. (U) The AECI manager of the hospital project, Luis de la 
Fuente Martin, stresses that while the physical improvements 
are impressive, operational and capacity building parts of 
the reform effort will also contribute greatly to improved 
medical care.  During the initial assessment of the hospital, 
Martin found the organization structure in complete disarray. 
 Administrative offices were intermingled with patient 
treatment areas, wards and labs were located randomly 
throughout the building, and newborn babies were co-located 
with adults suffering from both blunt force trauma wounds and 
infectious diseases. 
 
¶5. (U) The massive remodeling project enabled AECI to 
reorganize and reallocate space, which greatly improved the 
hospital's functionality.  One reorganizational highlight 
includes relocating various labs into one central area. 
Providing cross-training to the lab technicians ensures that 
more than one lab technician who can perform a specific 
function and that 24-hour laboratory assistance is available. 
  Separating pregnant women and newborns from the general 
hospital population was also achieved, and a separate 
out-patient facility was established. 
---------------------------------------- 
Building Staff Capacity Is Key Component 
---------------------------------------- 
 
KABUL 00000955  002 OF 003 
 
 
¶6. (U) AECI is working to increase the human capacity of the 
hospital with training and mentoring.  In April, a Spanish 
hospital management specialist will conduct a training needs 
assessment and begin a month-long training program in medical 
care.  Six other specialists will subsequently conduct 
month-long training programs in gynecology, anesthesia, and 
general surgery.  Martin mentors the hospital administrator 
and leads medical staff on a wide-range of issue areas on a 
daily basis. 
 
------------------------------------ 
Goal: Afghan-Led and Funded Hospital 
------------------------------------ 
¶7. (U) A key component of AECI,s reform plan is the agency's 
financial commitment to establish and maintain the hospital 
while ensuring that it transitions toward an Afghan-led and 
eventually funded institution.  Initially, AECI provided 
almost all the hospital's operational funding, including 
salaries, patient meals, medicine, generator fuel and large 
amounts of donated medical equipment.  The GOA now pays the 
basic salaries of most hospital employees.  AECI continues to 
provide incentive pay and covers costs associated with meals, 
medicine and many operational aspects.  The hospital is a 
long way from self-sufficiency, but steps are being made in 
the right direction. 
 
---------------------------------------- 
Goal: Increase Hospital (vs Home) Births 
---------------------------------------- 
¶8.  (U) Part of the challenge in reforming the hospital has 
been improving the public's impression of the services 
offered by the hospital.  AECI has devised a program aimed at 
encouraging more women to opt for giving birth in the 
hospital, as opposed to choosing more traditional locations. 
In 2006, 319 children where born at the hospital compared to 
271 in 2005. This year, each baby born in the hospital will 
receive a newborn kit that includes a blanket, towel, hygiene 
supplies and Dari language health-related material.  Based 
upon initial reaction to this program, AECI estimates that at 
least 600 babies will be born in the hospital this year. 
 
-------------------------------------- 
4WD Ambulances Will Reach Remote Areas 
-------------------------------------- 
¶9.  (U) AECI is embarking on a project to create an EMS 
system to increase the reach of the province's medical staff. 
 AECI will provide each district with a four-wheel-drive 
ambulance complete with anti-mine protection, radio, and 
basic life-support equipment.  The Qal-e Now hospital will 
also receive two ambulances, a mobile vaccination unit, and a 
coordination center that will enable hospital staff to 
monitor, advise and direct EMS operations province-wide. 
AECI plans to conduct a month-long EMT course in May for all 
ambulance staff to ensure that the ambulances are more than 
merely a taxi service to the hospital.  When fully deployed, 
the EMS system will be able to reach individuals in need of 
medical attention in remote areas, transport patients from 
district hospitals and clinics to Qal-e Now, and transport 
patients to the Herat hospital if their injuries cannot be 
treated adequately in Qal-e Now.  The infrastructural 
improvements, including the EMS system and nursing school are 
scheduled to be completed in 2008. 
 
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COMMENT 
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¶10.  (U) AECI coordinators realize that the financial 
support, mentoring and training aspects of their hospital 
project will continue many years into the future.  AECI is 
not only committed to the long-term success of the medical 
system in Badghis, but to the lengthy process of slowly 
increasing Afghan control and responsibility for their 
medical system.  AECI,s long-term project to drastically 
improve the quality of life for the average resident of 
Badghis mixes a blend of rebuilding (and in many cases 
 
KABUL 00000955  003 OF 003 
 
 
creating) infrastructure, increasing staff capacity, and 
empowering locals in ways that could serve as a model for 
other health sector reform efforts in Afghanistan.  END 
COMMENT. 
NEUMANN