KASHMIR WELFARE & RESEARCH TRUST, BARNALA, AZAD KASHMIR, PAKISTAN

HOSPITAL FEASIBILITY REPORT

Home
Right Of Self-determination
World Social Forum 2006
Contact Us
Online Membership Form
A Letter from Earthquake Effected Area
Donations
City Representatives & Overseas Co-ordinators
BECOMING A NEW MEMBER
HOSPITAL FEASIBILITY REPORT
Kashmir Info
AIMS AND OBJECTIVES

Homebased Business, Golden Earning Opportunity
2.jpg
You can be millionar if you believe

Preliminary Fesibility Study Report for the Construction
          and Operation of 50 bed hospital in Dera,
               Tehsil: Barnala, District Bhimber,
                      Azad Jummu & Kashmir.
 
                                 Jan 2006
 
    Designer RECKON Architecture & Construcion
           Office # 47, 48. Quaid-e-Azam Stadium
                        Mirpur, Azad Kashmir.
                        Ph. +92-58610-32406.

1) INTRODUCTION:

 

Bhimber is 7th District of Azad Jammu & Kashmir and established in December 1995.  It is situated on South East side of Azad Jammu & Kashmir.  It consists of three Sub Division: -

 

1. Bhimber

2. Barnala

3. Samahni

 

Subdivision Barnala and Samahni are situated over line of control (more than 70 KM in length).  Sub Division Bhimber is not situated over Line of Control but whole of the District is in the range of medium artillery and worst affected by Indian shelling in recent years.

 

This District consists of three legislative units, one municipal Committee and 18 Union Councils with total population of 3,63,420 (three lac sixty three thousand four hundred twenty only), 95% of which is Rural and only 5% urban population.  Total area of the District is approx. 1516 sq. Km.

 

            "He who saved a life saved the Mankind - (Al-Quran ) "

 

There can be no second opinion to the fact that better health facilities are a fundamental requirement of mankind.  Undoable the Government, at its own level and private sector as well has been endeavoring hard in this sector and special attention is being paid to

excel the establishment of various health units.  The fact is that still a lot is yet to be done in this sector for which government encourages the private sector.  NGOs and other agencies to participate either individually or in collaboration with the Government.  One such example is the construction of a 50-bed hospital at Dera, Tehsil Barnala, District Bhimber and Azad Kashmir.  For which Kashmir Welfare and Research Trust has planned to collect funds on charity basis.  The charity “Kashmir Welfare And Research Trust” or there representatives will monitor the utilization of funds.  The hospital shall be equipped with all necessary medical and other equipments.

 

Barnala, where hospital is to be built is a Sub Division of District. Bhimber and is situated near the control line.  By virtue of its location it has been the most affected area due to very less health facilities as a remote area (refer location map attached). There is another fact due to the Indian shelling in the recent years before ceasefire on LOC. The hospital apart from facilitating the medical assistance to the patients shall also provide treatment to the injured.

 

This Preliminary Feasibility Report provides the merits and other benefits of establishing the planned hospital at Dera, Tehsil Barnala, District Bhimber, and Azad Kashmir.

 

 

 

2) AVERAGE ANNUAL GROWTH RATE AND EXISTING FACILITIES IN THE DISTRICT AND AT BARNALA;

 

2.1 Average Annual Growth Rate;

 

District Bhimber spread over an area of approximately 1516 sq. Km. had a population of 2,97,336 (two lac ninety seven thousand three hundred thirty six) in the year 1998.  The break up of this in the rural and urban area is given below;

 

                          District Bhimber                         Population

                            Rural Areas                                 2,81,381

                            Urban Areas                                15,955

                            Total                                            2,97,336

 

The Rural and Urban Population as per 1981 census was 1,87,666 and 7,343 respectively.  The comparison of both the census shows that there had been an Annual Average Growth rate of 2.41% per year in the rural areas and 4.67% in the urban areas, which yields an overall Annual Average Growth Rate of 2.51%.  The comparison is given below;

 

          Annual Average Growth Rate (AAGR)

       

          District Bhimber    

                                                  

Population

 

YEARS

AAGR (%)

1981

1998

1999

2000

2001

2002

2003

2004

2005

2006

 

Rural

 

 

187666

 

 

281381

 

 

288162

 

 

295107

 

 

302219

 

 

309503

 

 

316962

 

 

324600

 

 

332423

 

 

340435

 

 

2.41

Urban

 

 

7343

 

 

15955

 

 

16700

 

 

17480

 

 

18296

 

 

19150

 

 

20044

 

 

20980

 

 

21960

 

 

22985

 

 

4.67

Total

 

 

195009

 

 

297336

 

 

304862

 

 

312587

 

 

320515

 

 

328653

 

 

337006

 

 

345580

 

 

354383

 

 

363420

 

 

2.51

 

 

Overall annual average growth rate is 2.51 (as refer table in attachment.)

 

 

  Applying the above estimated growth rate the estimated growth rate the estimated            population now would be around 3,63,420.             

 

 

 

2.2)  THE EXISTING FACILITIES;                  

 

The present facilities for this population in the district and for the injured from the Line of Control are given below;

 

*         District Head Quarter Hospital  (DHQH)-----------------------------------01

*         Rural Health Centre (RHC)                    ----------------------------------- 03

*         Basic Health Units (BHU)                      -----------------------------------25

*         Civil Dispensary (CD)                           ----------------------------------- 13

*         First Aid Post (FAP)                              ----------------------------------- 19

*         Mother & Child Health Centre (MCHC)  ---------------------------------14

*         Tuberculosis/ Leprosy Center               ----------------------------------- 06

*         Expanded Program in Immunization (EPI) ------------------------------ 31

 

The population of Tehsil Barnala according to 1997 was 104301 (refer table in attachment), which if increased at a growth rate of 2.51% would be around 121000 at present for which there exist the following facilities;

 

*   Basic Health Unit at Der, Kanjloor, Kot Jamel, Kherowal  --------------- 07

                                           Banian, Patni and Maloot.

*  Civil Dispensary at Nali, Mera Jattan, Channeer & Sardari.  -------------- 04

 

*  First Aid Point at Kadhala, Haji Pura, Pantra, Baboot, Glota, -------------08 

                                    Abowala, Chandni Chowk and Thub.                                       

 

*  Rural Health Centre at Barnala -------------------------------------------------01

 

The Basic Health Units of East border includes Banian,Kot Jamel and Kherowal can take care of area of  Watala up to Iftikhar Abad. These Basic Health Units are serving well the injured in emergency from Iftikhar Abad,Chumb, Munawar, Dewa and Watala border, the villages located near Line of control (L.O.C).  The Basic Health Unit of north border is only Nali.  Basic Health Unit Nali is located in remote and difficult travel area. The Nali BHU is serving basic health facilities more than ten villages on the north border of L.O.C. The patients from these villages cannot be shifted to R.H.C Barnala.  As such B.H.U at Kherowal and Nali are justified as in emergency the injured and patients from these BHUs can be shifted to Mirpur and Gujrat (Pakistan).  Unlike Kot Jamel and Barnala the injured and patients from Ghakrai, Patian, Jhang, Baliwal, Moil, Patni and Sardari by virtue of its location cannot be shifted to Mirpur in case of emergency, as they have to be transported a long distance along the Line Of Control where there is all the time a danger of sporadic Indian shelling.  Refer attachment for road connection of Barnala RHC to with other towns.  Refer attachment for road connection of Barnala with other towns.

 

 

 

3) MAJOR HEALTH PROBLEMS IN THE PROJECT AREA;

 

There are following major health problems, which shall be addressed in the proposed hospital;

 

*  Infectious Diseases and Diarrhea

*  Worm Infestation

*  Malnutrition

*  Inadequate facility to the injured from LOC

*  Inadequate and inefficient health services on LOC

*  Inadequate health facility for mother and childcare

*  Inadequate and inefficient maternity services

 

The proposed hospital at Dera, Tehsil: Barnala, District. Bhimber shall be a step towards improving the health facilities to the people of Tehsil Barnala and people from the area of influence of this hospital, which extends from Gujrat border on the East, West and North villages on L.O.C.  Presently the patients are given basic treatment at RHC Barnala, whereas more serious patients and injured are required to be moved to Mirpur, which is risky and inconvenient for the patient / injured and its caretakers.

 

The proposed hospital shall provide better treatment and other facilities to the residents of Tehsil Barnala and adjoining areas at their doorsteps.

 

4) OBJECTIVES OF THE PROJECTS;

 

The main objectives of the project are as follows;

 

              I.      To efficiently provide better treatment and health facilities to the residences of Tehsil Barnala and adjoining area of District. Gujrat, Pakistan.

                                                                                                                                                                     

           II.      To provide efficient and quick treatment to the wounded from line of control and its   adjoin areas of District Gujrat.

         III.      To provide at the doorstep of residents of the area more efficient and better Maternity Facilities.

        IV.      To provide more efficient Mother & Child Health Care.

           V.      To help bring down the Infant Mortality Rate (IMR), the present estimate of which is 86/1000 children.

        VI.      Similarly to help bring down the Maternal Mortality Rate (MMR) the present estimate of which is 5/1000 Births.

      VII.      To promote better health education and on job training to the paramedical staff.

   VIII.      To promote family planning concept in the area.

        IX.      To provide better, efficient and regular Vaccination to the children.

5) THE PROJECT COST;

 

The hospital building as per the specifications shall be adequate to accommodate all treatment and other facilities required for a 50-bed hospital.

  In general the hospital building shall comprise of;

 

*  Patient’s wards adequate to accommodate 50 beds along with affiliated facilities.

*  Fully equipped operation theatre.

*  Fully equipped labour room.

*  Casualty / Emergency ward

*  Doctor’s Rooms

*  Paramedical Staff Rooms

*  Out Patient Ward

*  Reception and other Services area etc.

 

The building as per requirements shall cover an area around 30,000 sq. ft. Excluding ancillary buildings (Staff quarters etc.), which shall cover approximate estimated cost of the building and other affiliated structures is computed as follows;

 

*  Cost of main hospital building @ Rs.1500 per sq. ft.                       = Rs.  45,000,000

*  Cost of ancillary building @ Rs. 1100.00 per sq. ft.                         = Rs.  7,700,000

*  Cost of Parking lot (taken as Lump Sum)                                         = Rs.  1,300,000

*  Cost of Furniture and Equipment (taken as Lump Sum)                  = Rs.   6,000,000

*  Cost of External Services                                                                  = Rs.  2,000,000

*  Cost of Ambulances                                                                          = Rs.  10,000,000

*  Contingencies (taken as 5% of above cost)                                      = Rs.   3,600,000

 

*  Total Approximate Estimated Cost                                               = Rs.  75,600,000      

 

6) ANNUAL RECURRING COST;

 

The annual recurring cost is the expense required to meet with the maintenance of building, hospital equipment, furniture etc. that cannot be calculated more accurately at this stage. However an approximately estimated requirement of annual recurring cost for first five years would be as under,

 

       *   First year after construction                             = Nil  (contractor’s liability)

       *   Second year after construction                        = Rs. 1800,000

       *   Third year after construction                           = Rs. 1800,000

       *   Fourth year after construction                         = Rs. 1800,000

       *   Fifth year after construction                            = Rs. 2,500,000

 

The building will have to be maintained properly for a longer service life otherwise the level of serviceability of the building shall keep on deteriorating and ultimately shall result in shorter service life and more recurrent cost.

 

 

7) OPERATION OF THE HOSPITAL BUILDING;

 

 

The proposed hospital as earlier stated in this report shall be a Charity based hospital, as such, the following is proposed;

 

·        The hospital building completed, equipped, and furnished can be donated to the Government of Azad Jammu & Kashmir for operation and bear the future maintenance.

 

·          It is normally seen that procurement of adequate funds for the maintenance of the building is difficult exercise and most inadequate funds are provided considering this to be a low priority requirement, which results in perpetual deferment of important maintenance works in the building.  To lesson the burden of the government and to meet with the balance requirement to ensure sufficiency of funds it is suggested to levy a nominal fee of Rs.  10.00 (Ten only) per patient per visit which will result in generation of estimated additional revenue of around Rs.  540,000.00 per year during first five years.  This additional revenue can help in meeting any shortfall in the funds for maintenance released every year by the government.

 

·        Cost of medicines, Syringes, Bandages etc. shall be met out by the government.

 

 

8)   GENERAL REQUIREMENT OF THE STAFF;

 

 

      Generally the following is proposed to require;

 

 

       *  Doctors (Male)                              04

       *  Doctors (Female)                          02

       *  Nurses   (Female)                          08

       *  Room Boys                                   12

       *  Sweepers                                       04

       *  Other Staff                                    As per requirement

 

 

The above strength may vary with the actual requirement at the time when the hospital is put to operation.

 

 

 

 

9)  PROJECT VIABILITY;

 

The hospital as stated earlier shall be a charity Hospital thus bears very high moral values, which cannot be measured by any Empirical Formula. The building, if regularly maintained, shall last for along time and the people shall reap the benefits of the hospital for years to come?  It will be a boon not only for the present generation, rather, also for the generation to come.  The construction of the hospital, as compared to the direct benefits is justified.  These benefits for the Donor to satisfy his donation are detailed as below;

 

·        Direct benefits to the National Exchequer for the first year of Hospital operation due to Donor` act of Charity;

 

                                   i.         Estimated saving in maintenance cost to be incurred Rs. 360,000 by the Govt. due to proposed registration token fee of Rs. 10.00 per person per visit.

 

                                  ii.         Estimated saving in transportation of serious patients Rs. 740,000 required to be shifted to Mirpur.

 

·        Indirect benefits of the hospital to the residents of Barnala due to Donor’s act of   Charity.

 

                                i.            Construction of hospital shall provide better health and treatment facilities to the residents of Barnala and adjoining areas at their doorsteps.

 

                              ii.            Hospital shall provide efficient treatment to the serious patients / injured from LOC       who otherwise are shifted to Mirpur for treatment thus reducing the risk for their lives.

 

 

                             iii.            Hospital shall ensure efficient and better maternity services, thereby reducing the rate of Infant Mortality and Maternal Mortality.

 

                            iv.            Hospital shall cause awareness amongst the people of the area about family planning and consequently of a better living.

 

 

                              v.            The project shall create jobs for the residents of Tehsil Barnala during construction and after it is put   to operation.

 

                            vi.            It shall help in propagating the Health Education as provision in made for that. (See Art. 4)

 

 

                           vii.            It will be an efficient Vaccination Centre for the children in the area.

 

 

Above mentioned are the major indirect benefits of the hospital that cannot be measured in Financial Terms by any of the Empirical formula, however the cause is of immense moral value.

 

Looking into the Geographical and strategically position of Tehsil Barnala also the constraints of existing RHC to handle serious cases due to inadequate health and treatment facilities, which has been discussed in detail in this report, it is concluded that the proposed Hospital is more viably required as Tehsil Barnala.

 

The construction of the hospital as stated above shall remain viable provided an assurance by the government is given for better hospital goverance timely provision of maintenance, operation and other funds for smooth running of this proposed Charity hospital at Dera, Tehsil Barnala, District. Bhimber, Azad Jammu & Kashmir.

 

 

 

 

 

 

 

Rural & Urban Population Of District Bhimber

Azad Jammu & Kashmir
Year 1981 & 1998 Census

 

 

 

District

Bhimber

1998 Censes

1981

Population

Male

Female

Total

Rural

140264

141117

281381

187666

Urban

8241

7714

15955

7343

Total

148505

148831

297336

195009

    

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TABLE-1 DISTRICT WISE POPULATION BY SEX AND RURUAL / URBAN

 

1998 CENSUS  -AZAD KASHMIR, PAKISTAN.

 

 

 

Area /

District

Households

Male

Female

Both Sexes

1981 Population

1981-1998 Avg.Annual Growth Rate %

 

Azad Kashmir

Rural

363310

1273736

1282734

2556470

1822067

2.01

Urban

51810

189335

169762

359097

161398

4.81

Total

415120

1463071

1452496

2915567

1983465

2.29

District

Muzaffarabad

Rural

89304

318780

306639

625419

419323

2.38

Urban

14988

54071

44930

99001

46780

4.51

Total

104292

372851

351569

724420

466103

2.63

District

Bagh

Rural

50243

187241

185832

373073

275832

1.79

Urban

3032

11374

10596

21970

5275

8.75

Total

53275

198615

196428

395043

281107

2.02

District

Poonch

Rural

48349

177015

174361

351376

265999

1.65

Urban

6915

26213

25165

51378

15763

7.19

Total

55264

203228

199526

402754

281762

202

District

Sundhonti

Rural

28947

95379

105172

200551

160140

1.33

Urban

1976

6996

6824

13820

 

 

Total

30923

102375

111996

214371

160140

1.73

District

Mirpur

Rural

33053

106354

105193

211547

164126

1.50

Urban

16657

58622

53306

111928

70458

2.76

Total

49710

164976

158499

323475

234584

1.91

District

Bhimber

Rural

41571

140264

141117

281381

187666

2.41

Urban

2328

8241

7714

15955

7343

4.67

Total

43899

148505

148831

297336

195009

2.51

District

Kotli

Rural

71843

248703

264420

513123

348981

2.29

Urban

5914

23818

21227

45045

15779

6.36

Total

77757

272521

285647

558168

364760

2.53

 

 

 

  

 

Enter supporting content here