Susila Dharma

International Association
777 Campbell Greenfield Park,
Quebec J4 V1Y8, Canada

Tel 1-450-761-0592
Fax 1-450-761-9797
info@susiladharma.org

www.susiladharma.org

Proposal for 11 new Community Health and Energy Centers - 2014-2017

1. BACKGROUND

From 2010 through 2013, SDIA and the Buchan Family Foundation have collaborated on a number
of projects that bring real and tangible benefits to the people of the DRC, immediately and for
years to come. Perhaps most important among them have been a series of collaborations in the
health sector: first, refurbishments of the Community Health Center (CHC) at Lemba Imbu and the
CEDERI-Madimba Health Center, together improving health infrastructure for 40,000 residents. In
August 2012, it was agreed that SDIA-SDDRC would build another two CHCs at Nkandu III, a semi-
urban center, and Kingantoko in the hills on the border of the Kinshasa and Lower Congo
provinces. Together these two centers will provide quality health services to another 39,000
inhabitants. Buchan family investments in the health sector to date have affected the lives of
around 80,000 people. All these investments have raised the quality of care and improved health
infrastructure in a country with some of the highest levels of mortality and morbidity in the world.

In th three health centers (CEDERI, Lemba Imbu and Nkandu) supported by the Buchan Family
Foundation, in the month of May, 2013 alone:

 142 women received pre-natal care

 475 children, the majority between 0 and 11 months, received care
 87 women delivered their babies in safe and healthy conditions
  214 children were vaccinated
 40 pregnant women were vaccinated

 The Lemba Imbu and Nkandu III health centers are both self-sustaining. The financial
situation at Lemba Imbu, our pilot CHC, is borderline for now, as it functions without any
government contribution. The situation there is expected to improve with the completion
of the maternity ward, currently under construction.

 Nkandu III, serving a semi-urban population of 35,000, is considered sustainable as of its

first month of operation, due to agreements entered into with the local health authorities.

 The CHC at Kingantoko, serving a rural population of 6,000 due to open at the end of June,
benefits from the same agreements with the local health authorities. It is expected to be
self-sustaining within less than a year of operation.

2. LESSONS LEARNED FROM EXPERIENCE TO DATE

SDIA-SD DRC are committed to building local capacity to improve lives through education,
healthcare and sustainable livelihoods. Experiences to date have shown that in all communities
approached there is a great willingness and enthusiasm to create meaningful partnerships
between NGOs, communities and local authorities to improve living conditions. What is most often
lacking are financial resources, but also and most importantly capacities: knowledge, skills,
equipment, tools and organisational models that help groups meet their objectives effectively and
efficiently. The following lessons can be drawn:

1. Local health authorities will contribute: To date, assumptions of the SD sustainable health
care model have proven correct: when approached collaboratively at the outset of a project, local
health authorities are highly receptive and ready to commit what local resources, in the form of
salaries and some medical supplies, to help the CHC achieve sustainability before the 12 month
mark.

2. Local leaders are ready to get involved: It has not been a problem in any setting to find
community leaders ready to take up volunteer roles, either as members of the community health
committees, or even contributing their labour to assist in the center construction.

3. CHC leaders and local health authorities are very interested in the concept of a broader
national network, and eager to help structure and support this work.

4. Our investment in training in the management of Health Mutual Associations is timely, as

the DRC government has been debating a law that will require the introduction of these structures
for all who can afford them. Communities partnering with us, and even those that are not, are
eager to have support and training to show them how to do this.

5. The social and training aspects of the projects have gone remarkably well, and in most cases
coming in within or under budget. The model is valid and worthy of scaling up.

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6. The timeline for the social work, construction, and opening of the center needs to maintain
some flexibility and donors need to be advised that things in the DRC do not work like clockwork,
as they can do in Canada: at several points in the process external events, such as the Summit of
the Francophonie, the death of a local politician, or other external constraints can often impose
setbacks during which normal business activities - meetings, bank transfers, transport, etc. come
to a halt.

7. The Health Center can become a Community Energy Center at very little added cost. SDIA is
working with Canadian NGO Power Africa to look at ways of maximizing the renewable energy
(solar, wind, and small-scale hydro-electric) generated by a CHC that can be shared to form a
community-managed utility. It is proposed that where donors agree, for an added cost of
$12,000, each CHC will be accompanied by Community Learning Center providing evening
tutoring for children, literacy classes for men and women, laptop libraries and a cellphone
charging station that will be community managed and generate income that will go to pay for local
health and educational priorities (see Concept Note in Annex).

8. The most complicated and difficult aspect has been the management of construction of the
infrastructure since:

 To be realistic, a construction project of this nature requires a minimum of four to five

months, to be planned around the seasonal rains. For greatest efficiency, the foundation
work, main structure and roof should go up during the dry season (May-October).

 Once the roof is up other interior and finishing work can be done during the rainy season. A
lesson is not to initiate building during the rainy season because it leads to significant
delays, such as work on the foundations having to be done again and again because rains
wash away the previous work. Although Nkandu was initiated during the right period it
was not early enough. Kingantoko was initiated during the rainiest part of the year. SDIA
has developed a tool and asked SD DRC to compile a meteorological calendar to show how
and to what extent work is affected by seasonal rains, which should assist in future
planning of construction activities.

 Problems in the contracting of the supervising engineer: the engineer contracted at

Nkandu was the same one used at Lemba Imbu, because he had proved himself to be
reliable and able to remain within budget, which is key. However, he severely under
estimated the number of days it would take to build the CHC, and contracted labourers on
a daily basis, rather than at a fixed price. SD DRC had to take back the management of the
labourers, which gave rise to a period of about a month during which the work came to
halt. This initial delay brought us into the heaviest part of the rainy season and led to
subsequent delays. This experience also had repercussions for Kingantoko. It was decided
to find a new contractor for that site, which meant going back to a new bidding process.

 Additional challenges to keeping construction projects on track within a short timeframe:

materials are not always available and prices fluctuate significantly. Sub-contractors who
have committed to a price may delay work waiting for the prices of materials to come back
to lower levels.

3
  There is a tension between giving contracts to local labourers and sub-contractors and
maximizing efficiency. Of course it is good to hire locals so they feel the benefit of the
project and to build a commitment to it. At the same time when there is a shortage of
skilled labour, other workers or machines need to brought in. Initial delays lead to greater
ones when there are difficulties in managing the labour supply - not enough skilled labour
locally or added expenses when these need to come from out of town.

 Items like windows, doors etc. are not standardized but built on site and the availability of
materials and skilled labour can affect their production and time required.

 Contractors, sub-contractors and SD DRC require standardized procedures, management

tools and some better equipment to improve performance and deliver projects on time and
within budget. SDIA has provided a number of management tools, but actual tools and
equipment are necessary as everything now is done by hand and on site (a cement mixer,
for example would speed up work enormously).

3. EXPANDING THE NETWORK WITH 11 NEW COMMUNITY HEALTH AND ENERGY CENTERS
(CHECS) BASED ON LESSONS LEARNED

To support project implementation, SDIA-SDDRC provide training in all aspects associated with
the health, education and agriculture projects in the DRC, including management and
administration. It is now recognised that training and guidance is also needed in the management
of construction projects. We cannot take for granted that NGOs, contractors and sub-contractors
have the capacity to carry out construction projects in a high quality and/or timely manner.

As the Buchan Family's experience now demonstrates, the challenges to the management of such
projects in the DRC are significant. A key contribution to building the capacity of NGOs and their
partners is to train people in the design, planning and management of construction activities. The
skills developed will be transferable, not only affecting future Health Centers, but to schools,
learning centers, agricultural and marketing infrastructure and other construction work needed
by Congolese communities.

It is therefore proposed that the Buchan Family Foundation , Canada Gives and SDIA undertake a
three-year project to construct 11 new Community Health and Energy Centers (CHECs) in
Kinshasa Province, the Bas Congo and Bandundu (see Annex 1 for recommended Health Zones
as per the PNDS) that includes a strong capacity building component covering training,
supervision and equipment. This will support the construction of cost-effective and high quality
centers in line with donor expectations.

3.1 Capacity building in construction management

3.1.1 Training and supervision

SDIA proposes to send a construction expert, Paul Roberge, as an advisor to train SD DRC, other
NGO, project participants, and local contractors in a range of skills, including:

 Establishing guidelines for architectural and engineering drawings

4|Page
  Preparing 'General Conditions' and calls for proposals
 Preparing bidding documents and process
 Administration of contracts and payment schedule
 Planning and managing the construction calendar
 Contingency planning
 Standardized construction methods
 Use of mechanisation to improve performance (tractors, brick-making machine, etc.)
 Purchasing, lists of suppliers and trades
 Evaluation report and list of deficiencies

This training will take place during two visits in the second half of 2013 (August-September and
November-December), as well as during a six month (180 day) period when the advisor will
supervise and bring to completion the first three builds.

In August, the advisor's role will also be to hire and train two staff members to form a construction
team: one "representant du maitre d'ouvrage" and one construction project manager who will be
supported by an administrative assistant in the SD DRC office, and accompany them through the
first three projects in building techniques, procedures and the use of mechanised equipment. It is
expected that during this period, sufficient knowledge will be transferred to ensure the capacity
of SD DRC and local contractors to achieve quality standards within the agreed upon timeframe.

In April, a trainer from Hydraform will accompany the local construction, contractors and
community members in the use and maintenance of the Hydraform block making machine for a
total cost of $6500 USD.

The total cost of this international advisor's role, including travel, accomodation, salary and
expenses is $137,570 (see Annex 2)

3.1.2 Building equipment and a standardized design enhance quality and timeliness of
delivery

In order to strengthen performance in the construction field, some key equipment is needed,
including:

 a Hydraform block maker, which will greatly improve the quality and ease of builds, using
less cement and more local materials. Stackable, inter-locking blocks (no mortar) can be
assembled by anyone in the community, with proper supervision. Production is faster than
with traditional cement or bricks. They are more durable and provide better insulation.
These are structural blocks that can, in most cases, replace columns. ($53,000 USD)

 a cement mixer: to create a good, consistent quality of cement much faster than manually
($1500)

 a compactor: to compress stones for the foundation ($1500)

5
  a compressor: to operate machines like a nailing machine to building ceilings and assembly
of doors and windows ($600)

 a generator: 6 kw diesel-operated generator to power all electrical devices that can be

moved from site, based on work phases. Allows work at night when necessary ($2000)

 an 8 cylinder vehicle with a hitch is needed to pull the hydraform block maker and
transport all other equipment from site to site, where local labourers and community
volunteers will be engaged in block making for the CHECs ($35,000 USD)

The total estimated cost mechanised equipment is $96,278 USD (see Annex 3).

3.2.1 A three-year cycle of 11 CHEC builds

It is proposed that between 2014 and project completion in 2017, 11 new CHECs be built: 3 in
Year 1, 4 in Year 2 and 4 in Year 3. The communities will be identified following the same
approach and criteria as in past builds:

1. Need - in terms of current access to health services and infrastructure (national

standards being 10,000 in urban areas and 5,000 in rural areas - within a radius of 8
kilometres - without a health center with appropriate infrastructure, equipment, services
and personnel).

2. Sustainability: Finding an overall financial balance between services to high population

density areas and underserved rural areas.

3. Partnerships: willingness of both health authorities and community to enter into

appropriate Memoranda of Understanding (MOUs)

4. Logistics: Availability of appropriate land on which to build and construction capacity

(preferably donated by the community).

A key reference in this regard, although not the only one, is the Plan National de Développement
Sanitaire (PNDS) - 2011-2015, which specifies those Health Zones favoured for development,
based on current levels of population growth. The table below shows the existing discrepancy
between Planned Health Areas (column 3) and those with health centers with appropriate
infrastructure, equipment, services and personnel.

6|Page
Based on experience to date, SDIA-SD DRC have come up with a standardized design, adaptable to
different locations, that will facilitate future builds. This concept consists of two structures: 1) the
Community Health Center (CHC), and 2) an optional Community Learning Center (CLC). The
Community Learning Center is a low-cost structure that would benefit from electricity generated
by the CHC to provide a number of services needed by the community: it is a multi-purpose
classroom/community space that will offer evening tutoring, literacy classes, a computerised
"resource center", a cell-phone charging station and other services that will be managed by and
with local teachers and volunteers. It is anticipated that the cell-phone charging station will
generate additional resources that can be put to priority health and educational needs determined
by community representatives. (see SDIA-Power Africa concept Note in Annex 6).

The total cost of the CHEC Pilot Project is $39,900.

7
Graphic 1. Standardized design of a Community Health and Energy Center (CHEC)

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Year 1 (2014): It is considered that three new builds be carried out in the Bas Congo, with some
of the following sites identified as possibilities:

 HZ - Kisantu, Health Area of Kintanu II (17,323 inhabitants)

 HZ - Ngidinga, Health Area of Kinyengo (19,377 inhabitants in 12 villages)

 HZ - Kwilu Ngongo, Health Area Kwilu Ngongo ( 140,971 inhabitants)

For the schedule of implementation of Year 1, see Annex 5: PROVISIONAL PLANNING

Year 2 (2015) : Builds have not been confirmed, but will likely extend to Kinshasa and Bandundu
Provinces

Year 3 (2016): Builds have not been confirmed, but will include the Bas Congo, Kinshasa,
Bandundu Provinces and possibly other provinces.

Year 4 (2017): External Evaluation

For detailed estimate of construction costs per build, see Annex 4 below.

9
The cost of each CHC is estimated as follows, but may vary according to several factors:
ITEM BUDGET REAL DIFFERENCE REVISED COMMENTS
NKANDU NKANDU

Preliminary studies and 450 $ 450 $ 0$ 500

establishment of partnership
with HZ
Purchase of land, as needed 4,500 $ 4,500 $ 0$ 7000 More land required for the
drawing as proposed
Acquire title to property 1,000 $ 490 $ 510 $ 800
Community information and 3,650 $ 2,532 $ 1,118 $ 2700
engagement
Organisation and training of 1,000 $ 1,645 $ (645 $) 2000
COSA + signing of the MOU
with community leadership
Construction of 99,500 $ 150,873 $ (51,373 $) 163,500 This design is 100 m2 more
infrastructure than previous design
Recruitment and training of 2,000 $ 1,950 $ 50 $ 2000
medical and administrative
staff
Training of the COGES 1,500 $ 0$ 1,500 $ 1000
Medical and laboratory 22,900 $ 18,232 $ 4,668 $ 20,000
equipment
Furniture (tables, benches, 6,000 $ 4,075 $ 1,925 $ 5000
chairs, shelves, cupboards)
Medicines and lab supplies 10,970 $ 1,796 $ 9,174 $ 10,000 For 12 month operating
period
Clearning products and 850 $ 348 $ 502 $ 1000 For 12 month operating
equipment period
Supply and installation of 12,400 $ 1,780 $ 10,620 $ 15,500 Experience shows we need
solar panels more power - Nkandu will be
connected to the grid

Backup generator 1,500 $ 2,890 $ (1,390 $) 3000

Computer equipment and 1,650 $ 1,870 $ (220 $) 2000
supplies
Salaries for 12 months 18,900 $ 0$ 18,900 $ 15,000 For 12 month operating
period
Feasibility study and training 2,200 $ 2,170 $ 30 $ 7,000 Experience at Lemba Imbu
of health mutual association shows training process is
more expensive than budgeted
Opening Ceremony 1,200 $ 1,713 $ (513 $) 1500
Monitoring and supervision 6,000 $ 4,796 $ 1,204 $ 5000
in the field
Unforeseen expenses 8,000 $ 8,000 $ 0$ 8000
Management and 20,817 $ 20,817 $ 0$ 27000
administration
TOTAL 228,987 $ 230,928 $ (1,941 $) $299500
IF THE CLC IS INCLUDED $12,000 Materials only, built by the
community
TOTAL $311500
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4. MEASURABLE RESULTS AND THEIR INDICATORS

4.1 Expected long-term results (10 years +)

 Residents in 11 target communities in the DRC are benefitting from improved quality and
accessibility of health care
 Target populations are able to access a Network of Community Health Centers (CHCs) and
their health mutual associations exist for the purpose of shared learning, improving skills,
joint advocacy and building a national movement for access to affordable, primary health
care in the DRC
 Communities are developing and managing their own power utilities and learning centers
to meet health and learning objectives

Indicators of success:
 70% of the inhabitants of the health area are able to access quality healthcare at a
cost they can afford.
 % Reduction in maternal and child mortality in the areas served by the CHCs
 % Reduction in recurrent cases of malaria and other preventable diseases in the
areas served by the CHCs
 50% Coverage in Health Mutual Association of the CHCs in target communities
 Operating costs, including those of community outreach activities and health
promotion, are covered by revenues
 15 CHCs and HMAs are operating as an effective network and advocacy group
 Learning and energy priorities are defined and met

4.2 Expected medium-term results (5-10 years)

 11 new CHCs are implementing and improving on medical and administrative protocols
introduced
 11 new CS COMs are financially self-sustaining, meeting their operating costs
 Community Representatives and Health Authorities are participating in the management
of health services.
 Local families are saving for healthcare needs through Health Mutual Association.
 In centers where it is viable, Health Mutual Associations exist and are being well managed
and administered according to established protocols.
 Annual Network Meetings lead to identification and dissemination of improved practices
 Community Power Utilities and Learning Centers are implementing their strategic plans

Indicators of success:
 Monitoring missions show CHCs meet and exceed national administrative,
management and medical standards
 3 annual network and training meetings have taken place
 # of CHC Health Committees attracting active community participation, developing
and implementing health strategies within the communities
 30% Coverage in Health Mutual Association of the CHCs in target communities
11
  Monitoring missions show Health Mutuals are operating transparently and
accountably towards members and CHC
 # and effectiveness of Annual Network Meetings
 CPUs and CLCs are implementing their strategic plans

3.3 Expected short-term results (3 years)

 11 new CHCs have been built and are operating in manner that meet or exceed national
norms
 11 new CHCs are co-managed by a trained and elected community Board, health authorities
and SD DRC
 11 new CHCs are financially viable and autonomous after one year.
 Feasibility studies have been carried out for the establishment of HMAs
 All medical staff of the CHCs are trained to the care of the sick people according to well-
defined protocols.
 Established MOUs are being implemented and adjusted as needed
 The follow-up and supervision of 11 new CHCs is done by SD DRC and the Chief Medical
Doctor of the Health Area
 11 new CHCs have met in Network Meetings to share lessons learned and good practices.
 11 Community Power Utilities and Learning Centers have been organised and have
developed their strategic plans

Indicators of success:
 # of CHCs that exist with infrastructure that meets or exceeds government norms
 # of new CHCs with by-laws that reflect the principles of community-co-
managements with sound contribution from government health sector
 # of Health Mutual feasibility studies which have been carried out, followed by
appropriate training

 # of CHCs with staff and management trained in appropriate health protocols, management
and administration
 # of CHCs implementing all health, management and administrative protocols
 Network meeting have been organised and carried out
 Community Utilities have been established
 Community Learning Centers have established their strategic plans and are offering
needed educational services

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5. OVERALL BUDGET OVER 3-4 YEARS

OVERALL
BUDGET
CHEC Pilot Project 39,900
Capacity Building - Construction Supervisor and Trainers 137,570
Capacity Building - Equipment and 96,278
Transport
Sub-total 273,748

Development of 11 new CHECS $311,500 (11) 3,426,500

TOTAL COST $3,700,248

13
Annex 1. POTENTIAL AREAS FOR COVERAGE IN NEXT 10 BUILDS, BASED MAINLY ON PNDS

KASAI KASAI PROVINCE

BANDUNDU BAS-CONGO EQUATEUR OCCIDENTAL ORIENTAL KATANGA KINSHASA MANIEMA NORD KIVU SUD KIVU ORIENTALE
BOMA ou BIYELA BAGIRA
BAGATA BONDE BOLENGE BILOMBA BIPEMBA ANKORO (Nandora) KAILO BENI KASHA ABA
KIMPANGU
BANDUNDU (Kuilungongo) BOENDE BUNKONDE BONZOLA BAKA KIKIMI KALIMA BIENA IBANDA ADI
KIMBANSEKE
BOKORO KIMPESE TANDALA DEMBA CITENGE DILALA (Yenge) KAMPENE BINZA IDJWI AKETI
KISANTU
BOLOBO (Kintanu) GBADOLITE DIBAYA DIBINDI DILOLO KINTAMBO KASONGO BUTEMBO KABARE ARIWARA
BULUNGU KITONA KARAWA ILEBO DIKUNGU KABALO KISENSO KIBOMBO GOMA KADUTU ARU
FESHI LUKULA BUDJALA KAKENGE KABEYA K KAFAKUMBA MASINA I KINDU KARISIMBI KALEHE BAFWASENDE
KALONDA
GUNGU MATADI BOMONGO OUEST KABINDA KALAMBA MATETE KUNDA KAYNA KAMITUGA BANALIA
MBANZA NDJILI
IDIOFA NGUNGU BOLOMBA KANANGA KALENDA KAMALONDO (Brasserie) LUBUTU KIROTSHE KATANA BASOKO
NGIDINGA
(Kimvumu - MITI
INONGO rural) YAMBUKU LUEBO KANSELE KAMBOVE NGABA LUSANGI KYONDO MURHESA BENGAMISA
KAHEMBA NSELO BOKUNGU LUIZA KASANSA KANZENZE NSELE PUNIA LUBERO MUBUMBANO BILI
KASONGO
LUNDA BOSONDJO LUKONGA KATAKO KAPANGA MANGUREDJIPA NYANGEZI BONDO
KENGE MONKOTO MASUIKA LODJA KAPOLOWE MASEREKA RUZIZI BUNIA
KIKWIT MONT SHABUNDA
NORD INGENDE MIKALAYI LUBAO KASAJI NGAFULA MASISI CENTRE BUTA
KIRI BEFALE MUETSHI LUDIMBI LUK KENYA MUSIENENE UVIRA ISANGI
MOKALA BINGA MUTOTO LUPUTA KIKULA MUTWANGA WALUNGU ISIRO
MOSANGO WANGATA MWEKA MAKOTA KONGOLO MWESO KABONDO
MUSHIE LISALA NDEKESHA MUENE DITU MANIKA OICHA LOGO
OSHWE LUKOLELA NYANGA MULUMBA MANONO
POPOKABAKA
Annex 2. Capacity Building Budget 1: Construction Supervisor and Trainer(s)

UNIT
QTY Construction Supervisor and Trainer - August 2013-September 2014 PRICE AMOUNT
1 CB trip to the DRC August 10-September 7, 2013 7500 7500
1 CB trip to the DRC November-December 2013 7500 7500
6 Furnished apartment 2500.00 April - September 2500.00 15000.00
24 Expenses (food, malaria medication, bottled water) 600.00 14400.00
24 Salary - 6 months 2000.00 48000.00
24 driver and household help 200.00 4800.00
1 Return trip to DRC - Family of three - April-September (179 days) 15000.00 15000.00
Hydraforma Trainer for the month of April 6500.00
3 Health Insurance 2000.00 2000.00
Management and administration 16870.00
SUB-TOTAL 137570.00

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Annex 3. Capacity Building Budget 2: Construction Equipment and transport

QTY CONSTRUCTION EQUIPMENT AND TRANSPORT UNIT PRICE AMOUNT

1 Compacteur sauteur a essence 11" compaction 3200/145lbs 1200.00 1200.00
1 Compresseur 4.2 pcm prevoir achat 600.00 600.00
1 Cloueuse de finition 150.00 150.00
1 Cloueuse a charpente clou de 2-a 3-1/2" 225.00 225.00
1 Generatrice 6 kw reservoir 4.5 poid 145 lbs .8 gallons heures 2000.00 2000.00
Pelle sur chenille moteur 52 hp force de levage 6milles lbs 0.00
Transit
2 electronique 450.00 900.00
1 Betonniere a essence 6 pied cube 1500.00 1500.00

Coupeur de bloc Inclue 0.00

tester de bloc Inclue 0.00
6 Bache de recouvrement 30' par 50' 100.00 600.00
1 Drill a percution Bosch model ds 300.00 300.00
1 Scie a onglet 650 650.00
1 Machine a bloc Hydroforme F.O.B. Matadi and by land to Kinshasa 53000.00 53000.00
10 Bidon d'essence20 litre 15.00 150.00
0.00
1 Camion/Vehicule de transport 35,000.00 35000.00
3.00
0.00
0.00
0.00
SUBTOTAL 96278.00

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Annex 4. ESTIMATED CONSTRUCTION COSTS PER CHC

QTY Construction Amount AMOUNT

1 Frais Generaux Supervision+ transport 10500.00 10500.00
1 Maind'oeuvre 17500.00 17500.00
1 Excavation remblayage site et batiment 500.00 500.00
1 Amengement du site: Fausse septique +placenta = pit perdue 8600.00 8600.00
1 Incinerateur et Ba a lessive
1 Betonnage Semelle fondation 19112.00 19112.00
1 Collonne Arme 30 et ceinturage "Linteaux" prix Forfaitaire 8800.00 8800.00
1 Maconnerie 44124 mille Bloc Hydroforme .32 unitee 14119.68 14119.68
1 Enduit Mortier 3143.84 3143.84
1 Charpenterie menuiserie Soffit et plafonnage 4100.00 4100.00
1 Coffrage 3132.00 3132.00
1 toiture metal corriguer voir plan pour detail 9458.00 9458.00
1 Porte cadre et fenestration en bois incluant quincallerie 17525.00 17525.00
1 Vitrage 5mm Nacko, mousticaire et grille d'aeration 3940.00 3940.00
1 Finition mur Faience 7393.00 7393.00
1 Finition revetement sol ceramique 9095.00 9095.00
1 Peinture vernie mur int., Ext, porte cadre plafond et toiture 2480.00 2480.00
1 Finition Plafond Triplex inclue suspention et moulure de conourt 8003.60 8003.60
1 Plomberie incluant appareil pour Latrine et Douche telque plan 3500 3500.00
total 110
1 Goutiere metre 750 750.00
1 Electriciter Travaux et accessoire GROUPE ELECTROGENE N/I 3850 3850.00
1 Amenagement paysager et cloture communautaires 8000 8000.00
ST
TL 165,502.12

17
Annex 5. PROVISIONAL PLANNING YEAR 1 - 3 NEW CHECs - 2013-2014
n° Activities Responsible JL AU SE OC NO DE JA FE MA AP MA JN JL AU SP OC NO DE

1 Sign agreement BFF-CG- Tina,Gilles,

SDIA Denise, Virginia
2 Prepare backgrounder on SDIA- SD DRC
cycle of potential sites
(locations, population size,
existing access, etc.)

3 Pilot CHEC visit with Power Power Africa-

Africa to Kingantoko SDIA-SD DRC
4 Discussions with HZs and SDIA-SD DRC
CLs and do selection of first
3 sites
5 Sign MOUs with HZ and visit SD DRC
potential sites

6 Interview and hire 1 rep, 1 SDIA (Paul) and

project manager and SD DRC
shared secretary

7 Training in Construction Trainees and Paul

Manual
8 Purchase all mechanical SDIA-SD DRC
equipment and transport (Paul and team)

9 Sensitize the community SD DRC medical

(community relays and team
leaders) and create and
train the COSA
1 Sign MOU with the COSA COSA, SD DRC
0

1 Acquire title to lands SD DRC

1

1 Adapt existing Engineer, SDDRC

2 architectural drawings and SDIA

1 Identify contractors and Paul and

3 suppliers (December) construction team

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 - December

1 Prepare all tending Paul and const

4 documents (December) team-December

1 Go to tender and hire 3 Paul,

5 contractors construction
team

1 Launch construction of 3 Paul, construction

6 sites (see Construction team, and
Schedule for details) contractors

1 Begin discussions 4 HZs for SD DRC

7 Year 2 and start cycle again

1 Recruit and train health SD DRC medical

8 care and administrative team and HZ
team
1 Train the COGES SD DRC medical
9 (management committee) team
2 Involve COGES in SD DRC Medical
0 procurement of furniture, team, CGS and
medical equip, solar panels COSA

2 Purchase medicines SD DRC Medical

1 team and COGES
2 Open Center 1, 2 and 3 All partners
2
2 Begin feasibility and SD DRC Health
3 training of HMA Mutual Team

2 Monitor and supervise the SD DRC medical

4 functioning of the centers team and HZ
(monthly)
2 Implement training plan SD DRC medical
5 (every three months) team

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Annex 6. Concept Note: CHEC

Piloting a Community Health and Energy Center in the DRC

1. Who we are

SDIA is an international association and US-registered not-for-profit (501c3) whose mission is to relieve human suffering and
promote just and sustainable development through: partnerships and support for grassroots, participatory development;
empowering individuals and communities to engage in positive human, social and economic change; and raising awareness of global
issues and inter-dependence. SDIA and its national chapter, SD DRC, have been instrumental in adapting and piloting and adapting
the CSCOM (Community Health Center) model in the DRC based on the recommendations of the Bamako Initiative to improve quality
and accessibility of health care on the African continent. SD DRC currently operates the first three CSCOMs in the DRC, on the basis of
a three-way partnership between community, local health authorities and the NGO.

Power Africa is a new not-for-profit corporation whose vision is to facilitate the establishment of affordable & reliable energy
solution and micro grid infrastructure for communities in sub-Saharan Africa. Power Africa is aiming to pilot one or more projects in
a Sub-Saharan community to model accessible, sustainable energy usage for people severely lacking that access. Power Africa has
considerable expertise with renewable energy technologies including fuel cells, solar photovoltaic system, inverters, “energy storage”
and small scale wind, geothermal and biomass systems.

Together, SDIA and Power Africa are seeking to pilot the first Community Health and Energy Center in the DRC, which addresses two
core and inter-related needs facing communities in the DRC: access to quality, sustainable healthcare services that are accountable to
the community served, and access to electricity needed both to operate these services and meet a range of other energy needs of rural
and semi-urban off-the-grid communities.
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2. The problems and solutions

The Democratic Republic of Congo’s (DRC) health indicators are among the worst in the world and reflect the hardships resulting
from many years of civil war, continuing conflict in some regions, high levels of government corruption and the deterioration of
health services throughout the country. Malaria, tuberculosis and HIV/AIDS take a high toll on both human and economic resources.
One out of six children dies before their fifth birthday and chronic malnutrition affects both educational performance and individual
productivity. The synergistic effects of malnutrition and disease currently shape the lives of most young children in the DRC.

Since 2008, SDIA/SD DRC have been working with communities to improve the situation and create sustainable, quality, accessible
care. One solution is the CSCOM or Community Health Center (CHC): in partnership with local health authorities, community and
NGOs operate their own health centers and health mutual associations to reduce healthcare costs, enhance accountability of the state
to the community, and improve disease prevention in both the rural and urban areas. A critical challenge encountered on this road
has been the cost and logistical problems associated with electrification of CHCs, as the DRC national electrical grid capacity is far too
small, difficult to access, and with poor quality infrastructure even to meet the needs of the country's capital, Kinshasa, let alone
smaller centers and rural areas. As a result access to energy is one of the biggest challenges facing communities in the DRC.

Electrification is increasingly central to providing life-saving healthcare: without sufficient energy, medicines and vaccines cannot be
kept cold, equipment cannot be kept sterile, one cannot operate a cellular phone to make emergency calls or a computer/modem to
access information from the outside world. More sophisticated diagnostic equipment, such as x-ray and ultrasound machines require
a significant amount of stable electrical current. Indeed, the access to a stable, substantial power supply has become a precondition
for providing quality medical care, and yet most communities in the DRC do not have access to it.

Beyond the health centre, communities also need access to electricity for basic things like the ability to charge a cell phone or use
other equipment. In the rural DRC, having access to a cell phone can itself be considered essential for safety and security of the
person.

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3. Objectives of the Community Energy Center Pilot Project

Together SDIA-SD DRC and Power Africa envisage that with the ability to generate sufficient electricity, a Community Health Centre
can become a Community Energy Centre, with the ability to serve multiple needs of the community and generate income for priority
community projects. The objectives of the Community Energy Center (CEC) pilot project are:

 Generate sufficient electricity to provide lighting, ventilation, refrigeration, communications and basic sterilisation and
diagnostic equipment to the CHC, as well as a surplus of energy to meet other community needs.
 Test an approach to bringing an affordable, sustainable power supply to communities in the DRC and to allow them to
use their energy supply to meet agreed health, educational and other priorities;
 Empower the communities served by CHC at Kingantoko to maintain and manage their own energy supply, create
appropriate management structures and set common priorities for energy use.
 Develop income generating activities (such as a charging station where community members can recharge cell phones,
battery operated lamps and other devices) as a basis for agreed upon priority needs such as improving community
health coverage and education among vulnerable groups;
 Create educational spaces that will allow for evening tutoring and literacy classes for women and children or other
educational needs as prioritised by the community.
 Assess approaches to scalability

4. Pilot Site: Community Health and Energy Centre at CSCOM Kingantoko

With funding from the Buchan Family Foundation, in 2012 SDIA-SD DRC undertook the construction of a CHC at Kingantoko,
approximately one hour's drive outside of Kinshasa on the road to Inkisi. The community served by the CSCOM is approximately
5000, scattered in 12 surrounding rural villages. As a pilot site, Kingantoko is ideal because:
 It is close enough to the city of Kinshasa to be easy to get to and visit, and yet it faces the same problems that any rural
community in the DRC does: access to electricity is non-existent except for a few who can afford their own generators, and due
to the rugged terrain, the cost of connection to the national electrical grid will be prohibitive for many years to come.
 The 12 participating communities are already mobilised and working with SD DRC to develop their CHC. Engaging them in a
complimentary process to learn about and take responsibility for the installation and maintenance of a power supply will build
on the community dynamic already initiated in the health sector.
 Because the site is centrally located, SDIA and Power Africa can learn what needs to be learnt from the experience at a limited
cost in time and resources.
 The benefits of electrification can allow additional benefits in education and literacy by opening up the opportunity for night
classes and tutoring for children and adults.
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5. Relationship between Community, SD and Power Africa

SDIA-SDDRC, Power Africa and the community operate in partnership for the realisation of this pilot project. The efforts to
operationalise the center will be shared by all parties. The community, through its designated representatives, will be helped to take
ownership of the process at every step along the way. Power Africa and SD will, however, have authority in the selection of project
staff, engineers and suppliers to the project and the management of project designated funds.

6. Methodology

Step 1: Validation of the Pilot Project Site at Kingantoko and national norms and legislation:
The criteria for site selection are the following: 1) populations under 10,000; 2) located in the DRC; and 3) whose various levels of
government allow for communities to own and operate their own Community Energy projects independent of government
interference. It will be SD DRC's role to confirm the government regulations on the installation and use of equipment for the
generation of electricity prior to establishing a meeting with a community.

Step 2. Joint Visit-SDIA/SD DRC and Power Africa

The purpose of the joint visit is for Power Africa to see and understand the context of working in the DRC and the approach of SDIA-
SD DRC to the development of the CHCs overall and community empowerment, as well as to begin to train an SD DRC team member
or energy analyst who will become the main liaison between SDIA-SD DRC and Power Africa on all technical matters related to the
pilot project and future joint initiatives. The joint visit will include:
 Meetings between Power Africa and SDIA-SD DRC teams
 Overview of the project and the communities involved including existing community institutions, structures and community
health committee
 Visit to the CHC Kingantoko site, meeting with village representatives
 Carrying out of a feasibility study with recommendations
 Agreement between SDIA-SDDRC and Power Africa on a community energy program, best energy options and next steps, "who
does what"
 Determination of the cost of a Feasibility Assessment

Step 3. Initial Presentation/Proposal to the Community

This would, if possible, happen during the joint visit, or if not possible, afterwards. The purpose of this stage is to introduce the
community to the concept of the Energy program proposed by Power Africa and SD; and to get the community to sign the Letter of
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Direction. The Letter of Direction does not obligate the Community to take any action with Power Africa/SD. It simply directs Power
Africa/SD to prepare a proposal for the community and directs Power Africa/SD to apply for grants on the Community’s behalf.

Step 4. Funding for Feasibility Assessment

Once Power Africa and SD have determined the cost of the feasibility analysis, it applies on behalf of the community to acquire grants
to cover the cost of these feasibility studies. This process could take several weeks or longer. The feasibility study will be a carried out
by a designated SD DRC energy analyst with additional outside technical support as needed.

Step 5. Pre-funding Analysis

The SD DRC energy analyst appointed by Power Africa/SD will visit the Community to complete an analysis of the energy needs for
the Community Energy Center project. Power Africa/SD may wish to accompany the analyst. Once the information has been gathered
it is sent to a electrical/ construction firm to design a solution for the community. Once the solution has been designed and supply
pricing confirmed then Power Africa completes the rest of the Planning Sheet.

Step 6. Presenting the Proposed Design to the Community

At this point, the proposed design of the Community Energy Center (CHC) is presented to the community to get agreement to take the
next steps for moving the project forward. Assuming the community likes the proposed solutions then the community
representatives need to sign the Letter of Interest. The purpose is to confirm to financial organizations that this Community is
interested in establishing a Community Energy project and may require funding.
Unlike the Letter of Direction this Letter shows commitment to the Power Africa program and its suppliers. This letter also gives
authority to Power Africa/SD to apply on the community’s behalf for all necessary financing to fund the construction and
commissioning of this project.

For the community to be part of the ownership and management of its own power system or utility it will have to set up some form of
business structure. SDIA-SD DRC will explore with the community the appropriate types and options for a business structure and will
seek an agreement with the community as to which structure is preferable, and support the establishment of this structure before any
funding will be applied for. Power Africa/SD will need to discuss various organisational alternatives with the community.

Step 7. Formation of Community Energy Cooperative (CEC) or other relevant community structure
SD DRC will facilitate the setting up of the business structure by the community. Power Africa and SD will need to be closely involved
to help the Community through this process.

Step 8. Funding Application

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Power Africa applies for the required funding for the purchase/acquisition and transportation of all equipment, cables, etc for the
realisation of the project. Once the funding has been approved it will be released either to SDIA-SD DRC or Power Africa to be
managed on behalf of the community.

Step 9. Project Installation

The entire project is built at this stage

Step. 10 Training

The CEC or other appropriate body needs to be trained in the operation and maintenance of its electricity-generating equipment and
the management of its utility. Power Africa and SD will arrange for both technical and management trainers.

Step 11. Monitoring and Evaluation

Power Africa/SD will review what has worked and not worked in the pilot project. Have the project objectives been achieved? What
could be done differently or better?
Particular attention will be paid to the following indicators:
1. Community ownership and appropriation:
Has the community been able to identify and create a business model to define priorities and manage and maintain the power supply?
2. Quality of technical solutions: Amount of power generated - have needs of the CHC been met or surpassed? How much surplus
power is generated? Are technical solutions cost effective and durable?
3. Income Generation and Community Needs met: Has it been possible to generate income from surplus power - why or why not?
How have the funds been used? How many health, educational or other projects have been realised with income generated from the
CEC?
4. Identify and assess challenges to scaling up to other CHC/CECs.

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7. Budget

The following budget is needed for the realisation of the pilot project:
Project activity Implemented by Estimated Cost

1. Validation of Pilot Site and government SDIA-SDDRC - staff time, travel and $1000 (travel to site and visit to government offices in
norms/regulations communications Kinshasa, write ups)

2. Joint SDIA-Power Africa visit to the DRC SDIA-Power Africa $9000 - including international travel, hotel and local
transport for 3 persons, local transport costs

3. Technical and organizational feasibility SD DRC-Power Africa $2000 in salary and transport costs
study
120 hours of work on and off site, travel
back and forth to site

4. Community mobilisation, training and SD DRC-Power Africa 12 months to $6000 in local staff time
support establish community commitment, explore
appropriate organisational structures and $2000 in local transport costs
support the achievement of objectives

5. Training of Energy Analyst and the Power Africa and local EPC, 2- 3 months of $4000
community in maintenance and use of training and technical support
power supply

6. Construction and electrification of one SD DRC to provide materials and local $12,000
multi-purposes community learning space community will contribute labour
for evening, night-time use

6. Project monitoring and evaluation SDIA-SDRC-Power Africa In kind contribution

7. Management and administration SDIA-SD DRC-Power Africa $3900

TOTAL Pilot project cost $39,900

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