- The Washington Times - Thursday, January 14, 2016

In the wake of the mistaken bombing of a charity hospital in Afghanistan last year, one might think the U.S. government would at least be able to locate its own hospitals in the region. That would be wrong.

To make matters worse, many of the U.S.-funded clinics are falling apart, lacking access to running water, electricity and sanitary waste disposal, according to a new watchdog report.

The U.S. Agency for International Development (USAID) spent nearly $260 million between 2008 and 2015 to build 600 health facilities in 13 Afghan provinces, including 42 in Kabul province.

A new audit conducted by the Special Inspector General for Afghanistan Reconstruction (SIGAR) found that, of 32 Kabul clinics, five did not have running water, three did not have electricity, and eight may not have adequate or consistent power required for proper lighting and to refrigerate certain medications. Staff at six facilities indicated there might be a lack of medical supplies.

“The absence or inconsistency of electricity to refrigerate these basic stocks raises questions about whether USAID funding is indeed reaching these facilities,” John F. Sopko, the special inspector general for Afghanistan reconstruction, wrote in a Jan. 5 letter.



Sixteen of the facilities auditors visited disposed of medical waste in open-air kilns, some of which were publicly accessible.

“This method of unsecured disposal does not adhere to best practices and raises the risk that patients seeking treatment — or children we observed playing outside at several facilities — could be accidentally exposed to contaminated waste,” Mr. Sopko wrote.

In addition, many of the facilities were difficult to locate using official GPS coordinates provided by the U.S. government. Much of the location data USAID provided to SIGAR was useless or extremely limited, according to the report.

Mr. Sopko wrote that “13 of the coordinates were not located within Afghanistan,” while another 13 of the locations were duplicates of other sites; 189 locations did not correspond to any health structures within 400 feet of the geotag. One of the coordinates that USAID provided actually led to a spot in the middle of the Mediterranean Sea, according to the report.

The report has outraged federal spending watchdogs who say it’s the latest example of how Afghanistan has become a virtual money pit, where billions of dollars in American aid produce little to no results.

“The situation at these USAID hospitals is another example of mismanagement on a shocking scale. In nearly every conceivable way, these hospitals failed to meet even the most basic standards,” said Curtis Kalin, a spokesman for the nonpartisan Citizens Against Government Waste.

For spending hundreds of millions of American tax dollars on hospitals that are falling apart and nearly impossible to find, USAID wins this week’s Golden Hammer, a weekly distinction awarded by The Washington Times highlighting examples of wasteful federal spending.

The inaccurate GPS data for the clinics could result in something far worse than wasted money as drones and warplanes frequent the skies over Afghanistan.

In October a U.S. AC-130 gunship mistakenly bombed a Doctors Without Borders hospital in the northern Afghan city of Kunduz, killing 42. U.S. officials claimed they did not know the building was a hospital and had intended to bomb another building nearby where Taliban fighters were launching their operations.

“In the case of mislocated hospitals, the issue goes well beyond tax dollars and boils down to safety,” said Pete Sepp, president of the National Taxpayers Union. “A military operation in those areas could make a tragic mistake. Meanwhile, much of the goodwill that might have been built with the Afghan people evaporates when they discover the medical facilities they were told about can’t keep the lights on.”

 

In its response letter to the report, USAID said it “has helped Afghans receive critical health services over the past decade and is committed to continuing those efforts and “ensures that adequate oversight occurs for all USAID-supported projects.”

The clinics were built in Afghanistan through the Partnership Contracts for Health program, which ended in June 2015. Now the World Bank continues to administer the initiative through the System Enhancement for Health Action in Transition Project.

The World Bank did not immediately respond to a request for comment.

At the time of the clinic inspections, USAID explained that locating health centers by coordinates was not a priority for health care providers in Afghanistan.

“GPS coordinates are not the first line in monitoring a health facility,” said Larry Sampler, an assistant in USAID’s Afghanistan and Pakistan affairs department, in a public statement. “It has been a common practice for Afghan ministries to use the location of a village center as the coordinates for a facility, particularly when there was limited access to GPS technology.”

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