Multi-Sectoral Humanitarian Response Targeting IDPs, Returnees and Host Communities in Districts of Khakriz and Shorabak (Kandahar) and Maidan and Gardiz (Paktia), Afghanistan.

The whole infrastructure will have 10-12 small rooms (including two separate rooms for CHS and meetings/gathering outside the main infrastructure for healthcare service delivery) organized on a single floor and the main part of the health facility establishment work will be the installation of metallic Conex containers for service delivery rooms, waiting areas, along with two separate washrooms. An incinerator made with bricks & cement, a deep well for water supply with a reservoir, solar power supply system and a boundary wall will also be a part of the establishment. Each health facility will cover a land of about 1600-2000 m2 depending on local context and will be protected by a boundary wall (160-180 meters long, 2.5-3 meter high and 25-30 centimeters wide) constructed using bricks, stone, sand and cement with a metallic gate of 3x2 meters. For installation of Conex containers as main infrastructure of the health facility, 240-260 square meters of land will be paved with 10 centimeters thick concrete layer of standard quality. Each Conex containers will of a standard size (40x8x9.5 cubic feet) with all accessories and fitting of electric system. All containers will be made ready for installation in the selected site with completion of related construction works, fitting of electricity supply system, steel framing/support works for ceilings and walls, and complete roof system. Each health facility will be powered by a 10 KW standard solar power system. The exact components may vary per location, but there would be around 36 solar panels of 300 watts, 24 green power batteries of 100 Ah-12 V, 3 fully automatic by grid inverter of 5 KW/48V and electric cables, conduits with frames and will be carefully designed and fitted to avoid any potential risk of damage to working environment, staff or clients.

Each health facility will have a deep bore well of 14 inches size that will be dug in a corner of the health facility with at least 25-30 meters away from septic well/latrine and healthcare waste unit/incinerator with an average depth of 70-100 meters depending on local ground water table and will be connected to a 2,000-liter tank/reservoir for regular water supply. Shallow wells for rain & snow water injection into ground according to government/local authorities' recommendation will also be dug in each HF. A standard incinerator will be constructed and installed in each health facility with a 25–30-meters distance from water source and away from the main building (in a safe corner) considering recommended design/criteria and standards of ministry of public health and WHO health facility design. A septic well for drainage of health facility washrooms will be constructed considering WHO guidelines and ministry of public health safe environmental standards. Pits for organic healthcare wastes disposal will also be constructed with necessary safety measures and mitigation activities, for example, all pits & septic well will be located at 25-30 meters from water source and depth of these pits will be at least 3 meter above ground water table. Additional measures will be in place for further safety and security/protection like installation of metallic fences and avoiding access of clients/visitors to this area.

The environmental assessment report reveals that there are no specific permits required from NEPA (National Environmental Protection Agency) which is the concerned authority in country dealing with environmental compliance. All other written agreements/approvals that are needed for new health facility establishment/construction by Ministry of Public Health and for land acquisition have been acquired in advance.

The project will be implemented in rural areas of Shorabak and Khakriz districts that lay in a semi-arid region with dry, desert-like landscapes where summers are extremely hot (temperatures often exceeding 40°C), and winters are mild (temperatures averaging 10°C during the day and 0°C at night). Maidan and Gardiz, on the other hand experience harsh winters and heavy snowfall, and blizzards.