PROJECTCONCEPT FORMAT
ERD Reference Number
(for ERD use only)
Concept ID
(for ERD use only)
Previous Concept ID (if any)
(for ERD use only)
Please refer “Project Concept Format Filling Guidelines” before continue.
01. Project Information
1.1) Concept Date:01.06.2008
1.2) Project Title: Construction of Trauma Care Unit and Surgical Ward with Operating Theater
Complex
1.3) Thematic Area:
Human Resources Development, Capacity Building
and Institutional Strengthening.
1.4) Total Project Cost in LKR (mn): 150 million
1.5) Proposed Duration of the Project:
(a) Unit - 18 months
(b) Duration - January 2009 to June 2010
1.6) Sector & Sub sector:
Main Sector
Sub Sector
Health, Nutrition and Social
Protection
Health Care
1.7) Type of the Proposal:
i. Project Type Assistance
Goods, Services and Equipment Supply
√ Facilities Construction
Both
ii. Feasibility study
Pre-feasibility / Basic Study
√ Feasibility
iii.Technical Assistance
√ Master Plan for Development
Training and Human Resources Development
Project Development
02. Applicant’s Information
(Consist of brief introduction of the agency that creates and owns the project concept / forwarding ministry/Provincial Councils / Stand alone organizations covering Organizational and personnel details)
2.1) Host Country / Applicant Government of Sri Lanka
2.2) Project Proponent:
2.2a) Name of the Agency - Ashraff Memorial Hosptal Kalmunai
2.2b) Address - Main Street, Kalmunai.
2.2c) Phone - 067-2229496 / 067-2222261/ 067-2223572
2.2d) Fax - 067-2221922
2.2e) Contact Person - 1
i) Name Dr. A.L.F. Rahaman
ii) Designation Medical Superintendant
iii) Phone 067 – 2223572, 0773420513
iv) Fax 067 – 2221922
v) E mail rahmanahamed@yahoo.com msamhkalmunai@yahoo.com
2.2f) Contact Person – 2
i) Name Dr. M.M.H.Ilahi
ii) Designation Medical Officer - Planning
iii) Phone 0777766805
iv) Fax 067 – 2221922
vi) E mail msamhkalmunai@yahoo.com
2.3) Forwarding Ministry/ Provincial Council:
2.3a) Name - Ministry of Healthcare & Nutrition,
2.3b) Address - 359, Ven.Wathagama Vimalavangsa Mawatha, Colombo-
2.3c) Phone - 0112694033
2.3d) Fax - 0112698507
2.3e) Contact Person - 1
i) Name Dr. H.A.P.Hahandaliyanahe
ii) Designation Secretary
iii) Phone 0112698511
iv) Fax 0112692913
vii) E mail secretary@health.gov.lk
2.3f) Contact Person – 2
i) Name Dr. U.Ajitj Mendis
ii) Designation Director General of Health Services,
iii) Phone 0112694860
iv) Fax 0112693869
viii) E mail dght@health.gov.lk
03. Project Rationale
(Do not indicate /explain the objective of the project. Answer to each sub section should be in brief)
3.1) Introduction to the Project:
(General sector information and information specific to the area)
The Ashraff Memorial Hospital is a leading developing tertiary health care institution in the Regional Director of Health Services division Kalmunai, in the coastal area of the Ampara District in Sri Lanka. This hospital is serving to a population of nearly half million. It is the mother institution to 38 smaller healthcare institutions which come under the purview of the Kalmunai RDHS. Patients are referred to Ashraff Memorial Hospital Kalmunai for specialized care and treatment by these 38 smaller institutions.
This hospital which has accommodation for about 300 beds gives specialized treatment in Medicine, Surgery, Gynaecologys & Obstetrics and Paediatrics and is planning to introduce sub specialarities like Dermatology, Eye, ENT and Radiology etc. in order to extend its services to the patients coming for treatment which is increasing daily. We also have a mobile clinical team which visits remote areas and conducts clinics for the local population. There is an Intensive Care Unit and Premature Baby Care Unit functioning in this hospital. Although we have the above mentioned facilities yet we do not have a Trauma unit which is very essential for management of Road Traffic accident and Home accidents. Further we are unable to meet the medical needs of the ever increasing. Elderly population of this area, especially in Orthopedics and Surgical care.
At present the surgical teams are sharing the Gynaecologys & Obstetrics operation theatre thereby the surgical operative time as well as the intake of patients is restricted. Due to this drawback causes unnecessary transfer of patients, prolonged stay of patients in wards awaiting surgical treatment and long waiting list for elective operations. Further we are unable to maintain adequate sterlity in the Operation Theater
Presently the surgical patients are sharing the Medical Intensive Care Unit with Medical Patients. Therefore a separate Surgical Intensive Care Unit will facilitate better care for surgical patients (every year 50 to 60 patients with critical burn injury are treated.) these patients have to under go prolonged critical care. Therefore a separate Burns Unit will enable better care.
Attachments (if any):-...............................
3.2) Specific Problem to be Addressed by the Project:
The trauma Unit is to accommodate Accident service Operating Theatres, Surgical Wards, Eye Ward, ENT Ward, Burn Unit, SICU, Paediatric Surgical Ward and Physiotherapy unit. Providing separate surgical OT will reduce the waiting list for elective surgery, reduce unnecessary transfer of patients to other hospital and enable to maintain good sterile condition. This also improves Gynaecologys & Obstetrics operative time & other operative facilities.
( Last year the total operations done were about 2600-2700 and Gynaecologys & Obstetrics about 1500-1600. This numbers are increasing every year)
attachments (if any):-...............................
3.3) Mode of Intervention in term of this Project (Justification):
Patients seeking treatment for surgical problems and casualty admission following Road Traffic Accidents, Bomb blasts and War casualties are very high in this hospital. At present, there are no proper ward facilities for surgical casualty admissions and orthopaedics admission in this institution. At the same time, this project will bring the Health Care services to the doorstep of poor remote villagers living in this region. This is the main referral centre for Tertiary Care Services for more than 35 smaller institutions in the coastal region of Ampara District with all other supportive facilities such as Intensive Care Unit, Blood Bank and Radiology Unit without adequate infrastructure facilities.
Therefore, this project will definitely improve the health status of the population of this are who were internally displaced and resettled by one or other incidences during the last two decades due to communal violence and civil War and recently by the Tsunami tidal wave. Hence, this project is urgently needed and should be given priority considering the difficulties faced by the poor and marginalized people living in this region.
attachments (if any):-...............................
3.4) Composition of Target Beneficiaries / Stakeholders (indicate Gender Ratio):
Beneficiary/
Stakeholder
Description
Gender
Ration
Male
Female
Population
Kalmunai RDHS
Division
500,000
51%
49%
The entire population of the coastal area of Ampara District will benefit from this project of which 72% are Samurdhi recipients. The entire population of this area have been displaced and resettled at one or other incidences during past and majority of this population are living in remote rural villages. 175000 Tsunami affected peoples are living in this region.
attachments (if any):-...............................
3.5) Relationship of the Project to Government Policy Framework / Plan
Fifty-one (51%) percentage of population is female, and majority of minor employees of the hospital are female and they will be directly benefited from this project.
Name of the Government Policy Framework / Plan:-. Improvement of health care
attachments (if any):-...............................
3.6) Coherence with Sectoral Policies and Strategies:
....................................................................................................................................
............................................................................................................................................................................................................................................................................................................................................................................................................
Name of the plan:....................................................................
Attachments (if any):-...............................
3.7) Considered Project Alternatives and Reasons for Rejection:
(Indicate the identified possible alternatives to achieve the project objectives and explain the reasons for rejecting them)
.........................................................................................................................
Attachments (if any):-...............................
3.8) Whether a Feasibility study for the Project has been carried out
√
Yes No
If so attach the Feasibility report...................
04. Project Objective & Purpose
(Indicate the main objective and the purpose of the project without adding project justification)
4.1) Goal of the Proposed Project:
No. 05 Capacity Building / Institutional Strengthening is the Primary Objective
No. 03 Social Development) is the Secondary Objective
(Select and Indicate the Number(s) Pertaining to the Primary Objective and the Secondary Objective from list below)
1. Economic Development/Reform for Economic Growth.
2. Poverty Alleviation
3. Social Development
4. Environmental Management
5. Capacity Building / Institutional Strengthening. √
4.2) Purpose of the Project:
Improving health care and infrastructure facilities.
....................................................................................................................................
....................................................................................................................................
Attachments (if any)..................................
05. Project Outputs, Activities and Duration
5.1) Expected Project Output:
Output
Unit of Measure
Quantity
Attachments (if any)..................................
5.2) Project Activities:
Activity
Unit of Measure
Quantity
1
2
3
4
5.3) Proposed Duration of the Project:
5.3a) Unit - 18 Months
5.3b) Duration – January 2009 to June 2010
06. Project Location & Land Requirement
6.1) Is the Project Location Islandwide or Area Specific:
Islandwide
√
Area Specific
6.2) Total Land Requirement:
Unit of Measurement - 110’ x 76’ = 8360 Sq. feet
Extent -............................................................................
6.3) Specify the Project Location:
(Indicate the places where project activities take place)
Site
Province
District
Division
Location
Land Required
Extend
01
Eastern
Ampara
Kalmunai
AMH Kalmunai
No
07. Environment and Environment Impact
7.1) Please indicate if any of the following Land Uses are Within the Project Site of with in 1 km Distance from any Boundary of the Project site:
National reserves, Sanctuaries, Forest reserves and proposed forest reserves, National Heritage, wildness areas, Coastal zones, flood areas and flood protection areas, Ancient protected monuments, Schools, Religious places and Hospital
√
Yes, one or more of the above land uses are within the site boundary
Yes, one or more of the above land uses are within 1km of the site boundary
No, none of the above land uses are within the project boundary or within a
1 km distance from any boundary of the project site.
If the answer to this question is affirmative, please list land use(s) and provide a map (1:50,000 or smaller scale) showing the project boundary and a distance of 1 km from each boundary:- Hospital (Proposed site is the hospital)
attachments: ..................................................
7.2) What are the possible Environment and Natural Resources Constraints to the Existing Activities to the Proposed Project?
7.3) Indicate which of the following Resources may be required for the Project. If possible specify quantities and from what source.
Resource
Required for this project
Unit of Measurement
Extent
(if known)
Location
(if known)
Surface Water
Yes/No
Ground Water
Yes/No
Quarry Stone or Earth fill
Yes/No
Energy
Yes/No
Forest
Yes/No
Others (Specify)
Yes/No
7.4) Will the Project require Relocating 100 or more families? - No
7.5) Whether the Project Location is Inside the Coastal Buffer Zone? - No
7.6) Is the Proposed Project a Prescribed Project? (Please refer to Sri Lanka Government Gazette Extraordinary-772/22 of 1993.06.24 and the Gazette Extraordinary No 1104/22 of 1999.11.05 You are advised to consult CEA to verify the Prescribed status)
08. Gender Perspective
8.1) Does the Project identify any Gender Gaps? If so describe: No
8.2) Is there any Strategy in the Project to address the Gender Imbalance?
..................................................................................................................................
8.3) Which Project Activities are Designed to Bridge such Gender Gaps and what will be their impact on Gender Imbalance?
..................................................................................................................................
09. Cost & Financing
9.1) Total Project Cost in LKR (mn) - 150
9.2) Cost Components
Component
Activity
Cost in Local Currency (LKR mn)
1.Building
1.1 Construction
150
1.2
1.3
2
2.1
2.2
9.3) Financing Plan:
Finance Source
Cost – Local Currency (LKR mn)
External Source
Proponent (Implementing Agency) Funding
Beneficiary Contribution
Consolidated Fund
Others
Total
9.4) Details of Already Offered External Assistance to Projects in the Related Sector in the Last Five years
Donor
Related field
Project title Assistance already offered
Amount USD (mn)
Year of Commencement
State whether completed or ongoing
Pharmacies
Health
CSSD
10. Project Implementation
(If the Project Proponent is the Implementing Agency the information at 2.2 should Appear Here)
10.1) Implementing Agency with overall Responsibility
10.1a) Name of the Agency
10.1b) Address
10.1c) Phone
10.1d) Fax
10.1e) Contact Person – 1
a) Title
b) Name
c) Designation
d) Phone
e) Fax
f) E-mail
10.1f) Contact Person – 2
a) Title
b) Name
c) Designation
d) Phone
e) Fax
f) E- mail
10.2) Function of the Implementing Agency with Overall Responsibility
..................................................................................................................................
10.3) Implementing Agency / Agencies and their functions and Prior Experience with similar Projects Activities
Implementing Agency
Functions
Prior Experience
01
02
03
10.4) Responsibilities of Other Entities (Other Relevant Agency)
10.5a) Applicable / Not Applicable
10.5b) Narration
10.5) Staff availability for Implementing the Proposed Project (Specify additional staff required)
Implementing Agency
No of Staff Members Available
Additional Staff Required
Dr.ALF.Rahman
Medical Superintendent
Ashraff Memorial Hospital,
Kalmunai.
ERD Reference Number
(for ERD use only)
Concept ID
(for ERD use only)
Previous Concept ID (if any)
(for ERD use only)
Please refer “Project Concept Format Filling Guidelines” before continue.
01. Project Information
1.1) Concept Date:01.06.2008
1.2) Project Title: Construction of Trauma Care Unit and Surgical Ward with Operating Theater
Complex
1.3) Thematic Area:
Human Resources Development, Capacity Building
and Institutional Strengthening.
1.4) Total Project Cost in LKR (mn): 150 million
1.5) Proposed Duration of the Project:
(a) Unit - 18 months
(b) Duration - January 2009 to June 2010
1.6) Sector & Sub sector:
Main Sector
Sub Sector
Health, Nutrition and Social
Protection
Health Care
1.7) Type of the Proposal:
i. Project Type Assistance
Goods, Services and Equipment Supply
√ Facilities Construction
Both
ii. Feasibility study
Pre-feasibility / Basic Study
√ Feasibility
iii.Technical Assistance
√ Master Plan for Development
Training and Human Resources Development
Project Development
02. Applicant’s Information
(Consist of brief introduction of the agency that creates and owns the project concept / forwarding ministry/Provincial Councils / Stand alone organizations covering Organizational and personnel details)
2.1) Host Country / Applicant Government of Sri Lanka
2.2) Project Proponent:
2.2a) Name of the Agency - Ashraff Memorial Hosptal Kalmunai
2.2b) Address - Main Street, Kalmunai.
2.2c) Phone - 067-2229496 / 067-2222261/ 067-2223572
2.2d) Fax - 067-2221922
2.2e) Contact Person - 1
i) Name Dr. A.L.F. Rahaman
ii) Designation Medical Superintendant
iii) Phone 067 – 2223572, 0773420513
iv) Fax 067 – 2221922
v) E mail rahmanahamed@yahoo.com msamhkalmunai@yahoo.com
2.2f) Contact Person – 2
i) Name Dr. M.M.H.Ilahi
ii) Designation Medical Officer - Planning
iii) Phone 0777766805
iv) Fax 067 – 2221922
vi) E mail msamhkalmunai@yahoo.com
2.3) Forwarding Ministry/ Provincial Council:
2.3a) Name - Ministry of Healthcare & Nutrition,
2.3b) Address - 359, Ven.Wathagama Vimalavangsa Mawatha, Colombo-
2.3c) Phone - 0112694033
2.3d) Fax - 0112698507
2.3e) Contact Person - 1
i) Name Dr. H.A.P.Hahandaliyanahe
ii) Designation Secretary
iii) Phone 0112698511
iv) Fax 0112692913
vii) E mail secretary@health.gov.lk
2.3f) Contact Person – 2
i) Name Dr. U.Ajitj Mendis
ii) Designation Director General of Health Services,
iii) Phone 0112694860
iv) Fax 0112693869
viii) E mail dght@health.gov.lk
03. Project Rationale
(Do not indicate /explain the objective of the project. Answer to each sub section should be in brief)
3.1) Introduction to the Project:
(General sector information and information specific to the area)
The Ashraff Memorial Hospital is a leading developing tertiary health care institution in the Regional Director of Health Services division Kalmunai, in the coastal area of the Ampara District in Sri Lanka. This hospital is serving to a population of nearly half million. It is the mother institution to 38 smaller healthcare institutions which come under the purview of the Kalmunai RDHS. Patients are referred to Ashraff Memorial Hospital Kalmunai for specialized care and treatment by these 38 smaller institutions.
This hospital which has accommodation for about 300 beds gives specialized treatment in Medicine, Surgery, Gynaecologys & Obstetrics and Paediatrics and is planning to introduce sub specialarities like Dermatology, Eye, ENT and Radiology etc. in order to extend its services to the patients coming for treatment which is increasing daily. We also have a mobile clinical team which visits remote areas and conducts clinics for the local population. There is an Intensive Care Unit and Premature Baby Care Unit functioning in this hospital. Although we have the above mentioned facilities yet we do not have a Trauma unit which is very essential for management of Road Traffic accident and Home accidents. Further we are unable to meet the medical needs of the ever increasing. Elderly population of this area, especially in Orthopedics and Surgical care.
At present the surgical teams are sharing the Gynaecologys & Obstetrics operation theatre thereby the surgical operative time as well as the intake of patients is restricted. Due to this drawback causes unnecessary transfer of patients, prolonged stay of patients in wards awaiting surgical treatment and long waiting list for elective operations. Further we are unable to maintain adequate sterlity in the Operation Theater
Presently the surgical patients are sharing the Medical Intensive Care Unit with Medical Patients. Therefore a separate Surgical Intensive Care Unit will facilitate better care for surgical patients (every year 50 to 60 patients with critical burn injury are treated.) these patients have to under go prolonged critical care. Therefore a separate Burns Unit will enable better care.
Attachments (if any):-...............................
3.2) Specific Problem to be Addressed by the Project:
The trauma Unit is to accommodate Accident service Operating Theatres, Surgical Wards, Eye Ward, ENT Ward, Burn Unit, SICU, Paediatric Surgical Ward and Physiotherapy unit. Providing separate surgical OT will reduce the waiting list for elective surgery, reduce unnecessary transfer of patients to other hospital and enable to maintain good sterile condition. This also improves Gynaecologys & Obstetrics operative time & other operative facilities.
( Last year the total operations done were about 2600-2700 and Gynaecologys & Obstetrics about 1500-1600. This numbers are increasing every year)
attachments (if any):-...............................
3.3) Mode of Intervention in term of this Project (Justification):
Patients seeking treatment for surgical problems and casualty admission following Road Traffic Accidents, Bomb blasts and War casualties are very high in this hospital. At present, there are no proper ward facilities for surgical casualty admissions and orthopaedics admission in this institution. At the same time, this project will bring the Health Care services to the doorstep of poor remote villagers living in this region. This is the main referral centre for Tertiary Care Services for more than 35 smaller institutions in the coastal region of Ampara District with all other supportive facilities such as Intensive Care Unit, Blood Bank and Radiology Unit without adequate infrastructure facilities.
Therefore, this project will definitely improve the health status of the population of this are who were internally displaced and resettled by one or other incidences during the last two decades due to communal violence and civil War and recently by the Tsunami tidal wave. Hence, this project is urgently needed and should be given priority considering the difficulties faced by the poor and marginalized people living in this region.
attachments (if any):-...............................
3.4) Composition of Target Beneficiaries / Stakeholders (indicate Gender Ratio):
Beneficiary/
Stakeholder
Description
Gender
Ration
Male
Female
Population
Kalmunai RDHS
Division
500,000
51%
49%
The entire population of the coastal area of Ampara District will benefit from this project of which 72% are Samurdhi recipients. The entire population of this area have been displaced and resettled at one or other incidences during past and majority of this population are living in remote rural villages. 175000 Tsunami affected peoples are living in this region.
attachments (if any):-...............................
3.5) Relationship of the Project to Government Policy Framework / Plan
Fifty-one (51%) percentage of population is female, and majority of minor employees of the hospital are female and they will be directly benefited from this project.
Name of the Government Policy Framework / Plan:-. Improvement of health care
attachments (if any):-...............................
3.6) Coherence with Sectoral Policies and Strategies:
....................................................................................................................................
............................................................................................................................................................................................................................................................................................................................................................................................................
Name of the plan:....................................................................
Attachments (if any):-...............................
3.7) Considered Project Alternatives and Reasons for Rejection:
(Indicate the identified possible alternatives to achieve the project objectives and explain the reasons for rejecting them)
.........................................................................................................................
Attachments (if any):-...............................
3.8) Whether a Feasibility study for the Project has been carried out
√
Yes No
If so attach the Feasibility report...................
04. Project Objective & Purpose
(Indicate the main objective and the purpose of the project without adding project justification)
4.1) Goal of the Proposed Project:
No. 05 Capacity Building / Institutional Strengthening is the Primary Objective
No. 03 Social Development) is the Secondary Objective
(Select and Indicate the Number(s) Pertaining to the Primary Objective and the Secondary Objective from list below)
1. Economic Development/Reform for Economic Growth.
2. Poverty Alleviation
3. Social Development
4. Environmental Management
5. Capacity Building / Institutional Strengthening. √
4.2) Purpose of the Project:
Improving health care and infrastructure facilities.
....................................................................................................................................
....................................................................................................................................
Attachments (if any)..................................
05. Project Outputs, Activities and Duration
5.1) Expected Project Output:
Output
Unit of Measure
Quantity
Attachments (if any)..................................
5.2) Project Activities:
Activity
Unit of Measure
Quantity
1
2
3
4
5.3) Proposed Duration of the Project:
5.3a) Unit - 18 Months
5.3b) Duration – January 2009 to June 2010
06. Project Location & Land Requirement
6.1) Is the Project Location Islandwide or Area Specific:
Islandwide
√
Area Specific
6.2) Total Land Requirement:
Unit of Measurement - 110’ x 76’ = 8360 Sq. feet
Extent -............................................................................
6.3) Specify the Project Location:
(Indicate the places where project activities take place)
Site
Province
District
Division
Location
Land Required
Extend
01
Eastern
Ampara
Kalmunai
AMH Kalmunai
No
07. Environment and Environment Impact
7.1) Please indicate if any of the following Land Uses are Within the Project Site of with in 1 km Distance from any Boundary of the Project site:
National reserves, Sanctuaries, Forest reserves and proposed forest reserves, National Heritage, wildness areas, Coastal zones, flood areas and flood protection areas, Ancient protected monuments, Schools, Religious places and Hospital
√
Yes, one or more of the above land uses are within the site boundary
Yes, one or more of the above land uses are within 1km of the site boundary
No, none of the above land uses are within the project boundary or within a
1 km distance from any boundary of the project site.
If the answer to this question is affirmative, please list land use(s) and provide a map (1:50,000 or smaller scale) showing the project boundary and a distance of 1 km from each boundary:- Hospital (Proposed site is the hospital)
attachments: ..................................................
7.2) What are the possible Environment and Natural Resources Constraints to the Existing Activities to the Proposed Project?
7.3) Indicate which of the following Resources may be required for the Project. If possible specify quantities and from what source.
Resource
Required for this project
Unit of Measurement
Extent
(if known)
Location
(if known)
Surface Water
Yes/No
Ground Water
Yes/No
Quarry Stone or Earth fill
Yes/No
Energy
Yes/No
Forest
Yes/No
Others (Specify)
Yes/No
7.4) Will the Project require Relocating 100 or more families? - No
7.5) Whether the Project Location is Inside the Coastal Buffer Zone? - No
7.6) Is the Proposed Project a Prescribed Project? (Please refer to Sri Lanka Government Gazette Extraordinary-772/22 of 1993.06.24 and the Gazette Extraordinary No 1104/22 of 1999.11.05 You are advised to consult CEA to verify the Prescribed status)
08. Gender Perspective
8.1) Does the Project identify any Gender Gaps? If so describe: No
8.2) Is there any Strategy in the Project to address the Gender Imbalance?
..................................................................................................................................
8.3) Which Project Activities are Designed to Bridge such Gender Gaps and what will be their impact on Gender Imbalance?
..................................................................................................................................
09. Cost & Financing
9.1) Total Project Cost in LKR (mn) - 150
9.2) Cost Components
Component
Activity
Cost in Local Currency (LKR mn)
1.Building
1.1 Construction
150
1.2
1.3
2
2.1
2.2
9.3) Financing Plan:
Finance Source
Cost – Local Currency (LKR mn)
External Source
Proponent (Implementing Agency) Funding
Beneficiary Contribution
Consolidated Fund
Others
Total
9.4) Details of Already Offered External Assistance to Projects in the Related Sector in the Last Five years
Donor
Related field
Project title Assistance already offered
Amount USD (mn)
Year of Commencement
State whether completed or ongoing
Pharmacies
Health
CSSD
10. Project Implementation
(If the Project Proponent is the Implementing Agency the information at 2.2 should Appear Here)
10.1) Implementing Agency with overall Responsibility
10.1a) Name of the Agency
10.1b) Address
10.1c) Phone
10.1d) Fax
10.1e) Contact Person – 1
a) Title
b) Name
c) Designation
d) Phone
e) Fax
f) E-mail
10.1f) Contact Person – 2
a) Title
b) Name
c) Designation
d) Phone
e) Fax
f) E- mail
10.2) Function of the Implementing Agency with Overall Responsibility
..................................................................................................................................
10.3) Implementing Agency / Agencies and their functions and Prior Experience with similar Projects Activities
Implementing Agency
Functions
Prior Experience
01
02
03
10.4) Responsibilities of Other Entities (Other Relevant Agency)
10.5a) Applicable / Not Applicable
10.5b) Narration
10.5) Staff availability for Implementing the Proposed Project (Specify additional staff required)
Implementing Agency
No of Staff Members Available
Additional Staff Required
Dr.ALF.Rahman
Medical Superintendent
Ashraff Memorial Hospital,
Kalmunai.
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