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TERMS OF REFERENCE International Expert for (I) Preparation of the Main Project for Infrastructure Rehabilitation for Installation of the Ventilation System and Patient Separation Measures, and (II) Preparation of the Bidding Documents for Civil Works in two MDR-TB treatment sites and two TB Reference Laboratories in Turkmenistan Project title: Position: Duty station: Starting date of the assignment: Purposeful strengthening and expanding of qualified services on tuberculosis diagnostics and treatment in Turkmenistan International Expert for (I) Preparation of the Main Project for Infrastructure Rehabilitation for Installation of the Ventilation System and Patient Separation Measures, and (II) Preparation of the Bidding Documents for Civil Works in two MDR-TB treatment sites and two TB Reference Laboratories in Turkmenistan Turkmenistan, Ashgabat End of July-early August 2011 1. Background UNDP is a key partner to the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria (GFATM) and is the UN agency assuming the role of Principal Recipient of GFATM grant for implementation of the Project “Purposeful strengthening and expanding of qualified services on TB diagnostics and treatment in Turkmenistan” for the period of 2010-2012. The overall goal of the Project is to reduce the burden of tuberculosis in Turkmenistan by consolidation of DOTS framework, its expansion by introducing and scaling up the management of drug-resistant tuberculosis (DR-TB) and strengthening the health system performance for effective TB control. Three main Objectives of the Project are: 1. To consolidate the DOTS framework through strengthening programme management, improving TB case detection and diagnosis and ensuring quality treatment; 2. To improve the health system performance for effective tuberculosis control; 3. To introduce and expand access to diagnosis and treatment of drug-resistant tuberculosis. The accomplishment of the project’s objectives will be ensured through strengthening human and infrastructural capacities, decentralization and upgrading the laboratory services and provision of up-todate treatment of TB and DR-TB of the National Partners represented by the Ministry of Health and Medical Industry (MOHMI) and Ministry of Internal Affairs of Turkmenistan (MIA). In particular, it is planned to strengthen infection control measures at two regional tuberculosis reference laboratories in the Mary velayat TB Hospital in Mary city and the Lebap velayat TB Hospital in Turkmenabat city; as well as in-patient DR-TB treatment delivery sites, infrastructure rehabilitation for installation of the ventilation system and patient separation measures in the Ahal velayat TB Hospital in Dushak city and the Central Prison Hospital in Turkmenbashy settlement of Mary velayat. In order to coordinate the smooth implementation of planned activities according to the WHO standards the UNDP Turkmenistan is seeking the services of an Expert on engineering design and specifications development for renovation and installation of the ventilation system in two regional TB Reference Laboratories to ensure level III biosafety, and DR-TB departments of two TB institutions in Turkmenistan (in civil and penitentiary sectors accordingly). 2. Consultancy Objectives The objectives of this assignment are: To Prepare the Main Project and Bidding Documents for Civil and Engineering Works for Infrastructure Rehabilitation for Installation of the Ventilation System in two Regional TB Reference Laboratories (upgrading facilities to Biosafety level III); and To prepare the Main Project and Bidding Documents for Civil and Engineering Works for Infrastructure Rehabilitation for Installation of the Ventilation System and Patient Separation Measures in two MDR-TB (Multi-Drug Resistant Tuberculosis) treatment sites in Turkmenistan. 3. Scope of work A. Phase I: ASSESSMENT & DESIGN WORKS I. The Consultant will conduct on-site feasibility studies and develop subsequent engineering designs of infrastructure rehabilitation for installation of the negative pressure ventilation system in the Mary velayat and Lebap velayat TB Hospitals’ Reference Laboratories (both facilities are built in 1950th1960th); and infrastructure rehabilitation for installation of the negative pressure ventilation system and patient separation measures in the Ahal velayat TB Hospital in Dushak city and the Central Prison Hospital in Turkmenbashy settlement of Mary velayat (both DR-TB departments are planned for about 50 beds in each facility, built in 1960th-1970th): Ahal velayat TB Hospital in Dushak city MDR-TB Department is a free-standing one-floor building, size 12,5m x 66,7m. The size of inside area is 734 square meters. The building is constructed out of reinforced concrete framing; 3 meters height walls are bricks made; ceiling panel is made of reinforced concrete; lean-to roof covered by waterproofing material; window and door cases are made of wood; the building base is made of reinforced cement; and floor is made of cement. The heating system is executed by three separate mini gas heaters connected to three parts of the building; electrical supply is executed by electrical transforming sub-station locating in about 100 meters; water supply executed by three separate refilled 200 liters tanks maintained on the roof, no connection to the general water supply infrastructure. It is planned to carry out rehabilitation works in January-March 2012. Central Prison Hospital MDR-TB Department is a free-standing two-floor building size 12,5m x 36,5m. The size of inside area of each floor is 372 square meters. The building is constructed out of reinforced concrete framing; 2,95 meters height walls are bricks made; ceiling panel is made of reinforced concrete; lean-to roof covered by waterproofing material; window and door cases are made of wood; the building base is made of reinforced cement; and floor is covered by cement. The heating system is centralized, electrical supply by local electrical transforming sub-station; water supply is centralized. It is planned to carry out rehabilitation works in October-December 2012. Mary velayat TB Hospital Reference Laboratory occupies about 106 sq.m free-standing one-floor building with outhouse annex. The building is constructed out of bricks with reinforced base, major walls are made of reinforced cement, outhouse annex is made of half-bat bricks, floor is made of old wood boards; slated roof; window and door cases are made of wood. The heating system is centralized, electrical supply by local electrical transforming sub-station; water supply is centralized, with a separate used waters discharge system. It is planned to carry out rehabilitation works in October-December 2011. Lebap velayat TB Hospital Reference Laboratory occupies about 125 sq.m free-standing one-floor building. The building is constructed out of bricks with reinforced base, major walls are made of reinforced cement; floor is made of old wood boards; slated roof; window and door cases are made of wood. The heating system is centralized, electrical supply by local electrical transforming sub-station; water supply is centralized, with a separate used waters discharge system. It is planned to carry out rehabilitation works in January-March 2012. The Consultant will work in cooperation with appointed specialists from the MOHMI and MIA (members of the MDR-TB Working Group) in consultation with the project’s specialists on TB and construction issues to comply the above-mentioned designs with the WHO standards and national regulations regarding infection control in TB, and conduct of constructional works in healthcare facilities. While developing the design of the ventilation system to be established for the healthcare facilities (i.e. mechanical or mixed-mode) the Consultant will consider local conditions, such as building structure, climate, national building bye-laws and regulations, cost and outdoor air quality. II. The proposed infrastructure rehabilitation and installation of ventilation system will necessitate optimal utilization of available indoor space, including laboratory and MDR-TB treatment facilities to reduce airborne transmission, protecting workers, and specimens. The Consultant will incorporate relevant recommendations as a part of the engineering design, provide specification for IC engineering equipment and means of personal protection, as well as develop a maintenance plan of the ventilation system for each Reference Laboratory and DR-TB healthcare facility. The maintenance plans will adopt appropriate actions for different high-risk areas of the facilities and identify the workers responsible for the maintenance and monitoring of the ventilation system and infection control equipment, as well as provide recommendations for staff need to be educated about use, safety and maintenance of the equipment. B. Phase II: PREPARATION of PACKAGE of BIDDING DOCUMENTATION The Consultant will work in cooperation with specialists from the MOHMI and MIA (members of the MDR-TB Working Group) in consultation with the Project’s specialists on TB and construction issues to prepare the following documents for initiating a tender process for selection of a Construction company to implement planned rehabilitation of two Reference Laboratories and two MDR-TB treatment sites, including installation of negative pressure ventilation system: - Technical description and scope of work of Constructor for each site; - Bill of quantities for each site; - Technical specifications of the ventilation equipment for each site; - Construction drawings of each site. 4. Proposed Time Frame Location and duration of Phase A: Total number of days for Phase A – 40 days from the date of contract signature. The total duration of Phase A is divided into two stages: stage of on-site assessment of two Reference Laboratories and two MDR-TB treatment facilities – about 10 calendar days (travel to Turkmenistan is required, including visits to Ashgabat, Mary, Dushak, and Turkmenabat cities); and stage of home-based design development - 30 calendar days (The assignment does not assume any travel; Actual correspondence to be conducted via email and land mail.) Location and duration of Phase B: Total number of days for home-based preparation of package of bidding documents for each site is 20 calendar days after completion of Phase A (The assignment does not assume any travel; Actual correspondence to be conducted via email and land mail.) 5. Expected Output The Consultant will submit the reports by phases to the UNDP-GF Grant Implementation Unit in Turkmenistan in accordance with contracting duration of each phase (Report of the mission including main findings and recommendations on administrative, engineering and personal protection measures). The draft report (plans and preliminary drawings) indicating the location, length, capacity, and proposed solutions for renovation should be submitted to the UNDP-GF Grant Implementation Unit in Turkmenistan before proceeding with the final technical and engineering design. The UNDP-GF Grant Implementation Unit in Turkmenistan will provide comments on the draft report which will be included in the consultant’s final report. 6. Competencies Experience in conducting feasibility study and design of health care facilities requiring implication of infection control measures; Knowledge of WHO standards and recommendations associated with construction works at the health care facilities requiring implication of infection control measures; Experience in designing of ventilation systems in BSL-III health care facilities; Knowledge of the WHO standards and recommendations associated with patient separation in the MDR-TB departments; Experience in working with CIS countries or Eastern Europe is an asset. 7. Qualifications The Consultant must have proven consultancy experience in similar projects; University Degree in Civil engineering or Architecture (as a minimum requirement); Advanced university degree in ventilation systems designing (desirable); At least 5 years of professional experience in inspection or supervision of construction works on health care sites; experience in design of ventilations systems for health care facilities requiring implication of infection control measures; Effective verbal and written communication, multi-tasking, organizational and prioritization skills are necessary; Proficiency in AutoCad; Knowledge of English language; Russian would be an asset. 8. Field Work Arrangement & Methodology The consultant will deliver the final technical design and the bidding documents (based on the final report) to the UNDP-GF Grant Implementation Unit in Turkmenistan in English language in 2 copies with translation into Russian language. Consultant will be reported to UNDP/GFATM GIU Grant Manager for the fulfillment of the assignment.