MEMORANDUM OF UNDERSTANDING(MOU) by rvk23499

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                 MEMORANDUM OF UNDERSTANDING (MOU)

                                         between

                            World Health Organization
                                        and
                      The Ministry of Health South Darfur State

Ref: WHO support to Nyala General Teaching Hospital, July – December 2004


This Memorandum of Understanding (MOU), is entered into by and between the
Ministry of Health of South Darfur State, to be implemented through the Directorate of
the Nyala General Teaching Hospital, the hereinafter known and referred to as MoH and
NGTH Authority, and the World Health Organization, hereafter known and referred to as
WHO, through the Organization’s field office in Nyala.

                                       Objectives

To ensure that Nyala General Teaching Hospital (NGTH) is able to provide free and
effective secondary care to conflict affected population, and in particular is able to:
    1. provide emergency assessment, treatment and follow up of weapon wounded,
        surgical, obstetric and pediatric emergencies;
    2. ensure safe blood transfusion, and laboratory services;
    3. ensure free access by waiving user fees for all patients, be they resident,
        internally displaced and/or conflict affected, attending the Out Patient and First
        Aid Department (OPD),
    4. ensure free and effective secondary care for the Internal Displaced People (IDPs)
        also by extending the waiver to the fees related to the hospitalization of this
        category of patients.

To reach above objectives, support to NGTH is required. Now therefore, the Parties
hereto mutually agree as follows:

                                      Section I:
                                General Responsibilities.

MoH will continue to support the entire NGTH with personnel, surgical and medical
material, and funds for recurrent costs. Furthermore, MoH will increase the qualified
medical, health and administrative support staff of the Out Patient and First Aid
Department (OPD), of the transfusion and laboratory services, and of the Operating
Theatre (OT)/ Surgical Ward. This is a necessity in order to guarantee the quality of care
in these critical areas of work, which face an increased workload due to the high number
of Internal Displaced People (IDPs) and weapon injuries referred for secondary care to
the hospital.
Financial restitution of these staff remains a MoH responsibility.



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However, in view of the tremendous increase of work related to the Darfur crisis, WHO
shall make available to MoH the funds to set up a mechanism of incentives for all the
medical and non medical staff of the OT and OPD Departments, the transfusion and
laboratory services, and of the Operating Theatre and Surgical Ward. These incentives
will be released on a monthly basis and related to the performance of the individuals.

WHO will provide equipment, essential drugs and consumables to the OPD and
OT/surgical wards according to the needs reflected in the statistics of these departments

WHO will complement the essential equipment and will supply the reagents and
consumables of both the in-patient and out patient laboratories and of the Blood Bank
services of the NGTH, according to the needs reflected in the statistics of these services.

WHO will rehabilitate the water supply of the OPD, OT/surgical ward, laboratory and
blood bank, as well as the sewage system and sanitation facilities of the OPD and the
surgical wards.

WHO will ensure in-service training and support to the technical management of the the
OPD and OT/surgical wards through the full time presence of the WHO senior surgeon
for the first three month of implementation of the present MoU.

WHO will provide technical support and opportunities for performance enhancement to
the surgeon working in the NGTH in the form of in-service training by a visiting health
expertise team.

MoH and WHO will work together with WFP to ensure free alimentation of IDPs
admitted in NGTH and their co-patients.


                                      Section II
                              Monitoring and Supervision

A joint MOH/WHO Task Force will be set up in order to plan in detail, implement and
monitor the changes within the Out Patient and First Aid Department (OPD), of the
transfusion and laboratory services, and of the Operating Theatre (OT)/ Surgical Ward of
the NGTH.

Through this Task Force, WHO will monitor and supervise all aspect of the project and
make recommendations for improvement where necessary.


                                        Section III
                                         INPUTS




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The parties mutually agree that the in order to facilitate the smooth, efficient and
professional service by the MOH of the Nyala General Hospital, contemplated by this
MOU, the parties shall make the respective contributions enumerated hereunder.


-The MoH’s Contribution

MoH will take the appropriate steps with the NGTH Authority and its staff so to ensure
that all patients attending the Out Patient and First Aid Department (OPD) are exempted
from the payment of any user-fees and/or charges as resulting from dispensation of drugs
from the NGTH store, laboratory and transfusion services.

 MoH will take the appropriate steps with the NGTH Authority and its staff so to ensure
that all IDPs admitted in the hospital for medical or surgical treatment are exempted
from the payment of any user-fees and/or charges as resulting from hospitalization,
medical and/or surgical acts, dispensation of drugs from the NGTH store, laboratory,
transfusion and Xrays services.

MoH will take the appropriate steps with the NGTH Authority and its staff so to ensure
that each employee of the NGTH works according to the WHO guide lines. The NGTH
Authority will conduct Health education sessions for all its staff and the public, to ensure
appropriate the use of the hospital water and sanitation facilities.

MoH shall employ and make available qualified and competent local personnel who will
be responsible to cover routine and emergency day to day activities of the Out Patient and
First Aid Department (OPD), of the transfusion and laboratory services, and of the
Operating Theatre (OT)/ Surgical Ward, as well as ancillary hospital staff for
maintenance of the equipments and the infrastructure of the building, and administration.

MOH will be the employer of all staff assigned to the NGTH and shall be solely
responsible for the implementation and use of the staff regulation and payment of salaries
of their personnel assigned to the hospital

The MoH shall facilitate and ensure that all materials and equipments brought by WHO
to the premises of Nyala general Hospital are pilferage-proof and securely stored

The MOH shall be responsible for undertake all maintenance work, after WHO has
finished the rehabilitation of the laboratory and the Blood Bank.

The NGTH Maintenance Team will provide professional repair, regular maintenance and
preventive measures in the hospital, taking into consideration the exposure of the
equipment to the climatic condition as dust, and rain.

The NGTH Authority will submit weekly reports relating to the services performed by
Out Patient and First Aid Department (OPD), of the transfusion and laboratory services,
and of the Operating Theatre (OT)/ Surgical Ward.



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- The WHO contribution:

For the duration of this MoU, WHO shall make available to MOH through a dedicated
bank account the monthly sum of ………… SD . This sum will be utilized by MOH to
pay incentives to the staff of the Out Patient and First Aid Department (OPD), of the
transfusion and laboratory services, and of the Operating Theatre (OT)/ Surgical Ward.
Payment of incentives will be subject to a monthly review of each incumbent’s
performance, to be conducted through the joint MoH/WHO Task Force.

For the duration of this MOU the WHO shall provide the NGTH with visiting temporary
expertise in different clinical areas, as necessary, in agreement with MOH as as the
situation allows.

For the duration of this MOU the WHO shall provide the NGTH with essential furniture,
equipments and essential drugs, reagents, consumables as related to the Out Patient and
First Aid Department (OPD), of the transfusion and laboratory services, and of the
Operating Theatre (OT)/ Surgical Ward.

For the duration of this MOU the WHO may assist the MOH in the planning and
monitoring of major repair of the hospital infrastructures and systems of the NGTH.
Specifically, the WHO will cover the costs of the rehabilitation of the water supply of
the OPD, OT/surgical ward, laboratory and blood bank, as well as the sewage system and
sanitation facilities of the OPD and the surgical wards. In the interim period the WHO
will support the pumping out of septic tanks in OPD. WHO will also support the
technical assessment of sanitation in the rest of the hospital..

Starting End- September 2004, the WHO will provide the NGTH with medical and
surgical materials in the form of Italian Trauma 4 Kit, each is designed to treat 100
trauma affected patients. The use of these materials will be jointly monitored by MoH
and WHO and manage according to the needs depends on the admission and discharge
statistics.

For the duration of this MOU, the WHO shall coordinate between MoH, NGTH and WFP
to ensure daily meals for IDP patients and co-patients admitted in the NGTH.

It being understood by the parties, that all equipments brought into Nyala General
Hospital for the Laboratory and blood Bank shall become the Property of MOH and shall
thereafter assume full responsibility for the professional use, protection and maintenance




                                       Section IV
                                        Liability



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The WHO shall not be liable to:
   - any costs or expenditure in excess of its contribution
   - to pay any compensation for death, disability or other complication suffered by
     the staff results of their employments in activities that are subjected to this MoU.
   - Toward any staff nor held responsible for any disagreement between WHO and
     the staff on matters pertaining to their employments in the hospital.


                                     Section V
                                 Duration of the MoU

This MoU has the duration of 6 months certain commencing from the date of signature
by both parties


                                      Section VI
                                  Renewal of the MoU

The parties mutually agree that MoU may, upon its expiry, be renewed for 3 months and
on such terms and conditions as may agreed upon by parties.


                                      Section VII
                                  Disputes Settlement

The Parties hereby agreed that any and all disputes arising out of this MOU shall be
submitted to the FMoH and the WHO office in Khartoum, who shall endeavour to
resolve any and all disputes amicably.


                                      Section VIII
                                     Binding Effect

The terms and conditions of this MOU shall be Binding on the parties hereto, their
assigns, and successors-in-interest, as if they were specifically mentioned herein by name



This MEMORANDUM OF UNDERSTANDING is signed in two originals only, of
which each of the parties will keep one.


DONE AND AGREED UPON IN NYALA on the…../…/2004.




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FOR THE STAT MINISTRY OF HEALTH

FOR THE WHO




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