A recent audit conducted by the Controller and Auditor General (CAG) has uncovered significant issues in the construction of eleven hospitals in Zanzibar. The audit report reveals that many of these facilities are experiencing structural problems due to a lack of geological surveys before construction. This oversight has led to cracks in the buildings, resulting in substantial financial losses and construction quality issues.
According to the audit report, which was summarized by Dr. Abbas Ali Othman and presented to the President of Zanzibar, Dr. Hussein Mwinyi, on May 13, 2024, the findings were also shared with the Zanzibar House of Representatives on June 27, 2024. The report will be discussed in upcoming legislative sessions.
The construction of these hospitals began in response to the COVID-19 pandemic, declared a global emergency by the World Health Organization (WHO) on March 11, 2020. To tackle the pandemic, the Tanzanian government received $1 trillion from the International Monetary Fund (IMF) under a rapid credit facility program. Of this amount, the Revolutionary Government of Zanzibar (SMZ) received $230 billion.
In response to the pandemic, SMZ allocated $72.8 billion for the construction of these hospitals and the distribution of medical supplies. However, the costs eventually increased by an additional $19.2 billion beyond the initial contract amount. The construction included one regional hospital and ten district hospitals, making a total of eleven newly built facilities.
The CAG report identifies two main issues leading to the audit: high construction costs and operational deficiencies, as well as excessive costs for project repairs. One critical finding is the absence of geological surveys before the commencement of construction, which has contributed to structural defects in several buildings. The audit highlights that improper site preparation and a lack of adherence to engineering ethics have led to these issues.
The audit further indicates that failure to conduct geological surveys could result in building foundations not accounting for potential hazards like soil instability and landslides, jeopardizing the long-term stability and safety of the structures. The CAG has noted that one of the hospitals, located in Vitongoji, exhibited significant structural cracks from the foundation through the first floor.
The CAG has recommended that the Ministry of Health conduct a soil stability assessment with geological experts before initiating future projects. Immediate action is needed to address the defects identified in the district hospitals. The report also highlights an increase in project costs by $18.5 billion due to inadequate needs assessment.
The procurement board is criticized for failing to provide guarantees related to the project scope and needs. The audit points out that the board did not ensure the project requirements were met before construction began.
Technical experts involved in the project were not included in the review process, resulting in increased costs due to additional and external work, which amounted to 26% of the initial contract price. The audit warns that future projects might face challenges if the government does not secure additional funds beyond the initial plan.
The report also reveals that the procurement regulations were violated. According to the public procurement and disposal regulations of 2020, procurement institutions should only invite bids when complete drawings and cost estimates are available. However, the audit found that payments were made to professionals for incomplete designs and bidding documents, resulting in a financial loss of $527.7 million.
The construction of hospitals was carried out without proper adherence to the Ministry of Health’s standards for building sizes and room requirements. The audit found discrepancies between the constructed facilities and the approved standards.
Additionally, the audit discovered that some districts, including Vitongoji, Kinyasini, Dunga, and Kitogani, were awarded construction contracts to unqualified bidders. This led to an additional cost of $995.5 million. The audit also found that some contractors failed to meet contractual obligations regarding project plans and delays.
The audit further highlighted that two out of eleven companies involved used unregistered foreign professionals, violating legal requirements. This included ten workers across various hospitals who lacked registration and certification from the Engineers Registration Board (ERB).
Attempts to reach Health Minister Ahmed Mazrui for comment were unsuccessful as calls and messages went unanswered. Deputy Health Minister Hassan Khamis Hafidh indicated he would be available for comment next week.
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