A $243 million program led by the United States Army Corps of Engineers to build 150 health care clinics in Iraq has in some cases produced little more than empty shells of crumbling concrete and shattered bricks cemented together into uneven walls, two reports by a federal oversight office have found.
The reports, released yesterday, detail a close inspection of five of the clinics in the northern city of Kirkuk as well as a sweeping audit of the entire program, which began in March 2004 as a heavily promoted effort to improve health care for ordinary Iraqis. The reports say that none of the five clinics in Kirkuk and only 20 of the original 150 across the country will be completed without new financing.
Written by the Special Inspector General for Iraq Reconstruction, an independent office, the reports cite a wide range of factors, including disputes among Iraqi construction companies and problems with local materials, that have contributed to the program's failures. The American company Parsons, the prime contractor for the work, also comes in for stiff criticism.
But the reports' main finding is that lax oversight by the Army corps is responsible for the failure of the overall program. Cowed by security fears that the reports suggest may have been overblown, the corps sometimes inspected the work only through what it called "windshield surveys" — hasty drive-bys.
Poor cost accounting and a rapid turnover of United States government personnel in Iraq also contributed to the problems, the reports say.
Whatever the causes, the impact of the failure on the American effort to rebuild Iraq is enormous, said the inspector general, Stuart W. Bowen Jr.
"This was the most important program in the health sector," Mr. Bowen said in an interview. "It sought to fulfill a strategy to get health services to rural and remote poor in Iraq."
But he said it was not until the fall of 2005, a year and a half after the program began, that the corps began focusing on the shortcomings of the work by Parsons and its Iraqi subcontractors. By then, Mr. Bowen said, "the chasm was so wide that the remedial actions were unable to salvage the overall program."
Because most of the clinics are more than half finished, Mr. Bowen added, it is still possible that with new money many of the program's original goals could be realized.
But the criticisms in the reports have created deep disagreements between Mr. Bowen's office and the gulf region division of the Corps of Engineers, which is responsible for the program. In a series of objections included in the reports, the division's commander, Brig. Gen. William H. McCoy Jr., rejected many of the findings and tried to shift much of the blame to American and Iraqi contractors.
"Contractor performance and lack of openness in addressing schedule and budget issues in a timely fashion obscured the severity of the financial problem," General McCoy wrote.
"It should be noted that until the fall of 2005, the contractor insisted their schedules were correct and that they would finish up to 114 P.H.C.'s by the end of December 2005," he wrote, using an abbreviation for primary health care centers.
The reports, however, say that in effect, the buck stopped with the Army corps.
"It is the government's responsibility to oversee the contract and, given that the government was aware of problems with the project for quite some time, we believe the effective government contract oversight was not provided," the report covering all 150 clinics says.
The reports describe a series of baffling managerial decisions by the Army corps. For example, Parsons estimated that completing all the clinics would take two years, but the corps ordered the company to complete them in one year. Parsons also asked that the construction take place region by region in order to husband the company's thin supervisory staff in Iraq, but the corps directed that all 150 clinics be started simultaneously.
Some of the most remarkable observations appear in the inspection reports on the five clinics in Kirkuk. Interior photographs of the structures show bare walls made of brick fragments through which sunlight streamed and stairs made of concrete already crumbling into dust.
And when inspectors compared what they saw to progress reports, some of the numbers seemed suspiciously high. One structure, essentially a rickety shell of uneven bricks, had been declared 56 percent complete. The second floor of another shell held up by little more than wooden sticks — a standard method of bracing unfinished floors in Iraq — had been declared half complete.
Late Friday, the inspector general also released an audit report on a $147 million United States-led program to train and equip thousands of Iraqis to protect oil pipelines, electrical transmission lines and hundreds of key installations in both sectors.
Begun in September 2003, the effort, called Task Force Shield, was so disorganized that the auditors were never able to determine basic facts like how many Iraqis were trained, how many weapons were purchased and where much of the equipment ended up, the report says.
Of 21,000 guards who were to be trained in protecting oil equipment, for example, probably only about 11,000 were, the report says. And of 9,792 automatic rifles purchased for those guards, auditors were able to track just 3,015.
Even more severe shortcomings plagued the program to protect the electricity infrastructure, which ended almost as soon as it had begun.
In an echo of management problems that have hobbled nearly every noncombat effort in Iraq, the training in both programs was partly controlled by three different entities: the American military, the civilian-run Coalition Provisional Authority and an Army Corps of Engineers initiative to restore Iraq's oil infrastructure.
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