Biomedical Engineer

I - PRESENTATION OF EXPERTISE FRANCE
Expertise France (EF) is a public agency created on January 1, 2015 and merging six French public agencies under the supervision of the French Ministries of Foreign Affairs and Economy and Finance with a strong inter-ministerial vocation. EF offers project engineering and technical assistance by developing and implementing international cooperation actions worldwide. EF operates in various fields of development and institutional cooperation including safety and security reform, post-crisis/ stability, public health, human rights, strengthening of institutions and NGOs and governance. Carrying out large-scale, multi-stakeholder programs, EF can ensure the cooperation between individuals, teams and institutions with very different statuses, cultures and specialties. Besides, EF has acquired a sound experience in administrative and financial management of large-scale international programs.
Expertise France in Iraq
Expertise France opened its first office in Iraq on October 2019 with the financial support of the Crisis and Support Centre of the Ministry for Europe and Foreign Affairs (CDCS). EF is currently working on three main thematic in Iraq: youth, entrepreneurship and mental health.
II - BACKGROUND
Nineveh governorate
Nineveh Governorate was once known for its good healthcare services and highly qualified doctors. Between 2008 and 2014, a substantial number of facilities were rehabilitated and equipped with new medical instruments. Before the conflict between Islamic State of Iraq and the Levant (ISIL) group and the Iraqi forces, Mosul city had six private medical centers, including 16 hospitals with 4,600 beds . All these facilities were managed by specialist doctors and were working properly until ISIL occupied the city.
At that point, hospitals that were not destroyed by air strikes continue to receive patients, but health services have been severely affected by the ISIL occupation: many medical staff members have fled, priority access to surgeries is given to non-civilians, medical fees for services and operations have increased significantly, segregation which is affecting maternal health, poor sanitation in hospitals, absence of obstetric and neonatal care, etc. Although many pharmacies are still open, their stock is limited. Medicine, when available, is largely unaffordable.
During the conflict, 9 out of 13 public hospitals were damaged in Mosul, slashing healthcare capacity and the number of hospital beds by 70%. The reconstruction of health facilities has been extremely slow and there are still less than 1,000 hospital beds for a population of 1.8 million people . This is half of the internationally recognized minimum standard for health service delivery in a humanitarian context. Over four years after the ISIL was forced from the embattled city of Mosul, the city’s healthcare system remains in ruins and struggling to cope with the needs of the growing population. Thus, accessing healthcare services is a daily challenge for thousands of children and adults in Mosul.
The unsafe living conditions in Mosul – poor hygiene due to a lack of water and electricity, falling rubble, buildings collapsing and the presence of improvised explosive devices and booby traps – also pose a risk to people’s health and increase the need for healthcare facilities. National authorities and the international community are required to urgently rebuild public health infrastructure, provide patients with access to affordable medication and ensure medical facilities are supplied with the necessary equipment.
College of Medicine
Two public universities coexist in the Mosul campus (Nineveh Governorate): the University of Mosul (founded in the late 1950s) and the University of Nineveh (founded in the early 2000s). The University of Mosul (UoM) was one of the largest and most respected educational and research institutions in the Middle East, and the second largest in Iraq behind the University of Baghdad . It was located on the west bank of the Tigris, within the Al-Shifa hospital complex in Mosul. This site was heavily damaged during the 2014 Northern Iraq Offensive, until it was recaptured in 2017. Mosul University is now located on the same campus as the University of Nineveh .
Each one of them has its own “College of Medicine” managed by the Ministry of Higher Education and Scientific Research (MOHESR). There is a clear lack of cooperation between this ministry and the Nineveh Health Directorate regarding ongoing projects to rebuild the health sector. However, there is a shared willingness between both College of Medicine and their teachers to restore the capacities of the public health sector and improve health-care facilities.
The challenge for the Mosul and Nineveh College of Medicine remains the creation of a university hospital, in a context where the quality of education and training of medical students has deteriorated. In fact, the renewal of healthcare workers in Nineveh, the partial or complete destruction of teaching hospitals, the overwhelmed and disorganized services, the decay of primary health centers in the governorate, etc. has led to the decreasing of the number of enrollments students in the two College of medicine and the disorganization of the education system.
Both Colleges of Medicine seek international funding to build a university hospital in Mosul. As a first step, the priority is to rehabilitate the existing Medical Research and Care Centers within the campus and ensure its proper functioning. This could relieve overcrowded Mosul's hospitals, improve access to comprehensive and quality health care services in the governorate and support university research. In the longer term, the objective would be to enhance the capacity of the Medical Research and Care Centers to become a university hospital.
Medical Research and Care Centers
Within the Mosul campus, there is a site called “Medical Research and Care Centers”. This site - built and equipped by the Turkish company Tek-Imas Medical - was delivered a few weeks before the capture of Mosul. It is a complex of two-floors buildings divided into several specialized consultation centers (surgery, pediatrics, obstetrics, cardiology, gastroenterology, renal dialysis, hematology, oncology, etc.). This complex also has several operating rooms and a hospital wing with a capacity of 50 beds. Some teachers from the Mosul College of Medicine had been sent to Turkey to be trained to use equipment (CT scan, PET scan, radiotherapy, endoscopy, etc.).
This site suffered very slight damage and most of the sophisticated medical equipment was saved from destruction and looting during the fighting. Some rehabilitation/ repairs may be necessary on building services (electrical, plumbing and mechanical systems). The Turkish company Tek-Imas has already done some rehabilitation work during the first semester of 2020.
III - PRESENTATION OF THE PROJECT
The French Development Agency (Agence française de Développement - AFD) has set up a dedicated financing instrument for peace and resilience in the Middle East, called the Minka Middle East Initiative. This instrument finances projects aiming at increasing living conditions and access to essential services of crisis-affected population. These projects should also contribute to build trust between State and society and reduce tensions between communities.
In Mosul, AFD aims at strengthening the functioning of the newly rehabilitated Medical Research and Care Centers established within and under the leadership of the University of Mosul (UoM). This project proposal received strong support from the Iraqi authorities and stakeholders met on AFD’s first mission in the health sector in Iraq, during the second quarter of 2019.
AFD expressed interest to participate in the final investments required to upgrade the current medical equipment and ensure the proper functioning of this site. On the one hand, AFD would finance the acquisition, maintenance and/or repair of medical equipment. This may include small renovations as well as mechanical, electrical and plumbing engineering (based on identified needs) to ensure the proper functioning of the material and equipment. On the other hand, AFD would participate in the training of medical, paramedical, and administrative personnel.
The overall objective of the project would be to improve access to quality and accessible healthcare services for the population of Nineveh Governorate. It breaks down into three specific objectives:
- to support the proper functioning of the newly rehabilitated Medical Research and Care Centers in the UoM;
- to strengthen the capacity, skills and resources to attract and retain qualified employees of the Medical Research and Care Centers;
- to support the UoM's management capacities to ensure the long-term sustainability of the project.
IV - OBJECTIVE OF THE ASSIGNMENT
The objective of the assignment is to conduct a feasibility study of the Medical Research and Care Centers at the University of Mosul (UoM).
The feasibility study aims to inform the project described above by providing a comprehensive update on the Medical Research and Care Centers priority needs in order to upgrade its service-delivery capacities.
The scope of this study covers three specific areas, which are (i) the infrastructure, (ii) the medical equipment and (iii) the governance/HR management. Therefore, the consultant team will be composed of several profiles and expertise (public health, health systems strengthening, public health infrastructure and biomedical engineering, administrative and economic management of health, medical/social facilities).
The sub-objective of this study are:
- To assess the engineering services of the Medical Research and Care Centers;
- To assess the availability and proper use of the required equipment of the Medical Research and Care Centers;
- To assess the relevance of the human health resources available and governance mechanisms at the Medical Research and Care Centers.
The expected results are:
- The strategic medical and functional orientations stated by the University of Mosul are known and analyzed with regard to the healthcare priority needs at city/governorate level;
- The capacity of the Medical Research and Care Centers to deliver planned services in terms of engineering services, equipment, human resources and management is evaluated;
- An assessment of organizational and functional needs of the Medical Research and Care Centers is conducted, fostering local participation and ownership;
- The needs for maintenance, replacement, repairs, renovation, upgrading of mechanical and electrical equipment and systems are identified, and the related cost is estimated ;
- An overall capacity building strategy and action plan is proposed (on the specific components covered by the study), including a description of the necessary means and resources to be mobilized for its implementation.
V - METHODOLOGY
a. Phases of the mission
1. Preparation of the mission
The consultant team will perform a preliminary analysis of available information (document and literature review, key informants interviews, WHO and health working group documents, NGOs reports, local health policies and local media sources etc.) and work with the consultant lead to prepare the field missions in Mosul, jointly conducted with technical expert from the UoM.
The desk review will also examine the contractors and suppliers’ technical assessments of the equipment purchases and the rehabilitation completion reports handed over to Mosul University.
2. Field missions in Mosul
Following these work sessions, the national experts - supported by the consultant lead and EF Erbil’s office and the consultant lead - will conduct key informant interviews covering several levels:
- Strategy/policy and organizational level – with governorate and city level heath authorities and Mosul Medical Research and Care Center decision makers as well as with key local health providers,
- Medical Research and Care Center level – with health practitioners,
- Technical level – engineers and supply chain team in charge of the procurement of the equipment and contracting the rehabilitation company.
The national experts will then carry out the necessary field investigations at the Medical Research and Care Centers at the University of Mosul; site observations and analysis related to their field of expertise.
3. Data analysis and technical reports writing
These field investigations will result in the production of technical reports on main findings and proposed interventions for each component of the study. Technical reports should include photographs / sketches and high level estimates for the necessary interventions required.
VI - DELIVERABLES AND REPORTS
A technical report for each of the three technical components related to this study.
Related to the medical equipment, it is expected to provide:
- A comprehensive medical equipment inventory and diagnosis (availability and use of equipment): comprehensive data collection and testing of all equipment assets functionality, specifying their condition (functional or not), the availability of maintenance skills and spare parts, the equipment distribution between the buildings/rooms, etc.
- A mapping of resources setting (financial, logistic, human) allocated to deliver equipment maintenance activities (at all levels of the health system);
- An evaluation of the capacity of the biomedical equipment technicians to analyze, maintain, repair and upgrade equipment;
- A mapping of financial and technical support already provided by the other actors/ donors to coordinate activities and assess the potential for synergy;
- An identification and costing of priority needs for equipment repairing/replacing (logistics of delivery and installation, etc.) in order to address the actual needs to align with relevant strategic choices with regards to the epidemiological situation in the city/area;
- A technical capacity-building plan to enhance equipment management and maintenance according to priority needs identified, including human resources training needs.
For each component, the expert will:
- Undertake desk reviews of drawings, maintenance records and other relevant and available documents to conduct a preliminary analysis (national policies and strategic plans, etc.);
- Identify gap in terms of human resources, equipment, infrastructure and processes/procedures
- Develop appropriate proposal and recommendations to address these gaps and assess the necessary means to implement recommendations;
- Assess the anticipated risks and benefits associated with the orientations proposed (requirement for specific supplies or materials, availability of technical support for maintenance, availability of space, availability of human and financial resources, etc.).
Discussions will take place throughout the mission in order to specify the structure, content and format of the deliverable.
VII - TIMEFRAME
This assignment is expected to be carried during the first semester of 2021 (exact period to be confirmed).
VIII - ORGANISATION OF THE MISSION
Composition of the expert team:
- A “lead” consultant to develop and coordinate the implementation of the study process and content (scoping meetings, data collection, monitoring of national experts work, consolidation and analysis, reports writing, etc.);
- A building services engineer (specialized in healthcare facilities);
- A Biomedical engineer;
- A Healthcare/hospital governance specialist.
The consultant team - supported by the EF’s office in Erbil and headquarter – will conduct the study in close cooperation with the Iraqi health care sector, including the UoM (administrative authorities, medical community), the Ministry of Higher Education and Scientific Research (MOHESR) and local health authorities who will facilitate the mission.
The consultant team will be autonomous in terms of equipment (computers, offices, etc.), communication (telephone and internet), travel and accommodation.
IX - REQUIRED PROFESSIONAL SKILLS AND EXPERIENCE
a. Expected qualification and experiences
Biomedical engineering (senior)

Academic qualifications
Advanced University degree in biomedical engineering, with knowledge in civil and environmental engineering.

Technical competencies and experience:
Proven experiences in:
- Needs assessment, analysis and resource planning;
- Medical equipment maintenance management (preventive and corrective);
- Medical equipment acquisition process;
- Identify requirements for medical equipment and furnishings;
- Analysis of the equipment purchase/ installation/ maintenance/ and repairs related costs (transportation, consumables, spare parts, etc.);
- Establishment of a continuing education program for biomedical technicians and other personnel in the public sector on the proper use and maintain of biomedical equipment;
- Safety, efficiency, and effectiveness of biomedical equipment evaluation.
The expert must meet the following requirements:
- High-level written and oral communications skill in English;
- Proven experience in writing and reporting skills in English.
The application of the consultant team must include:
- CV of the consultant;
- Details of the company applying (if relevant);
- A cover letter describing the relevant experiences. This letter should also mention the consultant(s)’ availabilities;
- A technical offer presenting the understanding of the present Terms of Reference, the approach suggested including the methodology;
- A financial offer indicating consultant fees and estimated mission expenses. The financial proposition may include expert’s fees and all other costs and associated charges related to the implementation of the study (travel expenses, accommodation, insurance, etc.).