Having discovered that X-ray machines at 85 U.S.-built public health clinics across Iraq have leaked excessive but low-levels of radiation for four years, the U.S. Corps of Engineers has used emergency procedures to contract with three firms to halt the long-term cancer threat to patients and X-ray operators.
The leakage, which at some clinics exceeds the permissible standard set by the Iraqi Ministry of Environment, has several causes, including “design deficiency, whereby the designer had neglected to specify shielding in some openings; and some construction deficiencies where the proper lead shielding had not been installed either in accordance with the specifications or at all,” according to a Corps of Engineers report made public last week.
Other than the X-ray machine operators, limited danger faces the estimated 1,700 people served each day at the U.S.-constructed and outfitted clinics, which are now operated by the Iraq Ministry of Health.
Think of this as a cautionary tale. The repairs needed by the X-ray machines initially will cost the United States just over $1 million. But eventually the cost could involve much more, depending on what happens next.
The Iraq clinics program has had a checkered past. Begun in 2004, the original plan called for 150 primary health-care clinics. An $88.5 million contract was awarded to Parsons Global Services for design and construction. Parsons received another $70.4 million contract to pay for medical and dental equipment for the clinics, including 150 X-ray machines.
In March 2006, with 77 percent of the money spent, the U.S. government stopped work on all but 20 of the clinics because of “lack of progress,” according to a report by the special inspector general for Iraq (SIGIR). Only six clinics had been completed and both Parsons and the government contract managers were faulted for “poor performance,” the SIGIR report said.
At that time, the medical equipment for the remaining 130 clinics, including the X-ray machines, was shipped to a contractor-run warehouse in Abu Ghraib to be stored for at least six months or longer. SIGIR wrote that the 12-month warranty on the equipment may be nullified because the assumption had been that the equipment was “to be delivered and installed in new and undamaged condition.” SIGIR investigators noted damage of some shipment crates was visible.
In June 2006 the State Department came forward with an additional $63 million to continue work on the remaining clinics, though several were dropped from the program. Some 132 were eventually completed by “a multitude of construction contractors,” according to the Corps report.
In 2008, the Corps hired a firm to check on the clinics and over a year’s time its personnel found evidence of possible X-ray leakage. Further testing at 15 operating clinics with appropriate devices “identified ‘hotspots’ at multiple locations within and outside of the X-ray suites,” the Corps said.
A new contract financed more detailed inspections at the remaining clinics beginning in 2010, which ended in February. Of the 98 inspected, nine had non-working X-ray machines, four had none on-site, and one site prevented the inspection. All those inspected “have confirmed radiation leakage,” the Corps reported.
Based on a plan set up last month, each of three new contractors would work in one of three regions in Iraq and finish repairs in three clinics per week. The Corps projected the 85-clinic project could be concluded within 10 weeks. It would take twice as long if the job were given to one contractor and speed was considered important.
Who was at fault and who — besides the U.S. taxpayer — will pay the bill? “Stopping the leakage” rather than immediately assessing blame was described as the priority of U.S. Ambassador to Iraq James F. Jeffrey, the Corps said.
But there is plenty of blame to go around. For example, the Corps reported routine quality assurance inspections by government contracting officers “should have caught these errors, but given the wartime conditions at the time of construction, the errors were not discovered.”
As the current repairs are made, information is to be collected at each of the 85 clinics to determine “which repairs are attributable to construction contractor problems versus design issues,” according to the Corps report. Based on that evidence, the report said the Corps will “identify the amounts it believes attributable to Parsons Global performance and seek reimbursement.”
It warns, however, that any design defect “is arguably non-compensable,” and Parsons could claim under government contracting rules that it had not been given notice of the construction defects nor an opportunity to address the problem.
So who could be liable long-term if, as the Corps report says, if someone suffers serious injury or long-term illness?
You guessed it: the U.S. government, the Corps said
How many other well-meaning projects in Iraq and Afghanistan carry similar seeds of future U.S. liability?