Facilit y Construction and Maintenance. Existing health facilities in rural areas, while affording at least minimal space, are deficient in staff housing. As most medex are married and have growing families, adequate housing is considered an absolute prerequisite to their posting to rural areas. Hence, at the approximately 100 rural locations where medex are to be deployed, the Project will undertake·construction of three-bedroom houses at an estimated 41 locations. As most existing rural health facilities do not have a dependable 24-hour water supply and sanitary latrines, the Project is allocating funds for construction of approximately 50 elevated water tanks with trestles and latrines to be built at the rural health facilities where medex are posted. Though existing rural health facilities are all usable, many are barely so and in need of renovation, including some expansion/upgrading. During the first year, the Project will finance the costs of a local engineering firm to do a site-by site study of all proposed or actual medex- locati-ons and determine the specific renovation required at each site to ensure that the medex will have adequate · facilities in which to work, such as examination room, laboratory and some reception/ education space. The Government of Guyana and USAID will then consider wh�ther additi0nal financing will be necessary for this work. Facility maintenance and repair will be supported in part by the Project Loan.
