develop Africa but it will be impractical for them to return to Africa. Today, one in three African university graduates now lives and works outside Africa. There are more Sierra Leonean medical doctors in the city of Chicago than in the entire nation of Sierra Leone. Africa's most important
export to Europe and the United States is
trained professionals, not petroleum, gold,
and/or diamonds. The widely held myth is that Africa is only exporting raw materials to the west. Africa is also exporting talented human resources to Europe and America. One million Africans are working outside Africa. At the same time, Africa spends four billion dollars a year on the salary of 100,000 foreign experts. Yet, African nations are unwilling to spend a similar amount of money to recruit one million African professionals currently working outside Africa.
WRHC is in a perfect situation as our charter allows us to transcend these issues and contribute to the solution instead of acting as one more cog in the wheel of a seemingly never-ending problem.
HOSPITAL CONSTRUCTION AND OPERATIONS
Our hospitals are to be constructed of
the best available materials using pre-fabrication design methods. This process of construction is intended to meet all standards set forth by the International Building Codes and Standards. While giving attention to the Standard Building Codes, it will also meet all Hospital Standards necessary, in order to provide a level of medical care equal to that of any modern hospital in the world. WRHC intends to use
state-of-the-art medical procedures and equipment.
WRHC Personnel will be deployed to the hospital construction site. Approximately 150 WRHC personnel will make up an individual deployment team (World Team). These teams will include, at a minimum:
supervisors, carpenters, plumbers, electricians, trainers, inspectors, cooks, computer and communications specialists, HR
representatives, administrators, payroll
and finance specialists, medical personnel, water and waste systems specialists, mechanics, and heavy equipment operators.
Once deployed, our teams will establish a construction compound to house, feed, and maintain the efforts of WRHC and local construction personnel while building the hospital. When the hospital is complete the World Team housing will become housing for single medical personnel working at the hospital.
The construction facilities will include: pure water facility, waste water facility, electrical generation, fuel storage, construction training facilities, dry and wet construction facilities, cold and dry food storage facility, kitchen, food service facility, dining hall, recreation hall, medical facility, construction administration facility, employee administration facility, housing,
vehicle maintenance facility, laundry facility, tool storage, security facility, employee store, warm water generators, sanitary facility, shipping/receiving warehouse facility, general supply facility, construction supply facility, and in some cases we will need a helicopter maintenance and storage facility. Our preferred option is to install pre-fabrication factories at each hospital construction site. These facilities may be
used after the completion of the hospital to fabricate panels for housing, community centers, commercial developments, and other suburban environments.
The patented system relates to a pre-designed series of batteries, which contain vertically slung steel molds from which panels are cast to suit the production requirement. Additionally, a pre-designed number of steel molds are set up, on site,
to produce columns and ground beams at a rate to suit the project requirements.
The production compound, where the casting facility is located, is positioned on site to best suit the overall layout, also taking materials delivery into account.
The pre-fabricated, structural panels can be manufactured in batteries of up to 25 per battery. Once cured, two or three men can easily manipulate these lightweight panels into place. Windows and other openings are planned into the battery as are electrical chases and some rudimentary plumbing lines. Once in place, the panels do not need an external covering, but will require an interior surfacing. Those panels used on the interior may not require any surfacing at all other than paint. All panels required for the construction of a
single hospital can be manufactured in 30
days or less.
The hospital will be constructed on a site designated and donated by the host country using experienced indigenous construction workers. This virtually assures WRHC of having access to a trained work force should any post-construction servicing or additions to the hospital building be necessary. WRHC will institute a training program for unskilled workers.
BASIC RURAL HOSPITAL DESIGN
Our Architectural Design Group will be
chartered with the task of coming up with as many as six basic hospital designs. While each will share many similarities, each will be slightly different in ways that can conform to minor changes in the landscape or to adapt to specific cultural requirements.
ENVIRONMENTAL FACTORS:
As often as the geo-environment will allow, we will be utilizing solar or co-generation power in all hospitals. The advantage of a single level hospital design is that we have massive rooftop spaces, which are perfect for solar fields, incorporating many banks of solar panels.
A single level design allows us to make generous use of skylights, for the inclusion of natural light into the clinics, wards, and public spaces. The hospital design will include several interior courtyards, which will allow a greater opportunity for the circulation of natural air.
The largest single issue will be the storage of excess electrical energy. In developed nations this excess energy can often be sent back into the established electrical grid with credit given to the
initiator (the hospital). At night or during other periods when the solar cells won't provide the energy, the initiator can go back onto the grid to retrieve energy for operations. In less developed countries, this is an issue since the grid is often less reliable.
OPERATING ROOMS AND OTHER AREAS:
When the first WRHC Rural Hospital opens its suite of new operating rooms, we hope that it will signal a new way of performing surgery. For efficiency, the OR suite will be connected to the Shock Trauma Center and share recovery and sterile areas. Fully wired rooms will contain sterile environment computers, X-ray capability online, voice control lights, laparoscopic cameras and video-enhanced white boards. One room will be able to
convert from interventional
radiology/catheter lab to a conventional operating room, allowing surgeons to operate if a patient's condition deteriorates or presents an option for a combination angioplasty and open technique, without moving the patient. Another room will be copper shielded to prepare for a portable intra-operative MRI. Each OR will use high definition flat panel display screens for crisper details and greater videoscopic control in the body cavity. The screens will be moveable and can be placed for more optimal use by the surgical team as well as for observation outside the OR by students and others.
The Chiefs of Surgery, Nursing, and Medicine, at the local level will have 24 hour access via closed circuit television to all surgeries in WRHC hospitals, anywhere in the world. Interested WRHC surgeons, physicians, and nursing staff,
around the world will also be able to tune in to observe procedures or the introduction of new techniques. While today's OR is cluttered with equipment, cables and instrumentation, the WRHC operating rooms will house bulky equipment in sterile spaces connected to the suites, allowing immediate service access without impeding traffic flow in activity in the OR. Staff will no longer need to run or call from room to room asking about status. With video and other communication technologies, the WRHC suites will allow immediate visualization of all the operating rooms to offer a visual context in each OR and know if they need help if a patient has "crashed", or the surgical team has finished a case.
The general OR area will house one or more medical simulators s
o surgeons and residents can practice new techniques.
They can rehearse a procedure until they are comfortable. Simplifying the influx of information falls to a discipline called medical informatics, which assembles all patient information electronically. By scanning the patient's RFID device attached to the wrist, surgeons will be able immediately access patient histories and
recent test results. Moreover, this hybrid of medical records and technology allows for enhanced documentation and connectivity with other medical departments.
NEW ER LAYOUTS
Each new emergency room will contain the most advanced technology available in an emergency setting and offer multidisciplinary care across the entire medical spectrum. The new emergency department will also feature comforts designed to ease patient anxiety and
promote privacy. Visibility and accessibility are key points for the WRHC Emergency rooms so that staff, and possibly security personnel, can be quickly alerted or informed in difficult situations. Each WRHC ER will feature a chest pain evaluation center, fast track services for patients who are not critically ill and immediate access to CT scan and other radiology services without leaving the suite.
Patient rooms will be designed with privacy in mind, as well as workflow efficiency for the medical staff. The space will be designed to be more efficient and with patient and clinical needs in mind. As mentioned earlier, each unit will be next door to the Shock Trauma Center, the Operating Rooms, X-Ray, and the hyperbaric chamber.
HOSPITAL ROOM DESIGN
The floor plan is perhaps the most important design element and can only be addressed with new construction. By using a modified hexagon configuration or a circular design with the nursing station in the center, all rooms are equidistant from the staff. With this design, all rooms can be visible from the nursing station. Many hospitals have long corridors, which places some rooms at a great distance from the staff. This makes it necessary to triage patients and place those that are more ambulatory and less ill in the distant rooms. All patient corridors are visible from the nursing station and there are no dead ends where patients cannot be seen while ambulatory. It has been shown that an ideal number of beds for a critical core unit is twelve. Big is not always better
when it comes to taking care of acutely ill
patients.
In any WRHC hospital room or ward environment, should a patient's condition deteriorate suddenly, then all the equipment needed will be built into the cabinetry, thereby avoiding a transfer to a critical care unit. This design allows for a comfortable and quiet environment, such that we have noted a virtual absence of confusion and disorientation. Heart patients are especially prone to sudden life-threatening events and therefore minute by minute monitoring is important rather than relying on sporadic "bed checks" during nursing rounds. Each area will be fully computerized with monitoring capability to allow all vital signs including pulse, EKG rhythm, blood pressure, oxygen saturation, and temperature to be visualized in the room
and simultaneously at the nursing station.
If only the EKG is being monitored at the nursing station, many patient problems may be missed until a crisis develops.
Hospital acquired infections are of great concern especially with the rise of resistant bacteria. Recent studies have shown that both fungi and bacteria can grow in carpet and upholstery fabric. Linoleum when washed can harbor certain microbial organisms. In an effort to better sanitize and clean patient areas, our suites will have tiled floors with sealed epoxy grout, which is impervious to fluids.
The majority of hospital injuries occur due to falls from beds. Both the likelihood of falling and the severity of the injury increase with age. Falls tend to occur in the first three days of a hospitalization when the patient is unfamiliar with the surroundings and may be early in the recovery from an operation.
Most falls occur at night prompted by a need to use the bathroom and they are more frequent on medical-surgical floors where the nurse to patient ratio is lower therefore bed alarms are vital in these areas. Potential injuries in the shower are decreased by having built-in benches and grab bars. Fall-prevention interventions will involve using bed devices that have a built-in alarm system monitored in the room, and at the nursing station, using both visual and auditory signals to alert the staff that a patient is attempting to get out of bed without help. When this devise is used in combination with guardrails, we feel that
falls can be decreased by an astounding 75%.
Video cameras with night vision have been placed in each suite for added protection. These cameras can be adjusted
from the nursing station to either give a panoramic view of the room or a zoom in on the patient to make sure that oxygen, catheters, and the like are not inadvertently discontinued by the patient. At each patient bed, a small flat panel LCD video display (approximately 6 by 11 inches) will be attached to an adjustable swing arm. This display can be used for a variety of things including, watching television, conferences with physicians and nursing staff, as well as the display of medical information and education regarding the individual patient's medical situation.
Access to medical condition information (how does my new knee replacement work) will be initiated with the input of the patient's bar code identification. By utilizing this technology, our hope is that patients will be better informed and less frightened
about upcoming procedures or their future.
Diversion total to date $207,500,000
Donation total to date $195,000,000
World-Wide Military Tactics
Because we have the ability to secretly occupy any computer in the world it becomes critical that we establish an internal department of military tactical information. We will enter the computer networks of countries that may be a threat to the security of the United States and the world such as:
RUSSIA
The Russian government spied on hundreds of American, European and Asian companies, the first time Moscow has been linked to cyber attacks for alleged economic - rather than political - gains. The victims of the previously unreported cyber espionage campaign include energy and technology firms, some of which have lost valuable intellectual property.
These attacks appear to have been motivated by the Russian government's interest in helping its industry maintain competitiveness in key areas of national importance.
IRAN
Iran is responsible for a wave of computer attacks on US corporations, with targets including oil, gas and electricity companies, citing American officials and corporate security experts. The officials stated that the goal of the Iranian attacks is sabotage rather than espionage. The cyber attacks are seen as attempts to gain control of critical processing systems.
JAPAN
The Japanese have mounted a comprehensive economic espionage and economic intelligence collection effort directed against the United States.
Because Japan has a very small government intelligence organization, most intelligence is collected by Japanese companies in coordination with the Japanese Ministry of International Trade and Industry (MITI). Major Japanese multinational corporations such as Mitsubishi, Hitachi, and Matsushita have large corporate intelligence organizations that collect political and economic intelligence. The quasi-official Japanese External Trade Organization (JETRO) has also been used as an intelligence asset, collecting information and even supporting espionage activities.
FRANCE
The French General Directorate of External Security (DGSE) has targeted U.S. economic and proprietary data since at least 1964. The top priorities of the DGSE
are combating terrorism and collecting economic intelligence. Service 7 of the DGSE has successfully conducted technical operations against telecommunications systems throughout the world and has gathered significant data through these activities. Reportedly, the DGSE targeted Loral Space Systems and Hughes Aircraft for information on telecommunications satellite technology, Lockheed Missile and Space Company for data on the MILSTAR milit
ary communications satellite system, TRW for military telecommunications technologies, and GTE Telecommunications Products for microwave technologies.
SOUTH KOREA
The South Korean government and South Korean businesses have also conducted operations directed at collecting U.S.
economic and proprietary data. South Korea
has centered its collection efforts on computer systems, aerospace technologies, and nuclear technologies. According to the Defense Intelligence Agency, South Korean activities have included stealing information from computerized databases maintained by U.S. government agencies and the U.S. companies.
GERMANY
Germany has been accused of using computer intrusion techniques and SIGINT to gather information on foreign competitors to be passed on to German companies. There are no indications of a HUMINT effort against United States corporations, however, it is likely that German trade officers are collecting economic intelligence through open-source analysis. The German Federal Intelligence Service (BND) is alleged to have created a
classified, computer intelligence facility outside Frankfurt designed to permit intelligence officers to enter data networks and databases from countries around the world. This program, code named Project RAHAB, is alleged to have accessed computers in Russia, the United States, Japan, France, Italy, and the United Kingdom.
ISRAEL
Israel has an active program to gather
proprietary information within the United States. These collection activities are primarily directed at obtaining information on military systems, and advanced computing applications that can be used in Israel's sizable armaments industry. Two primary
The Robin Hood Virus Page 4
