Specifying a Level-2 field hospital in under two weeks

A Level-2 field hospital is, in WHO language, an emergency medical team with inpatient surgical capability. That phrase hides an 850 m² building that has to ship in a 40-foot container and be triaging patients seventy-two hours after it reaches site. Most tenders we read make the job harder than it needs to be. This is the checklist we wish procurement teams used.

Why Level-2, and why two weeks is enough

A Level-1 unit does triage, stabilisation and outpatient primary care. A Level-2 unit does all of that plus damage-control surgery, inpatient wards and basic imaging. A Level-3 unit adds CT, specialty surgery, and is — realistically — a modular hospital on wheels rather than a deployable emergency facility.

The jump from Level-1 to Level-2 is the one most ministries of health and NGOs get wrong. They over-specify, asking for Level-3 capabilities they will never use, and the tender collapses under its own weight. Two weeks is enough to write a competent Level-2 tender if — and only if — you start from a reference configuration and then remove the things that do not apply to your context.

The WHO EMT baseline you cannot skip

The WHO Emergency Medical Team (EMT) classification is the only international baseline worth anchoring your tender to. It is not optional. Donors, UN clusters, insurance carriers and host-nation ministries all read "WHO EMT Type 2" the same way. If you cannot tick their checklist, your unit will not be accepted into a coordinated deployment.

The baseline is public. Type 2 requires 20 inpatient beds, two operating tables doing seven major and fifteen minor surgeries a day, basic imaging (ultrasound and plain X-ray), laboratory, pharmacy, sterile services and inpatient rehabilitation. It must self-sustain for fourteen days with no external water, power or consumables. Build backwards from that.

The twelve functional rooms

A competent Level-2 unit resolves into twelve functional spaces. Number them in your tender. The order matters because the clinical flow — entry, triage, resuscitation, surgery, recovery, ward, discharge — has to be unidirectional, with a clean and dirty spine.

1. Triage tent or awning — outdoor, weather-protected, 20–30 m².
2. Resuscitation bay — 2 trolley spaces, adjacent to triage, with direct access to OR.
3. Emergency / short-stay ward — 6 beds, curtain-separated.
4. Operating room(s) — 2× 28 m², HEPA HVAC at 20 ACH, medical-gas panel.
5. Sterile services (CSSD) — washer-disinfector, steam autoclave, dirty and clean sides.
6. Inpatient ward — 20 beds, male/female/paediatric zones.
7. Imaging — digital X-ray room with 2 mm lead shielding, ultrasound bay.
8. Laboratory — haematology, biochemistry, rapid tests; negative-pressure microbiology bench.
9. Pharmacy — locked, air-conditioned, with a 2–8 °C cold-chain cabinet.
10. Outpatient / consultation rooms — 2 to 4 rooms.
11. Staff rest and changing — separate gowning for theatre.
12. Utilities and plant — gensets, fuel, water, oxygen, waste, IT.

Utilities that ship with the building

If the tender does not specify utilities as part of the unit, you will end up paying twice — once for the building and again, in a panic, for the generators and tanks that were supposed to come with it. Every structmod Level-2 ships with a pre-sized utility pack: 2× 80 kVA gensets in N+1, 5,000 L potable water, 2,000 L wastewater, a 10-bottle medical oxygen manifold, and a fuel bund sized for fourteen days of continuous operation. The numbers are not aspirational — they are what the WHO EMT Type 2 verification team will actually measure when they inspect.

Oxygen is the one most tenders get wrong. Twenty beds and two theatres draw a lot more oxygen than a fixed hospital of the same size, because trauma patients are ventilated. Specify a manifold, not cylinders on carts.

Specifying for the worst day

Your unit will not be judged on a Tuesday morning with three patients on the ward. It will be judged on the day two hundred casualties arrive in six hours, half of them needing surgery. Every clinical adjacency, every door width, every circulation spine in your tender has to survive that day.

That means the OR must be directly accessible from triage without crossing the clean ward. It means the CSSD has a pass-through autoclave so a single dirty instrument never re-enters the clean side. It means the genset room is outside the building envelope with its own fuel bund. None of this is expensive if you design it in on day one. All of it is ruinous if you try to bolt it on later.

A redline tender paragraph you can copy

Copy that paragraph, substitute the bed count for your context, and you have a defensible Level-2 tender. Everything else — manufacturer qualifications, warranty, training, spares — is boilerplate.