Cayma La Tomilla health project audit finds waste

That matters economically because health infrastructure is only productive when buildings, power, oxygen and vacuum systems, and equipment procurement are planned as one package. When they are split apart, governments can end up with stranded assets: machines that are installed, invoiced and counted as delivered, but cannot safely operate or must be exposed to damage from power interruptions. For a local municipality, that means sunk costs, maintenance burdens and a lower return on scarce public investment. For patients, it means delayed or compromised care.

According to the audit, the technical file for the second stage failed to include a UPS system for eight items covering 21 medical devices that needed uninterrupted power. It also omitted a medicinal oxygen network and a medicinal vacuum network, along with the related piping, valves and central systems required for equipment tied to those utilities. The Contraloría said some devices could not enter service because the infrastructure they depended on did not exist.

The review also found procurement problems. In one process, Cayma granted conformity to a bidder even though several required health registrations were not properly evidenced. The audit cited equipment including a perfusor, blood or solution warmer, fetal stimulator, BMI meter and vacuum-suction unit. In another case, six refrigerators were accepted despite not meeting one of the technical conditions set in the specifications. The report said other items were also approved without fully complying with the tender requirements.

The broader significance is political as well as fiscal. Peru’s local governments often rely on direct administration and fragmented contracting to move projects quickly, but this case shows how speed without technical integration can produce low-quality public assets and future repair bills. It also raises accountability questions over who signed off on the technical file, who accepted non-compliant goods and whether the municipality will have to spend again to make the equipment usable.

For investors, the immediate read-through is limited to TOMZ and other listed water and health-infrastructure suppliers only in the sense that public-sector procurement risk remains a persistent issue in emerging markets. The more relevant market takeaway is that capital spending, especially in municipal health projects, can be misleading when execution quality is weak. The difference between budget authorization and operational capacity is where waste is created.

The case now shifts from construction to enforcement: whether Cayma can correct the missing systems, challenge faulty acceptances or recover value from the purchases. If not, La Tomilla will remain a reminder that infrastructure spending is not the same as infrastructure delivered.