The project is classified as category B. An initial environmental examination including an environmental management plan (EMP) was prepared in compliance with ADB's Safeguard Policy Statement (2009) and the Mongolia regulatory framework, and was posted on the ADB website on 21 August 2012. The initial environmental examination assesses and addresses environment impacts and risks related to (i) the Ulaanbaatar central medical waste management facility; (ii) the new National Transfusiology Center; (iii) smaller blood safety, infection prevention and control, medical waste facility installations in project aimags; and (iv) project associated facilities. The main adverse impacts and risks during the construction and operation phase include limited standard construction impacts, and risks related to unsafe collection, storage, treatment, and disposal of medical and chemical liquid waste generated by health facilities. These impacts and risks will be addressed through the implementation of the EMP that includes adequate mitigation and monitoring arrangements, responsibilities for EMP implementation and supervision, environmental training and capacity building, and budgets for implementation of EMP.
The EMP will be updated based on final design and will be submitted to ADB for review and approval prior to awarding the civil works contract. Contractors during construction, and facility operators as well as MOH during operation will implement these measures. The effectiveness of these measures will be regularly evaluated in the framework of the environmental monitoring program, and corrective actions defined as required. The Government of Mongolia, through MOH, is committed to manage identified environmental risks and agreed on a comprehensive set of loan covenants. Relevant environment information was disclosed to potentially affected people, and the results and findings of the consultation process were used to modify the initial environmental examination and the project design. Consultation and participation will continue throughout project implementation and any environmental complaints or disputes will be handled in accordance with the grievance redress mechanism established for the project. The project will have significant environment, health, and safety benefits. Mongolia's medical waste management system, including liquid hazardous waste, will be significantly strengthened by improving medical waste management systems within health care facilities, by upgrading the central medical waste management facility in Ulaanbaatar to meet internationally accepted standards.
|During Project Design
||Three workshops were held with related governmental departments, beneficiaries, environment protection bureau, local governments, etc., to inform the project design. The poverty and social analysis involved focus group and key informant interviews with health care workers, patients, and the general public. Development of the environmental impact assessments and environmental management plan (EMP) involved two rounds of public consultations. The gender action plan (GAP) has been prepared and discussed with the Ministry of Health. The GAP and EMP set out detailed ongoing public participation plans.
|During Project Implementation
||Public disclosure of all project documents was made at the project management office and on the ADB website, including the project information document, design and monitoring framework, consolidated environmental impact assessment, report and recommendation of the President, public sector legal agreement, project administration memorandum, and environmental monitoring reports. The GAP and EMP indicate how consultation will continue throughout implementation.