26820 - Metropolitano

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Environmental & Social Review Summary

Project Number

26820

Company Name

Hospital Metropolitano Vivian Pellas

Date ESRS Disclosed

May 9, 2008

Country

Nicaragua

Region

Latin America and the Caribbean

Last Updated Date

Jun 11, 2022

Environmental Category

B - Limited

Status

Active

Previous Events

Approved : Jun 25, 2008
Signed : Jun 27, 2008
Invested : Mar 31, 2009

Sector

Hospitals and Clinics

Industry

Health, Education and Life Sciences

Department

Gbl Ind, Manufact, Agribus & Services

Project Description

The proposed transaction is a $26 million expansion and refinancing project for Hospital Metropolitano S.A. (the Hospital, Metropolitano or the company). The Hospital offers a broad range of high quality health care services though its 45-bed existing facility in Managua, Nicaragua. After beginning operations in 2004, it rapidly established itself as a leading institution within the Nicaraguan health sector, developing a reputation for quality.

Overview of IFC's Scope of Review

IFC’s environmental and social review included review of project information and documents provided by the sponsor, and field visits to their operation in Nicaragua.

E & S Project Categorization and Applicable Standard

While all Performance Standards are applicable to this investment, IFC’s environmental and social due diligence indicates that the investment may have potential impacts that must be managed in a manner consistent with the following Performance Standards:

- PS1: Social and Environmental Assessment and Management Systems
- PS2: Labor and Working Conditions
- PS3: Pollution Prevention and Abatement
- PS4: Community Health, Safety and Security
- PS5: Land Acquisition and Involuntary Resettlement
- PS6: Biodiversity Conservation and Sustainable Natural Resource Management

This is a category B project according to IFC’s procedure for Environmental and Social Review of projects because a limited number of specific environmental and social impacts may result that can be avoided or mitigated by adhering to generally recognized performance standards, guidelines, or design criteria. IFC professional staff performed a physical evaluation of the project and environs, and reviewed relevant company and government documentation.

Environmental and Social Mitigation Measures

Environmental, Health and Safety, and Social Assessment and Management Systems:

- Environmental and social management system:

The company agrees that it needs to establish an integrated management system tailored to the company size, and based upon internationally recognized management systems (e.g. ISO 9001-2000, ISO 14000, and OHSAS 18000). The management system will address identified environmental, human resources, safety of radiation sources, and occupational health and safety issues associated with operations, and social impacts and risks of all existing and future operations. The company will design the ESMS system to comply with Nicaragua regulations and IFC policies and performance standards.

The ESMS will include stipulations for monitoring of environmental, social, health and safety of radiation sources (consistent with IFC EHS Guidelines and international standards for the safety of radiation sources), and for reporting back to IFC. It will also specify operating policy requirements as well as basic procedures that must be in place for quality control and compliance during construction as well as during the operation of the Cancer Centre (pollution loads, solid waste, safety management of hazardous materials, etc.). The company will retain an experienced scientific/technical professional in radiation protection to supervise the construction of the Cancer Centre. Metropolitano will formalize the managerial duties for environmental and social performance in all operations by making a change in the title name to “Operations and Environmental Management”.

Metropolitano will implement a training programme on Environmental and Social issues for its workforce, and as part of the content of the induction process for new employees. The company will implement a formal system for monitoring and reporting environmental and social issues to senior management. To ensure quality assurance during construction of the Cancer Centre, Metropolitano will retain the current level of radiation protection scientific/technical expertise to supervise the construction of the Cancer Centre.

Labor and Working Conditions:

- Update Human Resources Policy:

All employment relationships are in compliance with national labour law in Nicaragua. Metropolitano is a non-discriminatory and equal opportunity business enterprise. Metropolitano provides PPE and safety training to all workers. OHS issues are managed following corporate standards and are available to all employees. During the induction period, technical, hygiene and quality procedures are fully explained to employees. Metropolitano will update its human resources policy in accordance to Nicaragua labour laws and regulations and IFC standards, to specifically include reference to non-discrimination, freedom of association and collective bargaining, and will submit the policy to IFC for review. The company will also develop and implement a formal employee grievance redress mechanism and will further disseminate the grievance process as part of their ESMS Operational Safety Plan for site infrastructure: This plan will include the implementation of pavement markings, traffic signals, regulatory signs, warning signs, and emergency exits signs, according to international standards, to ensure safety of the workforce and clients.

Pollution Prevention and Abatement:

The main sources of emissions to the environment and the risk of environmental include process liquid effluents, sanitary discharge, and solid and radioactive waste. Process and sanitary wastewater is discharged to the municipal’s sewage facility. Power is obtained from the national grid, and usage of generators is limited to a few hours per annum. The company will present a plan for IFC’s approval to dispose the solid waste in an environmentally sound manner (such as a sterilization system for infectious waste or other), and waste segregation. The company will ensure that the plan is in compliance with regulatory limits of Nicaragua and IFC guidelines. Metropolitano will ensure that the activity and volume of any radioactive waste that results from the sources for which they are responsible be kept to the minimum practicable, and dispose of in accordance with IFC EHS Guidelines and the International Atomic Energy Agency international Standards for safety use of radiation sources. The Company will ensure that the waste managed will be segregated if appropriate by differences in factors such as radionuclide content, half-life, concentration, volume and physical and chemical properties, taking into account the available options for waste disposal. Metropolitano will ensure that radioactive substances are not discharged to the environment unless the discharge is within limits authorised by the Regulatory Authority.

Community Health, Safety and Security:

- Community Engagement Plan:

Metropolitano is surrounded by a residential neighborhood and the company lacks a formal community engagement and grievance mechanism. Metropolitano will develop a formal plan for community engagement and grievance mechanism, including a monitoring system and the ability to express concerns about acts of security personnel, and will ensure it is clearly communicated by posting on the company website and included in relevant written public communications. The company will provide written information to IFC showing that an Emergency Planning and Response plan (EPR) has been developed.

Land Acquisition and Involuntary Resettlement:

According to legal documents presented by the company, all their land acquisitions or rentals are done within a willing buyer-willing seller framework.

Biodiversity Conservation and Sustainable Natural Resource Management:

Natural or critical habitat or endangered species: There are no legally protected areas where Hospital Metropolitano located. The company operations do not involve modification, conversion, or degradation of any critical habitats.

Sustainable Water Management Plan: Metropolitano will:

- Develop a water management plan to implement a water conservation programme to reduce the impact on groundwater. The plan will be submitted for IFC’s approval. It will include policies and procedures on sustainability of water resource management to be included in the ESMS
- Install remote control computer-based groundwater level monitoring tool in the operating well
- Implement the water management plan
- Provide a hydrogeological assessment of groundwater, including reasons (supported by detailed technical data) why the aquifer use can be considered sustainable in the long term

- Indigenous People: The appraisal mission found no evidence of indigenous people in the area where the Metropolitano is located.

- Cultural Heritage: No sites of potential archeological interest have been identified in the area where the Metropolitano is located.

Stakeholder Engagement

Metropolitano has developed a large programme to support communities throughout Nicaragua. The Hospital Metropolitano Vivian Pellas supports a “Burn unit for children”, it is cost-free and further supported with contributions from private-sector entities led by Mrs. Pellas. This facility has four semi- private rooms with a total of 13 beds, operating room, procedure room and hydrotherapy equipment.

Client Documentation

File Name	Actions
MetrOPOLITANO ESAP MARCH 24 2008.pdf

**Information on IFC's Policy and Performance Standards on Environmental and Social Sustainability can be found at www.ifc.org/sustainability

IFC supports its clients in addressing environmental and social issues arising from their business activities by requiring its real sector clients to set up and administer appropriate grievance mechanisms and/or procedures to address complaints from Affected Communities in relation to environmental and social issues arising from IFC's clients' business activities. Since 2012, IFC's Financial Intermediary clients applying the Performance Standards are required to develop External Communications Mechanisms to receive and review inquiries or complaints from any interested party regarding the E&S risks and impacts of their operations.

For IFC projects that are active or under consideration, individual(s), or their authorized representative(s), who allege they have been or will be adversely affected by E&S risks or impacts arising from IFC's clients' business activities, may submit a complaint to IFC directly for consideration. When receiving an E&S complaint, IFC engages with complainants and works with its clients to find solutions to E&S concerns as quickly and efficiently as possible.

Complaints can be submitted to IFC online at www.ifc.org/escomplaints or by email to EScomplaints@ifc.org.

IFC complaint response is separate from and complementary to IFC’s clients’ project level grievance mechanisms and IFC’s Independent Accountability Mechanism (CAO). Lodging a complaint directly with IFC does not, at any time, restrict access to CAO.

Affected communities have unrestricted access to the Compliance Advisor Ombudsman (CAO), the independent accountability mechanism for IFC and MIGA. CAO facilitates the resolution of complaints related to IFC and MIGA projects and sub-projects, undertakes reviews of IFC’s and MIGA’s environmental and social compliance, fosters public accountability for their commitments, and enhances the environmental and social performance of IFC and MIGA.

Independent of IFC and MIGA management and reporting directly to the IFC and MIGA Boards of Executive Directors, CAO helps resolve issues raised about the environmental and social impacts of projects through a neutral, collaborative, problem-solving approach via its Dispute Resolution function. It also reviews IFC’s and MIGA’s compliance with environmental and social policies, assesses related harm, and recommends remedial actions through its Compliance function. Additionally, CAO provides advice to IFC, MIGA, and their Boards to enhance environmental and social sustainability performance and minimize the risk of harm.

Complaints may relate to environmental and social harm regarding any aspect of the planning, implementation, or impact of a project or sub-project, and can be made by any individual, group, community, entity, or other party affected or likely to be affected by the environmental or social impacts of an IFC- or MIGA-financed business activity.

Complaints can be submitted by any of the following methods:

Online form: available at https://www.cao-ombudsman.org/
Mail/Hand Delivery to: 2121 Pennsylvania Avenue, NW, Washington, DC 20433, USA
Voice mail: +1 202 458 1973
Email: cao@worldbankgroup.org
SMS, WhatsApp, Telegram, and Signal: +1 202 650 2627

CAO receives and addresses complaints in accordance with the CAO Policy, which can be accessed at: https://www.cao-ombudsman.org/policies-guidelines.

This Environmental and Social Review Summary (ESRS) is prepared by IFC to disclose its findings and recommendations related to environmental and social considerations regarding potential investments. Its purpose is to enhance the transparency of IFC's activities. For any project documentation or data included or attached herein, whether prepared by the project sponsor or otherwise, authorization has been given for public release by the project sponsor. IFC considers that this ESRS is of adequate quality for release to the public, but has not necessarily independently verified all of the project information therein.
It is distributed in advance of IFC Board of Directors' consideration and may be periodically updated thereafter. Board dates are estimates only and this document should not be construed as presuming the outcome of the Board Directors’ decision. The following ESRS is disclosed in accordance with IFC's Access to Information Policy (AIP).

The map is for illustrative purposes and does not imply the expression of any opinion on the part of the World Bank, concerning the legal status of any country or territory or concerning the delimitation of frontiers or boundaries. Country borders or names do not necessarily reflect the World Bank Group's official position. In some cases, available project location information is limited to the country of the project's activities. Locations are approximate.

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Environmental & Social Review Summary

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