While all Performance Standards are applicable to this investment, IFCs environmental and social due diligence indicates that the investment will have impacts which must be managed in a manner consistent with the following Performance Standards. If IFC's investment proceeds, IFC will periodically review the the project’s ongoing compliance with the Performance Standards.

PS 1 – Assessment and Management of Environmental and Social Risks and Impacts
PS 2 - Labor and working conditions
PS 3 - Resource Efficiency and Pollution Prevention
PS 4 – Community Health, Safety and Security

This is an E&S category B project because, on the basis of information reviewed by IFC, this investment will have limited adverse social and environmental impacts that are few in number, are generally site specific, largely reversible and readily addressed through mitigation measures, as outlined in the Environmental and Social Action Plan (ESAP) attached to this ESRS.

Specific key environment, social, health and safety issues reviewed during the appraisal included environmental and social (E&S) management capacity of the sponsors to undertake the project and operations in a manner consistent with IFC Performance Standards; working conditions for employees and contract workers during both construction and operation of the hospital; efficient use of energy, water and resources; plans for the management of liquid effluents and its discharge; and management of hazardous materials and hazardous health care wastes during the operations. Specific attention will be required to ensure Life and Fire Safety systems are constructed and operated according to relevant national and international standards.

The findings of the project appraisal indicate that there are no impacts related to PS5: Land Acquisition and Involuntary Resettlement given that the land is being acquired under a willing buyer-willing seller transaction; no one is living on, or making a living from, the land at this time. PS6: Biodiversity conservation and Sustainable Management of Living Natural resources, PS7: Indigenous Peoples and PS8: Cultural Heritage do not apply because no adverse impacts to biodiversity or sustainable natural resource management have been identified, land has been used previously for agricultural and cattle grazing projects, and no Indigenous People are known to have been in the area of the project. No sites of cultural heritage are expected at the location of the development.

IFC's appraisal considered the environmental and social management planning process and documentation for the project and gaps, if any, between these and IFCs requirements. Where necessary, corrective measures, intended to close these gaps within a reasonable period of time, are summarized in the paragraphs that follow and (if applicable) in an agreed Environmental and Social Action Plan (ESAP). Through the implementation of these measures, the project is expected to be designed and operated in accordance with Performance Standards objectives.

Environmental and Social Assessment and Management Systems: The project is in its early stages of planning; nevertheless, the company has presented an Environmental Management Plan to the local environmental authority (CARDIQUE: Corporacion Autonoma Regional Del Canal Del Dique). As per local regulations, this development does not require a full Environmental Impact Assessment. The proposed Environmental Management Plan describes the key environmental impacts and mitigation measures proposed. The company will comply with proposed mitigation measures and the monitoring plan agreed with CARDIQUE, which includes periodic monitoring and reporting by an independent party. The company will request the construction license once the project has detailed engineering plans.



The Company has commissioned the design of the hospital to an international company specialized in the design of health care facilities and well recognized local and international architecture firms. The planned design aims to achieve international standards for patient safety, life and fire safety and environmental protection. The new hospital is being designed to be in compliance with the Joint Commission International (JCI) standards, and to adhere to Leadership in Energy and Environmental Design (LEED) principles among other standards.



Environmental and social impacts during the operations will be managed aligned with the policies of the University Hospital of Fundación Santa Fe de Bogotá (FSFB) which have a well established and operational management system. The current management system has in place procedures and programs to address key issues such as hazardous health care wastes, efficient use of energy and water and occupational health and safety aspects of the operations as will be detailed further in this document. The Centro Hospitalario Serena del Mar, once it is operational, will implement a social, environmental and Occupational Health and Safety (OHS) management systems aligned with FSFB practices to ensure adequate management of its impacts during the operation of the new hospital.



Organizational capacity and Competency: Centro Hospitalario Serena del Mar has appointed a technical manager who is responsible for the coordination of the development of the new hospital. Specialized firms for structural safety, life and fire safety, ventilation, sanitary systems, etc are providing technical input in the planned design of the hospital. During construction the Company will assign a responsible supervisor to verify that environmental and OHS measures are addressed as described in the Environmental Management Plan and to ensure compliance with contract requirements.



With regards to operation of the new hospital, the project will have a management structure for E&S issues similar to the one currently in place at the FSFB. Currently the FSFB has an environmental coordinator, an occupational health coordinator, a security coordinator, a human resources manager and
an infrastructure chief who interact with other divisions to manage E&S issues in an integrated way. The company will appoint personnel with sufficient knowledge, experience and skills to implement the specific measures to ensure compliance with local regulations and the requirements of IFC’s Performance Standards. The company will guarantee E&S competency of the employees by hiring qualified individuals and/or providing additional training to the employees.



Emergency Preparedness and Response: Centro Hospitalario Serena del Mar will have in place emergency response plans including mechanisms to inform affected communities. The emergency plan will include a training program for all employees and in particular for the internal emergency brigade. The emergency plan will consider the identification of potential hazards and the response to emergency situations. FSFB have currently comprehensive internal and external emergency response plans and well trained personnel.



Monitoring and Review: The Company will implement the monitoring measures defined in the Environmental Management Plan. Before construction starts, the Company will present to IFC a detailed monitoring plan during construction, and will report on it during the construction stage. Centro Hospitalario Serena del Mar will ensure monitoring plans and targets are aligned with the WBG EH&S Guidelines for Health Care Facilities and the EH&S General Guidelines.



Monitoring of E&S elements during operations will be aligned with current practices at the FSFB and with the E&S Management System to be implemented. Centro Hospitalario Serena del Mar will monitor fire safety, including periodic internal audits; water and energy use; waste generation; OHS injuries; and liquid effluents, among other indicators; as needed corrective and preventive actions will be implemented.





External Communications and Grievance Mechanisms: Centro Hospitalario Serena del Mar will implement and maintain a procedure for external communications (during construction and operations) to receive and register external communications from the public in order to assess the issues raised and to provide responses; as needed the company will adjust the E&S management programs to address the community concerns.

Human Resources Policies, Procedures and Terms of Employment: The FSFB has policies regarding human resources management. The policies are aligned with Colombian requirements and supporting documents include: the Internal Rules and Regulations document (reglamento interno de trabajo) and the Code of Ethics. In addition labor contracts define the working conditions. Elements such as rights of the employees, working hours, compensation scheme, non-discrimination requirements, and minimum age of employment among others are described in the policy documents. All employees receive copy of the employment contract and additional details are provided in the induction training that is mandatory to all employees. Centro Hospitalario Serena del Mar will apply similar policies and procedures in compliance with local regulation and the requirements of IFC’s Performance Standard 2 regarding labor and working conditions.



The current workforce at FSFB is 1495 direct employees, 77% are female workers. Additional 350 workers are third party employees working at FSFB premises. The project is expected to create near 1.000 jobs during construction and near 350 new direct jobs during the operation of the first phase of the new hospital.



Workers Organizations: FSFB employees do not belong to workers organizations or unions, and there has not been such request among the employees. The management team of FSFB and from Centro Hospitalario Serena del Mar confirmed that they would not prevent employees to organize or participate in workers’ organizations.



Non-Discrimination and Equal Opportunity: The Ethics code have explicit reference to principles of non-discrimination based on sex, skin color, nationality, political affiliation, etc. which are highly valued by the Company.



Grievance Mechanism: FSFB has well defined communication mechanisms and has channels for employees’ grievances. The company uses HR as vehicle for grievances, direct access to supervisors and directors is available to all employees; in addition there is a committee for working relations (Comité de convivencia laboral) that documents and resolves grievances on behalf of the employees. As standard practice such mechanisms will be implemented in the new Hospital.



Protecting the Workforce and Workers Engaged by Third Parties: Policies regarding age of employment and compensation are based upon national law. All employees should be at least 18 years to be employed; salaries paid are above minimal salary. No child labor or forced labor is used by the Company; these practices are not suspected in the supply chain. The company contracts with reputable companies the outsourced services to ensure compliance with Colombian law. Centro Hospitalario Serena del Mar will implement mechanisms to ensure that contractors performing construction activities for the project are in compliance with local legislation and IFC requirements regarding Performance Standard 2, in particular regarding working condi
tions and terms of employment and compliance with Occupational Health and Safety obligations according to local law.



Occupational Health and Safety: FSFB has in place a detailed and comprehensive Occupational Health and Safety (OHS) program consistent with the requirements of the Colombian legislation and best practices for health care facilities such as JCI accreditation program. The OHS program is aligned with quality programs and patient safety requirements, the program covers among others biological hazard safety (e.g. nonsocomial infections, needle stick injuries), practices for handling hazardous drugs (e.g. chemotherapeutic drugs), radiation protection, preventive medicine, workplace monitoring and medical examination of employees. The new hospital, as part of the E&S Management System will implement an equivalent OHS management system to manage all the identified risks.



A joint workers-employer health and safety committee (COPASO: Comité Paritario de Salud Ocupacional) is in place. It meets bimonthly and part of its tasks is to identify potential risks, address workers concerns regarding OHS and ensure proper implementation of the OHS program. FSFB has a comprehensive training program and accidents are investigated and corrective actions implemented.



During the design, installation, acceptance testing, and operations of all the radiology and oncology facilities Centro Hospitalario Serena del Mar will ensure the guidance and verification of qualified experts and the clearance of the local authorities (Ingeominas and Secretaria de Salud). Centro Hospitalario Serena del Mar will retain a radiation protection scientific/technical expert, satisfactory to IFC, to supervise the construction of the radiology facilities and to carry out post construction inspections to verify that the facilities were constructed as designed. The protective measures installed should focus on keeping occupational doses and public doses As Low As Reasonably Achievable (ALARA) which aims at radiation safety and avoidance of all unnecessary exposure. Existing radiology facilities managed by FSFB have the approval of the local authorities and a full monitoring program for ionizing radiation is in place.

Resource Efficiency: FSFB has implemented internal programs for management of water and energy; a systematic water saving program implemented in previous years achieved reduction of near 25% of total consumed water at the hospital by metering water consumption by areas, improving maintenance of critical equipment (vacuum system, refrigeration system and the distiller unit), changing water pipes, and by communication campaigns. FSFB monitors and controls the current use of water and electricity, current level of water usage is 0.85 m3/bed/day and for electricity is 92.5 kWh/bed, aligned with industry benchmarks (e.g. USAID Eco III-project report: Energy Efficiency in Hospitals Best Practice Guide). The new hospital will integrate energy and eater efficiency in the design and selection of equipment. The design is in early stages but selection of HVAC (Heating, Ventilation, and Air Conditioning) system; lighting and sanitary facilities will consider energy and water efficient criteria. Centro Hospitalario Serena del Mar will consider the WBG Health Care Facilities EH&S Guidelines and LEED (Leadership in Energy and Environmental Design) principles in the selection of equipment to be used in the new hospital. Water will be sourced from the municipality and supplemented by wells within the location of the hospital.



Liquid effluent management : Effluents at FSFB are discharged to the municipal sewage in compliance with local regulation, periodic effluent monitoring is performed and the results show compliance with local requirements. For the new hospital in Cartagena municipal sewage system is not available at the proposed site. As part of the pre-feasibility studies Centro Hospitalario Serena del Mar has defined the need to install a wastewater treatment plant (WWTP), the final discharge point of effluents is not defined at the moment. The Company will commission and implement a WWTP to comply with local and IFC requirements for the discharge. Centro Hospitalario Serena del Mar will submit to IFC the design for the WWTP and once in operation it will provide confirmation of compliance with local and IFC requirements, including the requirements in the WBG EH&S Guidelines for Health Care Facilities.



Greenhouse Gas Emissions: Greenhouse gas (GHG) emissions resulting from operation of the new hospital are estimated based upon actual resource consumption at FSFB. The phase one of the new hospital will have fewer beds than FSFB but similar space dedicated to clinical offerings, the GHG emissions during the operational stage of Centro Hospitalario Serena del Mar have been estimated as 1,750 tons CO2 equivalent per year. Actual records will be used to review amounts of tons CO2 equivalent per year that will be emitted from the new hospital once it is operational.



Wastes: Functional procedures to manage wastes are implemented in the existing hospital. Wastes are segregated at the point of generation by risk, including segregation of organic, recyclab
le, biological, infectious and hazardous health care waste. Procedures for handling materials are defined in FSFB’s solid waste management program (PGIR: Plan de Gestion Integral de Residuos). Wastes are stored temporarily for daily pickup by specialized and licensed service companies. The provided facilities for storage and management of health care waste are in compliance with [best practices in the industry, including refrigeration and encapsulation (jellification) of organic liquid wastes. FSFB commissions periodic audits and visits to the service company to follow up on the handling and disposal of the materials. Management of hazardous and non-hazardous wastes for the new hospital will follow the procedures defined in the solid waste management program (PGIR). Centro Hospitalario Serena del Mar will use reputable enterprises licensed by the relevant local authorities to handle the wastes and will obtain chain of custody documentation to the final destination.



Hazardous Materials: Hazardous chemicals in the hospital are limited to small volumes of laboratory reagents, chemicals, solvents, chemotherapeutic drugs, medicinal gases and anesthetics. Hazardous chemicals are handled in accordance with acceptable practices; only trained personal handles the materials, precautions are taken when using and handling the materials, required protection equipment, such as ventilation hoods and personal protective equipment is provided. Material Safety Data Sheets are available. Radioactive material used in the radiology labs are controlled through internal procedures and only approved personnel access and manipulate the materials. Similar practices for management of hazardous materials will be implemented in the proposed project. HVAC system in the new hospital will use refrigerants with zero ozone depletion potential.

Infrastructure and Equipment Design and Safety: Centro Hospitalario Serena del Mar will comply with Colombian seismic and fire protection codes for the design of the new hospital. The requirements of life and fire safety will be aligned with local legislation and the requirements of the Joint Commission International (JCI), the company is planning to use NFPA (US-National Fire Protection Association) codes as reference. In order to confirm compliance with IFC requirements, Centro Hospitalario Serena del Mar will engage the professional services of a qualified Life and Fire Safety Engineer acceptable to IFC to prepare a Master Plan (engineering design) and, upon physical completion of the building, to verify that the systems were installed as designed and in line with good installation practices. Life and fire safety design and operation shall comply with the Life and Fire Safety requirements of the WBG General EHS Guideline, and be responsive to one internationally recognized life safety code, and the Colombian life safety code.



The radiology area will be designed considering the requirements of the local authorities (Ingeominas and Secretaria de Salud) and good international industry practices (GIIP). The company will engage a professional to verify compliance with radiation protection measures.



The new hospital will be designed to provide universal access and to facilitate the mobilization of patients, including ramps for access.



Community Exposure to Disease: FSFB has a strong program relating to patience safety, aligned with the requirements of the Joint Commission International (JCI), which includes control of nosocomial infections. FSFB has in place comprehensive engineering and administrative controls such as proper ventilation systems, architectural segregation, decontamination practices, and controls on water, food and waste, among other preventive and corrective measures. The new hospital will be designed and operated under JCI criteria to manage nosocomial infections.



Potable water for the existing operation is provided by the municipality, FSFB monitors periodically the potable water to confirm physical and microbiological parameters. FSFB performs periodic maintenance to the storage tanks. Centro Hospitalario Serena del Mar will confirm the quality of the potable water, before starting operations, ensuring compliance with WHO standards. In case of non-compliance, Centro Hospitalario Serena del Mar will install the required treatment facility.

The project is in its early stages and there have not been formal consultations with the community, only with local authorities. The site of the project is an area used for agricultural purposes, with no local communities in the immediate vicinity. Negative impacts on local community are not expected from this project. A key sponsor of the project (Fundación Carlos y Sonia Haime) has social programs in the area of la Boquilla, in the north of Cartagena (Manzanillo del Mar, Tierra Baja, Puerto Rey and Zapatero). The programs undertaken by the Fundación have focused on the areas of education, health and employment generation, with concrete projects such as community lunch rooms for kids (comedores comunitarios); promotion of music and arts (orquestas y coros) with dedicated instructors; provision of basic medical services to local communities and promotion of garden agricultural projects, among other initiatives. The programs are focused on vulnerable population and equality. As needed and dictated by local legislation, Centro Hospitalario Serena del Mar will conduct formal consultation regarding the project and will address community concerns.

This Environmental and Social Review Summary (ESRS) and accompanying Environmental and Social Action Plan will be publicly disclosed locally at:

Centro Hospitalario Serena del Mar, Calle 79B No 4-29, Bogota
Fundación Carlos y Sonia Haime, Manzanillo del Mar, Calle 25 de Diciembre – Calle del Curato 38-102, Cartagena

To contact the project company, please write to:

Centro Hospitalario Serena del Mar.
Dr. Roberto Esguerra, M.D.
Calle 79B No 4-29
Bogotá. Colombia
Tel (571) 3198081
Email: mailto:resguegu@hotmail.com

Centro Hospitalario Serena del Mar will make adequate public disclosure of this transaction in the Colombian business and trade press.

Broad Community Support is not applicable for this project

Serena del Mar(31477) Supervision Disclosure Snapshot – Version 3
Description	Anticipated Completion Date	Status	Comments	Completion Date
Establish Procedures to Implement and Monitor the Environmental Management Plan During Construction. Centro Hospitalario Serena del Mar will define specific procedures to implement the Environmental Management Plan presented to CARDIQUE (Corporacion Autonoma Regional Del Canal Del Dique) for the construction of the project. The procedures will address management of labor and occupational requirements for contractors, management of relations with local communities, and the issues raised in the risks and impacts identification process (management plan).	31-Oct-2014	Completed	Completed	2/6/2016
Extend Environmental and Social Operational Procedures, Practices and Management Programs to the new Hospital. Centro Hospitalario Serena del Mar will develop and implement a social, environmental and Occupational Health and Safety (OHS) management system to cover operations of the new hospital as required by PS1. The scope of the ESMS will include but not be limited to: (i) management of Human Resources policies and procedures; (ii) management of OHS risks; (iii) management of environmental impacts including waste management, liquid effluents and resource efficiency;(iv) Life and Fire Safety management, including compliance with international Life and Fire Safety standards and practices and (v) stakeholder engagement (grievance mechanisms). The management system will include monitoring mechanisms.	29-Mar-2019	In progress	Due date revised as agreed with IFC Client
Liquid Effluents to be in compliance with local and IFC’s requirements. Centro Hospitalario Serena del Mar will submit to IFC confirmation of compliance with local and IFC requirements regarding liquid effluents, including the requirements in the WBG EH&S Guidelines for Health Care Facilities.	15-Nov-2019	In progress	Due date revised as agreed with IFC Client
Certification of Life and Fire Safety Systems Construction. A qualified Life and Fire Safety Engineer acceptable to IFC shall provide a professional certification affirming that facility construction faithfully incorporates all elements of the Life and fire Safety Master Plan (engineering design).	07-May-2020	In progress	Due date revised as agreed with IFC Client
Certification of Radiation protection design. Centro Hospitalario Serena del Mar will retain a radiation protection scientific/technical expert, satisfactory to IFC, to carry out post construction inspections to verify that the facilities were constructed as designed.	27-Sep-2019	In progress	Due date revised as agreed with IFC Client