Environmental & Social Review Summary
Project Number
9031
Company Name
Belvedere Nursing Home (PVT) Ltd.
Date ESRS Disclosed
Feb 5, 2010
Country
Zimbabwe
Region
Africa
Last Updated Date
Dec 31, 2016
Environmental Category
B - Limited
Status
Completed
Previous Events
Approved : Jun 11, 1998
Signed : Apr 7, 1999
Invested : Sep 7, 1999
Sector
Hospitals and Clinics
Industry
Health, Education and Life Sciences
Department
Regional Industry - MAS Africa
Project Description
ENVIRONMENTAL REVIEW SUMMARY
Project Name ZIMBABWE: BELVEDERE PRIVATE HOSPITAL (PVT.) LTD.
Region Sub-Saharan Africa
Sector Hospitals
Project No. 009031
April 29, 1998
______________________________________________________________________________
1. This project is to be financed through the Africa Enterprise Fund (AEF). Belvedere Maternity Home was set up in 1996 by 10 established obstetricians practicing in Harare, the capital city. It operates from a converted private residence in the suburb of Belvedere. The home has 18 ante/post natal beds and 4 delivery beds. Because of the well established practices of the shareholders it quickly became Harare’s second busiest maternity center with about 120 deliveries per month at present. However, the home does not have an operating room and cannot perform cesarean sections which makes it unsuitable as a proper private maternity hospital in the longer term. The sponsors were fully aware of this shortcoming (mothers in need of cesareans are currently evacuated to a nearby government hospital) and in mid-1997 started building a new two story ward and operating room block on an adjoining site. This facility will have the capacity for 200 deliveries per month, and will have two operating rooms and ancillary services to provide full support. The existing building will be converted into an outpatient and same-day procedures clinic.
2. This is a Category B project according to IFC''s environmental review procedure because specific impacts may result which can be avoided or mitigated by adhering to generally recognized performance standards, guidelines, or design criteria. The key environmental health and safety issues that were analyzed are as follows:
• handling and disposal of medical materials;
• disposal of medical and bio-hazardous wastes;
• disposal of solid and liquid wastes, including sewage;
• power and water supply, including fuel storage if applicable;
• hygiene and implementation of good hospital management practices;
• CFC-free air conditioning and cold storage equipment;
• employee health and safety training; and
• fire protection and safety.
IFC has reviewed the project proposal provided by the Belvedere project sponsors, as well as detailed documents regarding the environmental policies and good management practices in use at its existing facility. Relevant elements of this information as regard the issues listed above are described below.
3. Handling and disposal of medical materials: Belvedere already has comprehensive policies and procedures for handling and disposing of all types of wastes, which will be implemented at the new facility. Radioactive materials used in x-rays and other diagnostic equipment will be kept in a separate room and locked at all times. Routine laundry (sheets, towels, kitchen linens) will be sent to a commercial dry cleaner/laundry. Soiled linen will be bagged, labeled and sent to the hospital''s laundry for laundering at high temperatures in disinfectant detergents. Heavily soiled linen, delivery packs and baby bath kits will be autoclaved in one of three autoclaves on the premises.
4. Disposal of medical and bio-hazardous wastes: Belvedere will contract with a private waste disposal company that specializes in the collection and disposal by incineration of clinical wastes from medical facilities. The contractor will collect contaminated sharps, cotton swab waste, general medical wastes, laboratory cultures and organic reagents, blood, urine, fecal cultures and expired reagents. It will also supply the hospital with appropriately labeled containers and bags for each type of waste. Wastes are to be collected three times a week by vehicles marked with the appropriate labels and biohazard logo. All vehicles are equipped with spill kits in the event of an accident, and swabs are routinely taken from each vehicle and sent to a laboratory for analysis to verify that health, safety and hygiene standards are being met. The contractor''s incinerators are licensed by the Ministry of Health and reach a maximum temperature of 1200° C.
5. Disposal of solid and liquid wastes, including sewage: Non-medical wastes (e.g., office wastes, used packaging materials) will be disposed of in covered bins and collected by the Harare municipal authorities. Waste water and sewage are discharged to the municipal sewerage system.
6. Power and water supply, including fuel storage if applicable: The hospital will draw water from both the municipal water supply system and an on-site borehole. Power will be supplied by the Zimbabwe Electricity Supply Authority (ZESA), the national provider. In addition, the hospital will have a standby diesel generator for use in the event of a power interruption. Fuel for the generator will be stored on site in an above-ground tank fitted with a secondary containment structure capable of holding the entire contents of the tank in the event of a spill or breach.
7. Hygiene and implementation of good hospital management practices: The hospital will operate on established standards of hygiene and good management practices laid down by the Public Health Act and enforced by the Ministry of Health and City Health Department (city health inspectors make unscheduled "spot checks" of the hospital at least three times a year). Consistent with practices at its existing facility, Belvedere will establish an infection control committee to ensure that relevant policies and procedures are adhered to in all departments. The team includes a nurse, pharmacist and one general staff member. In addition to inspecting all areas of the hospital on a routine basis, this committee will be responsible for conveying policies and procedures to staff members at all grades, ensuring that disinfectants and protective clothing are supplied to all staff, training staff, and notifying all cases of infectious diseases to the appropriate government authorities. The committee will also collect culture swabs from strategic areas in the hospital, including the kitchen, to ensure a safe and hygienic environment for patients and staff. In addition, all staff will be trained in proper waste disposal procedures by the hospital''s waste disposal contractor. Courses are conducted in both English and vernacular languages and cover waste management requirements and procedures, basic hygiene and risky behavior, "special" wastes (including hospital, laboratory and hazardous chemical wastes), and public health and environmental considerations.
8. CFC-free air conditioning and cold storage equipment: The sponsors have agreed to install only cold storage and air conditioning equipment that utilizes non-CFC refrigerants, in accordance with the provisions of the 1987 Montreal Protocol on Substances that Deplete the Ozone Layer.
9. Employee health and safety training: As has been done at their existing facility, the project sponsors intend to implement a comprehensive health and safety program for all employees. Medical examinations will be conducted for all employees at the time of employment and on an annual basis thereafter. Staff with infectious diseases will not be permitted to come to work until a full recovery has been made. Belvedere will utilize its exiting health education unit to provide training on a number of topics. All staff will be required to complete training programs in proper waste disposal, basic hygiene, good hospital management practices, and fire prevention and response.
10. Fire protection and safety: Belvedere will contract with a private licensed supplier to supply, fit and service all fire safety equipment required to comply with all relevant Government of Zimbabwe regulations and World Bank guidelines. The supplier also will provide on-site demonstrations and training to all staff in the proper use of this equipment twice a year. A desk review of the detailed hospital design will be conducted by a fire safety expert prior to disbursement of IFC funds to ensure that the facility conforms to World Bank guidelines.
11. Based on its review of available information regarding Belvedere Hospital’s potential environmental, health and safety impacts and proposed mitigation measures, IFC concludes that the proposed project is being designed and will be operated to meet Government of Zimbabwe requirements, as well as all relevant World Bank policies and environmental, health and safety guidelines, and environmental clearance is given for this project. IFC will monitor ongoing compliance with World Bank policies and guidelines during the life of the project by evaluating monitoring reports submitted annually to IFC by the sponsor and by conducting periodic site reviews during project supervision.
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April 30, 1998 4:21 PM
Environmental and Social Mitigation Measures
Broad Community Support
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