Environmental & Social Review Summary
Project Number
9402
Company Name
CHEIRON HEALTH TECHNOLOGIES (PTY) LTD
Date ESRS Disclosed
Feb 5, 2010
Country
South Africa
Region
Africa
Last Updated Date
Jan 2, 2017
Environmental Category
B - Limited
Status
Completed
Previous Events
Approved : Jun 29, 1999
Signed : Aug 17, 1999
Invested : Sep 29, 1999
Sector
Computer Systems Design and Related Services (System Integration, Custom Computer Programming, IT Services etc.)
Industry
Manufacturing
Department
Regional Industry - MAS Africa
Project Description
ENVIRONMENTAL REVIEW SUMMARY
Project Name AEF/SOUTH AFRICA: IHS TECHNOLOGIES (PTY.) LTD.
Region Sub-Saharan Africa
Sector Health care
Project No. 009402
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1. This project is to be financed through the Africa Enterprise Fund (AEF). IHS Technologies is a newly-formed information technology company that will provide computer services to Sizwe Medical Fund (SMF), other medical aid companies, independent practitioner associations, and health care provider organizations. SMF is a medical insurance company, and is controlled by the same investment company, Kwacha (Pty.) Ltd., as IHS. Kwacha also owns 90% of Lesedi Private Hospital in Soweto. In 1997 Lesedi established an Intensive Care Unit (ICU) in which IFC invested. Kwacha is currently purchasing a 24% stake in The Dialysis Center and has asked IFC to finance this acquisition through a special purpose company. IFC is at present completing the appraisal of this project; an Environmental Review Summary for the project was made available for public review through the World Bank InfoShop on November 10, 1998. SMF’s drug and other claims are currently being processed by Medscheme, the largest medical administrator in South Africa. SMF now wants to set up its own computer unit to provide this service. IHS has contracted with Kaiser Permanente, a large US-based medical services provider, to assist it in setting up the system, which will include processing of drug claims, doctor and patient profiling, utilization reviews and authorizations.
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;
• source of water and power including fuel storage if applicable;
• disposal of solid and liquid wastes, including sewage;
• 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 life safety.
3. IFC has reviewed environmental information supplied by IHS, Lesedi Clinic and The Dialysis Center regarding their policies and procedures and good management practices. Key elements of this information are described below.
4. Handling and disposal of medical materials safety: In its capacity as a processor of medical records and claims, IHS itself does not utilize any medical materials requiring special handling or disposal. Lesedi Clinic, which is largely owned by Kwacha, has in place a detailed set of Policies and Procedures Manuals that lay out clearly how the hospital should handle, and dispose of all types of wastes. The policies and procedures are clearly written and comprehensive, and outline proper handling and disposal procedures for specific kinds of medical materials. Kwacha is in the process of acquiring a 24% stake in The Dialysis Centre, an acquisition that IFC has been asked to help finance. The Dialysis Centre has established procedures for handling and disposing of those types of materials and wastes that are used that conform to all relevant Government of South Africa regulations.
5. Disposal of medical and bio-hazardous wastes: IHS does not generate any medical or bio-hazardous wastes requiring disposal. Both Lesedi Clinic and The Dialysis Centre have in place detailed plans for disposing of both hazardous and non-hazardous wastes. All contaminated sharps are disposed of in special containers from which they cannot be removed. When full, these containers are sent to high temperature incinerator to be destroyed. Contaminated dressings and other potentially hazardous wastes are disposed of in color-coded plastic bags, sealed, and sent to an incinerator for disposal. Non-hazardous solid waste at both facilities is disposed of in heavy duty plastic bags which are collected weekly by the municipal refuse authority.
6. Source of water and power including fuel storage if applicable: Power for IHS (which operates out of leased office space), Lesedi Clinic and The Dialysis Centre is supplied by the South African electric utility, Eskom. IHS’s office space and computer control room are equipped with an Uninterruptable Power Supply (UPS). The batteries are sealed within the UPS and can be recharged as needed. In the event of a recharge failure, IHS has a maintenance contract with a company authorized to remove and replace the batteries, and to dispose of the spent batteries in a regulated disposal facility. Although power cuts are not frequent, both Lesedi Clinic and The Dialysis Centre have backup diesel generator to supply power for emergency lighting and critical equipment (e.g., the dialysis machines). In both these facilities the generators are housed in separate buildings constructed with effective secondary containment features, in the event of a fuel spill or leak. Water for all three facilities is supplied by the relevant municipal authority. Water used in the dialysis process is purified on site using a specialized reverse osmosis purification system, which is sanitized once a week by the supplier.
7. Disposal of solid and liquid wastes, including sewage: Solid and liquid wastes from IHS’s office facilities are disposed of, respectively, to the Johannesburg municipal refuse and wastewater authorities. As described above, both Lesedi Clinic and The Dialysis Centre have specialized arrangements for the disposal of medical and bio-hazardous wastes. Conventional wastes from these facilities are collected by the municipal authorities and domestic wastewater is discharged to their respective municipal systems.
8. Hygiene and implementation of good hospital management practices: Lesedi utilizes "universal precautions" as its infection control system. This approach assumes that all patients are potentially infectious and that appropriate precautions must be taken in all instances. All employees take part in a comprehensive occupational health and safety training program. Employees are required to complete a comprehensive medical questionnaire when they are hired. Housekeeping and maintenance staff are given strict training in the policies and procedures outlined above for handling and disposing of medical and other potentially hazardous wastes. The Dialysis Centre provides hygiene and personal health and safety training for all employees. Sinks, floors, air conditioning units and dialysis machines are tested regularly by an independent analytical laboratory to ensure that bacterial contamination is within safe limits. All dialysis machines, including those that have not been used, are heat sterilized daily. All other dialysis equipment comes in sterilized kits supplied by the manufacturer and is not reused.
9. CFC-free air conditioning and cold storage equipment: IHS operates out of leased office space. Both Lesedi and The Dialysis Centre have confirmed that all cold storage facilities and air conditioning equipment on their premises utilize non-CFC refrigerants acceptable under the terms of the 1987 Montreal Protocol on Substances that Deplete the Ozone Layer.
10. Employee health and safety training: All of Lesedi’s nursing staff are registered nurses. Lesedi''s matron and high-care charge nurse oversee the recruitment and site-specific training of all new staff hired. One part of the training encompasses personal health and safety, as well as the maintenance of hygienic standards. All other staff (orderlies, nurses'' aides, housekeeping) are given comprehensive health, safety and hygiene training. All Dialysis Centre medical staff are provided with rubber gloves, aprons and masks in accordance with its hygiene and safety protocols. Housekeeping staff are provided with gloves and aprons, as needed, to ensure that the Centre’s hygiene standards are maintained and protect them against infections or other exposure to other bio-medical hazards.
11. Fire protection and life safety: As described above, IHS operates out of leased office space. IHS’s computer control room will be equipped with a state-of-the-art alarm system including program alarms for fire, smoke and temperature. In addition, the room is equipped with smoke detectors in both the fire and ceiling that automatically set off CO2 extinguishers in the event of a fire. Lesedi Clinic is equipped with smoke detectors, fire alarms, extinguishers and fire reels in accordance with South African regulations. In addition, the clinic has made several improvements to its fire protection equipment and procedures, as recommended in a fire safety audit report carried out by independent engineers. The Dialysis Centre is equipped with smoke detectors, fire hoses, a fire alarm and lightning protection in accordance with relevant South African fire safety regulations. These are tested and serviced regularly by a fire protection equipment supplier. Patients requiring acute dialysis are treated with a machine taken to the hospital where they are located. Similarly, patients who suffer complications while undergoing dialysis at the Centre can be quickly transferred by ambulance to a nearby hospital.
12. Based on its review of the environmental information provided by IHS, Lesedi Clinic and The Dialysis Centre, IFC concludes that these enterprises are being operated in a manner that meets all pertinent Government of South Africa requirements and all relevant World Bank Group policies and environmental, health and safety guidelines.
13. 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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November 17, 1998 11:42 AM
Environmental and Social Mitigation Measures
Broad Community Support
Related SII
