AEF AAR Health Services Limited, kenya

completed

- 2 - International Finance CorporationA Member of the World Bank GroupInternational Finance CorporationA Member of the World Bank GroupEnvironmental Review Summary (ERS)Project Name AEF-KENYA: AAR Health Services Ltd.Region Sub-Saharan AfricaSector Social Services (Health Care, Education)Project No. 008632 1. This project involves the expansion of AAR’s medical services in Kenya and Uganda through acquisition of ambulances and medical equipment and the setting up of additional out-patient medical centers. AAR currrently operates five out-patient medical centers which offer day surgery under local anaesthetic, family planning surgery, preventive and educative counseling, immunization and normal out-patient treatment. The existing centers are located in leased premises on the first through third floors of multi-story buildings. Co-tenants of these buildings include an embassy, insurance company, bank, and supermarket. Two new centers on the outskirts of Nairobi will be developed on the ground floors of existing buildings in space leased from the Kenya Ministry of Health. Utilities (electricity, water) are provided by existing infrastructure serving the respective buildings. One center is served by an emergency diesel power generator.2. This is a Category B project according to IFC’s environmental review procedure because a limited number of specific environmental impacts may result from this project. IFC’s Technical and Environmental Department staff review of this project consisted of appraising technical and environmental information submitted by the project sponsor. The following potential environmental, safety and health impacts of the project were analyzed:· sewage and other effluent discharges;· medical waste management, including handling, storage, disposal;· hazardous materials use, storage, and handling;· fire protection and emergency response; and· employee health and safety.The sponsor has presented plans to address these issues and demonstrate that the proposed project will comply with Kenya environmental laws and regulations and applicable World Bank requirements. The information about how these potential impacts are addressed by the sponsor is summarized in the paragraphs that follow.3. Minimal amounts of sanitary sewage and non-medical liquid effluents are (and will be) generated; these are and will be discharged to existing publicly-owned sewerage systems with the approval of the local authorities.4. AAR has a comprehensive waste management plan developed under the direction of the Infection Control Officer. All pathogenic, infectious, and hazardous waste is segregated at the source, appropriately bagged or containerized, labeled, and sent off-site for incineration at the approved medical waste incinerator at Nairobi Hospital. All sharps waste objects are placed in puncture-proof containers and sent to the Nairobi Hospital incinerator for disposal. All unused/expired pharmaceuticals are returned to the suppliers. All other solid wastes are collected and disposed in approved off-site facilities.5. No cytotoxic or genotoxic drugs are used. No ozone depleting substances (e.g., CFCs) are used in refrigeration systems on the premises. All hazardous materials are stored in clearly labeled containers, and are handled a manner that will prevent release to the environment and in accordance with local regulations and manufacturers’ recommendations. Secondary containment will be provided in the area where diesel fuel is stored for the emergency power generator.6. Adequate fire protection and life safety measures and designs are provided by the respective landlords for the buildings in which AAR’s facilities are located. New centers will conform to the appropriate NFPA 101 codes. Measures include the provision of hose reels, emergency water supply, fire detection and alarms, and adequate means of egress in the case of emergency. Regular fire and safety response drills and training will be instituted. Adequate access is provided for local municipal fire-fighting and emergency response teams. AAR is developing an Emergency Response Plan appropriate for each location.7. Sanitary facilities are adequate in number and scope, and are equipped with protective creams for use by employees. Pre-employment and periodic medical exams will be conducted for all personnel. AAR will be providing employees with disposable rubber gloves, plastic aprons, and face masks to be worn for all invasive procedures that might involve exposure to infectious diseases, such as hepatitis B and AIDS. Employees will undergo training in the handling of hazardous materials and in other relevant health and safety matters.8. Based on its review of available information regarding potential environmental impacts and proposed mitigation measures, IFC concludes that the proposed project will meet World Bank environmental, health and safety policies and guidelines and Kenya environmental, safety, and health requirements.8. IFC will monitor ongoing compliance with World Bank environmental, health and safety policies and guidelines during the lifetime of the project by evaluating monitoring reports submitted annually to IFC by the sponsor and by conducting periodic site reviews during project supervision.