Guyana COVID-19 Emergency Response Project (P175268): Environmental and Social Commitment Plan (ESCP) The Co-operative Republic of Guyana Ministry of Health Guyana COVID-19 Emergency Response Project (P175268) Negotiated Version ENVIRONMENTAL and SOCIAL COMMITMENT PLAN (ESCP) [November 2, 2020] 1|Page Guyana COVID-19 Emergency Response Project (P175268): Environmental and Social Commitment Plan (ESCP) ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN 1. The Co-operative Republic of Guyana (hereafter, the “Recipient”) will implement the Guyana COVID-19 Emergency Response Project (the Project) through the Ministry of Health (MOH) and its Project Implementation Unit (PIU). The International Development Association, IDA (hereinafter, the “Association”) has agreed to provide financing for the Project. 2. The Recipient will implement material measures and actions so that the Project is implemented in accordance with the Environmental and Social Standards (ESSs). This Environmental and Social Commitment Plan (ESCP) sets out material measures and actions, any specific documents or plans, as well as the timing for each of these. 3. The Recipient is responsible for compliance with all requirements of the ESCP even when implementation of specific measures and actions is conducted by the Ministry or unit referenced in one above. 4. Implementation of the material measures and actions set out in this ESCP will be monitored and reported to the Association by the Recipient as required by the ESCP and the conditions of the legal agreement, and the Association will monitor and assess progress and completion of the material measures and actions throughout implementation of the Project. 5. As agreed by the Association and the Recipient, this ESCP may be revised from time to time during Project implementation, to reflect adaptive management of Project changes and unforeseen circumstances or in response to assessment of Project performance conducted under the ESCP itself. In such circumstances, the Recipient will agree to the changes with the Association and will update the ESCP to reflect such changes. Agreement on changes to the ESCP will be documented through the exchange of letters signed between the Association and the Recipient through the Minister of Health. The MOH will promptly disclose the updated ESCP. 6. Where there are Project changes, unforeseen circumstances, or Project performance results in changes to the risks and impacts during Project implementation, the Recipient shall provide additional funds, if needed, to implement actions and measures to address such risks and impacts. 2|Page MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY/AUTHORITY MONITORING AND REPORTING A REGULAR REPORTING Quarterly reporting throughout Project Project Implementation Prepare and submit to the Association, regular monitoring reports on the implementation submitted not later than Unit (PIU) within the environmental, social, health and safety (ESHS) performance of the Project, including 45 days after the end of each quarter. Ministry of Health (MOH). but not limited to stakeholder engagement activities and grievance log. Mid-term and completion reports will also be submitted, as requested by the Association, during Project implementation. B Incidents and Accidents. The project will promptly notify the Bank of any incident or The Bank will be notified within 48 hours PIU/MOH accident related to the Project which has, or is likely to have, a significant adverse after learning of the incident or accident. effect on the environment, the affected communities, the public or the workers. The submission of the subsequent would be provided to the Bank in a timeframe acceptable to the Bank and or as requested. ESS 1: ASSESSMENT AND MANAGEMENT OF ENVIRONMENTAL AND SOCIAL RISKS AND IMPACTS 1.1 ORGANIZATIONAL STRUCTURE a. The PIU already established under the Ministry of Health (MOH) will be a. Throughout Project implementation. PIU/ MOH responsible for the implementation of the Project. b. MOH will hire and maintain throughout Project implementation one b. One environmental and social specialist environmental and social specialist (full-time) with qualifications and (full-time) will be contracted or assigned experience acceptable to the Association. In addition, the environment and no later than 30 (thirty) days after the social specialist will be assisted by two officers being released on a part-time Project Effective Date based on the basis as necessary. They will be the Principal Environmental Health Officer, agreed Terms of Reference (ToR) of the from the MOH Environment Health Unit, and the Director of Standards and Specialist. The specialist, technical Technical Service (STS). Further to that, MOH has already designated and officers and the focal points will be shall maintain an official as Environmental and Social Focal Point. MOH will retained throughout Project ensure sufficient time and resources of the specialist, two technical officers implementation. and the Focal Point for the Project’s environmental and social risk management. 3|Page MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY/AUTHORITY c. The Project Coordinator will be the ultimate responsible person to manage c. Throughout project implementation. and coordinate all environmental and social matters with the support from the pertinent personnel. d. Throughout project implementation. d. Adequate resources will be allocated to support management of ESHS risks of the Project. 1.2 ENVIRONMENTAL AND SOCIAL ASSESSMENT AND ENVIRONMENTAL AND SOCIAL MANAGEMENT PLANS a. Ensure, document and certify that adequate waste management practices, a. Throughout the project implementation. PIU/MOH appropriate laboratory facilities and completion of key staff training on the use of the supplies and equipment following Guyana’s “Hazardous Waste Regulation under the EPA 1996 (No 11 of 1996), Public Health Ordinance chapter 145, Section 64, Draft Medical Waste Management Guidelines”, “Health Facilities Licensing Act / Regulations 2007, GYS: 235,2003 Standard - National Certification and ISO:15190, 2019 Draft International Accreditation”, and the 2011 ”Environmental Guidelines for Storage, Transportation, and Occupational Handling of Biomedical Waste”, as well as relevant WHO Guidelines for medical waste management, were in place in a manner consistent with the ESSs. b. Prepared by negotiations and b. Prepare, adopt and implement Interim Health and Safety Guidelines consistent implemented until approval of the ESMF. with the ESSs. 4|Page MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY/AUTHORITY c. Assess the environmental and social risks and impacts of proposed Project c. ESMF, acceptable to the Association, to activities, in accordance with ESS1 and the Environmental and Social be adopted within 60 (Sixty) days of the Management Framework (ESMF) to be prepared for the Project including to Project Effective Date and followed ensure that individuals or groups who, because of their particular throughout the project implementation. circumstances, may be disadvantaged or vulnerable, have access to the No activities that have any significant development benefits resulting from the Project. The ESMF should also build potential environmental and social risks on a comprehensive review of the existing acts/rules related to medical waste and impacts will be initiated within this management and an assessment/audit of relevant incinerator facilities to period. Activities prior to approval of the determine whether they currently meet Association/WHO standards. The ESMF will follow the Interim Health and ESMF should identify critical gaps (if any) and suggest appropriate measures Safety Guidelines. to overcome the gaps. The ESMF needs to be prepared accordingly the Bank ’s ESMF-COVID Template d. Prepare, disclose, adopt, and implement Environmental and Social d. Plans or instruments prepared after Management Plans (ESMPs), Infection Control and Waste Management Plan approval of the ESMF and before the (ICWMP), Community Health and Safety Plan (CHSP), and any other carrying out of relevant activities and environmental and social management plans or other instruments required implemented throughout the carrying for the respective Project activities based on the assessment process, in out of such activities. accordance with the ESSs, the ESMF, and other relevant Good International Industry Practice (GIIP) including relevant WHO Guidelines on COVID-19. e. Before initiating the procurement e. Incorporate the relevant aspects of this ESCP, including, inter alia, any process for the relevant activities and environmental and social management plans or other instruments, ESS2 thereafter throughout the requirements, and any other required Environmental, Social, Health and implementation of such Project Safety (ESHS) measures, into the ESHS specifications of the procurement activities. documents and contracts with suppliers. Thereafter ensure that the suppliers comply with the ESHS specifications of their respective contracts. f. f. Within 60 (sixty) days of the Project f. Gender Based Violence (GBV) risks will be assessed and necessary measures Effective Date. will be completed as part of project implementation through the ESMF and GRM. 5|Page MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY/AUTHORITY 1.3 EXCLUSIONS: Exclude the following types of activities as ineligible for financing under the Project: During the assessment process conducted PIU/MOH • Activities that may cause long term, permanent and/or irreversible (e.g. loss of under action 1.2.c. above. major natural habitat) adverse impacts. • Activities that have high probability of causing serious adverse effects to human health and/or the environment not related to COVID-19 treatment. • Activities that may have significant adverse social impacts and may give rise to significant social conflict. • Activities that may involve any resettlement or land acquisition/use restriction or adverse impacts on cultural heritage. • All the other excluded activities set out in the ESMF of the Project. 6|Page MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY/AUTHORITY ESS 2: LABOR AND WORKING CONDITIONS 2.1 LABOR MANAGEMENT PROCEDURES The Project shall be carried out in accordance with the applicable requirements of Throughout Project implementation. The PIU/MOH ESS2, in a manner acceptable to the Association, including through, inter alia: LMP, GRM and Code of Conduct will be • The Recipient shall adopt and implement Labor Management Procedures (LMP) prepared as part of the ESMF which will be incorporating the relevant requirements of ESS2. The LMP for the project will finalized 60 (sixty) days after the Effective establish how project workers will be managed in accordance with the requirements Date; until then the recommendations of national laws and legislation. The LMP will contain terms and conditions of referenced in the Interim Health and Safety employment, nondiscrimination and equal opportunity. The LMP will include the Guidelines for workplace safety and appropriate considerations for COVID-19 situations. infection control will apply. • Implement adequate occupational health and safety measures (including emergency preparedness and response measures) to ensure the health and safety of workers, especially women, are given adequate attention in line with the ESMF and LMP. World Health Organization (WHO) guidelines on COVID19 shall be established and complied with in all facilities, including laboratories, quarantine and isolation centers, and screening posts. • The LMP will include a Grievance Redress Mechanism (GRM) for health workers. • The LMP will incorporate labor requirements into the ESHS specifications of the procurement documents. • The Recipient will prepare and adopt a Code of Conduct for Health Workers. The Code of Conduct will include guidelines to ensure that all the patients regardless of their social, ethnic, preferences, or cultural characteristics receive health services. Likewise, the code of conduct will include guidelines for all project workers to ensure that ESS2 requirements are met, including measures to prevent GBV, as part of the LMP. 7|Page MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY/AUTHORITY ESS 3: RESOURCE EFFICIENCY AND POLLUTION PREVENTION AND MANAGEMENT 3.1 MEDICAL AND HAZARDOUS WASTE MANAGEMENT: Throughout Project implementation. PIU/MOH Relevant aspects of this standard shall be considered, as needed, under action 1.2 above, including, inter alia, measures to: manage health care wastes, and other types of hazardous and non-hazardous wastes including appropriate selection and safe usage and disposal of personal protective equipment (PPE), and relevant medical evaluation and health surveillance of PPE users. The PIU/MOH will implement accepted techniques and procedures on medical waste management including auditing for appropriate treatment and disposal. Given the potential resource scarcity in the face of an outbreak, the PIU/MOH will commit to the provision of services and supplies based on the urgency of the need, in line with the latest data related to the prevalence of the cases. ESS 4: COMMUNITY HEALTH AND SAFETY 4.1 COMMUNITY HEALTH AND SAFETY a. Relevant aspects of this standard shall be considered, as needed, under action 1.2 a. Throughout Project implementation PIU/MOH above including, inter alia, measures to: minimize the potential for community exposure to communicable diseases; ensure that the public is safe from potential wastes, especially disposed biohazardous materials and PPE; manage risk associated with visits to health centers; ensure that individuals or groups who, because of their particular circumstances, may be disadvantaged or vulnerable have access to the development benefits resulting from the Project; manage the risks of the use of security personnel; manage the risks of labor influx; and, prevent and respond to sexual exploitation and abuse, and sexual harassment. b. Safety protocols will be prepared by the Recipient following the national b. Same timeframe as for the preparation standards, and the WHO recommendations and will be incorporated in the and implementation of the ESMPs, Community Health and Safety Plan (CHSP), which will be developed as part of the under action 1.2.d. ESMF. 8|Page MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY/AUTHORITY 4.2 OTHER COMMUNITY HEALTH AND SAFETY ISSUES a. The Recipient will put measures in place to prevent or minimize the spread of the a. Throughout Project implementation. PIU/ MOH infectious disease/COVID-19 to the community, including inter alia: i. Ensure the isolation of patients as much as possible, separate from people presenting with COVID-19. People with COVID-19 should be separate from each other by curtains or in different rooms if possible. Only place together in the same room patients who are have all contracted COVID- 19. People with COVID-19 must be separated at all times from other hospital patients, health workers, and other staff. This means there must be dedicated toilet facilities (or bedpans), hand washing facilities, and medical equipment (stethoscope, blood pressure machine, etc.) for patients with COVID-19 only. ii. The Recipient will maintain the dashboard and command center established to support COVID-19 surveillance activities and for enquiries and other COVID-19 related concerns as an important communications link to the public and a significant contact for public requests for information on the COVID-19 pandemic. iii. The Recipient will ensure that communities, COVID-19 patients and their families are treated with respect and dignity, in reference to infrastructure, accommodation and supplies, and communication in the quarantine and isolation centers. b. The Recipient will prepare an emergency response plan for laboratory operations b. Same timeframe as for the preparation and implement emergency preparedness measures in case of laboratory accidents/ and implementation of the ESMPs, under emergencies (e.g. a fire response or natural phenomena event). action 1.2.d. c. The Recipient will operate quarantine and isolation centers in line with the c. Throughout the project implementation. applicable requirements of ESS4, the World Bank Group Environmental, Health and Safety Guidelines (ESHGs) and other relevant GIIP including the WHO guidelines on “Key considerations for repatriation and quarantine of travelers in relation to the outbreak of novel coronavirus 2019-nCoV”. ESS 5: LAND ACQUISITION, RESTRICTIONS ON LAND USE AND INVOLUNTARY RESETTLEMENT ESS5 is currently not relevant. 9|Page MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY/AUTHORITY ESS 6: BIODIVERSITY CONSERVATION AND SUSTAINABLE MANAGEMENT OF LIVING NATURAL RESOURCES ESS6 is currently not relevant. ESS 7: INDIGENOUS PEOPLES/SUB-SAHARAN AFRICAN HISTORICALLY UNDERSERVED TRADITIONAL LOCAL COMMUNITIES 7.1 Indigenous Peoples Plan (IPP) Within 60 (Sixty) days of Project Effective PIU/ MOH a. The Recipient will develop, consult, update, adopt and disclose relevant IPPs Date. The IPPs should be implemented in consistent with ESS7 and in a manner satisfactory to the Association. an effective way prior to disbursing/initiating any activities that b. The Recipient will implement and monitor the implementation of the IPPs. present potential E&S risks or impacts. 7.2 Grievance Redress Mechanism (GRM) a. Within 60 (Sixty) days of the Project PIU/ MOH a. Prepare and adopt the relevant modalities for the GRM for indigenous peoples in Effective Date. the IPPs. b. Throughout the preparation of the IPPs. b. Describe in more detail these modalities in the respective IPP (in case the GRM is different from the established under ESS10). c. Throughout project implementation. c. Implement the modalities for the GRM for indigenous peoples. ESS 8: CULTURAL HERITAGE 8.1 HEALTH PRACTICES OF IPS Consider the distinct health practices of IPs and include appropriate measures in IPPs. Within 60 (Sixty) days of Project Effective PIU/MOH Date. 8.2 SCREENING Include cultural heritage screening tool in the ESMF and screen out activities that will Preparation of screening tools within 60 PIU/MOH negatively impact cultural heritage or will require the development of the Cultural (Sixty) days of Project Effective Date as part Heritage Plan. if ESMF. Apply the screening tools throughout project implementation. ESS 9: FINANCIAL INTERMEDIARIES ESS 9 is currently not relevant 10 | P a g e ESS 10: STAKEHOLDER ENGAGEMENT AND INFORMATION DISCLOSURE 10.1 STAKEHOLDER ENGAGEMENT PLAN PREPARATION AND IMPLEMENTATION Prepare, disclose, consult, update, adopt and implement a Stakeholder Engagement A draft SEP was prepared during project PIU/MOH Plan (SEP), in a manner acceptable to the Association, and in a culturally appropriate preparation and was disclosed prior to manner to establish measures to allow for a continuous engagement and adequate project negotiations, with an annex report communication strategies with relevant stakeholders throughout Project of a first round of consultations. implementation. The Draft shall be finalized and publicly disclosed no later than 60 (Sixty) days after the Effective Date, and after the second round of public consultations have been held. The SEP shall be implemented throughout Project implementation. 10.2 PROJECT GRIEVANCE MECHANISM a. Implement the GRM described in the SEP. The Ministry of Health will maintain the a. The GRM described in the SEP will be PIU/MOH existing grievance redress mechanism (GRM) to be made publicly available to adopted no later than 60 (Sixty) days receive and facilitate resolution of concerns and grievances in relation to the after the Project Effective Date. The GRM Project, consistent with ESS10 as described in the SEP. will be implemented throughout Project implementation. b. The Recipient will share reports of the GRM implementation with the Association. b. Quarterly reports together with the project reports. CAPACITY SUPPORT (TRAINING) CS1 a. The Recipient will continue to train all categories of workers (lab technicians, Throughout Project implementation. PIU/MOH doctors, nurses, cleaning/waste disposal staff, etc.) on the medical waste disposal mechanisms and procedures. b. The Recipient will train the key personnel such as contact tracers and provide capacity support including training for MOH and PIU staff based on identified needs to support the management of ESHS risks and impacts of the Project. 11 | P a g e