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Appendices
Chapter 19
Appendices

APPENDIX 1: BASELINE HEALTH DATA
TABLE 23: POPULATION, NUMBER OF MEDICAL INSTITUTIONS AND PHARMACIES IN THE TERRITORY OF MUNICIPAL ENTITIES IN THE SAKHALIN REGION Municipal entity
Population in thousands
*Number of
Number of
Number of
outpatient
pharmacies
institution
clinics and
obstetrics
*Health institutions as legal entities includes municipal and district “Population” column shows the total population of respective districts.
Source: Statistical data report, Centre for Sanitary and Epidemiology Supervision, 2000 118 S A K H A L I N E N E RGY I N V E ST M E N T CO M PA N Y • H E A LT H I M PAC T A S S E S S M E N T Chapter 19
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TABLE 24: NUMBER OF HEALTH INSTITUTIONS AND AVAILABILITY OF SPECIALISED MEDICAL SERVICES IN THE DISTRICTS ALONG THE SAKHALIN II PIPELINE ROUTE District
Number of
Wards (consulting rooms)
Clinical
Exercise
Exercise
Ultrasonic
Computer-
Diagnostic
functional
diagnostics
institutions
laboratories
diagnostics for adults for children
tomography
1. Medical care institutions include institutions of any form of ownership including departrmental ones as at 01.01.2001. Departmental medical care institutions are health institutions run by the Communication Lines Ministry, Defence Ministry, Ministry of Internal Affairs,water transport patient care institutions.
2. Health institutions do not include outpatient clinics and medical attendant and obstetric points.
3. Regional patient care institutions (multi-type specialised health institutions run by Sakhalin regional administration) are located in 4. Information on specialised wards in each health institution is unavailable. However, considering that the health system is organised on the territorial and production lines, this is not of material significance. As a rule, specialised consulting rooms are organised on the basis ofcentral district hospitals and provide services to all district residents.
* These institutions are included also in Districts Source: Statistical data report Centre for Sanitary and Epidemiology Supervision, 2000 S A K H A L I N E N E R G Y I N V E S T M E N T C O M PA N Y • H E A L T H I M PA C T A S S E S S M E N T 119 Chapter 19
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TABLE 25: NUMBER OF DOCTORS PER 10,000 PEOPLE BY REGION Indicator
Number of doctors per 10,000 people
Sakhalin region
Source: Sakhalin Region at the Turn of the 21st Century. Jubilee Collection. Yuzhno-Sakhalin RegionalCommittee of State Statistics, 2001.
120 S A K H A L I N E N E RGY I N V E ST M E N T CO M PA N Y • H E A LT H I M PAC T A S S E S S M E N T Chapter 19
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District
Mortality
Antenatal
expectancy expectancy
fertility
childbirth
weight at
(per 1000)
(per 1000)
(per 1000
(absolute
pregnant
birth (% of
numbers)
newborns
provided
Source: Statistical data report TsGSEN, 2001 * Life expectancy in 1996, Baseline study social and economic, 1998 table 1.1.7 page 13 ** Life expectancy in 2000 according to Russian Goskomstat forecast (mean) Baseline study social and economic, 1998 Table 1.1.7 page 13 *** Birth / death rate in 2001: Socio-economic status of the Sakhalin Region in January-December 2001, Gubernskiye Vedomosty April 29, 2002 S A K H A L I N E N E R G Y I N V E S T M E N T C O M PA N Y • H E A L T H I M PA C T A S S E S S M E N T 121 Chapter 19
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TABLE 27: DISEASE INCIDENCE IN POPULATION* BY MAJOR CLASSES OF DISEASES (NUMBER OF CASES PER 1,000 PEOPLE All diseases
Endocrine, nutrition diseases, metabolic and immune disorders Muscular-skeletal and connective tissue diseases Source: Sakhalin Region at the Turn of the 21st Century. Jubilee Collection. Yuzhno-Sakhalin Regional Committee of State Statistics, 2001 122 S A K H A L I N E N E RGY I N V E ST M E N T CO M PA N Y • H E A LT H I M PAC T A S S E S S M E N T Chapter 19
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Nosologic
Aleksandrovsky-
Aniva 2000
Dolinsk 2000
Sakhalinsky
Pop 15600
Pop 32200
cases / 1000
cases / 1000
cases / 1000
Acute intestinal infections of est. etiology Acute intestinal infections of non-est. etiology Total (excl. influenza)
S A K H A L I N E N E R G Y I N V E S T M E N T C O M PA N Y • H E A L T H I M PA C T A S S E S S M E N T 123 Chapter 19
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TABLE 28: COMMUNICABLE DISEASES, 2000 (continued) Nosologic
Nogliki 2000
Okha 2000
Poronaisk 2000
Pop 14600
Pop 36700
Pop 35300
cases / 1000
cases / 1000
cases / 1000
Acute intestinal infections of est. etiology Acute intestinal infections of non-est. etiology Total (excl. influenza)
124 S A K H A L I N E N E RGY I N V E ST M E N T CO M PA N Y • H E A LT H I M PAC T A S S E S S M E N T Chapter 19
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TABLE 28: COMMUNICABLE DISEASES, 2000 (continued) Nosologic
Uglegorsk 2000
Kholmsk 2000
Yuzhno 2000
Pop 186900
cases / 1000
cases / 1000
cases / 1000
Acute intestinal infections of est. ethiology Acute intestinal infections of non-est. ethiology Total (excl. influenza)
S A K H A L I N E N E R G Y I N V E S T M E N T C O M PA N Y • H E A L T H I M PA C T A S S E S S M E N T 125 Chapter 19
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TABLE 28: COMMUNICABLE DISEASES, 2000 (continued) Nosologic
Markarov 2000
Nevelsk 2000
Korsakov 2000
Pop: 11400
Pop 45900
cases / 1000
cases / 1000
cases / 1000
Acute intestinal infections of est. ethiology Acute intestinal infections of non-est. ethiology Total (excl. influenza)
126 S A K H A L I N E N E RGY I N V E ST M E N T CO M PA N Y • H E A LT H I M PAC T A S S E S S M E N T Chapter 19
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TABLE 28: COMMUNICABLE DISEASES, 2000 (continued) Nosologic
Smirnykh 2000
Tomari 2000
Tymovsk 2000
Pop:16.700
Pop:20.800
cases / 1000
cases / 1000
cases / 1000
Acute intestinal infections of est. ethiology Acute intestinal infections of non-est. ethiology Total (excl. influenza)
Source: Statistical data report TsGSEN, 2001 Source population numbers: Sakhalin Region at the Turn of the 21st Century. Jubilee Collection. Yuzhno-Sakhalin Regional Committee of State Statistics, 2001 S A K H A L I N E N E R G Y I N V E S T M E N T C O M PA N Y • H E A L T H I M PA C T A S S E S S M E N T 127 Chapter 19
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TABLE 29: FATALITY RATE OF THE SAKHALIN REGION POPULATION 1995-2000 Indicator
Fatality Rate by major classes of cause of death
(per 100,000 of population)

Population at Large
Able-Bodied Population **
*Accidental alcohol intoxication, alcohol addiction, alcohol insanity, gin-drinker’s liver**Per 100 ,000 of population of the respective sex and age Source: Sakhalin Region at the Turn of the 21st Century. Jubilee Collection. Yuzhno-Sakhalin Regional Committee of State Statistics, 2001 128 S A K H A L I N E N E RGY I N V E ST M E N T CO M PA N Y • H E A LT H I M PAC T A S S E S S M E N T Chapter 19
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Mortality
Poronaisk
Smirnykh
population
Uglegorsk
S A K H A L I N E N E R G Y I N V E S T M E N T C O M PA N Y • H E A L T H I M PA C T A S S E S S M E N T 129 Chapter 19
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APPENDIX 2: MEDICATION
Medication
Availability
Prescription
Cost of a course
English/Russian
(% of time)
Required?
or 1 month
treatment plan USD
Source: Data is compiled by ISOS, Sakhalin 130 S A K H A L I N E N E RGY I N V E ST M E N T CO M PA N Y • H E A LT H I M PAC T A S S E S S M E N T Chapter 19
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APPENDIX 3: STAKEHOLDERS
TABLE 32: STAKEHOLDERS AND ISSUES DISCUSSED STAKEHOLDER
Introduction of Dr. Paul Boelens to the healthcare community Development of relations with key health authorities Healthcare provider scope of work and introductions Overview of community ER capabilities and introductions Water quality monitoring of SEIC facilities and introductions Clarification of Russian labor law legislation Introduction & evaluation of nearest centre of excellence abroad for Medical center for Moscow expatriate staff LNG medical support and overview of healthcare initiatives with Baylor Health performance Indicator reporting issues Medical fitness standards and medical evacuation capabilities Evaluation of specialised healthcare capabilities locally Water quality monitoring issues at SEIC facilities Local programme issues & implementation Intergration of pre-employment health standards in new contract Attendance of Korsakov/Baylor college of medicine joint seminar on S A K H A L I N E N E R G Y I N V E S T M E N T C O M PA N Y • H E A L T H I M PA C T A S S E S S M E N T 131 Chapter 19
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TABLE 32: STAKEHOLDERS AND ISSUES DISCUSSED (continued) STAKEHOLDER
Mandatory annual health testing of offshore employee’s/Order #90 Medical insurance capabilities for future workforce Health standard medical fitness capabilities of local healthcare facilities Developing a sustainable healthcare model on Sakhalin Consolidation of 4 facility water quality contracts into a single contract Approval of renewal of contract. Update HPI within contract Potential future employee assistance programmes Growing scope of work on Sakhalin for future healthcare providers Growing scope of work on Sakhalin for future healthcare providers HIA base line data & stakeholder identification exercise City Hospital #1Regional Sanitary and Epidemiology City Hospital #1Regional Sanitary and EpidemiologySakhalin Drug & Alcohol centre Invitation to speak at HIA: Topic discussion Kick off meeting for Island health professional survey Participation in Khabarovsk telemedicine seminar with Sakhalin Regional health services & City Diagnostic Center 132 S A K H A L I N E N E RGY I N V E ST M E N T CO M PA N Y • H E A LT H I M PAC T A S S E S S M E N T Chapter 19
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TABLE 32: STAKEHOLDERS AND ISSUES DISCUSSED (continued) STAKEHOLDER
Participation in Khabarovsk telemedicine seminar with Sakhalin Regional health services & City Diagnostic Center Completed 3 training sessions for field survey team Assignment of Sakhalin Health report to RHS for baseline HIA data Completion of 123 interviews by Island survey team. Critique of survey Meeting Vice-President Exxon Neftegas; to exchange information in relation to the HIA and stakeholder engagement Pre-qualification process introduction for Healthcare Service providers Review of draft report “Sakhalin Healthcare Survey” Preparation for upcoming HIA seminar: planning and logistics City Hospital #1Regional Sanitary and EpidemiologySakhalin Drug & Alcohol centre City Hospital #1Regional Sanitary and EpidemiologySakhalin Drug & Alcohol centre Review of draft report “Sakhalin Healthcare System Infrastructure” Announcement of intention to form healthcare joint venture “Island Aid”.
Joint participation of catastrophic response drill Medical insurance capabilities and overview of project plans and the Guidance documentation & standards for new JV S A K H A L I N E N E R G Y I N V E S T M E N T C O M PA N Y • H E A L T H I M PA C T A S S E S S M E N T 133 Chapter 19
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TABLE 32: STAKEHOLDERS AND ISSUES DISCUSSED (continued) STAKEHOLDER
Emergency response capabilities for upcoming projects. Contractual issues and update on JV with EMC Prescription eyewear for remote site staff. Upcoming demand Industrial Hygiene monitoring on the Molikpaq Contractual issues and capabilities for occupational Training health and environmental monitoring Meeting with City Diagnostic HCP regarding tick born Meeting with Sanitary Agency regarding Pseudo-tuberculosis Medical evacuation of General Gamov & Mrs. Gamov Meeting to discuss development of “health steering committee” Preparation training contract ‘“Basics of Sanitary Laws, Laboratory Control for Quality, Safety, Rules of Sample Collection and Delivery for Following Laboratory Study”. Training to be provided by Sanitary Agency Meeting with ‘Island Aid’; checklist of core health components prior Meeting and discussion with Vice Governor Sklyarenko and a team of senior health officials; establishment coordination council Regional Healthcare and SEIC, way forward Meeting and discussion with Senior Health Adviser Exxon Mobil and team of line managers; review health initiatives and future operation plans, potential opportunities cooperation and sharing Meeting/dinner with Sakhalin senior health officials & Regional Sanitary and EpidemiologySakhalin Drug & Alcohol centre Meeting with Korskov hospital director & deputy. Update on Baylor College of medicine/Korsakov hospital joint project & preparation for Phase 2/LNG. HIA progress report Meeting with Dr. Penkovsky/Regional Health Services. -2nd HIA workshop tentative dates & agenda-Hospital survey team members/SOW & survey dates-Vice Governor/Reg. HS health strategy paper & follow up 134 S A K H A L I N E N E RGY I N V E ST M E N T CO M PA N Y • H E A LT H I M PAC T A S S E S S M E N T Chapter 19
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TABLE 32: STAKEHOLDERS AND ISSUES DISCUSSED (continued) STAKEHOLDER
Meeting with City Diagnostic center Medical Director. Update on EMC joint venture progress and 2002/03 development planning Meeting with Regional hospital Director, Regional Health Services & JV representatives regarding planned upgrades to the healthcare facility & education programmes for the HCP’s Participation first medical professional Yuhzno-Sakhalisk ‘evening gathering’l attended by both Russian national and foreign national Medical Doctors with the objective to regularly share and discuss medical scientific information Meeting Dr Siberkin, director regional healthcare; review and input Meeting Dr Beyfus, director regional hospital; clarification on health Meeting direcctor CDC; reviewing progress development joint venture Healthcare Service provider ‘Sakhalin International Clinic (CDC & EMC).
Completion and agreement draft scope of work ‘Review and GAP analysis of Emergency Care Facilities of Key Hospitals on Sakhalin’, study to be done in cooperation with Exxon Neftegas Meeting and discussion Dr Papirenko and his team of senior specialists of the Sanitary Agency, presentation and discussion feedback Russian Meeting and discussion Mr Dinty Miller, CEO British Petroleum Sakhalin; introduction HIA issues, agreement intention cooperation SE-BP on Meeting and discussion Dr Penkovski, Regional Healthcare; feedback Russian version draft HIA report and agreement to plan a coordinated feedback input meeting, planning HIA stakeholders follow up workshop.
Meeting and discussion Dr Beauvieux Europ Assistance; pre-qualification Meeting and discussion Dr Samarsky, Sanitary Agency; pre-work health conference organised by Sanitary Agency.
Meeting and discussion Health Advisers ExxonMobil and ExxonNeftegas; to Review and GAP analysis of Emergency Care Facilities of Key Hospitals on Sakhalin Island, joint strategy engaging community stakeholders,northern pipeline sharing, Nogliki hospital.
Confirmation nomination of a Regional Healthcare specialist as team member of the Hospital Review study of Emergency Care Facilities of Meeting and discussion Regional Healthcare; alignment of issues related to review HIA report, hospital survey, HIA follow up workshop.
Meeting and discussion Sanitary Agency; alignment process and content Contributed to the scientific practical conference state sanitary end epidemiological service in Yuhzno. The conference was chaired by the RF deputy minister of health Presented presentation on ‘implementationof health auditing’ Scientific-Social event meeting for medical practitioners working in Yuhzno Sakhalinsk attended by about 20 doctors. Exchange of medical- S A K H A L I N E N E R G Y I N V E S T M E N T C O M PA N Y • H E A L T H I M PA C T A S S E S S M E N T 135 Chapter 19
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TABLE 32: STAKEHOLDERS AND ISSUES DISCUSSED (continued) STAKEHOLDER
Meeting and discussion Dr Derabin, regional healthcare representative, participating in the hospital emergency care study.
‘Kick-off meeting’ of the ‘Review and GAP analysis of Emergency Healthcare Facilities of Key Hospitals on Sakhalin Island’. Participants; SEIC health advisers, Exxon Neftegas senior manager and the ISOS/regional healthcare survey team. Mobilisation survey team.
Review draft HIA report Russian version together with representatives of the State Sanitary and Epidemiological service and regional healthcare Completion of island survey ‘Emergency Healthcare Facilities of Key Hospitals on Sakhalin Island’. Draft report to be jointly reviewed by SE Corporate/Project health and ENL health team.
136 S A K H A L I N E N E RGY I N V E ST M E N T CO M PA N Y • H E A LT H I M PAC T A S S E S S M E N T Appendices
APPENDIX 4: HIA HEALTHCARE PRACTITIONER (HCP) QUESTIONNAIRE
Objective: To determine the healthcare practitioners’ perception of community health issues 1. What do you see as the important health concerns in your community? 2. Do you have any health concerns about yourself or your family? 3. What sort of healthcare facilities are in this area? What type of care is available at this facility (e.g. acute treatment, preventive, immunisations etc)? 4. Are you happy with this facility? Are then any changes you would like to occur? 5. Is there information available to the community about family planning? Are contraceptives availablee.g. pill, condoms, others)? 6. Where do you source your drinking water? 7. Have there been any health problems associated with contamination of drinking water? 8. What is the current situation with respect to immunisations for both children and adults? 9. Do you know how many of your patients smoke? 10. At what age to people start smoking? 12. Are there any problems in the community associated with alcohol use? 14. Is there any treatment available in this area? 15. Are there any other drugs used in the community? 16. Do you know of any sex workers in your community? 17. What is the community view of prostitution? Is it an accepted occupation? 19. Is there a health monitoring programme for prostitutes? 20. Are sexually transmitted diseases common? Which diseases are common? Is the incidence changing? 22. Do you see many people with TB in the community? 23. Were they treated in hospital or as an outpatient? 24. What is the compliance with outpatient treatment? 25. Is there much treatment resistant TB? S A K H A L I N E N E R G Y I N V E S T M E N T C O M PA N Y • H E A L T H I M PA C T A S S E S S M E N T 137 Appendices
27. Are any other infectious diseases a problem in your community? 28. Have you seen any cases of pseudo tuberculosis, tick borne encephalitis, Lyme disease,Leptospirosis, tularemia in the past 2 years? 29. Are there any other important health issues related to animals or blood sucking arthropods? 30. Do you anticipate any health issues in the community which could relate to the Project? 31. What sort of health concerns do you expect the community to have? 138 S A K H A L I N E N E RGY I N V E ST M E N T CO M PA N Y • H E A LT H I M PAC T A S S E S S M E N T Appendices
APPENDIX 5: SOW ISLAND HEALTH REPORT
Background HIA:
The success of a HIA depends on team effectiveness and appropriate stakeholder engagement.
Participation of health practitioners living and working on the island in the HIA team is likely to enhancethe focus on real health issues within the community and to aid in the development of practicalmitigation and improvement measures.
Description of Duties/Tasks:
The contracted health practitioner will be expected to: Prepare a report based on available health data as presented in annual and specific reports issued by the following health institutions: Regional healthcare, Regional Sanitary and Epidemiology Agency, Yuhzno-Sakhalinsk hospital, Korsakov hospital, Nogliki hospital, regional disaster response, cityambulance services, private clinics, Sakhalin centre for prophylactic of HIV, regional centre for alcoholand drugs and Sakhalin State University.
Scope of work:
The objective of this report is to enable the reader to understand the current operation and futuredirection for healthcare on Sakhalin Island.
The introduction should include a description of the healthcare system on Sakhalin covering both publicand private systems. It should examine policies and activities of health departments and ministries.
A general overview of the important health issues and stated health targets should also be included.
The report should comment on the following: PhilosophyOn what philosophical principles is the health system based? Do these include the concepts ofhealthcare for all and the provision of acceptable standards? Eligibility Define who has access to the system and what services are covered by system. Are the different servicesaccessed by self-referral or by one medical practitioner to another? Benefits How are costs covered i.e. is the system fully or partly government funded? Does the patient make anycontribution, does private health insurance exist? FinancingHow is the health system funded? Is it federally funded, regionally funded or locally funded? Is there amixture of funding arrangements? What is the breakdown of this split? What is the division of expenditure between primary, secondary and tertiary care and pharmaceuticals?How much expenditure is private and how much is public? Payment of medical care providersHow are medical care providers paid? By their employer, the state, by the patient? Service delivery systemThis section should address how primary, secondary and tertiary care are organised and delivered. What sort of expertise is required for the delivery of these elements? Transition issues Are there any changes evolving or in the way health is managed on Sakhalin? S A K H A L I N E N E R G Y I N V E S T M E N T C O M PA N Y • H E A L T H I M PA C T A S S E S S M E N T 139 Appendices
Health reform
Organisation and structureWhich government organisations are involved in healthcare and what are their responsibilities in termsof health? How do these departments interface with each other? What levels of government areinvolved? Does the private sector have a role? How are pharmaceuticals accessed in hospitals andoutside the hospital system? Healthcare professionalsWhich healthcare groups are recognised in the Russian system?E.g. Medical practitioners, nurses, chiropractors, osteopaths, speech pathologists, physiotherapists,occupational therapists, pharmacists, others? Qualifications and TrainingDescribe the training required to be recognised by the various healthcare professions? Is there anyrequirement for continuing professional development? Legal requirements What is the regulatory framework for healthcare including public health, environmental health andoccupational health?How does this legislation impact on foreign companies?What is the mechanism (if any) for recognition of foreign medical staff?Are there any specific health reporting requirements within the Russian legislative system? Facilities and resourcesWhat resources are available within the healthcare facilities in the different regions on Sakhalin? Comment on the availability of the following staff and services throughout Sakhalin:emergency medicine physiciansorthopaedic specialists general surgery neurosurgeryambulance Comment on the current situation of the following specific sectors:
Private sectorGeneral practitioners, dentistry, consultants, hospitals, physiotherapy, mental health and psychology.
Child & adolescent health developmentSchool health, disease prevention management, integrated management of childhood illnesses,immunisation programmes, prevention of substance abuse.
NutritionAssessment of food technology, chemical contaminants of food, child growth and malnutrition, foodhygiene and food safety regulations, inspection methods and food-borne infections, deficiencydisorders (iron, iodine, vitamins).
Public healthDrinking water quality, water resources, sustainable water supply and sanitation, sewage water, waterrelated burden of disease.
EnvironmentAir, chemical safety, climate and health, environmental epidemiology, environmental burden of disease,healthcare waste, recreational water Accidents and violenceManagement of accidents, ambulance services, traffic injuries, burden of disease related to accidentsand violence, child abuse, domestic and sexual violence, small arms, industrial accidents, poisoning andsuicide.
Statistics, WHO liaisonSystem used for collecting health data, associated reporting structures and projects.
140 S A K H A L I N E N E RGY I N V E ST M E N T CO M PA N Y • H E A LT H I M PAC T A S S E S S M E N T Appendices
Occupational healthStructure, health hazards control, registration of occupational illnesses and accidents, burden of disease,preventive health programmes, inspections and the role of regulatory agencies, disability assessment,health surveillance, occupational health professionals.
PharmaceuticalsLegislation and regulation of medicines, drug policies, quality assurance, vaccines and immunisations,distribution system.
DeliverablesThe Sakhalin health system report will be submitted electronically (on Disk) in MS word. The Report is not to exceed 60,000 words.
A draft will be produced. Following submission of the draft SEIC shall have the text translated andprovide comments within 5 working days of completion of the translation. The final report shall beprepared following receipt of SEIC comments.
One copy of the draft and two copies of the final shall be submitted in Russian in MS Word 6.0 forWindows or another pre-approved compatible programme. In addition, the following information should be provided: Source locations (e.g. institutions and departments where information is obtained) should be clearlyidentified in a Terms of Reference (TOR).
Copies of resumes of health professionals employed to compile this data including a list of theiractivities and responsibilities.
Citations/ReferencesAll information sources should be fully referenced (e.g. bibliographic source, statistical data set)including name of agency responsible for compiling the data). Archives of local and centraladministrative authorities and organisations should also be included with names of individuals consulted within an organisation consulted.
With respect to reports and other “grey literature” the repository where this information can be foundshould be fully referenced in the bibliographic text.
Bibliographic sources for information contained in each tables and figures should be fully referenced.
Each source should be cited and the applicable information presented.
Work RequirementsAll work should be carried out in accordance with this contract.
Duration of AssignmentThe assigned work scope is to be completed between the dates of November 15, 2001 and December 15, 2001. Estimated EffortThe total effort is expected to deliver about 120 pages of text, excluding figures and tables, based on the assigned tasks. S A K H A L I N E N E R G Y I N V E S T M E N T C O M PA N Y • H E A L T H I M PA C T A S S E S S M E N T 141 Appendices
APPENDIX 6: HIA WORKSHOP SUMMARY
Background:
The objective of a Health impact assessment is to predict the health impacts of a development beforethe project proposal has been approved, so that the negative impacts can be reduced or avoided,positive impacts can be enhanced and the probability of sustainable development increased. The key objective of the HIA workshop is to share, discuss and evaluate the present available informationon health in dialogue with health community leaders and other stakeholders. The first HIA workshop washeld on 24 and 25 January, 2002 at the Santa Resort in Yuzhno-Sakhalinsk, Russia.
Aims of the HIA workshop:
Introduce the participants to the Sakhalin II Project and involve them in the HIA process Engage the health community in identifying health issues Gain agreement on the priority of health issues Jointly develop measures to mitigate impacts of the Project on the basis of sustainable development Identify other stakeholders in health on Sakhalin Island Create a shared ownership of the assessment process and the overall plan for the outcome, based onrealistic expectations of the company investment. Methods:
Key to gaining optimum stakeholder participation and their input is a structured programme thatparticipants can relate to and influence. To this end a recognised Russian professional facilitator wasselected and contracted to lead the workshop. Pre-workshop sessions were conducted with thefacilitator, Mikhail Klarin, to ensure the workshop process and structure met the defined aims.
Stakeholder participation included: individual presentations, direct dialogue, syndicate exercises, teamdiscussions and team presentations.
The workshop programe was based on the following elements: Introduction of the Sakhalin II Phase 2 Project: Technical Director Engel Van SpronsenAims, expectations and objectivesAbstract presentationsHealth Impact Assessment stagesHIA vignetteHealth issue identification Prioritising health issues Stakeholder identificationWorkshop closure: Review aims, objectives, concerns and action planningHR Director David Smith; HSE Manager Bob Hill Results:
The following is a summary of the exercises undertaken and the conclusions reached during the HIAworkshop: Sharing informationThe following local healthcare professionals shared information and concerns and suggestions fordirections. Abstracts are attached as appendices of the HIA workshop report.
Dr Fomitskaya, Korsakov Hospital: Partnerships: Real and valuable supportDr Beyfus, Regional Hospital: Sakhalin Regional Hospital health management issuesDr Bouriy, Sanitary & Epidemiology: Focal infections of the Sakhalin RegionDr Morozova, Sanitary & Epidemiology: Social infections of the Sakhalin region 142 S A K H A L I N E N E RGY I N V E ST M E N T CO M PA N Y • H E A LT H I M PAC T A S S E S S M E N T Appendices
Dr Konushenko, Narcological centre: Drug & alcohol abuse in the Sakhalin regionDr Selyuk, Sanitary & Epidemiology: Sanitary and hygienic issues in the Sakhalin regionDr Skylarova, City Hospital: Epidemiology on Sakhalin Island and therapeutic diagnostic processes Health Data ReviewedThree health baseline studies were conducted and the important health data gathered was shared andreviewed during the workshop. Island health infrastructure study (Sakhalin general health system report)Health data baseline study (Statistical report)Island community health survey (Survey of the health community professionals) HIA VignetteThis was a HIA exercise in which the workshop participants learned how to predict potential impacts ofprojects. Based on a one-page vignette describing a water reservoir project in China, workshopparticipants were asked to describe the potential health impacts. The participants then identified andlisted priorities in an open forum.
Health issue identification and prioritisationIn a group exercise the health hazards tables were developed and classified under five major categories(see HIA report table 2-5: health hazard identification); LifestyleCommunicable and non-communicable diseasesPublic healthHealth servicesFacilities. Input from the health professionals allowed these issues to be better understood and prioritised.
Focusing on vulnerability, specific communities which could be impacted upon were identified. Impactson environmental, physical and social factors were considered. The health service capability wasassessed and reviewed.
Stakeholder IdentificationPrimary stakeholders are those parties that are directly affected by or have a specific interest in theSakhalin II Project. The following important stakeholders were identified and listed: Sakhalin Regional AdministrationRegional Health Services and associated infrastructureRegional hospital, Regional Polyclinics etc.
Municipal Health Services and associated infrastructureCity Hospitals, including City polyclinics etc.
SE Staff members and their familiesMass mediaTrade UnionsSakhalin youthVarious (sub) communities of the Sakhalin Island populationEnvironmental agenciesOther oil and gas companiesIndustry associations e.g. fishing industryDistrict community members potentially affected by the Phase 2 development: S A K H A L I N E N E R G Y I N V E S T M E N T C O M PA N Y • H E A L T H I M PA C T A S S E S S M E N T 143 Appendices
Conclusions and mitigation:
The HIA workshop participants unanimously agreed that a specific plan of action should be developed inorder to follow up on identified health impact issues. The following action items were identified: 1. Establish a joint committee of the Island Health Authority and SEIC Health Advisory Committee toaddress, review and advise on management with respect to island health issues of common interest. TheTerms of Reference of this committee are to be agreed upon in detail by the members, they will includebut are not limited to, development of initiatives and monitoring. The exact form and composition ofthis committee is still to be determined. Sub-committees will be established to address and study certainspecific health issues in more detail.
2. Develop and implement a specific health issue engagement plan and consult the general communityand identified key health stakeholders.
3. Establish a health data reporting structure in co-operation with the local health authority based onstandardised definitions. The database will comprise community health data as well as company andcontractor managed health data 4. Investigate the potential to assist and support hospital authorities in Nogliki, Korsakov and Yuhzno-Sakhalinsk with hospital upgrades and healthcare improvements based on the shared need for medicalemergency response. Respect the investment responsibility of the local authorities 5. Jointly review and update community guidance on prevention of communicable diseases such as STD,HIV/AIDS and Tuberculosis. Assist and support the health community in specific programmemanagement. Include elements of these programmes in the health education programmes of thecompany and its contractors with an extension to the work related camps. 6. Overall the HIA workshop was a great success. Senior Sakhalin health professionals expressed fullsupport for the HIA concept and are eager to proceed further with the development plans. Theimportance of the workshop and its outcomes was emphasised by the coverage in the Sakhalin mediaincluding television, radio and newspaper reports.
Dr Darizhapov Deputy chief, Centre for Sanitary and Epidemiological SupervisionDr Skylarova, hospital directorDr Vera V. Fameetskya, Korsakov hospitalDr Paperinko, Director, Regional Centre for Sanitary and Epidemiological Supervision Dr. I.V. Morozova, Centre for Sanitary and Epidemiological Supervision Dr. V.L. Bouriy, Centre for Sanitary and Epidemiological Supervision / Focal infections Dr Beyfus, director, Regional HospitalDr Konavolov, director, Regional Disaster Response Dr Lyubov Konyushenko, Regional Centre for alcohol and drugsDr Kondritiev, Director , City diagnostic CentreDr Kendjiev, Nogliki hospitalDr. Kovalyov, Yuzhno ambulance serviceDr. Selyuk, Centre for Sanitary and Epidemiological Supervision Dr. VaselchenkovDr. Paul Boelens, SEICDr. Judy Balint, SEICMark DeBello, SEIC HIA Baseline studies and HIA workshop preparation Dr Bersenev, Kizima, Island health survey teamDr. Pavel Beresnev, Island health survey teamDr.Samarvsky, Sakhalin health report author Dr Siberkin, director, Regional HealthcareDr Penskovsky, deputy chief, Regional Health CentreDr Elena Lomakina, AIDS / HIV centre 144 S A K H A L I N E N E RGY I N V E ST M E N T CO M PA N Y • H E A LT H I M PAC T A S S E S S M E N T Appendices
APPENDIX 7: HIA HEALTH QUESTIONNAIRE (PART OF SIA)
Objective: To determine the public perception of health issues Locality__________________________________________________________________________Group / Individual Health in the community
What do you see as the important health concerns at present in your community? (expect answerswhich relate to both the medical illnesses and the structure of medical practice) Do you have any health concerns about yourself or your family? What sort of healthcare facility do you have access to? What type of care is available at this facility (e.g. acute treatment, preventive, immunisations etc?) Are you happy with this facility? Are there any changes you would like to occur? Are medications and food available in your local hospital? Public health
Where do you source your drinking water? Have you or your family had any problems related to thewater? If sewerage contamination not mentioned ask the following. Have there been any health problemsrelated to contamination of drinking water with sewerage? How do you find out if there is a particular problem with the drinking water? What do you do if there is aproblem with the drinking water? In this area have many people had any illnesses which you relate to the environment, such as diseasescaused by ticks? Do many people smoke in this community? At what age do people start smoking? Is there any concernabout smoking? Alcohol use in your community
Are there any problems in the community associated with alcohol use? How often do you and your family eat fruit, vegetables, meat (classify as daily, several times per week,once each week)in summer? in winter ? Health and the Project
Do you have any concerns about the effect that the Project could have on people in this community? S A K H A L I N E N E R G Y I N V E S T M E N T C O M PA N Y • H E A L T H I M PA C T A S S E S S M E N T 145 146 S A K H A L I N E N E RGY I N V E ST M E N T CO M PA N Y • H E A LT H I M PAC T A S S E S S M E N T

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