Initial Environmental Examination...Initial Environmental Examination August 2020 INO: Higher Education for Technology and Innovation Rumah Sakit Pendidikan Tinggi Negeri Universitas

Initial Environmental Examination

August 2020

INO: Higher Education for Technology and Innovation Rumah Sakit Pendidikan Tinggi Negeri Universitas Lampung (RSPTN UNILA)

Prepared by the Government of Republic of Indonesia’s Ministry of Education and Culture for the Asian Development Bank.

CURRENCY EQUIVALENTS

(as of 04 August 2020)

Currency unit – Rupiah (Rp) KN1.00 = $ 0.00006799

$1.00 = Rp 14,708

ABBREVIATIONS

ACCCRN - Asian Cites Climate Change Resilience Network ADB - Asian Development Bank AMDAL - Analisis Mengenai Dampak Lingkungan (Analysis of

Environmental Impact) ANDAL - Analisa Dampak Lingkungan (Environmental Impact Assessment) ASEAN - Association of Southeast Asian Nations BAPPEDA - Badan Perencanaan Pembangunan Daerah (Regional

Development Planning Board) BAPPENAS

- Badan Perencanaan Pembangunan Nasional (National Development Planning Board)

BMKG - Badan Meteorologi, Klimatologi, dan Geofisika CEMP - Contractor’s Environmental Management Plan DELH - Dokumen Evaluasi Lingkungan Hidup (Environmental Evaluation

Document) DLH - Dinas Lingkungan Hidup (Environmental Agency) EA - Executing Agency EHS - Environment, Health and Safety EIA - Environmental Impact Assessment EMP - Environmental Management Plan EPA - Environmental Protection Agency GOI - Government of Indonesia GRM - Grievance Redress Mechanism HEI - Higher Education Institution HETI - Higher Education for Technology and Innovation IA - Implementing Agency IEE - Initial Environmental Examination IUCN - International Union for Conservation of Nature KEPMEN - Keputusan Menteri (Ministerial Decree) KEPRES - Keputusan President (Presidential Decree) MOEC - Ministry of Education and Culture MOEF - Ministry of Environment and Forestry PCR - project completion report PIC - Project Implementation Consultant PMC - Project Management Consultant PIU - Project Implementation Unit PMU - Project Management Unit REA - rapid environmental assessment RSPTN - Rumah Sakit Perguruan Tinggi Negeri SPS - ADB Safeguard Policy Statement (2009) TVET

UKL - UPL - technical and vocational education and training

Upaya Pengelolaan Lingkungan dan Upaya Pemantauan Lingkungan

UNDP - United Nations Development Program UNFCC - United Nations Framework Convention on Climate Change UNILA - Universitas Lampung (Lampung University)

WEIGHTS AND MEASURES

ha - hectare m - meter km - kilometer

dBA - decibels km - kilometer hr - hour mm - millimeter oC - Degree Centigrade

NOTE In this report, "$" refers to US dollars.

This initial environmental examination is a document of the borrower. The views expressed herein do not necessarily represent those of ADB's Board of Directors, Management, or staff, and may be preliminary in nature. Your attention is directed to the “terms of use” section on ADB’s website. In preparing any country program or strategy, financing any project, or by making any designation of or reference to a particular territory or geographic area in this document, the Asian Development Bank does not intend to make any judgments as to the legal or other status of any territory or areas.

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TABLE OF CONTENTS

EXECUTIVE SUMMARY 1

I. INTRODUCTION 1

A. Purpose of the IEE Study 1 B. Extent of the IEE Study 1 C. Methods Used for the IEE Study 1 D. IEE Report Content 3

II. POLICY, LEGAL AND ADMINISTRATIVE FRAMEWORK 3

A. ADB’s Environment Safeguards Policies 3 B. Legal and Institutional Framework on Environmental Management in Indonesia 4 C. ADB Environmental Safeguards Guidelines in the Context of Indonesia’s

AMDAL 6 D. Environmental Study Required for the Project under ADB and Indonesian

Regulations 7 E. International Good Practices and Relevant Environmental Standards 7 F. Laws and Regulations Related to Hospitals 12 G. Regional Spatial Planning and Traffic Management Requirements 13 H. International Conventions 13

III. DESCRIPTION OF THE PROJECT 15

A. Conceptual Design of Teaching Hospital and Integrated Research Center 17 B. Functional Zones and Access 17 C. Green Building Concept 19 D. Waste Management 23 E. Existing Buildings 25 F. Schedule of Implementation 26

IV. DESCRIPTION OF THE ENVIRONMENT 27

A. Physical Environment 27 B. Biological Environment 36 C. Socio-economic Environment 40 D. Climate Risk Vulnerability Assessment 44

V. ANTICIPATED ENVIRONMENTAL IMPACTS AND MITIGATION MEASURES 46

A. Impact Assessment 46 B. Evaluation of Impacts 47 C. Negative Impacts and Mitigation 53 D. Climate Change Impacts 65 E. Analysis of Alternative 66

VI. INFORMATION DISCLOSURE, CONSULTATION AND PARTICIPATION 67

A. Information Disclosure 67 B. Key stakeholder consultation during project preparation 67

VII. GRIEVANCE REDRESS MECHANISM 69

A. Grievance Redress 69

B. ADB’s Accountability Mechanism 70

VIII. ENVIRONMENTAL MANAGEMENT PLAN 70

A. Institutional Arrangement and Capacity Development 70 B. Capacity Building 75 C. Impact Mitigation Plan 75 D. Environmental Monitoring Plan 75 E. Cost for EMP Implementation 94

IX. CONCLUSION AND RECOMMENDATIONS 95

APPENDIXES

1. Rapid Environmental Assessment (REA) Checklist 96 2. Consultation With Stakeholders 102 3. Grievance Intake Form 105 4. Outline Of Environmental Safeguard Monitoring Report 106

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List of Tables

Table 1. World Bank - IFC Guidelines Applicable to the Project 7

Table 2. Air Quality Standards 9

Table 3. Noise Standards 10

Table 4. Effluent Standards 10

Table 5. Solid Waste Categories under Waste Management Act (2008) 10

Table 6. Civil Works Components and Costs 26

Table 8. Monthly Average Rainfall Data, in mm (2016-2018) 29

Table 9. Wind Speed Data and Direction (degrees) at the Proposed Development Site and Surroundings 31

Table 10. Results of Surface Water Quality Measurement (2020) 32

Table 11. Air Quality Measurement in Ramayana and Perwira Roads 35

Table 12. Noise Level Measurement Results Near the Rajabasa Terminal 35

Table 13. Trees Affected by the Project 36

Table 14. Near Threatened Floral Species Potentially Present Within 25-km Radius of UNILA 37

Table 15. List of Critically Endangered and Endangered Faunal Species Possibly Present Within 25-km Radius of UNILA 38

Table 16. Diversity of Phytoplankton and Zooplankton in Drainage Ditch Near UNILA 39

Table 17. Distribution and Population Distribution of Lampung Provinces (Year 2018) 40

Table 18. Distribution of Population of Provinces by Age Group 40

Table 19. Bandar Lampung City Health Facility (2018) 41

Table 20. Water Consumption and Wastewater Generation 42

Table 21. Power Supply Requirement for the Teaching Hospital 42

Table 22. Traffic Survey on the Zainal Abidin Pagar Alam Road Service Level 43

Table 23. Summary of VECs for the Proposed Construction of Teaching Hospital and Integrated Research Center, Bandar Lampung City, Indonesia 48

Table 24. Intensity, Duration and Scope Classification of Impacts 49

Table 25. Multi-criteria Analysis to Determine the Potential Environmental Impacts 49

Table 26. Matrix Showing the Relationship Between VECs and Project Components and Activities for the Construction of Teaching Hospital and Integrated Research Center 50

Table 27. Analysis of Environmental Impacts 51

Table 28. Potential Climate Change Impacts and Proposed Adaptation Measures 66

Table 29. Summary of Consultation with UNILA and Relevant Agencies 68

Table 30. Institutional Arrangement for EMP Implementation in UNILA 73

Table 31. Capacity Building Program for RSPTN UNILA 75

Table 32. Impact Mitigation Plan for RSPTN UNILA 77

Table 33. Environmental Monitoring Plan 90

Table 34. Cost Estimate for Environmental Monitoring 94

List of Figures

Figure 1. Site Development Plan of Universitas Lampung 15

Figure 2. Location of the RSPTN UNILA and IRC, Bandar Lampung City, Lampung Province 16

Figure 3. Proposed Site of RSPTN UNILA and IRC 16

Figure 4. Area Allocation for Hospital and IRC 17

Figure 5. RSPTN UNILA Functional Zones 18

Figure 6. Main Access to RSPTN UNILA 19

Figure 7. Emergency, Pedestrian and Public Access 19

Figure 8. Green Building Strategy for RSPTN UNILA 20

Figure 9. Use of Green Space for RSPTN UNILA (Teaching Hospital) 20

Figure 10. Use of Fins and Secondary Shading for the Façade of RSPTN UNILA 21

Figure 11. Green Building Strategies for RSPTN UNILA 22

Figure 12. Use of Solar Power for RSPTN UNILA 23

Figure 13. Schematic Diagram of Anaerobic – Aerobic Biofilter Technology 24

Figure 14. Existing Structures in the Proposed RSPTN UNILA 25

Figure 15. Schedule of Implementation 26

Figure 16. Earthquake Intensity Zones in Indonesia 28

Figure 17. Map of Tsunami Disaster Coastal Zone in Bandar Lampung (2017) 28

Figure 18. Map of Flood Prone Area in Bandar Lampung (2013-2014) 30

Figure 19. Windrose at the Development Site of UNILA Hospital and Surrounding areas 31

Figure 20. Drilling Wells Surveyed to Determine Discharge Rate 34

Figure 21. Air Quality Measurement Stations 34

Figure 22. IBAT Generated Report for UNILA showing the absence of protected areas and key biodiversity areas within the 3-km buffer zone. 36

Figure 23. Flora and Fauna Inventory in Proposed Project Location 37

Figure 24. Proposed Main Access to RSPTN UNILA via Jalan Soemantri Brojonegoro 44

Figure 25. Trend of Average Annual Temperature for Land Areas in Indonesia based on Data from CRU T53.1 45

Figure 26. Earthquake-resistance Building Technology Options 55

Figure 27. Seismic Vibration Control Technology Options 55

Figure 28. Prevailing Wind Directions (North, Northwest and South and Southeast) 59

EXECUTIVE SUMMARY

1. In response to the government’s vision and plan to strengthen the role of higher education as a skills and innovation driver, the Asian Development Bank will invest in two Higher Education Institutions (HEIs) in Indonesia - Institut Teknologi Sepuluh Nopember Surabaya (ITS) in East Java and Universitas Lampung (UNILA) in Bandar Lampung City, Lampung. The Executing Agency for the project is the Ministry of Education and Culture (MOEC) and the Implementing Agencies are the two HEIs. The two HEIs are included in MOEC priority investment list, given their high level of readiness, capacity, commitment and potential to become top universities in specific specializations. 2. In compliance with the ADB Safeguard Policy Statement (SPS) 2009, this Initial Environmental Examination (IEE) has been prepared for the construction of University of Lampung State Higher Education Hospital or Rumah Sakit Perguruan Tinggi Negeri Universitas Lampung (RSPTN UNILA) (the Project). The Project, which consists of the teaching hospital and the integrated research center, has been categorized as B for environment since the anticipated impacts are site-specific, few if any of them are irreversible, and most often mitigation measures can be readily designed. 3. The ADB’s environmental safeguards policy stipulates that an IEE (including an Environmental Management Plan, EMP), shall be approved by ADB prior to the commencement of construction. The draft report will be made public on the ADB website and by MOEC and the HEI locally. The IEE will be updated as required, and progress on implementing the IEE and EMP will be reported semi-annually, and the progress report will be made public on the ADB website and by MOEC and the HEI. The ADB SPS (2009), ADB Operational Manual Section F1/BP, Access to Information Policy (2018), World Bank Group Environment, Health and Safety (EHS) Guidelines (2007), and relevant environmental laws and regulations of the Government of Indonesia guided the preparation of the IEE and EMP. 4. The Project will also comply with the Government of Indonesia (GOI) regulation on Environmental Impact Assessment (EIA), the Analisis Mengenai Dampak Lingkungan (AMDAL). Based on Indonesia’s environmental regulations, specifically Regulation No. P.38/MENLHK/SETJEN/KUM.1/7/2019, the type of environmental study required depends upon the land area and size of the building. AMDAL is required for lot areas greater than 5 hectares or buildings with total floor area of 10,000 m2. Since the project will be constructed inside the 58,105 m2 lot and the teaching hospital and integrated research center buildings have a combined floor area of 16,200 m2 (10,000 m2 and 6,200 m2, respectively), the project is categorized as C for environment under the GOI AMDAL, will require the preparation of AMDAL. 5. UNILA will secure environmental permits for the teaching hospital and integrated research center buildings. These permits will be issued after UKL-UPL have been completed and approved by the environmental services agency of the city, Dinas Lingkungan Hidup of Bandar Lampung. 6. Following the field assessment and consultations, secondary information was gathered from various sources about other environmental parameters such as proximity to protected areas or biodiversity conservation areas, climate, natural and geological hazards, and socio-economic condition in Bandar Lampung. Environmental implications of project activities were reviewed and mitigation measures to address adverse environmental impacts are proposed in the EMP. The site assessment was done on March 2 to 6, 2020. Consultations were also conducted with the Preparation Team of UNILA, the City Health Office, the City Environment Office and the City Traffic Management Office of Bandar Lampung City.

7. The assessment of impacts shows that the project activities will not have any significant adverse impacts on the environment. Impacts, which will mostly occur during the construction phase, are expected to be temporary, localized and can be readily mitigated with proper management and good practices. The identified impacts during pre-construction phase include conformity to land use, earthquake hazards, permanent loss of trees, additional strain to public services such as waste collection, management of wastewater, power and water supply. During construction, potential impacts include disturbance of land and soil condition, impacts on air quality, contamination of waterways, solid waste management impacts, and community and occupational health and safety. During operation, anticipated impacts include the occupational and community health and safety hazards from the management of traffic, wastewater, solid waste and hazardous wastes. 8. Environmental management plan (EMP) includes requirements for environmental monitoring and reporting, the proposed institutional arrangement, capacity development and training needs, performance indicators, standards and regulations to be followed, implementation schedule and cost estimates to implement the EMP. 9. The final IEE, including the EMP will be updated during detailed engineering design stage and subject to approval from the relevant government agencies, MOEC and ADB. The tendering process will advocate environmentally responsible procurement by ensuring the inclusion of EMP provisions in the bidding and construction contract. Contractor will be required to submit Contractor’s EMP (CEMP) as part of the construction contract. Training and/or workshop on environmental management and monitoring plan will be programmed for PMU, PIU, Contractor and other relevant parties. Monitoring of occupational and community health and safety requirements will be prioritized during construction and operation to reduce risks to workers and the community. PMU and PIU of the project will continue the process of public consultation and information disclosure in accordance with the requirements of the SPS and the government rules and regulations during detailed design and construction phases. With proper mitigation and monitoring, the proposed RSPTN UNILA project can be implemented in an environmentally acceptable manner. This IEE, including the EMP, is a living document that can be updated further during detailed engineering design stage, and during project implementation. 10. The project will establish a Grievance Redress Committee (GRC) that will address the issues raised by affected people on the project. In case issues are not resolved through the grievance redress mechanism (GRM), affected persons may elevate their complaint to Indonesia ADB resident mission (IRM) in Jakarta. The complainant can elevate the case further through the ADB’s Accountability Mechanism in case issues are not resolved through the GRM and the ADB resident mission. In line with the Access to Information Policy of ADB (2018), the Initial Environmental Examination (IEE) Report for the project will be made available in a timely manner, in an accessible place, and in a form and language that will be understood by affected people and other stakeholders. ADB will post safeguard documents on its website upon receipt.

I. INTRODUCTION

A. Purpose of the IEE Study

1. This initial environmental examination (IEE) has been prepared for the construction of University of Lampung State Higher Education Hospital or Rumah Sakit Perguruan Tinggi Negeri Universitas Lampung (RSPTN UNILA) and Integrated Research Center (IRC UNILA) (the Project). 2. The IEE has the following objectives: (i) identify the environmental issues that should be taken into account due to project interventions (ii) determine the magnitude of potential environmental concerns and to ensure that environmental considerations are given adequate weight at planning/design stage (iii) identify need for further environmental studies and (iv) propose enhancement measures, if any. The IEE report includes the following major elements: (i) executive summary, (ii) project description, (iii) description of the environment, (iv) anticipated environmental impacts and mitigation measures, (v) analysis of alternative, (vi) environmental management plan, (vii) grievance redress mechanism, (viii) consultation and information disclosure, and (ix) conclusion and recommendation.

B. Extent of the IEE Study 3. The Project is categorized as “B” for environment based on the Safeguard Policy Statement (SPS) 2009, which means that the anticipated impacts of the project on the environment are site-specific, few if any of them are irreversible, and most often mitigation measures can be readily designed. This necessitates the preparation of an initial environmental examination (IEE), which covers the identification of environmental issues in all phases of the project, specifically during construction phase. The IEE report also covers the general environmental profile of the study area and includes an overview of the potential environmental impacts and their magnitude on physical, ecological, economic, and social and cultural resources within the project’s influence area during design, construction, and operation stages. An Environmental Management Plan (EMP) is also proposed as part of the IEE, which includes mitigation measures for significant environmental impacts during implementation of the project, environmental monitoring program, and the responsible entities for mitigation, monitoring and reporting.

C. Methods Used for the IEE Study

4. This Initial Environmental Examination (IEE) and Environmental Management Plan (EMP) have been prepared based on ADB’s Safeguard Policy Statement (SPS, 2009). The ADB SPS (2009), ADB Operational Manual Section F1/BP, Access to Information Policy (2018), World Bank Group Environment, Health and Safety (EHS) Guidelines, and relevant environmental laws and regulations of the Government of Indonesia guided the preparation of this IEE and EMP.

a. Site Assessment and Public Consultation

5. Rapid environmental assessment (REA) was done to determine the environmental conditions of the proposed RSPTN UNILA, the purpose of which is to identify any existing or potential concerns that may generate potential environmental impacts. The REA Checklist result is attached in Error! Reference source not found.. Site assessment and consultations with relevant stakeholders were also conducted on March 2-6, 2020 in UNILA to gather baseline conditions, determine the valued environmental components (VECs), and to solicit information

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from relevant stakeholders regarding the proposed project. Consultations were also conducted with the City Health Office, City Environment Office and the City Traffic Management Office of Bandar Lampung City. The information gathered from these consultations were incorporated in the IEE. 6. The Higher Education for Technology and Innovation Project (HETI) project is one of Indonesia’s long-term development plan for higher education. The Project was conceptualized to consider the increasing role of technology in innovation, labor productivity, and increasing economic growth. The Project activities will be carried out in two higher education institution (HEIs), i.e.: the Institut Teknologi Sepuluh Nopember (ITS) in Surabaya and Universitas Lampung (UNILA) in Lampung, Sumatra, to provide high quality and demand-based programs as part of support to the higher education reform strategy. 7. The Government of Indonesia (GOI) with loan financing from the ADB will upgrade these two HEIs for constructing new buildings and the associated facilities, and human development. The proposed project is an integral part of ADB’s support to the government’s human capital development agenda, which prioritizes investment in industry-driven skills development, and policy and operational support to enhance productivity and competitiveness. It will synergize with ADB’s ongoing and planned knowledge and policy support to prepare the country’s workforce for 4IR. The proposed project builds upon ADB’s ongoing projects to strengthen Indonesia’s higher education system. The project development in ITS will cover on the development of (i) Center for Maritime, (ii) Center for Automotive, (iii) Center for Creative Industries, (iv) Center for ICT and Robotics, ITS Tower (1 units), and Building and laboratory for cultural and language center. The project development in UNILA will include construction an earthquake-resilient, green building, gender responsive, and energy-efficient teaching hospital and integrated research center, and procure medical and laboratory equipment.

b. Primary and Secondary Data Collection

8. Primary and secondary data were collected for the physical, biological and socio-economic environment of Bandar Lampung City in general and UNILA in particular. Primary data were collected for flora and fauna for the proposed site. Secondary data were collected for air quality and noise and water quality of receiving body of water. Secondary data were also sourced from publications and journals, and information provided by government agencies, for geological information, climate, flood hazards, climate vulnerability, and socio-economic information.

c. Other Tools, Additional Surveys and Studies

9. Climate change risk assessment identified Bandar Lampung as vulnerable to flooding, sea level rise, drought, landslides and windstorms.1 These hazards will affect the drainage system, water supply and the soil condition of the project. Climate resilient design will be incorporated to the project to mitigate the induced impact of climate change, particularly flooding and drought. 10. Following the field assessment and consultations, secondary information were gathered from various sources about other environmental parameters such as proximity to protected areas or biodiversity conservation areas, climate, natural and geological hazards, and socio-economic condition in Bandar Lampung. Environmental implications of project activities were reviewed and mitigation measures to address adverse environmental impacts are proposed in the EMP.

1 ADB. 2014. Urban Climate Change Resilience, A Synopsis. Manila.

https://www.adb.org/sites/default/files/publication/149164/urban-climate-change-resilience-synopsis.pdf

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11. The assessment focused on the existing environmental and socio-economic conditions at the project areas and the likely positive and significant negative impacts on the physical, biological and socio-economic environment. Mitigation measures were developed in the EMP to address identified impacts and risks during design, construction and operation. Environmental monitoring and reporting, institutional arrangements, and capacity development measures to ensure the implementation of the mitigation measures are outlined in the EMP.

d. Assessment of Potential Impacts

12. The assessment of the type, nature, direct, indirect, cumulative or induced impacts and their significance to the physical, biological, and socio-economic components of the environment has been done to ascertain whether the project is environmentally sustainable or not. Nature of impacts has been classified as significant, insignificant, short-term, long-term, reversible, irreversible etc. After identification of nature and extent of impacts, mitigation measures have been proposed.

e. Preparation of the Environment Management Plan

13. The Environment Management plan has been proposed with the objective of avoiding, reduction, mitigation, or compensation for adverse environmental impacts/risks and proposal for enhancement measures. This includes (i) mitigation of potentially adverse impacts (ii) monitoring of impacts and mitigation measures during project implementation and operation (iii) institutional capacity building and training (iii) compliance to statutory requirements (iv) and integration of EMP in the design during pre-construction phase, and implementation of EMP provisions during construction and operation phases. D. IEE Report Content

14. The IEE has been prepared based on ADB Safeguard Policy Statement (SPS), 2009. The content covers following eight chapters, including this introduction chapter:

Chapter – 1: Introduction Chapter – 2: Policy, Legal and Administrative Framework Chapter – 3: Description of the Project Chapter – 4: Description of the Environment Chapter – 5: Anticipated Environmental Impacts and Mitigation Measures Chapter – 6: Information Disclosure, Consultation and Participation Chapter – 7: Grievance Redress Mechanism Chapter – 8: Environmental Management Plan Chapter – 9: Conclusion and Recommendation

II. POLICY, LEGAL AND ADMINISTRATIVE FRAMEWORK

A. ADB’s Environment Safeguards Policies

15. All ADB supported projects subscribe to the following environment safeguards guidelines: Safeguard Policy Statement (SPS) (2009), Operational Manual Section F1/BP2 and Access to Information Policy (2018).

2 Operations Manual Bank Policies (BP) issued on 1 October 2013, based on ADB Safeguard Policy Statement, 2009.

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16. ADB’s Strategy 20303 emphasizes the pursuit of environmentally sustainable and inclusive economic growth for developing member countries (DMCs) and requires mitigation to address environmental and social impacts of projects. ADB’s Safeguards Policy Statement (SPS 2009) governs the environmental and social safeguards of ADB’s operations. When a project has been identified for ADB financing, it is screened and categorized to determine the following: significance of potential impacts or risks of the project to the environment; level of assessment and institutional resources required to address the safeguard issues; and information disclosure and consultation requirements.

17. Environmental Safeguard Requirements 1 (SR1) of the SPS outlines the requirements that borrowers/clients have to meet. These requirements include assessing impacts, planning and managing impact mitigations, preparing environmental assessment reports, disclosing information and undertaking stakeholder consultations, establishing a grievance redress mechanism, and monitoring and reporting mechanisms. It also includes specific environmental safeguard requirements pertaining to biodiversity conservation and sustainable management of natural resources, pollution prevention and abatement, occupational and community health and safety, and conservation of physical cultural resources. 18. All projects subject to ADB support are categorized for potential environmental impacts and risks. Category A projects are those that will likely have significant adverse environmental impacts that are irreversible, diverse, or unprecedented. The impacts may affect an area larger than the sites or facilities subject to physical works. A full-scale environmental impact assessment (EIA) including an environmental management plan (EMP) is required. Category B projects are those whose potential environmental impacts are less adverse and fewer in number than those of category A projects. Impacts are site-specific, few if any of them are irreversible, and impacts can be readily addressed through mitigation measures. An initial environmental examination (IEE), including an EMP is required. Category C projects are those that will likely have minimal or no adverse environmental impacts. No EIA or IEE is required although environmental implications need to be reviewed. Category FI is assigned to projects that involve investment of ADB funds to or through a financial intermediary. 19. The Access to Information Policy (2018) requires meaningful consultations, participation and disclosure of information. It establishes the disclosure requirements for documents produced or to be produced through ADB assistance. The IEE, EMP and the environmental monitoring reports of the project are to be disclosed at the ADB website in accordance with the Access to Information Policy (2018). 20. Based on the screening for the project, the proposed teaching hospital and integrated research center was categorized as B for environment since expected environmental impacts during construction are not adverse and impacts can readily be mitigated, hence an Initial Environmental Examination (IEE) should be prepared and should be available to interested stakeholders prior to project approval. The IEE, and its revisions need to be posted in the ADB website. B. Legal and Institutional Framework on Environmental Management in Indonesia 21. Besides ADB’s SPS (2009), the construction of RSPTN UNILA consisting of teaching hospital and research center must comply with the Government of Indonesia’s environmental

3 ADB. 2018. Strategy 2030: Achieving a Prosperous, Inclusive, Resilient, and Sustainable Asia and the Pacific.

Manila.

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laws, standards, rules, and requirements which impose restrictions on activities to avoid, minimize, or mitigate likely impact on the environment. It is the responsibility of UNILA to ensure that all activities are in accordance with the legal framework, whether national or local. Compliance is required in all stages of the projects’ implementation, including design, construction, and operation and maintenance. Key laws and regulations that apply to this project are presented in succeeding sections. 22. Law No. 32 (2009) on Environmental Protection and Management is the primary law that establishes environmental safeguards in Indonesia. This law replaced Law no. 23/1997 on Environmental Management, which repealed Law no. 4/1982 on Main Principles of Environmental Management. Some of the key improvements introduced by Law no. 32/2009 include: (i) detailed requirements for environmental impact assessment (EIA) / (AMDAL) and environmental management and monitoring plans (EMP) / RKL-RPL; (ii) systematic planning for environmental protection and management; (iii) clear distribution of responsibilities between central and local authorities for environmental supervision; (iv) use of an “ecoregion” or ecosystem approach; and (v) expanded provisions for civil, administrative, and criminal enforcement. 23. Article 22 requires any business and activity that has significant impact on the environment to prepare environmental impact assessment (AMDAL). Article 34 specifies that any activity business and activity that does not require an AMDAL shall undertake UKL-UPL, whereas for small activities that do not require an UKL-UPL, a statement of ability to undertake an environmental management and monitoring of their activity, SPPL, is required. Article 36 further specifies that all activities shall have relevant environmental permit from concerned government agency after environmental assessment document has been approved. Based on the AMDAL or UKL-UPL approval, the mentioned Government Regulation 27/2012 requires that the business and/or activity apply for the Environmental Permit (Izin Lingkungan) to the same government authority granting the AMDAL and UKL-UPL approval. 24. Law No. 32/2009 has other implementing regulations which address environmental safeguards, in addition to other laws and a hierarchy of national regulations at the government, presidential and ministerial levels that also govern environmental safeguards and with which RSPTN must comply. These include, but are not limited to, regulations on hazardous waste, water pollution, air pollution, environmental monitoring and reporting, information disclosure, and community involvement. 25. Government Regulation (Peraturan Pemerintah) No. 27/2012 on Environmental Permit. Article 3 of Government Regulation No. 27/2012 requires every business and/or activity with significant impact on the environment shall prepare AMDAL. Every business and/or activity which did not meet the criteria of AMDAL shall prepare UKL / UPL. Article 13 further states that business and/or activity with significant impact to the environment is exempted from AMDAL requirement if the following conditions are met:

a. location of the business and/or activity lies within an area with approved regional AMDAL;

b. location of the business and/or activity lies within a district/city with approved district/city detail spatial plan and/or district/city strategic spatial plan; or

c. business and/or activity carried out for responding disaster emergency.

26. Business and/or activity with approved regional AMDAL and with detailed spatial plan and/or district / city strategic spatial plan, shall prepare UKL-UPL based on: i) regional RKL-RPL document; or ii) district/city detail spatial plan and/or district/city strategic spatial plan.

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27. Regulation No. P.38/MENLHK/SETJEN/KUM.1/7/2019, which replaces Regulation No. 05 of 2012 further stipulates (i) the types of businesses and/or activities which require an AMDAL and which are exempted from the requirement; (ii) the screening process; and (iii) additions to and reductions from the types of business/activity plans which require an AMDAL. The regulation further provides more specific details than the previous regulation, increases the threshold for some activities or business and introduces the AMDAL categories which will affect the timing for preparing the AMDAL document. 28. MOEF Regulation No. 16/2012 on Guidelines for the Preparation of Environmental Documents. The regulation requires the assessment of direct and indirect impacts during the preparation of AMDAL. Further, it requires the description of environmental setting of previous and ongoing work or activities around targeted site of activities, including other activities around the area where the proposed activities are planned. Annex 3 of the regulation further elaborated In formulating the documents of Environmental Management Plan and Environmental Monitoring Plan (RKL-RPL), specifically in regards to the period of environmental management, the compiler of the Environmental Impact Assessment (AMDAL) should elaborate the timeline of when and how long the environmental management activities will be implemented, with careful consideration of the significant environmental impact (duration, cumulative nature and irreversibility of the impact). Identification of the cumulative impact should also be done while formulating the plan for environmental management, specifically on the timeline and frequency of the monitoring. 29. MOEF Regulation No. 24/2018 on Guideline on Preparation and Assessment and Examination of Environmental Document for the Integrated Electronic Licensing Service (online single submission/OSS). This regulation and implementing Ministry of Environment and Forestry (MOEF) regulations issued in 2018 introduced electronic integrated business licensing through an online single submission (OSS) system to process applications for business and project licenses. MOEF regulation No. 24/2018 also regulates the exemption of the obligation to prepare an AMDAL. C. ADB Environmental Safeguards Guidelines in the Context of Indonesia’s AMDAL 30. The AMDAL is almost equivalent to the Safeguard Policy Statement of ADB. In case there are differences, the ADB’s SPS requirements will prevail during preparing and processing of the environmental safeguard document of this Project. According to Indonesian regulations, all projects should undergo environmental clearance before proceeding to implementation. Essentially, an AMDAL study conforms to ADB’s Environmental Impact Assessment (EIA), while an Environmental Management Measure (UKL) and Environmental Monitoring Measure (UPL) corresponds to an IEE. The EIA and AMDAL are somewhat equivalent, though the criteria used for ADB’s EIA requirements categorization and those under the Government of Indonesia’s AMDAL procedure are slightly different. Indonesian regulations provide quite rigid quantitative criteria, while ADB relies on quantitative criteria (e.g., significance). For example, ADB’s SPS 2009 categorizes projects based on the “significance of impacts” whereas Indonesia’s AMDAL procedure classifies projects based on specific magnitude (length, depth, width, size, or other physical dimensions).2 31. AMDAL. Under this category, these include projects that according to law require an Environmental Impact Assessment. This is equivalent to category A under ADB SPS, or those

2 ADB 2015. Environmental Assessment and Review Framework for Indonesia: Flood Management in Selected River

Basins Sector Project. Manila.

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projects with potential for significant adverse environmental impacts, requiring an environmental impact assessment (EIA). 32. UKL / UPL. These are projects that according to law require Environmental Management Measure (UKL) and Environmental Monitoring Measure (UPL). This category however, maybe elevated to AMDAL category based on judgment of environmental agencies at local and national levels. Under ADB SPS, this is equivalent to category B. These projects have less adverse environmental impacts compared to category A projects. Category B projects requires the preparation of an IEE under the ADB system. 33. SPPL. These are projects that do not require AMDAL or UKL / UPL, but the proponents are required to submit a statement of management and environmental monitoring ability or SPPL. Compared to ADB SPS, this is equivalent to category C. This means that projects are unlikely to have adverse environmental impacts, but nonetheless, the environmental implications are also reviewed. D. Environmental Study Required for the Project under ADB and Indonesian

Regulations 34. Based on Indonesia’s environmental regulations, specifically Regulation No. P.38/MENLHK/SETJEN/KUM.1/7/2019, the type of environmental study required depends upon the land area and size of the building. AMDAL is required for lot areas greater than 5 hectares or buildings with total floor area of 10,000 m2. Since the project will be constructed inside the 58,105 m2 lot and the teaching hospital and integrated research center buildings have a combined floor area of 16,200 m2 (10,000 m2 and 6,200 m2, respectively), the project is categorized as C for environment under the GOI AMDAL, will require the preparation of AMDAL. E. International Good Practices and Relevant Environmental Standards 35. ADB’s SPS requires the borrower/client to apply pollution prevention and control technologies and practices consistent with international good practice, as reflected in internationally recognized standards, particularly the World Bank Group’s Environment, Health and Safety Guidelines (EHS), which is derived from the IFC environmental guidelines. These standards contain performance levels and measures that are normally acceptable and applicable to projects. When host country regulations differ from these levels and measures, the borrower/client will achieve whichever is more stringent. The following table (Error! Reference source not found.) presents a list of IFC guidelines applicable to all activities supported by ADB funding, and therefore should be used and referred to in environmental safeguard documents, i.e. Initial Environmental Examination (IEE) and Environmental Management Plan (EMP).

Table 1. World Bank - IFC Guidelines Applicable to the Project

EHS Guideline Description and Relevance to Teaching Hospital

General EHS Guidelines (2007) (Section 1.0)

Good International Industry Practice (GIIP) that must be applied for facilities and activities to be supported under the project. Key sections of relevant guidelines to the project include:

• Environmental guidelines (covering air emission, wastewater and ambient water quality, hazardous materials management, waste management, and noise)

• Occupational health and safety

• Community health and safety

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• Construction and decommissioning (including debris removal and clearance).

The General EHS Guidelines are designed to be used together with the relevant Industry Sector EHS Guidelines which provide guidance to users on EHS issues in specific industry sectors.

EHS Guidelines for Health Care Facilities (2007)

Provide guidance relevant to the management of EHS issues associated with the operation of health care facilities (HCF). The guidelines cover the following aspects that should be considered in the design and operation of HCF to be supported by the project:

• HCF design considerations

• HCF waste management, including need to establish HWMS

• Air emission control, especially if medical waste incineration is practiced (including air emission benchmarks).

• HCF wastewater management (including effluent quality benchmarks)


EHS Guidelines for Water and Sanitation (2007)

Provide guidance on operation and maintenance of (i) potable water treatment and distribution systems, and (ii) collection of sewage in centralized systems (such as piped sewer collection networks) or decentralized systems (such as septic tanks subsequently serviced by pump trucks) and treatment of collected sewage at centralized facilities. Most importantly, the guidelines cover the following aspects that should be considered in the design and operation of water supply and sanitation activities to be supported by the project:

• Water supply (including water abstraction, water treatment, and water distribution)

• Sanitation (including fecal sludge and septage collection, sewerage, wastewater and sludge treatment and discharge)



EHS Guidelines for Water Management Facilities (2007)

Provide guidance for facilities or projects dedicated to the management of municipal solid waste and industrial waste, including waste collection and transport; waste receipt, unloading, processing, and storage; landfill disposal; physical-, chemical- and biological treatment; and incineration projects. Most importantly, the guidelines cover the following aspects that should be considered in the design and operation of solid waste management activities:

• Municipal solid waste management (collection and transport, processing and storage, treatment, disposal)

• Industrial non-hazardous waste management (such as sludge from water supply treatment plant, wastewater treatment plant, inert construction/demolition waste)



Environmental, Health, and Safety Guidelines: Occupational Health and Safety (2007) (Section 2.0)

Employers and supervisors are obliged to implement all reasonable precautions to protect the health and safety of workers. Section 2 of the EHS (this section) provides guidance and examples of reasonable precautions to implement in managing principal risks to occupational health and safety.

Environmental, Health, and Safety Guidelines: Community

This section complements the guidance provided in Section 1.0 of the EHS Guidelines, the environmental and occupational health and safety sections, specifically addressing some aspects of project activities taking place outside of the traditional project boundaries, but nonetheless related to the project

9


Health and Safety (2007) (Section 3.0)

operations, as may be applicable on a project basis. These issues may arise at any stage of a project life cycle and can have an impact beyond the life of the project.

EHS = Environmental, Health, and Safety; HWMS: health care waste management system.

36. SPS 2009 requires projects to apply pollution prevention and practices in line with international good practices such as the World Bank Group–International Finance Corporation’s Environment, Health and Safety (EHS) General Guidelines 2007. If Indonesia’s environmental standards differ from WB-IFC EHS Guidelines 2007, the project must achieve whichever is more stringent, as required in SPS 2009. The following tables present the environmental standards required to meet national regulations and the IFC-WB EHS General Guidelines 2007.

Table 2. Air Quality Standards Parameter Averaging Time Air Quality Standard, µg/m3

GR No. 41/1999 on Air Pollution Control

WB – IFC EHS Guidelines 2007

Carbon monoxide (CO) 1 hour 30,000 -

24 hours 10,000 -

Hydrocarbons (HC) 3 hours 160 -

Nitrogen dioxide (NO2) 1 hour 400 200

24 hours 150 -

1 year 100 40

Sulfur dioxide (SO2) 10 minutes - 500

1 hour 900 -

24 hours 365 125 (interim target 1)

50 (interim target 2)

20

1 year 60 -

Total suspended particulates

24 hours 230 -

1 hour 90 -

Lead 24 hours 2 -

1 year 1 -

Particulate matter (PM10) 24 hours 150 150 (interim target 1)



50

1 year 70 (interim target 1)

- 50 (interim target 2)


20

Particulate matter (PM2.5) 24 hours 15 75 (interim target 1)


37.5 (interim target 3)

25

1 year 65 35 (interim target 1)



10

10

Table 3. Noise Standards

Receptor Unit National

Noise Level Limits3


Daytime (07:00-22:00)

Nighttime (22:00 – 07:00)

Residential, educational, hospital, institutional, and religious

One hour LAeq (dBA)

55 55 45

Industrial and commercial

70 70 70

Office and trade 65 70 70

Green open space 50 Background level + 3 dB at the nearest receptor location offsite

Background level + 3 dB at the nearest receptor location offsite

Government and public space

60 Background level + 3 dB at the nearest receptor location offsite


Recreation 70 Background level + 3 dB at the nearest receptor location offsite


Cultural heritage 60 Background level + 3 dB at the nearest receptor location offsite


Table 4. Effluent Standards

Pollutants Units Guideline Value

Ministry of Environment Decree No. 68/2016


pH pH 6-9 6-9

BOD mg/l 30 30

COD mg/l 125 100

Total nitrogen mg/l 10 10

Total phosphorus mg/l 2

Oil and grease mg/l 10 5

Total suspended solids mg/l 50 30

NH3 ppm 10

Total coliform bacteria MPNa / 100 ml 400 3000 a most probable number

37. Solid Waste. Solid Waste Management Act No. 18 / 2008 and Act No. 32 / 2009 (Environmental Protection Act) govern the solid waste management in Indonesia. The former regulates solid waste management, mainly on municipal waste management. Act No. 32/2009 regulates industrial waste and hazardous wastes.

Table 5. Solid Waste Categories under Waste Management Act (2008) Waste Category Description

General waste (household waste)

Wastes generated from daily family life but excluding feces and special waste

General waste equivalents Waste generated from commercial facilities, industrial parks, community public facilities and other facilities, etc.

Special waste Waste requiring special management due to their special properties as follows:

- Waste containing noxious materials and substances

- Hazardous waste

- Waste generated from disasters

- Waste impossible to process due to technological constraints

- Irregularly generated wastes

3 Ministry of Environment Decree No. 48 of 1996.

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38. Government Regulation No. 101 of 2014 on Management of Toxic and Hazardous Waste Substances (GR No. 101/2014). In general, the GR No. 101/2014 regulates the management and disposal procedures for toxic and hazardous waste substances (“hazardous waste”), covering: › Method of identifying, reducing, storing, collecting, transporting, utilizing, processing, and hoarding hazardous wastes; › Procedures for dumping hazardous wastes into the open sea or land; › Risk mitigation and emergency responses to address environmental pollution caused by hazardous waste; and › Sanctions for non-compliance. 39. The current regulation does not explicitly require the Environmental Authority to develop and/or maintain registration of hazardous waste generators. However, all hazardous waste generators are obliged to notify the Authority on their hazardous waste generation and management. The HWM service providers are also required to apply for permits/licenses from the Environmental Authority and the Environmental Authorities are obliged to control and take necessary actions for any noncompliance occurrence. Hence, it implies that the Environmental Authorities are supposed to develop and maintain register of hazardous waste generators and the other actors. 40. The Ministry of Environment and Forestry Regulation No. 56 of 2015 concerning "Procedures and Technical Requirements for the Management of Hazardous and Toxic Waste Materials from Health Service Facilities" requires labelling and symbols for hazardous materials and waste, waste reduction, segregation, storage, transportation (manifest), treatment and handling (with autoclave, incineration), health workers’ occupational health and safety and public health and safety. 41. Permitting Requirements. List of necessary permits and related legislations to be prepared includes:

• Permission principle from the regent/mayor stating that the local government approved in principle the plan to build the teaching hospital and integrated research center.

• A list of permits and environmental documents to be prepared, submitted to and approved by the local environment agency.

• Affidavit of Bappeda (Regional Development Planning Agency) that the site plan of the project does not conflict with the local regional spatial plan.

• Proof of registration of constituent EIA consultant from the Ministry of Environment and Forestry of the Republic of Indonesia.

• Official certificate confirming the accreditation of the EIA team. 42. Prior to subproject implementation, concerned agencies should consult Dinas Lingkungan Hidup (DLH, Provincial and District Environmental Office) to ensure compliance with environmental laws and regulations as well as Law No. 23 of 2014 on Local Government (particularly authority in environmental management). 43. Government Regulation No. 50 on Occupational Safety and Health (OSH) Management Systems (2012). Regulation No. 50 prescribes the establishment of OSH management systems in every undertaking employing 100 workers or more or which has a high level of potential hazard, to protect the safety and health of workers through the prevention of occupational accidents and diseases.

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44. Medical Solid Wastes. Medical solid wastes are regulated under MOEF Regulation No 56/2015 and MOH Decree No 1204/Menkes/SK/X/2004 on Provision of Hospital Environmental Sanitation. PP 101/2014 and MOH Decree no 1204/Menkes/SK/X/2004 on Provision of Hospital Environmental Sanitation specifies incinerator requirements and outlines requirements for safe-handling of hazardous waste materials. MOH Decree no 1204/Menkes/SK/X/2004 provides specific treatment for each type of medical wastes. 45. Medical Liquid Wastes. MOH Decree no 1204/Menkes/SK/X/2004 (aligned with WHO’s guidelines) require HCFs to apply measures in the handling of medical liquid wastes. MoE Decree No 58/1995 on Hospital Effluent Discharge Standard includes pH, BOD, COD, Temperature, NH3, PO4, Microbiology (e-Coli) and Radioactive (11 elements, 12 isotopes). MOH Regulation No 37/2012 about Laboratory Management for puskesmas covers provisions about liquid and hazardous waste from hospital laboratory. 46. Other Government Regulations. Other applicable government regulations include Government Regulation No. Per.07/Men/IV/2008 on the placement of manpower, Government Regulation No. 66/2014 on environmental health, Government Regulation No. 50/2012 on occupational health and safety management system, Minister of Manpower Regulation No. 9 of 2016 concerning Occupational Health and Safety at Height. F. Laws and Regulations Related to Hospitals

47. Law No. 36 on Health. Under Articles 15 and 16 of Law No. 36 on Health, the local government is responsible for the provision of both physical and social services for the community and the availability of health resources. Revisions under Law No. 23/2014 focus local government responsibility on the delivery of defined basic services (which include health, education, social assistance etc.), while the central government has the responsibility to define the expected standards for provision of services. 48. The governance of health-care facilities, particularly hospitals, is set out in the Hospital Act, which provides for the application of good governance and clinical governance principles. In the public sector, public hospital governance is also regulated through public administration regulations should the hospital obtain the status of a Public Service Agency (Badan Layanan Umum/BLU). Both public and private hospitals are subject to supervision by the Monitoring and Supervision Bureau for Hospitals (Badan Pengawas Rumah Sakit Indonesia/BPRSI). At the local level, there are supposedly provincial bodies for supervision of hospitals (Badan Pengawas Rumah Sakit Propinsi/BPRSP). 49. The Minister of Health Regulation No. 43/2016 consists of minimum standard of services in health sector. Hospitals in Indonesia must be accredited every three years (House of Representatives, 2009a). Hospital accreditation has been conducted by the Hospital Accreditation Committee (KARS) since 1995 (KARS, 2012). Accreditation commenced with five types of health-care services in 1995, increased to 12 types of health-care services in 1998 and expanded to 16 types of health-care services in 2002. Hospitals may choose to follow the accreditation system in a stepwise manner, commencing with five and later expanding to 16 types of services. 50. Accreditation System. A new accreditation system (Minister of Health, 2012c) has been established as a follow-up to the new hospital accreditation standard (MoH, 2011). The new standard is based on the standards of the Joint Commission International (JCI), the International Principles of Health-care Standards from the International Society for Quality in Health-care

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(ISQUA), and the previous KARS standard (2007 version), together with relevant standards issued by the MoH, as well as local content from national priority programmes, e.g. PONEK, HIV/AIDS and TB-DOTS. The MoH issues the accredited status for a hospital following a recommendation from the KARS, after a hospital is deemed to meet the accreditation standards. 51. Accreditation of Health Care Facilities. All health-care facilities are regulated by Act No. 36 of 2009 on Health, Act No. 44 of 2009 on Hospitals, and other MoH regulations related to hospitals or the respective health services regarding requirements, standards and accreditation, as well as by the local government, particularly in relation to registration and licensing. For instance, any clinic and hospital type C or D is required to be registered and licensed by the district/municipality local governments; hospital type B is required to be registered and licensed by the provincial local government; while hospitals type A and teaching hospitals are required to be registered and licensed by the MoH. These are the mechanisms that are intended to ensure equitable geographical distribution of capital and investment across different levels of care. 52. Law on Public Consultations. Public consultation is a key element of Indonesia’s regulatory framework under Law 12/2011 on the Development of Laws and Regulations. This is complemented by commitments to transparency and engagement in regard to citizens Indonesia’s Laws on Public Service (Law 25/2009), Transparency in Public Information (Law 14/2008) and State Development Planning System (Law 25/2004).4 G. Regional Spatial Planning and Traffic Management Requirements 53. Based on the Bandar Lampung City Regulation Number 10 of 2011 concerning the 2011-2030 Regional Spatial Plan, the Kedaton City Service Sub-Center (SPPK) with the service areas of the Kedaton and Rajabasa Districts serves as a Center for Higher Education and Culture, the Main Node of Land Transportation, Trade and services, and Urban Settlements. The main objective of the development of UNILA Teaching Hospital is to improve higher education, especially the Faculty of Medicine, University of Lampung. In addition, it is separately serving the public in the health sector. Therefore, the construction of UNILA Teaching Hospital is not in conflict with the Regional Spatial Planning (RTRW) of Bandar Lampung City. 54. Based on the Regulation of the Minister of Transportation of the Republic of Indonesia Number 75 of 2015 concerning the Implementation of Traffic Impact Analysis, the construction of educational facilities and public service facilities including the construction of activity centers that will cause disruption to security, safety, order, and smooth traffic and road transportation requires the preparation of Traffic Impact Analysis. Therefore, it is mandatory to conduct a Traffic Impact Analysis (Andalalin). UNILA will prepare the Traffic Impact Analysis for the project. H. International Conventions 55. Convention on Biological Diversity (1990). Convention on Biological Diversity, for parties to require the environmental assessment of their proposed projects that are likely to have significant adverse impacts on biological diversity with a view of avoiding or minimizing such impacts. Indonesia is obliged to respect and protect traditional knowledge related to sustainable utilization of biodiversity, including promote fair benefit sharing of the use of traditional knowledge.

4 The Republic of Indonesia Health System Review. Health Systems in Transition Vol. 7 No. 1 2017. Asia Pacific

Observatory on Health Systems and Policy.

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56. Convention on Wetlands of International Importance Especially as Waterfowl Habitat (1972). Indonesia follows an international agreement to control the continuous encroachment of wetland in the present and future, to recognize the basic ecological functions of wetlands follows the economic, cultural, scientific, and recreation. 57. Vienna Convention for the Protection of the Ozone Layer, in 1998, and subsequent protocol and amendments, for parties to take appropriate measures to protect human health and the environment against adverse impacts likely to arise from human activities that will/likely modify the ozone layer. 58. Basel Convention on the Control of Transboundary Movements of Hazardous Wastes and Their Disposal (1989). Indonesia has ratified the international agreement to reduce cross-country movement of waste in accordance with the minimum limit of the Convention to create an environmentally friendly waste management and efficient; reducing toxicity of waste generated and to ensure that environmental management is the basis for resource development. 59. Stockholm Convention on Persistent Organic Pollutants (2001). This is a global treaty to protect human health and the environment from chemicals that remain intact in the environment for long periods, become widely distributed geographically, accumulate in the fatty tissue of humans and wildlife, and have harmful impacts on human health or the environment. Exposure to Persistent Organic Pollutants (POPs) can lead to serious health effects including certain cancers, birth defects, dysfunctional and reproductive systems, greater susceptibility to diseases and damages to central and peripheral nervous systems. Indonesia adopted the Convention in 2001 and entered into force in 2009. Parties are required to take measures to eliminate or minimize the production, unintentional production, use, and release of POPs, including dioxins and furans 60. United Nations Framework Convention on Climate Change (1992). Indonesia has ratified the international agreement to achieve stabilization of greenhouse gas concentrations in the atmosphere as low as possible to prevent dangerous anthropogenic interference with the climate. 61. Kyoto Protocol to the United Nations Framework Convention on Climate Change. Indonesia has ratified the international agreement to reduce greenhouse gas emissions by promoting national programs in developed countries aimed at reducing greenhouse gas emissions and determine the percentage of reduction targets for developed countries. Indonesia has ratified the Paris Agreement within the United Nations Framework Convention on Climate Change (UNFCCC) dealing with greenhouse gases emissions mitigation, adaptation and finance in October 2016. 62. Promotional Framework for Occupational Safety and Health Convention, 2006 (No. 187). In August 2015, Indonesia ratified the International Labour Organisation’s Occupational Safety and Health Convention to reinforce the country’s commitment to achieve sustained and continuous improvement of occupational safety and health to prevent occupational injuries, diseases and deaths, in consultation with social partners. Ratified by 34 member states as of August 2015, Convention No. 187 is one of the ILO’s three key occupational safety and health instruments, alongside the Occupational Safety and Health Convention, 1981 (No. 155) and its Protocol of 2002.

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III. DESCRIPTION OF THE PROJECT

63. The proposed project, Rumah Sakit Perguruan Tinggi Negeri (RSPTN) UNILA will integrate teaching hospital and integrated research center (IRC). The IRC is designed to support the research capacity of the teaching hospital. The site development plan, indicated in Figure 1, shows the proposed RSPTN UNILA (1) and Research Center (2). The proposed teaching hospital and IRC will be located on 58,105 m2 lot at the corner of Jalan Soemantri Brodjonegoro and Jalan Z.A. Pagar Alam, Gedung Meneng Building, Rajabasa District, Bandar Lampung City. The proposed site is located in the Village of Gedung Meneng, Rajabasa District, Bandar Lampung City, Lampung Province. Lampung Province is located at the southern tip of Sumatra Island, which borders Banten Province of Java Island (Figure 2).

Figure 1. Site Development Plan of Universitas Lampung

2 FLOORS

3 FLOORS

4 FLOORS

5 FLOORS

6 FLOORS

7 FLOORS

10 FLOORS

DEVELOPMENT PLAN 2018-2023

1. RSPTN UNILA 2. RESEARCH CENTER 3. STUDENT CENTER 4. SDI CENTER 5. INTEGRATED PARKING 6. INTEGRATED FOODCOURT 7. SHUTTLEBUS TERMINAL 8. AREA RUSUN 9. SPORT CENTER 10. WASTE PROCESSING AND RAW WATER 11. KULIAH TERPADU 12. RESEARCH AND DEVELOPMENT 13. MEDICAL LABORATORY 14. HOTEL BINTANG 4 15. GUEST HOUSE 16. INTEGRATED SOLID WASTE FACILITY 17. WATER RESERVOIR 18. RAW WATER 19. TPST

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Figure 2. Location of the RSPTN UNILA and IRC, Bandar Lampung City, Lampung

Province

Figure 3. Proposed Site of RSPTN UNILA and IRC

64. In line with the national health system policy, Sistem Kesehatan Nasional (SKN), UNILA will develop the teaching hospital as one the regional referral centers for general medical, academic and research activities. The hospital is envisioned to be class B hospital that can accommodate approximately 300 inpatient beds.5 It will also be designed as a “green hospital” as

5 Class A Hospital: Consists of minimum 4 basic specialist services (internal, pediatric, obstetric, and surgery), 5 supporting medical

specialist services (anesthesia, radiology, medical rehabilitation, anatomic pathology, clinical pathology), 12 other specialist services, and 13 sub-specialists. Basic medical services have at least 18 doctors and 4 dentists on staff. Minimum 400 beds.

17

a means to conserve natural resources and to provide holistic healing environment for patients and medical workers. 65. The proposed teaching hospital will provide the following medical services: i) emergency services; ii) general medical services which include basic medical services, maternal and child health, and family planning; iii) basic specialist medical services, which include internal medicine, child health, surgery, and obstetrics and gynecology; iv) supporting medical services, which include anesthesiology, radiology and clinical pathology services; v) other specialist medical services; vi) subspecialty medical services; and vii) dental and oral specialist medical services. 66. The Integrated Research Center (IRC), on the other hand is designed to support lecturers in carrying out research in collaboration with lecturers from other disciplines within and outside UNILA. IRC will support the following areas of studies/laboratories: i) tropical medicine; ii) bio-molecular, genetic and degenerative diseases; iii) pathology and toxicology; iv) clinical trial and diagnostic trial laboratory; and v) nutrition. A. Conceptual Design of Teaching Hospital and Integrated Research Center

67. The proposed hospital building will tentatively consist of two connected buildings with a gross floor area of 10,000 m2, while the integrated research center will have a floor area of 6,200 m2. The project details are shown below.

Civil Works Components Area (m2) Hospital Hospital building 10,000

Basement 2,985 Parking area 6,087 Landscape and supporting facilities 13,278 Connection Bridges 3 nos.

Integrated Research Center

IRC building 6,200 Parking area 1,856 Landscape and supporting facilities 7,732

Wastewater and Solid Waste Management 1 no.

Figure 4. Area Allocation for Hospital and IRC 68. The Ministry of Health Decree No. 26, 2017 prescribes the area allocation for number of beds for hospitals. For 100 beds, the floor area should be at least 8,000 sqm. The UNILA teaching hospital is planned for a maximum of 10,000 sqm area floor area. B. Functional Zones and Access

69. The proposed project is divided into 4 zones. Zone 1 (southeast side) is the main entrance access to the UNILA RSPTN area which will be connected with access to the hospital and research buildings. In this area there is pedestrian access that is connected directly to the hospital building and landscape area in the form of vegetation barrier for hospital buildings. Zone 2 (west

Class B Hospital: Consist of minimum 4 basic specialist services (internal, pediatric, obstetric, and surgery), 4 supporting medic

specialist services (anesthesia, radiology, rehabilitation medic, anatomic pathology), 8 other specialist services and 2 sub-specialist services. Basic medical services have at least 12 doctors and 3 dentists on staff. Minimum 200 beds.

Class C Hospital: Consists of minimum 4 basic specialist services (internal, pediatric, obstetric, and surgery), 4 supporting medical specialist services (anesthesia, radiology, rehabilitation medicine, anatomic pathology). Basic medical services have at least 9 doctors and 2 dentists on staff. Minimum 100 beds.

Class D Hospital: Consists of minimum 2 basic specialist services among 4 specialist services (internal, pediatric, obstetrics, and surgery). Basic medical services have at least 4 doctors and 1 dentist on staff. Minimum 50 beds.

18

side) is devoted for public space. The main component in this area is the arboretum which also has a jogging track facility. This area will also be used as access for emergency section. 70. Zone 3 (northwest side) has a semi-public character where the public can access this area but is limited. In this area there are 3 existing buildings that will be used as clinics, medical check-up, medical rehabilitation, library and IT rooms. In this area there are also service areas from the entire UNILA RSPTN area. In addition to several buildings, this area is also equipped with corridors that connect hospital buildings, 3 additional facility buildings, and a research center building. Zone 4 (east side) is the area devoted for the UNILA Integrated Research Center (IRC). In addition, there are to the research center facilities, this zone is equipped with pedestrian areas, parking lots, as well as religious facilities.

Figure 5. RSPTN UNILA Functional Zones

71. RSPTN UNILA will utilize Jl. Soemantri Brodjonegoro as the main access to the teaching hospital and integrated research center (Figure 6. ). Access for emergency will be on the left side of the hospital building while public access to the integrated research center will be on the right side of the main access. There will be a separate pedestrian access, with entrance also in front of Jalan Soemantri Brodjonegoro (Figure 7).

Zone 1

Zone 2

Zone 3

Zone 4

19

Figure 6. Main Access to RSPTN UNILA

Figure 7. Emergency, Pedestrian and Public Access

C. Green Building Concept

72. The proposed teaching hospital and integrated research center will apply green building concepts in its design, construction and operation, the objective of which is to reduce or eliminate negative impacts and create positive impacts on climate and the natural environment. The project will employ both active and passive strategies in implementing this strategy. Active strategy involves the use of solar panels for energy production, and reuse of treated wastewater for flushing toilets and irrigation of plant. Passive measures include the use of skylights, application of landscape elements in buildings to improve indoor air quality, roof garden as green open space, and use of environment friendly building materials.

20

Figure 8. Green Building Strategy for RSPTN UNILA

Figure 9. Use of Green Space for RSPTN UNILA (Teaching Hospital)

73. To reduce the risk of waterlogging in the area within and around RSPTN UNILA, the hospital building will be equipped with rainwater catchment facilities in the roof area which will then be diverted to the rainwater reservoirs located in the jogging track area. In addition, at some points in the park area around the RSPTN building, biopori will be provided to increase the local infiltration of rainwater into the soil. Biopori, which is also referred as biopori hole or biopori absorption hole is a technique developed by Dr. Kamir Brata, a researcher at the Bogor Institute of Agriculture, Indonesia.6 74. Other strategies include the construction of an inner courtyard in the public services and inpatient area to reduce heat in the room. Aside from aesthetics purpose, the façade of the teaching hospital will function as sun-shading element, reducing the use of energy for air conditioning.

6 Environmental Science for Social Change Inc. Integrating Biopori in Drainage Management in Campuses.

https://essc.org.ph/content/view/418/161/.

• The use of solar panels for energy resources

• Utilizing gravity for water distribution systems in buildings

• Treated wastewater for reuse

• Ceiling height is set to reduce heat in the room

• Use of skylight

• Application of landscape elements in buildings

• Roof garden application as a green open space

• Use of environmentally

https://essc.org.ph/content/view/418/161/

21

Figure 10. Use of Fins and Secondary Shading for the Façade of RSPTN UNILA

22

Figure 11. Green Building Strategies for RSPTN UNILA

75. As part of the green building strategy for the project, resource efficiency and energy conservation will be of paramount importance. Some of the measures to attain this objective include allowing the natural light to enter from all sides of the building through the use of transparent material as a building envelope. The use of transparent material will allow maximum light to enter the building but not to the point that heat can penetrate that will reduce the comfort of patients and workers inside the building. 76. The hospital area will be equipped with a garden where patients and visitors can relieve stress and become one with nature. Besides, the hospital has a green rooftop area to provide more comfort for patients and hospital visitors. Hospital gardens will only be planted with local, non-invasive plant species that do not require much water and will not require pesticide use for maintenance. 77. The project will also install solar cells, which will only be used for road lighting, to complement power coming from the grid. The main electric power will still come from the State Electricity Company, Perusahaan Listriik Negara (PLN), with backup from generator.

Allow the entry of sunlight to illuminate the corridor

In addition to aesthetics, façade treatment serves as sun shading element

Serves as healing garden

Natural ventilation for the building

23

Figure 12. Use of Solar Power for RSPTN UNILA

D. Waste Management

a. Wastewater treatment facility

78. The proposed teaching hospital and integrated research center will be equipped with an on-site wastewater treatment facility utilizing anaerobic – aerobic biofilter technology to treat wastewater from these facilities. This technology, which utilizes honeycomb plastic media, is one of the most reliable domestic wastewater treatment technology, with low operational cost, and easy maintenance. 79. Wastewater generated from the hospital and integrated research center comes from different units of the hospital such as emergency room, operating rooms, drug treatment, intensive care unit (ICU), chemical and biological laboratories, radiology, canteen and laundry activities, among others. Wastewater consists of blackwater or sewage, which contains high concentration fecal matter and urine food residues, and toxic chemicals; and greywater, which has low level of pollution that comes from washing, bathing, laboratory processes and laundry. 80. Stormwater, which consists of rainfall collected from the roofs of hospitals and integrated research center, grounds and paved surfaces, maybe allowed to seep into groundwater or can be reused for irrigation and toilet flushing. 81. If not properly treated, wastewater from the hospital may pose health and environmental hazards as these contain excessive nutrients that may cause biological degradation of groundwater and receiving bodies of water, endocrine disruptors in the case of pharmaceuticals, mercury and heavy metal poisoning, among others. 82. Wastewater from the teaching hospital primarily consists of conventional domestic wastewater, but some wastewater streams may contain residues of pharmaceuticals and its metabolites, radioactive isotopes, hazardous chemicals. It is recommended that prior to discharge to wastewater treatment facility, pre-treatment of hazardous liquid must be done. Pre-treatment can be in the form of acid-base neutralization, filtration and sedimentation, or autoclaving. As recommended in Global Health-care Waste Project jointly sponsored by UNDP, the Global Environment Facility, WHO, Health-care Without Harm and the University of Illinois School of Public Health, pre-treatment must be done in the dental department (installation of amalgam

24

separators in sinks and storage of separated mercury waste), radiotherapy department (separate collection of radioactive wastewater, and kitchen (installation of grease trap to remove grease, oil and other floating materials). Large quantities of blood may require pre-treatment if it is indicated by a risk assessment.7 83. Treated effluent will comply with both the Ministry of Environment Decree No. 68 / 2016 and WB-IFC EHS Guidelines (2007). The effluent will be disinfected using a chlorination stage prior to reuse.

Figure 13. Schematic Diagram of Anaerobic – Aerobic Biofilter Technology

b. Solid Waste Management Facility

84. The operation of teaching hospital and integrated research center will generate wastes, 87% of which are general, non-hazardous wastes. The remaining 13% will be considered hazardous materials that maybe infectious, toxic or radioactive.8 The hospital will establish a waste management system in compliance with Waste Management Act No. 18 (2008) concerning management of municipal solid waste, and Act No. 32/2009, which regulates hazardous wastes. 85. The management of municipal solid waste is the responsibility of local government (city and regency) as stipulated in Government Regulation No. 38/2007 (Role of Central Government and Local Government). To manage hazardous wastes, UNILA will engage accredited third-party hazardous waste service provider that will transport and process said wastes in Jakarta. As per WHO guidelines, only modern incinerators operating at 850-1100 °C and fitted with special gas-cleaning equipment are able to comply with the international emission standards for dioxins and furans will be acceptable for the project. Alternatives to incineration such as autoclaving, microwaving, steam treatment integrated with internal mixing, which minimize the formation and release of chemicals or hazardous emissions should be given consideration in settings where there are sufficient resources to operate and maintain such systems and dispose of the treated waste. Domestic wastes will be collected regularly by Bandar Lampung City.

7 World Health Organization (WHO). Water Sanitation Hygiene. 8 WHO. Health-care Waste. https://www.who.int/news-room/fact-sheets/detail/health-care-waste (accessed on 10

March 2020).

Wastewater from laundry

Wastewater source

Wastewater from kitchen

Wastewater from hospital

Runoff from septic tank

Wastewater from bathroom

Wastewater from sink, etc.

Wastewater from hospital

Wastewater - other sources

Backflow control

Oil and grease separator

Collection sump

Collection sump

Collection sump

Oil and grease

separator

Equaliz

ation t

ank

Pri

ma

ry

se

dim

en

tatio

n

tan

k

25% eff.

Anaerobic biofilter 65-70%

efficiency

Aero

bic

bio

filter

50%

effic

iency

Fin

al se

dim

en

tatio

n

tan

k

Circulation pump

Flow meter

Chlorinator

Processed water

Air blower

https://www.who.int/water_sanitation_health/facilities/waste/training_modules_waste_management/en/

https://www.who.int/news-room/fact-sheets/detail/health-care-waste

25

E. Existing Buildings

86. There are three existing buildings (namely Buildings 4, 5, 6) on the existing site, which were financed by the local government. These three buildings are intended to serve as clinics, medical check-up, medical rehabilitation, library and IT rooms. Each building consists of 4 floors, with footprint of 36 x 20 meters each. The total floor area of the existing buildings is 9,120 sqm. These three buildings will be connected with the main hospital using 3 (three) walking bridges. 87. Opposite Buildings 4, 5 and 6 are the existing structures consisting of unfinished basement floor and unfinished concrete columns. To determine the feasibility of incorporating the existing structures for the proposed teaching hospital, chloride content and compressive strength using hammer test were performed. Based on the tests conducted by UNILA, compressive strength obtained from the core drill and hammer test do not meet the compressive strength required in SK SNI 2847,2013. It is recommended that special treatment will be done to increase the existing structure’s compressive strength.

Figure 14. Existing Structures in the Proposed RSPTN UNILA

26

88. The estimated cost for the civil works of RSPTN UNILA is $14,184,193. These include the teaching hospital, which comprised 66.62% of the total, integrated research center (31.87%) and provision for wastewater treatment and solid waste management facilities (1.51%).

Table 6. Civil Works Components and Costs Civil Works Components Estimated Cost,

$ Percentage

Teaching hospital Hospital building 7,430,556

66.62

Basement 621,875

Parking area 422,708

Landscape and supporting facilities

922,110

Connection bridges 52,083

Sub-total 9,449,332

Integrated Research Center (IRC)

IRC building 4,176,389

31.87

Parking area 128,916

Landscape and supporting facilities

214,778

Sub-total 4,520,083

Wastewater and solid waste management

Wastewater treatment and solid waste management facilities

214,778 1.51

Total 14,184,193 100.00

F. Schedule of Implementation

89. The construction of teaching hospital, integrated research center and supporting infrastructure is estimated to commence on the 4th quarter of 2021 and will finish on the 3rd quarter of 2024, or approximately 3 years.

Figure 15. Schedule of Implementation

27

IV. DESCRIPTION OF THE ENVIRONMENT

A. Physical Environment

a. Elevation, Topography and Soil

90. The proposed location of RSPTN UNILA is 132 meters above sea level (masl). The proposed location of the teaching hospital and integrated research center is tilted to the west (towards the villages around the Rajabasa Terminal and Bukit Kencana Housing) and south (towards Jalan Zainal Abidin Pagar Alam Road). The dominant slope is slightly tilted / bumpy with a slope, then followed by a gentle slope / wavy, flat, rather steep, and the rest is steep slope. The steep sloping land is located in the southwest part.9 91. The soil type in UNILA can be classified as Ultisol soil groups with igneous / volcanic rock parent material. The effective depth of soil ranges from 72 cm to 136 cm. In general, the soil in the study area is classified as fine textured clay, with a structure that is classified as already developed. The structure of the ground is in the form of an angular cube of medium size to coarse.10

b. Seismicity and Related Hazards

92. Geographically, the area around Bandar Lampung in Lampung Province is located near two plates subduction – the Indo-Australia and Eurasia plates. The Indo-Australian plate is moving beneath the Eurasia Plate, resulting to subduction zone and many earthquake sources. Beside the subduction zone, the Sumatra Mega Fault made areas in Sumatra including Bandar Lampung are vulnerable to earthquakes. Other than the fault zone, Lampung area also showed ground acceleration value that are getting bigger from Bandar Lampung to the west direction).11 Since the location is near earthquake sources, this made Bandar Lampung City vulnerable to earthquakes. 93. Bandar Lampung has high potential for tsunami specifically in coastal areas as it is located at the base of the bay which is adjacent to the waters of the Sunda Strait connecting Java Sea and Indian Ocean. There are 105 recorded tsunamis in Indonesia from 1600 to 1998, 95 of which were caused by earthquakes, 9 by volcanic eruptions, and 1 by a landslide.12 Potential tsunami disaster in the city of Bandar Lampung came not only from the earthquake, but also from Anak Krakatau volcano, which is located in the waters of Sunda Strait. Since the project is located about 12 km from the coastal area of Bandar Lampung, in addition to its high elevation of 132 masl, the project is not vulnerable to tsunamis.

9 Setiawan, A., Draft UKL-UPL for RSPTN Unila. Department of Forestry, Faculty of Agriculture, University of

Lampung, Indonesia. March 2020. 10 Zulkarnain, Iskandar and Banuwa, Irwan Sukri and Syam, Tamaluddin and Buchari, Henrie. (2017). Agrotechnology

Approach of Laboratorium Lapang Terpadu Faculty of Agriculture University of Lampung By Land Units. Proceeding of ISAE International Seminar, Bandar Lampung, 1 (1). pp. 654-664. ISSN 978-602-72006-2-3.

11 Hidayat, N., & Naryanto, H. S. (2007). Tectonics and their effects on earthquake in Sumbagsel. Natural, 2 (3), 8–12. 12 Hamzah, L., Puspito, N., Imamura, F (2000). Tsunami Catalog and Zones in Indonesia. Journal of Natural Disaster

Science 22(1), 25-43.

28

Source: UN Office for the Coordination of Humanitarian Affairs, 2008.

Figure 16. Earthquake Intensity Zones in Indonesia

Source: Urban and Regional Planning, Institut Teknologi Sumatera 2 Informatics Engineering, Institut Teknologi Sumatera.

Figure 17. Map of Tsunami Disaster Coastal Zone in Bandar Lampung (2017)

29

c. Climate, Rainfall and Precipitation

94. The Köppen Climate Classification for Bandar Lampung is "Af" or Tropical Rainforest Climate. Tropical rainforest climate, also known as equatorial climate, is a type of tropical climate in which there is no dry season - all months have mean precipitation values of at least 60 mm (2.36 in). Tropical rainforest climates have no pronounced summer or winter; it is typically hot and wet throughout the year and rainfall is both heavy and frequent.13 95. The average temperature for the year in Bandar Lampung is 78.8°F (26°C). The warmest month, on average, is October with an average temperature of 79.5°F (26.4°C). The coolest month on average is July, with an average temperature of 77.9°F (25.5°C).14 96. The average amount of precipitation for the year in Bandar Lampung is 77.9 in (1978.7 mm). The month with the most precipitation on average is January with 11 in (279.4 mm) of precipitation. The month with the least precipitation on average is June with an average of 3.5 in (88.9 mm). On average, there are 173.4 days of precipitation, with the most precipitation occurring in December with 19.1 days and the least precipitation occurring in August with 10.1 days.15 97. Data on rainfall and rainy days for the past 10 years are presented below.

Table 7. Monthly Average Rainfall Data, in mm (2016-2018) Month 2016 2017 2018 Average

January 327.8 197.2 158.0 253.5

February 304.8 293.4 337.6 218.9

March 294.9 194.9 399.5 238.6

April 217.2 213.1 213.0 141.3

May 173.7 136.4 147.2 94.9

June 106.3 65.7 108.3 117.1

July 99.9 30.9 9.3 71.8

August 54.4 23.4 3.5 71.7

September 173.4 73.6 53.6 76.9

October 103.2 66.8 48.6 98.6

November 229.6 233.8 137.8 124.1

December 200.8 294.9 80.5 271.3 Source: Badan Meteorologi Klimatologi dan Geofisika, Stasiun Meteorologi Branti (2019).

98. Based on the results of the calculation of the data above, it is known that the range monthly rainfall over the past 10 years (2008-2017) is between 71.7 mm and 271.3 mm, with the highest rainfall occurring in December and the lowest rainfall in August. The mean annual rainfall was 1,771.4 mm. Wet months (rainfall> 200 mm) occur in December to March, and dry months (rainfall <100 mm) occur in June to September. The month that has rainfall between 100 mm to 200 mm, is a transitional month, which occurs in April, May, July, October, and November.

d. Flood

99. Floods in Sumatra Island, where Bandar Lampung is located, occur mainly along the Tulang Bawang River in Lampung Province. The river is located about 52 km away from UNILA.

13 Weatherbase. Climate Summary in Bandar Lampung, Indonesia. 14 Ibid. 15 Badan Meteorologi Klimatologi dan Geofisika, 2019.

https://www.weatherbase.com/weather/weather-summary.php3?s=602243&cityname=Bandar+Lampung%2C+Lampung%2C+Indonesia&units=metric.

30

Besides, the proposed site has an average elevation of 132 masl, and there are no streams or river nearby the project site.

Figure 18. Map of Flood Prone Area in Bandar Lampung (2013–2014)

e. Wind

100. Wind direction data were obtained from the National Meteorology, Climatology and Geophysical Agency, or Badan Meteorologi, Klimatologi, dan Geofisika (BMKG) Lampung. Processing of wind statistics is presented in wind roses. Windrose is presented using 16 directions of the compass. Windrose also presents the frequency distribution of wind direction and speed as shown in Figure 19. The highest average monthly wind speed recorded, based on 2016-2018 period, occurred in October 2017 (4.5 knots or 2.32 m/s) at SE direction), while the lowest occurred in November 2016 at 2.2 knots or 1.13 m/s at W direction. The annual wind speed pattern shows that the wind speed tends to decrease from January to June, and tends to increase at the latter half of the year. Dominant wind direction occurs during January to March and October.

UNILA

31

Figure 19. Windrose at the Development Site of UNILA Hospital and Surrounding areas Table 8.Wind Speed Data and Direction (degrees) at the Proposed Development Site and

Surroundings

Wind Parameters Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Mean wind speed (knots) 2016

3,5 3,9 3,6 3,0 3,1 3,1 2,7 2,9 2,7 2,5 2,2 2,6

Direction 315 315 315 90 90 VRB VRB 135 135 315 270 225


2,7 3,0 2,8 2,8 2,6 2,9 2,7 3,4 3,9 4,5 4,4 3,4

Direction 315 315 315 225 90 90 135 135 135 135 135 315


2,8 3,3 2,6 2,4 2,7 2,6 3,3 4,7 4,1 4,0 3,3 3,1

Direction 315 315 315 90 90 90 135 135 135 135 135 225

Mean wind speed (knots) Rerata

3,0 3,4 3,0 2,7 2,8 2,9 2,9 3,7 3,6 3,7 3,3 3,0

Direction 315 315 315 90 20 90 135 135 135 315 135 225 Source: Badan Meteorologi Klimatologi dan Geofisika, Stasiun Meteorologi Branti (2019).

f. Surface Water Quality

101. Surface water around the RSPTN UNILA is limited to a drainage ditch located in the west, about 50 m from the perimeter of the site. The water flows from South to North, crossing the Jalan Zainal Abidin Pagar Alam Road, entering and crossing the terminal area. The flow crosses the village area so that it becomes a place for garbage disposal and household wastewater discharge. The results of measurements of drainage ditch water quality in the downstream area are presented below.

32

Table 9. Results of Surface Water Quality Measurement (2020) No. Physical Unit Measurement Environmental

Quality Standards

Ministry of Environment

Decree No. 68/2016

WB – IFC EHS

Guidelines

1 Temperature oC 31.7 Dev. ± 3

2 Total Dissolved Solids (TDS) mg/l 389 1000

3 Total Suspended Solids (TSS) mg/l 10 400 50 30 Chemical

1 pH - 6.19 5 - 9 6-9 6-9

2 Biochemical Oxygen Demand (BOD5)

mg/l 8 6 30 30

3 Chemical Oxygen Demand (COD)

mg/l 42 50 125 100

4 Dissolved Oxygen (DO) mg/l 4.2 3

5 Total Phosphate as P mg/l 0.97 1 2a

6 Nitrate as N (NO3-N) mg/l 0.4 20 10b 10c

7 Ammonia (NH3-N) mg/l 19 -

8 Chloride (Cl-) mg/l 57 -

9 Cyanide (CN-) mg/l 0.001 0,02

10 Fluoride (F) mg/l 0.15 1,5

11 Nitrite as N (NO2-N) mg/l < 0.003 0,06

12 Sulfate (SO42-) mg/l 19 -

13 Chlorine (Cl2) mg/l 0.02 0,03

14 Hydrogen Sulfide (H2S) mg/l 0.05 0,002

15 Oil and Fat mg/l < 0.4 1 10 5

16 Detergent (MBAS) mg/l 0.009 0,2

17 Phenol compound as Phenol mg/l 0.004 0,001 Dissolved Metals

18 Arsenic (As) mg/l 0.001 1

19 Cobalt (Co) mg/l 0.0007 0,2

20 Barium (Ba) mg/l 0.2 -

21 Boron (B) mg/l 0.02 1

22 Selenium (Se) mg/l 0.001 0,05

23 Cadmium (Cd) mg/l 0.001 0,01

24 Chromium Hexavalent (Cr6+) mg/l < 0.002 0,05

25 Copper (Cu) mg/l 0.003 0,02

26 Iron (Fe) mg/l 0,1 -

27 Lead (Pb) mg/l 0.0003 0,03

28 Manganese (Mn) mg/l 1 -

29 Mercury (Hg) mg/l 0.0003 0,002

30 Zinc (Zn) mg/l 0.003 0,05 Microbiology

1 Fecal Coliform MPN/100ml

160,000 2000

2 Total Coliform MPN/100ml

160,000 10000 400 3000

a Total phosphorus b,c Total nitrogen Source: PT. Adhya Tirta Lampung (ATL), 2020.

102. As shown above, several environmental quality parameters, namely BOD5, Cl2, H2S, Phenol and Coliform have exceeded the environmental quality standard (BML). When compared to Ministry of Environment Decree No. 68/2016 and WB-IFC EHS Guidelines, the total coliform of the drainage ditch is exceedingly high. 103. The high level of BOD5 indicates higher level of organic pollution in water body, which is caused usually by poorly treated wastewater. The disposal of chlorine-containing waste into water

33

has the potential to pollute the waters and its ecosystem. This element is a very reactive element and a strong oxidizing agent: chlorine has the highest electron affinity and the third highest electronegativity behind oxygen and fluorine. High concentrations of chlorine are very dangerous and toxic to all living things. 104. H2S gas occurs because of natural processes as a by-product of the decomposition / decomposition of organic substances by bacteria or because it is deliberately made. This gas can be toxic. The highest ionizing power of Hydrogen Sulfide (H2S) is at low pH. H2S is formed and converted to oxidized forms such as sulfate when there is oxygen. Unionized hydrogen sulfide (H2S) is not present in oxygen-rich waters. H2S blocks oxygen between cells. The effects of H2S poisoning are the same as those due to lack of oxygen and may be worse than too low dissolved oxygen concentrations (Tsai, C.K, 1989). 105. Phenolic compounds in waters have toxic properties to living organisms such as fish in the range of 1000 μg / L for phenols, 200 μg / L for cresol, 50 μg / L for 4 - chlorophenol, 15 μg / L for 2-chlorophenol, and 5 μg / L for 2,4-dichlorophenol (Dojlido, 1993). 106. Coliform bacteria are microorganisms that can be used as indicators to determine the quality of contaminated water sources. The presence of faecal coliform bacteria in the aquatic environment indicates that water has been contaminated with human or warm-blooded faeces containing pathogenic bacteria or viruses.

g. Groundwater Quality

107. Groundwater in the project area is found at a depth of 45-60m. Natural groundwater recharge ability is low, caused by the dominant near-surface clay layer. The size of the clay grains is smooth, so it is unable to produce effective porosity to help rainwater infiltration, resulting in low infiltration rate. Other evidence is that there is a rapid change in ground water level, in the wellbore. Behind UNILA the ground water level has shrunk to a depth of 45 - 60 m, from a depth of less than 30 m. 108. The Drilling Well 1, located in a parking area, has a discharge rate equivalent to 15 liters/second, while Drilling Well 2, located near UNILA Computer Center Technical Implementation Unit (Puskom Building) only produces 5 liters/second.

34

Figure 20. Drilling Wells Surveyed to Determine Discharge Rate

h. Air Quality and Noise

109. The air quality data used is secondary data from the measurement results around UNILA RSPTN. The Ramayana measurement location is about 200 m south of the UNILA RSPTN location and the Perwira Road measurement location is about 300 m west of the UNILA RSPTN location, crossing the Rajabasa Terminal. Rajabasa Terminal, which serves as depot for buses coming from different parts of Lampung Province, is about 500 meters from the proposed RSPTN. The terminal can be accessed from the project site via Jalan ZA Pagar Alam. The results of measurements of several air quality parameters at the two locations are presented below

Figure 21. Air Quality Measurement Stations

35

Table 10. Air Quality Measurement in Ramayana and Perwira Roads No Parameter Measurement Results, µg/Nm3

Averaging Time

Ramayana Perwira Environmental Quality

Standards

WHO Standards

1 Sulfur Dioxide (SO2) 1 hour 79 82 900 500a

2 Carbon Monoxide (CO) 1 hour 1,254 1,418 30,000

3 Nitrogen Dioxide (NO2) 1 hour 62 64 400 200

4 Particulate Matter < 2,5 µm (PM2,5) 24 hours 32 33 66 25

5 Total Suspended Particles (TSP) 24 hours 88 96 230 50b

a WHO standard for SO2: 24 hr – 20 µg/Nm3, and 10 min – 500 µg/Nm3

b There is no WHO standard for TSP. Instead, the standard is for PM10. Source: PT. Adhya Tirta Lampung, 2020.

110. Data above shows that the air quality around the UNILA RSPTN location is still good, and classifies as non-degraded airshed. The parameters measured are within Government Regulation No. 41/1999 on Air Pollution Control. Although the PM2.5 measurement is within the national regulation, it did not meet the more stringent WHO standard, which is 25 µg/Nm3. Indonesia still measures TSP, whereas WHO’s guideline is the measurement of particulate matter less than 10 micrometer (PM10). 111. The noise data used is the result of 24-hour measurements on Jalan Zainal Abidin Pagar Alam, right in front of the Rajabasa Terminal (± 50 m from the western boundary of the UNILA RSPTN area). The measurement results are presented below.

Table 11. Noise Level Measurement Results Near the Rajabasa Terminal

Average Noise Level Quality Stda

IFC Stdb

07.00 10.00 15.00 20.00 22.00 06.00

Measurement results (dB(A))

75.01 73.03 76.14 75.59 75.61 79.93 RS = 55 PJ = 70

Daytime: 55 Nighttime: 45

RS = Hospital; PJ = Trade and Services Note: Daytime: 07:00 – 22:00 Nightime: 22:00 – 7:00 a Attachment I to the Decree of the Minister of Environment Number Kep-48 / MENLH / 11/1996. b International Finance Corporation (2007). Environmental, Health and Safety (EHS) Guidelines. General EHS Guidelines: Environmental. Noise Management. Guidelines values are for noise levels measured out of doors. Source: Guidelines for Community Noise, World Health Organization (WHO), 1999. Source: PT. Adhya Tirta Lampung, 2020.

112. Data above shows that for 24 hours, the noise at that location exceeded both the national standard as well as the IFC guideline values for nighttime (45 dB) and daytime (55 dB), respectively. Rajabasa Terminal, which is about 120 meters from the proposed site, is a transportation hub for buses from different parts of Lampung Province, is a commercial area. Main noise sources primarily include vehicles passing at the observation site. Because the location is close to the terminal and the road is the main road in Bandar Lampung, traffic is relatively heavy both during daytime and nighttime. More specific baseline noise measurement will be conducted in RSPTN location before start of construction.

36

B. Biological Environment

a. Integrated Biodiversity Assessment Tool

113. Using the Integrated Biodiversity Assessment Tool (IBAT) proximity analysis, the tool identified biodiversity features and species which may be present within the 3-km buffer from the proposed teaching hospital and research center within UNILA. The IBAT screening confirmed that there are no protected areas nor key biodiversity areas (KBAs) within the buffer zone.

Figure 22. IBAT Generated Report for UNILA showing the absence of protected areas and

key biodiversity areas within the 3-km buffer zone.

b. Flora

114. There are 42 trees in the proposed project location which are likely to require removal, as shown below.

Table 12. Trees Affected by the Project No. Scientific name Common name IUCN Status* Quantity

1 Paraserianthes falcataria Sengon NE 35

2 Acacia auriculiformis Akasia LC 6

3 Melia azedarach Mindi LC 1

Total 42 IUCN = International Union for Conservation of Nature, LC = least concern, NE = not evaluated. 115. Paraserianthes falcataria (L.) Nielsen, also known as sengon, is one of the most important pioneer multipurpose tree species in Indonesia. It is one of the tree species preferred for industrial forest plantations in Indonesia because of its very fast growth, its ability to grow on a variety of soils, its favourable silvicultural characteristics and its acceptable quality of wood for the panel and plywood industries. Acacia auriculiformis, also known as akasia, is raised as an ornamental plant and used as shade tree. It is raised on plantations for fuelwood throughout southeast Asia. Melia azedarach, locally known as mindi, is mainly utilized for its timber. The woody seed within the fruit is highly poisonous to humans. Paraserianthes falcataria is included in the Global

37

Register of introduced and Invasive Species in Indonesia (gbif.org, 2020). IUCN has not evaluated the conservation status of this species. Both Acacia auriculiformis and Melia azedarach are of least concern under IUCN Red List of Threatened Species (IUCN, 2020). 116. There are two near threatened plant species within 25-km radius zone of UNILA. Sonneratia ovata is an evergreen tree with a columnar crown; it can grow up to 10 meters tall with occasional specimens to 20 meters.16 Phoenix paludosa, also called the mangrove date palm, is a family indigenous to coastal region of India, Bangladesh, Myanmar, Thailand, Cambodia, Sumatra, Vietnam and Peninsular Malaysia. 17

Table 13. Near Threatened Floral Species Potentially Present Within 25-km Radius of UNILA

Scientific Name Red List Category Population

Trend

Sonneratia ovata Near Threatened Decreasing

Phoenix paludosa Near Threatened Decreasing Source: International Union for Conservation of Nature, 2020.

c. Fauna

117. Several fauna species were found during the survey conducted by Agus Setiawan, the national Environment Consultant, on March 4-5, 2020. These include Pycnonotus aurigaster or Sooty headed bulbul (Burung kutilang) (LC), Spilopelia chinensis or tekukur (large turtledove) (LC), and Tupaia minor or tupai (squirrel) (LC). Figure 23 indicates the location of fauna during the time of the survey.

Figure 23. Flora and Fauna Inventory in Proposed Project Location

16 Flora of China (1994). Missouri Botanical Garden Press. St. Louis. http://flora.huh.harvard.edu/china/. Retrieved 19 April 2020. 17 Phoenix paludosa". Germplasm Resources Information Network (GRIN). Agricultural Research Service (ARS), United States

Department of Agriculture (USDA). Retrieved 19 April 2020.

http://flora.huh.harvard.edu/china/

https://npgsweb.ars-grin.gov/gringlobal/taxonomydetail.aspx?id=28051

https://en.wikipedia.org/wiki/Germplasm_Resources_Information_Network

https://en.wikipedia.org/wiki/Agricultural_Research_Service

https://en.wikipedia.org/wiki/United_States_Department_of_Agriculture

https://en.wikipedia.org/wiki/United_States_Department_of_Agriculture

38

Table 14. List of Critically Endangered and Endangered Faunal Species Possibly Present

Within 25-km Radius of UNILA

Scientific Name Red List Category Population Trend

Carcharhinus longimanus Critically Endangered Decreasing

Sphyrna lewini Critically Endangered Decreasing

Millepora boschmai Critically Endangered Unknown

Carcharhinus hemiodon Critically Endangered Unknown

Eretmochelys imbricata Critically Endangered Decreasing

Glaucostegus typus Critically Endangered Decreasing

Rhynchobatus australiae Critically Endangered Decreasing

Gracupica jalla Critically Endangered Decreasing

Manis javanica Critically Endangered Decreasing

Rhina ancylostoma Critically Endangered Decreasing

Glaucostegus thouin Critically Endangered Unknown

Rhynchobatus springeri Critically Endangered Decreasing

Fregata andrewsi Critically Endangered Decreasing

Pristis pristis Critically Endangered Decreasing

Pristis zijsron Critically Endangered Decreasing

Batagur affinis Critically Endangered Decreasing

Manouria emys Critically Endangered Decreasing

Holothuria scabra Endangered Decreasing

Holothuria lessoni Endangered Decreasing

Thelenota ananas Endangered Decreasing

Rhincodon typus Endangered Decreasing

Isurus oxyrinchus Endangered Decreasing

Isurus paucus Endangered Decreasing

Hylobates agilis Endangered Decreasing

Lobophyllia serratus Endangered Unknown

Porites ornata Endangered Unknown

Montipora setosa Endangered Decreasing

Alveopora excelsa Endangered Unknown

Alveopora minuta Endangered Unknown

Pectinia maxima Endangered Unknown

Presbytis melalophos Endangered Decreasing

Symphalangus syndactylus Endangered Decreasing

Chelonia mydas Endangered Decreasing

Aetobatus flagellum Endangered Decreasing

Aetomylaeus maculatus Endangered Decreasing

Lutra sumatrana Endangered Decreasing

Pteromyscus pulverulentus Endangered Decreasing

Cynogale bennettii Endangered Decreasing

Porites eridani Endangered Unknown

39

Scientific Name Red List Category Population Trend

Anacropora spinosa Endangered Decreasing

Aetomylaeus vespertilio Endangered Decreasing

Alopias pelagicus Endangered Decreasing

Eusphyra blochii Endangered Decreasing

Cuon alpinus Endangered Decreasing

Scleropages formosus Endangered Decreasing

Tringa guttifer Endangered Decreasing

Mycteria cinerea Endangered Decreasing

Ciconia stormi Endangered Decreasing

Asarcornis scutulata Endangered Decreasing

Mobula mobular Endangered Decreasing

Numenius madagascariensis Endangered Decreasing

Orcaella brevirostris Endangered Decreasing

Mobula tarapacana Endangered Decreasing

Mobula thurstoni Endangered Decreasing

Balaenoptera borealis Endangered Increasing

Rhabdotorrhinus corrugatus Endangered Decreasing

Anoxypristis cuspidata Endangered Decreasing

Pristis clavata Endangered Decreasing

Calidris tenuirostris Endangered Decreasing

Chloropsis sonnerati Endangered Decreasing

Balaenoptera musculus Endangered Increasing

Stegostoma tigrinum Endangered Decreasing Source: International Union for Conservation of Nature, 2020.

d. Aquatic Ecology

118. Data below shows that the diversity of phytoplankton and zooplankton species in the drainage ditch near UNILA RSPTN is very low, and tends to decrease.

Table 15. Diversity of Phytoplankton and Zooplankton in Drainage Ditch Near UNILA

Parameter Measurement results

2018 June 2019 December 2019

Number of species / phytoplankton taxon

7 21 18

Phytoplankton Diversity Index 1.487 1.213 0.587

Number of species / Zooplankton taxon

0 10 3

Zooplankton Diversity Index 0 1.753 1.090 Source: PT. Adhya Tirta Lampung, 2020.

119. The phytoplankton and zooplankton diversity index used was Shannon-Wiener Index with formula

𝐻′ = − ∑ 𝑝𝑖 ln 𝑝𝑖𝑠𝑖=1 ,

Where: H’ = Shannon – Wiener Index;

40

pi = the number of individual species i divided by the total number of individuals; s = total number of species. C. Socio-economic Environment

a. Demography

120. In 2018, the population of Lampung Province reached 8,370,485 with a density of 241 people / km2. The numbers are distributed in 15 urban districts as can be seen below.

Table 16. Distribution and Population Distribution of Lampung Provinces (Year 2018) No. District / City Area

(km2) Male Female Total Density

(pax/km2) Growth rate per year, % (2010–2018)

1 Lampung Barat 2.142,78 159.636 141.067 300.703 140,3 0,98

2 Tanggamus 3.020,64 308.578 284.025 592.603 196,2 1,21

3 Lampung Selatan 700,32 513.985 488.300 1.002.285 1.431,2 1,14

4 Lampung Timur 5.325,03 529.369 506.824 1.036.193 194,6 1,03

5 Lampung Tengah 3.802,68 646.867 624.699 1.271.566 334,4 1,00

6 Lampung Utara 2.725,87 312.075 302.626 614.701 225,5 0,60

7 Way Kanan 3.921,63 229.636 216.477 446.113 113,8 1,14

8 Tulang Bawang 3.466,32 230.528 215.269 445.797 128,6 1,39

9 Pesawaran 2.243,51 226.506 213.686 440.192 196,2 1,20

10 Pringsewu 625,00 203.282 193.937 397.219 635,6 1,01

11 Mesuji 2.184,00 104.094 95.074 199.168 91,2 0,72

12 Tulang Bawang Barat 1.201,00 138.926 132.280 271.206 225,8 0,95

13 Pesisir Barat 2.907,23 80.622 73.121 153.743 52,9 0,98

14 Bandar Lampung 296,00 520.078 513.725 1.033.803 3.492,6 1,96

15 Metro 61,79 82.494 82.699 165.193 2.673,5 1,56

Provinsi Lampung 34.623,80 4.286.676 4.083.809 8.370.485 241,8 1,12

Source: Badan Pusat Statistik Provinsi Lampung, 2019.

121. By age group, the distribution of Lampung Provincial population is presented below. The data shows that the majority (5,619,809 people or 67.14%) of Lampung Provinces belong to the productive age (15–64 years).

Table 17. Distribution of Population of Provinces by Age Group No. Age Group Male Female Total %

1 0-4 390.734 376.138 766.872 9,16

2 5-9 407.882 390.146 798.028 9,53

3 10-14 381.780 361.666 743.446 8,88

4 15-19 363.132 340.279 703.411 8,40

5 20-24 351.586 325.357 676.943 8,09

6 25-29 338.956 318.169 657.125 7,85

7 30-34 334.047 317.151 651.198 7,78

8 35-39 327.316 317.083 644.399 7,70

9 40-44 317.172 302.157 619.329 7,40

10 45-49 279.312 265.676 544.988 6,51

11 50-54 235.877 227.801 463.678 5,54

12 55-59 193.426 185.142 378.568 4,52

13 60-64 147.001 133.169 280.170 3,35

14 65-69 96.648 89.399 186.047 2,22

15 70-74 58.938 62.323 121.261 1,45

16 75+ 62.869 72.153 135.022 1,61 Total 4.286.676 4.083.809 8.370.485 100,00

Source: Badan Pusat Statistik Provinsi Lampung, 2019.

41

b. Health Services and Facilities

122. As of 2018, there were 20 hospitals in Bandar Lampung City, 30 public health centers (Puskemas), 50 supporting public health centers, 3 maternity clinics, 71 clinics, and 704 integrated health centers (Posyandu).18 Of the 20 hospitals in Bandar Lampung City, 16 are type C while the rest are type B. n 2018, there were 3,091 beds available in the city.

Table 18. Bandar Lampung City Health Facility (2018) District Hospital Health

Center Supporting

Hospital Maternity

Clinic Clinic Posyandu

Teluk Betung Barat 0 1 4 0 0 26

Teluk Betung Timur 0 2 2 0 0 30

Teluk Betung Selatan

3 1 1 0 7 40

Bumi Waras 0 1 3 0 0 40

Panjang 0 1 2 0 7 51

Tanjung Karang Timur

0 1 0 0 4 31

Kedamaian 0 1 3 0 0 31

Teluk Betung Utara 3 2 1 0 1 42

Tanjung Karang Pusat

2 2 1 0 12 34

Enggal 3 1 1 0 6 23

Tanjung Karang Barat

0 2 3 1 2 34

Kemiling 1 3 8 0 6 42

Langkapura 1 1 2 0 4 25

Kedaton 0 1 1 0 6 31

Rajabasa 2 1 5 0 4 37

Tanjung Senang 0 1 5 0 2 28

Labuhan Ratu 1 1 1 1 4 28

Sukarame 0 3 2 1 0 35

Sukabumi 0 3 2 0 1 48

Way Halim 4 1 3 0 5 38

20 30 50 3 71 694

Source: Badan Pusat Statistik Kota Bandar Lampung, 2018.

c. Basic municipal services

123. Water Supply. The Bandar Lampung City Regional Drinking Water Company or Perusahaan Daerah Air Minum (PDAM) is currently developing the Bandar Lampung Drinking Water Supply System (SPAM) that will source water from Sekampung Way at 750 l / sec. The Sekampung Water Way is treated as drinking water in the Rulung Helok Village of Natar District, South Lampung and is conveyed through a 21-km transmission pipeline to the reservoir in Bandar Lampung. The location of the reservoir is behind the Robinson Mall, located directly in front of the potential RSPTN location. The drinking water distribution pipeline is currently being installed that will supply water to the UNILA area. The planned commercial operation date is 2020, and will be available during facility construction and operation. 124. The demand for water in the operation phase is calculated based on the number of beds (200 beds at 6th year of operation @ 450 liters/bed/day), minimum hot water requirements (45

18 Badan Pusat Statistik of Bandar Lampung City; City of Bandar Lampung in Figures 2019.

42

liters/bed/day),19 and 1.65 m3/built surface area/year20 for 10,360 m2 gross floor area for the teaching hospital, and 6,200 m2 for the integrated research center. Built surface area is expressed in m2. 125. Wastewater collection and treatment. Given the discharge of domestic wastewater treatment accounts for 80% of supplied water, the daily domestic wastewater generated for the teaching hospital and integrated research center will be 139.0 m3.

Table 19. Water Consumption and Wastewater Generation Parameters Water

Demand Water Use per

Unit Total Water

Use (m3/day) Wastewater Generation

Hospital beds 200 beds 450 liter/bed/day 90.0 72.0

Hot water 200 beds 45 liter / bed / day

9.0 7.2

Built surface area – hospital

10,360 m2 1.65 m3/m2/year 46.8 37.4

Built surface area – integrated research center

6,200 m2 1.65 m3/m2/year 28.0 22.4

Total 173.8 139.0

126. The proposed teaching hospital and integrated research center will be equipped with an on-site wastewater treatment facility utilizing anaerobic – aerobic biofilter technology to treat wastewater from the teaching hospital and integrated research center. 127. Power Supply. The electricity supply for RSPTN UNILA will come from PT Perusahaan Listrik Negara (Persero) (PLN) or the State Electricity Company (2750 kVA), and 2 units of standby generators (2 x 600 kVA or 1200 kVA). An uninterrupted power supply (UPS) (50 kVA) will provide ride-through power to cover for short-term outages, and to condition incoming power to smooth out the sags and spikes common on public utility grid and other primary sources of power. 128. In line with the green building concept strategy for the project, PV panels will be installed, but this will be defined during the technical design stage.

Table 20. Power Supply Requirement for the Teaching Hospital

Hospital Classification

PLN Emergency Generator Set

UPS Requirement/TT

Power supply

Requirement Unit

Class A: 1000 – 1600 tt 2.5 kVA 4000 kVA 1600 kVA 2 x 800 kVA 80 kVA

Class B: 400 – 1000 tt 2.75 kVA 2750 kVA 1200 kVA 2 x 600 kVA 50 kVA

Class C: 200 – 400 tt 3 kVA 1000 kVA 400 kVA 2 x 200 kVA 30 kVA

Class D: 50 – 100 tt 3 kVA 300 kVA 100 kVA 2 x 50 kVA 15 kVA

129. Transportation. The main access to UNILA is Zainal Abidin Pagar Alam, which is also the main road from Radin Inten II Airport to the city center. The traffic survey done in three periods is shown below. Based on the traffic survey data, the degree of saturation was computed.21

19 Balwani, K. and Nagarnaik, P. B., Water and Waste Water Management of a Hospital - A Review. International

Journal of Science and Research, ISSN (Online): 2319-7064, 2015. 20 García-Sanz-Calcedo, Justo; López-Rodriguez, Fernando; Yusa, Talal; and Al-Kassir, Awf, Analysis of the Average

Annual Consumption of Water in the Hospitals of Extremadura (Spain). Energies 10(4):479 · April 2017. 21 Degree of saturation equals the Planning Hour Volume/Road Capacity.

https://www.ijsr.net/archive/v6i4/ART20172640.pdf

43

Table 21. Traffic Survey on the Zainal Abidin Pagar Alam Road Service Level No. Time 23 August 2017

(Wednesday) 24 April 2019 (Wednesday)

17 October 2019 (Thursday)

Kend/hr pcu/hr Kend/hr pcu/hr Kend/hr pcu/hr

1 06.00-07.00 4.079 2.340,80 3624 2684,20 4477 3230,00

2 07.00-08.00 5.779 3.105,40 4027 2935,20 3510 2535,80

6 11.00-12.00 1.866 1.228,20 3304 2454,40 3022 2291,4

7 12.00-13.00 1869 1.201,20 3548 2585,00 3218 2401,00

11 16.00-17.00 3.612 2.138,20 4387 3156,80 5220 3680,80

12 17.00-18.00 5.175 2.809,20 3531 2612,40 3366 2344,80

Source: PT. RTL, 2020.

130. It showed that the level of service or the degree of saturation is greater than 1 (Level F), meaning, the volume of vehicle traversing Jalan Zainal Abidin Pagar Alam exceeded the road capacity. This indicates that the existing traffic load has exceeded the capacity of roads, causes high delay, traffic congestion, the inconvenience of travel and finally lead to the decreasing of the productivity. Based on this initial analysis, it is recommended to use Jalan Prof. Dr. IR. Soemantri Brojonegoro as the main access (entrance and exit) for vehicles and pedestrian. A detailed traffic impact analysis will be conducted during detailed design. Traffic Impact Assessment will be done during detailed design phase to determine the impact of construction and operation of RSPTN UNILA.

C = Co x FCw x FCsp x FCsf x FCcs Co = 1,650 x 3 = 4,950 pcu / hour (6/2 D) Fcw = 0.92 (lane width = 2.9 m) Fcsp = 0.97 (60: 40) FCsf = 0.95 (parking on the road) FCcs = 0.94 (population of Bandar Lampung = 979,287 inhabitants) C = 3,688.80 x 0.92 x 0.97 x 0.95 x 0.94 = 2,933.72 pcu / hour Planning hour volume: 3,105.40 pcu / hour. Calculation of degree of road saturation: DS = V / C Where: V = traffic volume C = road capacity From the analysis above: V = 3105.40 pcu / hour C = 2,933.72 pcu / hour Thus, the degree of saturation is: DS = V / C = 3,105,40 / 2,933.72 = 1.06 Road Service Level = "F"

44

Figure 24. Proposed Main Access to RSPTN UNILA via Jalan Soemantri Brojonegoro

131. Drainage. Drainage canal is located in the west of RSPTN. The water flows from South to North, crossing the Zainal Abidin Pagar Alam Road, entering and crossing the Rajabasa terminal area. The drainage canal, which is a tributary of Kandis River, serves as catchment for rainwater runoff. D. Climate Risk Vulnerability Assessment

a. Background 132. Being the largest archipelago nation in the world, Indonesia is one of the countries most vulnerable to the negative impacts of climate change. Global climate change model predicted that the country will experience increased temperature, increased intensity of rainfall, and extended dry season. The impact of climate change includes, among others: droughts, floods, biodiversity degradation, and economic instability. The largest climate change threats in Indonesia are increase in sea surface temperature, sea level rise, and changes in the intensity and patterns of rainfall.22 133. Indonesia holds 20% of freshwater reserves of Asia. Despite this, the country has difficulty in supply potable water to meet the domestic consumption, industry and agriculture. Water shortage is acute during dry season specially in urban areas. Total economic losses due to limited access to safe water and sanitation was estimated at 2% annually.23 In 2007, clean water supplies only reach 37% of urban residents and 8% in rural areas. Although shallow groundwater supplements the demand for household consumption, water quality and quantity fluctuate, particularly during dry season.24

b. National Action Plan for Climate Change Adaptation

22 National Action Plan for Climate Change Adaptation (RAN-API) (2012). Ministry of National Development Planning /

National Development Planning Agency. Jakarta, Indonesia. 23 Worldbank. 2009. Climate Knowledge Portal. Climate Risk and Adaptation Country Profile (accessed on 20 April

2020). 24 State Ministry of Environment, Republic of Indonesia, 2007. National Action Plan Addressing Climate Change.

https://climateknowledgeportal.worldbank.org/sites/default/files/2018-10/wb_gfdrr_climate_change_country_profile_for_IDN.pdf

45

134. The Government of Indonesia initiated various initiatives to adapt to climate change, including the formulation of national policy documents on climate change adaptation. These include Indonesia Adaptation Strategy (Bappenas, 2011), the National Action Plan for Adaptation to Climate Change of Indonesia (DNPI, 2011), the Indonesia Climate Change Sectoral Road Map (Bappenas, 2010), the National Action Plan for Climate Change Mitigation and Adaptation (Ministry of Environment, 2007), and other sectoral plans from other line agencies. These were harmonized into one consolidated policy, the National Action Plan for Climate Change Adaptation, or the RAN-API (2012).25 The policy identifies two key areas of climate change and their impacts on livelihoods. These two areas are increases in sea level and changes in weather, climate, and rainfall. Increasing sea level rise impacts fisheries, marine economies, and agriculture. Changes in weather, climate, and rainfall impacts health (vector borne disease and respiratory illness from fire), water availability, and contributes to natural disaster. Bappenas – the ministry of national development planning – implements RAN-API.26

c. Climate Baseline Conditions

135. Trend in Surface Temperature Changes. The effect of global warming to the increase in surface temperature in Indonesia is estimated to not be greater than 1.0° C during the 20th century. An accurate estimation is difficult to obtain due to the lack of consistent data recording in Indonesia territory.

Figure 25. Trend of Average Annual Temperature for Land Areas in Indonesia based on

Data from CRU T53.1 136. Trend of Rainfall Changes. The increasing trend of rainfall indicates that for Sumatra, where the proposed project is located, rainfall tends to increase from December to April, and July to September (Bappenas, 2010). 137. Trend of Occurrences of Extreme Weather and Climate. For the 1998–2020 period, Bappenas (2010) study showed increased probability of extreme occurrence of daily rainfall in Sumatra in months of October to February. Based on the Climate Vulnerability Assessment carried out by ACCCRN,27 Bandar Lampung is at high risk from extreme weather events such as droughts and floods. In Sumatra, these are strongly related to large scale climate phenomena such as El Niño Southern Oscillation (ENSO) and the Indian Ocean Dipole (a.k.a. Indian Niño) that often regulates the rainfall pattern in the western and eastern Indian Ocean of Indonesia.

25 National Action Plan for Climate Change Adaptation (RAN-API) (2012). Ministry of National Development Planning /

National Development Planning Agency. Jakarta, Indonesia. 26 Ibid. 27 Asian Cities Climate Change Resilience Network. Rockefeller Foundation. Accessed 18 March 2020.

46

d. Future Climate Scenario

138. Surface Temperature Changes. Warming will increase by 0.2–0.3°C per decade in Indonesia.28 The projected increase in surface temperature on the basis of AR4 IPCC models shows that for 2020–2050 period, there will be an increase of 0.8–1.0 °C.29 139. Rainfall Changes. Increasing annual precipitation across the majority of the Indonesian islands, except in southern Indonesia where is it projected to decline by up to 15%. Based on the consolidation of output of 14 models of AR4 – IPCC under scenario A2 and B1 for the period 2050 and 2080, there will be an increase in rainfall levels in December, January and February, and reduction of rainfall in June, July and August (Second National Telecommunication, KLH (2010).30 140. Projected Increase of Sea Temperature and Sea Surface Level. The projected sea surface temperature is predicted to increase by 1.0–1.2 °C by 2050, with year 2020 as base year (Bappenas, 2010). This is consistent with results of AR4 IPCC models for surface temperature. The sea level rise, on the other hand, will reach 30–40 cm compared with year 2000 baseline. The maximum rise will reach 175 cm by 2100 based on Bappenas (2010) projection. The proposed site, located at 132 masl and 12 km from the coast, will not be affected by increase in sea surface temperature and by inundation caused by sea level rise. 141. Occurrences of Extreme Weather and Climate. Changes in the seasonality of precipitation are projected: parts of Sumatra may become 10–30% wetter by the 2080s during December-February. A 30-day delay in the annual monsoon is projected, bringing a 10% increase in rainfall later in the crop year (April–June), and up to a 75% decrease in rainfall later in the dry season (July–September).31 142. Based on the analysis of climate baseline conditions and future climate change scenario, the project will be affected by increase in surface temperature, increase in rainfall, and extreme occurrences of precipitation.

V. ANTICIPATED ENVIRONMENTAL IMPACTS AND MITIGATION MEASURES

A. Impact Assessment 143. This section will evaluate the impacts of the proposed construction of teaching hospital and integrated research center in Bandar Lampung City on the physical, biological and socio-economic environment within the project’s impact areas. Likewise, this section will also recommend corresponding mitigating measures on identified risks related to the construction of the proposed facilities. 144. Most of the impacts are anticipated during construction phase. There are also anticipated impacts during pre-construction and operation phases of the facilities, although these are

28 M. Hulme and N. Sheard. 1999. Climate Change Scenarios for Indonesia. Climatic Research Unit, Norwich, UK, 6

pp. 29 National Action Plan for Climate Change Adaptation (RAN-API) (2012). Ministry of National Development Planning/

National Development Planning Agency. Jakarta, Indonesia. 30 Kementerian Lingkungan Hidup, 2012. Indonesia Second National Communication Under the United Nations

Framework Convention on Climate Change (UNFCCC), Jakarta, November 2010. 31 R. Boer and A. Faqih. 2004. Current and Future Rainfall Variability in Indonesia. In an Integrated Assessment of

Climate Change Impacts, Adaptation and Vulnerability in Watershed Areas and Communities in Southeast Asia. Report from AIACC Project No AS21. International START Secretariat. Washington, DC.

47

considered minor compared to construction phase impacts. The following project components and activities per phase that will have substantial interaction with the environment were identified:

i. Preconstruction stage: a. Location and design of facilities (including wastewater treatment and solid waste

management system) b. Leveling off with relevant agencies on permits and requirements c. Survey of vegetation and tree cutting d. Survey of unfinished UNILA building e. Traffic planning f. Constituting PMU within UNILA

ii. Construction Phase

a. Site mobilization and construction of temporary facilities - establishment of storage areas for construction materials, mobilization of construction equipment and perimeter fencing

b. Construction of teaching hospital c. Construction of integrated research center d. Construction of laboratories e. Management of construction activities- worker camps, stockpiles, solid wastes and

wastewater

iii. Post-Construction Phase a. Demobilization b. Revegetation c. Operation of RSPTN UNILA

145. The assessment of impacts, both quantitatively and qualitatively, are based on the site visit in UNILA, consultation with relevant stakeholders within UNILA and government agencies, and literature review of environmental impact studies of similar facilities. These impacts can be classified as major, moderate, minor and negligible. Some of the impacts associated with the construction of teaching hospital and research center include impacts on vegetation, wastes from building construction, air quality impacts, and occupational and community health and safety risks. Prevalent impacts during operation phase includes the management of solid waste and wastewater. B. Evaluation of Impacts

a. Beneficial Impacts

146. The establishment of RSPTN and IRC in UNILA as center of medical education and research center in Bandar Lampung in particular and on a wider scale, Lampung Province will enhance high quality medical education and research with modern and up to date facilities. With the existence of IRC, it is expected that specialist doctors can conduct research according to their field of specialization and collaborate with doctors or researchers from the field of basic sciences so that they can support various researches of UNILA. This can be realized by the existence of complete facilities that support interdisciplinary researches. 147. Researches result of IRC could be used as reference in health service development of RSPTN. The collaboration among hospital, IRC, and Fakultas Kedokteran of University of

48

Lampung could increase the quantity and quality of research of the university. This will in turn has the potential to address the health concerns of the residents in Lampung.

b. Adverse Impacts 148. The identification of potential negative impacts requires the identification of the components of physical, biological and socio-economic environment that are at risk from the proposed construction of teaching hospital, integrated research center and laboratories. A modified Leopold matrix, involving interactions between valued environmental components and project activities are proposed. Valued environmental components (VECs) are defined as fundamental elements of the physical, biological or socio-economic environment, including the air, water, soil, terrain, vegetation, fauna and land use that may be affected by a proposed project. The VECs for the proposed project are indicated in the succeeding table.

Table 22. Summary of VECs for the Proposed Construction of Teaching Hospital and Integrated Research Center, Bandar Lampung City, Indonesia

Environment Valued Environmental Components

Rationale and Relationship to the Project

Physical Geological condition

Based on the Modified Mercalli Scale, Bandar Lampung City is located within Earthquake Intensity VII.

Land and soil condition

As the site is located in flat area, there will be only slight alteration of the terrain. Construction timing is important though as rainy and windy season impacts the soil condition.

Surface water quality

Nearby receiving body of water (canal) contributes to quality of receiving river, and eventually, the water in the Sunda Strait.

Air quality Air quality will be temporarily affected from the construction activities.

Ambient noise As a university, UNILA values the ambient level of noise that will be conducive for learning for students.

Biological Vegetation Forty-two trees will be cut for the project.

Aquatic environment

It is important not to further contribute to the deterioration of the water quality of the nearby canal.

Fauna Since the proposed site is already in developed areas, potential impacts on fauna will be limited.

Socio-economic Access to health facilities and research

The construction of teaching hospital and integrated research center will provide opportunity to the Faculty of Medicine students to have access to teaching hospital. The institution will also cater to the medical needs of Bandar Lampung residents.

Public infrastructure and public access

The proposed project will contribute to minor increase in traffic generation. Public access to the project is via JI. Prof. Dr. Ir. Sumantri Brojonegoro through the service road Jalan H. Z. A. Pagar Alam.

Water supply The teaching hospital will require water supply from Bandar Lampung. Recycling of water will be prioritized in the design.

Acoustic environment

The level of ambient noise is an important aspect for this project for the well-being of patients and workers.

Vehicle traffic Project’s operation will contribute to UNILA and Bandar Lampung City’s traffic volume.

Occupational health and safety

Health and safety of construction workers must be prioritized during construction and operation phases.

Community health and safety

Protection of the public is paramount for the project, primarily during construction

149. Negative impacts can be mitigated through good construction management practices while positive impacts will be further enhanced. Impacts from the proposed projects are classified into intensity, duration and scope. Intensity refers to the level of disruption, duration pertains to

49

the time dimension of impact, while scope refers to the spatial impact. These can be further classified into different levels, as shown in the next table.

Table 23. Intensity, Duration and Scope Classification of Impacts Intensity: Level of impacts Duration: Time dimension of

impacts

Scope: Spatial dimension of the

effect

Low: Little change in the

characteristics of the component.

Difficult to quantify.

Short-lived: Effect dissipates easily Regional: Action affects areas outside

UNILA

Average: Change in certain

characteristics of the components.

Change may be quantified.

Temporary: Effect does not last.

Effect is felt during one project

activity or throughout project

implementation

Local: Action affects areas within

UNILA

High: Change in all or in the main

characteristics of the component.

Change is quantifiable.

Permanent: Effect leaves lasting

impact for the life of the

infrastructure

Limited: Action affects only the building

footprint of the project

150. The three parameters – intensity, duration and scope are incorporated to form multicriteria matrix that can be categorized into the following: Major – effect is permanent that substantially alters the environment quality; Medium – signifies temporary and perceptible effect that has little effect on the environmental component and can be reversed, the effect is only limited and short-lived; and Minor – effect does not affect the environmental component in qualitative or quantitative terms, that is, the effect is short-lived and very limited in scope.

Table 24. Multi-criteria Analysis to Determine the Potential Environmental Impacts

Intensity

Duration

Scope

Short-lived Temporary Permanent

Low

Limited MIN MIN MED

Local MIN MIN MED

Regional MIN MED MED

Medium

Limited MIN MED MED

Local MED MED MAJ

Regional MED MAJ MAJ

High

Limited MED MAJ MAJ

Local MED MAJ MAJ

Regional MAJ MAJ MAJ

50

Table 25. Matrix Showing the Relationship Between VECs and Project Components and Activities for the Construction of Teaching Hospital and Integrated Research Center

Valued

Environmental

Components

Project Phases

Pre-construction Construction Operation

Loca

tio

n a

nd d

esig

n

Desig

n o

f w

aste

wa

ter

tre

atm

en

t

facili

ty

Desig

n o

f so

lid w

aste

ma

na

gem

en

t syste

m

Surv

ey o

f ve

ge

tation

an

d t

ree

cu

ttin

g

Mo

bili

za

tio

n o

f co

nstr

uctio

n

equ

ipm

en

t a

nd

co

nstr

uction

of

tem

po

rary

fa

cili

tie

s

Con

str

uctio

n o

f te

ach

ing

ho

sp

ita

l

and

in

teg

rate

d r

esea

rch

ce

nte

r

Ma

na

gem

en

t o

f co

nstr

uction

activitie

s

Dem

ob

iliza

tio

n

Reve

geta

tio

n

Op

era

tio

n o

f h

ealth

un

it f

acili

ties

Physical Environment

Geological

condition

✓ ✓ ✓

Land and soil

condition

✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓

Surface water

quality

✓ ✓ ✓ ✓ ✓ ✓ ✓

Air quality ✓ ✓ ✓ ✓ ✓ ✓ ✓

Ambient noise ✓ ✓ ✓

Biological Environment

Vegetation ✓ ✓ ✓ ✓ ✓

Aquatic

environment

✓ ✓ ✓ ✓ ✓

Fauna ✓ ✓ ✓ ✓ ✓ ✓

Socio-economic Environment

Access to health

facilities and

research

✓ ✓

Public

infrastructure and

access

✓ ✓ ✓ ✓ ✓ ✓

Water supply ✓ ✓ ✓ ✓ ✓ ✓

Acoustic

environment

✓

Vehicle traffic ✓ ✓ ✓ ✓ ✓ ✓ ✓

Occupational

health and safety

✓ ✓ ✓ ✓ ✓

Community health

and safety

✓ ✓ ✓ ✓ ✓ ✓ ✓

51

Table 26. Analysis of Environmental Impacts Project

Components Environmental Components

Description of Environmental

Effects

Intensity Duration Scope Assessment of Potential

Negative Impacts

Preconstruction Phase

Location and design

Land use Conformity with zoning

High Permanent Regional Major

Geological condition

Compromised structural integrity

High Permanent Regional Major

Vegetation Loss of trees Medium Permanent Limited Medium

Aquatic environment

Deterioration of water quality

Low Temporary Local Minor

Fauna Loss of fauna Low Temporary Limited Minor

Public infrastructure and access

Additional strain to public infrastructure services

Medium Temporary Local Medium

Water supply Additional strain to existing resource


Vehicle traffic Traffic generation Medium Temporary Local Medium

Design of wastewater treatment facility


Disturbance of soil

Medium Permanent Limited Medium


Improved water quality


Air quality Impact on nearby community



Additional wastewater treatment service


Water supply Reuse of wastewater


Design of solid waste management system


Potential leaching of soil

Low Temporary Limited Minor


Contamination of waterways

Low Temporary Local Minor

Air quality Nuisance to affected community



Potential obstruction to public access


Vehicle traffic Disruption in traffic flow


Survey of vegetation and tree cutting


Disturbance of soil

Medium Permanent Limited Medium

Ambient noise Increase in noise level

Medium Short-lived Limited Minor

Vegetation Loss of vegetation


Fauna Loss of fauna Medium Short-lived Limited Minor


Impact on health and safety



Impact on health and safety of the community


Construction Phase

52

Project Components

Environmental Components


Effects


Negative Impacts

Mobilization of construction equipment and construction of temporary facilities; Construction of teaching hospital and IRC

Geologic condition

Compromised structural integrity

High Temporary Limited Major


Soil disturbance High Temporary Limited Major


Deterioration of water quality


Air quality Increase in particulate matters

High Temporary Local Major

Vegetation Loss of trees Medium Temporary Local Medium

Aquatic environment

Loss of aquatic biota


Fauna Loss of fauna Low Temporary Limited Minor


Temporary disturbance of access to UNILA


Water supply Increased level of use of water


Vehicle traffic Increased level of traffic



Impact on health and safety of workers

High Short-lived Local Medium


Impact on health and safety of community

High Short-lived Local Medium

Operation Phase

Demobilization Land and soil condition

Compaction of soil



Increase in level of pollutants


Air quality Increase level of particulate matter


Ambient noise Increased level of noise


Vehicle traffic Increased level of traffic



Impact on the community


Operation of RSPTN and Integrated Research Center


Potential deterioration of water quality

High Temporary Regional Medium

Air quality Increase level of particulate matter

High Temporary Local Medium

Aquatic environment

Possible negative impact from wastewater effluent

High Temporary Regional Medium

Vehicle traffic Vehicle congestion and public disturbance

Medium Short-lived Local Medium


Risks from handling of hazardous wastes

Medium Permanent Regional Medium

53

Project Components

Environmental Components


Effects


Negative Impacts


Risks from exposure from unmanaged hazardous wastes

Medium Permanent Regional Medium

151. The analysis of impacts shown in the preceding table revealed the following:

(i) During the pre-construction phase, major risk and potential negative impact and risk include conformity to land use, earthquake hazards, and medium impacts on permanent loss of trees, additional strain to public services such as waste collection, management of wastewater, power and water supply.

(ii) During construction, major potential impacts include geological hazards (earthquake), disturbance of land and soil condition and impacts on air quality; and medium impacts on contamination of waterways, loss of aquatic biota, strain in public services such as collection of wastes and provision of water supply, and community and occupational health and safety.

(iii) During operation, there will be medium impacts from the operation of wastewater management and solid waste management facilities specifically on the management of hazardous wastes. Impacts from the operation of wastewater treatment facility include the potential contamination of waterways and impacts on air quality, increase in traffic level, and potential impact on workers and the community arising from the operation of wastewater treatment and solid waste management facilities.

C. Negative Impacts and Mitigation

a. Pre-construction Phase

152. The teaching hospital and integrated research center will be constructed within the 58,104.92 m2 lot at the corner of Jalan Soemantri Brodjonegoro and Jalan Z.A. Pagar Alam, Gedung Meneng Building, Rajabasa District, Bandar Lampung City. Major risk and potential negative impact and risk include conformity to land use, earthquake hazards, and medium impacts on permanent loss of trees, additional strain to public services such as waste collection, management of wastewater, power and water supply. Displacement and involuntary resettlement are not anticipated for the project. Further evaluation of the site condition, components, design, and sizes of facilities of teaching hospital and integrated research center will be done once the detailed engineering design is completed. 153. During the preparation phase, UNILA, through contracted firm will prepare detailed engineering design (DED) that will incorporate all the inputs of different stakeholders. These include incorporation of EMP in design. In line with the green building concept for RSPTN UNILA, the DED consultant shall incorporate earthquake resilient design, energy conservation and use of natural light, wastewater recycling, water conservation, solid waste recycling, reuse, treatment and disposal, use of biopori for underground recharge for the teaching hospital and integrated research center buildings. DED consultant must also incorporate design that will facilitate easy access for disabled people in compliance with applicable government regulations.

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154. In terms of social preparation, UNILA will establish the Grievance Redress Mechanism and consult and disclose the project and the IEE and EMP with different stakeholders following SPS 2009 guidelines. Following Regulation Number 75 of 2015 concerning the Implementation of Traffic Impact Analysis, UNILA will conduct a Traffic Impact Analysis (Andal Lalin) for the project. 155. During this period, the winning Contractor must also prepare the following Contractor’s EMP: waste management plan; emission and noise management plan; wastewater management plan; workers’ accommodation plan; occupational health and safety plan; emergency response plan; and traffic management plan. 156. The following are the major environmental issues related to location and design of teaching hospital and integrated research center. 157. Conformity of the Project to Land Use Plan. The Regional Spatial Planning 2011-2030 for Bandar Lampung City, contained in Regional Regulation Number 10 of 2011 contains the zoning regulations in Rajabasa district, where UNILA is located and the proposed RSPTN will be constructed. The proposed teaching hospital and integrated research center buildings are within the regional higher education facilities zone. This zone is bounded by Jalan ZA Pagar Alam, Gedong Meneng, and Rajabasa Road. 158. Kedaton and Rajabasa districts have a combined area of 2,390 hectares as part of City Region B. Under the plan, Rajabasa region, where Rajabasa terminal is located, will be further developed as a regional transportation node. Rajabasa terminal will serve as Type A passenger terminal and freight terminal and motor vehicle testing unit. The development of housing and settlement areas will be concentrated to the north of Kedaton and Rajabasa districts. Kedaton City Service Sub-center (SPPK) within Kedaton and Rajabasa districts will function as higher education and cultural centers (where UNILA and proposed teaching hospital and integrated research center are located), main nodes of land transportation, trade and services and urban settlement. For utilities, a 150 kV electric transmission network line and extra high voltage line pass through Rajabasa village. 159. Geologic hazards. The proposed location is within the earthquake intensity VII zone based on Modified Mercalli Scale. Aware of this hazard, UNILA will ensure that the design of the buildings will be earthquake resilient. Since Bandar Lampung region is located in a high earthquake intensity risk zone because of its proximity to Sunda Strait, the project will explore various earthquake resistant building technologies, as adopted in Japan.32 These include menshin or base isolation, taishin or dampening, and seishin or structural reinforcement. Menshin is a device separating the building from the ground to prevent shock waves from being transmitted to the structure. Options for making RSPTN UNILA and IRC UNILA earthquake-resistant will be finalized during detailed engineering.

32 Real Estate Japan. https://resources.realestate.co.jp/buy/earthquake-building-codes-and-technology-in-japan/a.

https://resources.realestate.co.jp/buy/earthquake-building-codes-and-technology-in-japan/a

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Figure 26. Earthquake-resistance Building Technology Options

Figure 27. Seismic Vibration Control Technology Options

160. Loss of flora and fauna species. The proposed project will require the cutting of 42 trees. The trees comprised Paraserianthes falcataria (83%), Acacia auriculiformis (14%) and Melia azedarach (3%). Animals found include Pycnonotus aurigaster or Sooty headed bulbul (Burung kutilang) (LC), Spilopelia chinensis or tekukur (large turtledove) (LC), and Tupaia minor or tupai (squirrel) (LC). There are no rare, endemic and endangered animal or plant species listed in IUCN. All vegetation and animals found during the survey are common in Bandar Lampung and other places in Sumatra. Therefore, the ecological change caused by the Project will not have significant negative impacts on biodiversity and are considered acceptable given the benefits of the project. As part of the green building concept for the project, UNILA will devote 13,278 m2 for RSPTN and 7,732.00 m2 for IRC landscaping, fully offsetting the loss of trees. These figures will

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be updated during the detailed design stage. The project will utilize native trees. All cut trees will be sold to commercial wood processor in Sumatra.33 The contractor will schedule the cutting of trees progressively so as not to expose soil for long period. Contractor will be responsible for transport and disposal of biomass wastes from cut trees. Catching of animals will be prohibited. 161. Contractor also need to strip the topsoil from any areas to be covered by pavement, structures or where utilities will be located, to be used later for revegetation. Stripping of topsoil shall be at a depth to the bottom of the grassroots zones. Grass shall be stripped together with topsoil. 162. Availability and requirements for power, water supply, sanitation and drainage. The construction and operation of the teaching hospital and integrated research center will increase the demand for Bandar Lampung City’s available water supply, sanitation facilities and drainage system. As envisioned by UNILA during the feasibility study, the facilities will be green building, where the electricity supply from Perusahaan Listrik Negara (PLN) will be supplemented by solar power and its own generator. The electricity supply will come from PLN or the State Electricity Company (2750 kVA), and 2 units of standby generators (2 x 600 kVA or 1200 kVA). UPS with a 50 kVA capacity, will provide an alternative ‘no-break’ electrical supply that will be crucial in the operation of medical facilities such as RSPTN UNILA. 163. The façade of the teaching hospital will allow natural light penetration, equipped with vertical sun shading to prevent glaring. In addition to construction and operation of wastewater treatment system that will meet Indonesian regulations, the facility will also recycle wastewater, where it will be reused as flushing water for the toilets and to water the plants within the compound. At present the Bandar Lampung Municipal Water Supply Company (PDAM) is developing the Bandar Lampung City Drinking Water Supply System (SPAM) with a capacity of 750 l / sec (64,800 m3/day). This is to ensure to meet the demand of growing population, as well as the development of new facilities, such as the teaching hospital and integrated research center. It was estimated that the teaching hospital and integrated research center will require 173.8 m3/day of water per day. 164. Vulnerability to climate change. Based on the Climate Vulnerability Assessment carried by ACCCRN in 201434, Bandar Lampung is at high risk from extreme weather events such as droughts and floods. Since water supply is a critical component in the operation of the project, specifically the hospital, UNILA will ensure the conservation of water resources by addressing the demand side such as recycling used water for flushing toilets and for watering lawn and garden within the compound. As for flooding, since the compound has an average elevation of 132 masl, the project will ensure that there will be no localized flooding by designing properly the drainage system for the project.

b. Construction Phase 165. Major potential impacts during construction phase include geological hazards (earthquake), disturbance of land and soil condition and impacts on air quality; and medium impacts on impact on surface water quality, loss of aquatic biota, strain in public services such as

33 Falcata wood can be used for match-sticks, chopsticks, shipping pallets, and wooden boxes. Pulp is used for paper-

making. Falcata can also be used for plywood production and veneer-based products. 34 Jonatan A Lassa, Erwin Nugraha. From Shared Learning to Shared Action in Building Resilience in the City of Bandar

Lampung, Indonesia. 2014.

https://journals.sagepub.com/doi/full/10.1177/0956247814552233

https://journals.sagepub.com/doi/full/10.1177/0956247814552233

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collection of wastes and provision of water supply, increase in level of traffic, and impact on occupational health and safety and community health and safety. 166. Disturbance of land and soil condition. Prior to the construction of teaching hospital and integrated research center buildings, contractors will transport construction materials and equipment that will disturb soil condition within the project area. The impact will be permanent since the area traversed will be used for roads and buildings. Impacts will be limited to the building footprint area and areas devoted for roads and parking. 167. To mitigate the impacts on disturbance of land and soil condition, best management practices include limiting the amount of erosion and sediment by disturbing only the areas necessary for construction, phasing of construction activity, lessening the grade of steep slopes, and covering of exposed soils until time of revegetation or building of facilities. Soil loss can also be lessened by scheduling construction activities during fair weather to prevent soil erosion, use of appropriate sedimentation and soil erosion and control devices (sediment traps or silt fences). Stockpiles of soil removed during construction should be covered. Storage of construction materials should be limited to paved parking lots or inactive areas within existing building or temporary shed. Construction machineries should be parked in paved areas. Drivers should also be instructed to observe speed limit to reduce soil disturbance. 168. Impact on surface water quality. Construction of buildings and associated facilities will generate construction wastewater as well as domestic wastewater from workers who will temporarily stay inside workers’ camp. With an area of greater than 5 ha and with large buildings to be constructed, it was estimated that at construction peak, approximately 60 workers at the minimum will be needed, 40% of which will stay at workers’ camp. It is estimated that water consumption for each worker is 80 liters/day or a total of 1.92 m3/day. Sources of water consumption will come from toilets, housing, dining area, laundry and kitchen. It was also estimated that 80%, or 1.5 m3/day will drain into drainage canal beside RSPTN. This volume of wastewater will have high level of BOD5, nutrients, bacteria and pathogen. This will further contribute to local water pollution if not treated, although the intensity of impact is considered medium, duration is temporary and impact is only localized. The impacts on waterways can be mitigated through appropriate collection and treatment. 169. The construction and movement of vehicles will generate sediments that will possibly contaminate waterways beside UNILA compound. To ensure the canal located at the west side of the proposed project will not be contaminated, the contractor will ensure that the wheels of vehicles transporting aggregates and other materials are thoroughly washed to prevent sediment runoff going to the canal. Portable toilets will be provided to manage the wastewater coming from the workers. Contractor through third party service provider, will be responsible for the operation, maintenance and disposal and treatment of collected wastes from portable toilets. Oil and grease containing effluent will be segregated and pre-treated using grease trap prior to discharge. Potential impacts on the water quality of the canal west of the proposed site will be addressed through minimization of exposed soil from erosion, construction of silt traps, interceptor drains and sedimentation pits around work areas and camp site. 170. The contractor must also ensure to clean construction vehicles within paved surfaces to lessen contamination of soil and groundwater. As part of the Contractor’s EMP, the contractor must implement the wastewater management plan. The contractor will be responsible for compliance with the Ministry of Environment Decree No. 68 / 2016 guideline value and WB – IFC EHS Guidelines on wastewater discharge standard.

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171. Impact from generation of solid wastes and hazardous wastes. The project will generate different types of solid wastes (wastes from cut trees, spoil, construction wastes and hazardous wastes (used oil, used batteries, CFLs, electronic wastes, etc.) that can negatively the environment and workers and people. During land clearance, vegetation, which includes the cutting of 42 trees and other small vegetation, will generate organic wastes from trunks, leaves and roots that may contaminate waterways. The usable lumber will be sold to wood processors in Sumatra. Construction of buildings and associated facilities entail the movement into the site of large volume of sand and gravel for ground preparation. This activity will generate construction wastes, although the volume cannot be ascertained yet. Construction of buildings will generate both general wastes and hazardous wastes. 172. For solid wastes, contractor must implement a waste management plan as part of Contractor’s Environmental Management Plan (CEMP). The contractor must ensure to put up waste collection points for construction, non- hazardous and domestic solid wastes; and hazardous waste temporary storage (TPS) for hazardous wastes. The contractor will also ensure to install garbage receptacles at worker camp and construction area. The contractor may enter into partnership with private contractor for the collection, treatment and disposal of wastes to comply with Solid Waste Management Act No. 18 (2008) and Act No. 32 (2009). Another option is to directly coordinate with Bandar Lampung City for the management of wastes. Solid wastes must be properly segregated into biodegradable, recyclable, residual and hazardous wastes. Some of the construction wastes (consisting of concrete and rubble, steel rods, damaged formworks, paper) that can be recycled must be separated. 173. For hazardous wastes, the contractor will ensure compliance with national regulations, international commitments where Indonesia is a party, and WB - IFC Environment, Health and Safety Guidelines (2007) on hazardous waste storage, transportation and treatment and disposal. Hazardous wastes generated during construction, which include fuel and chemicals, among others, should be stored to prevent or control accidental releases to air, soil and water resources. Stored waste should have physical separation or containment curbs, and should be stored in closed containers away from direct sunlight, wind and rain. There should be adequate ventilation where volatile wastes are stored. 174. On-site and off-site transportation of waste should be conducted to prevent or minimize spills, releases, and exposures to workers and the public. All waste containers designated for off-site shipment should be secured and labeled with the contents and associated hazards, be properly loaded on the transport vehicles before leaving the site, and be accompanied by a shipping paper (i.e., manifest) that describes the load and its associated hazards. The shipping document should establish a chain-of-custody using multiple signed copies to show that the waste was properly shipped, transported and received by the recycling or treatment/disposal facility. In case of third-party hazardous waste transporter, employees involved in the transportation of hazardous materials should be trained regarding proper shipping procedures and emergency procedures. 175. Increase in the level of air pollutants and noise. The movement of vehicles carrying aggregates and construction materials will disturb the soil that will generate increased level of air pollutants. The dominant monthly average wind direction in the site is towards the northwest and north direction, and to a lesser extent, south and southeast directions. This will impact residential units and establishments across Jalan Jauhari Wahid, Rajabasa terminal and commercial and institutional establishments.

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176. To mitigate the impact of increased level of particulate matter resulting from soil disturbance and pollutants coming from vehicles, contractor will ensure that the wheels of vehicles transporting aggregates and other materials are thoroughly washed, use of dust curtains and covering of material piles during high wind condition. Imposition of speed limit within the compound will also be enforced to lessen disturbance of the soil. The contractor must also ensure that their vehicles meet the regulatory requirement on air quality. Watering of exposed soil will be done to prevent suspension of particulate matter. Construction materials will be covered with canvas to prevent erosion and dispersion of materials. Dust suppression techniques should be implemented, such as applying water to minimize dust from vehicle movements. 177. Drivers will also be trained on good driving practices, including driving within safe speed limits and measured acceleration to prevent to lessen dust. Contractor must also ensure that all air emission licenses and permits of construction machineries and equipment are updated. Contractor must also ensure to implement a regular vehicle maintenance and repair program. The Contractor will ensure to comply with either GR No. 41/1999 on Air Pollution Control or WB – IFC EHS Guidelines 2007 on air quality standards, whichever is stricter. The Contractor will also comply with Ministry of Environment Decree No. 48 of 1996 or WB – IFC EHS Guideline on Noise. The contractor will also be required to monitor air quality standards and noise, together with other parameters, quarterly, to ensure compliance. This will be defined in the Environmental Monitoring Plan. 178. Fencing of the compound, with higher elevation at the right angle in north and northwest sides will serve as barrier to dust blowing in north and northwest directions, thus containing the pollutants in the project location. Exposed workers will also be required to wear appropriate personal protective equipment (PPE) such as masks and goggles. Workers most exposed to excessive noise must wear hearing protection and must only have limited exposure time.

Figure 28. Prevailing Wind Directions (North, Northwest and South and Southeast)

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179. Timing of operation that avoids sensitive hours, shielding of noise sources, and proper maintenance and operation of equipment will also be implemented. Work will be restricted between 8:00 AM and 5:00 PM. UNILA will also temporarily schedule classes and activities in buildings not directly affected by the construction activities. Workers exposed to high level of noise will be required to wear ear muffler. Dust suppression techniques should be implemented, such as applying water to minimize dust from vehicle movements. Workers will also be prohibited from open burning of wastes. The Contractor will prepare all the mitigation measures in the emission and noise management plan as part of the CEMP. 180. Loss of aquatic biota. The construction activities will generate sediments and could result in oil leakages from machineries, that (without control measures) could be transported to the canal on the west side of the proposed project through runoff. This may impact the aquatic biota in the canal and downstream waterways. To mitigate the impact, the contractor must implement soil erosion prevention and stabilization practices and use of filter sediment prior to run-off of sediments to open canal. Contractor must also ensure that their construction machineries and equipment are properly maintained. The Contractor must also prepare spill prevention, reporting and cleanup procedures to handle oil and chemical spills. 181. Strain in public services such as collection of wastes and provision of water supply. The construction of the teaching hospital and integrated research center, and other associated facilities will generate different types of wastes – construction wastes (concrete, wood, plastic, plumbing fixture, lighting fixture, etc.) domestic wastes (food and food packaging) and wastewater from workers, and hazardous wastes (oil, used battery, electrical and electronic wastes, solvents, chemicals, and paints, etc.). If not properly managed, these will impact the health of the community and workers themselves, in addition to contributing to environmental degradation and strain on public services. 182. UNILA will require contractor to coordinate with relevant agencies for the collection of wastes and provision of water supply. The contractor must require its workers to practice segregation of wastes and to implement the CLAYGO (clean as you go) in managing solid wastes. 183. Impacts from transportation of construction materials and wastes. The movement of vehicles that will be used for construction will contribute to the volume of traffic passing through Soemantri Brodjonegoro and H. Z.A. Pagar Alam. The contractor will prepare and implement traffic management plan as part of the Contractor’s EMP, in coordination with the Traffic Management Office of the city to manage the traffic in the area. The plan will include driving policy, roles and responsibilities of drivers, workers and management, traffic management procedures, site layout and traffic flow pattern and schedule, road safety rules, training and vehicle inspection registries, road safety records and incident reports, and performance reports. The contractor must set speed limit for all construction vehicles and install traffic warning signs within the project site. The contractor must also conduct regular orientation and capacity building on safe driving for drivers and workers. Contractor must also be responsible for regular vehicle maintenance and use of genuine parts to prevent malfunction that may lead to accident. Warning and informatory signs will also be put up along the two roads. There will be prior coordination with the affected stakeholders prior to commencement of construction. 184. Occupational health and safety of workers. During construction phase, approximately 60 workers will be hired, 40%, or equivalent to 24 workers of which will require accommodation in the construction camp. To provide workers with safe and healthy working conditions, including accommodation, the Contractor must prepare workers’ accommodation plan as part of the CEMP

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that includes the following: details on the space allocated per person, supply of safe water that will cover all personal and household uses, adequate sewage and garbage disposal system, ensure that accommodation will protect workers against heat, cold, damp, noise, fire and disease-carrying animals, adequate sanitary and washing facilities, good ventilation, provision for cooking, and storage facilities with natural and artificial lighting.35 185. Workers are also faced with different occupational health and safety hazards. These include physical (noise and vibration), biological (viruses, bacteria, parasites, insects, etc.), chemical (dusts, vapor, mists, etc.), and ergonomic risks (exhaustive physical exertion, lifting of heavy load, working in heights and confined spaces, etc.). 186. Workers exposed to high noise levels (i.e., 90 dBA) may suffer from physical and psychological stress, reduced productivity, interference with communication and concentration, and may contribute to workplace accidents and injuries due to difficulty in hearing warning signals36. Workers who are exposed to repeated exposures to high levels of vibration may suffer from hand-arm and whole-body vibration. Hand-arm vibration exposure, is a known contributing factor to carpal tunnel syndrome and other ergonomic-related injuries. It also causes direct injury to the fingers and hand that affect feeling, dexterity and grip.37 187. Biological safety hazard comes from any biological organism that may pose as threat to worker’s health. These may include mold and fungi, bloods and body fluids, sewage, airborne pathogens such as the COVID 19, insects, animal and bird droppings and plants that may cause harm. Chemical hazards, which includes air pollution from dusts and construction materials can affect lung function, cause lung diseases and acute respiratory diseases. Ergonomic hazards account for the most injuries that occur in a construction project. Some of the ergonomic practices that lead to workers’ injury include heavy and frequent lifting, repetitive tasks, awkward handgrip, postures using excessive force and hand intensive work. Traffic incidents and accidents may happen during transport of construction materials and movement of vehicles. 188. To mitigate various occupational and safety hazards, the Contractor will prepare and implement occupational health and safety plan as part of the CEMP, format of which is based from Section 2.0 of World Bank – IFC EHS Guidelines on Occupational Health and Safety.38 189. To mitigate excessive noise, no worker should be exposed to a noise level greater than 85 dB(A) for a duration of more than 8 hours per day without hearing protection. In addition, no unprotected ear should be exposed to a peak sound pressure level (instantaneous) of more than 140 dB(C). The use of hearing protection should be enforced actively when the equivalent sound level over 8 hours reaches 85 dB(A), the peak sound levels reach 140 dB(C), or the average maximum sound level reaches 110dB(A). Impact of vibration can be lessened through choice of equipment, installation of vibration dampening pads or devices, and limiting the duration of exposure. Electric hazard from exposed or faulty electrical device can be mitigated by such measure as marking all energized electrical devices and lines with warning signs and protecting

35 International Finance Corporation. Workers’ Accommodation: Processes and Standards. A Guidance Note by IFC

and EBRD. August 2009. 36 United States Department of Labor. Occupational Safety and Health Administration. Occupational Noise Exposure. 37 R. Brauch. 2015. Vibration Hazards in the Workplace: The Basics of Risk Assessment. Occupational Health and

Safety online. 38 International Finance Corporation (WorldBank group). Environmental, Health, and Safety (EHS) Guidelines, General

Ehs Guidelines: Occupational Health and Safety.

https://www.osha.gov/SLTC/noisehearingconservation/healtheffects.html

https://ohsonline.com/Articles/2015/02/02/Vibration-Hazards.aspx

https://www.ifc.org/wps/wcm/connect/1d19c1ab-3ef8-42d4-bd6b-cb79648af3fe/2%2BOccupational%2BHealth%2Band%2BSafety.pdf?MOD=AJPERES&CVID=ls62x8l.

https://www.ifc.org/wps/wcm/connect/1d19c1ab-3ef8-42d4-bd6b-cb79648af3fe/2%2BOccupational%2BHealth%2Band%2BSafety.pdf?MOD=AJPERES&CVID=ls62x8l.

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power cords and extension cords against damage from traffic by shielding or suspending above traffic areas. 190. Contractor shall require workers with high exposure to hazards to wear personal protective equipment (PPE) such as face and eye protection device with side shields, welder goggles for welding and hot works, gloves, facemasks with appropriate filters for dust removal, plastic helmets with top and side protection, body suits, and safety shoes and boots. Contractor must also implement fall prevention and protection measures for workers exposed to falling hazard. These include installation of guard rails, proper use of ladders and scaffolds, and use of fall prevention devices such as safety belt. The Contractor should also provide first aid attendant for the project as well as medical kit to treat workers’ injuries and illnesses prior to transportation to hospital. 191. To mitigate exposure from chemical hazards, contractor will train workers in the use of MSDS of chemicals used in the construction site, safe work practices, and appropriate use of PPE. To lessen risk of fire, flammables should be stored away from entry and exit points of buildings, and storage area should have natural floor and ceiling level ventilation. Fire extinguishers must also be installed in workers’ camp and in construction site. 192. For biological hazards, the Contractor must review and assess known and suspected presence of biological agents and implement safety measures, monitoring and training. The Contractor must also ensure and enforce hygiene among workers and to allow sick workers not to continue working in the construction site. Breeding grounds of vectors such as mosquitoes should be kept free from stagnant water. The premises must be kept clean to ensure cleanliness and not to attract pests such as rodents and cockroaches. 193. To address ergonomics and other health hazard, the contractor must provide emergency and health services on site to address worker’s injury and illness, including access to ambulance and medical services from nearby hospitals. 194. Community health and safety. The proposed construction of teaching hospital and integrated research center will also impact the public since the main access to UNILA–Zainal Abidin Pagar Alam, is considered a major busy road. Being the bus terminal hub of the city, Rajabasa also attracts commuters going to and from other parts of Lampung Province. 195. The contractor must restrict the access of the public to the site as the construction posed hazards for the community. These include accidents associated with building structure failure, injuries from falls, open excavation or contact with heavy equipment, respiratory problems from dust and fumes, and exposure to hazardous materials. 196. To lessen the impact of the project on the community’s health and safety, the contractor must restrict access of the public to the site through fencing the perimeter of the construction site, installation of signages, assigning guards at entrance and exit, and by informing the public through consultation. The contractor must also ensure that there are no hazardous conditions inside the project site such as open excavation and unstable piles. 197. As traffic accidents have become one of the most significant causes of injuries and fatalities among members of the public worldwide, the project must prioritize and promote traffic safety during construction phase when project equipment and machineries were utilized that may impact the safety and health of the public. In Indonesia, there were 28,297 (2014 est.) road traffic fatalities, representing 3.0 per cent of GDP loss. The road user groups most represented in road

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traffic deaths were riders of motorized 2- or 3-wheeled (36 per cent), drivers/ passenger buses (35 per cent) and pedestrians (21 per cent).39 198. To prevent and control traffic related injuries and fatalities caused by construction vehicles carrying construction materials, contractor must adopt safety measures to protect workers, road users and pedestrians. These measures include hiring professional licensed drivers and training them on safe driving, limiting the duration of trips to avoid overtiredness, and regular maintenance of vehicles and use of manufacturer approved parts to minimize potentially serious accidents caused by equipment malfunction or premature failure. 199. The movement of vehicles carrying construction materials may generate dust that may affect the air quality in surrounding areas and may also impact the health of the people. The contractor must require covering trucks carrying construction materials to prevent dispersion of dust during transport. 200. To mitigate various community health and safety hazards, the Contractor will prepare and implement emergency response plan as part of the CEMP to primarily assist staff and emergency response teams during real life emergency that may also affect the community.

c. Operation Phase

201. Management of solid wastes, including hazardous wastes. The operation of teaching hospital and integrated research center will generate wastes from people working in the two facilities and from hospital patients. Assuming that the hospital will employ 600 full time staff and 200 part-time staff for the hospital, and another 100 for the integrated research center, and that each person will generate 0.7 kg/person/day and that each person will only stay for 0.5 day, the average domestic wastes from the two facilities is 315 kg/day. In addition, since it was estimated that the training hospital will host 150 beds and 200 beds after 6th year of operation (Readiness Criteria Project Proposal, University of Lampung, 2020), the estimated hazardous waste per hospital bed per day is about 30 to 40 kg/day using the 0.2 kg per hospital bed per day estimate of WHO for low-income countries.40 In total, the total generated waste for the project during operation is 355 kg/day, 13% of which or 40 kg is considered hazardous. This is close to WHO estimate that 85% of wastes generated by hospitals worldwide are general, non-hazardous wastes. The remaining 15% will be considered hazardous materials that maybe infectious, toxic or radioactive.41 These hazardous wastes include:

• Infectious waste: waste contaminated with blood and other bodily fluids, cultures and stocks of infectious agents from laboratory work, or waste from patients with infections;

• Pathological waste: human tissues, organs or fluids, body parts and contaminated animal carcasses;

• Sharps waste: syringes, needles, disposable scalpels and blades, etc.; • Chemical waste: solvents and reagents used for laboratory preparations, disinfectants,

and heavy metals contained in medical devices and batteries; • Pharmaceutical waste: expired, unused and contaminated drugs and vaccines; • Cyctotoxic waste: waste containing substances with genotoxic properties, such as

cytotoxic drugs used in cancer treatment and their metabolites;

39 ASEAN Secretariat. 2016. ASEAN Regional Road Safety Strategy. Jakarta; The ASEAN Regional Road Safety

Strategy has been produced with the support of Asian Development Bank (ADB) Technical Assistance 8075-REG: Improving Road Safety in ASEAN, financed by the Japan Fund for Poverty Reduction.

40 Ibid. 41 WHO. https://www.who.int/news-room/fact-sheets/detail/health-care-waste (accessed on 10 March 2020).

http://asean.org/storage/2016/10/ASEAN-Road-Safety-Strategy_full_24Oct16_rev_clean.pdf

https://www.who.int/news-room/fact-sheets/detail/health-care-waste

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• Radioactive waste: such as products contaminated by radionuclides including radioactive diagnostic material or radiotherapeutic materials; and

• Non-hazardous or general waste: waste that does not pose any particular biological, chemical, radioactive or physical hazard.42

202. Adverse risks to workers and the community associated with health care wastes include sharps-inflicted injuries; toxic exposure to pharmaceutical products, chemical burns from disinfection, sterilization or waste treatment activities, air pollution from release of particulate matter during medical waste incineration, thermal injuries, and radiation burns. Treatment and disposal of healthcare waste may also pose health risks through the release of pathogens and toxic pollutants into the environment. 203. RSPTN UNILA will abide by the guidelines of Solid Waste Management Act No. 18 / 2008 and Act No. 32 / 2009 (Environmental Protection Act) in its solid waste management planning and implementation for the facility. The former regulates solid waste management, mainly on municipal waste management. Act No. 32/2009 regulates industrial waste and hazardous wastes. RSPTN will also be guided by the Indonesian Ministry of Environment and Forestry Regulation No. 56 of 2015 concerning "Procedures and Technical Requirements for the Management of Hazardous and Toxic Waste Materials from Health Service Facilities". Government Regulation No. 101 of 2014 on Management of Toxic and Hazardous Waste Substances (GR No. 101 of 2014) requires all hazardous waste generators to notify the Authority on their hazardous waste generation and management. The HWM service providers are also required to apply for permits/licenses from the Environmental Authority and the Environmental Authorities are obliged to control and take necessary actions for any noncompliance occurrence. 204. The Ministry of Environment and Forestry Regulation No. 56 of 2015 concerning "Procedures and Technical Requirements for the Management of Hazardous and Toxic Waste Materials from Health Service Facilities" requires labelling and symbols for hazardous materials and waste, waste reduction, segregation, storage, transportation (manifest), treatment and handling (with autoclave, incineration), health workers’ occupational health and safety and public health and safety. 205. MOH Decree no 1204/Menkes/SK/X/2004 (aligned with WHO’s guidelines) require HCFs to apply measures in the handling of medical liquid wastes. MoE Decree No 58/1995 on Hospital Effluent Discharge Standard includes pH, BOD, COD, Temperature, NH3, PO4, Microbiology (e-Coli) and Radioactive (11 elements, 12 isotopes). MOH Regulation No 37/2012 about Laboratory Management for puskesmas covers provisions about liquid and hazardous waste from hospital laboratory. 206. To manage general, non-hazardous wastes, the management must install 3 types of solid waste containers with the following labels: biodegradable or organic (food waste, kitchen waste, paper), recyclable (plastics, glasses and metals), and residuals. The management will engage solid waste management service to manage the cleaning of facilities, and collection of wastes. All domestic wastes must be collected, segregated, and transported to common solid waste management facility. The collected wastes will be transported by a licensed collection / treatment company to materials recovery facility and finally, at the disposal facility of the city. 207. To manage hazardous wastes, RSPTN UNILA will implement the provisions of Ministry of Environment and Forestry Regulation No. 56 of 2015 concerning "Procedures and Technical

42 Ibid.

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Requirements for the Management of Hazardous and Toxic Waste Materials from Health Service Facilities" requiring labelling and symbols for hazardous materials and waste, waste reduction, segregation, storage, transportation (manifest), treatment and handling (with autoclave, incineration), health workers’ occupational health and safety and public health and safety. The management will engage accredited third-party hazardous waste service provider that will transport and process said wastes in Jakarta. As per WHO guidelines, only modern incinerators operating at 850–1100 °C and fitted with special gas-cleaning equipment are able to comply with the international emission standards for dioxins and furans will be acceptable for the project. Alternatives to incineration such as autoclaving, microwaving, steam treatment integrated with internal mixing, which minimize the formation and release of chemicals or hazardous emissions should be given consideration in settings where there are sufficient resources to operate and maintain such systems and dispose of the treated waste. 208. Within the project site, the management must designate a specific storage zone for hazardous waste. The facility should be lined, with enclosed walls and roofs to store hazardous waste containers. The management should actively promote waste segregation to avoid hazardous waste mixing with general wastes. The management must also initiate regular training on safe practices to handle hazardous wastes. Appropriate PPEs will also be required for the workers. 209. Management of wastewater. The outfall of the wastewater coming from the teaching hospital and research center is a canal located west of the project site, about 50 meters from the boundary of the project. Based on the measurement conducted in 2020 by ATL, the following parameters did not meet Indonesian standard on water quality: BOD5 (8 mg/L vs 6 mg/L as standard), chlorine (Cl2) (0.02 vs 0.003 mg/L), hydrogen sulfide (H2S) (0.05 vs 0.002 mg/L), phenol compounds (0.004 vs 0.001 mg/L), fecal coliform (160,000 vs 2,000 MPN/100 ml) and total coliform (160,000 vs 10,000 MPN /100 ml). As regulated under MoE Decree No 58/1995 on Hospital Effluent Discharge Standard, the following parameters will be monitored: pH, BOD, COD, Temperature, NH3, PO4, Microbiology (e-Coli) and Radioactive elements (11 elements, 12 isotopes). 210. The estimated wastewater that will be generated from the operation of teaching hospital and integrated research center during operation will be 139.0 m3.43 The project will install a wastewater treatment system that will meet the effluent standard for water following Ministry of Environment Decree No. 48 of 1996 and WB-IFC EHS Guidelines. RSPTN UNILA aims to reuse the effluent for flushing toilets and irrigating plants, design of which will be finalized in detailed engineering design phase. 211. Impact on use of resources. Solar power will be utilized to complement the power from the grid. To preserve water, the hospital building will also be equipped with water retention facility in the roof area which will then be distributed to the rainwater reservoirs located in the jogging track area. In addition, at some points in the park area around the RSPTN building, biopori will be provided to increase the water infiltration capacity in the soil. Treated effluent will be used for flushing toilets and for watering plants. D. Climate Change Impacts

43 This report. See Description of the Environment. Basic municipal services. Wastewater collection and treatment (para

125).

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212. Based on the analysis of climate baseline conditions and future climate change scenario, the project will be affected by increase in surface temperature, increase in rainfall, and extreme occurrences of precipitation. Because of the project’s elevation and distance from the sea, the project will not be affected by increase in sea level temperature and sea level rise. The potential climate change impacts and proposed adaptation measures are discussed below.

Table 27. Potential Climate Change Impacts and Proposed Adaptation Measures Climate Change

Indicator Potential Climate Change Impacts Proposed Adaptation Measures

Surface Temperature Increased evapotranspiration that can lead to drought, which will impact vegetation planted in teaching hospital building

Effluent from wastewater and surface runoff from rainfall will be reused to supplement the water supply from the city, and the groundwater source.

Increased spread of diseases through air medium that may impact hospital capacity to treat patients

Capacity building of medical personnel to handle increased risk of spread of diseases. Upgrading of equipment to handle spread of diseases.

Increased demand for power supply for airconditioning and preservation of food for the hospital

Utilize solar PV panels to complement the power supply from the grid. Use of fins and secondary skin as shading for the façade of the building. Use of skylight and skygarden to utilize natural light, and to lessen localized temperature.

Rainfall Drought caused by deficit in total precipitation that will lessen the groundwater that will supply the need of the project

Reuse of water for flushing toilets and to irrigate vegetation.

Flooding from increased total, duration, and intensity of rain, that may impact the capacity of drainage canals where the project’s surface runoff and effluent will also drain

In coordination with local government, increase capacity of drainage canals to accommodate flood water.

Extreme Occurrence Extreme precipitation from December to February that may result to flooding of drainage and oversoaking of vegetation planted in RSPTN

Modification of drainage canals within the project to accommodate extreme precipitation. Modification of drainage of skygarden to prevent flooding and oversoaking of plants.

E. Analysis of Alternative 213. The project only considers the no project option since UNILA has not considered other alternative sites, other than the 58,104.92 m2 lot at the corner of Jalan Soemantri Brodjonegoro and Jalan Z.A. Pagar Alam. This is reflected in the site development plan (Figure 1). 214. The no project option means that without the teaching hospital and integrated research center, the students of Faculty of Medicine will continue to access other teaching hospital in Bandar Lampung, such as Abdul Moelek General Hospital. With constrained access, the students will continue to have limited exposure to medical cases. With limited clinical teaching, the decline in the percentage of UNILA Faculty of Medicine graduates passing the government-administered National Licensing Examination on their first attempt will continue. 215. If the integrated research center will not be constructed and operationalized, the research and innovation capacity at UNILA will be further constrained. At present, there is essentially no dedicated facility for conducting medical research except for a shared facility that is used by other UNILA Faculties and researchers. Since the IRC is designed to support Faculty of Medicine lecturers to do research in collaboration with other faculty within UNILA and abroad, this will not

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happen if IRC will not materialize. Thus, it is of paramount importance for UNILA to construct both the teaching hospital and integrated research center.

VI. INFORMATION DISCLOSURE, CONSULTATION AND PARTICIPATION

A. Information Disclosure

216. In line with the Access to Information Policy of ADB (2018), the Initial Environmental Examination (IEE) Report for the project will be made available in a timely manner, in an accessible place, and in a form and language that will be understood by affected people and other stakeholders. The purpose is for affected people, including the general public, to provide meaningful inputs into project design and implementation. As this version of the IEE is based on the conceptual design, updated IEE reflecting detailed engineering design, which incorporates further inputs and feedbacks of all concerned stakeholders, will also be made available to the public. 217. ADB will post the following safeguard documents on its website: final or updated initial environmental examination upon receipt; and environmental monitoring reports submitted by UNILA / Ministry of Education and Culture during project implementation upon receipt. B. Key stakeholder consultation during project preparation

218. Safeguard Policy Statement 2009 (SPS) requires project proponents to carry out meaningful public consultation that begins early and carried out throughout the project cycle and to provide timely disclosure of relevant information that affected people can understand and can be easily accessed. Moreover, SPS also requires that consultations be free from coercion, be gender inclusive and caters to the needs of disadvantaged and vulnerable people, and that all relevant views of affected people are considered. 219. The environment consultant, Mr. Lizandro Racoma, met with the Proposal Team of RSPTN UNILA on March 2, 4 and 6 to discuss ADB’s environmental safeguards requirements, AMDAL’s environmental safeguards requirements, and the status of project preparation. The Consultant also met with the Faculty of Medicine (Facultas Kedokteran) on March 2 to discuss the proposed teaching hospital and integrated research center. 220. During the discussion with the Proposal Team, the team updated the status of the project. The PIC envisions the project to follow green building concept for environment sustainability. This will be done through the use of skylight in the building to maximize the entry of sunlight, use of solar power to supplement the supply from the grid, and recycling of wastewater. Dr. Andius Putra of Facultas Teknik provided the information on the design being earthquake resilient and the green building concept for RSPTN UNILA and IRC UNILA. Dr. Agus Setiawan also made the presentation on the AMDAL process and the baseline and secondary information collected necessary for the submission of IEE document to the Ministry of Environment and Forestry, and ADB. 221. The Consultant also met with Dr. Dyah Wulan SRW, S.K.M., M.Kes, the Dean of Facultas Kedokteran. The dean provided updates on the ongoing program of the college and how the proposed construction of teaching hospital and integrated research center will upgrade their medical program.

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222. The consultations with different government offices – the City Health Office, the City Environment Office and the City Traffic Management Office were done on March 3 and 5, 2020. The City Health Office reminded UNILA on the requirements for transport and treatment of hazardous wastes, including infectious wastes from the operation of the hospital. It was mentioned during the meeting that UNILA need to secure the services of third-party provider to properly manage the teaching hospital and integrated research center’s hazardous wastes. 223. The City Environment Office, who provided the secondary information on air, water and noise levels around the proposed project, mentioned that their office is ready to assist the project in monitoring environmental parameters during construction and operation phases of the project. 224. The Traffic Management Office also committed to provide assistance to the project during construction phase to monitor and manage the traffic in Jl. Soemantri Brodjonegoro and H. Z.A. Pagar Alam. Depending on the volume of traffic that the project will generate, the project may require the preparation of traffic impact assessment. 225. The complete list of stakeholders is detailed below, while the photographs of consultations are attached in Error! Reference source not found..

Table 28. Summary of Consultation with UNILA and Relevant Agencies Office Name Designation

Universitas Lampung

Dr. Satria Bangsawan Proposal Team member, Facultas Economic dan Bisnis

Dr. Andius Putra Proposal Team member, Facultas Teknik

Dr. Muhartono Proposal Team member, Facultas Kedokteran

Dr. Heri Satria Proposal Team member, Facultas Matematika dan Ilmu Pengetahuan Alam

Dr. Agus Setiawan Proposal Team member, Facultas Pertanian

Dr. Helmy Fitriawan Proposal Team member, Facultas Teknik

Susi Sarumpaet Proposal Team member, Facultas Economik dan Bisnis

Dr. Elida Purba Proposal Team member Facultas Teknik

Dr. Rizki Hanriko Proposal Team member, Facultas Kedokteran

Diah Sumardiani Secretariat Team, UNILA

City Health Office Hartono Sipayung Section Chief

City Environment Office

Haris Fadillah Section Chief

City Traffic Management Office

Iskandar Section Chief

226. In view of the corona virus disease (COVID 19) pandemic in Indonesia and the rest of the world, resulting in nationwide lockdown that restricted large-scale social restrictions (Pembatasan Sosial Berskala Besar or PSBB) for some regencies and cities, consultation with surrounding communities has yet to be conducted. Public consultation will be conducted prior to construction activities.

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VII. GRIEVANCE REDRESS MECHANISM

A. Grievance Redress

227. Safeguards Policy Statement (SPS) requires the borrower to establish a grievance redress mechanism (GRM) to receive and facilitate the resolution of environment-related issues and concerns affecting the project. A project-specific grievance redress mechanism will be established for the teaching hospital and integrated research center, to receive, evaluate and facilitate the complaints / grievances of affected persons on the environmental performance of the established facilities. 228. Rumah Sakit Pengguruan Tinggi Negeri (RSPTN) Universitas Lampung will establish a Grievance Redress Committee (GRC) that will address the issues raised by affected people on the project. The Rector will appoint the head and members of the committee. The members will come from different colleges (fakultas). During construction, the GRM will also include as its members: i) Project Implementation Consultant (PIC); ii) Designated Safety, Health and Environment Officer from the Contractor; (iii) Representative from Kecamatan Rajabasa (Rajabasa District). During operation, the committee will be designated by the Board of Directors of RSPTN. 229. For the quick filing of complaints, the GRC will use the attached grievance intake form (Error! Reference source not found.). RSPTN will be responsible for registration of grievances and communication with the aggrieved party. 230. The steps to be followed in filing complaints and the procedures for redress during construction phase are the following:

(i) Complainant will provide the background and file the complaint verbally or in writing to RSPTN. GRM committee will assist the complainant in filling-up the grievance intake form;

(ii) Within 2 working days, RSPTN, contractor’s representative, the Project Implementation Consultant and the complainant will discuss if the complaint can be resolved without calling for a GRC meeting;

(iii) Within 3 days of lodging the complaint, RSPTN will provide the complainant a written feedback on the process, steps and timeframe for resolving the complaint.

(iv) If the complaint cannot be resolved, a GRC meeting with the complainant will be called within 5 working days;

(v) The GRC will have 15 working days to resolve the complaint; (vi) The complainant will receive feedback from RSPTN within 5 working days after the

various steps of the GRM are completed. (vii) If the complainant is not satisfied with the feedback from RSPTN, the complainant

has the option to access the Government's judicial, administrative remedies or through concerned government agencies (e.g., City Environment Office, City Health Office, or the Ministry of Environment and Forestry).

231. The steps to be followed during operation will be the same, except that the contractor’s representative and the PIC will no longer be involved. 232. The GRC will receive, follow-up and prepare monthly reports regarding all complaints, disputes or questions received about the Project and corresponding actions taken to resolve the

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issues. These reports will be included in the semi-annual environmental monitoring reports to be submitted by UNILA to Ministry of Education and Culture and to ADB. B. ADB’s Accountability Mechanism

233. In case issues are not resolved through the GRM, affected persons may elevate their complaint to Indonesia ADB resident mission (IRM) in Jakarta. The complainant can elevate the case further through the ADB’s accountability mechanism in case issues are not resolved through the GRM and ADB resident mission. The accountability mechanism provides opportunities for people that are adversely affected by ADB-financed projects to express their grievances, seek solutions, and report alleged violations of ADB’s operational policies and procedures, including safeguard policies. ADB’s accountability mechanism comprises of (i) consultation led by ADB’s special project facilitator to assist people adversely affected by ADB-assisted projects in finding solutions to their concerns and (ii) providing a process through which those affected by projects can file requests for compliance review by ADB’s Compliance Review Panel.

VIII. ENVIRONMENTAL MANAGEMENT PLAN

234. The environmental management plan (EMP) was prepared based on the policy principles outlined in SPS 2009. The plan includes proposed mitigation measures, requirements for environmental monitoring and reporting, the proposed institutional arrangement, capacity development and training needs, performance indicators, implementation schedule and cost estimates to implement the EMP. Mitigation of potential adverse impacts identified in Chapter V were proposed, with the objective of no significant harm and in consideration of the polluters’ pay principle. 235. In general, the short-term construction impacts from the construction of teaching hospital and integrated research center can be prevented or mitigated with good construction management practices. The EMP includes mitigation measures to prevent or minimize construction impacts in line with the relevant provisions of the Environmental Health and Safety Guidelines of the World Bank Group (2007) for the guidance of UNILA, RSPTN UNILA, the Project Management Unit (PMU), Project Implementation Consultant (PIC), the Contractor and their subcontractors, to address environmental issues during construction. The EMP, which includes mitigation measures, responsible parties to implement and supervise the application of mitigation measures to address environmental impacts, performance indicators, and the cost of implementation, will be included in the bid specifications and contracts for civil works. A. Institutional Arrangement and Capacity Development

236. Part of the implementation of environmental management plan is the related institutional or organizational arrangement and capacity development for different parties involved in its implementation and supervision. The key organizations and their respective responsibilities in the EMP implementation are detailed below. 237. Ministry of Education and Culture (MOEC). As the executing agency for HETI Project, MOEC has the overall responsibility for preparation, implementation, supervision and financing of environmental safeguard management and monitoring tasks of the project, sub-projects at university level, and inter-agency coordination. MOEC will exercise its function through Project Management Unit (PMU) which will be responsible for project execution, coordination, monitoring and project management on a day-to-day basis. MOEC focuses its efforts on overall management,

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coordination, and monitoring and reporting at project level, and oversight and support of both ITS and UNILA. 238. Project Management Unit. The PMU already established in MOEC will be augmented sufficiently to implement the project and coordinate the activities of the universities under HETI – ITS and UNILA. The PMU is headed by a Project Director who will be supported by a team of full- time and part-time staff and consultants engaged under different project arrangements. PMU will be responsible for overall project management, coordination, supervision, supporting the universities, and reporting and monitoring at project level. PMU will also coordinate with BAPPENAS, Ministry of Finance and other concerned ministries and agencies. 239. The PMU will be supported by a team of consultants for carrying out project management, coordination, monitoring and supervision, including environmental safeguard management and monitoring. In the implementation of environmental management and monitoring tasks specific technical assistance will be provided by a national environmental specialist attached to PMU. The specialist will assist the PIUs in all aspects of implementation of environmental assessment and management, internal monitoring and evaluation (M&E), and training of PMU, PIU and other relevant government agencies. More specifically the PMU will be responsible for the following activities related to environmental safeguards:

(i) Confirm that the IEE is updated in accordance with ADB‟s SPS based on detailed designs and submit to ADB for review and clearance prior to contract award;

(ii) Confirm that for each HEI the required AMDAL or DELH, a GOI requirement, has been prepared during detailed design and approved by the respective environment agency, the Dinas Lingkungan Hidup (DLH)

(iii) Confirm that PIUs have included the IEE/EMP in the bidding documents and civil works contracts;

(iv) Ensure that the PIUs check that Contractor’s EMPs (CEMPs) are prepared by contractors prior to actual construction;

(v) Establish with the PIUs a system to monitor environmental safeguards of the subprojects including monitoring the indicators set out in the monitoring plan of the EMP;

(vi) Supervise the implementation of environmental mitigating measures required for the construction activities by the PIUs;

(vii) Review, monitor and evaluate the effectiveness of the CEMP implementation together with the PIUs, and recommend necessary corrective actions;

(viii) Verify that the PIUs prepare monthly, quarterly, and semi-annual environmental monitoring reports for submission to PMU;

(ix) Ensure timely disclosure of final IEE and EMP (or AMDAL, or DELH) in locations and form accessible to the public, and

(x) Address, record, and report on any grievances brought about through the Grievance Redress Mechanism either at university or MORTHE level in a timely manner.

240. PMU will prepare and submit to MOEC and ADB semi-annual environmental safeguard monitoring report (Appendix 4). The PMU environmental specialist will assist PMU in the preparation of this report which will incorporate the main items raised through the PIUs and Contractor’s reports and the environmental monitoring reports, as well as all other items required by MOEC and ADB. 241. Project Management Consultant (PMC). The PMU will be supported by a PMC. The PMC will comprise specialists as required to supplement existing PMU resources and deliver a

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capacity building program. In respect of safeguards the PMSC will include a national environment specialist and a national gender/social development specialist. The first inputs of each specialist will be in the early phase of the project to maximize capacity building efforts across number of activities required in first phases of implementation. 242. A capacity building program in environmental assessment and management will be delivered by the environmental specialist (ES). Staff in the MOEC, PMU, PIUs and contractors will receive training and capacity support from the ES to ensure effective implementation of the EMP. 243. Project Implementation Unit. The PIUs at HEI level are responsible for implementation of project activities at university level. They will engage Construction Supervision Consultant (CSC) from a fully qualified firm which will assist the PIU, among others, in the implementation of the EMP. PIU of UNILA will appoint one of their staff to be designated as their environmental officer. The environment officer in PIU must ensure that the required environmental mitigation measures, as reflected in the EMP, are implemented in a timely manner by actively participating in construction supervision. PIU will also address environment-related concerns through the Grievance Redress Mechanism set-up for the project. 244. Construction Supervision Consultant. CSC will be engaged to assist PIU in project monitoring and supervision, including environmental management and monitoring tasks. The CSC, supported by the national environmental specialist from the PMU, will support the PIU: (i) review the revised IEE for its respective university prepared during detailed design stage, (ii) assist PIU in ensuring that EMPs are included in the bidding documents and civil works contracts; (iii) assist the PIU in monitoring of EMP implementation by the contractors, (v) assist PIU in the preparation of monthly and quarterly environmental monitoring reports, and forward them to the PMU for preparation of the semi-annual environmental monitoring reports to be submitted to ADB. An environmental specialist will be included in the CSC. 245. Dinas Lingkungan Hidup as External Environmental Monitor. External environmental monitoring will be done by DLH as required by its mandate. DLH is tasked to prepare and implement regional policies and rules to promote environment protection and conservation. It reports to Mayor (Walikota) through the District Secretary (Sekretaris Daerah / Sekda). Its functions include: (a) formulate and recommend policies on environmental management; and (b) prepare and carry out work plans and programs on environmental management and monitoring. It is responsible for enforcing the AMDAL system and be involved in monitoring environmental parameters such as ambient and effluent quality of air/water. 246. ADB will conduct two review missions per year who will also assess implementation of the IEE and the EMP to ensure compliance with the SPS. 247. The Contractor. The civil works Contractor will be responsible for implementing all contract conditions including those covering environmental mitigation, social mobilization and awareness and monitoring. The Contractor will be responsible for implementing all environmental, health and safety (EHS) actions included in the EMP and relevant clauses in the bidding documents and contract during the pre-construction and construction period. 248. The Contractor will prepare the Contractor’s EMP (CEMP) after contract award based on the specific construction methodologies they propose to use. The CEMP will further develop the EMP contained in this IEE and will detail measures for all environmental health and safety management. The PMU will review and approve the CEMP before implementation.

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249. The Contractor will appoint an environment, health and safety officer (ESO) who will be responsible for regular site inspections to check compliance with the approved CEMP and ensuring implementation of all health and safety requirements. These will be subject to monitoring by PMU and DLH. The responsibilities of the Contractor include:

(i) During orientation by the PIU, familiarize with the EMP and the required mitigation measures to be delivered;

(ii) Appoint an ESO and staff, sending letter to PIU confirming that these positions have been filled up and by whom (the bidding documents and contract specify the roles and tasks of the ESO);

(iii) Seek training and support from PIU on any aspects of environmental management, as required;

(iv) Coordinate with PIU for preparing and submitting the CEMP following detailed design, the ESO will be responsible for ensuring that the Contractor complies with the environment, health and safety related clauses in the contract and bidding documents;

(v) As required, prepare, and submit for approval, appropriate CEMP plans (spoil disposal plan, waste management plan, occupational health and safety plan etc.);

(vi) Engage an eligible service provider to undertake sexually transmitted diseases (STDs) and HIV/AIDS briefings and awareness raising among the contractor’s employees and communities, and reporting on the same;

(vii) Coordinate with PIU for community consultations; and (viii) Undertake daily and weekly site inspections (by the ESO) recording the same in a

site diary and participate in monitoring and coordinating with PIU to ensure that environmental management activities are reported in Monthly Progress Reports as required.

Table 29. Institutional Arrangement for EMP Implementation in UNILA

Unit Unit Functions Responsible for Environmental

Aspects/Functions Consultant/ Functions

Construction Phase

Ministry of Education and Culture

Executing Agency for the HETI; provides technical supervision and responsibility over the financing/ budgeting.

Overall responsible for compliance with SPS and implementation of the IEE and EMP

Universitas Lampung

Implementing Agency Provides overall responsibility for the implementation of the project for RSPTN and IRC

Project Management Unit under the Ministry of Education and Culture

Responsible for the HETI implementation in project cities/ districts; coordinates with ADB and other external agencies.

PMU-environment specialist (to be designated under PMU-PMC); Responsible for overall environmental safeguards compliance and supervision of project/subprojects; Coordinates with PIU- environment officer to ensure environmental safeguards requirements are addressed effectively; Responsible for semi-annual environmental safeguards monitoring reports preparation.

Project Management Consultants (PMC); The national environmental specialist (part of PMC) will: (i) review the revised IEEs prepare during detailed design stage, (ii) assist PMU in ensuring that EMPs are included in the bidding documents and civil works contracts; (iii) assist the PMU, and PIU in monitoring of EMP implementation, (iv) train PMU and PIU staff in environmental safeguards

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and monitoring; and (v) assist PMU in preparation of semi-annual environmental monitoring reports.

Project Implementation Unit (PIU)

Key implementation unit in the field; Provide construction contracts’ supervision; closely monitors construction progress; coordinate with UNILA for its participation in the HETI project before turnover during the operation phase.

PIU-environment officer; responsible for overall environmental safeguards compliance supervision of construction activities; ensure that the Contractor’s EMP is properly implemented and monitored; prepare monthly environmental safeguards monitoring reports; Provide input to the CPMU Environment Officer in the preparation of the semi-annual environmental safeguards monitoring reports preparation; Coordinate with respective Province’s/ City’s/District’s environment agency, Dinas Lingkungan Hidup [DLH] Kota Bandar Lampung; assist the Grievance Redress Committee (GRC) in addressing environmental complaints; PIU chief sits as the Chairperson of the ad-hoc Grievance Redress Committee.

CSC: i) review the revised IEE for UNILA prepared during detailed design stage, (ii) assist PIU in ensuring that EMPs are included in the bidding documents and civil works contracts; (iii) assist the PIU in monitoring of EMP implementation by the contractors, (v) assist PIU in the preparation of monthly and quarterly environmental monitoring reports, and forward them to the PMU for preparation of the semi-annual environmental monitoring reports to be submitted to ADB. An environmental specialist will be included in the CSC. .

Municipal Environmental Agency (DLH)

External environmental monitoring agency (its mandate).

Its function is to: (a) formulate and recommend policies on environmental management and (b) prepare and carry out work plans and programs on environmental management and monitoring. It is responsible for enforcing the AMDAL system. It is also involved in monitoring the quality of different environmental parameters such as air and water quality.

Construction Contractors of the proposed HETI project/subprojects

Implement construction activities; Implement the Contractor’s EMP.

Contractor’s environment officer responsible for implementation of the Contractor’s EMP; coordinate with the PIU-environment officer and DLH; assist the PIU-Grievance Redress Committee in addressing environment related grievances / complaints; Construction Manager or Construction Superintendent sits as a member of the Grievance Redress Committee.

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Operational Phase

Project Implementation Unit (PIU)

Key implementation unit; Responsible for coordinating with DLH during the operational phase.

PIU-environment officer; responsible for overall environmental supervision of operational activities; ensure that the EMP is properly implemented and monitored; prepare semi-annual environmental monitoring reports.

B. Capacity Building

250. The Project Management Supervision Consultant will conduct capacity building for UNILA and RSPTN UNILA on relevant Indonesia’s rules and regulations, ADB SPS, World Bank – IFC EHS Guidelines, environmental management plan, and the grievance redress mechanism for the project. The capacity building on environmental management, including the estimated costs are detailed below.

Table 30. Capacity Building Program for RSPTN UNILA Project Phase

Trainers Attendees Schedule Estimated budget, US $

Source of fund

Construction PMC Environmental Specialist

UNILA and Contractor

Pre-construction and annually during construction

3,000 PMC

Operation PMC Environmental Specialist

UNILA and RSPTN UNILA

Before operation 2,500 PMC

C. Impact Mitigation Plan

251. The anticipated impacts of the project were identified in Chapter V. The mitigating measures with corresponding budget and implementation and supervision responsibilities are presented below. The plan considers the World Bank - IFC EHS General Guidelines, World Bank - IFC EHS Guidelines for Health Care Facilities and applicable Indonesian environmental standards regulations. D. Environmental Monitoring Plan

252. Based on the analysis of impacts in Chapter V where the potential impacts were assessed, the environmental monitoring plan (EMoP) for the EMP focuses on all three phases – pre-construction, construction and operation. The objective of monitoring is to measure the effectiveness of impact mitigation measures, and to document any unexpected positive or negative environmental impacts of the project. 253. The Construction Supervision Consultant and the Contractor will bear bulk of the responsibilities for implementation of environmental monitoring plan while PIU UNILA and MOEC will supervise during construction and operation phases, respectively.

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254. The EMoP will follow the environmental standards of Indonesia while World Bank – IFC EHS Guidelines will supplement standards not provided in the regulations of the country. Applicable standards are indicated in Chapter II. 255. For reporting requirements, the contractor will submit monthly reports on CEMP implementation to PIU UNILA. These include information on complaints received and appropriate action taken, incidents and accidents, contractors’ activities, consultations, information on manpower, equipment, materials and work compliance, implementation status, environmental monitoring, variation order, etc. 256. During the construction phase, based on contractor’s submitted monthly reports, PIU UNILA, with the support of CSC, will prepare the semi-annual environmental monitoring report and submit to MOEC for review and submission to ADB for disclosure. 257. The contractor must restrict the access of the public to the site as the construction posed hazards for the community. These include accidents associated with building structure failure, injuries from falls, open excavation or contact with heavy equipment, respiratory problems from dust and fumes, and exposure to hazardous materials. 258. During operation, PIU UNILA will prepare annual project environmental monitoring report for submission to MOEC for review and submission to ADB for disclosure. MOEC will disclose relevant information from these semi-annual and annual environmental monitoring reports to affected people promptly upon submission of each report.

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Table 31. Impact Mitigation Plan for RSPTN UNILA

Project Activities Environmental Impacts

Mitigation Measures Responsibility Budget Source

Implementation Monitoring

Pre-construction Phase

Preparation of plans and requirements to secure licenses and permits

Impact on commencement of construction activities

- Obtain all licenses or permits required for the proposed buildings prior to commencing construction in accordance with Law No. 28/2002 and Government’s Regulation No. 27/2012 on building structure and environment permits, respectively

- Ensure all designs conform with national environment regulations

- Ensure all licenses and permits have been secured prior to construction work

- Prepare the following Contractor’s Environmental Management Plan (CEMP): • Waste management plan • Emission and noise management plan • Wastewater management plan • Workers’ accommodation plan • Occupational health and safety plan • Emergency response plan • Traffic management plan • Spill prevention, reporting and cleanup

procedures -

PIU UNILA / Contractor

PMU MOEC Operational budget of PIU UNILA

Social Preparation Community Impact

- Establishment of Grievance Redress Mechanism

- Consultation and Information Disclosure - Conduct Traffic Impact Assessment - Capacity building

PIU UNILA PMU MOEC Operational budget of PIU UNILA

Detailed Design Impact on resources and disabled people

- Incorporate of EMP in design and contract. - Incorporate earthquake resilient design,

energy conservation and use of natural light, wastewater recycling, water conservation, solid waste recycling, reuse, treatment and disposal, use of biopori for underground recharge

- Incorporate design that will facilitate easy access for disabled people in compliance with applicable government regulations

DED Contractor PIU UNILA Part of detailed design cost

78




Conformity of the project to land use plan.

- The project is within the regional higher education facilities zone

Geologic hazards - Ensure that the design of the buildings will be earthquake resilient.

- Explore various earthquake resistant building technologies

Availability and requirements for power, water supply, sanitation and drainage

- The façade of the teaching hospital will allow natural light penetration, equipped with vertical sun shading to prevent glaring.

- The facility will also recycle wastewater to be used for flushing water for the toilets and to water the plants within the compound

Flora and fauna survey

Loss of flora and fauna species

- Allocation of 13, 278 m2 for RSPTN and 7,732.00 m2 for IRC landscaping to offset loss of trees

- Utilize native trees as much as possible - All cut trees will be sold to commercial wood

processor in Sumatra. - Schedule cutting of trees progressively so as

not to expose soil for long period. - Contractor will be responsible for transport

and disposal of biomass wastes from cut trees.

- Catching of animals will be prohibited. - Strip the topsoil at a depth to the bottom of

the grassroots zones from any areas to be covered by pavement, structures or where utilities will be located, to be used later for revegetation.

- Grass shall be stripped together with topsoil.

PIU UNILA / Contractor

PIU UNILA Operational budget of PIU UNILA

Climate change assessment

Vulnerability to climate change impacts

- Recycle used water for flushing toilets and for watering lawn and garden within the compound.

- Design properly the drainage system for the project to prevent flooding

DED Contractor PIU UNILA Operational budget of UNILA

Construction Phase

79




Mobilization of construction materials and heavy equipment

Disturbance of land and soil condition

- Limit the amount of erosion and sediment by disturbing only the areas necessary for construction, phasing of construction activity

- Lessen the grade of steep slopes - Cover exposed soils until time of revegetation

or building of facilities - Schedule construction activities during fair

weather to prevent soil erosion - Use of appropriate sedimentation and soil

erosion and control devices (sediment traps or silt fences).

- Cover stockpiles of soil removed during construction

- Limit storage of construction materials to paved parking lots or inactive areas within existing building or temporary shed

- Park construction machineries in paved areas - Drivers to observe speed limit to reduce soil

disturbance

Contractor Construction Supervision Consultant / PIU UNILA

Incorporated in environmental mitigations allocation of construction contract (contract of civil works)

Impact on surface water quality

- Ensure that the wheels of vehicles transporting aggregates and other materials are thoroughly washed to prevent sediment runoff going to the canal

- Provide portable toilets to manage the wastewater coming from the workers

- Contractor through third party service provider, will be responsible for the operation, maintenance and disposal and treatment of collected wastes from portable toilets

- Segregate and pre-treat oil and grease containing effluent using grease trap prior to discharge

- Minimize erosion from exposed soil, construct silt traps, interceptor drains and sedimentation pits around work areas and camp site

- Clean construction vehicles within paved surfaces to lessen contamination of soil and groundwater

- Implement wastewater management plan - The contractor will be responsible for

compliance with the Ministry of Environment



80




Decree No. 68 / 2016 guideline value and WB – IFC EHS Guidelines on wastewater discharge standard.

Impact from generation of solid wastes and hazardous wastes.

General non-hazardous wastes: - Contractor must implement a waste

management plan as part of Contractor’s Environmental Management Plan (CEMP)

- Ensure to put up waste collection points for construction, hazardous, non- hazardous and domestic solid wastes

- Install garbage receptacles at worker camp and construction area

- Enter into partnership with private contractor for the collection, treatment and disposal of wastes to comply with Solid Waste Management Act No. 18 (2008) and Act No. 32 (2009)

- Coordinate with Bandar Lampung City for the management of wastes

- Segregate solid wastes into biodegradable, recyclable, residual and hazardous wastes.

- Separate construction wastes (consisting of concrete and rubble, steel rods, damaged formworks, paper) that can be recycled

Hazardous wastes - Ensure compliance with national regulations,

international commitments where Indonesia is a party, and WB - IFC Environment, Health and Safety Guidelines (2007) on hazardous waste storage, transportation and treatment and disposal

- Store hazardous wastes generated during construction, which include fuel and chemicals, among others, to prevent or control accidental releases to air, soil and water resources

Contractor / Approved service provider

Construction Supervision Consultant / PIU UNILA


81




- Physical separation or use closed containers for hazardous wastes, away from direct sunlight, wind and rain.

- Provide adequate ventilation where volatile wastes are stored

- Conduct on-site and off-site transportation of waste to prevent or minimize spills, releases, and exposures to workers and the public

- Secure and label all waste containers designated for off-site shipment with the contents and associated hazards, and load on the transport vehicles before leaving the site, and accompanied by a shipping paper (i.e., manifest) that describes the load and its associated hazards

- Establish chain-of-custody for shipping document for hazardous wastes using multiple signed copies to show that the waste was properly shipped, transported and received by the recycling or treatment/disposal facility

- In case of third-party hazardous waste transporter, employees involved in the transportation of hazardous materials should be trained regarding proper shipping procedures and emergency procedures

Increase in the level of air pollutants and noise

- Ensure that the wheels of vehicles transporting aggregates and other materials are thoroughly washed

- Use dust curtains and cover material piles during high wind condition

- Impose speed limit within the compound to lessen disturbance of soil

- Ensure that contractors’ vehicles meet the regulatory requirement on air quality

- Water exposed soil to prevent suspension of particulate matter

- Cover construction materials with canvas to prevent erosion and dispersion of materials



82




- Implement dust suppression techniques such as applying water to minimize dust from vehicle movements

- Train drivers on good driving practices, including driving within safe speed limits and measured acceleration to prevent to lessen dust

- Ensure that all air emission licenses and permits of construction machineries and equipment are updated

- Implement a regular vehicle maintenance and repair program. The Contractor will ensure to comply with either GR No. 41/1999 on Air Pollution Control or WB – IFC EHS Guidelines 2007 on air quality standards, whichever is stricter

- Comply with Ministry of Environment Decree No. 48 of 1996 or WB – IFC EHS Guideline on Noise.

- Monitor air quality standards and noise, together with other parameters, quarterly, to ensure compliance

- Contain the pollutants by fencing of the compound

- Require exposed workers to wear appropriate personal protective equipment (PPE) such as masks and goggles

- For workers exposed to excessive noise, wear hearing protection and for a limited exposure time only

- Implement timing of operation that avoids sensitive hours, shielding of noise sources, and proper maintenance and operation of equipment

- Restrict work between 8:00 AM and 5:00 PM - UNILA must schedule classes and activities

in buildings not directly affected by the construction activities

- Require workers exposed to high level of noise to wear ear muffler

- Implement dust suppression techniques such as applying water to minimize dust from vehicle movements

83




- Prohibit workers from open burning of wastes.

Loss of aquatic biota

- Implement soil erosion prevention and stabilization practices and use filter sediment prior to run-off of sediments to open canal

- Ensure construction machineries and equipment are properly maintained.

- The Contractor must also prepare spill prevention, reporting and cleanup procedures to handle oil and chemical spills.



Strain in public services such as collection of wastes and provision of water supply

- Require contractor to coordinate with relevant agencies for the collection of wastes and provision of water supply

- Require workers to practice segregation of wastes and to implement the CLAYGO (clean as you go) in managing solid wastes



Impacts from transportation of construction materials and wastes

- Prepare and implement traffic management plan as part of the Contractor’s EMP, in coordination with the Traffic Management Office of the city to manage the traffic in the area

- Traffic management plan to include driving policy, roles and responsibilities of drivers, workers and management, traffic management procedures, site layout and traffic flow pattern and schedule, road safety rules, training and vehicle inspection registries, road safety records and incident reports, and performance reports

- Set speed limit for all construction vehicles and install traffic warning signs within the project site

- Conduct regular orientation and capacity building on safe driving for drivers and workers

- Regular vehicle maintenance and use of genuine parts to prevent malfunction that may lead to accident



84




- Put up warning and informatory signs along the two roads

- Prior coordination with the affected stakeholders prior to commencement of construction.

Hiring and mobilization of workers

Occupational health and safety of workers

The contractor will adhere to the following applicable government regulations:

- Law No. 13/2003 on Manpower (Ketenagakerjaan)

- Government Regulation No. Per.07/Men/IV/2008 on the placement of manpower

- Government Regulation No. 66/2014 on environmental health

- Government Regulations No. 50/2012 on occupational health and safety management system

- Minister of Manpower Regulation No. 9 of 2016 concerning Occupational Health and Safety at Height.

- Law 18/2008 Waste Management – general legislation and regulation regarding waste management

- Government Regulation No. 82/2001 on management of water quality and control of water pollution

- Government Regulation 101/2013: Hazardous Waste Management

- Prepare and implement occupational health and safety plan as part of the CEMP. Such plan shall also include a COVID-19 risk management protocol to address COVID-19 risks to workers and nearby community.

- Avoid forced labor and child labor (Contractor, subcontractors, and supply chain) as per ADB’s SPS, 2009 and Indonesia law.

- All the workers have the access to Grievances Redress Mechanisms (GRM).



85




- No worker should be exposed to a noise level greater than 85 dB(A) for a duration of more than 8 hours per day without hearing protection

- No unprotected ear should be exposed to a peak sound pressure level (instantaneous) of more than 140 dB(C)

- Enforce actively use of hearing protection when the equivalent sound level over 8 hours reaches 85 dB(A), the peak sound levels reach 140 dB(C), or the average maximum sound level reaches 110dB(A)

- Lessen impact of vibration through choice of equipment, installation of vibration dampening pads or devices, and limiting the duration of exposure.

- Mark all energized electrical devices and lines with warning signs and protecting power cords and extension cords against damage from traffic by shielding or suspending above traffic areas

- Require workers with high exposure to hazards to wear personal protective equipment (PPE) such as face and eye protection device with side shields, welder goggles for welding and hot works, gloves, facemasks with appropriate filters for dust removal, plastic helmets with top and side protection, body suits, and safety shoes and boots

- Implement fall prevention and protection measures for workers exposed to falling hazard

- Install guard rails, proper use of ladders and scaffolds, and use of fall prevention devices such as safety belt

- Provide first aid attendant for the project as well as medical kit to treat workers’ injuries and illnesses prior to transportation to hospital.

- Train workers in the use of MSDS of chemicals used in the construction site, safe

86




work practices, and appropriate use of PPE to mitigate exposure from chemical hazards

- Store flammables away from entry and exit points of buildings, and storage area should have natural floor and ceiling level ventilation

- Install fire extinguishers in workers’ camp and in construction site

- For biological hazards, review and assess known and suspected presence of biological agents and implement safety measures, monitoring and training

- Ensure and enforce hygiene among workers and to allow sick workers not to continue working in the construction site

- Breeding grounds of vectors such as mosquitoes should be kept free from stagnant water

- Ensure cleanliness and not to attract pests such as rodents and cockroaches

- To address ergonomics and other health hazard, provide emergency and health services on site to address worker’s injury and illness, including access to ambulance and medical services from nearby hospitals


- Restrict the access of the public to the site as the construction posed hazards for the community through fencing the perimeter of the construction site, installation of signages, assigning guards at entrance and exit, and by informing the public through consultation

- The contractor must also ensure that there are no hazardous conditions inside the project site such as open excavation and unstable piles.

- Prioritize and promote traffic safety during construction phase when project equipment and machineries were utilized that may impact the safety and health of the public

- Hiring professional licensed drivers and training them on safe driving



87




- Limit the duration of trips to avoid overtiredness

- Regular maintenance of vehicles - Use of manufacturer approved parts to

minimize potentially serious accidents caused by equipment malfunction or premature failure

- Cover trucks carrying construction materials to prevent dispersion of dust during transport

- Prepare and implement emergency response plan health as part of the CEMP to primarily assist staff and emergency response teams during real life emergency that may also affect the community

Operation Phase

Operation of teaching hospital and integrated research center

Management of solid wastes, including hazardous wastes

General, non-hazardous wastes - Management must install 3 types of solid

waste containers with the following labels: biodegradable or organic (food waste, kitchen waste, paper), recyclable (plastics, glasses and metals), and residuals

RSPTN UNILA UNILA Yearly

maintenance cost of building including fire protection and waste management is estimated 2% of the total building cost.

The budged to be included in operations and maintenance budget from the University

- Engage solid waste management service to manage the cleaning of facilities, and collection of wastes

- All domestic wastes must be collected, segregated, and transported to common solid waste management facility

- Transport collected wastes will by a licensed collection / treatment company to materials recovery facility and finally, at the disposal facility

Hazardous wastes - Implement the provisions of Ministry of

Environment and Forestry Regulation No. 56 of 2015 concerning "Procedures and Technical Requirements for the Management of Hazardous and Toxic Waste Materials from Health Service Facilities" requiring labelling and symbols for hazardous

RSPTN UNILA UNILA

88




materials and waste, waste reduction, segregation, storage, transportation (manifest), treatment and handling (with autoclave, incineration), health workers’ occupational health and safety and public health and safety

- Engage accredited third-party hazardous waste service provider that will transport and process hazardous wastes in Jakarta

- As per WHO guidelines, only modern incinerators operating at 850-1100 °C and fitted with special gas-cleaning equipment are able to comply with the international emission standards for dioxins and furans will be acceptable for the project

- Alternatives to incineration such as autoclaving, microwaving, steam treatment integrated with internal mixing, which minimize the formation and release of chemicals or hazardous emissions should be explored

- The management must designate a specific storage zone for hazardous waste

- The facility should be lined, with enclosed walls and roofs to store hazardous waste containers

- The management should actively promote waste segregation to avoid hazardous waste mixing with general wastes

- The management must also initiate regular training on safe practices to handle hazardous wastes

- Require appropriate PPEs for workers handling hazardous wastes

Management of wastewater

- Install a wastewater treatment system that will meet the effluent standard for water following Ministry of Environment Decree No. 48 of 1996 and WB-IFC EHS Guidelines

- Reuse the effluent for flushing toilets and irrigating plants

RSPTN UNILA UNILA

89




- Monitor effluent standard for water following Ministry of Environment Decree No. 48 of 1996 and WB-IFC EHS Guidelines

Impact on use of resources

- Hospital building will be equipped with water retention facility in the roof area which will then be distributed to the rainwater reservoirs located in the jogging track area.

- Biopori will be provided to increase the water infiltration capacity in the soil

- Treated effluent will be used for flushing toilets and for watering plants

RSPTN UNILA UNILA

90

Table 32. Environmental Monitoring Plan Environmental

Indicators Parameters Location Methodology Frequency Standard Responsibility Budget

Source Implementation Monitoring

General impact Licenses and permits, social preparation, detailed engineering design

RSPTN UNILA

Fieldwork, community consultation, consultant to prepare detailed engineering design, coordination with utility companies

Once, prior to construction phase

PIU UNILA / Consultant

PMU MOEC Operational budget of PIU UNILA

Flora and fauna Species, volume of yard wastes generated

RSPTN UNILA

Survey and marking of affected trees

Once, prior to construction phase

Service provider PIU UNILA / MOEF

Operational budget of PIU UNILA

Air quality SO2 (1 hour) CO (1 hour) NO2 (1 hour) PM2.5 (24 hours) TSP (24 hours)

RSPTN UNILA, Ramayana, Perwira

Field works with analysis approved by MOEF

Quarterly during construction

GR No. 41/1999 on Air Pollution Control Guidelines

Construction Supervision Consultant

PIU UNILA / MOEF

CSC budget

Noise level Average dB(A) RSPTN UNILA, Ramayana, Perwira



World Bank – IFC EHS Guidelines


PIU UNILA / MOEF

CSC budget


pH, temperature, color, BOD5, DO, oil and grease, TSS, nitrate, phosphate, ammonia, surfactant (MBAS), fecal coliform, total coliform

Drainage ditch near UNILA



MOEF Decree No. 68 (2016) / Act Number 18/2008


PIU UNILA / MOEF

CSC budget

Wastewater quality

pH, temperature, color, BOD5, DO, oil and grease, TSS, nitrate, phosphate, ammonia, surfactant (MBAS), fecal

Construction site and workers camp





PIU UNILA / MOEF

CSC budget

91

Environmental Indicators

Parameters Location Methodology Frequency Standard Responsibility Budget Source Implementation Monitoring

coliform, total coliform

Solid waste Domestic waste segregated, collected and disposed in disposal site; Hazardous waste, including infectious wastes collected, transported and treated in accredited facility

Construction site and workers camp

Visual observation Monthly Solid Waste Management Act No. 18 / 2008 and Act No. 32 / 2009 (Environmental Protection Act)

PIU UNILA / CSC

PIU UNILA / MOEF

CSC Budget

Soil As, Cd, Pb, Cr, Cu, Zn, oil and grease

Construction site


Only in case of soil contamination

Aquatic biota

Number of species / phytoplankton taxon, Number of species / zooplankton taxon, phytoplankton diversity index, zooplankton diversity index (Shannon – Wiener diversity index),

Drainage ditch near UNILA





PIU UNILA / MOEF

CSC budget


Space allocated per person, supply of safe water, adequate sewage and garbage disposal system, accommodation, sanitary and

Workers camp

Observation Daily Government Act No. 50 of 2012 – Occupational Safety and Health Management System

Contractor CSC / PIU UNILA

CSC budget

92



washing facilities, ventilation, provision for cooking, and storage facilities

Near misses, incidents, or accidents resulting in injuries and emergency response

Workers camp

Observation Daily Government Act No. 50 of 2012 – Occupational Safety and Health Management System


CSC budget

Dust mitigation, noise and vibration levels, stagnant water

Workers camp

Observation Daily Government Act No. 50 of 2012 – Occupational Safety and Health Management System GR No. 41/1999 on Air Pollution Control World Bank – IFC EHS Guidelines


CSC budget


Access to the site and dangerous conditions - fencing the perimeter of the construction site, installation of signages, assigning guards at entrance and exit, and informing public through consultation No hazardous conditions - open excavation and unstable piles

Construction site

Observation Daily World Bank – IFC EHS Guidelines


CSC budget

93



Traffic incidents and accidents

Operation Phase

Solid waste Domestic waste segregated, collected and disposed in disposal site; Hazardous waste, including infectious wastes collected, transported and treated in accredited facility

RSPTN UNILA

Observation Annually Solid Waste Management Act No. 18 / 2008 and Act No. 32 / 2009 (Environmental Protection Act)

RSPTN UNILA MOEC RSPTN UNILA budget

Wastewater quality pH, temperature, color, BOD5, DO, oil and grease, TSS, nitrate, phosphate, ammonia, surfactant (MBAS), fecal coliform, total coliform

RSPTN UNILA wastewater effluent


Annually MoE Decree No 58/1995 on Hospital Effluent Discharge Standard


Road traffic Impacts on road traffic in the project area, area of Influence and neighboring communes

RSPTN UNILA Jalan Soemantri Brodjonegoro and Jalan Z.A. Pagar Alam

Observation

Frequently the Minister of Transportation of the Republic of Indonesia Number 75 of 2015


94

E. Cost for EMP Implementation

259. The cost for the implementation of EMP during pre-construction phase involves the AMDAL preparation and securing of licenses and permits. The budget will come from UNILA for these activities. 260. During the construction phase, funding for the implementation of mitigation measures will be shouldered by the contractor while the cost for environmental monitoring will come from the CSC budget. Cost estimates for environmental safeguards are detailed in Table 34. 261. During implementation phase, the cost of mitigation and monitoring will come from UNILA budget while capacity building on operation of wastewater treatment facility and other environmental management measures for UNILA, will come from CSC. 262. The total cost of EMP implementation is estimated at 125,800.00 USD. This does not include the estimated cost of construction mitigation measures that will be included in the construction contract, estimated at 421,214.90 USD, or about 1% of the construction contract. In total, the EMP implementation and construction mitigation measure costs are estimated to reach 1.30% of total project cost.

Table 33. Cost Estimate for Environmental Monitoring

Item Unit Cost (USD) Unit Rate Source of Funds


1. AMDAL preparation 1 23,000.00

Package UNILA budget

Baseline environmental study

1 500.00


2. Securing of licenses and permits

1 3,500.00


Total for Pre-construction Phase

27,000.00

Construction Phase

1. Environmental effect monitoring

Air quality and noise Quarterly over 4 years at 4 locations

6,400.00

100 USD x 4 times/year x 4 years x 4 locations

CSC budget

Surface water Quarterly over 4 years at 4 locations

6,400.00


CSC budget

Wastewater Quarterly over 4 years at 4 locations

9,600.00


CSC budget

Soil Once in the beginning of works

600.00

150 USD x 1 time/year x 1 year x 4 locations

CSC budget

Aquatic biota Quarterly over 4 years at 4 locations

6,400.00


CSC budget

2. Project Management Consultant

National Environment Specialist

Person 30,000.00

3000 USD x 10 months MOEC budget

95

Item Unit Cost (USD) Unit Rate Source of Funds

3. Construction Supervision Consultant

CSC Environment Specialist

Person 30,000.00

3000 USD x 10 months CSC budget

4. Capacity building Environmental management

3,500.00

CSC budget

Total for Construction Phase

92,900.00

Operation Phase

1. Wastewater quality Annually over 4 years at 4 locations

2,400.00

Annually over 4 years at 4 locations

UNILA budget

2. Capacity building Environmental management

3,500.00

CSC budget

Total for Operation Phase 5,900.00

Grand Total 125,800.00

IX. CONCLUSION AND RECOMMENDATIONS

118. The results of the initial evaluation of RSPTN UNILA, which consists of the teaching hospital and integrated research center, shows that based on the preliminary design, location and environmental conditions, the anticipated environmental impacts will be primarily related to geologic hazards, vegetation, and impact of pollutants during construction phase. These impacts are not considered major, and environmental mitigation measures have been designed as outlined in the EMP to address identified impacts. There is no identified sensitive flora and fauna at the site and the biodiversity is common for the area. The site, being located inside UNILA compound is within the regional higher education facilities zone. 119. Environmental impacts during construction phase include geological hazards (earthquake), disturbance of land and soil condition, impact on air quality, impact on surface water quality, loss of aquatic biota, strain in public services such as collection of wastes and provision of water supply, increase in level of traffic, and impact on occupational health and safety and community health and safety. Mitigating measures were proposed and incorporated in the environmental management plan to lessen the identified risks. Stakeholders from UNILA were favorable of the project since the expected benefits far outweighed the anticipated impacts. 120. Overall, the project is expected to bring beneficial impacts to UNILA and Bandar Lampung City and Lampung Province on a wider scale in terms of not only enhancing the quality of medical education and research with modern facilities, but also providing quality medical services to the community.

Appendix 1 96

RAPID ENVIRONMENTAL ASSESSMENT (REA) CHECKLIST

97 Appendix 1

Appendix 1 98

99 Appendix 1

Appendix 1 100

101 Appendix 1

Appendix 2 102

CONSULTATION WITH STAKEHOLDERS

Figure 1. Orientation on ADB Safeguards and consultation with the UNILA Preparation

Team.

Figure 2. Consultation with Fakultas Kedokteran.

103 Appendix 2

Figure 3. Consultation with Hartono Sipayung of the City Health Office of Bandar

Lampung.

Figure 4. Consultation with the Environment Health Office of Bandar Lampung.

Appendix 2 104

Figure 5. Consultation with Iskandar of the Traffic Management Office of Bandar

Lampung.

Figure 6. Visit to the Traffic Control Center of Bandar Lampung City

105 Appendix 3

GRIEVANCE INTAKE FORM

Name of Project and Location

Contact Information

Name Gender Male Female

Home Address

Age

Phone Number

Email

Complaint/Suggestion/Comment/Question Please provide the details (who, what, where and how) of your grievance below:

How do you want us to reach you for feedback or update on your comment/grievance?

Project ____________________ welcomes complaints, suggestions, comments and queries regarding the project implementation and its stakeholders. We encourage persons with grievance to provide their name and contact information to enable us to get in touch with you for clarification and feedback. Should you choose to include your personal details but want that information to remain confidential, please inform us by writing/typing "(CONFIDENTIAL)" above your name. Thank you.

Appendix 4 106

OUTLINE OF ENVIRONMENTAL SAFEGUARD MONITORING REPORT

(Annotated Format)

I. INTRODUCTION

a. Report Purpose and Rationale b. Project Objective and Components

II. PROJECT IMPLEMENTATION PROGRESS

Using most recent project progress report, describe status of project implementation, including full list of contracts, status of contract implementation, name of contractors, availability of site-EMPs.

III. INSTITUTIONAL SETUP AND RESPONSIBILITIES FOR EMP IMPLEMENTATION

AND SUPERVISION

a. Institutional responsibilities for environmental management Describe institutional arrangements and responsibilities for EMP implementation, monitoring, and reporting, defining roles and capacities of CPIU, Implementation Consultant, Contractors. (Table format appropriate)

b. Incorporation of Environmental Requirements into Project Contractual Arrangements

• Define manner by which EMP requirements are incorporated into contractual arrangements, such as with contractors or other parties.

• Indicate when CEMPs were submitted by Contractors, and when these were approved by Engineer/Supervision Consultant (Table format appropriate).

IV. COMPLIANCE WITH ENVIRONMENT RELATED PROJECT COVENANTS

List all environment related loan covenants, and assess project’s compliance with the covenants (Table format is appropriate, with concluding statement on compliance or non-compliance, and corrective actions as needed)

V. ENVIRONMENTAL MITIGATIONS MEASURES IMPLEMENTED IN THE

REPORTING PERIOD

• Summarize main mitigation/protection measures implemented in the reporting period (narrative section). Structure in accordance to phases (detailed design, construction preparation, construction, and operation).

• Include EMP table or updated EMP table if applicable. Assess compliance of environmental management activities with the original or updated EMP. For that purpose, include an additional column in the EMP entitled “Implementation status and compliance”. E.g. is provided below:

107 Appendix 4

Impact Factor/ Stage

Potential Impacts

and/or Issues

Mitigation Measures defined in the EMP

NEW COLUMN Implementation status and compliance with

EMP


1. Design Stage Establishing CPIU

• An environmental management unit (EMU) will be established within CPIU

EMU established in CPIU, consisting of xxx persons. ➔ Complied with

… • … …

3. Biding and Construction Preparation

Bidding documents and contractors’ qualifications

• Environmental section will be included in the TOR for bidders.

• Environmental clauses for contractors in reference to the EMP and monitoring plan will be included in the construction and supply contracts.

Environmental section was included in TOR for bidders, environmental clauses were included in contracts (see chapter xxx). ➔ Complied with

Environmental operation and supervision manual

• Contractors will be required to prepare an environmental operation and supervision manual, for approval by PIC.

6 out of 7 contractors have prepared manuals, submitted to the respective IA. Contractor xxx was requested to prepare a manual, to be submitted by end of xxx 2016. ➔ Partly complied with

… … …

Construction Phase

1. Soil Erosion Excavation • Strip and stockpile topsoil, build retaining walls where necessary before dumping.

• Provide temporary detention ponds or containment to control silt runoff.

• Construct intercepting ditches and chutes to prevent outside runoff entering disposal sites, and divert runoff from sites to existing drainage or ponds.

Soil erosion protection measures are implemented at each site, fully complying with the measures defined in this EMP. ➔ Complied with

Appendix 4 108

Impact Factor/ Stage

Potential Impacts

and/or Issues

Mitigation Measures defined in the EMP

NEW COLUMN Implementation status and compliance with

EMP

… … … ➔ Not complied with. Corrective action plan developed.

Commissioning Phase

… … … …

Operation Phase

… … … … ➔ Not yet due

VI. ENVIRONMENTAL MONITORING

a. Monitoring plan and responsibilities Present the monitoring plan as defined in the EMP or adjusted monitoring plan. Describe monitoring responsibilities. Differentiate between internal and external/compliance monitoring responsibilities.

b. Environmental quality targets, sampling and analytical methods

Describe environmental quality targets for the different sites and environmental media (e.g. effluent quality standards, ambient air, noise, water quality standards etc). Define analytical methods applied for monitoring.

c. Monitoring Results

i. Emission Discharge (Source) Monitoring Results (if relevant) 1. Results

Table format is appropriate. Discharge levels should be compared to the relevant discharge standards and/or performance indicators noted in the EMP. Any non-compliance should be highlighted for attention and follow-up.

2. Assessment

Discharge levels should be compared to baseline conditions (if baseline data is available) and described in qualitative terms. Additional explanatory comments should be provided as necessary. Possible reasons for non-compliance should be identified.

ii. Ambient Monitoring Program

1. Results Table format is appropriate. Ambient environmental conditions should be compared to the relevant ambient standards and/or performance indicators noted in the EMP. Any non-compliance should be highlighted for attention and follow-up.

2. Assessment

109 Appendix 4

Ambient environmental conditions should be compared to the baseline conditions (if baseline data is available) and described in qualitative terms. Additional explanatory comments should be provided as necessary. Possible reasons for non-compliance should be identified.

VII. PUBLIC CONSULTATION, GRIEVANCE REDRESS MECHANISM

Describe mechanisms established to address and redress public complaints and grievances. Summarize grievances received, if any, and measures implemented to redress them. Describe public consultation activities during the reporting period. Present planned consultation activities in next reporting period.

VIII. HEALTH AND SAFETY

Describe health and safety management arrangements at project and contract level, including safety supervision and reporting procedures, people assigned (table format appropriate), training provided (table format appropriate), full list of fatal and serious occupational accidents including reference to minutes of investigation report meetings.

IX. INSTITUTIONAL STRENGTHENING AND TRAINING

Present training activities conducted in the reporting period (Table format appropriate). Compare training activities with approved training plan defined in EMP/PAM, if any. Present planned training and institutional strengthening activities in next reporting period.

X. KEY ENVIRONMENTAL ISSUES

a. Key Issues Identified, Actions Taken, Additional Actions Required Include a concise and clearly articulated table that lists (i) all observed non-compliances with the approved EMP or SEMP (both at project and contract level), (ii) corrective actions taken; (iii) implementation responsibility and timeframe.

XI. CONCLUSION

a. Overall Progress of Implementation of Environmental Management Measures

b. Problems Identified and Actions Recommended

XII. APPENDICES

1. Site Inspection / Monitoring Reports 2. Monitoring Results 3. Accidents/Incident investigation meeting minutes 4. Photographs 5. Others