Government of Nepal

Ministry of Physical Infrastructure and Transport

Department of Roads
Development Cooperation Implementation Division

Kathmandu, Nepal

Accelerating Transport and Trade Connectivity in Eastern

South Asia Nepal Phase 1 Project

(WB Credit No. 7159-NP)

Upgrading of Butwal-Gorusinghe -Chanauta Road and Bridges

Lot-2 from Km 615+000 to Km 640+000

Contract No.: ACCESS-DOR-W-BGC-ICB-01

COMMUNITY HEALTH AND SAFETY PLAN

Contractor Employer:
M/S Sharma-Longjian JV Department of Roads
R K Complex, Sitapaila Development Cooperation Implementation
Phone: 977-1-5673001, 5673002 Division

Date: Feb 2024

 Contents
1. Introduction......................................................................................................................................
2. Objective...........................................................................................................................................
3. Requirement for the Community health and safety...............................................................
3.1 Community Health and Safety.............................................................................................
3.2 Community Exposure to Health Issues.............................................................................
4. Aim of the Management Plan.......................................................................................................
5. Impacts and Key Project Risks...................................................................................................
6. Minimum Requirement for Contractor.......................................................................................
7. Additional Conditions Associated with Community Health.................................................
8. Management, Mitigation and Monitoring..................................................................................
9. Other requirements relating to community safety..................................................................
10. Engineers' responsibilities for projects................................................................................
11. Requirements for Monitoring...................................................................................................

Acronyms

E&S: Environment & Social

ESS: Environmental and Social Standards
GN: Guidance Note

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 Community Health and Safety Management Plan

1. Introduction

Under the World Bank’s E&S requirements, Community Health and Safety (ESS4) is
recognized that project-related activities, tools, and infrastructure may expose communities
to more risks and effects. Additionally, project operations may cause the effects on
populations already vulnerable to the effects of climate change to accelerate or intensify.
ESS4 addresses the health, safety, and security risks and impacts on project-affected
communities and the corresponding responsibility of Borrowers to avoid or minimize such
risks and impacts, with particular attention to people who, because of their particular
circumstances, may be vulnerable.

2. Objective

 To anticipate and avoid adverse impacts on the health and safety of project-affected
communities during the project life cycle from both routine and non-routine
circumstances.
 To avoid or minimize community exposure to project-related traffic and road safety
risks, diseases, and hazardous materials.
 To have in place effective measures to address emergency events.
 To ensure that the safeguarding of personnel and property is carried out in a manner
that avoids or minimizes risks to the project-affected communities.

3. Requirement for the Community health and safety

3.1 Community Health and Safety

GN5.1. A health impact assessment can be conducted as part of the environmental and
social assessment.
GN5.2. Some groups within a community may be particularly vulnerable to health and safety
risks from a project because of, for example, their age, health, level of education,
occupation, socioeconomic conditions, status, gender, and/or disability. Identifying individual
groups considered to be vulnerable is an important part of the environmental and social
assessment, and enables inclusive measures to be incorporated into projects to avoid harm
to vulnerable groups and improve project performance. Attention should be given to the
health and safety risks posed by the influx of workers or people providing support services
into an area as a result of the project. Risks related to labor influx are known to be potentially
highest for large infrastructure projects in remote areas.
GN5.3. Where an assessment identifies risks, for example Gender-Based Violence (GBV) or
Sexual Exploitation and Abuse (SEA) of children, or communicable diseases, which may
arise from the interaction of project workers with local communities, the environmental and
social documents for the project describe such risks and measures to address them. Such
measures can include, more generally, the use of skilled trainers to raise awareness among
project workers of the risks, expected behaviors, and consequences of violations,
communicated through training, and publicized codes of conduct. It may also be important to
raise awareness of the risks among community members and local health authorities and
inform them about available grievance mechanisms. Where appropriate, the risks and
mitigation measures relating to project workers should also be reflected in the labor
management procedures for the project as discussed in GN9.4 of ESS2.

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 Community Health and Safety Management Plan

GN5.4. Addressing community health and safety risks may require measures in all phases of
the project life cycle, for example, incorporating safe road crossings into project design;
establishing workers camps separated from local communities with strict protocols for
interaction with local communities in order to avoid project impacts from labor influx;
implementing sensitization and specific mitigation measures for social impacts from labor
influx during construction or service provision of the project; establishing emergency-
response planning and monitoring for pollution or other incidents during operation; putting in
place protocols for temporary blasting during demolition at the reinstatement or restoration
phase; or establishing health clinics. Local health authorities should ensure appropriate
processes are in place for community feedback and taking any necessary action.

3.2 Community Exposure to Health Issues

Avoid or minimize the potential for community exposure to waterborne, water based, water-
related, and vector-borne diseases, and communicable and non-communicable diseases
that could result from project activities, taking into consideration differentiated exposure to
and higher sensitivity of vulnerable groups. Where specific diseases are endemic in
communities in the project area, encouraged to explore opportunities during the project life
cycle to improve environmental conditions that could help minimize their incidence.

GN15.1. Waterborne diseases are conditions caused by pathogenic microorganisms within a

water source. Consuming water contaminated by human, animal, or chemical wastes while
bathing, washing, drinking, or by eating food exposed to infected water, is the primary
source of such diseases. These diseases are especially prevalent in areas lacking access to
adequate sanitation or treatment facilities, and include cholera, diarrhea, dysentery, and
typhoid.
GN15.2. Water-based diseases are caused by organisms that have an aquatic development
cycle and another cycle as fully grown parasites in other animal or human hosts. These
diseases include guinea worm and schistosomiasis.
GN15.3. Vector-borne diseases are caused by pathogens in human populations transmitted
by vectors and are often region specific in nature, such as mosquitoes, ticks, and so forth.
These diseases include Chagas disease, human African trypanosomiasis, Japanese
encephalitis, leishmaniosis, malaria, onchocerciasis, schistosomiasis, and yellow fever.
GN15.4. Communicable diseases are illnesses caused by an infectious agent or its toxins
that occur through the direct or indirect transmission of the infectious agent or its products
from an infected individual or via an animal, vector, or the inanimate environment to a
susceptible animal or human host. Communicable diseases are transmissible from person to
person through air, blood, or other bodily fluid and include hepatitis, HIV/AIDS, influenza,
polio, syphilis, and tuberculosis.
GN15.5. Non-communicable diseases are illnesses that are not passed from person to
person. They tend to be of long duration and generally slow progression and may include:
cardiovascular diseases (for example, heart attacks and stroke); cancers; chronic respiratory
diseases (for example, chronic obstructive pulmonary disease and asthma); mental and
substance use disorders; digestive diseases; genitourinary diseases; skin diseases; and
musculoskeletal diseases and diabetes. Air pollution is also a major contributor to non-
communicable diseases.
GN15.6. The types of projects that may contribute to increased health risks and, therefore,
call for particular consideration, include those that create permanent or temporary water

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bodies that may increase incidences of water-related diseases, such as dams, irrigation
schemes, construction pits, or other depressions; projects in areas that lack adequate
sanitary wastewater discharge and treatment infrastructure; projects that may result in
exposure to air pollution, hazardous materials, chemicals, particulate matter, or radiation, or
that contribute to a higher incidence of non-communicable diseases; projects that
exacerbate existing health conditions, affect mental health, or reduce the quality of nutrition;
and projects that lead to greater risk of exposure to disease or health issues, for example, as
a result of changes to mobility or behavior.
GN15.7. Project-related health risks are assessed as part of the environmental and social
assessment or, depending on the nature and significance of the project activities and the
potential risks and impacts, through a stand-alone health impact assessment. Where
appropriate, measures to avoid, minimize, or mitigate risks and impacts identified during the
assessment are integrated into the projects design and implemented throughout the life
cycle of the project. In accordance with the requirements of ESS10, community health and
safety assessments should be carried out in consultation with local communities, including
representatives of local health authorities.
GN15.8. Health risks from project activities may differ within communities, depending on
various factors that can contribute to vulnerability, including age, gender, status, physical or
mental illness or disability, poverty or economic disadvantage, or dependence on unique
natural resources. For example, households that rely on water directly from natural sources
may be more at risk of waterborne and water-based diseases than those that receive water
from a distribution network. Health risks may also place a disproportionate burden on
women, who are often responsible for family health care.
GN16.1. Labor influx is when all or part of a labor force for a project comes from outside the
area of the project. In some cases, other people may follow the incoming workforce with the
aim of selling them goods and services or in pursuit of job or business opportunities. Further
guidance is provided in the World Banks Managing the Risks of Adverse Impacts on
Communities from Temporary Project Induced Labor Influx, available on the World Banks
website.
GN16.2. The project’s environmental and social assessment is the main mechanism for
determining the risk of communicable diseases as a result of labor influx, and where
appropriate, identifying measures to avoid, minimize, or mitigate the transmission of such
diseases. It is important to establish a baseline as part of the environmental and social
assessment for monitoring and managing these risks. Risks and impacts may be potentially
more significant in certain circumstances, for example, when large numbers of project
workers, contractors, and third parties are involved in project activities, or due to the
sensitivity of project location or the characteristics of the affected communities.

4. Aim of the Management Plan

The Community Health and Safety Management Plan (CHSMP) is designed to ensure that
the contractor will complies with the requirements of the World Bank's Environmental and
Social Framework (ESS 4: Community Health and Safety), Environment, Health, and Safety
General Guidelines (WB, April 30, 2007, Section 3.0), and the World Bank's Guidance Note
for Boundaries (WB, June 2018).

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 Community Health and Safety Management Plan

5. Impacts and Key Project Risks

The following construction phase activities will have an effect on the community health
determinants and parameters:

 Changes in the physical, biological, and social factors may have an effect on a
person's health, especially for those who are more susceptible, such the elderly,
children, and those with pre-existing diseases;
 Potential introduction of communicable and infectious diseases (e.g., COVID-19) due
to contact with migrant workers or increase in vector population;
 Inappropriate use of force by security personnel in controlling access to construction
areas and protecting the project workers, equipment, and facilities from vandalism,
sabotage.
 Long-term presence of migrant labor may create social conflicts between workers
and local communities as well as increase the rate of illicit behavior and crime;
 Introduction of vehicular traffic in an area unfamiliar with traffic safety measures;
 Unsafe or inappropriate use of explosives and hazardous materials;
 Crowding of local health care facilities and potential shortage of medical supplies

6. Minimum Requirement for Contractor

A Community Health and Safety Management Plan must be created by the Contractor. The
following minimal requirements must be included in this strategy.

 Water Availability
 Project Demands on Community Infrastructure and Services
 Traffic Safety
 Security Personnel
 Emergency Preparedness and Response

7. Additional Conditions Associated with Community Health

 Conducting an obligatory health examination of arriving migrant workers to detect

infectious diseases before they arrive at the worker camps.
 Provide medical, health, and first aid facilities at each work camp to reduce the
pressure on nearby health posts. Only employees with urgent needs that go beyond
what the project's medical facilities can handle will utilize the public facilities.
 Engage an HIV/AIDS service provider, who will be available on site to monitor and
take appropriate preventive measures such as provision of condoms.
 Develop a communicable disease (e.g., COVID-19) management plan that describes
safety precautions, requirements for worker testing before coming to the worker
camps and periodically thereafter, visitor testing requirements and safety
requirements, and procedures to put in place in the event a worker tests positive for
COVID-19 or other communicable disease.

8. Management, Mitigation and Monitoring

Potential impacts on the communities along the Project may occur mainly during the
construction phase and are driven mainly due to the temporary deployment of Contractors’
workforce in the area where the Project will be implemented.
The main mitigation measures with regards to community health and safety issues foreseen
in the various Management Plans are listed below:

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 Community Health and Safety Management Plan

 Avoid, minimize or change traffic density with impact on other road users and on the
local community, in general;
 Introduction of new staff as a guarantee of security in order to avoid conflicts,
accidents or other forms of disturbance of public peace and healthy social local
climate;
 Avoid, minimize or change the direct impact on activities of the local services
providers (providers of water supply, electricity, etc.) and local entrepreneurs (Water
Management Plan, particularly, as regards the protection of water sources);
 Prevent, avoid or minimize exposure of communities to diseases caused by noise,
water and soil pollution (Pollution Prevention Plan);
 Implement measures to reduce the impact on socio-economic environment even
before the start of works (setting deviation routes, installation of sound-proofing
panels, demarcation and installation of warning elements related to the area of the
works, provision of alternative networks of utilities, etc.);
 Work forces’ strict adherence to the Worker’s Code of Conduct that is developed by
the contractor will aid in mitigating any unforeseen issues regarding community
disturbance (Labor Management Plan)
 Accidental leaks of fuel or oil will be quickly collected and removed with absorbent
material, collected in closed and labeled containers - temporarily stored in specially
designed spaces until their delivery to an operator authorized for the collection /
disposal of oil waste;
 Contractors are required to prepare a Traffic Management Plan detailing the routes
and mitigation measures for construction traffic, pipe and construction materials
transportation.
 Ensure contractors’ vehicles are parked in designated areas to minimize any
disruption to local communities;
 Store incompatible materials (acids, bases, flammables, oxidizers, reactive
chemicals) in separate areas, and with containment facilities separating material
storage areas. The storage and use of hazardous substances will be performed in
conditions of maximum security, in order to avoid the possibility of their accidental
spill;
 Provide rapid response to any complaints from local communities in relation to
inappropriate cultural behavior by personnel. Investigate and take appropriate action
within the timeframe specified in grievance procedure;
 In case of utility disruption (planned or unplanned) Contractor(s) will cooperate in an
efficient manner with the utility provider (s) and local authorities and take all
necessary measure to timely announce the community (whenever possible) and
keep this disruption as short as possible.
9. Other requirements relating to community safety
 Public education and awareness programs/seminars on project-related safety
concerns, such as those posed by traffic, hazardous materials, construction
equipment, , security personnel, and the use of the grievance procedure, should be
offered to the community.
 It is important to provide the community with public education and awareness
programs/seminars on project-related safety issues, such as those brought on by
traffic, hazardous materials, construction equipment, explosives, security guards, and
the usage of the grievance system.
 Provide adequate night-time lighting around the Contractor Worker Camps;
 Install a perimeter security fence around the Contractor Worker Camps with guards
to restrict public access;
 Restrict workers to worker camps during night time hours unless working a night
shift. No worker access to villages during night time hours; and

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 Adopt a policy on gender-based violence, sexual exploitation and abuse, and

trafficking in persons and collaborate with law enforcement agencies for investigation
of any violations of the law.

10. Engineers' responsibilities for projects

 Review and approval of the Contractor's Community Health and Safety Management
Plan
 Monitoring for water-borne illnesses all drinking water sources utilized by the public
and by employees;
 Monitoring of vectors to prevent the spread of vector-borne diseases;
 Monitoring for more communicable diseases

11. Requirements for Monitoring

The following indicators will be monitored by each prime contractor monthly, along with the
performance of both themselves and their subcontractors.

 How many employees undergo pre-employment health screenings for communicable

diseases, such as COVID-19; how many employees test positive for any
communicable diseases;
 Situations where workers needed to be treated in public hospitals or medical centers;
 Number of health and safety awareness and education training sessions offered;
 How many times project staff have engaged in any form of human trafficking,
violence against women, or sexual exploitation and abuse.
 Number of complaints made by members of the community about contacts with
project staff

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