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9Thpbmeeting Annex-1 List of Participants 9th Project Board Meeting Sl. Name Designation/Agency Email No. 1 Dasho Sonam Tshering Secretary, Ministry of Economic Affairs [email protected] (Chairperson) 2 Sonam Yangley Director General, DGM, MoEA 3 Yeshi Wangdi Director General, DoE, MoEA 4 Yeshi Dorji Project Director, GLOF Project, DGM [email protected] 5 Namgay Wangchuk Director, DDM, MoHCA 6 Ugyen Dophu Director, Department of Public Health, MoH 7 Kuenzang N. Tshering Dasho Dzongda, Punakha Dzongkhag 7 Dasho Sonam Jigme Dzongdag, Gasa Dzongkhag [email protected] 8 Karma Rapten Head, Env. Unit, UNDP, Thimphu [email protected] 9 Anne Erica Larsen UNDP, Thimphu [email protected] 10 Ramesh Chhetri ACO, Thimphu [email protected] 10 Chencho Tshering Project Manager, GLOF Project, DDM [email protected] 11 Dowchu Dukpa Project Manager, GLOF Project, DGM [email protected] 12 Karma Chophel Head, HMSD, DoE, MoEA [email protected] 13 Karma Dupchu Project Manager, GLOF Project, DoE [email protected] 14 Tshering Penjor GNH Commission [email protected] 15 Tshewang Lham GNH Commission 16 Jamyang Chophel Dy.Project Manager, GLOF Project, DGM 17 Chado Rinchen DGM, MoEA 18 Karma Toeb DGM, MoEA 19 Dr. Rinzin DMO, Punakha Dzongkhag 20 Dr. Tandi Dorji UNDP Health and Assessment Consultant AGENDA FOR THE 9th PROJECT BOARD MEETING(Annex-2) “Reducing Climate Change-Induced Risks and Vulnerabilities from Glacial Lake Outburst Floods in the Punakha-Wangdue and Chamkhar Valleys” Venue : Department of Energy, Conference Hall Date : 11th January 2011 (Tuesday) 1 10:00-10:10 Opening by Dasho Sonam Tshering, Secretary, MoEA (Chairperson) 2 10:10-10:15 Rectification/Adoption of minutes of 8th PB meeting 2 10:15-10:40 Presentation by Dr. Tandi Dorji, UNDP consultant on Health and Safety Assessment for Lunana Project 4 10:40-11:05 Presentation by Mitigation Project Team Leader/Project Engineer, on the progress in 2010 and targets for 2011 5 11:05--11:30 Presentation by Dowchu Dukpa, Project Manager, GLOF on overall achievements and challenges in 2010; Annual Work Plan (AWP) for 2011 and other issues; Project Mid Term Review and Auditing (2008-2010) 6 11:30-11:50 Tea Break 7 11:50-12:15 Presentation by Karma Dupchu, GLOF Project Manager, Department of Energy on GLOF early warning system 8 12:15-12:40 Presentation by Chencho Tshering, GLOF Project Manager, DDM, MoHCA 9 12:40-13:30 Discussions 10 13:30 Lunch ******************** (Annex-3) UNDP – Reducing Climate Change-induced Risks and Vulnerabilities in Punakha-Wangdi and Chamkar valleys Health and Safety Assessment UNDP ABBREVIATIONS ALS Advanced Life Support BBS Bhutan Broadcasting Service BMI Body Mass Index DDM Department of Disaster Management DSA Daily Subsistence Allowance ECG Electro-cardio-gram FGD Focus Group Discussion GEF Global Environment Facility GLOF Glacial Lake Outburst Flood GNM General Nurse Midwifery HA Health Assistant JDWNRH Jigme Dorji Wangchuk National Referral Hospital LDCF Least Developed Countries Fund MoEA Ministry of Economic Affairs MoH Ministry of Health MoLHR Ministry of Labour and Human Resources MoU Memorandum of Understanding PB Project Board PMU Project Management Unit RBA Royal Bhutan Army RGoB Royal Government of Bhutan TA Travelling Allowance ToR Terms of Reference TSAT Technical Support and Advisory Team UNDP United Nations Development Programme UNICEF United Nations Children's Fund WWF World Wildlife Fund Page | 2 Table of Contents ABBREVIATIONS ............................................................................................................................................ 2 EXECUTIVE SUMMARY .................................................................................................................................. 4 1. BACKGROUND ....................................................................................................................................... 7 1. OBJECTIVES ........................................................................................................................................... 8 2. METHODOLOGY .................................................................................................................................... 8 3. BACKGROUND AND OBSERVATIONS .................................................................................................. 11 4. REPORT ON THE THREE CASUALTIES .................................................................................................. 24 5. ANALYSIS OF MEDIA REPORTS ............................................................................................................ 28 6. CONCLUSIONS ..................................................................................................................................... 32 7. RECOMMENDATIONS ......................................................................................................................... 33 8. ANNEXURES ........................................................................................................................................ 37 ANNEX 1: STAKEHOLDERS CONSULTED ...................................................................................................... 37 ANNEX 2: MEDICAL SCREENING GUIDELINE ............................................................................................... 38 FORM- A. PRE-EXAMINATION MEDICAL HISTORY QUESTIONNAIRE ................................................. 39 FORM- B. GENERAL CLINICAL EXAMINATION ...................................................................................... 41 FORM - C: SUGGESTED LABORATORY INVESTIGATION .............................................................................. 43 FORM – D: CERTIFICATION OF FITNESS TO WORK AT HIGH ALTITUDE .................................................. 43 ANNEX- 3: GUIDELINE FOR MEDICAL CERTIFICATION .......................................................................... 44 ANNEX 4: COST ESTIMATE FOR IMPLEMENTING THE RECOMMENDATION ....................................... 46 ANNEX 5: Health Report and Recommendations, 2008 ..................................................................... 47 ANNEX 6: MEDICAL REPORT FOR 2009 PROJECT ............................................................................... 49 ANNEX 7: COST BREAKDOWN FOR PROJECT IN 2009 & 2010 ………………………………………………………………..51 Page | 3 EXECUTIVE SUMMARY 1. Climate change has placed Bhutan at high risk from Glacial Lake Outburst Floods (GLOF) due to rapid retreat of glaciers and formation of supra glacial lakes which have approached dangerous thresholds. Recognizing the catastrophic consequences on development, human lives and their livelihood, the project “Reducing Climate Change-induced Risks and Vulnerabilities from Glacial Lake Outburst Floods in the Punakha-Wangdi and Chamkhar Valleys’ was set up beginning in 2008, and to be completed in 2012. The project is implemented by the Department of Geology and Mines, Department of Energy and the Department of Disaster Management with financial assistance of LDCF, managed by Global Environment Facility (GEF) along with co-financing from WWF, Government of Austria and RGoB. Since 2009, approximately 340 workers along with a multi- disciplinary team have been working manually at Lunana to lower the level of Thorthormi Lake with a target to reduce 5 meters over the next three years. While there was no mortality in 2009, three people lost their lives in 2010, two enroute to Lunana and one at the project camp site in Thanza. Being deeply concerned of these unprecedented events, UNDP has initiated this independent review to make a comprehensive health and safety assessment and to propose concrete recommendations to further improve the existing safety measures. 2. The assessment was conducted in the month of October for duration of two weeks, this being the most opportune time to meet the workers and the team members who were returning at the end of the annual project in 2010. A rapid assessment methodology was used, incorporating multiple techniques such as a comprehensive desk review, in-depth interviews with stakeholders, key informant interviews using a pre developed semi structured questionnaire and Focus group discussions (FGD). A total of 33 workers were interviewed using the questionnaire while project team members were interviewed using a questionnaire guide. Two focus group discussions were held, one among the workers and the other among the multi-disciplinary team members. Consultative discussions were held with all the stakeholders and a separate analysis of the three deaths as well as all newspaper stories was also conducted. 3. The assessment revealed that the overall coordination of the project was managed efficiently by the Project management unit (PMU) under the guidance of the Project Board (PB) and the Technical Support and Advisory team (TSAT). The project documents and the minutes of the meeting showed that health and safety was discussed well in advance and there was emphasis to ensure that workers were well protected. However there was poor representation of health personnel in both the PB and the TSAT. There were no criteria in selecting the project medical team and there was no continuity in 2008 and 2009 with different doctors appointed in the two years. Although the medical team in both 2009 and 2010 was the same, they did not receive any training in high altitude illnesses nor were they adequately supported (technically) by the Ministry of Health. The team members were chosen based on their posting, rather than on technical
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