Download 5.01 MB

Initial Environmental Examination (Updated)

July 2021

Philippines: Emergency Assistance for Reconstruction and Recovery of Marawi

Output 3: Restoring Water Utilities and Health Infrastructure (Health Component)

Prepared by the Department of Health, Government of the Philippines for the Asian Development Bank. This is an updated version of the draft originally posted in July 2020 available on https://www.adb.org/projects/documents/phi-52313-001-iee-0.

CURRENCY EQUIVALENTS (as of 08 July 2021) Currency unit - Philippine Peso (PhP) PhP1.00 - $ 0.02006 $1.00 - PhP 49.85

ABBREVIATIONS

ADB - Asian Development Bank CCC - Climate Change Commission CFC - chlorofluorocarbon CITES - Convention on International Trade in Endangered Species of Wild Fauna and Flora DENR - Department of Environment and Natural Resources DO - Department Order DOH - Department of Health ECA - Environmentally critical area ECC - Environmental Compliance Certificate ECP - Environmentally critical project EMB - Environmental Management Bureau EMP - Environmental Management Plan EMOP - Environmental Monitoring Plan GRC - Grievance Redress Committee GRM - Grievance Redress Mechanism IEE - Initial Environmental Examination INDC - Intended Nationally Determined Contribution LGU - Local government unit LLW - Lanao Lake Watershed NSWMC - National Solid Waste Management Commission PHIVOLCS - Philippine Institute of Volcanology and Seismology PIU - Project Implementation Unit PMC - Project Management Consultant POPS - Persistent Organic Pollutants ROW - Right -of-way SPS - ADB Safeguard Policy Statement 2009 TB DOTS - Directly observed treatment, short-course for tuberculosis TSeKaP - Tamang Serbisyo sa Kalusugan ng Pamilya UNCSD - Unitedt Nations Convention on Sustainable Development UNFCCC - United Nations Framework Convention on Climate Change UCCRTF - Urban Climate Change Resilience Trust Fund

WEIGHTS AND MEASURES

dB (A) - A-weighted decibel ha - hectare km - kilometer km2 - square kilometer m - meter

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 of this 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 area.

TABLE OF CONTENTS

TABLE OF CONTENTS 4 LIST OF FIGURES 5 LIST OF TABLES 5 EXECUTIVE SUMMARY 7 I. INTRODUCTION 13 A. Project Background 13 B. Project Objectives 13 C. Purpose of the IEE Study 14 D. Extent of the IEE Study 14 E. Methods Used for the IEE Study 14 1. Site Assessment and Public Consultation 14 2. Primary and Secondary Data Collection 14 3. Other Tools, Additional Surveys and Studies 15 4. Assessment of Potential Impacts 15 5. Preparation of the Environment Management Plan 15 E. IEE Report Content 15 II. POLICY, LEGAL AND ADMINISTRATIVE FRAMEWORK 16 A. International Environmental Agreements 16 C. Regulatory Framework on Operationalization of Local Health Systems 24 D. Environmental Regulatory Framework Applicable to DOH 25 E. Regulatory Framework in Autonomous Region in Muslim Mindanao 25 F. Asian Development Bank Safeguard Policies 26 G. Other Applicable Regulations 27 III. DESCRIPTION OF THE PROJECT 28 A. Project Locations 28 B. Detailed Design 31 IV. DESCRIPTION OF THE ENVIRONMENT 41 V. IMPACT ASSESSMENT AND MITIGATING MEASURES 62 VI. CONSULTATION, PARTICIPATION AND INFORMATION DISCLOSURE 74 VII. GRIEVANCE REDRESS MECHANISM 79 VIII. ENVIRONMENTAL MANAGEMENT PLAN 81 IX. CONCLUSION AND RECOMMENDATION 96 BIBLIOGRAPHY 97 APPENDICES 98 Appendix 1. Certificates of Non-coverage 98 Appendix 2. Rapid Environmental Assessment (REA) Checklist 100 Appendix 3. Proof of Ownership Documents of City Health Unit (Marawi City) and Rural Health Unit (Lumbayanague) 106 Appendix 4. Summary of Meeting 111 Appendix 5. Site Assessment Report (18 December 2019) 114 Appendix 6. Site Assessment Report (28 – 29 May 2019) 117 Appendix 7. DOH Site Inspection Report (28-29 May 2019) 122 Appendix 8. Guidelines for Climate Change and Green House Resilience Design 128 Appendix 9. Laboratory Analyses 130 Appendix 10. Permit to Cut Trees 139 Appendix 11. Public Consultations 141 Appendix 12. Grievance Intake Form 143

LIST OF FIGURES

Figure 1. Map of Lanao del Sur 27 Figure 2. City Engineering Office building, Government Center of Marawi 29 Figure 3. General Services Office building, Government Center of Marawi City 29 Figure 4. Master Development Plan of Government Center of Marawi, including the proposed City Health Unit 30 Figure 5. Proposed location of Lumbayanague RHU 30 Figure 6. Location Map 33 Figure 7. Vicinity Map 33 Figure 8. Site Development Plan 34 Figure 9.Perspective 34 Figure 10.Ground Floor Plan 35 Figure 11. Second Floor Plan 35 Figure 12. Location Map 37 Figure 13. Site Development Plan 38 Figure 14. Perspective 38 Figure 15. Ground Floor Plan 39 Figure 16. Second Floor Plan 39 Figure 17. Lake Lanao Watershed Reserve Area 40 Figure 18. Slope Map of Lake Lanao Watershed Reserve Area 42 Figure 19. Topographic Map of Lanao del Sur 42 Figure 20. Active Faults and Trenches in Mindanao 43 Figure 21. Landslide Susceptibility Map of Marawi City 44 Figure 22. Landslide Susceptibility Map of Lumbayanague 44 Figure 23. Modified Coronas Classification of Climate of the Philippines 46 Figure 24. Sampling locations for soil, Marawi City 47 Figure 25. Sampling locations for soil, Lumbayanague 48 Figure 26.Sampling locations for drinking water and receiving body of water, Marawi City 49 Figure 27. Sampling locations for drinking water and receiving body of water, Lumbayanague 49 Figure 28. Philippine Biogeography Zone, DENR (2002) 53 Figure 29. PAs and KBAs within the 10-km and 50-km buffer zone, Marawi City Health Unit 55 Figure 30. PAs and KBAs within the 10-km and 50-km buffer zone, Lumbayanague Rural Health Unit 56 Figure 31. Population Density of Lanao del Sur (Philippine Statistics Authority, 2015). 58

LIST OF TABLES

Table 1. Summary of Environmental Legislations Applicable to the Proposed Project 19 Table 2. Project Thresholds for Coverage Screening and Categorization in Philippine EIS System 23 Table 3. Lot and Floor Areas Allotted for Health Facilities 31 Table 4. Floor Space Allocation for Marawi City Health Unit 31 Table 5. Floor Space Allocation for Lumbayanague Rural Health Unit 36 Table 6. Area by Slope Category 41 Table 7. Water Body Classification and Usage of Freshwater 45

Table 8. Details of Soil Sampling in Marawi and Lumbayanague 46 Table 9. Soil Analyses Result 47 Table 10. Details of Water Sampling in Marawi and Lumbayanague 48 Table 11. Drinking Water Result 50 Table 12. Receiving Body of Water Results 50 Table 13. Air Quality Sampling Results, Barangay Bubong, Saguiaran, Lanao del Sur 51 Table 14. Noise Level Sampling Results, Barangay Bubong, Saguiaran, Lanao del Sur 52 Table 15. IUCN Red List for Marawi (Mammals and Reptiles) 55 Table 16. IUCN Red List for Marawi (Birds) 56 Table 17. IUCN Red List for Lumbayanague (Mammals and Reptiles) 57 Table 18. IUCN Red List for Lumbayanague (Birds) 57 Table 19. Age Group for Marawi and Lumbayanague, 2015 58 Table 20. Highest Grade / Year Completed, Marawi City 59 Table 21. Major Occupation Group, Marawi City and Lumbayanague 59 Table 22. Morbidity Statistics in the Philippines 60 Table 23. Mortality Statistics, Marawi City and Lumbayanague 60 Table 24. Summary of VECs for the Proposed Construction of Health Units in Marawi City and Lumbayanague, Lanao del Sur 63 Table 25. Intensity, Duration and Scope Classification of Impacts 64 Table 26. Multi-criteria Analysis to Determine the Potential Environmental Impacts 64 Table 27. Matrix Showing the Relationship Between VECs and Project Components and Activities for the Construction of Health Units 65 Table 28. Analysis of Environmental Impacts 66 Table 29. Summary of Consultations with Relevant Agencies on May 28-29, 2019 73 Table 30. Summary of Consultations with Relevant Agencies on December 18, 2019 75 Table 31. Proposed Environmental Monitoring Plan 78 Table 32. Roles and Responsibilities of Offices in Project Implementation 81 Table 33. Organizational Set-up for Environmental Management Plan and Environmental Monitoring Plan Implementation 83

EXECUTIVE SUMMARY

1. This Initial Environmental Examination (IEE) was prepared for the health component of Output 3 of the Emergency Assistance for the Reconstruction and Rehabilitation of Marawi (ERRM)1 (the Project). Output 3 of the ERRM, which includes water supply and health components, will be financed by a $5 million grant under the Urban Climate Change Resilience Trust Fund (UCCRTF). UCCRTF, as a multi-donor trust fund was created to enhance resilience.

2. This is an updated IEE, incorporating the detailed design of the health units, COVID-19 health and safety guidelines, status of issuance of Certificates of Non-coverage (CNCs) from the Bangsamoro Autonomous Region in Muslim Mindanao – Ministry of Environment, Natural Resources, and Energy (MENRE), and further details on environmental management plan. The latest version prior to this updated IEE was disclosed in July 2020.

3. The Project will follow relevant provisions of the Safeguards Policy Statement (SPS) 2009 of Asian Development Bank and the Philippine government requirements. If there are changes in the project design or location, and if there are major unanticipated impacts that were not included in this assessment, this IEE will be updated.

4. The health component consists of construction of two local health units, procurement of mobile health units, and institutional and operational support (the Project). The grant will finance the construction of 2 local health units, which comprised the City Health Unit (CHU) in Marawi and Rural Health Unit (RHU) in Lumbayanague. The health units will incorporate climate resilience measures (solar powered refrigeration), be well equipped, have birthing facilities and have provisions for water supply and sanitation. The grant will also finance the procurement of medical transport vehicles, 2 ambulances, 2 patient transport vehicles and 2 monitoring vehicles for the Integrated Provincial Health Office (IPHO) and the City Health Office (CHO).

5. The Project is categorized as “B” for environment based on the Safeguard Policy Statement (SPS) 2009 since the anticipated impacts are site-specific, few if any are irreversible, and mitigation measures can be readily designed. As per SPS, the Project requires the preparation of an initial environmental examination (IEE), which covers the assessment of the Philippines’ legal framework applicable to the Project, the description of the proposed Project and the environment where the buildings will be located. Based on these assessments, potential environmental issues and impacts were identified and mitigating measures were proposed and institutionalized as Environmental Management Plan, which will be part and parcel of bidding document for the contractors who will build the two health units. The anticipated environmental impacts of the procurement of mobile health units, as well as institutional and operational support, are negligible. The construction of clinics, including rural health units is not covered by the Philippine Environmental Impact Statement (EIS) System. Hence, there is no requirement for the Project to secure Environmental Compliance Certificate (ECC) from the Department of Environment and Natural Resources (DENR). The Bangsamoro Autonomous Region in Muslim Mindanao – Ministry of Environment, Natural Resources and Energy (BARMM – MENRE) issued the Certificates of Non-coverage (CNCs) to Marawi City Health Office on May 28, 2021, and to the Integrated Provincial Health Office for Lumbayanague, on March 3, 2021.

1 The ERRM comprises of four outputs: (i) fiscal support (Output 1); (ii) reestablishing connectivity in Marawi by building back better public infrastructure (Output 2); (iii) restoring water utilities and health infrastructure (Output 3); and (iv) improving social services and livelihoods to affected persons (Output 4).

6. The IEE also proposed the mechanisms for grievance redress for the Project, as well as the disclosure of the IEE contents. All the information gathered for this IEE were based from site assessment of the two sites, consultations with Marawi and Lumbayanague stakeholders, and review of available literature from past studies. ADB subscribed as well as opensourced climate screening and biodiversity softwares, were also utilized.

7. The legal framework covering the project was assessed, including the country’s legal framework, the applicable international legal agreement where the Philippines is a member and, other regulations governing the health sector. The Project is governed primarily by the Philippine environmental impact statement (EIS) system and laws related to management of water (drinking water and receiving body of water), air, noise, solid wastes (including hazardous wastes), and protected areas system. Construction of clinics, including rural health units and the purchase of mobile health units are not covered is not covered by the Philippine EIA system.

8. The proposed location in Marawi City will be the present City Engineering Office (CEO) building and portion of the General Services Office (GSO) building. Both CEO and GSO buildings will be demolished as part of the greater masterplan for the Government Center of Marawi. The proposed location is about 3 meters away from the current City Health Office and the demolished Tuberculosis Directly Observed Treatment, Short Course (TB-DOTS) building, which will serve as the City Command Center. The proposed location in Lumbayanague, Lanao del Sur, on the other hand, will be in a vacant lot at the back of the municipal hall and adjacent to an elementary school. Both sites, located within the local government unit compounds, are both owned by the two LGUs. Based on certification from the Office of City Assessor on September 25, 2019, the proposed City Health Unit, which is located inside the government center, is owned by the local government of Marawi City for 79 years under Tax Declaration No. A-040-0034-03038. The City Government of Marawi also issued Executive Order No. 16, series of 2019, ordering the transfer of lot intended for the Urban Health Unit (the City Health Unit) from Old City Health Office to the City Engineering Office and General Services Office. The proposed Rural Health Unit in Lumbayanague, on the other hand, is covered by the Deed of Donation and Acceptance by and between Faiza Derico and Municipal Mayor Salamona Asum.

9. The proposed Project will be equipped to meet the 4:1 service delivery requirement, comprising (i) Tamang Serbisyo sa Kalusugan ng Pamilya (TSeKaP, a primary health care package under the Philippine Health Insurance Corporation); (ii) Maternal Care Package; (iii) Directly observed treatment, short-course for tuberculosis (TB-DOTS) and (iv) Animal Bite Services. The health units will also incorporate climate resilience measures, including raising the ground floor to at least 600 mm from finish grade line, provision of area at 2nd floor for installation of solar panels, provision for rain collection system, provision of water tank and water collection system, and provision of off the grid power supply (solar power). including installation of solar powered refrigeration. The health facility is a two-storey, a 22 meters (L) x 18.40 meters (W) for Lumbayanague with the floor area of approximately 809 sq. m for both floors and 26.00 meters (L) x 18.30 (W) for Marawi City with the area of approximately 951.60 sq.m. for both floors. Both RC building uses mono-slope rib-type metal roofing system.

10. Both Marawi City and Lumbayanague are part of Lake Lanao Watershed Reserve (LLWR) established as a Watershed Reservation under Presidential Proclamation No. 871 in February 26, 1992 to protect, maintain or improve its water yield for hydroelectric power production, irrigation and other ecological enhancement purposes. Both sites for local health units are located in alienable and disposable (A& D) lands, which means that these lands are of the public domain

and declared as not needed for forest, mineral purposes or national parks.2

11. The province of Lanao del Sur, and the Lake Lanao Watershed (LLW), is characterized by rugged terrain. Marawi City CHU site is about 700 meters above sea level (MASL), while Lumbayanague site is about 746 MASL.

12. Central Mindanao, including Lanao del Sur, is one of the seismically active areas in the country because of the presence of the western extension of the Mindanao Fault (Cotabato- Sindangan Fault), an active fault that runs from Sarangani province to northwest of Zamboanga Peninsula. Based on the landslide susceptibility map from the Mines and Geosciences Bureau, the proposed city health unit in Marawi and rural health unit in Lumbayanague are both located in low susceptibility to landslide areas.

13. Lake Lanao has been categorized by DENR as “Class A”, which means that the water coming from the lake requires complete treatment to meet the national standards for drinking water.

14. The province, being in the southern Philippines seldom experiences typhoons because of its proximity to the geographical equator. The typhoon frequency in the province is about one (1) in twelve years. Based on Corona’s Classification, the province belongs to the 3rd Climatic Type which is characterized by having no pronounced dry and wet season, where the average annual rainfall ranges from 1,329 mm to 5,235 mm. This Type III climate is a wet climate with a very short dry period lasting only for about two months. The maximum rain period occurs from June to September and the dry period is from March to April.

15. Baseline conditions were assessed for soil, drinking water and receiving body of water (Lake Lanao) for two sites. High level of lead was measured within the vicinity of the proposed CHU site in Marawi. Both drinking water samples from Marawi City Water District and the community water supply in Lumbayanague did not pass the Philippine National Standards for Drinking Water (PNSDW) for thermotolerant coliform. Total coliform in drinking water sample from Lumbayanague exceeds the PNSDW standard. Escherichia coli is also present in drinking water sample from Lumbayanague, while lead concentration is a concern in Marawi as it did not pass the PNSDW standard.

16. Air quality monitoring conducted on January 28, 2019 in Saguiaran, Lanao del Sur for Output 2 of ERMM showed that TSP, PM10, PM2.5 and SO2 are all within DENR National Ambient Air Quality Guideline Values. Noise levels measured on the same location showed that daytime, noise levels were within the allowable levels of the DENR, while morning, evening and nighttime levels were slightly higher than DENR standard.

17. Using the Integrated Biodiversity Assessment Tool (IBAT) proximity analysis, the tool identified biodiversity features and species which can be found within the 10-km and 50-km buffer from the proposed Marawi City Health Unit and Lumbayanague Rural Health Unit locations. IBAT generated list of species under red list category. The report generated list of species within 50- km range of the designated project site. Most of the species reside in lowland forests which are outside the impact area of the project. There are no species of concern within the project impact zones.

18. In terms of socioeconomic environment, Marawi City has a population of 201,785, making

2 Revised Public Land Act of the Philippines. Thirteenth Congress of the Philippines. June 30, 2004.

up 19.3 percent of the total provincial population. Lumbayanague, on the other hand has a population of 16,372. Although there are no available morbidity and mortality statistics for the province based on the Philippine Statistics Authority 2015 census, the top ten diseases in the Philippines that can also mirror the situation in Lanao del Sur include acute respiratory infection, hypertension, acute lower respiratory tract infection, bronchitis, influenza, acute watery diarrhea, dengue fever, tuberculosis, and acute febrile illness.

19. Potential impacts on physical, biological and socio-economic environment were identified using modified Leopold matrix. The matrix involves the identification of potential impacts of the Project based on the interactions between valued environmental components (VECs) and project activities. Major adverse impacts are anticipated during demolition of existing CHU in Marawi, tree cutting and debris clearing, mobilization of construction equipment and construction of temporary facilities and construction of health facilities. Among the major impacts identified during the CEO and GSO buildings demolition in Marawi include generation, storage, transportation and disposal of wastes from demolished buildings, which may affect the health of workers and people that might be exposed from passing or by being near the site, contamination of Lake Lanao from sediment transport of demolished buildings, suspension of health and emergency services, increase in particulate matter, noise level, and risk and inconvenience to the community.

20. As there are several trees that might be affected by the Project, land and soil condition will also be affected, in addition to the generation of particulate matter that will expose workers. During mobilization, the movement of vehicles carrying construction materials as well as the construction of temporary facilities will disturb the soil, generate sediments that may potentially contaminate Lake Lanao and Agus River, increase the level of air pollutants coming from emission from vehicle and the disturbance of soil, temporary suspension of health and emergency services, disturbance among the public and difficulty accessing other offices inside the local government units’ compounds.

21. The construction of two health units is anticipated to generate the majority of negative adverse impacts, hence this stage is the most crucial to mitigate environmental impacts. Major impacts at this phase include management of demolition wastes of the CEO and GSO buildings, in the case of Marawi, permanent loss of soil within building footprint, and generation of sediments, liquid and solid wastes that have the potential to pollute Lake Lanao and Agus River. The operation of vehicles carrying aggregates and construction materials may also generate oil, fuel and chemicals from construction site that can be transported to receiving body of water. The exhaust during vehicle movement, both from disturbed soil and from vehicles, will temporarily increase the level of air pollutants. The operation of vehicles will also increase the level of noise, vibration, and traffic congestion in the two sites. The construction of the buildings will likewise increase the risks to health and safety of construction workers that will be hired for the project. There will also be safety risks to public such as construction vehicle movement, uneven soil surfaces, pollution from sediments, and potential accident from transporting of construction materials.

22. Prior to start of construction, DOH should formally require the contractor to submit an updated site-specific health and safety management plan, which covers COVID-19 related health and safety risks. The updated site-specific health and safety management plan should be in accordance with DPWH’s Department Order No. 30, series of 2021 or the Construction Safety Guidelines for the Implementation of All Government and Private Construction Projects during the COVID-19 Public Health Crisis. DOH is required to inform ADB on the approval of the Health and Safety COVID-19 plan submitted by the Contractor. The ADB is not responsible for approving the Health and Safety COVID-19 plan; and clearance from the ADB is not a prerequisite to DOH’s

approval of the resumption of site works in the two locations.

23. The operation phase will also be crucial as the City Health Office (CHO) and Integrated Provincial Health Office (IPHO) must ensure the reliability and quality of water to be used for the operation of the health units. It was established that the quality of drinking water in Marawi has high levels of lead and thermotolerant coliform while drinking water in Lumbayanague has high levels of thermotolerant coliform, total coliform, and E. coli. Both sites should not use the tap water for drinking and washing utensils and laboratory equipment, and instead should be used only for flushing toilets and other uses that will not compromise the health and safety of personnel and patients of health units. Both sites should also explore alternative safe sources of water, in coordination with local water districts.

24. The operation of health units will generate solid wastes, including medical wastes, that will potentially impact the environment, if not properly managed and disposed. To mitigate the impacts of solid waste, the projecct will establish solid waste management system in the two health units. These include installation of segregated waste receptacles for biodegradable, recyclables, residual and hazardous wastes, implementation of the 3Rs of waste management (reduce, reuse and recycle), agreement with the local government units of Marawi and Lumbayanague for regular waste collection, and prohibition of burning of wastes and dumping of wastes in waterways.

25. Wastewater will also be generated from laboratories as well as different sections of health units during operation phase. The health units will comply with DENR’s Republic Act 6969 to manage hazardous contents, such as residual oil and toxic chemical materials. These hazardous wastes must be stored in a specific container that must be further processed by an accredited transport, storage and disposal (TSD) service provider. Three-chambered septic tank will be incorporated in the design to process wastewater coming from the toilets and kitchen.

26. In the proposed Environmental Management Plan (EMP), measures to mitigate negative impacts were proposed, as well as the assignment of institutional responsibilities to ensure that the proposed $ 5 million grant will be sustainable. The Department of Public Works and Highways (DPWH), as the Executing Agency (EA), has the overall strategic oversight of all infrastructure components. The Department of Health (DOH) Central Office Project Management Unit (PMU), as the Implementing Agency will be responsible for the implementation of the health component of the grant financed under the Urban Climate Change Resilience Trust Fund (UCCRTF). The PMU will be supported by procurement, contracts management and health specialists. The Integrated Provincial Health Office (IPHO) will be the project owner for the rural health unit (RHU), 1 ambulance, 1 patient transport vehicle and 1 monitoring vehicle in Lumbayanague. The City Health Office (CHO) meanwhile, will be the project owner for the city health unit (CHU), 1 ambulance, 1 patient transport vehicle, and 1 monitoring vehicle, in Marawi City. Both IPHO and CHO will be responsible for confirming specifications for all infrastructure and equipment. They also need to confirm the quality of works during construction. Both offices need to allocate resources (staff and budget) for operations and maintenance. Task Force Bangon Marawi (TFBM)3, through the Military Engineering Unit, will provide assistance in the demolition and transport of wastes from demolished CEO and GSO buildings. TFBM is tasked to facilitate recovery efforts and coordinate with development partners. To ensure that the operation of the Project will be environmentally sustainable, monitoring of drinking water, receiving body of water, air quality and noise levels, and soil quality, are proposed during construction and operation

3 Administrative Order No. 3 (28 June 2017) created the Task Force Bangon Marawi, an interagency group tasked to facilitate recovery efforts in Marawi.

phases.

27. As required in SPS 2009, consultations with Marawi and Lumbayanague local government units were conducted on May 28 and 29, 2019, respectively. A team from Asian Development Bank and Department of Health met with stakeholders from the two LGUs, Task Force Bangon Marawi (TFBM), and with affected people. Issues discussed include the final location of proposed CHU in case of Marawi, requirement for certificate of ownership of lots that will be developed for health units and sustainability of the operation of health facilities. Another consultation was conducted on December 18, 2019 in response to the request of the city government of Marawi to transfer the proposed site from the existing CHU to the existing CEO and GSO buildings. Both buildings are located about 3 meters from the CHU.

28. Information disclosure will be guided by ADB’s Public Communication Policy 2011 and Access to Information Policy 2018, and the procedures in ADB SPS 2009 for environment category B projects. The final IEE of the proposed health units in Marawi and Lumbayanague will be posted in ADB website upon receipt. Highlights of the IEE will be disclosed in the local language in Marawi and Lumbayanague. A subproject-specific grievance redress mechanism (GRM) was proposed for the Project to receive, evaluate and facilitate the complaints/grievances of affected persons on the environmental performance of the established health units.

I. INTRODUCTION

A. Project Background

1. The Government of the Philippines has requested ADB to provide emergency assistance combining a $400 million Emergency Assistance Loan (EAL) and $8 million in grants to support the reconstruction of Marawi. The Emergency Assistance for the Reconstruction and Recovery of Marawi Project (ERRM) is structured to provide the Government of the Philippines (Government) with immediate and flexible financing to implement programs, projects and activities (PPAs) included in the Bangon Marawi Comprehensive Rehabilitation and Recovery Program (BMCRRP), as may be updated from time to time. The ERRM comprises of four outputs: (i) fiscal support (Output 1); (ii) reestablishing connectivity in Marawi by building back better public infrastructure (Output 2); (iii) restoring water utilities and health infrastructure (Output 3); and (iv) improving social services and livelihoods to affected persons (Output 4).

2. Output 3 of the ERRM will be financed by a $5 million grant under the Urban Climate Change Resilience Trust Fund (UCCRTF). It will include a water supply component and a health component. These two sectors have been identified as critical components for the recovery of the city. Hence, UCCRTF as a multi-donor trust fund created to enhance resilience, particularly of the poor and vulnerable, is directing its support towards the provision of these key urban services.

B. Project Objectives

3. The health component under Output 3 of the ERRM will finance the construction of two local health units, procurement of medical transport vehicles, and institutional and operational support (the Project). The grant will finance the construction of 2 local health units (an Urban Health Unit or City Health Unit in Marawi; and a Rural Health Unit in Piagapo4) as model health units that meet or exceed national standards. The health units will incorporate climate resilience measures, including raising the ground floor to at least 600 mm from finish grade line, provision of area at 2nd floor for installation of solar panels, provision for rain collection system, provision of water tank and water collection system, and provision of off the grid power supply (solar power). including installation of solar powered refrigeration.

4. The grant will also finance the procurement of medical transport vehicles, 2 ambulances, 2 patient transport vehicles and 2 monitoring vehicles for the Integrated Provincial Health Office (IPHO) and the City Health Office (CHO). The provision of medical transport vehicles will enable the restoration of essential health services, including reproductive health services, to Marawi City (through the City Health Office) and surrounding areas hosting internally displaced persons (IDPs), through the Integrated Provincial Health Office.

5. As a UCCRTF grant, the design of the proposed interventions has to embed climate change and disaster resilience and must demonstrate transformative elements (i.e., building back better). The grant will also provide institutional and operational support related to the above activities.

4 It was later decided that the rural health unit will be constructed in Lumbayanague, Lanao del Sur because of land availability.

C. Purpose of the IEE Study

6. 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 will include 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 alternatives, (vi) environmental management plan, (vii) grievance redress mechanism, (viii) consultation and information disclosure, and (ix) conclusion and recommendation.

D. Extent of the IEE Study

7. 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 included 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 and monitoring.

E. Methods Used for the IEE Study

8. The initial environmental examination reviewed the legal framework applicable to the project and the technical details of the proposed local health units. Other methods used in the assessment include the following:

1. Site Assessment and Public Consultation

9. Site assessment and public consultations were conducted in Marawi and Lumbayanague to gather baseline conditions, determine the valued environmental components (VECs), and to solicit information from the public regarding the proposed project. Consultations were also conducted with the Department of Health, the Integrated Provincial Health Office (IPHO) of Lanao del Sur, and the City Health Office (CHO) of Marawi City. The information gathered from these consultations were incorporated in the IEE.

2. Primary and Secondary Data Collection

10. Primary and secondary data were collected for the physical, biological and socio- economic environment of Lanao del Sur in general, and Marawi City and Lumbayanague in particular. Primary data were collected for soil, drinking water and receiving bodies of water in the two local government units. Geological information, data on river basin, flora and fauna as well as socio economic data were all sourced from secondary sources. These include published government reports, journals, and relevant websites.

3. Other Tools, Additional Surveys and Studies

11. Climate risk screening identified Lanao del Sur as one of the provinces most at risk to temperature increase and El Niňo induced drought5 which may adversely impact the local health unit components. Climate resilient design will be incorporated to the project to mitigate the induced impact of temperature increase and El Niňo induced drought.

4. 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.

5. 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.

E. 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: Impact Assessment and Mitigation Measures Chapter – 6: Public Consultation and Information Disclosure Chapter – 7: Environmental Management Plan Chapter – 8: Grievance Redress Mechanism Chapter – 9: Conclusion and Recommendation

5 http://vm.observatory.ph/cw_maps.html

II. POLICY, LEGAL AND ADMINISTRATIVE FRAMEWORK

15. This section reviews all the relevant international agreements and commitments, existing institutions and legislations, both at the national and local levels. The environmental assessment process needs to adopt environmental regulations and guidelines of the Government of the Philippines (GOP) and ADB’s safeguard requirements.

16. The Philippines is a member of various international agreements, conventions and treaties for conservation of the environment at global level. Some of the international agreements where the Philippines is a party and applicable to the proposed projects are discussed in the following sections.

A. International Environmental Agreements

17. Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES). As a party to the convention, the Philippines is required to submit an annual report on CITES trade and a biennial report on legislative, regulatory, and administrative measures taken to enforce the Convention.

18. Convention on Biological Diversity, 1992. Under the Convention, Parties are required to develop national biodiversity strategies and action plans which are to be mainstreamed into the broader national plans for environment and development particularly for the forestry, agriculture, fisheries, energy, transportation and urban planning sectors.

19. Strategic Approach to International Chemicals Management (SAICM). The Strategic Approach to International Chemicals Management (SAICM) is a policy framework that aims to promote chemical safety throughout their life cycle, so that by 2020, chemicals are used in ways that minimize significant adverse impacts on human health and the environment. This "2020 goal" was adopted by the World Summit on Sustainable Development in 2002 as part of the Johannesburg Plan of Implementation.

20. United Nations Convention on Sustainable Development. Also known as Rio+20 or Earth Summit 2012, the UNCSD is the third conference on Sustainable Development. It followed the 1992 Earth Summit/United Nations Conference on Environment and Development (UNCED). UNCSD is the key forum for the consideration of issues related to the integration of the three dimensions of sustainable development: economic development, social inclusion and environmental protection. As such, its mandate is not limited to environmental issues.

21. Stockholm Convention, 2004. The Stockholm Convention is a global treaty to protect human health and the environment from the adverse effects of persistent organic pollutants (POPs). Adopted in 2001 and entered into force in 2004, the convention requires its parties to take measures to eliminate or reduce the release of POPs into the environment.

22. United Nations Framework Convention on Climate Change, 2003. The United Nations Framework Convention on Climate Change (UNFCCC) is an international treaty focusing on what countries could do to limit average global temperature increases and the resulting climate change. The ultimate objective of the convention is the stabilization of greenhouse gas concentrations in the atmosphere at a level that would prevent dangerous anthropogenic interference with the climate system. In 2013, both non-Annex (including the Philippines) and Annex I members to the UNFCCC were requested to prepare their Intended Nationally Determined Contributions (INDCs).

Activities/Goals set under the INDC, regardless of the legal nature of the contributions, will serve as the first Nationally Determined Contribution of the respective parties for the period beyond the Doha Amendment, upon ratification of the Paris Agreement.

23. Kyoto Protocol, 2003. The Kyoto Protocol is an international treaty under the UNFCCC. Adopted in 1997, the protocol commits 43 Annex I countries to limit their greenhouse gas emissions for the period 2008-2012 below or equal to the level of their emissions in 1990. By 2012, the Doha Amendment to the protocol was proposed to extend the protocol to a second commitment period for 2013-2020. However, only 37 countries have committed to binding targets. Binding targets for Kyoto Protocol are applicable only to Annex I (developed countries), and will end in 2020.

24. Vienna Convention for Protection of the Ozone layer, 1991 and Montreal Protocol on Substances Depleting the Ozone layer, 1991: The Vienna Convention outlines states’ responsibilities for protecting human health and the environment against the adverse effects of ozone depletion, and established the framework under which the Montreal Protocol was negotiated. The Montreal Protocol stipulates that the production and consumption of compounds that deplete ozone in the stratosphere chlorofluorocarbons (CFCs), halons, carbon tetrachloride, and methyl chloroform) are to be phased out by 2010. The project does not envisage production and consumption of ODS.

B. Country’s Legal Framework and Regulatory Requirements

25. Presidential Decree (PD) 1151, enacted on June 6, 1977, established the Philippine Environment Policy to address the need to formulate an integrated program to protect the environment. The policy mandates the government, in cooperation of concerned private organizations and entities to use all practicable means to promote the general welfare of the people through safe, decent, helpful, productive and aesthetic environment. All agencies and instrumentalities of the national government, including all government owned and controlled corporations, as well as private companies and entities with projects or undertakings that can significantly affect the quality of the environment, are required to prepare a detailed statement on the environmental impact of the proposed action, project or undertaking.

26. Presidential Decree 1586, which became effective on June 11, 1978, established the Philippine Environmental Impact Statement System. Section 4 of the decree empowers the President or his duly authorized representative to grant or deny the issuance of environmental compliance certificates (ECCs) for environmentally critical projects (ECPs) and projects within environmentally critical areas (ECAs).

27. Presidential Proclamation No. 2146 (Proclaiming Certain Areas and Types of Projects as Environmentally Critical and Within the Scope of the Environmental Impact Statement System Established under Presidential Decree No. 1586), proclaim certain areas and types of projects as environmentally critical, and hence within the scope of the EIS system.

28. Environmentally critical projects (ECPs) include the following: a. Heavy industries i. Non-ferrous metal industries ii. Iron and steel mills iii. Petroleum and petrochemical industries including oil and gas iv. Smelting plants

b. Resource extractive industries i. Major mining and quarrying projects ii. Forestry projects 1. Logging 2. Major wood processing projects 3. Introduction of fauna (exotic animals) in public / private forests 4. Forest occupancy 5. Extraction of mangrove products 6. Grazing iii. Fishery Projects 1. Dikes for/and fishpond development projects c. Infrastructure Projects i. Major dams ii. Major power plants (fossil-fueled, nuclear fueled, hydroelectric or geothermal) iii. Major reclamation projects iv. Major roads and bridges

29. Environmentally critical areas (ECAs) include the following: a. All areas declared by law as national parks, watershed reserves, wildlife preserves and sanctuaries; b. Areas set aside as aesthetic potential tourist spots; c. Areas which constitute the habitat for any endangered or threatened species of indigenous Philippine Wildlife (flora and fauna); d. Areas of unique historic, archaeological , or scientific interests; e. Areas which are traditionally occupied by cultural communities or tribes; f. Areas frequently visited and/or hard-hit by natural calamities geologic hazards, floods, typhoons, volcanic activity, etc. g. Areas with critical slopes; h. Areas classified as prime agricultural lands; i. Recharged areas of aquifers; j. Water bodies characterized by one or any combination of the following conditions: i. tapped for domestic purposes; ii. within the controlled and/or protected areas declared by appropriate authorities; iii. which support wildlife and fishery activities. k. Mangrove areas characterized by one or any combination or the following conditions: i. with primary pristine and dense young growth; ii. near or adjacent to traditional productive fry or fishing grounds; iii. which act as natural buffers against shore erosion, strong winds and storm floods; iv. on which people are dependent for their livelihood. l. Coral reef characterized by one or any combination of the following conditions: i. with 50% and above live coralline cover; ii. Spawning and nursery grounds for fish; iii. Which act as natural breakwater of coastlines.

30. Administrative Order No. 300 (Further Strengthening the Philippine Environmental Impact Statement System and Clarifying the Authority to Grant or Deny the Issuance of Environmental

Compliance Certificates), signed in 1996, confirm the power of the Secretary of the Department of Environment and Natural Resources and the DENR Regional Executive Directors to grant or deny the issuance of environmental compliance certificates (ECCs).

31. Section 3 of PD 1586 mandates the National Environmental Protection Council (NEPC), to review and evaluate the environmental impact statements on declared ECPs and ECAs. The NEPC and National Pollution Control Commission (NPCC) were merged in June 1987, and by virtue of Executive Order 192, became the Environmental Management Bureau (EMB). The EMB became a line bureau of the DENR pursuant to Republic Act 8749 (Philippine Clean Air Act) in 1999. The DENR is tasked to administer the EIS System through the EMB and its regional offices (ROs). The DENR-EMB central office reviews and processes ECPs while the DENR-EMB ROs review and approve projects considered to be located in ECAs, as well as projects outside the EIS system purview.

32. DENR Administrative Order No. 30, series of 2003 categorized single projects into three major groups:

a. Group I: ECPs in either ECAs or Non-ECAs i. Golf course ii. Heavy industries iii. Fishery iv. Logging v. Grazing projects vi. All projects introducing exotic fauna in public and private forests vii. Major wood processing viii. Major mining and quarrying projects ix. Major listed infrastructure projects

b. Group II: Non-ECPs in ECAs; i. Agriculture industry ii. Buildings, storage facilities and other structures iii. Chemical industries iv. Cottage industries v. Demonstration and pilot projects vi. Environmental enhancement and mitigation projects vii. Food and related industries viii. Packaging materials and miscellaneous products industries ix. Pipeline projects x. Textile, wood and rubber industries xi. Tourism industry xii. Transport terminal facilities xiii. Waste management projects xiv. Water supply, irrigation or flood control projects xv. Treasure hunting in National Integrated Protected Areas System (NIPAS) xvi. Wildlife farming or any related projects as defined by PAWB

c. Group III: Non-ECPs in Non-ECAs – All Group II project types outside ECAs

33. Environmentally critical projects require the completion of an EIA and the submission of an EIS report (Group I) while projects in ECAs (Group II) require the preparation of an Initial Environmental Examination (IEE) Report. DENR determines if a project is an ECP or if a project

will be implemented in an ECA. If either or both of these conditions apply, the proposal is required to secure an ECC. Otherwise, DENR – EMB or the ROs can issue a Certificate of Non-Coverage (CNC) certifying that the project will not significantly affect the environment (Group III). BARMM – MENRE issued Certificates of Non-coverage to both Marawi City Health Office and the Integrated Provincial Health Office on May 28, 2021 and March 3, 2021, respectively (Appendix 1).

34. Since the proposed local health units will be constructed in already built-up areas, the proposed projects are not within Environmentally Critical Areas, hence no requirement for securing ECC.

35. Table 1 contains the summary of environmental legislations applicable to the construction of health units in Marawi and Lumbayanague, Lanao del Sur.

Table 1. Summary of Environmental Legislations Applicable to the Proposed Project No. Legislation Legislation Title Relevance to the Project Responsible Number Institution 1 Presidential Philippine Environmental Project proponent is not Ministry of Decree 1151 Policy required to prepare an Natural (1977) environmental impact Resources statement or initial (1974-1987) environmental examination of proposed action, project or undertaking. 2 Presidential Philippine Environmental Establishment of Philippine Ministry of Decree 1586 Impact Statement environmental impact Natural (1978) System statement (EIS) system Resources based on Section 4 of (1974-1987) Presidential Decree 1151 3 Presidential Proclaiming Certain Proclamation of areas and Ministry of Proclamation Areas and Types of types of projects as Natural 2146 (1981) Projects as environmentally critical and Resources Environmentally Critical within the scope of Philippine (1974-1987) and Within the Scope of EIS system EIS Established under PD 1586 4 Presidential Creating the National Creation of the National National Decree 1121 Environmental Protection Environmental Protection Environment (1977) Council Council as a central authority al Protection that will oversee, unify and Council integrate the planning, (1977 – management, and 1987) implementation of the government’s environment program 5 Executive Reorganization Act of the Providing for the Department of Order No. 192 Department of reorganization of the Environment (1987) Environment and Natural Department of Environment, and Natural Resources Energy and Natural Resources Resources, renaming it as (1987 – the Department of present) Environment and Natural Resources and for other Purposes

No. Legislation Legislation Title Relevance to the Project Responsible Number Institution 6 DENR Defining the Strengthening the DENR and Administrativ Organizational Structure enforcement and EMB e Order No. and Major implementation of major 2002-17 Responsibilities of the environmental laws such as Environmental Presidential Decree 984 – Management Bureau as Pollution Control Law; a line Bureau by virtue of Presidential Decree 1586 – Section 34 of the The Environmental Impact Philippine Clean Air Act Assessment Law; Republic of 1999 (RA 8749) Act 6969 – Toxic Substances and Hazardous and Nuclear Wastes Control Act; Republic Act 8749 – Philippine Clean Air Act of 1999; and Republic Act 9003 – Ecological Solid Wastes Management Act, among others 7 DENR Implementing Rules and Incorporation of DENR and Administrative Regulations for the environmental EMB Order No. 30,Philippine Environmental considerations into the (2003) Impact Statement System Environmental Impact Assessment (EIA) process at an early stage to streamline the current procedure in the conduct of the EIA process to improve the effectiveness as a planning, regulatory and management tool, and enhance maximum public participation 8 Republic Act Toxic Substances and Mandates control and DENR and 6969 (1990) Hazardous and Nuclear management of import, EMB Wastes Control Act manufacture, process, distribution, use, transport, treatment and disposal of toxic substances and hazardous and nuclear wastes in the country 9 Republic Act Philippine Clean Air Act of Comprehensive air quality DENR and 8749 (1999) 1999 management policy and EMB program with the objective of achieving and maintaining healthy air for all Philippine citizens 10 Republic Act Ecological Solid Wastes Provides guidelines for National Solid 9003 (2000) Management Act ecological solid waste Waste management program and Management creating the necessary Commission institutional mechanisms and (NSWMC) and incentives as well as EMB prohibitions and penalties 11 Republic Act Philippine Clean Water Act Applies to water quality DENR and 9275 (2004) of 2004 management in all water EMB

No. Legislation Legislation Title Relevance to the Project Responsible Number Institution bodies. Primarily applies to abatement and control of pollution from land-based sources. 12 Republic Act National Integrated Establishment of a DENR 7586 (1992) Protected Areas System comprehensive system of Act integrated protected areas within the classification of national park to secure the present and future generations the perpetual existence of all native plants and animals 13 DAO 08, Water Quality Guidelines Amended DAO 34 and 35 DENR and series of and General Effluent series of 1990. Classifies EMB 2016 Standards of 2016 Agus River as Class C6, which is appropriate as fishery water for propagation and growth of fish and other aquatic resources, recreational water class II fit for boating, and industrial water class I for manufacturing process after treatment. 14 Republic Act National Cultural Heritage Provides for the protection National 10066 Act of 2009 and conservation of the Commission (2009) national cultural heritage, for Culture and strengthening the National the Arts Commission for Culture and (NCCA) the Arts (NCCA) and its affiliated cultural agencies 15 Republic Act The Right-of-Way Act Aims to streamline the basis DPWH 10752 for valuation, as well as the (2016) process for the negotiation and acquisition of right-of- way for government infrastructure projects 16 Presidential Requiring the planting of Guidelines on planting of Bureau of Decree 953 trees in certain places and trees and penalty for cutting Forest (1976) penalizing unauthorized and damaging of trees Development cutting, destruction and (BFD) damaging and injuring on certain trees, plants and vegetations destruction, damaging and injuring of certain trees, plants and vegetation

6 Lake Lanao has been classified as “Class A”, which means that waters coming from the lake require complete treatment to meet the national standards for drinking water (https://www.officialgazette.gov.ph/2014/03/13/denr- classifies-21-more-water-bodies/).

No. Legislation Legislation Title Relevance to the Project Responsible Number Institution 17 Republic Act An Act Strengthening Aims to ensure a safe and Department 11058 Compliance with healthful workplace for all of Labor and (2018) Occupational Safety and workers by affording them full Employment Health Standards and protection against all hazards (DOLE) Providing Penalties for in their work environment. Violations thereof Rules apply to contractors and subcontractors including projects in the public sector 18 Republic Act Climate Change Act of Mainstreaming climate Climate 9729 (2009) 2009 change into government Change policy and establishing Commission framework strategy and (CCC) program for its implementation 19 Executive Institutionalizing Institutionalization of GHG Climate Order 174 Philippine Greenhouse inventory management and Change (2014) Gas Inventory reporting system in relevant Commission Management and government agencies to (CCC) Reporting System ensure transition towards a climate-resilient pathway for sustainable development. 20 Administrativ Chemical Control Order Set a 90ppm total lead Department e Order 2013- (CCO) content limit in paint. The of 24 CCO provided for a three- Environment year phase out period from and Natural 2013 to 2016 for lead- Resources containing paints used for architectural, decorative and household applications.

36. Project Screening. To determine project coverage, the proposed projects in Marawi and Lumbayanague shall be screened based on the following EMB classification:

37. Category A. Projects or undertakings which are classified as environmentally critical projects (ECPs) under Presidential Proclamation No. 2146 (1981), Proclamation No. 803 (1996) (Annex A). Proponents of these projects implemented starting 1982 are required to secure an Environmental Compliance Certificate (ECC).

38. Category B. Projects or undertakings which are not classified as ECP under Category A, but which are deemed to affect the quality of the environment as these are located in an environmentally critical area (ECA) as declared under Proclamation No. 2146. Proponents of these projects implemented starting 1982 are also required to secure an Environmental Compliance Certificate (ECC).

39. Category C. Projects or undertakings not falling under Category A or B which are intended to directly enhance the quality of the environment or directly address existing environmental problems.

40. Category D. Projects or undertakings that are deemed unlikely to cause significant adverse impacts on the quality of the environment. These projects are not covered by the Philippine EIS System and are not required to secure an ECC.

41. Based on Annex A (Project Thresholds for Coverage Screening and Categorization – (http://119.92.161.2/portal/Portals/21/Downloads/Annex%20A%20Project%20Thresholds%20for %20Coverage%20Screening%20and%20Categorization.pdf)) of the Revised Guidelines for Coverage Screening and Standardized Requirements in the Philippine EIS System, clinics, including rural health units is not covered by the Philippine EIA system.

Table 2. Project Thresholds for Coverage Screening and Categorization in Philippine EIS System Category Philippine EIA Project Category Required Environment Coverage Document Yes No Primary, secondary, B (Non-ECP) IEE Checklist tertiary hospitals or ✔ medical facilities Clinics (outpatients, D (Not covered) Project Description health centers, dental clinics), including rural health units, X-ray ✔ clinic, diagnostic laboratory, assay laboratory

i) Under Annex A (Project Thresholds for Coverage Screening and Categorization) of EMB Memorandum Circular (MC) 005, series of 2014, screening must be done to determine what document type the proponent will prepare and submit to EMB for environmental compliance certificate (ECC) application. ii) Based on the same MC, screening must be done to determine whether the project is located within an environmentally critical area (ECA) as enumerated in Section 3-b of the guideline. iii) To determine the type of environmental report the proponent needs to prepare to secure environmental compliance certificate (ECC), Annex A of the guideline details the project thresholds for coverage screening and categorization. iv) Clinics, including rural health units, are not covered by the Philippine EIS System. v) Purchase of mobile health units are not covered by the Philippine EIS System. vi) Tree cutting permit from DENR Community Environment and Natural Resources Office (CENRO) is required for infrastructure projects if there will be affected vegetation

C. Regulatory Framework on Operationalization of Local Health Systems

42. The Local Government Code (Republic Act No. 7160) was enacted in 1991, which changed the health system by giving LGUs the responsibility and autonomy to manage local health facilities and services. As mandated by law, provincial governments are tasked with providing primary and secondary hospital care, while city and municipal governments are tasked with providing primary health care, promotive and preventive health programs and basic ambulatory clinical care. In this set up, the DOH, as the national health agency, is mandated to lay down national policies and plans, develop technical standards, enforce health regulations, and

monitor, evaluate and deliver tertiary and specialized hospital services.

43. In every province, city or municipality, there is a local health board chaired by the local chief executive. Its function is to serve as an advisory body to the local chief executive and the local legislative council (sanggunian) on health-related matters. Under the Local Government Code of 1991, the DOH maintains representation in all local health boards through the DOH representatives (organized most recently as Development Management Officers under the DOH Provincial Health Teams).

44. As a distinct subnational entity created by law (Republic Act No. 6734, as amended by Republic Act No. 9054), the ARMM consisting of five provinces has its own regional DOH headed by a Regional Secretary of Health directly responsible to the ARMM Regional Governor. It directly administers the provincial, city and municipal health offices, and the provincial and district hospitals within the autonomous region.

D. Environmental Regulatory Framework Applicable to DOH

45. The Inter-Agency Committee on Environmental Health (IACEH), with the DOH as chair and the Department of Environment and Natural Resources as vice-chair, was created in 1991 by virtue of Executive Order No. 489 as a venue for technical collaboration, effective monitoring and communication, resource mobilization, policy review and development on matters related to the effects of the environment on population health. Collaborative policies and actions within the IACEH are tackled under the five multisectoral task forces on water, solid waste, air, toxic and chemical 44 substances and occupational health to ensure that environmental and occupational hazards and risks are mitigated; and that diseases, disabilities and deaths from environmental factors are prevented (NEHAP, 2010). Related to this, the Climate Change Act of 2009 (Republic Act No. 9729) was enacted to mainstream climate change into Government policies and to establish strategies and programmes on climate change. For this purpose, the Climate Change Commission was established with the President of the Philippines as the Chairperson and three commissioners as members, with the DOH representing the health sector in the advisory board.

46. Another law, the Philippine Disaster Risk Reduction and Management Act of 2010 (Republic Act No. 10121) provided for the development of policies and plans, and the implementation of actions and measures pertaining to all aspects of disaster risk reduction and management (DRRM), including risk assessment and early warning, awareness-raising, reducing underlying risk factors and ensuring preparedness for effective response and early recovery. The law restructured the National Disaster Coordinating Council into the National Disaster Risk Reduction and Management Council (NDRRMC) chaired by the Secretary of National Defense. The active participation of the DOH in the Council ensures that health concerns are taken into account in all policies and decisions.

E. Regulatory Framework in Autonomous Region in Muslim Mindanao

47. Republic Act 11054 (An Act Providing for the Organic Law for the Bangsamoro Automous Region in Muslim Mindanao, Repealing for the Purpose Republic Act No. 6734, Entitled "An Act Providing for An Organic Act for the Autonomous Region in Muslim Mindanao," As Amended by Republic Act No. 9054, Entitled "An Act to Strengthen and Expand the Organic Act for the Autonomous Region in Muslim Mindanao") was signed by President Duterte on July 26, 2018 and became effective on August 2018. Following the plebiscite on January 2019, the following are considered the new composition of Bangsamoro Autonomous Region in Muslim Mindanao

(BARMM): 1. Basilan (except Isabela City), Maguindanao, Lanao del Sur, Sulu, Tawi-tawi, City of Cotabato, and 63 barangays from the province of Cotabato.

48. Proclamation No. 453, issued in 1953 (Reserving for Military Purposes a Portion of the Public Domain Situated in the City of Dansalan, Island of Mindanao) reserve for military purposes a parcel of the public domain, situated at Camp Keithley, City of Dansalan, Island of Mindanao and described in Bureau of Lands Plan II-5919. The proposed City Health Unit, to be located at the existing City Engineering Office and General Services Office is within the City Hall compound, which is part of Proclamation No. 453.

F. Asian Development Bank Safeguard Policies

49. The Safeguard Policy Statement (SPS) was approved by ADB’s Board of Director in July 2009. The consolidated policy framework builds upon the three previous safeguard policies on environment, involuntary resettlement and indigenous peoples. The SPS became applicable for all ADB-supported projects reviewed by ADB management after 20 January 2010. The SPS replaces ADB’s Involuntary Resettlement Policy (1995), Policy on Indigenous Peoples (1998), and Environment Policy (2002).

50. The objectives of ADB’s safeguards are to:

a. Avoid adverse impact of projects on the environment and affected people; b. Minimize, mitigate and/or compensate for adverse project impacts on the environment and affected people when avoidance is not possible; and c. Help borrowers / clients to strengthen their safeguard systems and develop the capacity to manage environmental and social risks.

51. The policy requires the borrowers to undertake social and environmental assessments, conduct consultations with affected people and communities, prepare and implement safeguard plans (environmental management plan, resettlement plan, and indigenous peoples plan), monitor its implementation, and prepare and submit monitoring reports, as required in the covenants entered into by the borrower with ADB.

52. The role of ADB on the other hand, is to explain policy requirements to borrowers, help borrowers meet SPS requirements during project processing and implementation through capacity building programs, ensure due diligence and review, and provide monitoring and supervision.

53. For environmental safeguards, projects are classified into the following categories:

i) Category A. The proposed project is likely to have significant adverse environmental impacts that are irreversible, diverse, or unprecedented; 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.

ii) Category B. The proposed project’s 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.

iii) Category C. The proposed project is likely to have minimal or no adverse environmental impacts. No EIA or IEE is required although environmental implications need to be reviewed.

iv) Category FI. The proposed project involves the investment of ADB funds to, or through, a financial intermediary.

54. Project categorization has been done using REA checklist following the guidance provided above and the project is categorized as B. As per SPS 2009, Category B projects warrants preparation of an IEE. The SPS includes 11 policy principles on environment safeguards on screening, conduct of environmental assessment, alternative analysis, mitigation hierarchy, need for meaningful consultation, public disclosure, environmental management planning, biodiversity protection and conservation, pollution prevention, occupational health and safety, and conservation of physical cultural resources.

G. Other Applicable Regulations

a. DOH – Health Facilities Development Bureau (HFDB)

55. The DOH National Center for Health Facilities Development, now called the Health Facility Development Bureau (HFDB), developed the first Philippine Hospital Development Plan (PHDP) in 1995 to create a more responsive hospital system in the country. The PHDP was further updated in 2000 as a major thrust of the Health Sector Reform Agenda (Asia Pacific Observatory on Health Systems and Policies, 2013; Romualdez et al., 2011).

56. The development of hospitals and other health facilities is planned and designed according to appropriate architectural practices, and technical and operational guidelines established by the DOH. As a framework for health facility development, the DOH issued Administrative Order No. 29 of 2006 (Guidelines for Rationalizing the Health Care Delivery System based on Health Needs), which provides the procedures and requirements for planning health facilities in the crafting of Province-wide Investment Planning for Health (PIPH) and City- wide Investment Planning for Health (CIPH) by the LGUs. The DOH also issued Administrative Order Nos. 2006–0004 and 2006–0004-A (Guidelines for the Issuance of Certificate of Need to Establish a New Hospital) covering both government and private hospitals, specifying the requirements for establishing new hospitals, and upgrading, converting or increasing the bed capacity of existing hospitals. The guidelines established the basic criteria for a proposed health facility such as the catchment population, location and the commitment of LGUs to fund and maintain the health facility.

b. National Historical Institute and National Museum

57. In case of chance find of important historical and cultural properties during the construction phase, the National Historical Institute shall be responsible for significant movable and immovable cultural property that pertains to Philippine history, heroes and the conservation of historical artifacts and the National Museum shall be responsible for significant movable and immovable cultural and natural property pertaining to collections of fine arts, archaeology, anthropology, botany, geology, zoology and astronomy, including its conservation aspect.

III. DESCRIPTION OF THE PROJECT

A. Project Locations

58. Marawi City, formerly called Dansalan, is the capital of Lanao del Sur province. The city is located on the northern shore of Lake Lanao, about 1,100 meters above sea level, is considered one of the Philippines’ largest cities with Muslim population, hence its official name Islamic City of Marawi. Lumbayanague, on the other hand, is located on the southern shore of Lake Lanao (Figure 1). The municipality was created by virtue of Presidential Decree 1091 circa 1977 from several barangays of Lumbatan and Butig.

59. The proposed local health units will be located inside Marawi City Hall compound at the current site of the City Engineering Office and General Services Office, and inside the municipal compound of Lumbayanague, Lanao del Sur. The proposed health units in the two LGUs will be equipped to meet the 4:1 service delivery requirement, comprising (i) Tamang Serbisyo sa Kalusugan ng Pamilya (TSeKaP, a primary health care package under the Philippine Health Insurance Corporation); (ii) Maternal Care Package; (iii) Directly observed treatment, short-course for tuberculosis (TB DOTS) and (iv) Animal Bite Services. The Rapid Environmental Assessment (REA) Checklist is attached as Appendix 2.

60. Based on certification from the Office of City Assessor on September 25, 2019, the proposed City Health Unit, which is located inside the government center, is owned by the local government of Marawi City for 79 years under Tax Declaration No. A-040-0034-03038. The City Government of Marawi also issued Executive Order No. 16, series of 2019, ordering the transfer of lot intended for the Urban Health Unit (the City Health Unit) from Old City Health Office to the City Engineering Office and General Services Office. The proposed Rural Health Unit in Lumbayanague, on the other hand, is covered by the Deed of Donation and Acceptance by and between Faiza Derico and Municipal Mayor Salamona Asum. All of the stated documents are attached as Appendix 3.

Figure 1. Map of Lanao del Sur

a. Marawi City

61. The proposed CHU is located inside the city hall compound of Marawi City, where government buildings, including the city hall and the City Health Office (CHO) and Integrated Provincial Health Office (IPHO), are located. The proposed site is about 100 meters from Agus River. During the assessments conducted on 28 May 2019 and 18 December 2019, the ADB team and DOH from the national and regional offices inspected the existing CEO and GSO buildings where the proposed CHU will be built. Appendix 4 and Appendix 5 include the summary of meeting with different Marawi stakeholders and site assessment conducted by ADB consultant on 18 December, 2019. Appendix 6 and Appendix 7 are the site assessment report done by ADB consultant and DOH site inspection report, both on 28-29 May, 2019.

62. Some of the observations during the 18 December 2019 site assessment in Marawi City include: a. The existing City Engineering Office and General Services Office buildings will be demolished as part of the overall rehabilitation of the Government Center compound of Marawi, as indicated in the Masterplan for the rehabilitation of government buildings of the city. b. No major impacts are anticipated in the construction of CHU, except for the impacts of demolition, including the management of demolition debris of the existing CEO and GSO buildings and the temporary detention facility for inmates c. The City Engineering Office and General Services Office will be transferred to a new building, also located within the Government Center compound. Employees are amenable with the relocation of their offices. The inmates will be also transferred to a new detention facility. d. The Mines and Sciences Bureau has conducted a geohazard susceptibility study for the whole government center complex and concluded that the area has very low susceptibility to landslide. e. The demolition of the CEO and GSO buildings shall follow the provisions of RA 9003 in the collection, storage, transport and disposal of demolition debris. Task Force Bangon Marawi, through the Military Engineering Unit will provide assistance in the demolition and transport of wastes. f. As regards the proof of ownership of the proposed site, the Office of the Mayor assured that the Land Registration Authority has confirmed that Proclamation Nos. 375, 453 and 806 are still in effect, which states that the area occupied by the Government Center is government property. g. The city has to coordinate with the Department of Environment and Natural Resources (DENR) to assess the two mature diseased trees that might be affected by the demolition of existing buildings and construction of the new CHU. 7 b. The proposed new city health unit will incorporate climate change resilience interventions, including raising the ground floor to at least 600 mm from finish grade line, provision of area at 2nd floor for future installation of solar panels, provision for rain collection system, provision of water tank and water collection system, and provision of off the grid power supply (solar power). including installation of solar powered refrigeration.

63. As reflected in the EARF and based on the site assessment conducted, potential impacts from the demolition of the old building and construction of new CHU include: (i) generation of solid wastes; deterioration of surface water quality of Agus River and Lake Lanao, soil and groundwater

7 Permit to Cut Trees has been secured from CENRO on August 25, 2020.

contamination arising from solid wastes from demolition of old building, occupational and community health and safety as the demolition and construction will be inside the government center, and traffic and obstruction concerns, as many people go to the government center to conduct business and access services.

Figure 2. City Engineering Office building, Government Center of Marawi

Figure 3. General Services Office building, Government Center of Marawi City

Figure 4. Master Development Plan of Government Center of Marawi, including the proposed City Health Unit

b. Lumbayanague

64. The proposed rural health unit in Lumbayanague will be constructed in a vacant 800 m2 vacant lot at the back of the municipal hall. The proposed site of the RHU is about 570 meters from Lake Lanao. The proposed building is at the back of the municipal hall and adjacent to Sultan Gunting Central Elementary School.

Figure 5. Proposed location of Lumbayanague RHU

B. Detailed Design

65. The detailed design of health facilities complies with the DOH service delivery requirements, as detailed in DOH Administrative Order No. 2020-0047 (Rules and Regulations

Governing the Licensure of Primary Care Facilities in the Philippines) and the Manual on Technical Guidelines for Hospitals and Health Facilities Planning and Design. Department of Health, Manila. The proposed health units will also comply with gender responsive design requirements of ADB, as stipulated in the grant agreement and the Project Administration Manual (PAM). These include foot washing area and worship, prayer room separate for male and female, and four child changing stations and restraint seats. The proposed health units will also incorporate access for persons with disability (PWD).

66. The design of the health units will also incorporate climate resilience measures in accordance to the requirements of the Urban Climate Change Resilience Trust Fund (UCCRTF) of the ADB, and the DOH guidelines in the design of Rural Health Units. These include:

a. Raising finished floor to at least 600mm from finish grade line b. Provision of area at 2nd floor for future installation of solar panels c. Provision for rain collection system d. Require Civil Works drawings, to ensure site conditions are properly addressed; i.e., conduct proper site investigation and corresponding drawings, such as topographic map, storm drainage plan, etc. e. Provision of water tank, and water collection system f. Provision of off the gird power supply, i.e., solar power (subject to funds availability)

67. The proposed local health units will also incorporate solar powered refrigeration to ensure the continuity of health services, specifically on the storage of heat-sensitive vaccines. The solar powered refrigerator that will be incorporated for the Project should be powered directly by the sun (with or without battery) to keep the heat-sensitive vaccines at the right temperature. The World Health Organization (WHO) requires a holdover time of 3 days at 43 °C. Appendix 8 contains the guidelines for climate change and greenhouse resilience design.

68. The health facility in Marawi, is a two-storey, reinforced concrete building with a mono- slope rib-type metal roofing system, with a total functional floor area of approximately 599.14 square meters. The facility will comprise of forty-three (47) functional spaces that will accommodate the processes and services to be rendered by its personnel.

69. Below are the details of the detailed design:

Table 3. Lot and Floor Areas Allotted for Health Facilities Parameters (m2) Marawi City Lumbayanague Lot area 772.461 702.029 Total floor area 599.14 535.06 - Ground floor 337.61 291.93 - Second floor 261.53 243.13

a. Marawi City

Table 4. Floor Space Allocation for Marawi City Health Unit Room ID Room Name Gross Floor Area (m2) Marawi City Ground floor 101 Lobby / Waiting area - 1 47.27 102 TB consultation 13.39

Room ID Room Name Gross Floor Area (m2) Marawi City 103 Nurse consultation 6.40 103A Nurse station records 4.33 104 Ante room 6.28 105 TB laboratory 16.02 106 Sputum collection area 2.82 107 Toilet 2.83 108 Triage area / Suspected TB 12.90 patients 108A Waiting area 6.96 109 Child minding station 7.73 110 Staff toilet 5.58 111 PWD toilet 4.42 112 Prenatal room 18.16 113 OB ward family room 35.10 114 Birthing room 21.36 115 Nurse supervisor 3.72 115A Toilet and bath 2.47 116 Sterilization room 1.83 116A Scrub area 5.58 117 Prenatal / Family planning 15.22 118 Reception 6.44 119 Botika ng Bayan / Medical storage 12.76 120 Hallway 38.35 121 Vestibule 6.27 122 Janitor closet 1.27 123 Exit area 16.75 124 Kitchenette 8.58 125 Laundry area 6.82 Second floor 201 Lobby / Waiting area - 2 21.86 202 Balcony 6.65 203 Male’s prayer room 8.38 204 Female’s prayer room 8.38 205 Women’s toilet 4.81 206 Men’s toilet 3.55 207 Janitor closet 1.08 208 Dental clinic 22.86 209 Drug storage room 8.87 210 Animal bite treatment room 1.84 211 Sanitary inspector 1.77 212 MHO Secretary 9.65 213 MHO Office 23.61 213A Toilet 1.87 214 Conference room 25.27 215 Laboratory 17.08 216 PhilHealth Business Area 6.17 217 Records room 5.91 218 Hallway 63.00 219 Utility room 10.17 220 Exit area 8.75

Figure 6. Location Map - Marawi City Health Unit

Figure 7. Vicinity Map – Marawi City Health Unit

Figure 8. Site Development Plan

Figure 9. Perspective

Figure 10. Ground Floor Plan

Figure 11. Second Floor Plan

70. The health facility in Lumbayangue is a two-storey, reinforced concrete building with a mono-slope rib-type metal roofing system, with a total main floor area of approximately 535.06 square meters. The facility will comprise of forty-three (43) functional spaces that will accommodate the processes and services to be rendered by its personnel.

Table 5. Floor Space Allocation for Lumbayanague Rural Health Unit Room ID Room Name Gross Floor Area (m2) Lumbayanague Ground floor 101 Lobby / Waiting area – 1 56.67 102 Reception 4.09 103 Consultation / Treatment room 15.67 104 Laboratory 15.58 105 TB laboratory 11.27 105A Ante room 3.45 106 Sputum collection room 2.84 107 Triage area / Suspected TB 19.31 patients 108 TB consultation 8.84 109 Nurse station 4.86 109A Nurse station records 2.25 110 Ante room 2.70 111 Prenatal room 12.72 111A Toilet 1.80 112 Nurse supervisor 2.52 112A Toilet and bath 2.38 113 Sterilization room 2.04 113A Scrub area 5.64 114 Birthing room 19.55 115 Kitchenette 9.22 116 OB ward family room 19.92 116A Toilet and bath 3.00 117 PhilHealth business area 4.78 117A Records room 3.07 118 Botika ng Bayan / Medical 7.62 storage 119 Staff toilet 4.92 120 PWD toilet 3.31 121 Toilet 3.06 122 Vestibule 14.00 123 Corridor 19.19 124 Janitor closet 1.20 125 Exit area 4.46 Second floor 201 Lobby / Waiting area - 2 15..16 202 Animal bite treatment room 10.19 203 Dental clinic 16.99 204 Drug storage room 8.69 205 Sanitary inspector 10.61 206 Conference room 19.54 207 Male’s prayer room 7.58 208 Female’s prayer room 7.66 209 Male staff quarters 13.79

Room ID Room Name Gross Floor Area (m2) Lumbayanague 209A Toilet and bath 3.58 210 Female staff quarters 19.81 210A Toilet and bath 3.53 211 Storage room 9.41 212 MHO office 17.12 212A Toilet and bath – 2 1.85 213 MHO Secretary 7.68 214 Corridor 56.10 215 Utility room 5.35 216 Public toilet 1.97 217 Foyer 3.88 218 Balcony 17.80

Figure 12. Location Map – Lumbayanague Rural Health Unit

Figure 13. Site Development Plan

Figure 14. Perspective

Figure 15. Ground Floor Plan

Figure 16. Second Floor Plan

IV. DESCRIPTION OF THE ENVIRONMENT

A. Physical Environment

1. Geographic Location

71. The province of Lanao del Sur is bounded by the provinces of Lanao del Norte in the north, Bukidnon in the east and the provinces of Maguindanao and Cotabato in the south. The proposed local health units will be constructed in Marawi City and Lumbayanague, both located in Lanao del Sur.

72. Marawi City, with a total land area of 8,755 hectares, is located on the shores of Lake Lanao and straddles the area where Agus River starts. The city is bounded by the municipalities of Kapai and Saguiaran to the north, Lake Lanao to the south, municipalities of Bubong and Ditsaan-Ramain to the east and the municipalities of Marantao and Saguiaran to the west.

73. Lumbayanague, with a total land area of 30,218 hectares, is located on the southern side of Lake Lanao. It is bounded on the east by Butig, to the north by Lake Lanao and Masiu, to the west by Lumbatan, and to the south by Sultan Dumalondong.

Marawi City

Lumbayanague

Figure 17. Lake Lanao Watershed Reserve Area

74. Both Marawi City and Lumbayanague are part of Lake Lanao Watershed Reserve (LLWR)

established as a Watershed Reservation under Presidential Proclamation No. 871 in February 26, 1992 to protect, maintain or improve its water yield for hydroelectric power production, irrigation and other ecological enhancement purposes. The proclamation delineated a parcel of land of public domain situated in 25 municipalities (including Lumbayanague and the city of Marawi in Lanao del Sur), covering an area of 180,460 hectares more or less. The Lake Lanao Watershed technically includes the lake itself and all the settled and unsettled lands surrounding the lake as physically defined by a watershed, which is delimited by the watershed divide.

2. Topography and Slope

75. The province of Lanao del Sur, and the Lake Lanao Watershed (LLW), is characterized by rugged terrain. LLW is drained by mountainous land with an area of 132,380 hectares with slopes that ranged from 0% (level) to 50% or more. Eighty-one percent of the province’s total land area have slopes with 3% to greater than 50%. Only about 19% are flat lands, suitable for agricultural production. The eastern portion of the LLW which is utilized for rice production, is mostly classified as forestland. Western and southwestern portions and the periphery of Lanao are mostly alienable and disposable (A & D) lands with small patches of forests. Both sites for local health units are located in A& D lands. Marawi City CHU site is about 700 meters above sea level (MASL), while Lumbayanague site is about 746 MASL.

76. The slope map shows that Marawi City lies in rolling slope (8-18%) with about 1,641 hectares of undulating to rolling slope. The slope classification and topography falls under Relief Number Four, which depict a hilly and gently rolling landscape. The area is favorable for permanent crops and ideal as pasture land. The proposed location of the city health unit is within the level to nearly level slope category.

Table 6. Area by Slope Category. Slope Category Area (hectares) Percent Marawi Lumbayanague Marawi Lumbayanague Level to nearly level (0-3%) 422.46 766.29 12.9 18.9 Gently sloping to undulating (3- 278.04 - 8.5 0.0 8%) Undulating to Rolling (8- 18%) 1,641.08 3,264.53 50.0 80.7 Rolling to Moderately Steep (18- 842.91 15.26 25.7 0.4 30%) Steep (30-50%) 95.51 - 2.9 0.0 Very Steep (above 50%) - - 0.0 0.0 Total 3280 4,046.08 100% 100% Source: Protected Area Suitability Assessment Report, 2012

Figure 18. Slope Map of Lake Lanao Watershed Reserve Area

Figure 19. Topographic Map of Lanao del Sur

3. Seismicity and Related Hazards

77. Data from the Department of Science and Technology (DOST) identified some of the active volcanoes as Mount Makaturing and Mount Ragang in Lanao del Sur. Ragang volcano rises to 2815 m at the NE end of a series of young volcanic cones SE of Lake Lanao in central Mindanao. A 3-km-long lava flow extends to the SE from the deep summit crater. Ragang is the

most frequently active volcano on the large southern Philippines island of Mindanao and is one of several dominantly basaltic volcanoes west of the cordillera in central Mindanao. Historical eruptions, many of which were at one time attributed to neighboring Makaturing volcano, have been recorded since 1765 and consist of moderate explosive activity from the summit crater.

78. Many active faults are present in the Philippines, including the Bangsamoro area. The Mindanao fault line traverses the region with northwest-southeast orientation. Two major fault zones are also present in the region – the Sulu Trench and the Cotabato Trench considered to have moderate to high seismicity based on the historical catalog of earthquakes by the Philippine Institute of Volcanology and Seismology (PHIVOLCS).

79. Central Mindanao, including Lanao del Sur, is one of the seismically active areas in the country because of the presence of the western extension of the Mindanao Fault (Cotabato- Sindangan Fault), an active fault that runs from Sarangani province to northwest of Zamboanga Peninsula. Cotabato Trench is also a major source of earthquakes which can affect the region. In addition, there exist other local active faults, which can be sources of small- to moderate- magnitude earthquakes.

80. On April 12, 2017, at 5:21 AM, a moderate earthquake of magnitude 6.0 shook Mindanao. The epicenter is located 13 km northwest of Wao, Lanao del Sur at a depth of 1 km. The earthquake was generated by the movement of a northwest trending active fault (Lanao Fault System) in the area. Small-magnitude earthquakes followed afterwards, and as of 3:00 PM of 12 April 2017, 73 aftershocks have been recorded by PHIVOLCS seismic monitoring network.

Figure 20. Active Faults and Trenches in Mindanao

81. On April 1, 1955, a magnitude 7.5 earthquake was experienced in Lanao area. This earthquake, which is considered to be one of the most damaging historical earthquakes in Lanao del Sur, resulted to about 400 deaths. Strong ground shaking was also felt during this event, resulting to significant damage to infrastructure including a mosque in Tugaya municipality near Lake Lanao.

82. Based on the landslide susceptibility map from the Mines and Geosciences Bureau (http://gdis.mgb.gov.ph/mgbpublic/), proposed city health unit in Marawi and rural health unit in Lumbayanague are both located in low susceptibility to landslide areas.

Figure 21. Landslide Susceptibility Map of Marawi City

Figure 22. Landslide Susceptibility Map of Lumbayanague

4. Watershed

83. Lake Lanao is the largest lake in Mindanao and the second largest in the Philippines. The

lake, with an area of 36,274 ha, has five watersheds – Taraka – Gata with an area of 548 km2 (39% of the basin area), Malaig, with 354 km2 (25%), Bubong with 195 km2 (14%), West with 175 km2 (12%) and Saguiaran – Marawi with 141 km2 (10%). The total area of the river basin is 1,413.39 km2. The lake drains into Agus River, its only outlet. Agus River, with a length of 36.5 km, traverses the municipalities of Saguiaran, Pantar and Baloi before reaching Iligan Bay. Lake Lanao has been categorized as “Class A”. This means that the water coming from the lake requires complete treatment to meet the national standards for drinking water

Table 7. Water Body Classification and Usage of Freshwater Water Body Classification Beneficial Use Class AA Public Water Supply Intended primarily for waters having watersheds, which are Class I uninhabited and/or otherwise declared as protected areas, and which require only approved disinfection to meet the latest PNSDW Class A Public Water Supply Intended as sources of water supply that will requiring Class II conventional treatment (coagulation, sedimentation, filtration and disinfection) in order to meet the PNSDW Class B Recreational Water Intended for primary contact recreation (bathing, swimming, etc.) Class I Class C 1) Fishery water for the propagation and growth of fish and other aquatic resources; 2) Recreational Water Class II- For boating, fishing or similar activities 3) For agriculture, irrigation, and livestock watering Class D Navigable Waters Source: DENR 5. Climate

84. Lanao del Sur, based on Corona’s Classification, belongs to the 3rd Climatic Type which is characterized by having no pronounced dry and wet season. The average annual rainfall ranges from 1,329 mm to 5,235 mm. This Type III climate is a wet climate with a very short dry period lasting only for about two months. The maximum rain period occurs from June to September and the dry period is from March to April. The climate is also affected by Lake Lanao. Cool air temperatures are experienced due to the cool and humid lake breeze aside from its high altitude and dense vegetation. The mean monthly relative humidity is very high, ranging from 82% to 89%. Relative humidity is minimum at 82% in the warm month of April and maximum in the cold month of January at 89%. Although the Philippines is a typhoon-prone area, its southernmost part seldom experiences typhoons because of its proximity to the geographical equator. In Lanao del Sur, the typhoon frequency is about one (1) in twelve years.

Figure 23. Modified Coronas Classification of Climate of the Philippines 6. Soil

85. Soil samples were taken near the existing CHU in Marawi City, and the vacant lot in Lumbayanague where the proposed RHU will be constructed. Details of soil sampling sites are indicated below. The official laboratory results, done by OSTREA Mineral Laboratories, are attached as Appendix 9.

Table 8. Details of Soil Sampling in Marawi and Lumbayanague Locations Soil Analysis Date of Time of Location Sampling Sampling Marawi City N: 08° 00’ 04.4” July 24, 2019 11:16 AM E: 124° 17’ 05.8” Lumbayanague N: 07° 46’ 58.6” July 30, 2019 10:45 AM E: 124° 16’ 56.4”

86. Two parameters were measured – lead and mercury. Although there is no national standard for pollutants in soil, the Environmental Protection Agency (EPA) in the United States, sets the standard for lead (https://www.epa.gov/lead/hazard-standards-lead-paint-dust-and-soil- tsca-section-403) at 400 parts per million (ppm) in bare soil in children’s play areas or 1200 ppm averages for bare soil in the rest of the yard. The high level of lead in Marawi may be attributed to the sampling site being adjacent to heavy traffic volume area, where leaded gasoline was used as antiknock agent for vehicle engines up until 2001 but remains in soil even if many years had passed. The other source of lead is leaded paint in buildings. It was only in 2013 when the Department of Environment and Natural Resources issued Administrative Order 2013-24, or the Chemical Control Order, which set a 90ppm total lead content limit in paint. The CCO provided for a three-year phase out period from 2013 to 2016 for lead-containing paints used for architectural, decorative and household applications.

Table 9. Soil Analyses Result Parameters Marawi Lumbayanague Unit Method Lead (Pb) 186.24 <0.10 mg/kg Direct Air-Acetylene Mercury (Hg) 0.209 0.225 mg/kg Cold Vapor AAS

87. For mercury, long-term and repeated occupational exposure to concentrations of 20 µg/m3 produced mild effects on the central nervous system (CNS) (http://residus.gencat.cat/web/.content/home/ambits_dactuacio/sols_contaminats/Cercasols_rec ursos_sol/Soil-Guideline-Values-for-mercury-in-soil-UK-Environment-Agency-March-2009.pdf). Mercury is used in agriculture, alkaline batteries, chloralkali plants, dental fillings, paints, pharmaceuticals, thermometers, and in electrical apparatus. Many of these applications have now been phased out in western countries (Steinnes, 1995; ATSDR, 1999; KabataPendias and Mukherjee, 2007). In the Philippines, mercury exposure may be attributed to small-scale gold mining, which proliferated in many parts of the country since 1980’s (Maramba, N.C, Rivera, A.T.F., Manglicmot, A., Santos, F., and Akagi, H. Health and Environmental Impact of Mercury in the Philippines using Nuclear Techniques. https://inis.iaea.org/collection/NCLCollectionStore/_Public/32/053/32053334.pdf ).

Figure 24. Sampling locations for soil, Marawi City

Figure 25. Sampling locations for soil, Lumbayanague

7. Water Quality

88. Baseline conditions of drinking water from community water supply and receiving body of water (Agus Riiver in Marawi and Lake Lanao in Lumbayanague) were assessed for the two locations. Table below and corresponding figures below indicate the sampling locations.

Table 10. Details of Water Sampling in Marawi and Lumbayanague Locations Drinking Water Receiving Body Date of of Water Sampling Marawi City N: 08° 00’ 06.0” N: 08° 00’ 16.8” July 25, 2019 E: 124° 17’ 08.5” E: 124° 17’ 05.9” Lumbayanague N: 07° 47’ 00.1” N: 07° 47’ 23.0” July 30, 2019 E: 124° 16’ 55.8” E: 124° 16’ 44.0”

Figure 26.Sampling locations for drinking water and receiving body of water, Marawi City

Figure 27. Sampling locations for drinking water and receiving body of water, Lumbayanague

a. Drinking Water

89. Both drinking water samples from Marawi City Water District and Lumbayanague community water supply did not pass the Philippine National Standards for Drinking Water (PNSDW) for thermotolerant coliform. Total coliform in drinking water sample from Lumbayanague exceeds the PNSDW standard. Escherichia coli is also present in drinking water

sample from Lumbayanague, while lead concentration is a concern in Marawi as it did not pass the PNSDW standard. All other parameters indicated below passed the PNSDW standards.

Table 11. Drinking Water Result PNSDW Parameters Marawi Lumbayanague Units Method 2017 pH 7.6 7.3 - 6.5 – 8.5 Electrometric Temperature (°C) 27 24 Color 5 5 ACU 10 Visual comparison Total Dissolved 229 64 mg/L 600 Gravimetric (dried at 180 °C) Solids Chloride 12 1 mg/L 250 Argentometric - Nitrate (NO3 -N) 1.35 1.16 mg/L 50 Colorimetric / Brucine Turbidity 0.51 0.60 NTU 5 Turbidity meter Arsenic (As) <0.001 <0.001 mg/L 0.01 Manual hydride generation AAS Cadmium (Cd) <0.003 <0.003 mg/L 0.003 Direct air-acetylene flame Lead (Pb) 0.07 <0.01 mg/L 0.01 Direct air-acetylene flame Total coliform <1.1 >8.0 MPN / <1.1 Multiple tube fermentation 100 mL technique Thermotolerant 2.6 4.6 MPN / <1.1 Multiple tube fermentation coliform 100 mL technique Escherichia coli Absent Present CFU/mL Absent Indole

b. Receiving Body of Water

90. Receiving body of water results for the two locations showed that fecal coliform exceeds the DENR Standard for Class A, with Marawi exceeding the standard by 35 thousand times, and Lumbayanague by almost four hundred fifty times the standard. All other parameters were within the DENR standards.

Table 12. Receiving Body of Water Results Parameters Results Units DENR Method Marawi Lumbayanague Standard (Class A)8 pH 8.0 7.4 - 6.5 – 8.5 Electrometric

Temperature 26 27 °C 26-30 (°C) Color 5 5 ACU 50 Visual comparison BOD 2 1 mg/L 3 5-day BOD Test Dissolved 7 7 mg/L 5 (minimum) Iodometric Oxygen Oil and grease <1 <1 mg/L 1 Liquid-liquid, Partition- gravimetric Total 20 <3 mg/L 50 Gravimetric (dried at suspended 103-105 °C) solids - Nitrate (NO3 - 0.24 0.11 mg/L 7 Colorimetric / Brucine N) Phosphate 0.04 0.01 mg/L 0.5 Stannous chloride

8 DENR Administrative No 2016 – 08. Water Quality Guidelines and General Effluent Standards of 2016.

Parameters Results Units DENR Method Marawi Lumbayanague Standard (Class A)8 3- (PO4 -P) Ammonia 0.06 0.08 mg/L 0.05 Ammonia - selective (NH3 -N) electrode Surfactant <0.10 <0.1 mg/L 0.2 Anionic surfactants as (MBAS) MBAS Fecal coliform 3.5 x 104 450 MPN/ <1.1 Multiple tube 100 mL fermentation technique

8. Air Quality

91. There are no national air quality monitoring stations established in the ARMM Region based on the Air Quality in the Philippines (2008 – 2015) Report and the National Air Quality Status Report (2010 – 2011) of the Environmental Management Bureau. The IEE Report of Output 2 of the Emergency Assistance for Reconstruction and Recovery of Marawi reported that air quality monitoring (24 hours) was conducted on January 28, 2019 at Barangay Bubong, Saguiran, Lanao del Sur, about 3.2 km from the proposed Marawi City CHU and about 47 km from the proposed Lumbayanague RHU. Results showed that TSP, PM10, PM2.5 and SO2 are all within DENR National Ambient Air Quality Guideline Values.

Table 13. Air Quality Sampling Results, Barangay Bubong, Saguiaran, Lanao del Sur Station No. Date and Time of TSP (µg/Ncm) PM10 PM2.5 SO2 Sampling (µg/Ncm) (µg/Ncm) (µg/Ncm) A1 January 18-19, 15.7 11.7 3.9 ND 2018 1415H – 1415H DENR National Ambient 24-hour sampling 230 150 150 180 Air Quality Guideline Values (NAAQGV) Remarks Passed Passed Passed Passed Source: Initial Environmental Examination Report of Marawi Ring Roads

9. Noise Level

92. The IEE Report for Marawi Ring Roads also reported noise level monitoring at the same location where air quality sampling was conducted. The location is an open area, without any obstruction, and around 100 m from the nearest house. The results of each station are summarized by getting the lowest (Min) and highest (Max) readings and by computing the equivalent continuous noise level in its logarithmic form (LAeq) for each time period. These are then compared with the DENR Ambient Noise Quality Standards for Class A (residential category). During daytime, noise levels were within the allowable levels of the DENR. Noise levels during morning, evening and nighttime were slightly higher where noise coming from animals and passing vehicles may have impacted the increase in sound measurement. Most of the noise sources measured came from animals and insects during nighttime. Activities from residents near the sampling area also influenced the sound measurements during morning and evening time.

Table 14. Noise Level Sampling Results, Barangay Bubong, Saguiaran, Lanao del Sur January 18-19, Average IFC EHS Noise Remarks Sources of Noise 2018 dB (A) Guideline Values9 Sampling time (H) 1415 53.3 55 Within range Residents, animals, passing vehicle 1615 51.3 55 Within range Residents, animals, passing vehicle 1815 52.8 55 Within range Residents, animals, passing vehicle 2015 52.3 45 Above standard Residents, insects 2215 51.1 45 Above standard Insects 0015 51.9 45 Above standard Insects 0215 51.4 45 Above standard Insects, roosters 0415 51.2 45 Above standard Insects, roosters 06615 53.9 45 Above standard Residents, animals 0815 52.9 55 Within range Residents, animals 1015 52.4 55 Within range Residents, animals 1215 54.2 55 Within range Residents, animals

B. Biological Environment

1. Biogeography

93. The Philippines has 16 terrestrial biogeographic regions based on the 2002 Philippine Biodiversity Conservation Priorities Final Report of the Biodiversity Management Bureau of the DENR. The terrestrial regions were classified based on the geographic distribution of vascular plants, arthropods, amphibians, reptiles, birds and mammals. The species and ecosystems found in Lake Lanao Watershed belong to Mindanao Zone (Code K) as reflected below. The Mindanao Zone harbors species shared with those found in the islands of Samar, Leyte, Bohol, Biliran, Panay and Negros which came about when these islands belong to one big island (Greater Mindanao) during the Pleistocene epoch. Apart from being a center of endemism for amphibians and reptiles, the Mindanao Biogeographic Zone evolved its own fauna including flying lemurs, tree shrews, tree squirrels and tarsiers with 80% endemism (Metillo and Garcia-Hansel, 2016).

9 Guidelines values are for noise levels measured out of doors. Source: Guidelines for Community Noise, World Health Organization (WHO), 1999.

Figure 28. Philippine Biogeography Zone, DENR (2002)

2. Lake Lanao Watershed Reserve

94. The Lake Lanao Watershed Reserve (LLWR), which was established under Presidential Proclamation 871 in 1992, comprised 27 municipalities and the City of Marawi. When the reserve was created, there were only 25 municipalities and 1 city comprising the area. Sultan Dumalondong and Lumbaca-Unayan were added in 1997 and 2005, respectively, when these two municipalities were created.

95. The boundary of Lake Lanao Watershed encompasses the topographic divide that includes the boundary of mountain ranges, with peaks that ranged from 1401 masl to 2815 (highest) at Mt. Piapayungan peak at Lumba Bayabao (DENR, 2012). The other important peaks include Mr. Maranat (1,858 masl), Butig mountains, with peaks that ranged from 1,860 to 2,060 masl, including Mt. Makaturing and Mt. Latukan. The entire watershed, with an area of 132,380 hectares, has slopes that ranged from 0% to 50% or more.

3. Key Biodiversity Area

96. The Haribon Foundation and Birdlife International have identified parts of Lake Lanao Watershed as Key Biodiversity Areas (KBAs) (e.g. western part of the Lake Lanao Watershed [KBA No. 108 – Munai/Tambo], Lake Lanao itself [KBA No. 109] and Mt. Piagayungan [KBA No. 110]), which are priority sites for conservation (Mallari, Tabaranza Jr. & Crosby, 2001). A KBA is

identified based on the presence of endemic and threatened species, and the area is an Important Bird Area of Birdlife International and an Important Plant Area of the DENR. DENR and UNEP (1997) classified the mountainous areas east and southeast of the lake as biodiversity-rich. Identified watershed KBAs and IBAs are supported by several new species discovered in the past five years.

97. The Ranao (Agus) River Basin has an area of 105,055 ha or about 53% considered as key biodiversity areas (KBA). Among the KBAs, the majestic Lanao Lake together with the scenic 'Sleeping Lady' or the Piagayungan mountain range which include Mt. Butig, Mt. Ragang, Mt. Makaturing occupy about half or 98,512 ha of total area of the river basin. Mt. Munai (Tambo) and Salikata National Park comprise 4,057 ha or 2% and 1,088 ha or 1%, respectively.

4. Flora

98. Family Dipterocarpaceae species dominate the lowland forests (0-1000 masl), particularly in the eastern portion of the Lake Lanao Watershed. Non-dipterocarps in this forest zone consist of Nauclea orientalis, Ficus variegate and Leucosyke capitellata. In the next upper zone, the lower montane forest (1000-1500 masl) is represented by Facaceaue species (oaks family), Araliaceae, Staphyleaceaue, and Lauraceae. The upper montane forest (1500-2400 masl) is predominantly from the families of Ericaceae, Myrtaceae and Theaceae. There are also limestone forests below 1000 masl where molave (molave (Vitex parviflora), lingo lingo (Viticipremna philippinensis), alagao (Premna odorata), and batete (Kingiodendron alternifolium) are common in these areas. Most of these plants have been regarded as critically endangered (DENR, 2012), particularly those belonging to the Family Dipterocarpaceae, Orchidaceae and Palmae (Arecaceae). Some critically endangered Dipterocarps are Hopea acuminata, Shorea astylosa and Vatica pachyphylla. The Genus Paphiopedilum has the most numbers of critically endangered species in the Orchidaceae Family and the Genus Hetorospathe and Pinanga for Palmae. Other endangered species belong to Family Cyatheaceae, Asclepiadaceae and Melastomataceae, and representatives of these families are found in the watershed (Metillo and Hansel, 2016).

99. The same report reported that common hardwoods include almon (Shorea almon), bagtikan (Parashorea plicata) kalunti (Shorea kalunti), mayapis (Shorea squamata), nato (Palaqium luzoniensis), red lauaan (Shorea negrosensis), tanguile (Shorea philippinensis) and white lauaan (Pentacme contorta). The furniture and construction wood species are apitong (Dipterocarpus grandiflorus), bangkal (Anthocephalus cadamba), batikuling (Litsea leytensis), bolong-eta (Diospyrus pilosanthera), dalingdingan (Hopea foxworthyii), ipil (Instia bijuga), kalumpit (Terminalia microcarpa), kamagong (Diospyrus philippinensis) and katmon (Dillenia philippinensis).

100. For the proposed site in Marawi, 2 unhealthy and diseased mature trees located at the front and back of City Engineering Office (CEO) and General Services Office (GSO) will be affected by the project.

5. Fauna

101. Based on the study by Birdlife International (2012), Lake Lanao supports large number of waterfowl such as Ardeidae (bitterns, egrets, herons), Anatidae (ducks, geese) and Rallidae (coots, crakes, rails and waterhens). Other birds in the area that are not strict forest inhabitants include the cattle egret Bubulcus ibis coromandus, slenderbilled crow Corvus enca, and white- collared kingfisher Halcyon chloris. Mammals occurring in the area include wild pig (probably Sus philippinensis) and deer Cervus mariannus and many endemic small mammals (Birdlife 2012).

DAO 2004-15 listed other threatened mammalian species: Cynocephalus volans, flying lemur; Macaca fascicularis, Philippine macaque; Tarsius syrichta, Philippine tarsier.

6. Biodiversity Assessment Using IBAT

102. Using the Integrated Biodiversity Assessment Tool (IBAT) proximity analysis, the tool identified biodiversity features and species which can be found within the 10 km and 50 km buffer from the proposed Marawi City Health Unit and Lumbayanague Rural Health Unit locations. Lake Lanao Watershed Reservation, a protected area, is within the 1-km buffer zone of the proposed Marawi City site. Protected areas that can be found within the 4-km buffer include Pantuwaraya Lake and Sacred Mountain. For the proposed Lumbayanague Rural Health Unit, protected areas include Lake Lanao Watershed Reservation and Lake Butig, while Lake Lanao is a key biodiversity area within 1-km distance. Both the proposed sites in Marawi and Lumbayanague, and most of the lake shoreline, belong to alienable and disposable (A & D) lands.

Figure 29. PAs and KBAs within the 10-km and 50-km buffer zone, Marawi City Health Unit

103. IBAT generated list of species under red list category. The report generated list of species within 50-km range of the designated project site. Most of the species reside in lowland forests which are outside the impact area of the project. There are no species of concern within the project impact zones.

Table 15. IUCN Red List for Marawi (Mammals and Reptiles) Within 50-km Range Scientific Name Common Name Red List Category Acerodon jubatus Golden-capped fruit bat EN Draco mindanensis Flying dragon (lizard) VU Dryophiops philippina Philippine whipsnake VU Megaerops wetmorei White-collared fruit bat VU Ophiophagus hannah King cobra VU

Source: IBAT

Figure 30. PAs and KBAs within the 10-km and 50-km buffer zone, Lumbayanague Rural Health Unit Table 16. IUCN Red List for Marawi (Birds) Within 50-km Range Scientific Name Common Name Red List Category Gorsachius goisagi Japanese night-heron EN Nisaetus pinskeri South philippine hawk-eagle EN Numenius madagascariensis Far eastern curlew EN Actenoides hombroni Blue-capped kingfisher VU Anas luzonica Philippine duck VU Bubo philippensis Philippine eagle-owl VU Buceros mindanensis Southern rufous hornbill VU Ceyx mindanensis South philippine dwarf-kingfisher VU Chloropsis flavipennis Philippine leafbird VU Ciconia episcopus Asian woollyneck VU Ducula carola Spotted imperial-pigeon VU Edolisoma mindanense Black-bibbed cicadabird VU Ficedula basilanica Little slaty flycatcher VU Gallicolumba crinigera Mindanao bleeding-heart VU Hypothymis coelestis Celestial monarch VU

Scientific Name Common Name Red List Category Mulleripicus fuliginosus Southern sooty woodpecker VU Otus gurneyi Giant scops-owl VU Phapitreron brunneiceps Dark-eared brown-dove VU Pitta steerii Azure-breasted pitta VU Sarcophanops steerii Mindanao wattled broadbill VU Streptopelia dusumieri Philippine collared-dove VU Todiramphus winchelli Rufous-lored kingfisher VU Source: IBAT

Table 17. IUCN Red List for Lumbayanague (Mammals and Reptiles) Within 50-km Range Scientific Name Common Name Red List Category Acerodon jubatus Golden-capped fruit bat EN Crocodylus mindorensis Philippine crocodile CR Source: IBAT

Table 18. IUCN Red List for Lumbayanague (Birds) Within 50-km Range Scientific Name Common Name Red List Category Pithecophaga jefferyi Philippine eagle CR Gorsachius goisagi Japanese night-heron EN Nisaetus pinskeri South philippine hawk-eagle EN Numenius madagascariensis Far eastern curlew EN Actenoides hombroni Blue-capped kingfisher VU Source: IBAT

C. Socio-economic Environment

1. Demography

a. Population

104. Among the 39 municipalities and lone city comprising Lanao del Sur, Marawi City, the provincial capital, was the most populous with a population size of 201,785, making up 19.3 percent of the total provincial population. Lumbayanague, on the other hand has a population of 16,372 (Philippine Statistics Authority, 2015).

Figure 31. Population Density of Lanao del Sur (Philippine Statistics Authority, 2015).

Table 19. Age Group for Marawi and Lumbayanague, 2015 Age Group Total Population Male Female (years) Marawi Lumbayanague Marawi Lumbayanague Marawi Lumbayanague 0 – 4 27,788 2,691 13,969 1,309 13,819 1,382 0 – 14 81,147 7,484 40,350 3,638 40,797 3,846 15 – 64 118,340 8,762 56,310 4,436 62,030 4,326 18 and over 105,793 7,878 50,511 3,999 55,282 3,879 60 and over 4,344 208 2,303 130 2,041 78 65 and over 2,298 126 1,202 73 1,096 53 Source: Philippine Statistics Authority, 2015

b. Education

105. Majority of the population of Marawi and Lumbayanague are in the elementary, followed by high school, and college levels. Those with college degrees comprised 8.79 and 4.56 percent for Marawi and Lumbayanague, respectively. Table below shows the highest grade / year completed for Marawi and Lumbayanague (Philippine Statistics Authority, 2015).

Table 20. Highest Grade/Year Completed, Marawi City Total Population 5 Years Old Highest Grade / Year Percent and Over Completed Marawi City Lumbayanague Marawi City Lumbayanague Both sexes 173,997 13,681 No grade completed 12,482 1,450 7.17 10.60 Preschool 6,853 771 3.94 5.64 Special education 56 - 0.03 Elementary 56,934 5,095 32.72 37.24 - 1st – 4th grade 31,922 2,849 56.07 55.92 - 5th – 6th grade 14,242 1,003 25.01 19.69 - Graduate 10,770 1,243 18.92 24.40 High school 47,489 4,197 27.29 30.68 - Undergraduate 25,062 1,856 52.77 44.22 - Graduate 22,427 2,341 47.23 55.78 Postsecondary 1,432 151 0.82 1.10 - Undergraduate 51 7 3.56 4.64 - Graduate 1,381 144 96.44 95.36 College undergraduate 26,745 1,371 15.37 10.02 Baccalaureate / college 15,296 624 8.79 4.56 graduate Post baccalaureate 385 3 0.22 0.02 Not stated 6,325 19 3.64 0.14 Source: Philippine Statistics Authority, 2015 c. Major Occupation Group

106. In terms of occupation, almost 65% of the population of Marawi City are into service industy which include managers (26%), plant and machine operators and assemblers (16%), and service and sales workers (13%). In contrast, more than half of Lumbayanague population are employed as skilled agricultural, forestry and fishery workers (56%). This is followed by managers (19%) and plant and machine operators and assemblers (6%) and service and sales workers (5%).

Table 21. Major Occupation Group, Marawi City and Lumbayanague Total Population 5 Years Old Percent and Over Major Occupation Group Marawi Lumbayanague Marawi City Lumbayanague City Both sexes 59,852 l,285 Managers 15,661 808 26.17 18.86 Professionals 4,679 310 7.82 7.23 Technicians and associate 1,263 34 2.11 0.79 professionals Clerical support workers 2,422 38 4.05 0.89 Service and sales workers 7,938 231 13.26 5.39 Skilled agricultural, forestry and 7,587 2,402 12.68 56.06 fishery workers Craft and related trades workers 2,887 80 4.82 1.87 Plant and machine operators and 9,363 246 15.64 5.74 assemblers Elementary occupations 2,591 99 4.33 2.31 Armed forces occupations 22 3 0.04 0.07

Total Population 5 Years Old Percent and Over Major Occupation Group Marawi Lumbayanague Marawi City Lumbayanague City Other occupation, not - - - - elsewhere classified Not reported 5,439 34 9.09 0.79 Source: Philippine Statistics Authority, 2015

d. Morbidity and Mortality

107. Although the 2015 Philippine Health Statistics has no data for ARMM, where Lanao del Sur is located, the statistics for the Philippines showed that the top ten diseases reported were acute respiratory infection with 2,094.5 per 100,000 population, followed by hypertension (595.3 per 100,000 population), acute lower respiratory tract infection (295.3 per 100,000 population), bronchitis (200.4 per 100,000 population), influenza (146.0 per 100,000 population), acute watery diarrhea (129.0 per 100,000 population), dengue fever (68.9 per 100,000 population), tuberculosis respiratory (62.3 per 100,000 population), and acute febrile illness (55.2 per 100,000 population).

Table 22. Morbidity Statistics in the Philippines Morbidity Causes Number Rate per 100,000 population 1. Acute respiratory infection 2,115,018 2,094.5 2. Hypertension 601,173 595.3 3. Acute lower respiratory tract infection 474,406 469.8 4. Urinary tract infection 298,200 295.3 5. Bronchitis 202,343 200.4 6. Influenza 147,400 146.0 7. Acute watery diarrhea 130,246 129.0 8. Dengue fever 69,532 68.9 9. TB respiratory 62,936 62.3 10. Acute febrile illness 55,759 55.2 Source: Philippine Statistics Authority, 2015

108. Both the live birth and death rates are lower in Lanao del Sur and ARMM, compared to the national average (4.2 and 3.9 per 1000 population compared to 17.3 per 1000 population for the Philippines in 2015). Infant deaths though are higher in the province and ARMM compared to the national average (13.9 and 13.3 per 1000 population compared to 11.9 per 1000 population for the Philippines in 2015). Maternal deaths are higher also in Lanao del Sur and ARMM compared to the national average (1.1 and 1.3 per 1000 population versus an average of 1.0 per 1000 population for the country).

Table 23. Mortality Statistics, Marawi City and Lumbayanague Health Statistics Lanao del ARMM Philippines Sur 2015 2010 Population 843,644 3,781,387 100,979,303 Live births 3,535 14,784 1,744,767 1,782,981 Live births rate (per 1000 population) 4.2 3.9 17.3 19.0 Total deaths 658 2,938 560,605 488,265 Total deaths rate (per 1000 population) 0.8 0.8 5.6 5.2 Infant deaths 49 196 20,750 22,476 Infant deaths rate (per 1000 live births) 13.9 13.3 11.9 12.6

Health Statistics Lanao del ARMM Philippines Sur 2015 2010 Fetal deaths 4 5 7,676 8,095 Fetal deaths rate (per 1000 live births) 1.1 0.3 4.4 4.5 Maternal deaths 4 19 1,721 1,719 Maternal deaths rate (per 1000 live 1.1 1.3 1.0 1.0 births) Source: Philippine Statistics Authority, 2015

2. Health Services

109. Marawi City has 1 government and 10 private hospitals. The government hospital is Amai Pak Pak Medical Center, a tertiary hospital with 275 bed capacity located at Barangay Datu Saber. A number of medical maternity and dental clinics complement the provision and delivery of medical and dental services to the residents of both city and the province of Lanao del Sur. There are five (5) rural health units (RHU) located at the different barangays of the city namely, Barangays Cabingan; Amito Marantao; Kapantaran; Timbangalan; and in the City Health Office which is also a Philhealth accredited birthing clinic.

110. There are fifteen (15) Barangay Health Stations (BHS) of which two (2) have Botika ng Barangay (BnB) and one (1) with Basic Emergency Obstetric and Neonatal Care. The City Health Office has a TB DOTS for the residents of the city suffering from pulmonary tuberculosis. It also has an ambulance used in bringing patients to tertiary hospital or in hospitals in Iligan City in extreme cases. The most recent acquisition of the City was a Mobile Dental Bus through the efforts of Mayor Majul U. Gandamra and ARMM Governor Mujiv Hataman.

111. Lumbayanague, on the other hand, has only one rural health unit but the facilities are inadequate to address the needs of the population.

3. Water and Power Supply

112. According to Marawi City Water District (MCWD), of the 96 barangays in Marawi, only 41 are covered by MCWD due to limited water sources. There are only 3 deep wells within the most affected area (MAA) which is now damaged and only serve barangays within MAA, and remaining 2 deep wells are located outside MAA namely: Bangon and Agus 1 deep well stations.

113. Lanao del Sur Electric Cooperative (LASURECO) generates and distributes electricity encompassing 13,979 sq. km, with a circuit kilometer of 1,159.3, and with a franchise population of 1,025,209. The system loss reported by the Department of Energy in 2018 showed LASURECO’s system loss equivalent to 38.21%, or 44,561 MWh. Businessworld reported on May 15, 2019 that the cooperative has the highest and longest overdue account at PhP 9.63 billion to Power Sector Assets and Liabilities Management Corporation (PSALM) that dates back 16 years.

V. IMPACT ASSESSMENT AND MITIGATING MEASURES

A. Impact Assessment

114. This section will evaluate the impacts of the proposed construction of local health units (city health unit in Marawi City and rural health unit in Lumbayanague, collectively, the Project)

on the physical, biological and socio-economic environment within the project’s impact areas. Direct impact areas of proposed projects in the two locations, include the government buildings within the City Hall compound of Marawi, and municipal government offices and Lumbayanague Elementary School in Lumbayanague. Sensitive receptors within the direct impact areas include government buildings inside the City Hall Complex in Marawi and Lumbayanague. These include Marawi City Hall, the existing City Health Unit of Marawi, the City Health Office and the Integrated Provincial Health Office, in Marawi. Sensitive receptors in Lumbayanague include the municipal government offices and Lumbayanague Elementary School. Indirect impact areas include the residential, commercial and institutional buildings outside the government compound in the two locations.

115. This section will also recommend corresponding mitigating measures on identified risks related to the construction of the proposed health facilities. Typical of the nature in most infrastructure projects, most of the impacts are anticipated during construction phase. There are also anticipated impacts during pre-construction and operation phases of the health facilities, although these are 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. Health unit location and design b. Demolition of existing City Engineering Office and General Services Office buildings (Marawi site) c. Tree cutting and clearing of debris - surface stripping, topsoil storage, excavation, earthwork; tree-cutting or removal 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 health units c. Management of construction - worker camps, stockpiles, solid wastes and wastewater iii. Post-Construction Phase a. Operation of health unit facilities b. Management of solid wastes and wastewater

116. The assessment of impacts, both quantitatively and qualitatively, are based on the site visit in the two sites, literature review of environmental impact studies on similar facilities, and consultations with stakeholders. These impacts can be classified as major, moderate, minor and negligible. Some of the impacts associated with construction of health units include biodiversity impacts, wastes from building demolition (in case of Marawi), wastes from building construction, soil erosion and contamination, wastewater impacts (sedimentation and pollution of Lake Lanao and Agus River), domestic water availability for drinking and domestic use for health facilities, air quality impacts, occupational and community health and safety risks, and visual impacts.

B. Evaluation of Impacts

117. The identification of potential impacts requires the identification of the components of physical, biological and socio-economic environment that are at risk from the proposed construction of city health unit in Marawi City and rural health unit in Lumbayanague. 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, wildlife, fish, birds and land use that may be affected by a proposed project.10The VECs for the proposed project are indicated in the succeeding table.

Table 24. Summary of VECs for the Proposed Construction of Health Units in Marawi City and Lumbayanague, Lanao del Sur Environment Valued Rationale and Relationship to the Project Environmental Components Physical Land and soil As the two sites are located in flat area, there will be slight condition alteration of the terrain. For Marawi, the present City Engineering Office and General Services Office buildings that will be demolished will generate construction wastes . In Lumbayanague, the proposed site was used as dumping site of solid wastes. Surface water The demolition of existing CEO and GSO buildings (in the case of quality Marawi) and land clearing for the foundation of the health units will only slightly affect surface water quality of Agus River and Lake Lanao. Air quality Air quality will be temporarily affected from the construction activities. Biological Protected area Although both project sites are within the Lake Lanao Watershed Reserve, these are outside the protected areas of Lake Lanao. Both sites are also within alienable and disposable (A & D) lands and within built-up areas already. Vegetation The proposed construction of two health units will affect several trees and vegetation. Two mature diseased trees will be affected in Marawi. Permit to cut will be secured. Aquatic Construction of health units will generate sediments that may affect environment Lake Lanao and Agus River. Fauna Since the proposed sites are already in a built-up areas, potential impacts on fauna will be limited. Socio- Rendering of Proposed demolition activities of CEO and GSO buildings will economic services to the temporarily affect its services to the public. No impact is foreseen public in Lumbayanague as there are no existing facilities yet. Public Public buildings within Marawi City Hall compound and infrastructure Lumbayanague will be affected during construction. Public access and public will also be affected during construction. access Acoustic People with transactions with the city hall in Marawi and the environment municipal hall in Lumbayanague will be affected with noise coming from construction equipment. Vehicle traffic Vehicle traffic will be affected with vehicle movement transporting construction materials. Water supply Since the health units will need potable water supply during construction and operation, its quality will affect the health of workers, patients and workers in the two facilities.

118. The construction of two local health units in Marawi and Lumbayanague will generate both negative and positive impacts. 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

10 https://www.gov.mb.ca/sd/eal/registries/5614keeyask_transmission/appendices/appendixc.pdf

disruption, duration pertains to 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 25. Intensity, Duration and Scope Classification of Impacts Intensity: Level of impacts Duration: Time dimension Scope: of Spatial dimension of the impacts effect Low: Little change in the Short-lived: Effect dissipates Regional: Action affects areas characteristics of the easily beyond project site component. Difficult to quantify. Average: Change in certain Temporary: Effect does not Local: Action affects areas characteristics of the last. Effect is felt during one within project site components. Change may be project activity or throughout quantified. project implementation High: Change in all or in the Permanent: Effect leaves Limited: Action affects only main characteristics of the lasting impact for the life of one aspect of the project component. Change is the infrastructure quantifiable.

119. 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 26. Multi-criteria Analysis to Determine the Potential Environmental Impacts

Intensity Duration Short-lived Temporary Permanent Scope

Limited MIN MIN MED Low Local MIN MIN MED Regional MIN MED MED Limited MIN MED MED Medium Local MED MED MAJ Regional MED MAJ MAJ Limited MED MAJ MAJ High Local MED MAJ MAJ Regional MAJ MAJ MAJ

Table 27. Matrix Showing the Relationship Between VECs and Project Components and Activities for the Construction of Health Units Project Phases Pre-construction Construction Operation Health Demoliti Tree Mobilization Constru Manage Operati Valued unit on of cutting of ction of ment of on of Environmental location existing and construction health construc health Components and building debris equipment units tion unit design clearing and activities facilities construction of temporary facilities Physical Environment Land and soil condition ✔ ✔ ✔ ✔ Surface water quality ✔ ✔ ✔ ✔ ✔ ✔ Air quality ✔ ✔ ✔ ✔ ✔ Biological Environment Protected area Vegetation ✔ ✔ ✔ ✔ Aquatic environment ✔ ✔ ✔ Fauna ✔ Socio-economic Environment Ventilation and use of ✔ renewable energy Rendering of services to the ✔ ✔ ✔ ✔ ✔ ✔ public Public infrastructure and ✔ ✔ ✔ ✔ ✔ access Acoustic environment ✔ ✔ ✔ ✔ ✔ Vehicle traffic ✔ ✔ ✔ ✔ ✔ ✔ Occupational health and ✔ ✔ safety Community health and ✔ ✔ safety

Table 28. Analysis of Environmental Impacts Project Environmental Description Intensity of Duration Scope Assessment Components Components Environmental of Potential Effects Impact Health unitVentilation Energy Medium Permanent Limited Medium location andand use of efficiency and design renewable comfort of users energy Rendering of Limited access Medium Temporary Limited Medium services to to public service the public Public Increased Medium Permanent Limited Medium infrastructure accessibility of and access the public Acoustic Reduced Medium Permanent Limited Medium environment disturbance to the public

Project Environmental Description Intensity of Duration Scope Assessment Components Components Environmental of Potential Effects Impact Vehicle traffic Location of Medium Permanent Limited Medium parking, loading and unloading will affect vehicle traffic Demolition Land and soil Potential High Temporary Local Major of existing condition contamination building from demolition debris from the 2 buildings, and contamination of landfill site where demolished buildings will be disposed Surface water Demolition of Medium Temporary Regional Major quality septic tank and building materials, wastes of which have potential to be transported to Lake Lanao through runoff Air quality Increase in Medium Short-lived Local Medium particulate matters Vegetation Cutting of trees Low Short-lived Local Minimal Rendering of Suspension of Medium Temporary Regional Major services to services the public Public Disturbance due Medium Temporary Local Medium infrastructure to movement of and access vehicle carrying demolished building Acoustic Increase in Medium Temporary Local Medium environment noise level from demolition activities Vehicle traffic Risk and Medium Temporary Local Medium inconvenience to community Tree cutting andLand and soil Disturbance of soil Medium Temporary Local Medium debris clearing condition Surface water Sediments may Medium Short-lived Regional Medium quality impact Lake Lanao and Agus River

Project Environmental Description Intensity of Duration Scope Assessment Components Components Environmental of Potential Effects Impact Air quality Increase in level Medium Short-lived Local Medium of particulate matter Vegetation Loss of trees Medium Short-lived Local Medium Public Risk to Medium Short-lived Local Medium infrastructure community and and access difficulty in accessing other services Mobilization Land of and soilDisturbance of Medium Short-lived Local Medium construction condition soil equipment andSurface water Potential Medium Short-lived Regional Medium construction quality of contamination of temporary Lake Lanao and facilities Agus River Air quality Increase in air Medium Short-lived Local Medium pollutants from construction activities and vehicles transporting construction equipment Aquatic Potential Medium Short-lived Regional Medium environment contamination of Lake Lanao and Agus River from sediments from cleared areas devoted to temporary facilities Rendering of Lack of access Medium Short-lived Local Medium services to the to public public services Public Difficulty in Medium Short-lived Local Medium infrastructure accessing other and access government offices Acoustic Increase in Medium Short-lived Local Medium environment noise level Vehicle traffic Vehicle Medium Short-lived Local Medium congestion and public disturbance Construction Land of and soilPermanent loss High Permanent Local Major health units condition of soil within building footprint Surface water Pollution of Lake High Temporary Regional Major quality Lanao and Agus River from sediments,

Project Environmental Description Intensity of Duration Scope Assessment Components Components Environmental of Potential Effects Impact wastewater from workers, oil and fuel and chemicals from construction site Air quality Increased level High Temporary Local Major of particulate matters from construction activities Vegetation Permanent loss High Permanent Local Major of trees and vegetation Aquatic Impact of High Temporary Local Major environment sedimentation on aquatic environment Rendering of Suspension of High Temporary Regional Major services to the full public public services Public Disturbance to Medium Temporary Local Medium infrastructure occupants of and access other buildings and the public Acoustic Increased noise High Temporary Local Major environment level from construction works Vehicle traffic Increased High Temporary Local Major congestion from construction vehicles Occupational Construction High Temporary Local Major health and risks to workers safety Community Risks to public High Temporary Local Major health and from safety construction activities Operation Land and soil Potential Medium Temporary Local Medium of health condition contamination facilities of land due to solid waste and hazardous wastes that will be generated from health units’ operation Surface water Contamination Medium Short-lived Local Medium quality of Lake Lanao and Agus River from

Project Environmental Description Intensity of Duration Scope Assessment Components Components Environmental of Potential Effects Impact wastewater and hazardous wastes from health units’ operation Rendering of Improved High Permanent Regional Major services to the services to the public public, including medical and emergency services from constructed health units Vehicle traffic Congestion Medium Temporary Local Medium inside compounds of city and municipal halls Community Improved High Permanent Regional Major health and access to health safety services

120. The construction of health units in Marawi City and Lumbayanague will likely bring both beneficial and adverse impacts on the environment. Based on the analysis of impacts in Table 28, beneficial impacts include reduced morbidity and mortality through the availability of services from the operation of health units, and improved health services for Lanao del Sur residents. Potential adverse impacts will happen during construction phase and will affect land and soil condition of the two sites, Lake Lanao and Agus River, the quality of the air, the workers as well as the people accessing the facilities inside the local government units’ compounds.

C. Potential Beneficial Impacts

121. The construction of the city health unit and rural health unit in Marawi and Lumbayanague, Lanao del Sur, will incorporate climate resilience measures including raising the ground floor to at least 600 mm from finish grade line, provision of area at 2nd floor for installation of solar panels, provision for rain collection system, provision of water tank and water collection system, and provision of off the grid power supply (solar power). The facilities, which will also have birthing facilities, and provisions for water supply and sanitation, will allow the restoration of essential health services, including reproductive health services to Marawi City, Lumbayanague, and surrounding areas hosting internally displaced persons. Enhancement measures to sustain the facilities include allocation of regular operations and maintenance budget from the local government units of Marawi and Lumbayanague.

D. Potential Adverse Impacts

122. The construction of health facilities will likewise cause adverse impacts on the environment with majority of these impacts expected to occur during construction phase. The following are the potential adverse impacts and corresponding mitigating measures per project component:

1. Demolition of existing buildings

123. The demolition of existing City Engineering Office and General Services Office buildings inside the city hall compound in Marawi will generate wastes from demolished building. These wastes include concrete, wood products, bricks, steel and general wastes. Mitigating measures to ensure safe and environmentally sound management of demolition wastes will prevent adverse health and environmental impacts on the community. The management of wastes will follow the Ecological Solid Waste Management Act of 2000.

124. The demolition of the CEO and GSO buildings in Marawi, including septic tank and building components has the potential to contaminate Lake Lanao through sediment transport. The potential contamination can be mitigated through the construction of sediment traps prior to release of water to drainage pipe leading to Lake Lanao. In addition, excessive sediments can be avoided by scheduling the demolition during days with less rainfall occurrence and by immediately transporting demolished materials away from the site. Based on classification of demolished materials, the demolished materials can be further recycled, treated or disposed to city accredited disposal site. These impacts will not occur in Lumbayanague since there is no existing building that will be demolished.

125. Another obvious impact of the demolition of existing CEO and GSO buildings is the suspension of public services for residents of Marawi. Based on discussion with CEO employees on December 18, 2019, their management has several options to relocate their offices while demolition of the buildings is ongoing.

126. Other potential impacts but can be easily mitigated include increase in particulate matter, disturbance due to movement of vehicle carrying demolished building, increase in noise level due to demolition activities, and risk and inconvenience to the community. Appropriate mitigating measures such as use of mask and other personal protective equipment, scheduling of vehicles transporting demolished materials, fencing of construction sites, and warning and information signs about the ongoing construction of health facilities.

2. Tree cutting and debris clearing

127. There are two mature diseased trees in Marawi and one tree in Lumbayanague that have potential to be affected by the proposed construction of health units. Since the two diseased trees in Marawi are already in deteriorated state, it is recommended to coordinate the cutting or transplanting of diseased trees with the Department of Environment and Natural Resources. Permit to cut has been secured from the City Environmental and Natural Resources Office of Marawi on August 25, 2020 (Appendix 10). Cutting of trees may generate negative impacts on the environment as sediments from loose soil from cut trees may affect the surface water quality of Lake Lanao. Temporary increase in air pollutants from debris clearing may also impact on workers and the people nearby. This can be mitigated by installing perimeter fence. The workers will also be required to put on masks during demolition, in addition to wearing other PPEs. Debris clearing will also affect the operation of other public infrastructure inside the local government units’ compounds, as well as the public’s access to other services. The local government will install information signs to warrant the public about the ongoing debris clearing.

3. Mobilization of construction equipment and construction of temporary facilities

128. Prior to construction of health units, the contractors for both sites will bring materials and machinery to the work area and store them in a staging area where construction workers will have

access during construction. The movement of vehicles carrying construction materials as well as the construction of temporary facilities will disturb the soil, generate sediments that may potentially contaminate Lake Lanao and Agus River, increase the level of air pollutants coming from emission from vehicle and the disturbance of soil, temporary suspension of health and emergency services, disturbance among the public and difficulty accessing other offices inside the local government units’ compounds. There will also be elevated level of noise from vehicles, in addition to increased congestion from additional construction vehicles transporting construction materials and equipment.

129. To mitigate these impacts, contractors for the two projects need to ensure that the wheels of vehicles transporting aggregates and other materials are thoroughly washed to prevent sediment runoff going to drainage pipes. The contractors also need to ensure that their vehicles comply with relevant emission standard. Contractors must also put warning signs for the public to increase their level of awareness regarding the projects.

4. Construction of health units

130. The construction of health facilities, details of which are discussed in Chapter III, will generate the majority of negative adverse impacts, hence this stage is the most crucial to mitigate environmental impacts. Major impacts at this phase include permanent loss of soil within building footprint, which is more pronounced in Lumbayanague as there is no existing building yet in the proposed site. Another major impact is the generation of sediments, liquid and solid wastes that have the potential to pollute Lake Lanao and Agus River. The operation of vehicles carrying aggregates and construction materials may also generate oil, fuel and chemicals from construction site that can be transported to receiving body of water. Moreover, the exhaust during vehicle movement, both from disturbed soil and from vehicles, will temporarily increase the level of air pollutants. The operation of vehicles will also increase the level of noise, vibration, and traffic congestion in the two sites. The construction of the buildings will likewise increase the risks to health and safety of construction workers that will be hired for the project. There will also be safety risks to public such as construction vehicle movement, uneven soil surfaces, pollution from sediments, and potential accident from transporting of construction materials.

131. To address major impacts during this stage, contractors will be required to implement combination of mitigating measures to minimize the impact of sediment transport to Lake Lanao and Agus River. These can be accomplished through installation of temporary silt fence barrier trenched into the ground in the perimeter of proposed sites, construction of sediment control traps, not implementing construction activities during rainy season, stabilization of areas being traversed by construction vehicles and regular washing of wheels of vehicles used for construction.

132. Regular maintenance of vehicles will also be required from the contractors to lessen the risk of oil leakage from vehicles to prevent this to be carried as runoff that will pollute waterways leading to Lake Lanao. To lessen the impact of elevated air pollution, contractors will ensure that vehicles being used for construction have updated vehicle registration with the Land Transportation Office, that regular spraying of disturbed soil will be conducted, and that dust masks be worn by workers.

133. Noise and vibration arising from the operation of vehicles and construction equipment will only be temporary, and it is important that public information be conveyed to the public about the temporary disturbance. Vulnerable workers will be required to wear ear muffler. To ease traffic congestion, CHO and IPHO need to coordinate with the mayors on the possibility of designating only one entrance and exit inside the local government compounds and installing traffic warning

and information signs to facilitate movements of vehicles and people.

134. Contractors will be required to ensure that workers receive training on safety, health and environment (SHE) prior to commencing their work. Workers will also be provided with PPEs to minimize risks on their health and safety. Contractors are also required to comply with Republic Act 11058 and its implementing rules and regulations. Likewise, the contractors need to ensure the safety of the public by following strictly the guidelines of RA 11058.

5. Operation of health facilities

135. The operation of health units in Marawi and Lumbayanague will markedly improve the delivery of health and emergency services in the two LGUs and nearby towns, specifically the internally displaced persons (IDPs). To ensure the smooth delivery of services, the local government units have to allocate funds and continually build the capacity of its personnel to maintain the level of services.

136. The operation of health units will generate solid wastes, including medical wastes, that will potentially impact the environment, if not properly managed and disposed. To mitigate the impacts of solid waste, both CHO and IPHO will establish solid waste management system in the two health units. These include installation of segregated waste receptacles for biodegradable, recyclables, residual and hazardous wastes, implementation of the 3Rs of waste management (reduce, reuse and recycle), agreement with the local government units of Marawi and Lumbayanague for regular waste collection, and prohibition of burning of wastes and dumping of wastes in waterways. The health units will also follow the relevant provisions of Republic Act 6969 or the Toxic Substances and Hazardous and Nuclear Wastes Control Act of 1990 and the Revised Health Care Waste Management Manual of the Department of Health.

137. Wastewater will be generated from laboratories as well as different sections of health units. Wastewater, consists of blackwater or sewage, which contains high concentration of fecal matter and urine food residues; and greywater, which has low level of pollution from washing, bathing, laboratory processes and laundry. The health units will comply with DENR’s Republic Act 6969 to manage hazardous contents, such as residual oil and toxic chemical materials. These hazardous wastes must be stored in a specific container that must be further processed by an accredited transport, storage and disposal (TSD) service provider. Three-chambered septic tank will be incorporated in the design to process wastewater coming from the toilets and kitchen.

VI. CONSULTATION, PARTICIPATION AND INFORMATION DISCLOSURE

A. Consultation and Participation

138. 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.

139. The consultation with Marawi and Lumbayanague local government units were conducted on May 28-29, 2019, and December 18, 2019. A team from Asian Development Bank11 and Department of Health met with stakeholders from the two LGUs, Task Force Bangon Marawi (TFBM), and with affected people. The list of stakeholders from various offices during the site assessment and the topics discussed is detailed below Photographs of the public consultation are attached in Appendix 11.

Table 29a. Summary of Consultations with Relevant Agencies on May 28-29, 2019 Office Name Designation Issues Discussed and Information Obtained Marawi City Office of the Mayor Majul Gandamra Mayor, Marawi Briefing on project scope and City proposed location of city health unit. Proposed site assessment was also discussed.

Discussed the necessary counterparts from Marawi City in terms of human resources, utilities and operation and maintenance sustainability. Task Force Bangon Felix Castro Assistant Updates on EARRM Output 3 Health Marawi Secretary Component developments City Health Office Dr. Ali Daligdig City Health Discussion of environmental Officer assessment for proposed CHU site in Marawi Integrated Provincial Dr. Alinader Provincial Health Discussion of environmental Health Office Minalang Officer assessment for proposed RHU site in Lumbayanague, Lanao del Sur Lumbayanague Office of the Mayor Salamona Asum Mayor, LumbayanagueBriefing on project scope and proposed location of city health unit. Proposed site assessment was discussed.

11 The team from ADB that conducted site assessment and consultation in Marawi and Lumbayanague on May 28-29, 2019 comprised the following consultants: Andrew Bucu (Health Specialist), Lizandro Racoma (Environment Specialist, Jones Dizon (Project Coordinator), and Raul Babiera (Project Coordinator). Because of the request of the LGU of Marawi to relocate the proposed City Health Unit to the existing City Engineering Office and portion of General Services Office buildings, ADB team, composed of Rikard Elfving (Senior Social Development Specialist), Lizandro Racoma (Environment Consultant), and Jane Austria-Young (Social Development Consultant), together with DOH team, consulted with stakeholders on December 18, 2019.

Office Name Designation Issues Discussed and Information Obtained

Discussed the necessary counterparts from Marawi City in terms of human resources, utilities and operation and maintenance Office of the Mayor Arimao Asum Vice-Mayor Briefing on project scope and proposed location of city health unit. Proposed site assessment was discussed.

Discussed the necessary counterparts from Marawi City in terms of human resources, utilities and operation and maintenance Office of the Mayor Engr. Abdul Jalil Unda Municipal Secured title of proposed RHU lot Department of Health DOH Field Abdullah Under Secretary Briefed Mayor Gandamra on status of Implementation Dumama EARMM Output 3 Health Component and Coordination development Team (FICT) Finalized proposed CHU lot within the City Hall compound, which is located at the present CHU

Rapid Environmental Assessment of RHU conducted by the Environment Consultant DOH Field Jet Tobias Staff Briefed Mayor Gandamra on status of Implementation EARMM Output 3 Health Component and Coordination development Team (FICT) Department of Wafa Biao Staff Supported the DOH team in finalizing Health, Health the building plan of proposed health Facility units Enhancement Program Department of Rowell Reyes Architect Supported the DOH team in finalizing Health, Health the building plan of proposed health Facility units Enhancement Prograim Health Facilities Arvin Matias Staff Supported the DOH team in finalizing and Infrastructure the building plan of proposed health Development units Team Department of Jeff Duhaylunsod Staff Supported the site assessment of Health Region X proposed health units Department of Jomari Maglacion Staff Supported the site assessment of Health Region X proposed health units

Table 30. Summary of Consultations with Relevant Agencies on December 18, 2019 Office Name Designation Issues Discussed and Information Obtained Office of the Mayor Sadiq Mohamad Project Management The Mines and Office Consultant Geosciences Bureau conducted a geohazard susceptibility study of the Government Center in Marawi and found that the site has low landslide susceptibility.).

LGU to facilitate transfer of the inmates, temporarily held at a small structure located behind the DPQH building. City Engineering Office Teban Petuas Architect Their office will support the relocation of the proposed CHU in the existing CEO. Task Force Bangon Colonel Tony Sugarol Deputy TFBM will request the Marawi assistance of Military Engineering Unit of Philippine Army to provide assistance for the demolition of the existing CEO and GSO buildings, and the transport and disposal of demolition debris. Extent of responsibilities need to be discussed with different stakeholders. EARRM Project Ar. Marirose Malapote EARRM Project PMO to closely Management Office Consultant coordinate with LGU EARRM Project Ar. Lord Jay Loma EARRM Project and Task Force Management Office Consultant Bangon Marawi to EARRM Project Assmin Alvarez EARRM Project facilitate the Management Office Consultant demolition of existing EARRM Project Annabelle B. Nanol EARRM Project CEO and GSO Management Office Consultant buildings, as well as other requirements prior to CHU construction City Health Office Dr. Ali Daligdig City Health Officer City Health Office to coordinate with

Office Name Designation Issues Discussed and Information Obtained different stakeholders to facilitate the management of demolition debris as well as to facilitate the approval of construction of CHU Center for Health Carmela Roa Engineer CHD NM to prepare Development Northern all requirements to Mindanao (CHD NM) facilitate the CHD NM Jeff Duhaylungsod Engineer construction of CHU CHD NM Jomari Maglacion in Marawi

140. Consultations were also conducted with Marawi and Lumbayanague local residents. Consultations were done on April 27-28, 2021 in Lumbayanague and from May 5 to 10, 2021 in Marawi City. In Marawi City, a total of 10 residents, 2 male and 8 female, were consulted. Their age ranged from 22-34 years old. Residents interviewed in Marawi live in the following barangays: Dimalna, Lomiliong, Basak Malutlut, Cabingan, and Gadungan. Three are married, while the rest are single. Two are government employees, 1 is self-employed, 1 is a student and the rest did not indicate their occupation. The following social and environmental concerns were highlighted as potential to cause impacts on their well-being and the environment, specifically during construction.

141. In Lumbayanague, 21 residents of Barangays Dilimbayan (1), Cabasaran (17), Nanagun (1), Miniros (1), and Daramoyod (1) between 21 to 65 years old, were consulted. Four of the residents consulted are male, and 17 are female; 19 are married, 1 is single and 1 widow. Four were government employees, two are farmers, 5 are involved in business, 3 are self-employed, 1 is a student, 1 is a barangay health worker, and 5 did not indicate any occupation.

142. In both sites, residents indicated potential social and environmental impacts of the proposed construction of health units, which ranged from legal issues surrounding construction, permits and clearances required prior to commencement of works, pollution from solid wastes and construction and demolition debris, noise, wastewater, vehicle emission, and runoff from vehicles and construction activities. In general, residents consulted were eager for the construction of health units to commence soon. They also raised the issue if the facilities to be constructed will have birthing and laboratory facilities and if there will be steady supply of medicines. Below are the perceived potential social and environmental impacts of proposed construction of health units among residents consulted in Marawi and Lumbayanague.

Table 29b. Consultations with Residents on April 27-28, 2021 (Lumbayanague) and May 5-10, 2021(Marawi City) Potential Social and Environmental Impacts Marawi Lumbayanague Road blockage/heavier traffic due to construction Medium Low Dust due to construction activities Medium High Increased wastewater discharge from workers Low High Legal issues of the construction Low Low Permits / clearances not secured prior to start of construction High Medium

Potential Social and Environmental Impacts Marawi Lumbayanague Elevated level of noise from construction activities High Medium Increased generation of solid waste from workers High High Increased generation and improper management of construction High High and demolition wastes Increased vehicle emission from idled vehicles High Medium Disturbance from operation of construction vehicles High Medium Disturbance from open burning of waste High Medium Increased runoff from washing of vehicles High High Improper management of wastewater and hazardous wastes High High from construction and operation of health units Increased turbidity of receiving body of water from construction High activities

B. Information Disclosure

143. Information disclosure will be guided with ADB’s Public Communication Policy 2011 and Access to Information Policy 2018, and the procedures in ADB SPS 2009 for environment category B projects. The final IEE of the proposed health units in Marawi and Lumbayanague will be posted in ADB website upon receipt. Highlights of the IEE will be disclosed in the local language in Marawi and Lumbayanague.

VII. GRIEVANCE REDRESS MECHANISM

144. Two subproject-specific grievance redress mechanisms (GRM) will be established, one at the City Health Office in Marawi City for the Marawi City Health Unit, and another at the Integrated Provincial Health Office, also in Marawi City, for the Lumbayanague Rural Health Unit. These will receive, evaluate and facilitate the complaints/grievances of affected persons on the environmental performance of the established health units.

145. Both the City Health Officer and Integrated Provincial Health Officer will constitute separate Grievance Redress Committee (GRC) for Marawi City and Lumbayanague, especially during construction of the two health units. The City Health Officer will head the committee in Marawi City while the Integrated Provincial Health Officer will head the committee in Lumbayanague. Each committee will include the following as members: (i) Construction Supervisor; (ii) Designated Safety, Health and Environment Officer from the contractor; (iii) Barangay Chair; and (iv) Task Force Bangon Marawi. For the quick filing of complaints, the DGRC will use the attached grievance intake form (Appendix 12). The CHO and IPHO will be responsible for registration of grievances and communication with the aggrieved party.

146. The steps to be followed in filing complaints and the procedures for redress are the following:

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

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

(iii) Within 3 days of lodging the complaint, the CHO or IPHO 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. The GRC will have 15 working days to resolve the complaint;

(v) The complainant will receive feedback from the CHO or IPHO within 5 working days after the various steps of the GRM are completed.

(vi) If the complainant is not satisfied with the feedback from the CHO or IPHO, the complainant has the option to access the Government's judicial, administrative remedies or through concerned government agencies (e.g., Community Environment and Natural Resources Office and Provincial Environment and Natural Resources Office of DENR BARMM, and DOH central and regional office).

147. 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 issues. These reports will be included in the semi-annual environmental monitoring reports to be submitted by DOH to ADB. All stakeholders will be informed of the existence of the GRM through

various channels such as project information billboards, flyers, and media, as well as contact details of GRM focal.

VIII. ENVIRONMENTAL MANAGEMENT PLAN

A. Overview

148. 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.

149. The Environmental Management Plan (EMP) has been developed based on consultations with the Department of Health and the local governments of Marawi City and Lumbayanague. The EMP is included in the bid and contract documents to ensure that contractors are aware of their obligations during construction phase. The plan will also guide the Department of Health, the IPHO and CHO, in the supervision and monitoring of contractors’ safeguards performance during construction.

B. Mitigation Plan

150. Environmental mitigation measures of the project have been formulated and summarized below. It presents summary information on: (i) project activity causing impacts by project’s phase; (ii) anticipated impacts associated with project activity; (iii) proposed mitigation measures for each environmental impact, (iv) responsible party for carrying out mitigation measures, and (v) associated cost (tentative). Details of mitigating measures are already discussed in Chapter V where the need for mitigation of each impact was determined in the screening process. The Impact Mitigation Plan also includes: (i) parameters to be monitored; (ii) frequency and means of verification; and (iii) party responsible for monitoring.

151. During the pre-construction phase the cost of preparing bid documents with provisions for the required environmental measures are part of DOH Project Management Office’s contract. During construction, all costs of environmental mitigation measures shall be the responsibility of contractors and are considered part of their contracts as specified in the technical specifications. During the operation phase, all costs of mitigation measures are part of the operation and maintenance costs of the CHO and IPHO. The EMP costs shall not be taken as separate environmental costs since they are already part of specific items such as the PMO’s contract, contractors’ contracts and CHO and IPHO’s operation and maintenance costs.

C. Reporting

152. Throughout the construction period, the contractor will submit monthly works progress to Project Management Unit of DOH (PMU). The PMU will prepare and submit semi-annual environmental monitoring report to ADB, including any grievances raised / resolved during the reporting period. The semi-annual environmental monitoring report will include progress of construction, results of site inspections and environmental monitoring, progress made in EMP implementation, status of compliance with domestic environmental regulatory requirements and other clearances, record of community complaints, unforeseen environmental impacts, and suggested corrective actions for the next monitoring period. Table below presents the environment safeguards reporting plan for the project.

Table 30. Environmental Safeguards Reporting Plan Type of Report Basic Content Prepared by Submitted to Frequency

Construction Phase

Construction Progress of construction, Contractors PMU / DOH Weekly / Monthly Progress Report CEMP implementation (checklists) Project Progress Project status Including a PMU ADB / DOH Monthly report summary section on EMP implementation, accidents and incidents, and any complaints received Environmental EMP implementation, PMU / DOH ADB Semi-annual Monitoring Report environmental monitoring, compliance with GOI environmental requirements, accidents/incidents, complaints received, and actions undertaken Operational Phase

Report to ADB Subproject progress report, PMU ADB Semi-annual until including section on EMP turn-over to IPHO / implementation and CHO (December monitoring 2022) DOH ADB From turn-over until completion of PCR ADB = Asian Development Bank; CEMP = contractor environmental management plan; CHO = City Health Office; EMP = environmental management plan; IPHO = Integrated Provincial Health Office; PCR = project completion report; PMU = project management unit.

D. Institutional Arrangement

153. The Department of Public Works and Highways (DPWH), as the Executing Agency (EA), has the overall strategic oversight of all infrastructure components. The Department of Health (DOH) Central Office Project Management Unit (PMU), as the Implementing Agency will be responsible for the implementation of the health component of the grant financed under the Urban Climate Change Resilience Trust Fund (UCCRTF). The PMU will be supported by procurement, contracts management and health specialists.

154. The ERRM Projects Steering Committee, which comprises representatives of Department of Finance (DOF, Chair); Department of Budget and Management (DBM); Department of Public Works and Highways (DPWH) and the National Economic and Development Authority (NEDA), oversees the implementation of the four outputs under the Marawi Reconstruction Emergency Assistance Project. Other agencies, including Task Force Bangon Marawi (TFBM); Local Water Utilities Administration (LWUA); the Department of Education (DepEd), Department of Labor and Employment (DOLE); Marawi City Local Government Unit (LGU), Department of Health Central Office (DOH-CO), Department of Health in the Autonomous Region for Muslim Mindanao (DOH- ARMM) and Office of Civil Defense (OCD) will be part of the Committee on an “on call” basis.

155. Within DOH, the following are the proposed organizational structure and corresponding responsibilities:

A. Project Board / Steering Committee (PB/SC)

1. Composition

The Project will be governed by a Project Board (PB) which shall be composed of the following:

Chairperson : Field Implementation and Coordination Team (FICT) for Visayas and Mindanao Vice-Chairperson : Northern Mindanao Center for Health Development Members : Officials, Task Force Bangon Marawi Health Facilities Development Bureau (HFDB) Health Facilities Enhancement Program (HFEP) Asian Development Bank

2. Functions

The PB shall perform the following tasks and responsibilities: a. Resolve issues and constraints that significantly impact on quality, budget and timeframe; b. Provide visible and sustained support to the Technical Working Group (TWG); c. Approves the Quarterly Accomplishment Report of the Contractor and recommends for payment; and d. Ensure effective communication both within the project and external stakeholders.

B. Technical Working Group (TWG)

1. Composition

A Technical Working Group (TWG) will be comprised of the following:

Chairperson : Asst. Regional Director, Northern Mindanao Center for Health Development Vice-Chairperson : HFEP/HFDB Coordinator Members : Provincial Health Officer, Lanao del Sur City Health Officer, Marawi City Representative, Task Force Bangon Marawi Bureau of International Health Cooperation (BIHC) Project Management Unit supported by Project Team Leader, Procurement and Civil Works Consultants Construction Manager Site Manager, Construction Firm

2. Functions The TWG shall perform the following tasks and responsibilities: a. Confirm and coordinate scope for civil works and specifications for goods with IPHO, CHO and team of consultants.

b. Supervise contractors and suppliers and ensure quality of works and goods for health component. c. Validate all claims from Contractors and suppliers for direct payments by ADB. d. Liaise and coordinate closely with FICT VisMin, CHD10, IPHO, CHO, LGU and other agencies to ensure field support for grant activities and works. e. Provide project updates to BIHC using the NEDA Form for Project Performance Updates. f. Prepare Quarterly Reports to the FICT VisMin for onwards submission to ADB. g. Prepare project financial reports and have them audited. h. Implement and monitor the Gender Action Plan set forth in the PAM for this project. i. Ensure the construction and completion of the two health facilities as indicated in the agreement/contract. j. Procure all civil works, goods and consulting services as per ADB Procurement Policy. k. Resolve issues, concerns and /or problems, make recommendations and decisions that may affect the execution of the project in terms of strategic directions, significant change of the scope, timing resources and cost requirements as elevated by offices concern.

Table 31. Roles and Responsibilities of Offices in Project Implementation Offices Roles and Responsibilities Field Implementation a. Act as the Implementing Agency (IA) for this project. and Coordination Team b. Responsible for the overall delivery of outputs, including (FICT) ensuring that outputs are delivered complying with agreed standards/quality. c. Responsible for the implementation, monitoring and reporting of the Gender Action Plan (GAP). Integrated Provincial a. Directly assist in the implementation of the health Health Office (IPHO) component. and City Health Office b. Project owner for rural health units. (CHO) c. Confirm ownership and furnish relevant ownership documents for RHU site. d. Project owner for mobile health clinics, ambulances, patient transport vehicles, patients transport vehicles and monitoring vehicles. e. Confirm specification for all infrastructure and equipment. f. Confirm quality of works during construction and good during delivery. g. Allocate physical space and necessary infrastructure for mobile health facilities. h. Allocate resources (staff and budget) for operations and maintenance. i. Ensure the Sustainability of the project. j. Ensure to bear the costs of security, proper storage, operation, maintenance and repair of the equipment and materials, during and after the completion of the Project.

Offices Roles and Responsibilities k. Provision of temporary fence around the site before commencement of construction. l. Make the necessary arrangements with concerned local government units and other related agencies to issue permits and authorization to carry out the construction work. m. Ensure utilization of the health facilities after completion. n. Obtain all necessary approval and consents required by the laws and regulations in effect in the Republic of the Philippines from the authorities concerned, and settle all administrative and legal matters, which could be brought regarding the implementation of the Project. Bureau of International a. Act as Project Management Unit (PMU) and designate Health Cooperation focal point to monitor Project preparation, (BIHC) implementation and completion; b. Facilitate all necessary approvals and consents required by the laws and regulations in effect in the Republic of the Philippines from the authorities concerned; c. Provide technical advice on project management that must be followed in the implementation of the Project; d. Secure budget or take necessary procedures for the Project such as value added taxes (VAT), custom duty and any other taxes and fiscal levies in the Philippines which is to be arisen from the Project activities. Health Facility a. Provide standards for health facilities and equipment Enhancement Program requirement (HFEP), Central Office b. Assist in the construction and identification/prevention and Regional Health of implementation problems. Office c. Conduct monitoring visits to the project sites together with the DOH technical inspection team to check and evaluate the general progress and quality of the work and to determine whether the work is proceeding in accordance with the contract. d. Ensure that the project/construction is completed within the project time-frame. e. Ensure the accomplishment of all the administrative procedures that are necessary for the implementation of the Project including approval of basic designs, testing and acceptance procedures upon the completion of the Project. f. Facilitate all necessary approval and consents required by the laws and regulations in effect in the Republic of the Philippines from the authorities concerned and settle all administrative and legal matters, which could be brought regarding the implementation of the project.

Offices Roles and Responsibilities Northern Mindanao a. Oversee the implementation and completion of the Center for Health Project in the region; Development b. Assist in the regular monitoring of the progress of the Project including the evaluation of the project and its implementation; c. In coordination with Health Facilities Enhancement Program (HFEP), ensure the accomplishment of all the administrative procedures that ate necessary for the implementation of the Project including approval of basic designs, testing and acceptance procedures upon the completion of the Project. d. Responsible in the preparation, review, and approval of the schematic plans, Detailed Architectural and Engineering Design (DAED) Documentation, Technical Specifications, Detailed Estimates, Scope of Works and other documents necessary for procurement of the civil work projects, in consultation with the LGUs and project consultants.

Asian Development Administer the grant, including procurement review and Bank support, public financial management, safeguards and social monitoring and supervision.

156. All communications and reports to the development partner (ADB) regarding this project shall pass through and be submitted to the Bureau of International Health Cooperation (BIHC) copy furnish FICT VisMin.

157. The Integrated Provincial Health Office (IPHO) will be the project owner for the rural health unit (RHU), 2 mobile health clinics, 1 ambulance, 1 patient transport vehicle and 1 monitoring vehicle in Lumbayanague. The City Health Office meanwhile, will be the project owner for the city health unit (CHU), 1 mobile health clinic, 1 ambulance and 1 patient transport vehicle in Marawi City. Both IPHO and CHO will be responsible for confirming specifications for all infrastructure and equipment. They also need to confirm the quality of works during construction. Both offices also need to allocate physical space and necessary infrastructure for mobile health facilities. Both offices also need to allocate resources (staff and budget) for operations and maintenance.

E. Environmental Management Plan

158. The Environmental Management Plan (EMP) includes the proposed mitigation measures, environmental monitoring and reporting requirements, related institutional or organizational arrangements, capacity development and training measures, implementation schedule, cost estimates and performance indicators for the Project. The Contractor must adhere to the mitigating measures and other requirements in the EMP to ensure that construction will not adversely affect the environment, the community and workers. In addition, the Contractor will prepare the following detailed Contractor’s EMP (CEMP): workers’ accommodation plan, occupational health and safety plan, emergency response plan, traffic management plan, waste disposal management plan, and demobilization plan. Contractors will assign qualified environment, health and safety (EHS) staff for the two sites to supervise and monitor the EMP

and ensure compliance with safeguards requirements of ADB and the Government of the Philippines. Contractors will be required to prepare and submit their construction EMP (CEMP) prior to commencement of works, to be cleared by the PMU. Key responsibilities for EMP implementation and details of the EMP are detailed below.

Table 32. Organizational Set-up for Environmental Management Plan and Environmental Monitoring Plan Implementation Agency / Position Responsibility DOH (Implementing Oversight and coordination of safeguards implementation Agency) throughout the grant. Submit semi-annual safeguard monitoring reports to EA. Communicate potential safeguards non- compliance to ADB promptly. DPWH (Executing Validate semi-annual safeguards monitoring reports and submit Agency) to ADB. Communicate potential safeguards non-compliance to ADB promptly. Project Director (Project Oversee safeguard implementation for the Project, in Management Unit (PMU)) coordination with the EA, consultants, contractors and local authorities. Safeguards Specialists Analyze monitoring information on safeguards and report the (UCCRTF grant) results and corrective actions to the IA and EA. Construction Supervisor Oversee field work of contractors and consultants and (PMU) coordinate closely with CHO and IPHO regarding potential safeguards impacts. Review safeguards reports submitted by consultants and contractors, and consolidate and send to IA. Project Coordinator (PMU) Assist the IA and EA with overall safeguards implementation and monitoring.

F. Capacity Building

159. Training and/or workshops on environmental management and monitoring requirements shall be done by ADB from time to time to build the capacity of the contractors in EMP implementation. Monitoring of occupational and community health and safety requirements, including COVID-19 risk management, will be prioritized during construction to reduce risks to workers and the community. PMU shall continue the process of public consultation and information disclosure in accordance with the requirements of the SPS and the government rules and regulations during preparation and construction phases.

G. COVID-19 Construction Safety Guidelines

160. Prior to start of construction, DOH should formally require the contractor to submit an updated site-specific health and safety management plan, which covers COVID-19 related health and safety risks. The updated site-specific health and safety management plan should be in accordance with DPWH’s Department Order No. 30, series of 2021 or the Construction Safety Guidelines for the Implementation of All Government and Private Construction Projects during the COVID-19 Public Health Crisis. DOH is required to inform ADB on the approval of the Health and Safety COVID-19 plan submitted by the Contractor. The ADB is not responsible for approving the Health and Safety COVID-19 plan; and clearance from the ADB is not a prerequisite to DOH’s approval of the resumption of site works in the two locations.

Figure 32. Summary of Construction Safety Guidelines Based on DPWH DO No. 30, series of 2021

Table 32. Impact Mitigation Plan Project Potential Impact Mitigation Measures Institutional Responsibilities Cost Estimate Components/ (PhP) Activities Implementation Supervision

Health unit location Potential increase in Proposed health units will be equipped to DOH ADB 34 million12 and design morbidity and meet the 4:1 service delivery requirement, mortality and further comprising (i) Tamang Serbisyo sa deterioration of Kalusugan ng Pamilya (TSeKaP, a primary health services health care package under the Philippine Health Insurance Corporation); (ii) Maternal Care Package; (iii) Directly observed treatment, short-course for tuberculosis (TB DOTS) and (iv) Animal Bite Services.

Ensuring sustainability by providing human resources and budget to sustain operations and maintenance of the health units. Climate change Incorporating Guidelines for Climate DOH ADB Included in impact (drought), Change and Green House Resilience design cost discomfort of people Design of this IEE) principles in the design and wastage of of health units. energy use Raising the ground floor to at least 600 mm from finish grade line, provision of area at 2nd floor for future installation of solar panels, provision for rain collection system, provision of water tank and water collection system, and provision of off the grid power supply (solar power). Demolition of Potential Ensure safe and environmentally sound Contractor City Health Part of Marawi existing building contamination of management of demolition wastes Office (CHO), City’s budget (applicable only in environment through Marawi Marawi) generation of Implementation of Ecological Solid Waste demolition wastes Management Act of 2000 Potential to Construction of sediment traps prior to Contractor CHO Marawi Part of Marawi contaminate Lake release of water to drainage pipe leading to City’s budget Lake Lanao.

12 Includes construction of City Health Unit in Marawi City and Rural Health Unit in Lumbayanague.

Project Potential Impact Mitigation Measures Institutional Responsibilities Cost Estimate Components/ (PhP) Activities Implementation Supervision

Lanao through sediment transport Scheduling the demolition during days with less rainfall occurrence and by immediately transporting demolished materials away from the site.

Recycling, treating and disposal of wastes13 Suspension of health Prepare a contingency plan, including Contractor CHO Marawi Part of Marawi and emergency allotting temporary office or building while City’s budget services for residents demolition is ongoing, to ensure continuity of Marawi and of health and medical services. neighboring towns, including internally displaced persons.

Increase in particulate Use of mask and other personal protective Contractor CHO Marawi Part of Marawi matter, disturbance equipment City’s budget due to movement of vehicle carrying demolished building Increase in noise Scheduling of vehicles transporting Contractor CHO Marawi Part of Marawi level due to demolished materials, fencing of City’s budget demolition activities construction sites, and warning and and risk and information signs about the ongoing inconvenience to construction of health facilities. the community. Tree cutting and Loss of vegetation Securing permit to cut trees from Contractor CHO Marawi / Local government unit debris clearing (approximately two Community Environment and Natural Integrated budget (Marawi and mature diseased Resources Office of Marawi. Replanting of Provincial Health Lumbayanague) trees in Marawi and replacement trees within City Hall Office (IPHO), one tree in compound of Marawi and the Municipal Lumbayanague Lumbayanague) Hall of Lumbayanague.

13 Marawi City has a dumpsite in Barangay Papandayan and planning to have its own sanitary landfill in Barangay Malimono (https://bangonmarawi.com/2019/04/29/denr-mapping-of-properties-inside-maa-done/).

Project Potential Impact Mitigation Measures Institutional Responsibilities Cost Estimate Components/ (PhP) Activities Implementation Supervision

Alteration of soil Restoration of top soil in available areas. Contractor CHO Marawi / Local government unit condition IPHO budget Lumbayanague Sediment transport Installation of perimeter fence within Contractor CHO Marawi / Local government unit from loose soil to construction area. IPHO budget Lake Lanao Lumbayanague Temporary increase Requiring workers to put on masks during Contractor CHO Marawi / Local government unit in air pollutants from demolition, in addition to wearing other IPHO budget debris clearing PPEs. Lumbayanague Public Installation of information signs to warrant Contractor CHO Marawi / Local government unit inconvenience the public about the ongoing debris clearing IPHO budget Lumbayanague Mobilization of Soil disturbance and Contractors for the two projects need to Contractor CHO Marawi / Local government unit construction generation of ensure that the wheels of vehicles IPHO budget equipment and sediments that may transporting aggregates and other Lumbayanague construction of potentially materials are thoroughly washed to prevent temporary facilities contaminate Lake sediment runoff going to drainage pipes. Lanao and Agus River Increase the level of The contractors need to ensure that their Contractor CHO Marawi / Local government unit air pollutants vehicles comply with relevant emission IPHO budget coming from standard. Lumbayanague emission from vehicle Temporary The city health office in Marawi must Contractor CHO Marawi Local government unit suspension of health ensure that a temporary health and budget and emergency emergency service is available, or in case services this is not possible, coordinating with other hospitals to refer people who need health and emergency services. Disturbance among Contractors must put warning signs for the Contractor CHO Marawi / Local the public and public to increase their level of awareness IPHO government unit difficulty accessing regarding the projects. Lumbayanague budget other offices inside the local government

Project Potential Impact Mitigation Measures Institutional Responsibilities Cost Estimate Components/ (PhP) Activities Implementation Supervision

units’ compounds. Elevated level of Scheduling of construction activities and Contractor CHO Marawi / Local noise from vehicles, in regular maintenance of vehicles used for IPHO government unit addition to increased construction. Lumbayanague budget congestion from additional construction vehicles transporting construction materials and equipment. Construction of healthPermanent loss of soil Installation of temporary silt fence barrier Contractor CHO Marawi / Included in units within building trenched into the ground in the perimeter of IPHO construction cost footprint. proposed sites, construction of sediment Lumbayanague control traps, Generation of sediments, liquid and Suspension of construction activities during solid wastes that have rainy season, stabilization of areas being the potential to pollute traversed by construction vehicles and Lake Lanao and Agus regular washing of wheels of vehicles used River. for construction.

Generation of oil, fuel Regular maintenance of vehicles will be Contractor CHO Marawi / Included in and chemicals from required from the contractors to lessen the IPHO construction the operation of risk of oil leakage from vehicles to prevent Lumbayanague cost vehicles carrying this to be carried as runoff that will pollute aggregates and waterways leading to Lake Lanao. construction materials from construction site To lessen the impact of elevated air that can be pollution, contractors will ensure that transported to vehicles being used for construction have receiving body of updated vehicle registration with the Land water. Exhaust during Transportation Office, that regular spraying vehicle movement, of disturbed soil will be conducted, and that both from disturbed dust masks be worn by workers. soil and from vehicles, will temporarily

Project Potential Impact Mitigation Measures Institutional Responsibilities Cost Estimate Components/ (PhP) Activities Implementation Supervision

increase the level of air pollutants. Suspension of Marawi LGU must prepare contingency Contractor CHO Marawi / Included in services to the public plan to ensure continuity of services. IPHO construction cost Lumbayanague The operation of Noise and vibration arising from the Contractor CHO Marawi / Included in vehicles will also operation of vehicles and construction IPHO construction cost increase the level of equipment will only be temporary, and it is Lumbayanague noise, vibration, and important that public information be traffic congestion in conveyed to the public about the temporary the two sites. disturbance.

To ease traffic congestion, CHO and IPHO need to coordinate with the mayors on the possibility of designating only one entrance and exit inside the local government compounds, and installing traffic warning and information signs to facilitate movements of vehicles and people. The construction of Contractors will be required to ensure that Contractor CHO Marawi / Included in the buildings will workers receive training on safety, health IPHO construction cost likewise increase the and environment (SHE) prior to Lumbayanague risks to health and commencing their work. Workers will also safety of construction be provided with PPEs to minimize risks on workers, including their health and safety. Contractors are COVID-19 risks, that also required to comply with Republic Act will be hired for the 11058 and its implementing rules and project. regulations.

Contractors will be required to submit an updated site-specific health and safety management plan, which covers COVID-19 related health and safety risks. There will also be The contractors need to ensure the safety Contractor CHO Marawi / Included in safety risks to public of the public by following strictly the IPHO construction cost such as construction guidelines of RA 11058. Lumbayanague

Project Potential Impact Mitigation Measures Institutional Responsibilities Cost Estimate Components/ (PhP) Activities Implementation Supervision

vehicle movement, uneven soil surfaces, pollution from sediments, and potential accident from transporting of construction materials.

Operation of healthEnsuring the smooth Allocate funds and continually build the CHO Marawi / DOH / ADB Part of monitoring facilities delivery of health capacity of its personnel to maintain the IPHO cost services level of services. Lumbayanague

161. To ensure that the operation of the Project will be environmentally sustainable, monitoring of drinking water, receiving body of water, air quality and noise levels, and soil quality, are proposed during construction and operation phases. Monitoring cost during construction for the two sites is estimated at PhP 100,000 for all the parameters indicated below,

Table 33. Proposed Environmental Monitoring Plan Environmenta Parameters Locations Standards Frequency of Responsibility Budget Source l Indicators Marawi Lumbaya Monitoring Implementation Supervision nague Drinking water pH, color, TDS, Cl, N: 08° 00’ N: 07° 47’ PNSDW 2017 Once during Contractor CHO / IPHO Contractor’s Nitrate, turbidity, As, 06.0” 00.1” construction and budget Cd, Pb, total coliform, E: 124° E: 124° 16’ annual during thermotolerant 17’ 08.5” 55.8” operation for 5 coliform, E. coli years Receiving pH, temperature, N: 08° 00’ N: 07° 47’ DENR Once during Contractor CHO / IPHO Contractor’s body of water color, BOD, DO, oil 16.8” 23.0” Standard for construction and budget and grease, TSS, E: 124° E: 124° 16’ Class A water annual during nitrate, phosphate, 17’ 05.9” 44.0” operation for 5 ammonia, surfactant years (MBAS), fecal coliform Air quality TSP, PM10, PM2.5, Within Within DENR Once during Contractor CHO / IPHO Contractor’s SO2 city hall municipal NAAQGV construction and budget

Environmenta Parameters Locations Standards Frequency of Responsibility Budget Source l Indicators Marawi Lumbaya Monitoring Implementation Supervision nague compoun hall annual during d compound operation for 5 years Noise level Average dB(A) Within Within IFC – EHS Once during Contractor CHO / IPHO Contractor’s budget city hall municipal construction compoun hall and annual d compound during operation for 5 years Soil quality Pb, Hg N: 08° 00’ N: 07° 46’ Once during Contractor CHO / IPHO Contractor’s budget 04.4” 58.6” construction E: 124° E: 124° 16’ and annual 17’ 05.8” 56.4” during operation for 5 years

162. Aside from the environmental monitoring of parameters detailed above, the status of compliance with grant covenants will be reviewed as part of ADB’s review missions. Any non-compliance issues will be specified in the quarterly progress reports together with remedial actions. Status of the implementation of the EMP will be discussed at each ADB review mission and integrated into semi- annual reports for the ERRM. These environmental monitoring reports will be prepared with assistance from environmental safeguards specialist recruited under the grant.

‘

IX. CONCLUSION AND RECOMMENDATION

163. The preparation of this Initial Environmental Examination (IEE), as per SPS, determines that the proposed Project – the construction of health units, and purchase of mobile health units, in Marawi City and Lumbayanague, will only result to minor and localized impacts. An environmental management plan was prepared outlining the mitigating measures that will be implemented, as well as the responsibility of implementing and monitoring these measures. The construction of health units is not covered under the Philippine Environmental Impact Statement System.

164. Baseline monitoring of environmental parameters showed that drinking water from Marawi City Water District and community water supply from Lumbayanague did not pass the Philippine National Standards for Drinking Water (PNSDW) for thermotolerant coliform. Total coliform in drinking water sample from Lumbayanague exceeds the PNSDW standard. Escherichia coli is also present in drinking water sample from Lumbayanague, while lead concentration is a concern in Marawi as it did not pass the PNSDW standard. This will be a major concern for both CHO and IPHO if tap water will be used for the operation of health units. It is recommended that both sites should not use the tap water for drinking and washing utensils and laboratory equipment, and instead should be used only for flushing toilets and other uses that will not compromise the health and safety of personnel and patients of health units. Both sites should also explore alternative safe sources of water, in coordination with local water districts.

165. The fecal coliform levels of the receiving body of water for the two sites also exceeds the DENR Standard for Class A body of water, with Marawi exceeding the standard by 35 thousand times, and Lumbayanague by almost four hundred fifty times the standard. The project must ensure that the effluent coming from the health units will comply with the Philippine Clean Water Act.

166. The lead level of the soil in Marawi, likewise, was found to be elevated, which may come from the exhaust of vehicles and deposited in the soil prior to the phasing out of unleaded gasoline, and from the paints used in old buildings, the City Engineering Office and General Services Office buildings included. The CHO must request the assistance of all stakeholders, including Task Force Bangon Marawi to manage the collection, transport and disposal of demolition debris from demolished CEO and GSO buildings. Air quality and noise levels likewise, must be managed during construction, as it is anticipated that there will be temporary impacts on people exposed to air and noise during construction.

167. Contractors will be required to ensure that workers receive training on safety, health and environment (SHE) prior to commencing their work. Workers will also be provided with PPEs to minimize risks on their health and safety. Contractors are also required to comply with Republic Act 11058 and its implementing rules and regulations. Likewise, the contractors need to ensure the safety of the public by following strictly the guidelines of RA 11058. Contractors will be required to submit an updated site-specific health and safety management plan, which covers COVID-19 related health and safety risks.

168. Contractors must assign Safety, Health and Environment (SHE) focal persons to implement the Environmental Management Plan and Environmental Monitoring Plan. The CHO and IPHO must also operationalize the Grievance Redress Mechanism to address complaints and grievances of the public.

BIBLIOGRAPHY Businessworld. “DoF: IPPAs, electricity co-ops owe PSALM P59.23B in unpaid bills. May 15, 2019. Center for Environmental Geomatics, Manila Observatory. Climate and Weather Related Risk Maps. http://vm.observatory.ph/cw_maps.html (Accessed August 2019). DENR Administrative No 2016 – 08. Water Quality Guidelines and General Effluent Standards of 2016. DPWH Department Order No. 30, series of 2021. Construction Safety Guidelines for the Implementation of All Government and Private Construction Projects during the COVID-19 Public Health Crisis. Environmental Management Bureau. National Air Quality Status Report (2008 – 2015). Visayas Avenue, Quezon City. Department of Environment and Natural Resources - Environmental Management Bureau. Environmental Management Bureau. 2014. National Water Quality Status Report 2006 -2013. Visayas Avenue, Quezon City. Department of Environment and Natural Resources - Environmental Management Bureau. 76pp. Environmental Protection Agency. Hazards Standards for Lead in Paint, Dust and Soil (TSCA Section 403). https://www.epa.gov/lead/hazard-standards-lead-paint-dust-and-soil-tsca-section- 403 (accessed August 28, 2019). Integrated Biodiversity Assessment Tool (IBAT), accessed August 2019. Keeyask Transmission Project Environmental Assessment Report. https://www.gov.mb.ca/sd/eal/registries/5614keeyask_transmission/appendices/appendixc.pdf. (Accessed July 2019). Official Gazette of the Republic of the Philippines. March 13, 2014. https://www.officialgazette.gov.ph/2014/03/13/denr-classifies-21-more-water-bodies/ (Accessed August 27, 2019.

Mallari, Tabaranza Jr. & Crosby. Key Conservation Sites in the Philippines: The Haribon Foundation / Birdlife International Directory of Important Bird Areas, 2001. Metillo and Garcia-Hansel. A Review on the Ecology and Biodiversity of Lake Lanao (Mindanao Island, the Philippines. IAMURE International Journal of Ecology and Conservation. March 16, 2016. Mines and Geosciences Bureau. http://gdis.mgb.gov.ph/mgbpublic/. (Accessed July 2019). Philippine Statistics Authority. 2015 Census of Population. Hansel C. G., Mero D., and Adiong SK. Protected Area Suitability Assessment Report Report. 2012. Quality Standard Memorandum Circular of the National Pollution Control Commission (NPCC), 1980

APPENDICES

Appendix 1. Certificates of Non-coverage

Appendix 2. Rapid Environmental Assessment (REA) Checklist

Philippines: Emergency Assistance for Reconstruction and Recovery of Country/Project Title: Marawi

Output 3. Water utilities and health infrastructure restored – Marawi City Health Unit

Sector Division: Human and Social Development Division, SERD

Screening Questions Yes No Remarks A. PROJECT SITING Two health facilities will be IS THE PROJECT AREA ADJACENT TO OR constructed in Marawi City and WITHIN ANY OF THE FOLLOWING AREAS: Lumbayanague, both in the province of Lanao del Sur. This REA checklist covers the two sites. The original site previously assessed was the present site of the city health unit (CHU), but the local government unit decided to propose the existing City Engineering Office (CEO) and portion of the General Services Office (GSO). The new site is about 3 meters away from the original site. There is no change in the location in Lumbayanague. ▪ UNDERGROUND UTILITIES ✔ The proposed site is the existing City Engineering Office and General Services Office inside the Government Center of Marawi. Portion of Level III water supply piping system is buried underneath the buildings. ▪ CULTURAL HERITAGE SITE ✔

▪ PROTECTED AREA ✔

▪ WETLAND ✔

▪ MANGROVE ✔

▪ ESTUARINE ✔

✔ The proposed sites in Marawi ▪ BUFFER ZONE OF PROTECTED AREA and Lumbayanague are both

covered by Presidential

100

Proclamation 871 establishing Lake Lanao Watershed Reservation. ▪ SPECIAL AREA FOR PROTECTING ✔ BIODIVERSITY

✔ The proposed site of the city health unit (CHU) of Marawi is ▪ BAY about 100 meters from Agus River. The proposed site of the RHU in Lumbayanague is about 570 meters from Lake Lanao. B. POTENTIAL ENVIRONMENTAL IMPACTS WILL THE PROJECT CAUSE…

Encroachment on historical/cultural areas? ✔

Encroachment on precious ecology (e.g. ✔ The wastewater coming from the sensitive or protected areas)? proposed health units, if untreated, will affect the water

quality of Agus River.

Impacts on the sustainability of associated ✔ There will be potential impacts if sanitation and solid waste disposal systems? mitigating measures are not implemented on the sustainability

of associated sanitation and solid waste disposal systems if wastewater treatment system and proper management of collection, storage, and disposal of demolition debris in the case of Marawi site.

▪ Dislocation or involuntary resettlement of ✔ There will be temporary people? dislocation of workers in the City Engineering Office and General Services Office buildings in Marawi during the construction period of new CHU in Marawi. No such concern exists in Lumbayanague as the proposed lot for the Rural Health Unit (RHU) is vacant. ▪ Disproportionate impacts on the poor, women ✔ The city government of Marawi and children, Indigenous Peoples, or other has several options for affected vulnerable groups? CEO and GSO workers to ensure

101

continuity of services. No such issue is anticipated in Lumbayanague. ▪ Accident risks associated with increased ✔ The proposed sites are located vehicular traffic, leading to loss of life? inside the city hall compound of Marawi City, and municipal hall compound in Lumbayanague, where vehicular traffic is regulated. ▪ Increased noise and air pollution resulting from ✔ Noise and air pollution will come increased traffic volume? from vehicles that will transport demolished building materials and transport of construction materials during construction of health facilities. ▪ Occupational and community health and safety ✔ The demolition of CEO and GSO risks? buildings and the construction of new CHU building in Marawi, and the construction of new RHU in Lumbayanague will pose occupational and community health and safety risks. The occupational and community health and safety risks for workers in Lumbayanague are minimal compared to Marawi. ▪ Risks and vulnerabilities related to ✔ There are potential occupational occupational health and safety due to physical, health and safety risks and chemical, biological, and radiological hazards vulnerabilities from the demolition during project construction and operation? of existing CEO and GSO buildings and construction of a new one. Risks and vulnerabilities in Lumbayanague are less compared to Marawi. ▪ Generation of dust in sensitive areas during ✔ There will be generation of dust construction? arising from transportation, storage and utilization of construction materials as well as from demolition activities, in Marawi’s case. ▪ Requirements for disposal of fill, excavation, ✔ The demolition itself of CEO and and/or spoil materials? GSO buildings will entail disposal of fill and spoil materials. Construction of two local health units will also generate solid wastes that need to be managed.

102

▪ Noise and vibration due to blasting and other ✔ It is expected that civil works of civil works? the new CHU and demolition of CEO and GSO buildings in Marawi will create noise and vibration, to a lesser extent. Blasting though is not expected. The construction of new RHU in Lumbayanague is expected to create noise and vibration as well but this is expected to be minimal. ▪ Long-term impacts on groundwater flows as ✔ The excavation of the foundation result of needing to drain the project site prior for the proposed CHU and RHU to construction? is not expected to warrant long term impacts on groundwater flows. ▪ Long-term impacts on local hydrology as a ✔ The local hydrology is not result of building hard surfaces in or near the expected to be affected with the building? building of hard surfaces of the proposed health units. ▪ Large population influx during project ✔ Local labor will be employed in construction and operation that causes the construction and operation of increased burden on social infrastructure and the new health units and the services (such as water supply and sanitation demolition of CEO and GSO systems)? buildings, in case of Marawi.

▪ Social conflicts if workers from other regions or ✔ The local labor pool is sufficient, countries are hired? hence there is less need to hire labor from other regions. ▪ Risks to community safety caused by fire, ✔ If there is no maintenance of the electric shock, or failure of the buildings safety health unit facilities, there is features during operation? increased possibility of risks to the community. The specification for the construction and operation of the health facilities will be based on the Department of Health specifications. ▪ Risks to community health and safety caused ✔ The demolition of existing CEO by management and disposal of waste? and GSO buildings as well as the construction and operation of the new CHU in Marawi; and construction of RHU in Lumbayanague will generate wastes that entail proper disposal management. ▪ Community safety risks due to both accidental ✔ Since the proposed CHU will be and natural hazards, especially where the constructed inside the

103

structural elements or components of the government center of Marawi, project are accessible to members of the and proposed RHU will be affected community or where their failure could constructed inside municipal result in injury to the community throughout compound in Lumbayanague, project construction, operation and where other government offices decommissioning? are located, the public can easily

access the sites. Temporary fencing will be installed to ensure that the public will not have access to the project sites during construction.

A Checklist for Preliminary Climate Risk Screening Country/Project Title: Emergency Assistance for Reconstruction and Recovery of Marawi Sector : Public Sector Management Subsector: Public expenditure and fiscal management Division/Department: SEHS

Screening Questions Score Remarks14 Location and Is siting and/or routing of the project (or The project is located within the Design of project its components) likely to be affected by government center of Marawi City 0 climate conditions including extreme and Lumbayanague, both of weather related events such as floods, which are considered a built-up droughts, storms, landslides? areas. Extreme weather- related events are not expected. Would the project design (e.g. the The Department of Health has a clearance for bridges) need to consider proforma for health unit design. any hydro-meteorological parameters 1 The design should consider the (e.g., sea-level, peak river flow, reliable hydrometeorological parameters water level, peak wind speed etc)? prevailing in the area.

Materials and Would weather, current and likely The project will utilize standard Maintenance future climate conditions (e.g. construction materials. prevailing humidity level, temperature contrast between hot summer days 0 and cold winter days, exposure to wind and humidity hydro-meteorological parameters likely affect the selection

14 If possible, provide details on the sensitivity of project components to climate conditions, such as how climate parameters are considered in design standards for infrastructure components, how changes in key climate parameters and sea level might affec t the siting/routing of project, the selection of construction material and/or scheduling, performances and/or the maintenance cost/scheduling of project outputs.

104

of project inputs over the life of project outputs (e.g. construction material)?

Would weather, current and likely Required maintenance will be future climate conditions, and related incorporated in the EMP. 0 extreme events likely affect the maintenance (scheduling and cost) of project output(s) ? Performance of Would weather/climate conditions, and Not applicable. project outputs related extreme events likely affect the 0 performance (e.g. annual power production) of project output(s) (e.g. hydro-power generation facilities) throughout their design life time?

Options for answers and corresponding score are provided below: Response Score Not Likely 0

Likely 1 Very Likely 2

Responses when added that provide a score of 0 will be considered low risk project. If adding all responses will result to a score of 1-4 and that no score of 2 was given to any single response, the project will be assigned a medium risk category. A total score of 5 or more (which include providing a score of 1 in all responses) or a 2 in any single response, will be categorized as high risk project. Result of Initial Screening (Low, Medium, High):_Medium______

Other Comments:______

Prepared by: Antoine Morel, Principal Environment Specialist, SEOD/SERD

105

Appendix 3. Proof of Ownership Documents of City Health Unit (Marawi City) and Rural Health Unit (Lumbayanague)

Figure 1.Certification from City Assessor of Marawi

106

Figure 2. Declaration of Real Property of proposed site in Marawi City

107

Figure 3. Deed of Donation – Lumbayanague

108

109

110

Appendix 4. Summary of Meeting 18 December 2019 Marawi City

Attendance

Name Agency Rikard Elfving Senior Social Sector Specialist, ADB Engr. Lizandro Racoma Environment Safeguards Specialist- ADB Jane Austria-Young Social Safeguards Specialist-ADB Ar. Marirose Malapote EARRM Project Consultant Ar. Lord Jay Loma EARRM Project Consultant Assmin Alvarez EARRM Project Consultant Annabelle B. Nanol EARRM Project Consultant Dr. Ali Daligdig City Health Officer Engr. Carmela Roa CHD NM Engr. Jeff Duhaylungsod CHD NM Engr Jomari Maglacion CHD NM Mr. Tony Sugarol Task Force Bangon Marawi Ar. Tiban Petuas City Engineering Office - Marawi Representative Office of the City Mayor

Mission Highlights: A. Environment Impact and Social Safeguards impact assessments on the proposed new site.

Environment Safeguards

1. There are no major environmental impacts on the new site, based on the results of the Environmental Impact assessment conducted by ADB environmental consultant, Lizandro Racoma, except for the management of the demolition of the existing City Engineering Office and General Services Office buildings, and hauling of demolition debris and waste from the proposed site. 2. The cost for the demolition and hauling of debris services will be taken cared of by Task Force Bangon Marawi. This was confirmed by Col. Tony Sugarol, based on a letter of request sent by ASEC Dumama, and approved by ASEC Felix Castro. A copy of the letter was requested from Mr. Tony Sugarol. 3. The structures for demolition will include the existing City Engineering Office Building, the existing General Services Building, and the temporary holding area used for inmates. 4. The demolition and construction cannot proceed until a written notice has been provided to DOH and ADB concerning the cost for the demolition and hauling of debris services.

111

Social Safeguards

1. The ADB social safeguards specialist confirmed that the proposed new site for the City Health Unit in Marawi will not have any adverse impact on people, community lands, structures or property, as the construction work will be carried out within the existing government compound. 2. Social screening identified that the land to be used for the proposed CHU will not necessitate any land acquisition and will have no involuntary resettlement or indigenous peoples impacts. 3. The field visit and the consultations with key health officials helped establish the land ownership status of the sites designated for the construction of the health center in Marawi City. Action Points: 1. The EARRM project consultants to closely coordinate with the LGU and the office of the Task Force Bangon Marawi. 2. Send the site assessment meeting minutes, and site assessment report to the relevant offices. 3. Mr. Tony Sugarol to send a copy of the letter of request from ASEC Dumama, and ASEC Castro’s approval, to DOH, through the EARRM project consultants, for official endorsement to ADB. 4. The office of TWBM , through Mr. Tony Sugarol to discuss the timeline for the demolition, to sync with the EARRM PMU overall project timeline. Proposed start of construction is July 2020. 5. LGU to facilitate transfer of the inmates, temporarily held at a small structure located behind the DPQH building. 6. The social safeguards specialist to update the DDR to include the findings in the new identified CHU site. B. Details of the proposed new site: Status Update: 1. The proposed new site will include the area where the existing City Engineering Office and former DPWH building is located, the parking space between the building and the perimeter fence, to its right, and will include 6 meters from the existing General Services Office Building, to its left. It will also include the area where the temporary structure used as holding area for inmates. 2. ADB requests the EARRM project consultants to consider the overall masterplan of the area. This will include options as follows: - Possible demolition of the laundry area, and storage room of the CHO, in order to link with the proposed CHU. - EARRM project consultants to assess the existing CHO building for possible upgrading, if necessary, and if there will be savings from the budget allocated for the CHU.

112

Action Points: 1. EARRM project consultants to present the proposed revisions to the CHU layout, which shall include the items mentioned above. 2. Documents required from relevant offices for the updating of the Initial Environmental Examination (IEE): a. Masterplan for the rehabilitation / construction of buildings inside Government Center of Marawi b. Geological study done by Mines and Geosciences Bureau, as highlighted by Sadiq Mohamad of PMO of Marawi c. Relocation plan for affected employees of City Engineering Office and General Services Office, and inmates housed in temporary detention cell d. Demolition debris management plan e. Cutting permit / transplantation plan for 2 unhealthy mature trees located at the front and back of CEO and GSO. 3. Social safeguards specialist to secure a copy of the DOH’s legal opinion and other attachments concerning land ownership in Marawi to update the due diligence review and the site assessment report.

113

Appendix 5. Site Assessment Report (18 December 2019)

1. Background. Because of the concern on the potential generation of hazardous and medical wastes from the demolition of existing City Health Unit (CHU) and TB DOTS Center as reported in initial environmental assessment done by the ADB team on 28 May 2019, the local government of Marawi requested the Department of Health to relocate the new City Health Unit in a less risky area – the existing City Engineering Office and the General Services Office buildings.

2. The proposed new site of the CHU in Marawi is still within the government center compound in Marawi City, which is about 3 meters from the existing CHU. The new site is about 100 meters from Agus River. Some of the observations during the site assessment include: a. The existing City Engineering Office and General Services Office buildings will be demolished as part of the overall rehabilitation of the Government Center compound of Marawi, as indicated in the Masterplan for the rehabilitation of government buildings of the city. b. No major impacts are anticipated in the construction of CHU, except for the impacts of demolition, including the management of demolition debris of the existing CEO and GSO buildings and the temporary detention facility for inmates c. The City Engineering Office and General Services Office will be transferred to a new building, also located within the Government Center compound. Employees are amenable with the relocation of their offices. The inmates will be also transferred to a new detention facility. d. The Mines and Geosciences Bureau has conducted a geohazard susceptibility study for the whole government center complex and concluded that the area has very low susceptibility to landslide. e. The demolition of the CEO and GSO buildings shall follow the provisions of RA 9003 in the collection, storage, transport and disposal of demolition debris. Task Force Bangon Marawi, through the Military Engineering Unit will provide assistance in the demolition and transport of wastes. f. As regards the proof of ownership of the proposed site, the Office of the Mayor assured that the Land Registration Authority has confirmed that Proclamation Nos. 375, 453 and 806 are still in effect, which states that the area occupied by the Government Center is government property. g. The city has to coordinate with the Department of Environment and Natural Resources (DENR) to assess the two mature diseased trees that might be affected by the demolition of existing buildings and construction of the new CHU. h. The proposed new city health unit will incorporate climate change resilience interventions, which include the raising of floor level by 2 feet to mitigate flooding. The building will also be equipped with solar panels to supplement the power coming from the grid.

114

Figure 1. GSO and CEO buildings that will be used for the new City Health Unit, with the diseased tree that needs to be cut.

Figure 2. Motorcycle shed in front of the CEO building that will also be demolished.

115

Figure 3. Temporary detention cell beside the CEO building that will also be relocated.

Figure 4. Diseased tree at the back of CEO building.

116

Appendix 6. Site Assessment Report (28 – 29 May 2019) Marawi and Lumbayanague, Lanao del Sur

1. Site assessment of proposed sites of city health unit in Marawi and rural health unit in Lumbayanague, both in Lanao del Sur was conducted on 28-29 May 2019.15 The site assessment team met with the City Health Officer of Marawi, Dr. Ali Daligdig, Integrated Provincial Health Officer of Lanao del Sur, Dr. Alinader Minaling, and local government units (LGUs) of Marawi and Lumbayanague.

2. Marawi. During the meeting with Mayor Majul Gandamra, it was decided that the proposed site for the new city health unit will be located inside the city hall compound, since the original site in Barangay Boganga has land ownership issue. The proposed site has an area of about 400 m2. The Mayor assured that the proof of ownership will be provided to ADB, as one of the requirements prior to approval of the grant for the construction of CHU in Marawi.

3. The proposed site in Marawi is within the government center compound in Marawi City, where government buildings, including the city hall and Integrated Provincial Health Office (IPHO), are located. The proposed site is about 110 meters from Agus River. Some of the observations during the site assessment include:

a. The demolition of the old CHU will generate concrete, wood, tile, steel, glass, and hazardous wastes. b. During demolition, hazardous wastes may include lead (from old paint, batteries, lead plumbing materials, electronic wastes); mercury (fluorescent light bulb and lamp, medical equipment such as thermometer and sphygmomanometer); polychlorinated biphenyls (PCBs) (caulking, adhesive, and paint), and chlorofluorocarbon (refrigerant). c. Hazardous materials will be required to be transported from Environment Management Bureau accredited hauler. This will be incorporated in the environmental management plan (EMP) of the IEE and mitigating measures to safely secure, transport and dispose the hazardous wastes will be included in the bidding contract. d. The proposed new city health unit will incorporate climate change resilience interventions.

4. Based on SPS 2009, if a project involves an upgrade or expansion of existing facilities that has potential impacts on the environment, IR and/or IP, the requirements specified in SPS will apply, in addition to compliance audit. For the proposed CHU in Marawi, a compliance audit of the existing CHU will be conducted, in addition to the IEE to be prepared for the new CHU. As reflected in the EARF and based on the site assessment conducted, potential impacts from the demolition of the old building and construction of new CHU include: (i) generation of solid and hazardous wastes; deterioration of surface water quality of Agus River and Lake Lanao, soil and groundwater contamination arising from solid and hazardous wastes from demolition of old building, occupational and community health and safety as the demolition and construction will be inside the government center, and traffic

15 The site assessment team comprised the following from ADB: Andrew Bucu – Health Specialist; Lizandro Racoma – Environment Specialist; Jones Dizon – Project Coordinator; Raul Babiera – Security Coordinator. The site assessment was also joined by DOH Central and Regional offices.

117

and obstruction concerns, as many people go to the government center to conduct business and access services.

Figure 1. Unused pipes stored beside the existing City Health Unit in Marawi.

Figure 2. Unused steel pipes stored beside CHU of Marawi.

118

Figure 3. Disorganized and unused furniture, equipment, bulletin board and oxygen beside Marawi CHU building.

Figure 4. The old painting of CHU building has high probability of lead content.

119

5. There will be temporary social impact on the existing operation of the CHU, as the demolition of existing building and construction of a new one, will disrupt the services provided by the existing facility. To mitigate the disruption of services, the LGU must locate the personnel and the medical equipment to a temporary building to continue with its operation.

6. Lumbayanague. The team met with the LGU officials of the town headed by Mayor Salamona Asum and Vice-mayor Arimao Asum. The proposed site, with an area of around 800 m2, will be at the back of the municipal hall. The 600 m2 out of 800 m2 lot is already cleared. If the proposed RHU will cover the whole 800 m2, 2 houses will be affected. Vice- mayor Asum mentioned that the structures are temporary, and that the LGU has an agreement with the residents that should the government needs the area, they will be transferred to the government sponsored housing shelter. This concern must be further assessed by the Social Development team.

7. The proposed site of the RHU is about 570 meters from Lake Lanao. The proposed building is at the back of the municipal hall and adjacent to Sultan Gunting Central Elementary School.

8. Based on the site assessment conducted and the meeting with the LGU, there are no major concerns in the preparation of the IEE. The proof of ownership for the lot has been provided already. The local council has already endorsed the proposed project. Some of the environmental concerns that need to be addressed in the IEE include:

a. The municipality has an intermittent source of water that might compromise water supply for the proposed RHU. The LGU proposed that in addition to the existing water supply, water from Lake Lanao can be tapped. The site is in higher elevation, so pump will be required if the LGU decided to source water from Lake Lanao. Filtration and chlorination might be needed to ensure safety of users. b. If the LGU decided to fully utilize the 800 m2 lot, the IR policy of ADB will be triggered as there are affected people currently living in two houses. Otherwise, if the 600 m2 is already enough, then there is no need for resettlement. c. Typical impacts indicated in EARF include temporary deterioration of air and noise during construction, potential soil and groundwater contamination, generation of solid wastes (domestic and construction), and workers and community health and safety. During operation, potential impacts include contamination of environment from generation of biomedical wastes, public health hazard specifically on students and LGU workers, congestion of access since the same road is used by students of nearby school, and morbidity arising from untreated or insufficiently treated water. Mitigating measures will be proposed in the IEE to lessen the environmental impacts on the community and the environment.

9. Next Steps. The site assessment conducted on 28-29 May 2019 partially met its objective to finalize the sites for the proposed CHU and RHU, although the proof of ownership of the land for Marawi site still needs to be submitted. As the funding for the construction of two health units will be sourced from Urban Climate Change Resilience Trust Fund (UCCRTF), the IEE will propose climate resilience measures. 10. Since majority of the impacts identified from the site assessment was related to water supply quality (for patients and personnel’s use), wastewater (water quality

120

of Agus River and Lake Lanao16), and soil (contamination from hazardous and domestic wastes), baseline data on the following environmental parameters still needs to be conducted, as part of the IEE study:

Environmental Maraw Lumbayanagu No. of Standards parameters i e samples A. Water 1. Water supply PNSDW, WHO 2 per site Guidelines for drinking water quality 2. Wastewater DAO 2016-08 2 per site B. Soil International 2 per site standards

11. Secondary information will be sourced for flora and fauna, since both sites are located within Lake Lanao watershed. Other secondary information such as socio- economic conditions and land use plan will be sourced from available publication, website and documents from the two LGUs.

Prepared by:

______Lizandro Racoma (signed) Environment Specialist

16 Lake Lanao has been classified as “Class A”. This means that the water requires complete treatment to meet national standards of drinking water

121

Appendix 7. DOH Site Inspection Report (28-29 May 2019)

HFEP FORM NO. PROJECT MONITORING REPORT

A. GENERAL INFORMATION NAME OF FACILITY: MARAWI CITY - RURAL HEALTH UNIT (RHU)

PROJECT DESCRIPTION: NEW CONSTRUCTION OF RHU

LOCATION: MARAWI CITY HALL COMPOUND

IMPLEMENTING AGENCY: CHD 10

APPROVED BUDGET: USD 325,000.00 (ADB Grant) CONTRACTOR: NOT APPLICABLE

DATE OF VISIT: MAY 28-31, 2019 CONTRACT AMOUNT: NOT APPLICABLE

B. PROJECT DATA C. PROGRESS REPORT ORIGINAL REVISED ACTUA SLIPPAG % COMPLETED TARGET L E

CONTRACT PREVIOUS AMOUNT NOT NOT START DATE APPLICABL THIS PERIOD NOT APPLICABLE APPLICABLE E COMPLETION TO DATE DATE

D. PERSONS MET NAME POSITION OFFICE CONTACT DETAILS

Raul Rabieza Consultant ADB 09266112523

Jones Dizon Consultant ADB

Adrew Bucu Consultant ADB 09989983781

Zanro Racoma Consultant ADB 09178526038

Jomari Maglacion Engr. II CHD 10 09754181493

Jeff Dihaylungsod Engr. II CHD 10 09561687003

Dr. Alinader Minalang PHO IPHO-LDS

Dr. Ali Dalidig CHO CHO-Marawi City

Engr. Abdul Jalil Unda Engineer IPHO – Lanao del Sur 09288540375

E. SITE MONITORING RESULTS SOLUTIONS/RECOMMENDATION FINDINGS/ISSUES/CONCERNS ACTION BY S

1. Lot ownership of the proposed site at Write a formal request to DOH-ADB CHO Buganga will be hard to acquire. to realign the project to the existing TB-DOTs building of the CHO to construct a new two-storey RHU.

122

2. Proof of Lot Ownership where the Existing Provide the Deed of Donation and LGU TB-DOTs building is situated. Lot Plan

3. Use of the existing TB-DOTs Building. Provide a Sanggunian Bayan LGU Resolution

4. No available plan for the existing TB- Take actual measurements of the HFEP MO and CHD 10 DOTs Building existing facility

5. Provision for Prayer Room, balcony. For incorporation to the proposed HFEP MO and CHD 10 plan.

6. Existing Plan for TB-DOTs Building will Modify the standard plan to a Two- HFEP MO and CHD 10 not fit the Standard Plan for RHU storey RHU

F. PHOTOS

Front View

Rear Side

Site Inspection Conducted by:

123

Arch. ROWELL R. REYES Ms. WAFA B. BILAO Mr. ARVIN M. MATIAS

DMO III DMO III Health Policy and Systems Research Fellow Health Facilities Enhancement Health Facilities Enhancement Program Management Office Program Management Office Health Facilities and Infrastructure Development Team

Noted by: Approved by: Concurred by:

LEONITA P. GORGOLON, MD, LILIBETH C. DAVID, MD, MPH, MAR WYNN C. BELLO, MD, MPA MHA, MCHM, CEO VI MPM, CESO III OIC-Director IV Director IV Undersecretary of Health Bureau of International Health Cooperation Health Facilities Enhancement Health Facilities and Program Management Office Infrastructure Development Team

HFEP FORM NO. PROJECT MONITORING REPORT

A. GENERAL INFORMATION NAME OF FACILITY: LUMBAYANAGUE RURAL HEALTH UNIT (RHU)

PROJECT DESCRIPTION: NEW CONSTRUCTION OF RHU

LOCATION: LUMBAYANAGUE MUNICIPAL COMPOUND

IMPLEMENTING AGENCY: CHD 10

APPROVED BUDGET: USD 325,000.00 (ADB Grant) CONTRACTOR: NOT APPLICABLE

DATE OF VISIT: MAY 28-31, 2019 CONTRACT AMOUNT: NOT APPLICABLE

B. PROJECT DATA C. PROGRESS REPORT ORIGINAL REVISED ACTUA SLIPPAG % COMPLETED TARGET L E

CONTRACT PREVIOUS AMOUNT NOT NOT START DATE APPLICABL THIS PERIOD NOT APPLICABLE APPLICABLE E COMPLETION TO DATE DATE

D. PERSONS MET

124

NAME POSITION OFFICE CONTACT DETAILS

Raul Rabieza Consultant ADB 09266112523

Jomari Maglacion Engr. II CHD 10 09754181493

Jeff Dihaylungsod Engr. II CHD 10 09561687003

MHO Municipal Office

Salamona L. Asum Mayor Municipal Office

Vice Mayor

Noronisa Acuad SB Secretary Municipal Office 09055199193

Moscos Guiterrez Municipal Treasurer Municipal Office 09167315366

Amenodin Gunting Councilor Municipal Office 09217206266

Almanhr Mhealandap Councilor Municipal Office 09129871566

Casan Gunting Brgy. Chairman Lumbuyanague 09093193288

Malic Disimbang Brgy. Chairman Lumbuyanague

Dagaranao Barauntong Brgy. Chairman Lumbuyanague 09125922082

Cabugatan Jamerah Brgy. Chairman Lumbuyanague 09504298678

Sohaimen Abdulazls Brgy. Chairman Lumbuyanague 09501834128

Nur-Asma Asum Brgy. Chairman Lumbuyanague 09307293514

Samiyada Gunting Brgy. Chairman Lumbuyanague 09121766599

Junaida Asum Brgy. Chairman Lumbuyanague 09203514940

Monizah Languan Brgy. Dalaon ABC Brgy. Dalaon ABC 0948318444

Engr. Abdul Jalil Unda Engineer IPHO – Lanao del Sur 09288540375

E. SITE MONITORING RESULTS SOLUTIONS/RECOMMENDATIO FINDINGS/ISSUES/CONCERNS ACTION BY NS

1. Municipality of Lumbayanague has no For verification/confirmation HFEP MO existing Barangay Health Stations LGU to request for funds LGU thru IPHO

2. Lumbayanague utilizes a private building For coordination with DOH- HFEP MO as its RHU. Proposed Construction for BARMM, their proposed DOH-BARMM Implementation not yet Construction for a RHU will be for started. For possible duplication if ADB an Annex Building to composed of will fund a RHU and DOH-BARMM will a Halfway House. construct another. 3. No medical transport available. Coordinate with IPHO for the Municipal Health Officer vehicles to be provided through the ADB.

4. No water supply. To incorporate a cistern tank and HFEP MO and CHD 10 water pump on the design.

125

5. Power interruption To incorporate solar panel or wind HFEP MO and CHD 10 turbine.

6. Manpower/Personnel Salary LGU

7. Proof of Lot Ownership and Utilization of Provide the Sanggunian Bayan LGU the site. Resolution, Deed of Donation, Site Development Plan, Lot Plan

8. Provision for Prayer Room, balcony. For incorporation to the proposed HFEP MO and CHD 10 plan.

9. Lot measures 40x20meters will be Modify the standard plan to a Two- HFEP MO and CHD 10 insufficient for a 4-in-1 RHU with storey RHU provision for Ambulance parking.

F. PHOTOS

Site Inspection Conducted by:

126

Arch. ROWELL R. REYES Ms. WAFA B. BILAO Mr. ARVIN M. MATIAS

Noted by: Approved by: Concurred by:

LEONITA P. GORGOLON, MD, LILIBETH C. DAVID, MD, MAR WYNN C. BELLO, MD, MPA MHA, MCHM, CEO VI MPH, MPM, CESO III OIC-Director IV Director IV Undersecretary of Health Bureau of International Health Cooperation Health Facilities Enhancement Health Facilities and Program Infrastructure Development Team

127

Appendix 8. Guidelines for Climate Change and Green House Resilience Design

1. Prepare site analysis, site plans, site development plans, architectural plans, scope and magnitude, cost of the subproject and implementation plan with due consideration on the project requirement on greenhouse and climate change resilience design as follows:

1.1 Conduct Surface Investigation to assess and evaluate the topographical or hydrographical conditions of the identified project sites to determine the following and ensure that required information of the Philippines Building Code will be provided:

1.1.1 The accurate and thorough understanding of the existing sites. The analysis should include, but not limited to, consideration of topography, point of access, existing structures/utilities and trees, soil characteristics, patterns of land use and views. 1.1.2 The sites’ topographical condition and other aspects such as flooding history which is essential in estimating required earthworks, selection of floor levels, drainage pattern and aesthetically pleasing site development. 1.1.3 Potential effects of Climate Change in the area and to the proposed project itself; 1.1.4 Potential Social and Environmental and Safety Risks that could be involved in the construction and operation of the projects. 1.1.5 Appropriate site development that is consistent with the objective of the project as well as its required green building and climate change resilient design; 1.1.6 Information regarding climatic condition that would be part of consideration in the preparation of structural design criteria and the design of Sewerage and Storm water drain system. 1.1.7 Existing supplies of water, electricity and its capacity to supply the requirements of the project during construction and operation as well, 1.1.8 Appropriate material specifications, sources and prevailing cost of construction materials as well as the availability of required manpower and equipment during construction.

1.2 Prepare the appropriate Green House Building design that would meet the International Standards particularly the required reduction of gas emission, energy saving, use of rain water, wind direction that is consistent with the topographic investigation report and project functional design requirement.

1.2.1 Site Development that must be planned to enhance the functions and aesthetical aspects of the buildings. Siting of buildings and placement of support facilities must be proposed as to best advantage the site topography and climatic conditions.

128

1.2.2 Siting of Buildings /Location and Orientation - Locate and orient buildings, to maximize energy consumption, within the constraints of the functional requirements, the topography and site configuration. Design the exposures of the buildings that would have the advantage of maximizing the cooling effect of prevailing winds coming from the appropriate directions that would minimize the effect of afternoon solar heat and would enhance the effect of natural ventilation and lighting.

1.2.3 Use of Off – Grid Sources of Electricity – Use solar power or its equivalent to reduce, if cannot be totally avoided the green-house gases and pollution. Since it will increase the cost of the health facility, it is suggested that it be provided in certain area of the RHU, if possible.

129

Appendix 9. Laboratory Analyses

130

131

132

133

134

135

136

137

138

Appendix 10. Permit to Cut Trees

139

140

Appendix 11. Public Consultations

Figure 1. Consultation with Marawi and Department of Health (18 December 2019)

Figure 2. Consultation at the Mayor’s Office of Majul Gandamra of Marawi City (28 May 2019).

141

Figure 3. Consultation with Task Force Bangon Marawi (28 May 2019)

Figure 4. Consultation with Lumbayanague LGU (29 May 2019).

142

Appendix 12. Grievance Intake Form

Name of Project and Location

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.

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?

143