Social Monitoring Report

External Resettlement Monitoring Report January 2015

L2468-VIE: Health Care in the South Central Coast Region Project

Prepared by the Ministry of Health, Socialist Republic of Viet Nam, for the Asian Development Bank.

This social monitoring report 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.

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.

MINISTRY OF HEALTH, VIETNAM

FINAL REPORT on

Land Acquisition and Resettlement Activities for Health Care in the South Central Coast Region Project (ADB Loan 2468)

Vietnam, November 2014 CONTENTS

LIST OF ABBREVIATIONS ...... - 3 -

GLOSSARY ...... - 4 -

PART I. OVERVIEW ...... - 6 -

PART II. ASSESSMENT METHODOLOGY ...... - 7 -

PART III. STATUS OF IMPLEMENTATION ...... - 8 - 1. Summary Scope of Land Acquisition and Resettlement Impacts ...... - 8 - 2. Detailed on the Status of Land Acquisition and Resettlement in Project Provinces/Cities .... - 11 - 3. Implementation procedure ...... - 16 - PART IV. RESULTS OF LAND ACQUISITION ACTIVITIES ...... - 22 - CONCLUSIONS AND RECOMMENDATIONS ...... - 27 -

ANNEX 1 ...... - 29 - ANNEX 2 ...... - 31 - ANNEX 3 ...... - 32 -

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LIST OF ABBREVIATIONS

ADB Asian Development Bank AP Affected person CPC Commune People’s Committee DH(s) District Hospital(s) ha Hectare HHs Households km Kilometer m Meter MOH Ministry of Health PMC Preventive Medicine Center PMU Project Management Unit PPC Provincial People’s Committee PPMU Provincial Project Management Unit RP Resettlement Plan SMS Secondary medical school US The United States VNĐ Vietnam Dong

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GLOSSARY Affected person means any person or persons, household, firm, private or public (AP) institution that, on account of changes resulting from the Project, will have its (i) standard of living adversely affected; (ii) right, title or interest in any house, land (including residential, commercial, agricultural, forest, salt mining and/or grazing land), water resources or any other moveable or fixed assets acquired, possessed, restricted or otherwise adversely affected, in full or in part, permanently or temporarily; and/or (iii) business, occupation, place of work or residence or habitat adversely affected, with or without displacement

Affected members residing under one roof and operating as a single household economic unit, who are adversely affected by a project or any of its components.

Compensation means payment in cash or in kind to replace losses of land, housing, income and other assets caused by the Project. All compensation is based on the principle of replacement cost, which is the method of valuing assets to replace the loss at current market rates, plus any transaction costs such as administrative charges, taxes, registration and titling costs

Entitlement means a range of measures comprising compensation, income restoration support, transfer assistance, income substitution, and relocation support which are due to affected people, depending on the nature of their losses, to restore their economic and social base

Land acquisition means the process whereby an individual, household, firm or private institution is compelled by a public agency to alienate all or part of the land it owns or possesses to the ownership and possession of that agency for public purposes in return for compensation equivalent to the replacement costs of affected assets.

Relocation means assistance provided to project affected persons due to the loss of productive assets, incomes, employment or sources of living, to supplement payment of compensation for acquired assets, in order to achieve, at a minimum, full restoration of living standards and quality of life

Resettlement means all measures taken to mitigate any and all adverse impacts of a projection AP property and/or livelihoods, including compensation, relocation (where relevant), and rehabilitation as needed

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Resettlement is a time-bound action plan with budget setting out compensation Plan (RP) and resettlement strategies, objectives, entitlement, actions, responsibilities, monitoring and evaluation. The RP must be prepared and approved prior to loan appraisal for the Project.

Severely affected Mean APs who will (i) lose 10% or more of their total productive persons land and/or assets; (ii) relocate due to insufficient remaining residential land to rebuild; and/or (iii) lose 10% or more of their total income sources due to the Project.

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PART I. OVERVIEW The Socialist Republic of Vietnam received a loan of $ 72,000,000 from the Asian Development Bank (ADB) and with the Vietnamese Government’s counterpart fund of $8,000,000 to implement the Health Care in the South Central Coast Region Project. The Project supported eight provinces/cities in the South Central Coast Region, including Da Nang City, Quang Nam, Quang Ngai, Binh Dinh, Phu Yen, Khanh Hoa, Ninh Thuan, and Binh Thuan over a six years period from 2009 to 2015. The overall goal of the Project is to improve the health status of the population in the eight Project provinces/cities. The Project’s expected outcome is a more comprehensive and well managed and better used provincial health systems in the eight Project provinces/cities with a focus on health care for the poor, women and children and ethnic minorities through 4 components: (A) improving health facilities, (B)strengthening human resources through improved workforce planning and training capacity and specific training programs, (C) improving access to health services for the poor, and (D) strengthening provincial health systems by improving management and monitoring of the provincial health systems and hospitals. In Component A, the Project upgraded or constructed a total of 25 facilities, including 11 district hospitals (DHs), 05 regional hospitals, 01 provincial hospital, 01 rehabilitation hospital, 01 traditional medicine hospital, 01 secondary medical school (SMS), and 05 Preventive Medicine Centers (PMCs). The upgrading/construction in some sites involved land acquisition and resettlement. A resettlement plan (RP) was prepared to address the land acquisition and resettlement impacts from the subprojects. RP implementation is required to be monitored internally with the objective of providing feedback to management on implementation and identifying problems and successes as early as possible to facilitate timely adjustment of implementation arrangements. Internal monitoring and supervision are expected to determine if: a. Compensation and other entitlements are computed at rates and procedures as provided in the approved RP, with no discrimination according to gender, membership in an ethnic group or any other factor; b. Affected households are paid their compensation and other entitlements as per approved updated RP, ensuring that all entitlements are delivered as planned and agreed, including compensation in cash or in kind, allowances, replacement land, resettlement sites developed and people moved onto them; c. income restoration programs designed and delivered including modifications in the programs and provision of additional cash and in-kind assistance to the participating affected households as and when necessary; and - 6 - d. Public information, public consultation and grievance redress procedures are followed as described in the approved updated RP. Independent monitoring of resettlement activities was conducted in November 2010. This was followed-up by safeguards review mission by the ADB VRM in April-June 2011 and in April 2012 during the mid-term review. All land acquisition and resettlement activities were completed in 2012. ADB policy on involuntary resettlement requires that upon completion of the project, the project should(i) provide a concise history of the involuntary resettlement aspects of the project and/or program to completion, (ii) conduct an evaluation of the implementation of the resettlement plan and or resettlement framework and involuntary resettlement loan covenants,(iii) assess the executing agencies performance; and (vi) summarize the monitoring and evaluation reports. This report aims to support in meeting this requirement. The report summarizes the land acquisition and resettlement impacts from the project, the activities undertaken to address such impacts, and the result of the resettlement plan implementation on the affected people.

PART II. ASSESSMENT METHODOLOGY 1. Assessment methodology Reviewed the socio-economic situation of the selected locality, the policies, provisions and legal documents provided by the State and the guidelines on resettlement activities of the ADB. Conducted in-depth interviews with representatives from 15 households affected by the land acquisition and resettlement activities in the project area to collect the detailed information related to their attitudes and reactions toward the implementation process of the related organization, as well as examining qualitatively the impacts of land acquisition and resettlement activities on the affected people’s lives. 2. Assessment timeline The assessment was conducted by eight PPMUs in October 2014. In early November 2014, eight PPMUs submitted the report to PMU for synthesizing. 3. Assessment sites The assessment was undertaken in eight provinces/cities covered by the Health Care in the South Central Coast Region Project, including Da Nang City, Binh Dinh, Binh Thuan, Khanh Hoa, Ninh Thuan, Phu Yen, Quang Nam, and Quang Ngai.

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4. Study objects Representatives from all related provincial units at eight project provinces/cities, who were able to clearly give answers to the survey questions on the situation of land acquisition and resettlement in the area due to the construction of health facilities belonged to the Health Care in the South Central Coastal Region Project. 5. Data processing All collected data were cleaned and analyzed according to the set objectives.

PART III. STATUS OF IMPLEMENTATION

1. Summary Scope of Land Acquisition and Resettlement Impacts Out of 25 sub-projects of eight project provinces, only nine sub-projects in six provinces involved land acquisition and resettlement activity. The other sub-projects were constructed within the existing compounds of hospitals/preventive medicine centers or sites that are already under the possession of the hospitals. For the nine subprojects with land acquisition impacts, a total of 120,978.2 m2 of land were acquired, of which 85% was productive land, 14% was public land and only 1% was residential land. There were 84 affected objectives, including 80 households and 4 public organizations(Commune/Ward People’s committees, District Youth Union, government-owned company, etc). Of the 80 households that were affected by the Project, five households lost more than 10% of their productive land and six households needed to be relocated1. A total of VND 10,322,041,151covered by provincial’s budget was used as compensation and allowances for the affected people. This amount included the cost of compensation for land, provision or purchase of other land for farmers (in cases of land for land compensation were applied), compensation for loss of houses, structures, crops and business, relocation, and living standards rehabilitation measures.

1 The Project was initially categorized as ‘A’ for involuntary resettlement, but was recategorized to ‘B’ because of the reduced impacts from the subprojects.

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SCOPE OF LAND ACQUISITION AND RESETTLEMENT IMPACTS

APs losing Acquired land (m2) Total of HHs to >=10% of Other No. Province/ Health facilities affected HHs / be Residential Agricultural Public productive impacts Tree land organizations relocated land land land assets I DA NANG 1 Hoa Vang District Hospital 0 0 0 0 0 0 0 0 2 Da Nang city Rehabilitation Hospital 0 0 0 0 0 0 0 0 II QUANG NAM 5 Dong Giang District Hospital 0 0 0 0 0 0 0 0 3 Bac Tra My District Hospital 0 0 0 0 0 0 0 0 4 Quang Nam Regional Hospital 0 0 0 0 0 0 0 0 Dien Ban Preventive Medicine 6 0 0 0 0 0 0 0 0 Centre III QUANG NGAI 8 Son Tay District Hospital 1,061.5 7,056.6 0 0 19 3 5 0 9 Tay Tra District Hospital 300 21,052.8 0 0 27 1 0 0 10 Tra Bong District Hospital 0 0 0 0 0 0 0 0 7 Ba To District Hospital 0 0 0 0 0 0 0 0 11 Mo Duc Preventive Medicine Centre 0 0 0 0 0 0 0 0 IV BINH DINH 12 OPD-Binh Dinh Provincial Hospital 0 0 0 0 0 0 0 0 13 Traditional Medicine Hospital 0 18,212.4 0.0 1,042.7 12 0 0 14 Phu My District Hospital 0 0 0 0 0 0 0 0

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SCOPE OF LAND ACQUISITION AND RESETTLEMENT IMPACTS

APs losing Acquired land (m2) Total of HHs to >=10% of Other No. Province/ Health facilities affected HHs / be Residential Agricultural Public productive impacts Tree land organizations relocated land land land assets V PHU YEN 16 Tay Hoa District Hospital 0 0 0 0 0 0 0 0 17 Song Cau District Hospital 0 0 0 0 0 0 0 0 15 Tuy An Regional Hospital 0 0 0 0 0 0 0 0 Song Cau Preventive Medicine 18 0 0 2,427.6 272.4 5 0 0 0 Centre VI KHANH HOA 19 Cam Ranh Regional Hospital 0 0 0 0 0 0 0 0 20 Van Ninh District Hospital 0 22,908.2 0 0 1 0 0 0 21 Ninh Hoa Prevent Medicine Centre 0 0 0 0 0 0 0 0 VII NINH THUAN 22 Secondary Medical School 0 23,918 7,613 3,816 17 0 0 0 VIII BINH THUAN 23 North Regional Hospital (Bac Binh) 240 0 0 11,057 3 2 0 0 24 South Regional Hospital (Duc Linh) 0 0 0 0 0 0 0 0 Phan Thiet Preventive Medicine 25 0 0 0 0 0 0 0 0 Centre Total 1,601.5 93,148.0 10,040.6 16,188.1 84 6 5 0

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2. Details on the Status of Land Acquisition and Resettlement in Project Provinces/Cities 2.1. Da Nang City

Da Nang City had constructed a new general DH and two new departments onadult and children rehabilitation and treatment. No resettlement or land acquisition wasrequired for the construction works. - The Hoa Vang DHis located at Hoa Nhon commune, Hoa Vang District, Da Nang city. The land for constructing the Hoa Vang DH was handed over by the City Government to Da Nang City Health Department2009 by virtue of Decision No. 4947/QĐ-UBND dated 01 July 2009 by the Da Nang City People’s Committee. - The Da Nang City Rehabilitation Hospital is located at My An Ward, Ngu Hanh Son District. The Project built two more departments, for adult and children rehabilitation treatment for poor patients. The construction of the two new departments was on vacant land owned by the hospital. No resettlement or land acquisition was required for this construction work.

2.2. Quang Nam Province Quang Nam province upgrade done regional hospital and two DHs, and built a new PMC. There is no land acquisition or resettlement impact for all project facilities in the province as the civil works were within the hospitals/center’s campuses. - Quang Nam Regional Hospital is located in Vinh Dien town, Dien Ban District. The Quang Nam Regional Hospital constructed a new building with 4 floors for the OPD – Emergency, Technical Professional Block, and E.N.T to replace the existing structure. The construction of the new building did not require any land acquisition because the land and structure were already owned by the hospital and there were no resettlement effects. - Bac Tra My DH is located in Tra My town, Bac Tra My district. The Bac Tra My DH replaced all of the medical examination and treatment departments. The construction works did not require any land acquisition or caused any resettlement effects. - Dong Giang DH is located in Prao town, Dong Giang district. The Dong Giang DH replaced all of the medical examination and treatment departments. The new construction works did not require any land acquisition or caused any resettlement effects. - Dien Ban District Department of Preventive Medicine is located at the Vinh Dien Town, Dien Ban District, Quang Nam Province. The land was handed over by the Quang Nam Provincial People’s Committee according to Official Dispatch No.

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653/UBND-VP Dated 26/6/2009 and there are no land acquisition nor resettlement requirements for construction works.

2.3. Quang Ngai Province Quang Ngai province upgraded four DHs and built one PMC. There was no need for land acquisition and resettlement for Tra Bong DH, Ba To DH, and Mo Duc PMC. Son Tay DH and Tay Tra DH required land acquisition. - Son Tay DH is located in Son Tay District. The hospital needed 8,118.1 m2 additional land for the upgrading. There were 19 affected households, of which three households needed to be relocated and 5 households lost 100% their agricultural (rice field). Three relocated HHs had their own land in other places, therefore, they only asked for cash compensation and and built new houses by themselves. The Son Tay District People’s Committee did not provide land for them. Other affected HHs, including 5 HHs lost all their productive land received cash compensation and support for changing occupation and job creation. The compensation and support to affected households were approved by Decision No. 1549/ QĐ-UBND of the Quang Ngai People’s Committee on 20 October 2010. All land acquisition activities already completed according to the approved plan and there was no complaints received. - The Tra Bong DH was constructed on an area of 10,274m2“clean” land. There was no requirement for land acquisition or resettlement effects. - The Ba To DH was constructed on an area of 19,458 m2of available/cleared land. There was no requirement for land acquisition or resettlement effects. - The Tay Tra DH is located in Tra Phong Town, Tay Tra District. The hospital needed 21,352.8 m2of additional land. There were 27 affected households, of which 01 HH was resettled while the other have only their productive assets, crops and trees affected. The District Resettlement Board paid compensation all 27 affected households and allocated a land plot for 1 relocating HH about 100 meters from his original residence. All affected HHs received and were satisfied with the compensation and allowance. All land acquisition activities were completed in February 2012. - Mo Duc Preventive Medicine Center was constructed on 2,200 m2land at Duc Thach Commune, Mo Duc District, Quang Ngai. The Quang Ngai Province People’s Committee issued Decision No. 47/QĐ- UBND on 15 March 2010 allocating the required land for the center. Thus, the construction works did not require any additional land acquisition or caused any resettlement effects.

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2.4. Binh Dinh Province Binh Dinh province upgraded 3 hospitals, i.e., one provincial hospital, one traditional medicine hospital and one DH. There was no land acquisition and resettlement required for Binh Dinh Provincial Hospital and Phu My DH as the civil works are within the hospitals’ compounds. For the traditional medicine hospital, the land was acquired by the Provincial Center for Land Resource Development. - Binh Dinh Provincial Hospital has a total land area of 58,000 m2. The hospital constructed a new building with 6 floors for the OPD under Health care in the South Central Coast Region Project. The construction of the new building did not require any land acquisition since the land was owned by the hospital and there was no resettlement effects. - Phu My DH has a total land area of 27,360 m2 and Project funded three new buildings for operating theaters, pharmacy and intensive care unit. The construction of these buildings is on existing land of the hospital and therefore, there was no requirement on land acquisition and resettlement. - The Traditional Medicine Hospital is located on a new site in Nhon Phu Ward, Quy Nhon city. Total area of land acquired for the hospital is 19,455 m2, of which residential land is 200 m2 belonging to two households and 19,255 m2 is agricultural land. There are 13 affected HHs and 1 Commune People’s Committee (of which 2 HHs lose their houses, 10 HHs lose their agricultural land and one household lose 8.6m2 garden and 657 m2 of agricultural land). Compensation was made for 10 households for the affected agricultural land and these households received the compensation without complaints because the affected agricultural land areas are minor (each household losing less than 100 m2). The remaining 03 households refused compensation due disagreement with the compensation price for land and tree. Two of these households have affected residential land (with houses) and garden land. They refused compensation because they claim that(i) the compensation unit rates for residential land/garden land and assets upon lands (houses and trees) were much lower compared to the market rates, and (ii) the replacement residential land in the resettlement site is smaller than the affected residential land. In 2011, these complaints were resolved. The household who lost agricultural land was compensated by “land for land” as their request and he was satisfied with this compensation. For the two other households, PPMU adjusted the alignment of the fence surrounding the hospital to avoid impacting on the land of these households. All of the land acquisition and resettlement activities were implemented by the Provincial Center for Land Resource Development and completed in July 2011 with total 1,013,756,000 VND of compensation.

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2.5. Phu Yen Province Phu Yen subprojects coveredthe upgrading and expansion of Tuy An Regional Hospital, Tay Hoa DH and Song Cau DH and construction of the Song Cau PMC. Only Song Cau Preventive Medicine Center has land acquisition impacts. Civil works in the three other subprojects are within land that is under the possession of the hospitals. Civil works in these three hospitals that involved land acquisition were funded through the Government Bonds which are not part to the project. - Tuy An Regional Hospital was built on its old location, with minor expansion. Civil works under the Project were done within the existing hospital compound. The minor expansion of the hospital was funded through the Government Bonds which are not part of the project. - Civil works under the Project for the Song Cau DH were limited to the existing 20,519.5 m2 of the hospital. Minor expansion of the hospital funded by the Government Bonds involved the acquisition of 5,694 m2. These works are not related to the project. - The Tay Hoa DH is located at Phu Thu Town. Civil works under the Project were done within the existing hospital compound. The minor expansion of the hospital was funded through the Government Bonds which are not part of the project. - Song Cau Preventive Medicine Center at first were proposed to locate in Le Uyen Village and would affect to 7 HHs, of which 3 HHs would be resettled. However, this area were allocated to another project by Phu Yen PPC. Therefore, Phu Yen DOH, PPMU and Song Cau Commune People’s Committee decided to move the sub- project to a new location in Trung Trinh Village with 2,700m2 of acquired land. There were 04 affected households which lost minor productive land and one small land of Xuan Phu Ward People’s Committee. None of the affected households had to relocate. The chairman of Song Cau District People’s Committee issued Decision No. 1007/QĐ-UBND approving the compensation plan for construction of Song Cau Preventive Medicine Center and the land acquisition activities already completed in 2012 with total compensation of VND22,600,000.

2.6. Khanh Hoa Province The Khanh Hoa Health Care Subproject includes upgrading of one DH district, one regional hospital, and 01 PMC. There were no land acquisition and resettlement requirements for Cam Ranh Hospital and Ninh Hoa PMC as the civil works were within the hospital and department’s campuses, while the Van Ninh Hospital required compensation for the Van Luong Commune People’s Committee. - Cam Ranh Regional Hospital has a total area of 19,800 m2 land and it is located at 97 Nguyen Thai Hoc Street, Cam Ranh Town. The replacement of old buildings is

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within the existing hospital premises and did not require any land acquisition or resettlement effects. - Ninh Hoa PMC is located at 8 Village, Ninh Hoa District, Khanh Hoa City. It is built in the former site of the PMC and did not require any land acquisition or resettlement effects. - Van Ninh DH: In 2009, Khanh Hoa PPMU the land handed over to PPMU in 2009 for construction of Van Ninh DH was “clean”. Before that, an area of 22,902.2m2aquaculture land of Van Luong Commune People’s Committee was acquired. Compensation was paid to the Communal People’s Committee and it has been used (VND 453,582,000) for the commune’s infrastructure constructions. The leaders of Van Luong Communal People’s Committee and the local people are satisfied with the compensation in-terms of compensation unit rates and the compensation manner. The compensation implementation is compliant with the provision on “compensation for public assets” of the approved Project Resettlement Framework. During constructions of the Government funded components of Van Ninh District Hospital, there were two households who had land temporarily affected and the impacts have been compensated properly by the construction contractors; and the affected households are satisfied with the compensation. In short, the land acquisition and compensation implementation by Van Ninh District Hospital Subproject conforms with the provisions of the approved Resettlement Plan and Project Resettlement Framework.

2.7. Ninh Thuan Province The Ninh Thuan Subproject supports the construction of one new DH in Thuan Bac District, and one new Secondary Medical School in Phan Rang-Thap Cham city. All land acquisition and compensation activities were completed according to the approved plan. - The Secondary Medical School is located at Van Hai Ward and a part of Khanh Hai town, Phan Rang-Thap Cham city. There were 17 affected households. A total of VND 5,463,653,899 was spent on compensation for acquiring 24,640 m2 agricultural land, construction works, crops and trees as well as support for settlement, changing occupation and job creation as clearly defined in Decision No 3769/ QĐ-UBND of Ninh Thuan Provincial People’s Committee on 21 September 2009. There was one complaint about low allowance. The Board provided additional allowance for that AP and he was satisfied with the additional allowance. The land acquisition activities for the sub-projectwere successfully completed in 2009.

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2.8. Binh Thuan Province The Binh Thuan Health Care subproject supports civil works in the upgrading of Northern Regional Hospital, Southern Region Hospital and Phan Thiet PMC. No land acquisition and resettlement requirements for the Southern Region Hospital and the Phan Thiet PMC as the civil works are within the premises’ campuses. - The Northern Regional Hospital is located at Cho Lau Town, Bac Binh District in the campus of the former Bac Binh Health. It required an additional 11,347 m2 for the proposed expansion. This expansion severely affected two households who had residential land and houses in the area (total of 240m2). At first, these households disagreed with the resettlement site because of these following reasons: (i) the offered replacement residential land ground is lower than the surrounding houses which makes it expensive to fill; (ii) it is expensive for the households to build a fence around the residential land; (iii) it will cost significant amount for the households to connect electricity and water; (iv) the offered replacement residential land has no location advantage over the affected residential land (the affected residential land of two households is in front of the large alley); and (v) the households have not yet been consulted on the compensation, assistance and resettlement policy, so they do- not know what allowances they will be entitled to for relocation. After receiving the grievance, the Board provided other places near the AHs’ previous residence (about 100m). There was also one district-owned TV station affected due to loss of land and structures. The land was acquired and handed over in 2011. All the households and the TV station were compensated and were satisfied with the compensation levels that they received. - The Southern Regional Hospital located at Duc Linh Commune, Duc Linh District currently owns a total land area of 28,216 m2. The construction work did not require additional land and there were no resettlement effects. - Phan Thiet City Department of Preventive Medicine is located at the Xuan An Ward, Phan Thiet City, with an area of 1000 m2. There was no need for land acquisition and resettlement.

3. Implementation procedure 3.1. Organizational structure model In order to carry out the land acquisition and resettlement activities, a managing organization structure has been set up in different levels. This model of organizational structure at project provinces/cities composed of the steering and implementation levels. The steering level included the steering committees of provinces, districts and communes with the role of speeding up the implementation of actions, carried out every regulations relating to land acquisition and resettlement activities, and directly provided guidance to

- 16 - settlement of any complaints that arose during the implementation of land acquisition and resettlement activities. The implementation level included the Board for compensation and land clearance (the Board) and representatives of the supporters such as: the Health Department, the Resources and Environment Department, the Finance Department, and other provincial organizations with the responsibilities of implementing, settling the issues relating to compensation and resettlement activities.

Province People’s Committee

STEERING LEVEL District People’s Committee

Com. People’s Committee

IMPLEMENTING LEVEL Land Local related The Project clearance and Departments, Management compensation Organizations Board

3.2. Procedure to implement compensation and site clearance The Board was responsible for reporting plans to get appraisal from the Department of Natural Resources and Environment, Department of Planning. After getting their approvals, related agencies were informed and consulted, such as Department of Finance, Planning, Natural Resources and Environment, Health Service all to consider plans according to land law, Provincial decisions on land price, and other related regulations. Having results of appraisal, the Board made decision on approving plans of compensation and resettlement. Province made decision on land recovery and approved the level of compensation after confirmation from the affected households.. Province assigned the Board to implement compensation and site clearance. The Department of Health played as investor, other involved departments acted as supervisors. The Board conducted detailed measurement surveys (DMS) and verified if relocation will be required. The Board together with local authorities organized meetings with people to communicate the purposes of land recovery for constructing hospitals/departments of preventive medicines. The Board had responsibilities for communicating the social nature, usefulness of hospital construction to each household. After this, the Board and representatives from involved and affected households clarified ground, arable and other works in planned area. Communicating and measuring land,

- 17 - estimating crop and tree loss etc. Results of measuring land, estimating losses in site had to be confirmed by each household. Once completing the statistics of measuring, the Board made plans of compensation, emigration and estimated the compensation levels according to the current government regulations, and then submitted to Province for appraisal. After getting response of appraisal, the Board in corporation with local authorities, representatives of affected households communicated and published levels of compensation approved by Province. After completing file of compensation, Health Service Department in coordination with the Board, local authorities gave compensation for all affected households in each sub-project area.

3.3. Consultation and Disclosure The consultation and disclosure activities were well implemented at the project areas by the Board for compensation and land clearance. At the early stages of project preparation, local authorities and leaders of different administrative levels in each of the Project towns/districts/communes were informed about the project proposal, its objectives, and proposed activities. They were consulted on development needs and land acquisition and/or resettlement issues, their perception toward project objectives, technical designs, and their tasks and roles in project planning and implementation. Affected persons have also been informed about the proposed Project on an individual household basis and using different communication channels including direct and indirect forms, such as: community meetings, households visits, official letters sent to each affected households, and officially notices displayed at the commune People’s Committees’ billboards. The affected households were consulted about how the Project was going to directly affect them. They have been involved in developing the proposed resettlement and compensation packages and expressed their preferences for the type of compensation. Disclosure of the RP to the affected people was done prior to appraisal, using locally appropriate information booklets. All affected households were well informed of all related information on the land acquisition, resettlement and compensation activities due to the sub-projects.

3.4. Entitlements A total of VND 10,322,041,151 covered by provincial’s budget was used as the compensation and allowances for the affected people. This amount included the cash cost of land acquisition, provision or purchase of other land for farmers (in cases of land for land compensation were applied), compensation for loss of houses, structures, crops and business, relocation, and living standards rehabilitation measures.

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All compensations were based on the principle of replacement cost. Compensation and provision of assistance were provided and income restoration programs were put in place prior to relocation of affected households from their houses/or land acquisition activities. The APs received not only compensations for their own property like land, crops and trees, work structure, but also various types of allowances like transition subsistence allowance, transportation allowance, training allowance, business transition allowance, incentive allowance, social assistance allowance. For vulnerable APs, the PPCs provided support for changing occupation or job creation by sending affected households for job training/vocational training for technical assistance or providing cash assistance at the request of the affected households. Practically, the APs agreed to receive money instead of joining job training/vocational training. The APs received monetary support for 6 months income restoration and support for job training to stabilize their living standard.

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COMPENSATION AND MONETARY SUPPORT FOR LAND ACQUISITION ACTIVITY Unit: VND

Compensation Monetary Total of Compensation Compensation for trees, supports(for moving, compensation No. Provinces / Health facilities for residential for productive crops, living stabilization, and monetary land land changing occupation structures and job creation…) support I DA NANG 1 Hoa Vang District Hospital 0 0 0 0 0 2 Da Nang city Rehabilitation Hospital 0 0 0 0 0 II QUANG NAM 5 Dong Giang District Hospital 0 0 0 0 0 3 Bac Tra My District Hospital 0 0 0 0 0 4 Quang Nam Regional Hospital 0 0 0 0 0 6 Dien Ban Preventive Medicine Centre 0 0 0 0 0 III QUANG NGAI 8 Son Tay District Hospital 206,220,000 690,208,200 585,340,840 67,656,000 1,549,425,040 9 Tay Tra District Hospital 0 433,003,200 56,297,000 1,005,188,000 1,494,488,200 10 Tra Bong District Hospital 0 0 0 0 0 7 Ba To District Hospital 0 0 0 0 0 11 Mo Duc Preventive Medicine Centre 0 0 0 0 0 IV BINH DINH 12 OPD-Binh Dinh Provincial Hospital 0 0 0 0 0 13 Traditional Medicine Hospital 0 773,900,000 216,647,000 23,209,000 1,013,756,000 14 Phu My District Hospital 0 0 0 0 0 - 20 -

COMPENSATION AND MONETARY SUPPORT FOR LAND ACQUISITION ACTIVITY Unit: VND

Compensation Monetary Total of Compensation Compensation for trees, supports(for moving, compensation No. Provinces / Health facilities for residential for productive crops, living stabilization, and monetary land land changing occupation structures and job creation…) support V PHU YEN 16 Tay Hoa District Hospital 0 0 0 0 0 17 Song Cau District Hospital 0 0 0 0 0 15 Tuy An Regional Hospital 0 0 0 0 0 18 Song Cau Preventive Medicine Centre 0 0 22,600,000 0 22,600,000 VI KHANH HOA 19 Cam Ranh Regional Hospital 0 0 0 0 0 20 Van Ninh District Hospital 0 453,582,000 0 0 453,582,000 21 Ninh Hoa Prevent Medicine Centre 0 0 0 0 0 VII NINH THUAN 22 Secondary Medical School 0 5,086,118,544 178,666,450 69,503,280 5,334,288,274 VIII BINH THUAN 23 North Regional Hospital (Bac Binh) 192,000,000 0 207,901,637 54,000,000 453,901,637 24 South Regional Hospital (Duc Linh) 0 0 0 0 0 Phan Thiet Preventive Medicine 25 0 0 0 0 0 Centre TOTAL 10,322,041,151

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3.5. Concerns/complaints resolution The responsibility and coordination between divisions in the land acquisition and compensation management bodies were clearly defined. As mentioned above, the managing organization structure was set up in functions or activated in accordance with recent regulations of Vietnam. The Board for compensation and land clearance (the Board) included representatives of commune president, representatives of functional divisions like finance, natural resources and environment, construction and representative of the hospital that was to be constructed. In which, the commune president played a crucial role in the compensation, land acquisition and resettlement process to ensure directly affected and in-directly affected people understood the benefits of the sub-projects and supported the activities. Communal authorities were closest body to the local residents and they were efficiently dealing with concerns/complaints that may arise during the process of land acquisition and/or resettlement. There were 6 cases of complaints that were received during the process of compensation, land acquisition and resettlement. For the subproject Binh Dinh Traditional Medicine Hospital, there were 3 HHs that disagreed with the compensation price for land and tree. One household losing agricultural land did not agree to receive the compensation because the household believed that the compensation unit rates for the affected land and trees were much lower compared to the market rates. He opted for “land for land” compensation. Two other households who had residential land (with houses) and garden land effected, refused the compensation because the replacement residential land in the resettlement site is smaller than the affected residential land. In 2011, the Board resolved these grievances. The household who lost agricultural land was satisfied with the replacement land that was provided to him. For two other households, PPMU adjusted the alignment of the fence surrounding the hospital to avoid impacting on the land of these households. The Ninh Thuan SMS also dealt with one complaint about low allowance. After receiving the grievance, the Board reviewed and provided additional allowance for that AP and he was satisfied with the additional allowance. In Binh Thuan North Regional Hospital, there were 2 HHs who needed to relocated and at first, these households disagreed with the resettlement site because living conditions in the site was not similar to the original one. The Board resolved by providing other places for these households with their concurrence.

PART IV. RESULTS OF LAND ACQUISITION ACTIVITIES The land acquisition and resettlement compensation implementation processes at project provinces/cities were published, transparent and conform with ADB’s social safeguards

- 22 - requirements and current regulations of Viet Nam. The impacts of the land acquisition and resettlement activities on the socio-economic recovery of the affected people/households in each sub-project areas were quite minor. Although there were few concerns/complaints arose during the land acquisition and resettlement process, the PPMUs and related stakeholders of the Resettlement Boards have settled all these complaints in accordance with recent regulations of Vietnam and in harmony with the wish of affected people. Out of nine sub-projects having land acquisition impacts, four sub-projects have outstanding issue because of resettlement requirement and large number of affected households. Binh Thuan North Regional Hospital: The relocated households have moved to locations near their previous residence and have the same conditions prior to their relocation. These households are families under preferential treatment policy, thus they receive monthly allowance from Government. Besides, they have a small counter to sell beverage near the hospital. Therefore, the resettlement did not affect seriously their livelihood and standard of living.

Picture 1. Two new houses which Binh Thuan PPC built for two Vietnamese heroic mother households, who had to resettle due to construction of North Regional Hospital.

Binh Dinh Traditional Medicine Hospital: Twelve households were affected by this sub-project. They all lost just a small portion of land at the back of their houses while

- 23 - their main income sources from the stores in the front were not affected. These households were satisfied with the compensation they received for their lost land.

Picture 2. The households who lost a part of their backyards due to construction of Binh Dinh Traditional Medicine Hospital.

Ninh Thuan Secondary Medical School: There were seventeen affected households due to the construction of Ninh Thuan Secondary Medical School. They all lost part of their agriculture land and tree land. They received the compensation for the lost land and

- 24 - have continued cultivate on the remaining land to maintain their livelihoods. Some households also opened stores to improve their income.

Picture 3. The remaining rice field and garden of the affected households in Ninh Thuan

Picture 4. The grocery store which Mr. Nguyen Van Tho, one of affected households in Ninh Thuan SMS built on the remaining land. Tay Tra District Hospital: Out of 27 households affected by the project (mostly lost small agriculture land), one household of Mr. Ho Minh Duc needed resettlement. This household received compensation for its lost assets and built a house in another area with - 25 - the same conditions as the old one. The main income of this household is from the salary of the husband who is working for a Medicine Center, therefore the land acquisition did not affect to their livelihoods.

Picture 5. Mr. Ho Minh Duc and his new house Son Tay District Hospital: There were 8 households that were seriously affected by this subproject. The others only lost small assets. Three households who lost their residential land with houses moved to new location and built temporary houses after receiving compensation. They and the other five vulnerable AP(s) also received monetary support to stabilize their livelihood. hey could cultivate on the remaining land to restore their main income sources from agricultural, gardening and breeding activities. Besides, some of them have salaries from their work or allowances from the Government (retirement pension, allowance for contribution to revolution).Thus, their livelihoods were not seriously affected by the land acquisition impacts. Generally, local residents were very supportive to the Project as they saw the real benefits for the communities when the new hospitals are in operation. Before project, the hospitals in project area were very overloaded and degraded with lack of modern equipment that did not meet the demands for health care and treatment. But now, the construction of new health facilities had already completed, and all health facilities had operated providing health care services to local residents. The local residents, including affected people, can now easily access to more qualified health care services with more spacious and modern hospitals/health facilities. Particularly, the opening of Ninh Thuan Secondary Medical School facilitated local residents and people in surrounding areas in saving time and cost for studying since they do not have to go to universities/schools in Ho Chi Minh City.

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CONCLUSIONS AND RECOMMENDATIONS 1. It can be concluded that the eight provinces/cities in the South Central Coastal Region that were covered by the Project did not face with major challenges in land acquisition and resettlement activities unlike many other projects. 2. Out of 25 sub-projects in eight provinces/cities, seven sub-projects in six provinces/cities required land acquisition/resettlement activities. All sites already completed land acquisition and/or resettlements activities in early 2012. 3. Generally, the land acquisition and resettlement objectives have been met. The impacts of the land acquisition and resettlement activities on the socio-economic recovery of the affected people/households were quite minor. The activities were in compliance with ADB’s social safeguards requirements and recent regulations of the Vietnamese Government. 4. Entitlements and compensation standards were clearly specified and adequate. 5. The compensation and site clearance implementation processes at project provinces/cities were conformity with current regulations, publicity and transparency. It was also clear in the process that local people (both directly affected and in-directly affected households) directly took part in compensation and site clearance. 6. The communication activities through different channels used at the commune-level and commune authorities played crucial role in the compensation, land acquisition and resettlement process to ensure directly affected and in-directly affected people understood the benefits of the sub-projects and support the activities. Commune authorities were the closest body to the local residents and they were efficiently dealing with concerns/complaints that arose during the process of land acquisition and/or resettlement. 7. The responsibility and coordination between divisions in the land acquisition and compensation management bodies were clearly defined. The managing organization structure was established fully and in accordance with recent regulations of Vietnam. The managing organization structure was set up in functions or activated, with responsibilities and coordinative relations clearly defined. The effective coordination between Project Management Unit, the Steering Committee and the Board of Land Clearance and Compensation was showed in every activity of land acquisition and resettlement. 8. Generally, communities in the sub-project areas highly supported the Project as they saw the real benefits for the communities. The current hospitals were very overloaded and degraded with lack of modern equipment that did not meet the - 27 -

demands for health care and treatment of the local people. Both local authorities and local residents were satisfied and supported the Project. 9. Initially, affected households had limited knowledge on the Project and levels of compensations they would receive according to current legislations and agreed policy framework for the project. Thus communication activities had to be implemented through different channels, such as community meetings, household visits, official letters sent to each affected household, and official noticeswere displayed at the Commune People’s Committee offices etc. to ensure local residents fully understand about the benefits of the sub-projects as well the impacts on their families.

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ANNEX 1 IN-DEPTH INTERVIEW GUIDELINE REPRESENTATIVE OF AFFECTED HOUSEHOLDS

Province: ………………………… Code: …………….. File name Name of interviewee: ……………………………………………. Name of head of household: ……………………………………………. House address ………………………………………………………………….. Date: ………/……./……….. Time started: ……… Time ended the interview: ……… Interviewer: ………………………………

Objectives: To qualitatively assess the impacts of the land acquisition and resettlement activities for the Health Care in the SCCR Project on the livelihoods of affected households

Required jobs before implementing deep-interviews 1. Interviewer introduces some information about himself/herself: name, job, interests etc. 2. Explain objectives and nature of the interview, reasons that interviewee is selected for interview, and importance of his/her participation 3. Inform interviewee about confidentiality of information and identification in announcing results. 4. Tell interviewee that there are no right or wrong answers and encourage interviewee to share his/her opinions and experiences. 5. Tell interviewee that he/she can ask again if not clear about questions, can refuse to answer, or can expose any comment or opinion if he/she think it is not appropriate. 6. Ask interviewee’s permission for recording the interview and explain reasons.

ASSESSMENT AND COMMENTS ON THE LAND ACQUISITION AND RESETTLEMENT ACTIVITIES OF THE SUB-PROJECTS IN THE PROVINCE/CITY AND IMPACTS (IF ANY) ON THE LIVELIHOOD OF AFFECTED HOUSEHOLDS

1. Please tell me if your family is affected by the land acquisition and resettlement activities of the Health Care in the SCCR Project? 2. Please describe the business activities of your family; what activities bring largest amount of income to your family? Does the business activities of your family change? If yes, how does it change?

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3. What is your family monthly income before and after land acquisition? Any changes? In what ways? 4. Your family living conditions: have your family’s accessibility to public services (such as clean water, electricity, transportation, health care services, schools etc.) changed after land acquisition? 5. What are the influences on security, environment, social status that your family have to face? 6. In general, could you assess the level of impacts that the land acquisition and resettlement activities of the project on your family’s life? 7. Do you have any comments, recommendations to PPMU and local authorities in order to effectively implement the land acquisition and resettlement activities for the Health Care in the SCCR Project in the province/city according to plan?

THANK YOU FOR YOUR TIME AND OPINIONS!

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ANNEX 2 LIST OF INTERVIEWED HOUSEHOLDS

No. Province Health Facilities Name of interviewed household

Mr. Hồ Minh Đức, Tay Tra District Hospital Mrs. Hồ Thị Trang

Mr. Đinh Văn Sáu, Mrs. Đinh Thị Trà, Mr. Đinh Văn Đuối, Mr. Đinh Văn Vênh, 1 Quang Ngai Mr. Nguyễn Hồng Hải, Son Tay District Hospital Mr. Hồ Minh Dụng, Mr. Lê Văn Hùng, Mr. Đinh Hồng Nhía, Mr. Nguyễn Quốc Dũng, Mrs. Đinh Thị Đèo,

2 Ninh Thuan Secondary Medical School Mr. Nguyễn Văn Thọ

Mrs. Lê Thị Cang 3 Binh Thuan North Regional Hospital Mrs. Võ Thị Thanh

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ANNEX 3 LIST OF PPMU STAFF INVOLVED IN THE ASSESSMENT

No. Province Name of staff Designation

1 Da Nang Đặng Văn Tường Engineer

2 Quang Nam Phan Anh Thống Civil work consultant

3 Quang Ngai Lê Thành Phương Civil work consultant

4 Binh Dinh Phạm Minh Hùng Civil work consultant

5 Phu Yen Nguyễn Công Thành Civil work staff

6 Khanh Hoa Nguyễn Bình Quốc Civil work consultant

7 Ninh Thuan Dương Thanh Tân Civil work consultant

8 Binh Thuan Huỳnh Ngọc Tú Civil work consultant

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