This document outlines the health surveillance start-up and approaches for communities near the Hongsa coal-fired power plant project in Laos. It discusses establishing baseline health checks, strengthening village health volunteers, popular epidemiology mapping of environmental hazards and illnesses, ongoing health surveillance, and capacity building programs. The ultimate goal is to ensure an improved quality of life for affected persons over the project's operation through a community-led health monitoring process. Key challenges include existing environmental health issues and developing sustainable surveillance capacity.

1. ປອດໄພໄວ້ ກ່ ອນ/ ໄວ້ ເນ້ ອເຆ່ ອໃ຅/ ລວມພະລັ ຄ/ ຃ົ ນດີ ຂອຄ
Hongsa Health Surveillance Start-up & Approaches
24th Nov 2015

2. 2
Hongsa
140 ກມ
35 ກມ
Nan
The Journey

3. 3
Construction Phase: Year 2010-2016
Concession Period: 25 years
Capacity: 1,878 MW (626 MW x 3 units)
Customers: EGAT 1,473 MW and EdL 100 MW
Power Plant
Lignite Mine
Limestone
Quarry
Water
Reservoirs
115kV Transmission Line EDL
Infrastructures
Environment & Resettlement
500kV Transmission Line to EGAT
Hongsa Project Profile

4. Safety First, Trust, Synergy and Good Citizen 4
Project Affected Persons (PAPs)
4
PAP1 or Resettler
5 villages: 422 hh; 1,995 persons
 Ban Mai – Power Plant
 Ban Champa – Diversion / Earth Bund
 Ban Na Mai Yom – Nam Kene Dam
 Ban Na Nong Kham – West Dump
 Ban Na Xay Kham – West Dump
PAP2 - Loss of land, but no relocation
12 Villages: 2,116 hh; 10,007 persons
PAP3 - Host communities
2 Villages, 50 hh, 334 persons
 Ban Nachan
 Ban Nabalone

5. Hongsa Health Surveillance Start –up &
Approaches
Background Information:
– There was a concern of environmental health from PAPs and knowledge gained from the
inappropriate information of the controversial coal-fired power plant.
– Study of Health Impact Assessment (HIA) and planning of Public Health Action Plan (PHAP) for
Hongsa Project was arranged in 2012.
– Health surveillance program for PAPs living in the community surrounded CA area has been
developed in 2014.
Objectives:
To ensure that environmental health concerns of PAPs living in the communities surrounded
Concession Area (CA):
– are given attention and priority;
– has the resources available to participate in the process;
– secured transparency and accountability of the healthy community;
– understood the decision-making process and are involved to the extent that allow for acceptance
of the final outcomes.

6. Hongsa Health Surveillance Start –up &
Approaches
Health Check for Baseline: TARGET
Total M F Total M F
I Hongsa 4,201 2,121 2,080 I Hongsa 6,168 3,120 3,048
1 Ban Han 1,713 863 850 1 Ban Phonesung 429 208 221
2 Ban Phonechan 473 243 230 2 Ban Phonexay 1,154 591 563
3 Ban Champa 421 211 210 3 Ban Phonesa-ad 568 276 292
4 Ban Viengkeo 970 490 480 4 Ban
Sibounheang
1,261 643 618
5 Ban Nasan 624 314 310 5 Ban Simongkol 1,372 697 675
II Muang Ngeun 1,999 1,009 990 6 Ban Chomcheng 893 455 438
6 Ban Kang 390 200 190 7 Ban Kiew
Muang
491 250 241
7 Ban Bi Mee 844 424 420 II Muang Ngeun 1,328 656 672
8 Ban PiaNgam 765 385 380 8 Ban Kiew Ngiew 527 257 270
6,200 3,130 3,070 9 Ban Na Yang
Kham
801 399 402
7,496 3,776 3,720
II. Communities Located within 6-10 km
Total
Total
Population of PAPs for Health Checks
VillageNo.
Population
No. Village
Population
I. Communities Located within 0-5 km

7. Hongsa Health Surveillance Start –up &
Approaches
Strategic Action:
1. Strengthen Village Health Volunteer:
– Focused existing village health
volunteer
– Clearly defined scope of responsibility
with a focus on environmental
sanitation.
– Jointly developed indicator of
environmental sanitation for monthly
monitoring.
– Provided greater education &
knowledge of environmental sanitation,
disease prevention, health promotion,
etc. will be through the Project COD
period.

8. Hongsa Health Surveillance Start –up &
Approaches
2. Health Check for Baseline:
– A number of discussion of health
indicators with relevant GOL for
baseline & vulnerable area.
– Taken photo of existing house
including risk point in the
communities for baseline.
– Arranged general health check
including respiratory issues, non
communicable disease, stress, ear
annoyance, etc.
– Result of health check and
recommended health promotion has
been disclosured by small group
discussion with PAPs.

9. Hongsa Health Surveillance Start –up &
Approaches
2. Health Check for Baseline -
Continued:
– The holistic health check was implemented
by GOL's medics team from Xayaboury
hospital as part of capacity building and use
of the medical equipment provided by the
Project.
– For those communities located within 6-10
km radius from the power plant (the second
most sensitive area) that will be Hongsa
municipality, health check for baseline will
be arranged in early 2016.
– Indicator of health check will focus the
related respiratory issues, non communicable
disease and the target group will be
population at risk e.g. child, elder, pregnancy,
underlying disease persons.

10. Hongsa Health Surveillance Start –up &
Approaches
3. Capacity Building Program:
– Comprehensive in nature, not limited to arranged
training, it includes on-the-job training.
– Focus village volunteer and District GOL's Public
Health.
– Arranged training of environment-related health
surveillance (e.g. linkage analysis of environment and
health, popular epidemiology, basic biostatistics, etc.).
– Active & passive surveillance will be implemented
through village volunteer & public health post,
respectively.
– Study trip for exploring the successful aspects of the
health program, etc. including technical collaboration
on health program between the two countries (Lao PDR
and Thailand) will also be arranged.

11. Hongsa Health Surveillance Start –up &
Approaches
4. Popular Epidemiology (Community-led Mapping
Breaks Cycle of Sickness):
– The concept was that villagers draw on their map, noting landmarks,
burning sites, other hazards and location of people who have been sick,
and record illness on the map.
– Later the maps will paint with colorful symbols and it provides
illustration of sick people clustered around the field that was burned (or
source of hazards), which it will be the starting point of discussion of
how they might reduce burning and/or source of vulnerability or hazards.
– Popular epidemiology is key to improve public health by enabling
villagers to link environmental cause with illness.
– People become engaged when they make discoveries and then take
action to lead their own health promotion.
– It could be say that community led mapping is a tool for community to
recheck the Project in term of HSE (Health, Safety and Environment)
perspectives.
– This activity will be implemented by a team of GOL though village
volunteer, which will be late 2015.

12. Hongsa Health Surveillance Start –up &
Approaches
5. Health Surveillance includes various
activities of environmental health by
village volunteers & including sampling
health check by GOL's medical team will
be fully implemented in the following year
and over the operation period.
6. Compensation Fund to remedy those
who will be affected by the Project in term
of health service, welfare, etc. will be
established though consultation among
PAPs, GOL, and HPC.

13. Hongsa Health Surveillance Start –up &
Approaches
Outcome:
As this program has just been set-up, output and outcome have not been yet concrete.
However, an improved quality of lives (healthy and wealthy) of the affected
community located nearby the coal-fired power plant over the operation period is an
ultimate goal of Hongsa Project.
Challenges:
1. The Project area is occupied by bush fire and smoke from clearing farmland;
2. Health indicators depends on how reliable and representatives of the local context; and
3. Capacity development of health surveillance.
Hongsa health surveillance program by a team of GOL and village volunteer is a must and
has just been set-up. The journey of healthy community is a continuous process and
may well be future challenge. The size of the challenge depends on commitment for
healthy community to be jointly agreed by PAPs, GOL, and HPC.