HEALTH IMPACT ASSESSMENT EXPERIENCES Sri Endah Suwarni, MPH, Dpl.WQM Budi Haryanto, MSPH, MSc, PhD MINISTRY OF HEALTH, REPUBLIC OF INDONESIA

Risk factors Disease or risk Water, sanitation and hygiene Indoor air pollution Outdoor air pollution Other housing risks Chemicals Recreational environment Water resources management Land use and built environment Radiation Lower respiratory Upper respiratory Diarrhoeal diseases Malaria Onchocerciasis Leishmaniasis Dengue Japanese encephalitis HIV Perinatal conditions Congenital anomalies Cancer Neuropsychiatric disorders Cardiovascular diseases COPD Asthma Poisonings INDICATIVE VALUES FOR ENVIRONMENTAL RISK FACTORS AND DISEASE RISKS

1.National Law No. 32/2009: PROTECTION AND MANAGEMENT ON ENVIRONMENT 2.National Law No. 36/2009: HEALTH 3.Government of Indonesia Regulation No. 27/1999: ENVIRONMENTAL IMPACT ASSESSMENT 4.Government of Indonesia Regulation No. 74/2001: HAZARDOUS WASTES MANAGEMENT 5.Government of Indonesia Regulation No. 82/2001: WATER QUALITY MANAGEMENT & WATER POLLUTION CONTROL 6.Government of Indonesia Regulation No. 40/1991: ERRADICATION OF COMMUNICABLE DISEASES OUTBREAK 7.Government of Indonesia Regulation No. 41/1999: AIR POLLUTION CONTROL 8.MOH Decree No. 876/2001: GUIDELINES FOR HEALTH IMPACT ASSESSMENT 9.MOE Decree No. 11/2006: TYPE OF ACTIVITIES PLAN WITH EIA THE REGULATIONS:

HIA ON EIA EHRA o EIA documents o Action for monitoring and controlling o Implementation report, Monitoring & controlling plan o Environmental base diseases o Pollution o Poisoning o Disease outbreak / disaster EHRA: Environmental Health Risk Assessment

IMPLEMENTATION OF HIA ON EIA IN INDONESIA (Started in early 90s) ACTIVITIES PLAN WITH EIA : 1. Term of Reference 2. EIA 3. Environmental Management Plan 4. Environmental Monitoring Plan ACTIVITIES PLAN WITHOUT EIA : 1. Action for Environmental Management 2. Action for Environmental Monitoring

SCOPE OF ASSESSMENT Environmental risk factors (physical, biological, chemical, and radiation agents and its media and transport) Disease occurrence in population (prevalence, incidence, re-emerging, new emerging, outbreaks, disaster) Health behavior (knowledge, attitude, and practice) Policy, program, projects associated with the health impacts to the population Potential environmental management, action for implementation, monitoring and controlling. Current, existing, and prospective directions of focus.

TYPE OF ACTIVITIES PLAN WITH HIA ON EIA  Defense  Agriculture  Fishery  Forestry  Health  Transportation  Satellite Technology  Industrial  Energy and Mineral Sources  Tourism  Nuclear Development  Hazardous Waste Management  Genetic Engineering  Transmigration

ROLE OF MOH ON EIA Board member of EIA reviewer commission in central, provincial and district levels Managing and monitoring health impacts cause by environmental challenges in district level Representative of MOH at 10 regional center for environmental health and disease control laboratories (laboratory for analyzing biomarker, biohazard and environmental samples).

RECOMMENDATION FOR ASEAN Network for communicating experiences, challenges, and achievements (regular meetings, teleconference, web publication, mailing list, articles on journal, etc.) Research development and capacity building on new issues and technologies. FEB 20129MOH_INDONESIA

Terima kasih