1. 3-9 June 2007 - COEX Convention Center, Seoul, Korea Build up a suitable model for health impact assessment on current situation of Vietnam Doan Ngoc Hai, MD., Ph.D 27th Annual Conference International Association for Impact Assessment Ministry of Health Vietnam National Institute of Occupational and Environmental Health

2. Introduction Many new plans, projects and policies (called projects) were promulgated each year in Vietnam. The projects in some specific areas were assessed for environmental impact including health impact assessment (HIA). Many projects gave negative impact to people’s health due to:  Lack of the proper concern of the law maker  Lack of legal base  The ineffectiveness of HIA in EIA.  No suitable HIA model for current situation of Vietnam

3. Current situation of Vietnam A part of HIA was carried out by medical worker in health system (effect of environmental pollution to people’s health) The awareness on HIA in most of health worker are still low. In most of projects, economic matter not health matter is priority. The coordination between other sectors is ineffective Many existent projects significant caused negative impacts to people’s health.

4. The Son La Hydropower Project The largest and most complex dam project ever built in Vietnam. The project will displace up to 91,000 ethnic minority people, requiring the largest resettlement in Vietnam’s history. These people live mainly by the river and practice wet rice cultivation. EIA was assessed carefully by many organizations and agencies

5. The Son La Hydropower Project The largest and most complex dam project ever built in Vietnam. The project will displace up to 91,000 ethnic minority people, requiring the largest resettlement in Vietnam’s history. These people live mainly by the river and practice wet rice cultivation. EIA was assessed carefully by many organizations and agencies. Two pilot resettlement sites were established. Initially heralded by the Vietnamese government as model sites that would dramatically improve the lives of the resettled people.

6. The Son La Hydropower Project Studies have shown the pilot project to be a failure. Resettlers lack adequate sources of livelihood in the new site and have difficulties maintaining cultural practices that were integrally linked to their former lands. The change in farming practices has proven extremely difficult for them to adjust to. One village headman said "More than two years has passed. The subsidy from the government is over, but we still struggle with how to live. The tea and coffee plants have not been successful, the cows died or were returned to the project”

7. The Son La Hydropower Project Resettlement policy has not paid sufficient attention to the concerns of ethnic minorities with regards to natural resource management of forests, agriculture and meadow lands, including the provision of credit to maintain them. The Resettlement Management Units did not coordinate with consultants, district agencies, line agencies and commune and village authorities in allocating residential and farm land. They did not joint develop plans for land use management in resettlement sites.  Suitable model HIA for current situation of Vietnam

8. Proposal of HIA model 1. Screening: Screening quickly and systematically establishes whether a particular project has an impact on health and whether a HIA is appropriate or necessary. 2. Getting the HIA team together : Input from a team of people to provide different perspectives and areas of expertise. 3. Scoping: Setting the boundaries of the HIA: the geographical scope, the population groups whose health is considered, and the timescale over which to predict impacts. Establishes a steering group and produces a work plan for the HIA.

9. Proposal of HIA model 4. Identifying impacts: Identifying possible health consequences of the projects. 5. Assessing impacts: Assessing the identified impacts, in order to inform recommendations to improve the health consequences. 6. Making recommendations: Giving recommendations to adjust the projects to maximize positive and minimize negative health impacts.

10. Proposal of HIA model 7. Evaluation and Monitoring :  Evaluating whether the HIA has influenced the decision making process. Evaluation of the HIA process is to answer why the HIA worked or not.  Monitoring the implementation of the projects is critical to ensure that any recommendations that decision-makers agreed to, actually occur.

11. Tentative Plan 1. Improve awareness for people about HIA (capacity building), especially for leader of local authority, law maker 2. Establishment of the complete model of HIA 3. Carry out Retrospective HIA, apply HIA on existent projects to find out solutions for minimizing of negative impact. 4. Carry out Concurrent HIA 5. Add more details for HIA in EIA regulations 6. Making as compulsory regulation to new projects

12. Thank for your attention! Doan Ngoc Hai M.D., Ph.D Ministry of Health of Vietnam Secretary board 138A Giang Vo Str. Ba Dinh Distr. Hanoi, Vietnam Tel: +84-4-2732221 Fax: +84 - 4- 8464051 Email: ngochai@moh.gov.vnngochai@moh.gov.vn haidoanngoc@gmail.com